1、2伸肌间室支持带上动脉桡骨瓣治疗舟骨骨不连的数字解剖及疗效分析

目的　探讨1、2伸肌间室支持带上动脉（the first and second intercompartmental supraretinacular artery,1,2 ICSRA）桡骨瓣治疗舟骨骨不连的可行性及疗效。 方法　收集47例正常人腕关节CT数据,分别测量桡骨茎突尖端到舟骨长轴近极及远极距离,并与1,2 ICRSA血管蒂的长度进行对比,分析1,2 ICSRA桡骨瓣治疗舟骨骨不连的可行性。对23例舟骨骨不连患者实施1,2 ICSRA桡骨瓣结合Herbert钉内固定手术治疗,随访患者骨折愈合情况;采用Cooney腕关节评分评估患者局部症状和功能。 结果　桡骨茎突尖端到舟骨长轴近极和远极距离分别为（15.66±1.89）mm和（17.07±1.60）mm,均小于1,2 ICSRA血管蒂长度。23例患者术后舟骨均获得愈合;随访时间（51.08±11.30）月,末次随访时21例患者腕关节疼痛感消失,2例患者重体力劳动时有轻微疼痛,但症状较术前得到明显改善;Cooney腕关节评分优20例,良3例,从术前（62.39±7.21）分提高至术后（92.39±4.23）分,差异有统计学意义（t=17.213,P=0）。 结论　1,2 ICSRA桡骨瓣长度足以覆盖舟骨任何部位,该方法治疗舟骨骨不连具备可行性且疗效肯定。     

Multilingual healthcare communication: Stumbling blocks,solutions, recommendations

ObjectiveTo provide guidance on multilingual and language discordant healthcare communication.DiscussionWe provide a critical reflection on common stumbling blocks to securing (professional) language support, as well as on the currently available solutions to language discordance in healthcare. We discuss issues pertaining to i) the assessment of the patient and healthcare professional’s language proficiency, ii) the decision making on whether to seek language support, iii) the currently available options of language support and the development of skills that ensure their effective use, iv) the inclusion of professional interpreters in the interprofessional healthcare team, and v) the transition from single- to integrated language support solutions that allow for a more comprehensive approach to multilingual healthcare communication. We present a set of recommendations for good practice.ConclusionUnderstanding the needs, capabilities and shortcoming of the available language- support solutions and the implications arising from them can enable decision makers to make informed decisions that ensure the quality of communication and care. The integrated use of language-support solutions at different stages of care can create the conditions for effective communication, while promoting patient and family participation in the decision making process. Evidence-based interventions that can inform the implementation of solutions are required.     

Estudio de la competencia digital docente en Ciencias de la Salud. Su relación con algunas variables

IntroductionThe digital competences of teachers (TDC) are a key variable to integrate practices with Information and Communications Technology (ICT) in the teaching-learning process. Its development has become one of the main training problems that affect the university field in general and, specifically, the training of Health Sciences professionals. The objective of this article is to determine whether there are significant differences with respect to the level of TDC shown by the teachers of Health Sciences of the Andalusian universities (Spain) based on the variables gender, age, teaching experience, years that they have been using ICT, as well as time spent on technology in the classroom, and technological mastery.MethodsAn inferential study is carried out using contrast statistics for this purpose. A total of 300 teachers completed the DigCompEdu Check In questionnaire, which is capable of evaluating their competence level.ResultsThe results of the study indicate that there are significant differences between different groups for each variable.ConclusionFor this reason, the need to structure personalised training plans and extend the research methodology to other related studies is highlighted.     

The way we were (and how we got here): fifty years of technology changes in dental and maxillofacial radiology

The history of the last 50 years (1970–2020) of technological changes and progresses for equipment and procedures in dental and maxillofacial radiology is related from the insider perspective of an industrial physicist and technologist who has been instrumental at innovating and developing medical equipment in different parts of the world. The onset and improvement of all major categories of dental and maxillofacial radiographic equipment is presented, from the standpoint of their practical acceptance and impact among common dentists and maxillofacial radiologists: X-ray sources and detectors for intraoral radiography, and panoramic systems, both film-based and digital (including photo-stimulated phosphor plates); and cone beam CT.     

组织工程软骨植入缺损后修复区力学特性分析

目的利用组织工程技术建立体外软骨缺损实验模型,研究修复区人工软骨和宿主软骨的力学特性。方法采用一种琼脂糖凝胶作为人工软骨,制作猪软骨深层缺损,在缺损处仿临床植入人工软骨,用生物胶黏接,建立组织工程修复膝关节软骨缺损的体外模型;在压缩载荷作用下,通过数字图像相关技术研究组织工程软骨植入缺损后修复区即刻力学行为。结果压缩过程中界面处没有出现开裂现象,压缩分别为软骨层厚度的3.5%、5.6%、7.04%和9.0%时获得了修复区中间层应变分布图和应变变化曲线。压缩量从3.5%增加到9%时,在垂直软骨面方向上宿主软骨最大压应变增加75.9%,人工软骨最大拉应变增加226.99%;在平行软骨表面方向,交界面处最大拉应变增加116.9%,增加量远高于宿主软骨区和人工软骨区;对于修复区剪应变,随着压缩量增加交界处剪应变方向发生相反的改变。结论软骨组织工程修复缺损效果有很大的不确定性,这与修复区的力学环境有关。组织工程软骨植入缺损后,修复区受到复杂应变状态,随着压缩量增加,界面处、宿主软骨、人工软骨都发生较大的应变变化,界面处垂直软骨面方向的应变由压应变可转化为拉应变,平行软骨表面方向的拉应变有显著增加,交界处剪应变方向甚至发生了相反的改变,而且剪应力数值迅速增加。这种复杂应变状态造成修复区细胞力学环境的较大变化,还可能引起界面的开裂,影响缺损修复过程,这些力学环境变化应受到临床治疗的重视。     

