创伤外科应用人性化护理的研究

目的 探讨人性化护理在创伤外科应用的效果.方法 转变服务观念,改变服务模式.结果 促进了医患关系和谐.结论 对创伤外科护理工作满意度提高.     

Transmastoid approach to the superior semicircular canal: An anatomical study

ObjectiveWe examined the anatomic features of the top of the superior semicircular canal (SSC) to help guide the surgeon considering resurfacing or plugging of an associated dehiscence, thorough the transmastoid (TM) approach.Methods19 selected cadaveric temporal bones, which had no supralabyrinthine tract, were dissected, and distances between the SSC and various structures within the temporal bone were measured with a, fine caliper.ResultsThe average distances from the sino-dural angle, horizontal canal top, and subacurate artery, to the top of the SSC were 31.1, 7.8, and 3.9 mm, within a small range. 7 (36.8%) out of 19 bones with a, low hanging tegmen needed a wide exposure and elevation of the dura to access the SSC top.ConclusionKnowledge of the anatomical details associated with the SSC from this study may help to, access the SCC dehiscence safely for resurfacing surgery via a TM approach.     

B超引导经皮肝穿射频治疗肝癌24例临床研究

目的探讨肝癌患者实施经皮肝穿射频治疗的效果。方法回顾性分析2006年11月～2011年1月本院24例肝脏恶性肿瘤患者行B超引导经皮肝穿射频治疗的临床资料。结果24例患者中，16例患者15min吲哚靛青绿储留率（ICGR15）〈10％，5例10％～20％之间，3例〉20％；甲胎蛋白提示阳性患者经治疗后转为阴性的有75．0％，呈明显下降的有25．0％；CT复查显示肿瘤缩小，完全凝固性的坏死率是87．5％。结论对于肝癌患者，尤其是重度肝硬化、肝功能较差、不耐手术、术后复发者，实施RF治疗不仅创伤小，而且方便、安全，疗效确切，应予临床合理推广。     

Mental well-being: A 16-year follow-up among older residents in Jyväskylä

This study investigated changes in perceived depression, anxiety and loneliness during a 16-year follow-up among elderly Jyväskylä residents born in 1914-1923. A further concern was with how perceived atmosphere in the formative environment was reflected in depression, anxiety and loneliness in old age. The first phase of the study took place in 1988 when interviews were conducted with 635 persons (241 men and 394 women). Depression and anxiety were assessed using the Finnish modified version of Beck's 13-item depression scale (RBDI), which was completed fully by 74% of the interviewees. Loneliness was assessed with a single four category item. In the second phase of the study in 1996, interviews were conducted with 410 persons, of whom 94% filled the RBDI questionnaire. In the third phase in 2004, the number of interviewees was 220 and the response rate 82%. There were no significant changes in the number of people with depressive symptomatology and anxiety, except in 1996 when the proportion of men with mild and moderate depression almost doubled. The number of men and women who felt lonely increased significantly during the 16-year follow-up. People who said they were lonely also had more depression and anxiety than others. People who had grown up in warm and safe environment were the most balanced mentally. The presence or absence of warmth and safety in the formative environment is reflected in mental well-being even at a very old age.     

Incidence rate of falls and its risk factors in patients with rheumatoid arthritis compared to controls: Four years of the TOMORROW study

Objective: Patients with rheumatoid arthritis (RA) have been recognized to experience falls frequently due to functional disabilities. The aim of this study was to prospectively investigate factors influencing falls in patients with RA compared to controls.

Methods: We compared the frequency of falls in 208 RA patients and 205 age- and sex-matched volunteers for four years and analyzed risk factors for falls in RA patients using multivariate regression analysis.

Results: No significant difference in the incidence rate of falls (/person-year) between patients with RA (median [interquartile range]: 0 [0, 0.5]) and controls (0 [0, 0.5]) was evident during four years. Logistic regression analysis identified age, sex, body mass index, history of falls, and lower limb implant at baseline as significant risk factors for falls. The highest quartile of anti-CCP antibody level (>300.6?U/ml) was the strongest predictor for multiple falls (odds ratio, 2.97; 95% confidence interval, 1.12–7.91, p?=?0.029) among RA patients.

Conclusion: During four years we could not observe the higher incidence rate of falls in RA patients compared to controls in our cohort. Subjects with a higher titer of anti-CCP antibody might be at higher risk of frequent falls among RA patients.     

Sleep duration and remaining teeth among older people

BackgroundNo studies have examined the associations between the numbers of teeth and sleep disturbance. Therefore, we examined the associations between the number of teeth and sleep duration in older people, considering the evidence linking fewer teeth and sleep apnoea through changes in jaw position.MethodsFor this study we used information from a sample of 23,444 cohort participants, randomly selected from the Japan Gerontological Evaluation Study 2010 (N = 169,215). The outcome variable was self-reported sleep duration (h/day), and the explanatory variable was self-reported number of teeth (0, 1–9, 10–19, ≥20). We treated age, sex, body mass index, educational attainment, annual equalized household income, depressive symptoms, physical activity, activities of daily living, presence of diabetes, and smoking status as covariates. Multinomial logistic regression was used among the 20,548 eligible participants with all necessary information.ResultsThe mean age was 73.7 (standard deviation = 6.13) years. Most participants (28.1%) reported sleep duration of 7 h, while a small proportion of the participants reported short (≤4 h, 2.7%) or long (≥10 h, 4.7%) sleep duration. The proportion of edentulous participants was 14.7%. Taking the 7-h sleep duration as the reference category, edentulous participants (relative risk ratio (RRR) = 1.43, 95% confidence interval (CI) = 1.07–1.90) or one to nine teeth (RRR = 1.29, 95% CI = 1.02–1.63) had a significantly higher relative risk ratio for short sleep, independent of covariates. Furthermore, they had a higher relative risk ratio for long sleep duration (RRR = 1.75, 95% CI = 1.40–2.19; RRR = 1.48, 95% CI = 1.21–1.81, respectively).ConclusionsCompared to people with 20 or more teeth, older adults with fewer than 10 teeth have higher risks for short and long sleep durations.     

Blunted cardiovascular reactions are a predictor of negative health outcomes: A prospective cohort study

The study examined whether cardiovascular responses to psychological stress tests predict future anxiety and depression scores 40‐months later. Hemodynamic measures were obtained from 102 healthy adults before, during and after mental arithmetic, a speech task, and a cold pressor task. The 14‐item Hospital Anxiety and Depression Scale was administered at initial testing and at 40‐months follow‐up. At initial testing analyses revealed that high anxiety symptoms were characterized by blunted cardiovascular reactions to acute mental stress, particularly mental arithmetic. Furthermore, after adjustment for baseline blood pressure (BP ), baseline anxiety levels and traditional risk factors, attenuated systolic BP responses to mental arithmetic were associated with future anxiety levels (ΔR ² = .055). These findings suggest that blunted cardiovascular reactions to stress may be an independent risk factor for future anxiety levels.