长期视远剥夺对人眼集合近点和调节近点的影响

Objective To study effects of sustained deprivation of far sight on human near point of convergence (NPC) and near point of accommodation (NPA). Methods Eight subjects were divided into two groups by age (group A ≥30 years old; group B<30 years old). All subjects had worked in the enclosed laboratory, unable to see the outside for 75 days. NPC and NPA were measured every 15 days. Results NPC values of both groups all increased when time elapsed. NPC of group A measured in the 75th day and NPC of group B in the 30th day all had statistical differences, when compared with the base NPC values measured in the 15th day (P<0.05). And NPC value of group B measured in the 45th, 60th and 75th days increased markedly, when compared with that of the 15th day (P<0.01 . However, statistical analysis showed that no significant difference could be seen in NPA values of the two groups (P>0.05). Conclusions Sustained deprivation of far sight could induce an increase in NPC values to various degreeal, but effects on NPA were not obvious, as noted in our experiment.     

Image distortion correction in EPI: comparison of field mapping with point spread function mapping.

Echo-planar imaging (EPI) can provide rapid imaging by acquiring a complete k-space data set in a single acquisition. However, this approach suffers from distortion effects in geometry and intensity, resulting in poor image quality. The distortions, caused primarily by field inhomogeneities, lead to intensity loss and voxel shifts, the latter of which are particularly severe in the phase-encode direction. Two promising approaches to correct the distortion in EPI are field mapping and point spread function (PSF) mapping. The field mapping method measures the field distortions and translates these into voxel shifts, which can be used to assign image intensities to the correct voxel locations. The PSF approach uses acquisitions with additional phase-encoding gradients applied in the x, y, and/or z directions to map the 1D, 2D, or 3D PSF of each voxel. These PSFs encode the spatial information about the distortion and the overall distribution of intensities from a single voxel. The measured image is the convolution of the undistorted density and the PSF. Measuring the PSF allows the distortion in geometry and intensity to be corrected. This work compares the efficacy of these methods with equal time allowed for field mapping and PSF mapping.     

A new analytical cut-off point for determining 18 years of age using MRI on medial clavicular epiphysis

Evaluation of the ossification of the medial clavicular epiphysis plays a key role in forensic age estimation. The purpose of the present study was to assess a new numerical cut-off at the age of 18 years, taking into consideration Magnetic Resonance (MR) images of the medial clavicular epiphysis. We analyzed 163 MR scans of Italian subjects aged between 14 and 25 years. Using the data obtained we calculated two ratios: REM-1 (ratio between the length of the whole epiphysis and the length of the metaphysis) and REM-2 (ratio between the length of epiphyseal-metaphyseal fusion and the length of the metaphysis). In 68 out of 163 cases it was not possible to measure REM-2. The reproducibility was demonstrated using the Intraclass Correlation Coefficient (ICC) (Cronbach’s alpha > 0.80). REM-1 and REM-2 were compared in each category of age (adult and minor) by the Wilcoxon signed-rank test. The cut-off points for measurements of REM-1 and REM-2 were determined by logistic regression. For REM-1, the cut-off scores were 0.83 for all individuals (accuracy = 94.77%) and males (accuracy = 96.05%), and 0.86 for females (accuracy = 92.30%). For REM-2, the cut-off values were 0.40 for all individuals and males (accuracy = 100.00%), and 0.41 for females (accuracy = 100.00%). Finally, receiver operating characteristic (ROC) curves for age classification based on REM-1 and REM-2 were constructed, showing that REM-2 had the highest discriminative power. Thus, a new cut-off model for predicting the age of majority has been introduced, conducting a quantitative analysis thanks to the use of a high-resolution imaging tool.     

Cervical pedicle screw insertion using a gutter entry point at the transitional area between the lateral mass and lamina

Purpose  

The purpose of this study was to describe a free-hand pedicle screw insertion technique and to evaluate the accuracy of pedicle screw placement and validity of pedicle screw fixation in patients with subaxial cervical spine injuries.     

