Effects of exogenous factors on spatial accuracy in neurosurgery

The study aimed to assess the effect of exogenous factors such as surgeon posture, surgical instrument length, fatigue after a night shift, exercise and caffeine consumption on the spatial accuracy of neurosurgical manipulations. For the evaluation and simulation of neurosurgical manipulations, a testing device developed by the authors was used. The experimental results were compared using nonparametric analysis (Wilcoxon test) and multivariate analysis, which was performed using mixed models. The results were considered statistically significant at p < 0.05. The study included 11 first-year neurosurgery residents who met the inclusion criteria. Hand support in the sitting position (Wilcoxon test p value = 0.0033), caffeine consumption (p = 0.0058) and the length of the microsurgical instrument (p = 0.0032) had statistically significant influences on the spatial accuracy of surgical manipulations (univariate analysis). The spatial accuracy did not significantly depend on the type of standing position (Wilcoxon test p value = 0.2860), whether the surgeon was standing/sitting (p = 0.1029), fatigue following a night shift (p = 0.3281), or physical exertion prior to surgery (p = 0.2845).When conducting the multivariate analysis, the spatial accuracy significantly depended on the test subject (p < 0.0001), the use of support during the test (p = 0.0001), and the length of the microsurgical instrument (p = 0.0397). To increase the spatial accuracy of microsurgical manipulations, hand support and shorter tools should be used. Caffeine consumption in high doses should also be avoided prior to surgery.     

Galanin is a modulator of eccrine sweat gland secretion

The neuropeptide galanin has been ascribed different roles in modulating physiological functions in the skin. The present study examined the function of galanin in eccrine sweat gland physiology. We demonstrated secretion of galanin by sweat glands in vivo by radioimmunoassay of human sweat (20–192 fmol galanin/ml). Furthermore, human sweat glands expressed galanin receptors GalR2 and GalR3. Using chamber short‐circuit current (Isc) measurements showed that application of galanin to human NCL‐SG3 cells led to a significant increase in Isc, which was inhibited by the presence of chloride channel blockers and in chloride‐free Krebs solution. Additionally, application of SNAP 37889, a non‐peptidergic selective antagonist of GalR3, abolished the effect of galanin on Isc. In summary, our results show that galanin can regulate transepithelial chloride ion transport and fluid secretion by stimulating GalR3 in NCL‐SG3 cells and demonstrate a possible important extraneural function of galanin in sweat gland physiology.     

iPhone charger-induced chemical burn from overnight contact with sweat: Two cases

Smartphones have become essential devices in modern society. The coverage rate of smartphones in 2017 in Japan was 75% according to the Ministry of Internal Affairs and Communications. The iPhone is one of the most well-known smartphone brands. According to the manufacturer of iPhones (Apple), more than 200 million iPhones had been sold worldwide by 2017. These devices are often charged at night-time, especially while being used in bed. There are only three reports of smartphone charger-induced skin damage. We present two new cases of skin ulcers induced by an iPhone charger. The iPhone’s “lightning cable” has electrodes outside, and we found that this can present a higher risk of causing a skin injury compared with other types of phone chargers. We also investigated the mechanism of the skin ulcers caused by the iPhone charger. The results indicated that these ulcers were chemical burns rather than an electrical injury or heat-induced burn.     

A-N两班制排班模式在医院优质服务病区的应用效果

目的探讨A-N两班制排班模式在优质病区的运用,使有限的护理人力达到更优化的组合,来提高护理质量和护士排班的满意度。方法将创优病区普外科采用APN排班模式的阶段为对照组,采用改革后A-N两班制排班模式的阶段(即A代表上午班,上班时间8:00～16:30;N代表夜班,双人上班,上班时间16:30～次日08:00,其中22:00～次日02:00时间段可休息1人,02:00～06:00时间段可休息1人)为实验组,评价两组实施前后的护理质量、病人满意度、护士对排班的满意度等效果。结果实施A-N两班制排班模式后创优病区的护理质量、病人满意度、护士排班的满意度明显高于APN连续性排班模式病区(p<0.05,差异有统计学意义)。结论 A-N两班制排班模式能满足当下护士的需要,值得基层医院优质服务病区在排班方面借鉴。     

