螺旋CT MPR重建在诊断茎突综合征中的应用价值

目的:探讨螺旋CT MPR重建技术在诊断茎突综合征(SPS)中的应用价值。方法:对临床疑似茎突综合征患者进行螺旋CT薄层扫描并通过MPR法及VRT或SSD法重建并测量其长度及角度,利用SPSS 11.5软件进行统计学分析。结果:茎突长度>30mm者54侧(56.2%),茎突向内偏斜角>25°者42侧(43.8%),向前偏斜角>25°者35侧(36.4%),茎突舌骨韧带骨化9侧。结论:茎突过长、角度异常及茎突舌骨韧带骨化是诊断SPS的重要依据,螺旋CT MPR重建可为诊断SPS首选的辅助检查。     

腹腔镜输尿管切开取石术4例报告

目的 :探讨经腹及经后腹腔腹腔镜输尿管切开取石的效果。方法 :输尿管上段结石 3例 ,双侧输尿管下段结石 1例 ,病程 2个月～ 3年 ,结石直径 1 5～ 2 2cm ,均经ESWL无效 ;用X线体表标志定位 ,输尿管上段 3例 ,用水囊扩张腹膜后间隙 ,经后腹腔操作 ,找到输尿管 ,用尖刀或钩刀切开输尿管 ,取出结石 ,在切口直接插入双J管 ,缝合切口 2～ 3针 ;输尿管下段结石 1例 ,用超声刀切开后腹膜 ,找到输尿管 ,同样处理结石及输尿管。结果 :4例手术均成功 ,手术时间 90～ 190min ,平均 135min ,随诊 2～ 10月 ,无并发症。结论 :腹腔镜经腹及经后腹腔输尿管切开取石术创伤小、恢复快 ,值得推广。     

充填式无张力疝修补术后复发的预防

目的　探讨充填式无张力疝修补术后复发的原因及对策。方法　通过对 1 0例腹股沟斜疝病人经疝环充填式无张力疝修补术后复发情况的研究。结果　网塞和补片的放置缝合欠佳及术后存在腹内压增高因素是引起复发的主要原因。结论　减少疝环充填式无张力疝修补术后复发应改进网塞和补片的固定方法及控制腹内压增高因素     

Ultrasound examination and localization of the sciatic nerve: a volunteer study

BACKGROUND: Few studies have examined the use of ultrasound for sciatic nerve localization. The authors evaluated the usefulness of low-frequency ultrasound in identifying the sciatic nerve at three locations in the lower extremity and in guiding needle advancement to target before nerve stimulation. METHODS: In this prospective observational study, 15 volunteers underwent sciatic nerve examination using a curved ultrasound probe in the range of 2-5 MHz and a Philips-ATL 5000 unit (ATL Ultrasound, Bothell, WA) in the gluteal, infragluteal, and proximal thigh regions. Thereafter, an insulated block needle was advanced inline with the ultrasound beam to reach the nerve target, which was further confirmed by electrical stimulation. The quality of sciatic nerve images, ease of needle to nerve contact, threshold stimulating current, and resultant motor response were recorded. RESULTS: The sciatic nerve was successfully identified in the transverse view as a solitary predominantly hyperechoic structure on ultrasound in all of the three regions examined. The target nerve was visualized easily in 87% and localized within two needle attempts in all patients. Nerve stimulation was successful in 100% after two attempts with a threshold current of 0.42 +/- 0.12 (mean +/- SD) eliciting foot plantarflexion or dorsiflexion. CONCLUSIONS: These preliminary data show that a curved 2- to 5-MHz ultrasound probe provides good quality sciatic nerve imaging in the gluteal, infragluteal, and proximal thigh locations. Ultrasound-assisted sciatic nerve localization is potentially valuable for clinical sciatic nerve blocks.     

