螺旋CT平扫对预测胃肠道穿孔部位的准确性研究

目的探讨螺旋CT平扫对预测胃肠道穿孔定位的准确性,为外科医生提供有价值的资料。方法选择中山市坦洲医院放射科2011年1月-2013年1月就诊的胃肠道穿孔患者62例,均行螺旋CT平扫,对穿孔部位进行预测,并与手术病理资料进行比较,观察CT诊断不同穿孔部位准确率,对有价值的CT征象进行总结。结果螺旋CT平扫预测穿孔部位分别为胃溃疡穿孔36例,十二指肠溃疡穿孔11例,外伤性空腔脏器穿孔8例,溃疡性结肠炎穿孔2例,肿瘤穿孔1例。与手术病理比较,胃溃疡穿孔、十二指肠溃疡穿孔、外伤性空腔脏器穿孔的符合率均达100%,溃疡性结肠炎穿孔、肿瘤穿孔的符合率分别为40.00%、50.00%,总符合率为93.55%。主要的CT征象为肠系膜间隙中游离气体、节段性胃肠壁增厚、肠壁灶状缺损、腔外气泡集中于邻近肠壁、腹部与盆腔中腔外气体、内脏周围脂肪索条影、腔外液体及脓肿。结论螺旋CT平扫不仅可准确定性,而且对穿孔部位可作出准确判断,具有较高的临床价值。     

正常牙合青年男性咀嚼肌不同功能位超声形态研究

目的:建立正常牙合青年男性浅层嚼肌、颞肌前束在下颌处于不同功能位置时超声形态正常值,比较其差异,为评价正畸患者浅层嚼肌、颞肌功能提供参考。方法:应用超声成像技术测量69位正常牙合青年男性下颌分别处于姿势位、最大紧咬位、最大前伸位时浅层嚼肌周长、面积、宽度、最大厚度、平均厚度、长度及颞肌前束最大厚度、平均厚度并对其不同功能位置的各项形态指标进行比较分析。结果:下颌处于姿势位时浅层嚼肌、颞肌前束的厚度与最大前伸位时比较,有显著性差异(P<0.05);下颌处于最大紧咬位时浅层嚼肌的各项超声形态指标及颞肌前束厚度与最大前伸位及姿势位时比较,有显著性差异(P<0.05)。结论:处于不同功能位浅层嚼肌、颞肌前束超声形态差异显著。     

Effect of incisor position on the self-perceived psychosocial impacts of malocclusion among Chinese young adults

Objective:To evaluate the impact of the incisor position on the self-perceived psychosocial impacts of malocclusion among Chinese young adults.Materials and Methods:This cross-sectional study included a convenience sample of 17.1- to 22.3-year-old young adults (n  =  1005). The five groups represented were normal occlusion as well as incisor Class I, Class II/1, Class II/2, and Class III malocclusion. For clinical assessment, the incisor relationship was evaluated according to the British Standards Institute Incisor Classification, and the self-perception of dental esthetics was assessed using the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). Statistical analysis involved the analysis of variance and Tukey multiple-comparison post hoc tests.Results:Psychosocial impacts were different among the five groups for the four PIDAQ domains (P < .001 for all four domains). Statistically significant differences were found between the four malocclusion groups and the normal occlusion group in all four domains (P < .001 for all four domains). Furthermore, statistically significant differences were found between four malocclusion groups.Conclusions:All four malocclusion groups had more severe psychosocial impacts than the normal occlusion group in the four PIDAQ domains. Statistically significant differences were also found between the four malocclusion groups; these malocclusion groups ranked by score, highest to lowest, were Class III, Class II/1, Class II/2, and Class I.     

