两种不同灌注方法对肩关节镜下手术出血与视野显露的影响

目的探讨改良加压灌注和常规重力灌注对肩关节镜下手术出血与视野显露的影响。方法选取我院2018-01/2019-07期间因肩袖撕裂收住我院骨科拟行肩关节镜手术治疗的患者60例,ASA分级Ⅰ或Ⅱ级,采用随机数字表法分为观察组(n=30)和对照组(n=30)。观察组应用改良气压止血仪加压灌注,对照组应用常规重力灌注,监测并记录关节腔压力(mmHg)、关节腔灌注引流液中红细胞计数(个)、灌注液总量(L)、手术时间(min)、术后肩关节肿胀度(cm)。结果观察组第1次更换灌注液时关节腔压力高于对照组,关节腔灌注引流液中的红细胞计数及手术时间少于对照组,差异有统计学意义(P<0.05);2组灌注液总量及术后肩关节肿胀度无统计学意义(P>0.05)。结论在肩关节镜手术中使用改良加压灌注法,具有操作简便、压力稳定、视野清晰、手术时间短等优点,值得临床推广使用。     

Assessment of family history of colorectal cancer in primary care: Perceptions of first degree relatives of people with colorectal cancer

Objective

First degree relatives (FDRs) of someone with colorectal cancer (CRC) are at increased risk of the disease. In this study we examine the factors associated with discussing family history of CRC with a health professional.

Methods

People with CRC, recruited through the population-based Victorian Cancer Registry in Australia, were asked to refer FDRs to the study. Eight hundred and nineteen FDRs completed a telephone interview.

Results

Thirty-six percent of FDRs recalled ever being asked about their family history of bowel cancer by a health professional. Factors associated with having this discussion were being aged 50–60 years, having a university education, being in the potentially high risk category, being very worried about getting bowel cancer and knowing that family history increases risk through discussions with family, friends or their own education.

Conclusion

Despite evidence that doctor endorsement is a key factor in the uptake of CRC screening, our study shows that the majority of FDRs do not recall being asked by a health professional about their family history.

Practice implications

There is a need to identify the most appropriate method to improve rates of health professional discussion of family history with relatives of CRC patients in order to improve screening rates.     

Is there an optimal degree of correction for ankle varus deformity after supramalleolar osteotomy? A systematic review

BackgroundThere is no consensus on the angle targeted for in varus ankle deformity after supramalleolar osteotomy (SMOT). The aim of this study was to investigate which obtained correction has the best clinical outcome after valgus SMOT.MethodsA systematic review according PRISMA guidelines was conducted with studies being eligible for inclusion when published in English, German or Dutch, patients older than 18 years at study entrance, primary or posttraumatic varus ankle osteoarthritis, using any valgus SMOT technique, describing radiological alignment and clinical outcome at baseline and after at least 12 months follow-up. Risk of bias was assessed using the McMaster University Occupational Therapy Evidence-Based Practice Research Group quality assessment tool. The electronical databases PubMed, EMBASE and Cinahl were used as data sources. Included cohorts were categorized according to the mean obtained medial distal tibia angle (MDTA; ranged between 87° and 100°). A linear mixed effect model was used for individual patient data to assess the association between the MDTA and the (difference in) clinical outcome.ResultsThirty studies including 33 patient cohorts with 922 ankles were identified. At a mean follow-up of 4 years no differences in clinical outcome between correction categories were found. Individual data of 34 ankles showed no relationship between obtained MDTA and clinical outcome either.ConclusionThis review could not demonstrate an optimal degree of correction after valgus SMOT. Results were hampered by biased low quality studies and the widespread use of unreliable 2D alignment measures such as the MDTA.     

术前心理干预对ERCP患者舒适度的影响

目的探讨术前心理干预对ERCP患者术中舒适度及术后满意度的影响。方法将106例选择接受ERCP诊治的患者随机分为实验组和对照组,各53例,对照组进行常规术前护理,实验组在常规术前护理的基础上,实施术前心理干预,比较两组的术中舒适度及术后满意度。结果实验组的术中舒适度及术后满意度均明显高于对照组,差异有统计学意义（P〈0.01）。结论采用术前心理干预不仅可降低ERCP患者术中的不适,而且可提高患者的术后满意度。     

Effect of Copper Sulfate and Sulfuric Acid on Blind Hole Filling of HDI Circuit Boards by Electroplating

Here, in a certain high density interconnect (HDI) printed circuit board, the effect of copper sulfate and sulfuric acid on the filling effect of a blind hole with a certain diameter and depth was investigated by making a blind hole using a CO₂ laser drilling machine, filling the blind hole via electroplating by simulating the electroplating line in a Halin cell, and observing the cross-section of a micro blind hole after polishing using metallographic microscope, as well as the effect of hole filling, are evaluated. The results show that, under the conditions of a certain plating solution formula and electroplating parameters (current density and electroplating time), the sag degree decreases with the increase in the copper sulfate concentration. When the concentration of copper sulfate increases from 210 g/L to 225 g/L, the filling effect is good and the sag degree is about 0. However, with the increase in sulfuric acid concentration, the sag increases gradually. When the sulfuric acid concentration is 25–35 g/L, both the sag and copper coating thickness are in a small range. Under appropriate electroplating conditions, a better blind hole filling effect can be obtained. The volume of blind hole has a certain effect on the diffusion and exchange of copper sulfate and sulfuric acid, as well as on the concentration distribution of additives.     

不同视觉方式引导下的运动想象脑电信号特征对比分析研究

目的 研究人服匹配因素（包括肘关节旋转中心位置、人服几何匹配度）对人服典型关节耦合运动的影响,了解人服耦合力学特性。方法 采用内置式测量方法进行试验,受试者穿戴航天服上肢组件在负压舱内指定位置完成肘关节屈曲运动,使用惯性运动捕捉系统与压力测量系统,分别采集人体运动数据与人服接触力的数据,并对测量结果进行分析。结果 人服耦合运动受到人服匹配因素的影响,受试者在4个位置肘关节屈曲40°时的平均力矩分别为3.7565Nm、2.8561Nm、2.9113Nm和4.0129Nm,屈曲过程消耗的能量平均为1.769J、1.565J、1.176J和1.982J;航天服关节阻尼力矩与围度比线性相关,相关系数r=0.7315。结论 航天服关节中间位置与人体肘关节旋转中心匹配时活动性能较好,较小的前臂围着服工况运动时受到的关节阻尼力矩较小,人服耦合力学特性与人服匹配因素密切相关。