神经外科病人水电解质失衡病因及治疗

目的探讨神经外科病人水电解质失衡的临床特点和处理。方法回顾分析108例我科住院并伴有水电解质紊乱的病人的临床资料,治疗方法和效果。结果46例诊断为中枢性尿崩症（CDU,27例为抗利尿激素分泌不当综合征（SIADH）,20例为脑性盐耗综合征（CSWS）,15例为脑性潴盐综合征。其中101例治愈,另有3例中枢性尿崩症需要长期替代治疗,1例抗利尿激素分泌不当综合征患者死亡,3例CSWS患者需长期高钠饮食以维持正常血钠。结论108例病人中水电解质紊乱原因有：CDI,SIADH,CSWS,脑性潴盐综合征,但无论哪种水电解质紊乱在早期明确诊断后积极治疗,绝大多数患者是可以治愈的。     

改良粘接固位后牙种植义齿修复对种植体周围组织的影响

目的:考察改良粘接固位后牙种植义齿修复对种植体周围组织的近期影响.方法:纳入后牙缺陷的患者182例,随机分为2组,对照组(n=89)接受传统粘接固位,观察组(n=93)接受改良粘接固位,考察治疗后1年的种植体周围骨吸收量、牙槽骨高度和厚度、粉红美观计分标准(pictorial view of pink esthetic score variables,PES)、改良菌斑指数(modified plaque index,mPLI)、改良出血指数(modified suleus bleeding index,mSBI)和患者对种植义齿的满意度.结果:与对照组比,观察组的近和远中边缘骨吸收量明显降低(P＜0.05),牙槽骨高度和厚度明显增高(P＜0.05),舒适程度、咀嚼功能、语言功能、固位功能、美观功能、PES、mPLI和mSBI均有不同程度的改善(P＜0.05).结论:改良粘接固位较传统粘接固位在稳定种植体的骨支持和降低细菌感染方面具有明显的优势.     

The Change in Retentive Values of Locator Attachments and Hader Clips over Time

Purpose: The aim of this study was to examine early changes in retentive values of implant overdenture attachments during multiple pulls.
Materials and Methods: Two implant attachment systems (Hader bar and clip, Locator system) were used in this study. The experimental groups were divided into yellow Hader clips, white Locator attachments, and green Locator attachments. Each group consisted of 21 matrix attachments. The attachments were placed into a custom-made acrylic resin block seated passively on another acrylic block containing a Hader bar or two Locator abutments with different angulations. Each attachment was subjected to 20 consecutive pulls using a universal testing machine. The peak load-to-dislodgement of the attachments after each pull was documented, and the percent reduction of the peak load-to-dislodgement was calculated. One-way ANOVA and Tukey's honestly significant difference test were used for data analyses. A p ≤ 0.05 was considered significant.
Results: There was a significant difference in the percent reduction in peak load-to-dislodgement between the attachments after the first pull ( p = 0.005) and after the final pull ( p = 0.0001). The yellow Hader clips exhibited the least percent reduction in peak load-to-dislodgement (6.50 ± 3.59%) after the first pull, followed by the white Locator attachments (8.60 ± 4.42%); the green Locator attachments exhibited the greatest reduction (11.05 ± 4.94%).
Conclusion: The results of this in vitro study demonstrate that retentive values of the Locator attachments are reduced significantly after multiple pulls. Although this reduction might not be noticeable to the patient, it is recommended that the clinician place and remove the overdenture multiple times before delivery.     

预防全脑血管造影术后发生尿潴留的护理干预

目的探讨降低全脑血管造影术后尿潴留发生率的护理干预措施。方法将120例行全脑血管造影术患者随机分为训练组和对照组,各60例。两组均给予常规术前和术后的护理,训练组给予术前排尿功能训练及术后心理干预。结果训练组在全脑血管造影术后卧床期间尿潴留的发生率明显低于对照组（P〈0．05）。结论术前排尿训练及术后心理干预可有效预防全脑血管造影术后尿潴留的发生。     

盆底肌训练对预防产后尿潴留的作用探讨

目的 观察盆底肌训练对于预防产妇产后尿潴留的效果.方法 将在本院进行阴道分娩的186例产妇随机均分为对照组与观察组,对照组给予常规护理,观察组在对照组的基础上给予专人一对一指导盆底肌功能训练,观察并对比两组产后尿潴留的发生率.结果 对照组6例发生尿潴留,尿潴留发生率为6.45％;观察组无尿潴留发生.结论 盆底肌功能训练可有效促进膀胱与尿道消肿,对膀胱逼尿肌实现有效刺激,从而促进排尿,预防产后尿潴留的发生.     

表面粗糙度对水与唾液在纯钛及PMMA上润湿作用的影响

目的:评价全口义齿基托材料及其表面粗糙度对义齿固位的影响。方法:测定水与唾液在表面粗糙度不同的纯钛和聚甲基丙烯酸甲酯(PMMA)上的前进接触角和后退接触角,通过两者的差值θh反映水与唾液对它们的润湿效果。结果:1、随着表面粗糙度增加,唾液在纯钛上的θh逐渐降低,但当Ra≥1.0,Rz≥1.5时,θh突然增大;而PMMA组,当Ra<1.2,Rz<2时,粗糙度对θh无明显影响,当Ra≥1.2,Rz≥2时θh也显著增加,多数情况下,唾液在相同粗糙度的纯钛上的θh大于在PMMA上的θh。2、水在光滑的PMMA和纯钛上的前进接触角比唾液的大。结论:唾液对纯钛的润湿效果,可以通过高度磨光或形成较为粗糙的表面(Ra≥1.0,Rz≥1.5)得到提高,多数情况下这种润湿效果好于PMMA。提示从润湿效果看,对于不能高度研磨和抛光的义齿组织面,全口义齿上颌腭托选择纯钛并形成较为粗糙的表面可能更有利于固位。     