一种新型数字化桩核修复技术

桩道信息获取不完整、数字化程度低等诸多缺陷限制了全数字化和半数字化桩核制造技术应用于临床。本文旨在介绍一种新型桩核数字印模采集技术,该技术利用计算机辅助设计和计算机辅助制造（computer-aided design/computer-aided manufacturing,CAD/CAM）来制作桩核,能生产出精度更高、外形更合理的定制桩核。     

舌静脉畸形的DSA分型及治疗—132例临床分析

目的:探讨舌静脉畸形(venous malformations,VM)的数字减影血管造影（digital substraction angiography, DSA）分型及治疗策略。方法:总结2016年2月—2019年2月收治的132例舌VM患者的DSA表现,根据影像学特征将其分为4型,Ⅰ型为无回流型、Ⅱ型为低回流型、Ⅲ型为高回流型、Ⅳ型为广泛型,依据分型选择不同的治疗方案。无回流型单纯采用平阳霉素进行硬化治疗,低回流型单纯采用聚桂醇泡沫硬化剂进行硬化治疗,高回流型采用无水乙醇结合聚桂醇泡沫硬化剂进行硬化治疗,广泛型先按高回流型进行硬化治疗后再结合整形手术切除。统计各组病例的治疗效果及不良反应。结果:本组132例病例获得12~41个月随访,平均15.8个月,所有患者术后舌VM明显缩小甚至消失。Ⅰ型8例,有效率100%;Ⅱ型17例,有效率100 %;Ⅲ型98 例,有效率90.8 %;Ⅳ型 9例,有效率77.8%。不良反应主要为组织溃烂、坏死,Ⅰ型0例;Ⅱ型1例,发生率5.88%; Ⅲ型16例,发生率16.33%;Ⅳ型7例,发生率77.78%。结论:基于DSA的舌VM分型对临床治疗具有重要指导意义。舌VM中大部分为Ⅲ型病例,Ⅰ型比例最小。经黏膜注射无水乙醇是治疗高回流型和广泛型舌VM的有效方法。     

Evaluating the accuracy (trueness and precision) of interim crowns manufactured using digital light processing according to post-curing time: An in vitro study

PURPOSEThis study aimed to compare the accuracy (trueness and precision) of interim crowns fabricated using DLP (digital light processing) according to post-curing time.MATERIALS AND METHODSA virtual stone study die of the upper right first molar was created using a dental laboratory scanner. After designing interim crowns on the virtual study die and saving them as Standard Triangulated Language files, 30 interim crowns were fabricated using a DLP-type 3D printer. Additively manufactured interim crowns were post-cured using three different time conditions-10-minute post-curing interim crown (10-MPCI), 20-minute post-curing interim crown (20-MPCI), and 30-minute post-curing interim crown (30-MPCI) (n = 10 per group). The scan data of the external and intaglio surfaces were overlapped with reference crown data, and trueness was measured using the best-fit alignment method. In the external and intaglio surface groups (n = 45 per group), precision was measured using a combination formula exclusive to scan data (₁₀C₂). Significant differences in accuracy (trueness and precision) data were analyzed using the Kruskal-Wallis H test, and post hoc analysis was performed using the Mann-Whitney U test with Bonferroni correction (α=.05).RESULTSIn the 10-MPCI, 20-MPCI, and 30-MPCI groups, there was a statistically significant difference in the accuracy of the external and intaglio surfaces (P <.05). On the external and intaglio surfaces, the root mean square (RMS) values of trueness and precision were the lowest in the 10-MPCI group.CONCLUSIONInterim crowns with 10-minute post-curing showed high accuracy.     

Diagnostic radiography students' experiences of a practical method demonstrating the effect of milliampere-second in digital X-ray imaging systems

BackgroundThe effect of exposure technique factors varies between analogue and digital X-ray imaging systems (DR). Understanding these variations is paramount to optimising radiation protection, yet radiographers are unclear about these effects. A practical method to demonstrate milliampere second (mAs) effect in DR was developed to assist diagnostic radiography students in understanding exposure technique factors in DR.ObjectivesTo explore second-year diagnostic radiography students' experiences of a practical method to demonstrate the effect of mAs in DR.MethodsA qualitative research approach employing an open-ended questionnaire explored second-year diagnostic radiography students' experiences of the practical method demonstrating the effect of mAs in DR. Twenty students participated in the study, and the data collected underwent thematic analysis.ResultsStudents appreciated working in small groups and provided suggestions to improve the practical method's instruction sheet. Most students' predicted outcome differed from the actual outcome of the demonstration. Seeing and documenting the effect of mAs in DR not only enhanced students' understanding of it but showed the implications of increasing mAs on image quality and radiation exposure.ConclusionStudents found that the practical method enhanced their understanding of mAs and exposure technique factors in DR. Additionally, the practical method highlighted exposure creep in DR and radiographers' role in protecting patients from overexposure to ionising radiation in the digital era.     

Digital Workflow for Retrofitting a Surveyed Crown Using a Removable Partial Denture as an Antagonist

Digital workflow expedites the procedure of retrofitting a surveyed crown against an existing removable partial denture (RPD). This article describes a simple and straightforward technique of digital workflow where an existing RPD is scanned as an antagonist to design the rest seat, guide plane, and height of contour of a surveyed crown.