Users' Perceptions of the Impact of Electronic Aids to Daily Living Throughout the Acquisition Process

This study investigated the experience of seven new users of a particular type of assistive technology through the stages of anticipating, acquiring, and using an electronic aid to daily living. A mixed methods research approach was used to explore each of these stages. The Psychosocial Impact of Assistive Devices Scale was used to measure the perceived impact of the new assistive technology on users' quality of life, and findings were further explored and developed through open-ended questioning of the participants. Results indicated that preacquisition of the device, users predicted that the electronic aid to daily living would have a positive impact on their feelings of competence and confidence and that the device would enable them in a positive way. One month after acquiring the device a reduced, yet still positive, impact was observed. By 3 and 6 months after acquisition, perceived impact returned to the same positive high level as preacquisition. It is suggested that prior to receiving the device, potential users have positive expectations for the device that are not based in experience. At the early acquisition time, users adjust expectations of the role of the assistive technology in their lives and strive to balance expectations with reality. Three to 6 months after acquiring an electronic aid to daily living, the participants have a high positive view of how the device impacts on their lives based in experience and reality. A model illustrating the electronic aids to daily living acquisition process is proposed, and suggestions for future study are provided.     

Endoscopic thyroidectomy by a modified anterior chest approach: A single institution`s 5-year experience

Endoscopic thyroidectomy embodies the features of both minimally invasive surgery and aesthetic surgery. However, none of the established approaches is minimally invasive and meanwhile maximally cosmetic. Here we applied a modified anterior chest approach to achieve excellent cosmesis with reduced physical invasion. Fifty-six patients with benign thyroid diseases accepted this procedure. A 10mm longitudinal incision was made about one-fourth of the distance from the xiphoid to the sternal notch. Bilateral transversal incisions (5mm and 10mm) were performed about one-third of the distance from the nipple to the sternoclavicular joint. The subfascial space was maintained with CO₂ insufflation. Endoscopic lobectomy or subtotal thyroidectomy was performed according to the diseases. Fifty-four of the 56 procedures were successfully performed endoscopically, including 41 unilateral lobectomies and 13 subtotal thyroidectomies. The mean operative time for uni- and bilateral procedures was 117.2 min and 184.5 min, respectively. Conversion occurred in two cases due to bleeding and malignant frozen section analysis, respectively. Postoperative complications included one temporary recurrent nerve palsy, one transient hypocalcemia, and one subcutaneous emphysema. 96.2%(50/52) of the patients were extremely satisfied or satisfied with the cosmetic effect. This procedure is more likely to be accepted by patients older than 30 years. Endoscopic thyroidectomy by the modified anterior chest approach is an effective procedure with both excellent aesthetic benefits and reduced physical injury.     

《临床检验仪器学》课程建设的探索与实践

临床检验仪器学是一门多学科交叉的专业技术课程。我们从课程体系的优化、教学内容的更新、教学方法和教学手段的改革、教材建设的开拓、师资队伍的建设和教学质量管理的研究等方面不断进行创新和实践,经过5年的积极努力,取得了显著的教学效果。     

口内进路下颌角及咬肌肥大矫正术

为了避免面部留有切口疤痕,寻找出一种简单方便的回内进路手术方式。方法：口内进路、用skruber摆动锯截除肥大的下颌角,来复锯经日内补充截除骨断面下部骨突起及部分骨下绿,再用长柄骨磨头进一步磨改。结果：12例患者面形改善明显。结论：下颌角及咬肌肥大采用正颌外科技术经单纯的日内进路不需作辅加切口即能达到良好的手术效果。     

Auxiliary liver transplantation in acute liver failure in the rat – an illustrated description of a new surgical approach

INTRODUCTION: To investigate auxiliary liver transplantation successfully in rats suffering from acute liver failure, we developed a new surgical approach. METHODS: A 70% hepatectomized liver graft was implanted into the right upper quadrant of the abdomen. The donor portal vein was anastomosed with the recipient's right renal artery using the splint technique. The donor infrahepatic vena cava was attached onto the recipient vena cava end to side. The bile duct was implanted into the duodenum.     

