34例小儿浅Ⅱ度烫伤的护理体会

目的：目的：探讨小儿浅Ⅱ度烫伤的有效护理。方法：通过对34例浅Ⅱ度烫伤小儿应用MEBO暴露疗法并配合观察和护理。结果：对34例浅Ⅱ度烫伤护理收到满意的效果，治愈率达97％。结论：及时有效地做好烫伤小儿的早期护理，使用MEBO对创面的保护，有效地预防饼发症的发生是烫伤小儿护理成功的关键。     

瘢痕子宫中期引产中米非司酮联合依沙吖啶的应用效果分析

目的研究并分析对中期引产的瘢痕子宫患者使用米非司酮联合依沙吖啶的效果和价值。方法收集2014年1月~2017年1月间在我院接受中期引产的瘢痕子宫患者50例,根据随机分组原则将其分为对照组(n=25)和观察组(n=25),对照组的引产药物为依沙吖啶,观察组在对照组基础上在联合使用米非司酮,将两组宫缩开始时间、宫缩到胎盘娩出时间、产后出血量、引产成功率、清宫率、胎膜胎盘残留发生率以及软产道裂伤发生率进行观察和对比。结果观察组的宫缩开始时间、宫缩到胎盘娩出时间、产后出血量分别为(15.38±4.12)h、(8.37±1.18)h、(112.58±5.95)m L均显著优于对照组;对比两组引产成功率,观察组100.00%显著高于对照组的84.00%;在清宫率、胎膜胎盘残留发生率以及软产道裂伤发生率方面,观察组均显著低于对照组(P均0.05)。结论在中期引产的瘢痕子宫患者的治疗过程中,米非司酮联合依沙吖啶能够显著缩短产程,减少软产道损伤及产后的出血量,提高引产安全性及引产的成功率,值得推广应用。     

中期妊娠胎盘前置状态引产剖宫产分娩影响因素分析

目的探讨中期妊娠胎盘前置状态引产分娩方式的相关影响因素。方法回顾性分析我院2012～2018年中期妊娠胎盘前置状态合并死胎或胎儿畸形的引产病例共51例,按分娩方式将其分为阴道分娩组和剖宫产组,比较两组间年龄、剖宫产史、孕次、产次、分娩孕周、胎盘覆盖宫颈内口范围、伴发胎盘植入、羊水量的差异。将单因素分析中具有统计学意义的变量(既往剖宫产史、胎盘覆盖宫颈内口范围、伴发胎盘植入)为自变量,拟合多因素Logistic回归方程,探讨胎盘前置状态引产剖宫产分娩的相关危险因素。结果 (1)阴道分娩组和剖宫产组比较,两组间既往剖宫产史、胎盘覆盖宫颈内口范围、伴发胎盘植入之间比较,差异均有统计学意义。(2)多因素Logistic回归分析显示,既往剖宫产史、伴发胎盘植入是剖宫产分娩的危险因素。与未植入比较,胎盘植入者剖宫产的危险度是其13.333倍;既往有剖宫产史者本次剖宫产的危险度是无剖宫产史者的8.727倍。结论胎盘前置状态中期妊娠引产,合并既往剖宫产史及胎盘植入者,其剖宫产分娩的危险度增加。     

拆分一个第二足趾重建单指或多指多关节复合组织缺损

目的 探讨对一指或多指的多关节毁损并伴有皮肤、肌腱、甲床等缺损的多处及复合组织缺损的重建与再造方法.方法 从2007年8月至2010年8月,共收治单指或多指多关节复合组织缺损8例20指,均应用第二足趾的跖趾关节、近、远侧指间关节及其皮肤、肌腱、甲床等为供体,按受区所需进行分配并解剖、游离及拆分,然后分别移植到手指各缺损部位,进行血管、神经、肌腱等吻合,用一个足趾的不同组织修复一指或多指多部位、多组织的缺损.结果 重建的20指术后均顺利成活,接近原手指外观及功能,足部供区外观及功能影响较小.随访3个月～3年,按手外科学会再造指功能评定试用标准评定:结果优16指,良3指,可1指.结论 根据受区所需,拆分第二趾,对一指多处或多个手指进行再造与重建,效果满意,是一种修复一指多处或多指多处包括关节在内的复合组织同时缺损的理想方法.     

前牙外伤性冠折根折的核桩烤瓷修复的临床应用探讨

目的：观察桩核加烤瓷冠技术在前牙牙冠外伤性根折修复中的临床应用疗效。方法：临床为63例外伤性前牙冠折或根折患者82颗患牙行桩核加烤瓷冠修复术,术后观察1～2年,计算成功率和失败率。结果：82颗烤瓷冠中77颗取得满意的临床效果,成功率为93.90%,失败5例,失败率为6.10%。结论：前牙牙冠外伤性冠折根折修复中,桩核加钛金烤瓷冠修复技术的临床应用是成熟的,值得临床推广应用。     