骨性Ⅰ、Ⅱ、Ⅲ类错殆患者自然头位、颅面形态与颈椎姿势的研究

目的：探讨骨性Ⅰ、Ⅱ、Ⅲ类错殆患者自然头位、颅面形态与颈椎姿势的关系。方法：测量86例8～15岁均角错胎患者自然头位头颅侧位片并对测量项目进行统计分析。结果：颅部水平参考线与真垂线之间的夹角及颅颈角在骨性Ⅱ类错骀最大,骨性Ⅲ类错殆最小。结论：骨性Ⅰ、Ⅱ、Ⅲ类错殆畸形间自然头位及颈椎姿势有显著差别。     

眼前节分析系统在有效晶状体位置及白内障术后屈光效果预测中的作用

目的　应用Sirius系统预测有效晶状体位置（ELP）,探讨影响ELP变化的因素及对术后屈光效果的影响。方法　对苏州大学附属第一医院行白内障手术的103例（103眼）白内障患者资料进行回顾性分析。用Sirius系统和LS900对患者进行眼部生物学参数测量,用Sirius计算预测晶状体位置（PLP）。术后3个月,用Sirius系统采集的Scheimpflug图像测量ELP。采用Pearson相关性分析和线性回归分析人工晶状体(IOL)实际位置与其他参数的关系。结果　按晶状体位置预测误差(LPPE)分组后,LPPE A组和LPPE B组患者的屈光误差(RE)差异有统计学意义(P<0.001),而绝对屈光误差(ARE)差异无统计学意义(P=0.716)。按年龄分组后,年龄A组、年龄B组、年龄C组患者LPPE整体比较差异有统计学意义(P=0.046);年龄C组与年龄A组患者的LPPE差异有统计学意义(P=0.014)。年龄A组、年龄B组、年龄C组患者术后RE和术后ARE整体比较差异均无统计学意义（均为P>0.05)。按照PLP分组后,PLP A组和 PLP B组患者的LPPE和术后RE差异均有统计学意义(均为P<0.05),而术后ARE差异无统计学意义（P=0.116）。按照前房深度(ACD)分组后,ACD A组和 ACD B组患者的LPPE、术后RE和术后ARE差异均无统计学意义（均为P>0.05)。按照眼轴长度(AL)分组后,短AL组、正常AL组和长AL组患者的LPPE、术后RE和术后ARE整体比较差异均有统计学意义(均为P<0.05);长AL组和正常AL组患者的LPPE、术后RE和术后ARE,以及长AL组和短AL组患者的术后RE和术后ARE差异均有统计学意义(均为P<0.05)。相关性分析结果显示,患者PLP与ELP(r=0.637,P<0.001)、ACD与ELP (r=0.526,P<0.001)、AL与ELP（r=0.505,P<0.001）、术前ACD+晶状体厚度(LT)/2 与ELP (r=0.659,P<0.001)均呈正相关。通过线性回归分析得到改良预测公式:ELP_术后=0.485×（ACD_术前+LT/2）+0.461×PLP。结论　年龄、PLP、AL、LT等因素对LPPE、术后RE均有影响。改良的回归公式为临床预测ELP和术后RE提供了理论依据。     

A position anchor sinks the double-drift illusion

When the internal texture of a Gabor patch moves orthogonally to its envelope''s motion, the perceived path, viewed in the periphery, shifts dramatically in position, and direction relative to the true path (the double-drift illusion). Here, we examine positional uncertainty as a critical factor underlying this illusory shift. We presented participants with an anchoring line at different distances from the drifting Gabor''s physical path. Our results indicate that placing an anchor (a fixed line) close to the Gabor''s path halved the magnitude of the illusion. This suppression was symmetrical for anchors placed on either side of the Gabor. In a second experiment, we used crowding to degrade the anchoring line''s position information by embedding it in a set of parallel lines. In this case, despite the presence of the same lines that reduced the illusion when presented in isolation, the illusory shift was now largely restored. We suggest that the adjacent lines crowded each other, reducing their positional certainty, and thus their ability to anchor the location of the moving Gabor. These findings indicate that the positional uncertainty of the equiluminant Gabor patch is critical for the illusory position offset.     