Awareness,Beliefs and Perspectives Regarding Weight Retention and Weight Gain among Postpartum Women in India: A Thematic Analysis of Focus Group Discussions and In-Depth Interviews

Background and AimsThe pregnancy weight is usually retained in the form of abdominal fat during the postpartum period. The willingness to lose weight is influenced by knowledge, attitude, beliefs and practices. This study aims to comprehend the awareness, beliefs and perspectives of postpartum women regarding their perceived factors, barriers and facilitators associated with post-pregnancy weight status.MethodsOverweight and obese postpartum women aged between 20 and 40 years and had delivered an infant in the last 2 years were recruited via convenience and purposive sampling techniques. The final sample comprised 27 participants with a mean age of 29.96 ± 4.50 years. Four focus group discussions and eight in-depth interviews carried out were audio-recorded and transcribed verbatim. Codes, sub-themes and themes were generated using Atlas.ti 9 software.ResultsMajor themes identified were perceived factors causing postpartum weight retention/weight gain including social and cultural beliefs related to diet and exercise specifically associated with this period, perceived motivators and deterrents of weight loss including eagerness to lose weight and perceived facilitators and barriers to weight loss including intrinsic and extrinsic factors such as time, energy, evidence-based knowledge about diet and physical activity, family support and obligation to family’s advice.ConclusionThe unique challenges and barriers associated with postpartum weight loss efforts should be taken into consideration by healthcare professionals and public health policy-makers to design strategies specific to postpartum women.Supplementary InformationThe online version contains supplementary material available at 10.1007/s13224-022-01644-9.     

Proteomic analysis of overweight/obesity and related abnormal glucose and lipid metabolism caused by phlegm-dampness retention

ObjectiveTo investigate the proteomic characteristics of overweight/obesity and related abnormal glucose and lipid metabolism caused by phlegm-dampness retention to identify related biomarkers.MethodsSeventy-one subjects were enrolled in the study. We assessed blood glucose, blood lipids, body mass index (BMI), and phlegm-dampness pattern, which was confirmed by a traditional Chinese medicine clinician. Of the participants, we included healthy participants with normal weight (NW, n = 23), overweight/obese participants with normal metabolism (ONM, n = 19), overweight/obese participants with pre-diabetes (OPD, n = 12), and overweight/obese participants with marginally-elevated blood lipids (OML, n = 17). Among them, the ONM, OPD, and OML groups were diagnosed with phlegm-dampness pattern. The data-independent acquisition (DIA) method was first used to analyze the plasma protein expression of each group, and the relevant differential proteins of each group were screened. The co-expressed proteins were evaluated by Venn analysis. The pathway analyses of the differential proteins were analyzed using Ingenuity Pathway Analysis (IPA) software. Parallel reaction monitoring (PRM) was used to verify the differential and common proteins in each group.ResultsAfter comparing ONM, OPD, and OML groups with NW group, we identified the differentially expressed proteins (DEPs). Next, we determined the DEPs among OPD, OML, and ONM groups. Using Venn analysis of the DEPs in each group, 24 co-expressed proteins were screened. Two co-expressed proteins were verified by PRM. IPA analysis showed that pathways including LXR/RXR activation, acute phase response signaling, and FXR/RXR activation were common to all three groups of phlegm-damp overweight/obesity participants. However, the activation or inhibition of these pathways was different among the three groups.ConclusionParticipants with overweight/obesity have similar proteomic characteristics, though each type shows specific proteomic characteristics. Two co-expressed proteins, VTN and ORM1, are potential biomarkers for glucose and lipid metabolism diseases with overweight/obesity caused by phlegm-dampness retention.     

Utilization of just-in-time training for nursing education using the LA Phonospirometry asthma tool

Objective: Just-in-time training (JITT) has been used to teach and re-teach known medical techniques, but has not been used to teach novel techniques. We aimed to assess the performance retention of JITT on a novel asthma exacerbation severity assessment technique known as Los Angeles (LA) Phonospirometry. Methods: This was a prospective cohort study using a convenience sample of pediatric emergency department registered nurses (RNs) who were asked to watch a brief instructional digital video on LA Phonospirometry, and then asked to practice the technique on a research assistant (RA). A checklist was used to evaluate proficiency with the primary outcome being the number correct on the checklist. The secondary outcome included whether or not they could identify a common error demonstrated by the RA. RNs were re-tested after 4–6 months to assess skill retention. Results: Forty RNs were enrolled in the study and six were lost to follow-up. The mean time from the first to second testing was 5.4 months ± 0.5 months. The mean score of the first part of the checklist on the initial testing was 4.6 ± 0.7 and on second testing was 3.8 ± 1.5 (p = 0.008). This represented a drop in scores and thus minimal knowledge decay of 18% (from 91% to 73%). The mean values for number of errors picked up for the first test and second test were 1.3 and 1.5, respectively (p = 0.2). Conclusions: JITT demonstrated feasibility as a rapid instructional tool for RNs, with a limited decay in cognitive knowledge surrounding the LA Phonospirometry technique.