全程心理护理在门诊重睑术患者中的应用效果

目的 探讨全程心理护理干预在门诊重睑术患者中的应用效果。方法 选取青岛大学附属山东省妇幼保健院2022年2月-2023年2月收治的60例门诊重睑术患者为研究对象,随机分为对照组30例（常规护理干预）与观察组30例（全程心理护理干预）,比较两组护理满意度、遵医行为、负面情绪评分、疼痛评分及并发症发生情况。结果 观察组护理满意度为96.67%,高于对照组的76.67%（P＜0.05）;观察组的饮食、作息的遵医行为评分均高于对照组（P＜0.05）;观察组护理后的负面情绪评分与VAS评分均低于对照组（P＜0.05）;观察组的并发症发生率为3.33%,低于对照组的20.00%（P＜0.05）。结论 在门诊重睑术患者的临床护理工作中,全程心理护理具有较高的应用价值,不仅有助于改善患者的负面情绪,同时也强化了患者的遵医行为,降低了并发症发生率,有助于护理质量的持续改进。     

Prenatal Sonography in Suspected Proximal Gastrointestinal Obstructions: Diagnostic Accuracy and Neonatal Outcomes

BackgroundThe purpose of this study was to assess diagnostic accuracy and neonatal outcomes in fetuses with a suspected proximal gastrointestinal obstruction (GIO).MethodsAfter IRB approval, a retrospective chart review was conducted on prenatally suspected and/or postnatally confirmed cases of proximal GIO at a tertiary care facility (2012–2022). Maternal-fetal records were queried for presence of a double bubble ± polyhydramnios, and neonatal outcomes were assessed to calculate the diagnostic accuracy of fetal sonography.ResultsAmong 56 confirmed cases, the median birthweight and gestational age at birth were 2550 g [interquartile range (IQR) 2028–3012] and 37 weeks (IQR 34–38), respectively. There was one (2%) false-positive and three (6%) false-negatives by ultrasound. Double bubble had a sensitivity, specificity, positive predictive value, and negative predictive value for proximal GIO of 85%, 98%, 98%, and 83%, respectively. Pathologies included 49 (88%) with duodenal obstruction/annular pancreas, three (5%) with malrotation, and three (5%) with jejunal atresia. The median postoperative length of stay was 27 days (IQR 19–42). Cardiac anomalies were associated with significantly higher complications (45% vs 17%, p = 0.030).ConclusionsIn this contemporary series, fetal sonography has high diagnostic accuracy for detecting proximal gastrointestinal obstruction. These data are informative for pediatric surgeons in prenatal counseling and preoperative discussions with families.Level of EvidenceDiagnostic Study, Level III.     

改良额肌悬吊术治疗儿童先天性上睑下垂的临床效果

目的 评估膨体聚四氟乙烯材料（e-PTFE）改良额肌悬吊术治疗低龄儿童先天性上睑下垂的临床效果。方法 选取2019年1月-2022年6月于我院眼科行e-PTFE改良额肌悬吊术矫正先天性上睑下垂的患儿42例（52眼）为研究对象。术后1、3、6个月对42例患儿进行随访,比较手术前后术眼上睑至瞳孔反射距离（MRD）、睑裂高度、眼睑闭合时间、美容效果及并发症发生情况。结果 患儿术后1、3、6个月MRD和睑裂高度均较术前有所提高,差异有统计学意义（P＜0.05）;平均眼睑闭合时间为（2.36±0.88）个月;术后1、3、6个月美容效果评分分别为（8.12±0.52）分、（7.78±0.60）分、（7.65±0.42）分,随着时间的延长评分虽略有下降,但差异无统计学意义（F=1.675,P＞0.05）;并发症总发生率为3.84%。结论 e-PTFE改良额肌悬吊术联合个体化重睑成形术治疗低龄儿童先天性上睑下垂眼睑形态美观,效果良好。     

股骨远端疲劳骨折误诊教训

目的 提高对疲劳骨折的认识和诊断水平,避免误诊误治。方法 报告和总结５例股骨远端疲劳骨折的诊治经验和误诊教训。结果 ５例患者均为男性,年龄１８￣２３岁,病程３￣６周,均有高强度运动史。经Ｘ线片检查及病理活检,初步诊断为骨肉瘤;后经仔细询问并分析病史,结合系列Ｘ线片观察,诊断为股骨远端疲劳骨折。经患肢适当制动和对症治疗,患者症状逐渐减轻或消失,均痊愈出院。随访７￣１８个月,患者无异常。结论 仔细询问     