腔镜下交通静脉离断术治疗严重下肢静脉曲张研究

目的探讨腔镜下交通静脉离断术治疗严重下肢静脉曲张的效果。方法将2010-05—2011-05收治的39例严重下肢静脉曲张患者(47条患肢)随机分成3组,每组各13例。A组施行传统高位结扎主干剥除、曲张静脉点式剥除术;B组实施筋膜下交通支离断术(SEPS)+传统手术;C组实施腔镜筋膜外交通支离断术(ELPS)+传统手术。比较3种手术方法术后疼痛时间、下地时间、溃疡愈合及色素沉着好转时间。结果 47条患肢经手术治疗后肢体症状及浅静脉曲张消失、溃疡愈合、色素沉着好转,3组患者住院时间、术后并发症、严重皮肤改变恢复时间等方面等差异有统计学意义,2种腔镜手术组均优于单纯传统手术组(P<0.05),证明腔镜手术组明显好于传统手术组,随访6～18个月,各组均未出现新生溃疡及浅静脉曲张复发。结论腔镜深筋膜下及筋膜外交通静脉离断术是治疗下肢静脉性溃疡的重要手术方式,安全有效、损伤少、并发症少,优于传统手术。     

头皮埋针联合耳穴压籽治疗脑卒中后认知障碍40例

目的 观察头皮埋针联合耳穴压籽治疗脑卒中后认知功能障碍（post- stroke cognitive impairment,PSCI）的临床疗效。方法 将80例脑卒中后认知功能障碍患者按照随机数字表法分组成对照组、治疗组,每组40例。对照组予尼莫地平片、吡拉西坦片治疗,治疗组在对照组疗法基础上予头皮埋针联合耳穴压籽治疗,共治疗4周。〖JP2〗治疗前后和随访时分别采用简易精神状态检查量表(mini- mental state evaluation, MMSE)、蒙特利尔认知功能评估量表(Montreal cognitive assessment, MoCA)和Barthel指数（Barthel index,BI）评估患者的认知功能。结果 治疗4周后及随访时,两组患者MMSE、MoCA、BI评分均显著升高（P<0.05）。治疗后4周和随访时,治疗组患者MMSE、MoCA评分显著高于对照组（P<0.05）,而两组患者BI评分的差异无统计学意义（P>0.05）。结论 头皮埋针联合耳穴压籽可以明显改善PSCI患者的认知功能。     

PCOS患者亚临床甲状腺功能减退与代谢异常的相关性研究

目的探讨多囊卵巢综合征(PCOS)患者亚临床甲状腺功能减退(SCH)与内分泌代谢异常的相关性。方法回顾性分析2016年6月～2018年12月在东昌府人民医院就诊的PCOS患者65例,另选取同期就诊的身体健康、月经周期和妇科B超正常的不孕症女性115例作为对照组。按促甲状腺激素(TSH)水平,PCOS患者分为A组(TSH2.5 mIU/L),B组(2.5 mIU/L≤TSH4 mIU/L),C组(TSH4.0 mIU/L),比较各组内分泌代谢特征的差异。结果PCOS组体重指数(BMI)、游离甲状腺素(FT4)、黄体生成素(LH)、LH/卵泡刺激素(FSH)、睾酮(T)及2.5 mIU/L≤TSH4 mIU/L发病率均高于对照组(P0.05),TSH4 mIU/L发病率增高(P0.05)。PCOS组内比较:随着TSH升高,糖类代谢指标均升高(P0.05);C组TSH、胰岛素抵抗β细胞功能指数高于A、B两组(P0.05);B组的FSH比A组略有升高(P0.05)。结论 PCOS患者更容易出现肥胖和代谢异常,TSH4 m IU/L组PCOS患者代谢异常更加明显,可以作为诊断PCOS患者SCH的截点。     

实习阶段本科护生临床能力调查分析

目的探讨围术期患者舒适护理的管理、实施方法和效果。方法树立正确的围术期护理理念,注重舒适护理和人文关怀;组织授课,提高舒适护理的理论水平;开展术前访视和术后随访;开展手术体位的规范化培训,提高患者术中体位舒适度;配置手术室舒适护理硬件设备、完善使用;制订围术期舒适护理考核评价标准等。结果患者围术期舒适度提高,患者和手术医生对手术室护士的满意度均得到提高。结论系统、科学的管理能促进手术室护士实施舒适护理,提高患者围术期舒适度,保证手术安全。     

对CT所见腰椎间盘突出的重新鉴别与治疗观察

目的：因临床发现有些经ＣＴ检查有腰椎间盘突出的患者，其症状体征与ＣＴ结果不符。对１１２ＣＴ阳性者根据症状体征进行重新鉴别。方法：将ＣＴ阳性者根据“三种试验”分为阳性、阴性两组，再选压痛点作注射治疗。结果：两组治疗结果阴性组优良率较高。结论：ＣＴ结果可供参考，但不能作临床考虑的主要依据。对腰椎间盘突出症的诊断与治疗要以症状体征为主