乳腺癌乳房再造术后患者创伤后成长体验的质性研究

目的 深入了解乳腺癌乳房再造术后患者创伤后成长的真实体验,为开展针对性护理干预提供参考。方法 采用现象学研究法,以目的抽样法联合滚雪球抽样法选取12例乳腺癌乳房再造术后患者作为研究对象,以面对面或电话访谈形式进行半结构式深入访谈,采用Colaizzi 7步分析法进行归纳分析并提炼主题。结果 共提炼出自我反思、自我重塑(人生价值观的改变、个人力量增强、对疾病认识由消极转变为积极)、自我实现(积极心理、有效应对、利他行为)3个主题及6个亚主题。结论 乳腺癌乳房再造术后患者在对抗逆境的过程中能体验到创伤后成长,并呈现出积极自我变化。临床医护人员应关注患者的积极体验,激发患者积极力量,促进患者心理健康。     

A Review of Stature,Body Mass and Maximal Oxygen Uptake Profiles of U17, U20 and First Division Players in Brazilian Soccer

Investigations in the physiological demands of soccer have identified that a significant percentage of energy production in match performance is provided through the aerobic pathways. It is therefore important to assess maximal oxygen uptake (VO_2Max) of players in order to evaluate their aerobic fitness status and optimize their physical conditioning. However, it is also important to consider the variation of (VO_2Max) profiles for soccer players, with differences having been identified in terms of playing position as well as playing style. This paper reviews the academic literature between 1996 and 2006 and reports on the methodologies employed and the values obtained for stature, body mass and (VO_2Max) profiles of soccer players of different positions in professional Brazilian clubs at U-17, U-20 and First Division levels. Indirect measurements accounted for the majority of tests conducted at U-17 (70%) and U-20 (84.6%) levels whereas at First Division level almost half of the (VO_2Max) evaluations were performed by direct measurements (47.8%). The mean (VO_2Max) profiles obtained for outfield players in U-17 was 56.95 ± 3.60 ml·kg^-1·min^-1, 58.13 ± 3.21 ml·kg^-1·min^-1 for U-20 players and 56.58 ± 5.03 ml·kg^-1·min^-1 for First Division players. In Brazil, the U-20 players appear to have highest VO_2Max values, however the profiles reported for all outfield positions in U-17 and First Division levels are often lower than those reported for the same category of players from other countries. This may be a reflection of the style of play used in Brazilian soccer. This is further emphasized by the fact that the playing position with the highest VO_2Max values was the external defenders whereas most findings from studies performed in European soccer indicate that midfielders require the highest VO_2Max values.

Key points

• Physical and physiological differences exist between Brazilian soccer and European soccer.
• Players in Brazil appear to be shorter in stature, similar in body mass and have a lower overall aerobic capacity to their European equivalents
• In Brazil, there seems to be a physical development phase for players at U-20 level which prepares them for the demands at First Division level.

Key words: Soccer, maximal oxygen uptake, playing positions     

The osseous and dental changes of patients with chronic renal failure by CBCT

Objectives:

The aim of the present study was to evaluate the osseous changes of the jaws of patients with chronic renal failure (CRF) by CBCT.

Methods:

On CBCT scans obtained from 15 patients with CRF and 15 control patients (7 males and 8 females), the mean was calculated for the antegonial index (AI), mental index (MI), panoramic mandibular index (PMI) and mandibular cortical index (MCI). The MI, AI and PMI, pulp chamber size, number of teeth with pulp calcification and lamina dura loss were compared using the paired t-test, and the MCI values were analysed using the χ² test.

Results:

There were no statistically significant differences in the PMI, MI and AI values in patients with CRF and the control group. With regard to MCI, the cortical margins of the mandible were more porous in patients with CRF than in the control group, and also soft-tissue calcifications, lamina dura loss and radiolucent defects were more common in patients with CRF. There were no statistically significant differences in pulp chamber size and pulp calcifications between patients with CRF and the control group.

Conclusions:

Radiographic changes in the jawbones of patients with CRF may be commonly seen. CBCT is a valuable diagnostic tool for the evaluation of osseous findings, pulp chamber, soft-tissue calcifications and MCIs and allows indices measurement in three dimensions without any superposition.