一期袢式胆肠—胃肠双侧吻合内引流术

应用袢式胆肠胃肠双吻合术（下称双吻合术）一期治疗不能切除的胰头癌所致的梗阻性黄疸１６例，与仅行袢式胆肠吻合术（ｎ＝２２）比较，具有同样的消除黄疸效果及防返流作用，并可避免由于术后癌肿压迫引起的十二指肠及幽门梗阻症状；手术操作简便、省时，更接近生理要求，使患者术后得到良好的生存质量。     

胰腺实性假乳头状瘤的CT表现简

目的：探讨胰腺实性假乳头状瘤（SPTP）的CT表现特征,提高其CT诊断准确性。方法回顾性分析手术病理结果证实的8例胰腺实性假乳头状瘤患者的CT表现,并与病理进行对照性分析。结果8例胰腺实性假乳头状瘤均为单发病灶,术前均行CT平扫及增强扫描。肿瘤直径1．5~6．4 cm,8例CT平扫为均匀或欠均匀类圆形低密度影,1例肿瘤内见点状钙化灶,所有病例为囊实性肿瘤,边界清楚,肿瘤质地较软。结论胰腺实性假乳头状瘤,肿瘤包膜清晰,内可见出血及部分囊变及钙化,肿瘤平扫密度较低,增强后可见轻度强化及强化,少数呈渐进性强化。     

MRI诊断骨嗜酸性肉芽肿的价值

目的：探讨MRI对骨嗜酸性肉芽肿的诊断及分期价值。方法：回顾性分析经病理证实的27例骨嗜酸性肉芽肿的临床和影像学资料。结果：病灶单发23例,多发4例。4例病灶呈斑片状骨破坏,边缘清但不规则;14例呈类圆形骨质破坏,边界清楚、规则,周围骨髓及软组织明显肿胀;9例呈斑片状骨破坏伴周围硬化,中间伴见分隔。所有病灶T1WI均呈低信号,T2WI呈低于周围骨髓的稍高信号,STIR呈高信号;三维容积快速采集（LAVA）动态增强扫描4例急性期病灶呈持续性环状明显强化,14例肉芽肿期病灶呈均匀持续性强化,9例修复期病灶早期强化不明显而延迟期呈轻度环状、分隔状强化;6例出现骨膜反应。结论：MRI能充分显示骨嗜酸性肉芽肿痛变的范围、细节,能提示病变的分期,对临床诊断、治疗本病具有重要的参考价值。     

放射性核素显像在小儿下消化道出血诊断中的应用

应用99mTcO及99mTc-RBC动态显像诊断消化道出血20例，结果阳性18例（美克尔憩室11例，肠重复畸形5例，克隆氏病1例，溃疡性回肠炎1例均被手术证实），阴性2例（肠息肉2例，内窥镜证实）。认为此种检查操作简单，损伤小，安全，灵敏度高，可提示出血部位及原因，对诊断及治疗有极大帮助。     

Maximum principle for optimal control of anticipated forward–backward stochastic differential delayed systems with regime switching

This paper is concerned with a Pontryagin maximum principle for optimal control problem of stochastic system, which is described by an anticipated forward–backward stochastic differential delayed equation and modulated by a continuous‐time finite‐state Markov chain. We establish a necessary maximum principle and sufficient verification theorem for the optimal control by virtue of the duality method and convex analysis. To illustrate the theoretical results, we apply them to a recursive utility investment‐consumption problem, and the optimal consumption rate is derived explicitly. Copyright © 2015 John Wiley & Sons, Ltd.     

高频彩超对腮腺肿瘤的诊断与鉴别诊断价值

目的:探讨超声对腮腺肿瘤的诊断与鉴别诊断价值。方法:回顾性分析经手术病理证实的173例腮腺肿瘤的声像图资料。结果:173例腮腺肿瘤中,良性159例,超声诊断符合率71.1%(113/159),恶性14例,超声诊断符合率71.4%(10/14)。良性病变常表现为形态规则边界清楚的肿块,以混合瘤居多,其次为腺淋巴瘤;恶性病变常表现为形态不规则,边界不清晰的肿块,以黏液表皮样癌居多。良恶性肿瘤在形态、边界、包膜、有无液化(囊实混合)、钙化及CDFI等表现方面差异有统计学意义(P0.05)。结论:高频彩超是腮腺良恶性肿瘤鉴别诊断的重要方法。