面中份骨折小钛板内固定和钢丝骨间结扎治疗的比较观察

目的比较钢丝骨间结扎和小钛板内固定治疗面中份骨折的临床效果。方法采用头皮冠状入路及辅助切口,对４０例面中份骨折行钢丝骨间结扎和小钛板坚固内固定治疗。结果钢丝骨间结扎不能获得良好的稳定性,而小钛板坚固内固定则可重建面中份骨骼的支柱结构,获得足够的三维稳定性和重建理想的面部外形。在眶下缘、颧上颌缝区,手术野显露较差,小钛板内固定较钢丝骨间结扎更为方便可靠。结论小钛板坚固内固定是治疗面中份骨折的最佳方法。     

High Cervical Disc Lesions in Elderly Patients – Presentation and Surgical Approach

Summary  The incidence of high cervical disc lesions is extremely rare, and the mechanism of their development is unclear. We report these three cases, and discuss the possible mechanisms. We also describe surgical strategies for these lesions.  The first and second cases were an 82-year-old male and an 84-year-old male with retro-odontoid disc hernia. The third was an 83-year-old female with a herniated disc at C2/C3. To investigate Aetiological mechanisms of these lesions, we examined the findings on cervical images in extension and flexion, and compared the results in a younger than 80-year-old group and an older than 80-year-old group.  The patients underwent surgery via a posterolateral intradural approach. Wide laminectomy and incision of the dentate ligaments enabled access to the ventral space of the upper cervical spinal canal and sufficient decompression. All patients became ambulatory postoperatively without special fixation of the cervical spine. In the younger group, the level mostly loaded during cervical movement was C5/6, however, the levels in the older group were C2/3 and C3/4.  In elderly patients, less mobilization of the middle and/or lower cervical spine due to spondylotic change causes overloading at higher levels resulting in high cervical disc lesions. Retro-odontoid disc lesions can be caused by a herniated disc at C2/C3, which migrates upward. Regarding surgical strategy, the posterolateral intradural approach is less invasive and more advantageous for these lesions.     

经腹腹腔镜肾癌根治术的肾蒂处理经验：手术技巧及出血性并发症的腔镜下处理（附视频）

作者对经腹腔途径腹腔镜肾癌根治术的肾蒂血管处理技巧进行改进及总结,并对其中大血管损伤所致出血性并发症的腔镜下处理经验及教训进行介绍。     

耳后入路行腮腺区域性切除的临床效果分析

目的:探讨耳后入路行腮腺区域性切除的可行性及美容效果。方法:对31例腮腺下极浅叶良性肿瘤(多形性腺瘤15例,沃辛瘤11例,基底细胞腺瘤2例,脂肪瘤2例,淋巴管畸形1例)患者,采用耳后入路行腮腺区域性切除。结果:全部患者的腮腺病变被完整切除,切口愈合良好,无面神经下颌缘支麻痹,无涎液潴留、涎瘘发生及Frey征出现。经6个月～5年(平均26个月)追踪复查,肿瘤无复发,切口瘢痕隐蔽,美容效果非常好。术后有2例患者出现耳垂麻木,随访3个月后,麻木消失。结论:经耳后入路切除腮腺良性病损是可行的,可获得较理想的美容效果。     

椎旁肌间隙入路和传统入路在治疗胸腰段骨折对椎旁肌损伤的比较研究

[目的]比较椎旁肌间隙入路与传统入路在治疗胸腰段骨折中对多裂肌的影响.[方法]自2010年6月～2012年6月,共45例胸腰段骨折满足研究条件的随机分为椎旁肌间隙入路21例和传统正中手术入路24例,比较两组术前及术后1、3、5d肌酸激酶水平,术后6个月随访时行椎旁肌肌内静息肌电图评估及磁共振检查评估椎旁肌肉萎缩程度,16例患者取内固定行多裂肌组织学检查.[结果]肌酸激酶传统入路组术后高于椎旁肌间隙入路组,术后第1、3d差异具有统计学意义,第5d差异不具有统计学意义.6个月随访行多裂肌肌电图检查及磁共振检查,发现椎旁肌间隙入路组出现失神经纤颤电位少且MRI评分高,差异具有统计学意义(P＜0.05),而术后组织学检查发现类似的结果.[结论]传统手术入路和和椎旁肌间隙入路对多裂肌均有损伤,但椎旁肌间隙入路对椎旁肌损伤小于传统手术入路.