牙色美容树脂结合根管钉内置固位治疗磨牙顽固性食物嵌塞

目的：评价树脂结合根管钉内置固位治疗顽固性食物嵌塞的疗效。方法：将根管钉作为树脂内置固位装置,连接并封闭导致食物嵌塞的29对（58颗牙）,对患者进行随访观察。结果：27对（54颗牙）术后均不再发生嵌塞食物（93.10%）,2对（4颗）因松动失败（6.90%）。结论：用光敏复合树脂结合根管钉内置固位充填法治疗食物嵌塞具有磨牙少、可一次完成不需复诊、操作简单、美观、舒适耐用、异物感小、经济实惠等优点,同时还起到牙周夹板的作用治疗松动牙。是一种较好的、治疗磨牙食物嵌塞的方法。     

第一、二鳃弓综合征颜面不对称的整形外科矫治

目的探讨第一、二鳃弓综合征面部不对称畸形的整形外科矫治方法。方法根据第一、二鳃弓综合征患者临床及X线所示面部双侧不对称情况,采用健侧下颌骨外板去除、颧骨截骨降低;患侧下颌体、颧骨应用健侧下颌骨外板贴附植骨或高密度多孔聚乙烯(Medpor)假体置入等术式,配合颏部水平截骨颏成形术,以缩小面部双侧宽度的差异,矫治颜面不对称畸形。结果共矫治23例,经6个月至3年的术后随访观察,双侧面部宽度差异明显缩小,正面观面部不对称明显改善。结论第一、二鳃弓综合征面部骨骼发育畸形是三维方向的,双侧面骨宽度的差异,是造成正面观面部不对称的重要因素,根据受术者的具体情况,采用以上术式的组合,扩充患侧或同时缩窄健侧骨骼,进行面部骨性支架重建,可以取得良好的矫治效果。     

Clinical correlates of DHEA associated with post-traumatic stress disorder

OBJECTIVE: Increased plasma dehydroepiandrosterone (DHEA) and dehydroepiandrosterone-sulfate (DHEAS) have been demonstrated in post-traumatic stress disorder (PTSD), but the documented beneficial effects of these steroids in enhancing mood and cognition, as well as neuroprotection, suggest their presence in PTSD may be associated with defensive rather than maladaptive effects. METHOD: We, therefore, examined plasma DHEA, DHEAS, cortisol, and the DHEA/cortisol ratio in 40 male veterans with or without PTSD, and determined their relationships to PTSD symptom severity and symptom improvement. RESULTS: The PTSD group showed significantly higher plasma DHEA and non-significantly higher DHEAS levels as well as a significantly lower cortisol/DHEA ratio, controlling for age. Regression analyses demonstrated that DHEA and DHEAS levels could be predicted by symptom improvement and coping, whereas the cortisol/DHEA ratio was predicted by severity of childhood trauma and current symptom severity. CONCLUSION: That greater symptom improvement was related to DHEA levels may suggest for a role for these hormones in modulating recovery from PTSD.     

Memory functioning in post‐traumatic stress disorder: objective findings versus subjective complaints

Although memory complaints are common in post‐traumatic stress disorder (PTSD), the only published study of objective and subjective memory in PTSD by Roca and Freeman indicates that subjective complaints may not accurately reflect objective performance. The present study examined memory in 21 PTSD patients, 20 combat controls and 23 non‐combat controls using two objective memory measures (Rey Auditory Verbal Learning Test; Backward Digit Span) and one subjective measure (Memory Functioning Questionnaire). Analysis of variances (ANOVAs) and analysis of co‐variances generally did not reveal group differences for objective memory performance. For subjective memory complaints, ANOVAs indicated group differences; PTSD participants reported more memory problems than controls. These differences disappeared, however, when depression was included as a covariate. Also, we provide some preliminary evidence that depression may mediate the relationship between PTSD symptomatology and subjective memory complaints. Findings suggest that reductions in depressive symptomatology in PTSD may be associated with decreased subjective memory complaints. Copyright © 2010 John Wiley & Sons, Ltd.     

KCNQ1 gene variants and risk of new-onset diabetes in tacrolimus-treated renal-transplanted patients

Recent genome-wide association studies identified single-nucleotide polymorphisms (SNPs) in the gene encoding the pore-forming subunit of the voltage-gated K+ channel (KCNQ1) as a risk factor for type 2 diabetes. Tacrolimus (Tac) increased the risk of new-onset diabetes after transplantation (NODAT). The aim of this study was to analyze the association between KCNQ1 variants and the risk for NODAT in kidney-transplanted patients who received Tac as primary immunosuppressor. We genotyped three common KCNQ1 SNPs in 145 Spanish patients who received a cadaveric kidney graft and developed NODAT in the first-year post-transplant (the NODAT group), and 260 patients who remained non-diabetics (non-NODAT). In addition, we searched for DNA variants in the whole KCNQ1 coding exons in these patients. SNP rs2237895 (genotype CC) was associated with an increased risk for NODAT in our population (p = 0.008; OR = 1.83, 95% CI = 1.14-2.93), independently of other risk factors as body mass index, recipient age, or tacrolimus dosage. Other KCNQ1 variants were not associated with NODAT in our patients. Our work supported a role for KCNQ1 gene variants as determinants of the risk of developing NODAT among Tac-treated patients.