现代座舱信息显示方式对飞行人员空间定向的影响

目的综述平显、头盔显示器、前视红外成像系统和夜视镜等现代飞机座舱信息显示方式对飞行人员空间定向的影响.资料来源与选择国外近30年来特别是近10年相关文献报道.资料引用国外相关文献20篇.资料综合对上述现代座舱信息显示（主要是空间定向信息显示）的形式特点,以及对飞行人员空间定向的影响和容易发生的空间定向障碍等作了详细论述.结论上述现代信息显示方式相对于传统的信息显示方式而言,在某些方面无疑具有许多优越性,但是在飞行中空间定向方面具有不同于传统座舱显示的特点,飞行人员只有了解这些特点,才能准确使用这些装备,避免空间定向障碍等负效果.     

浅谈“甲襞微循环加权积分法”

作者观测了2763例不同病种不同病期患者的甲襞微循环,对于1984年闻世的“甲襞微循环加权积分法”给予高度的评价。同时指出,这种检查方法需要在临床实践中加以充实和提高。作者认为,“管襻脱落”的发生机理和临床意义不同于“管襻出血”,应该把“管襻脱落”作为一项独立的观测指标。汗腺导管的出现率差别很大,应重视其临床意义,增加其权值。甲襞微循环形态,流态及襻周状态部分指标的分值宜作适当的补充和修订。为了把对病人甲襞微循环连续观测的结果更形象更直观地表示出来,作者提出了b=2a-X的校正公式。     

Immunoreactivity to desmin in secretory epithelium of eccrine sweat glands

The finding of immunoreactivity to desmin in eccrine sweat glands is reported. Two monoclonal anti-desmin antibodies of the same clone (33) produced a distinct positivity in the secretory cells of the sweat glands in 15/16 biopsies. No immunoreactivity for desmin was found in control sections from apocrine sweat glands, salivary, mammary, prostate and lacrimal glands.     

Nightshift work and fracture risk: the Nurses’ Health Study

Summary  Nightshift work suppresses melatonin production and has been associated with an increased risk of major diseases including hormonally related tumors. Experimental evidence suggests that light at night acts through endocrine disruption likely mediated by melatonin. To date, no observational study has addressed the effect of night work on osteoporotic fractures, another condition highly sensitive to sex steroid exposure. Our study, to our knowledge, the first to address this question, supports the hypothesis that nightshift work may negatively affect bone health, adding to the growing list of ailments that have been associated with shift work. Introduction  We evaluated the association between nightshift work and fractures at the hip and wrist in postmenopausal nurses. Methods  The study population was drawn from Nurses’ Health Study participants who were working full or part time in nursing in 1988 and had reported their total number of years of rotating nightshift work. Through 2000, 1,223 incident wrist and hip fractures involving low or moderate trauma were identified among 38,062 postmenopausal women. We calculated multivariate relative risks (RR) of fracture over varying lengths of follow-up in relation to years of nightshift work. Results  Compared with women who never worked night shifts, 20+ years of nightshift work was associated with a significantly increased risk of wrist and hip fractures over 8 years of follow-up [RR = 1.37, 95% confidence interval (CI), 1.04–1.80]. This risk was strongest among women with a lower body mass index (<24) who never used hormone replacement therapy (RR = 2.36; 95% CI, 1.33–4.20). The elevated risk was no longer apparent with 12 years of follow-up after the baseline single assessment of nightshift work. Conclusions  Long durations of rotating nightshift work may contribute to risk of hip and wrist fractures, although the potential for unexplained confounding cannot be ruled out.