Efficacy of wet-lab training versus surgical-simulator training on performance of ophthalmology residents during chopping in cataract surgery

AIM: To analyze whether wet-lab training(WLT) or surgical-simulator training(SST) is better for ophthalmology residents to master the chopping technique.METHODS: Sixty ophthalmology residents(in their second year) and three cataract surgeons participated in the study. The residents were randomly separated into two groups, WLT group and SST group. The residents in WLT group were asked to perform 10 trials of chopping using pig eyes and scored by the surgeons, and then they performed and scored using simulator for one time. The residents in SST group underwent 10 trials of chopping using simulator, and the simulator scored each trail. Then, this group were asked to perform the chopping using pig eyes and scored by the surgeons. At last, we investigated the residents’ satisfaction about the training.RESULTS: The demographic characteristics had no significant differences between the two groups. Recorded by the simulator, the residents in SST group got significantly higher overall score(83.90±1.31) than WLT group(78.73±1.92, P=0.03). And the residents in SST group got less corner area injured, and they spend less time than WLT group(P<0.05). Moreover, the residents in WLT group used more ultrasonic energy value than SST group(P=0.03). However, scored by the surgeons, the residents in two groups got nearly the same overall score. The residents in WLT group performed better on the frequencies of posterior capsule torn and incisional stress(P=0.03, 0.008, respectively). In the survey, the residents in two groups held the same opinion that the training was helpful and they strongly recommended this training. And all of them enjoyed the training, and enjoyed being randomized in their own group. However, with respect to the realistic character, the residents thought that WLT was better than SST(P<0.001).CONCLUSION: Both of the Eyesi surgical-stimulator and the wet-lab improve the residents’ chopping ability and each has its own advantages. The combination of the two training ways could be considered to be a part of the training curriculum for new residents.     

妇科腔镜手术患者人字形与截石体位的比较研究

目的 探讨人字形分腿位与截石位对妇科腔镜手术患者的影响.方法 将200例实施妇科腔镜手术患者随机分为对照组和观察组各100例.对照组采用常规截石体位;观察组采用人字形分腿位,即采用可分腿板式手术床,无需安装托腿架,双下肢平放于腿板上,腿板水平分开角度90°～1 00°.结果 观察组体位安置耗时(237.00±58.00)s,对照组(151.00士17.00)s,两组比较,差异有统计学意义(P＜0.01);观察组体温、血压、心率变化幅度小于时照组(均P＜0.01),麻醉苏醒期平稳性、术后舒适度改变等指标优于对照组(均P＜0.01).结论 与截石位相比,人字形分腿住手术野暴露充分,摆放简便,可有效预防并发症的发生,提高手术安全性.     

Ankle Arthroscopy in a Hanging Position Combined with Hindfoot Endoscopy for the Treatment of Concurrent Anterior and Posterior Impingement Syndrome of the Ankle

The purpose of the present study was to evaluate the results of arthroscopic and endoscopic treatment of concurrent anterior and posterior ankle impingement with the patient in a prone position. From May 2009 to September 2010, 22 patients with simultaneously combined anterior and posterior ankle impingements underwent ankle arthroscopy in a prone position. Noninvasive ankle distraction was achieved by hanging the affected ankle on a shoulder-holding traction frame, followed by hindfoot endoscopy. The mean age at surgery was 22.6 (range 20 to 46) years. The mean follow-up duration was 15.4 (range 12 to 29) months. The American Orthopaedic Foot and Ankle Society scores and Foot Function Index were checked preoperatively and at the final follow-up visit. The mean American Orthopaedic Foot and Ankle Society score increased from 62.6 preoperatively to 86.0 at the final follow-up visit (p < .05). The Foot Function Index improved from 45.8 to 17.2 (p < .05). Of the 22 patients, 18 were very satisfied or satisfied with the results, 2 rated their results as fair, and 2 were dissatisfied. No complications related to ankle distraction in a hanging position occurred. Ankle arthroscopy with the patient in a prone position with the ankle hung on a shoulder-holding traction frame combined with hindfoot endoscopy provided a useful method for treating anterior and posterior ankle impingement that does not require changing the patient's position from supine to prone.