小儿头皮静脉穿刺两种持针方法的对比观察

目的 :探讨不同持针方法对小儿头皮静脉穿刺成功率及其他因素的影响 ,提高静脉穿刺质量。方法 :随机将 2 0 0 3年 1月至 6月因患上呼吸道感染、肺炎 ,在门诊输液治疗的 2个月～ 3岁的患儿 5 0 0例分为两组 ,各 2 5 0例 ,实验组采用手持针柄的前后沿穿刺 ,对照组采用手持针柄的上下面穿刺。结果 :实验组皮下瘀血、针头阻塞、针头脱出例数明显低于对照组 ,首次穿刺成功的例数、血管重复利用次数明显高于对照组 (P <0 0 1)。结论 :手持针柄前后沿进行穿刺优于手持针柄上下面穿刺     

Sensitivity of repeated interdigital web pinching to detect antinociceptive effects of ibuprofen

AIMS: The aim of the current study was to assess the viability of the interdigital web pinch model as a test for analgesic activity in volunteer-based early phase drug development. METHODS: Pain thresholds and sensitization to a series of four sessions of interdigital web pinching (12 Newtons force) were measured in 26 male volunteers before and 1 and 3 h after oral dosing with ibuprofen (800 mg) or placebo to ibuprofen. Within each time point, the pain thresholds were measured by calculating the average visual analogue scores (VAS) for the first session of pinching (VAS-1). Sensitization to pinching was assessed by calculating the average changes in these scores for the three subsequent sessions of pinching (VAS-2). Moreover, the difference between the VAS score after the first session of pinching and that obtained at the end of the fourth session of pinching was calculated as a secondary endpoint (VAS-3). RESULTS: Treatment with ibuprofen had no significant effect on VAS-1 at either 1 or 3 h after dosing. However, the mean values of VAS-2 and VAS-3, were significantly reduced (P < 0.05) following treatment with ibuprofen. CONCLUSIONS: This model has been able to detect an antinociceptive effect with ibuprofen. However, large numbers of subjects were required in order to demonstrate this effect and this feature would restrict the model's utility in early phase clinical trials where small numbers of subjects are normally employed.     

The effect of clonidine on adrenal sympathetic nerve responses to mechanical, noxious and innocuous stimulation of the skin in rats

The effect of clonidine on the reflex responses of the adrenal sympathetic nerve to mechanical stimulation of the lower chest skin was studied in anesthetized CNS intact and spinalized rats. Clonidine (3-120 micrograms/kg i.v.) administration resulted in a dose-related decrease in spontaneous adrenal efferent nerve activity in both CNS intact and spinalized rats. In CNS intact rats, noxious pinching caused a reflex increase in adrenal nerve activity while innocuous brushing caused a reflex decrease. In both cases, clonidine reduced the reflex response in a dose-dependent manner. In spinalized rats, both noxious and innocuous stimulation caused reflex increases in adrenal nerve activity, and clonidine produced a similar dose-dependent decrease in these responses as seen in CNS intact animals. The similar dose-response relationships for adrenal nerve tone or reflex response in CNS intact and spinalized animals suggest, although not conclusively, that at least some of clonidine's effect in CNS intact animals may be mediated at the spinal level.     

一次性颈椎后路椎管扩大成形术加经硬脊膜入路髓核摘除术治疗脊髓钳夹型颈椎病

目的 探讨采用一次性颈椎后路单开门椎管成形术加经硬脊膜入路椎间盘髓核摘除术治疗脊髓钳夹型颈椎病的手术方法及观察其近期手术疗效.方法 本组6例脊髓钳夹型颈椎病患者术前均行X线片、CT和MRI检查确诊.手术方法均采用颈后路单开门椎管扩大成形术,然后在颈椎间盘突出相应的硬脊膜的位置上纵行切开硬脊膜,显露颈髓和上、下神经根及齿状韧带,切开纤维环取出髓核组织.结果 本组6例均获随访,按JOA评分标准平均提高3-6分,肌力平均提高2-3级,术前症状基本消失或缓解.术后予以X线片及MRI复查,无明显并发症,钳夹节段的颈髓均显示压迫解除.结论 一次性颈椎后路单开门椎管扩大成形术加经硬脊膜入路椎间盘髓核摘除术是治疗脊髓钳夹型颈椎病的一种可行有效的手术方法.它可避免多次手术的痛苦.     

Review of Modeling Techniques for Analysis and Assessment of RC Beam–Column Joints Subjected to Seismic Loads

Beam–column connections are the most critical components of reinforced concrete (RC) structures. They serve as a load transfer path and take a significant portion of the overall shear. Joints in RC structures constructed with no seismic provisions have an insufficient capacity and ductility under lateral loading and can cause the progressive failure of the entire structure. The joint may fail in the shear prior to the connecting beam and column elements. Therefore, several modeling techniques have been devised in the past to capture the non-linear response of such joints. Modeling techniques used to capture the non-linear response of reinforced-concrete-beam–column joints range from simplified lumped plasticity models to detailed fiber-based finite element (FE) models. The macro-modeling technique for joint modeling is highly efficient in terms of the computational effort, analysis time, and computer memory requirements, and is one of the most widely used modeling techniques. The non-linear shear response of the joint panel and interface bond–slip mechanism are concentrated in zero-length linear and rotational springs while the connecting elements are modeled through elastic elements. The shear response of joint panels has also been captured through rigid panel boundary elements with rotational springs. The computational efficiency of these models is significantly high compared to continuum models, as each joint act as a separate supe-element. This paper aims to provide an up-to-date review of macro-modeling techniques for the analysis and assessment of RC-beam–column connections subjected to lateral loads. A thorough understanding of existing models is necessary for developing new mechanically adequate and computationally efficient joint models for the analysis and assessment of deficient RC connections. This paper will provide a basis for further research on the topic and will assist in the modification and optimization of existing models. As each model is critically evaluated, and their respective capabilities and limitations are explored, it should help researchers to improve and build on modeling techniques both in terms of accuracy and computational efficiency.     

A study of the cutaneous afferent input to substantia gelatinosa

The primary afferent input to substantia gelatinosa of the spinal cord was studied in the decerebrate cat. The responses of cells in the substantia gelatinosa to natural stimulation of the skin and to graded electrical stimulation of the sural nerve were compared. The results show that the responses of these neurones are not predictable from the known properties of the primary afferent input. Interactions between A-fibre and C-fibre input to substantia gelatinosa cells were studied using A-fibre polarization block and conditioning A-fibre stimulation during C-fibre activation of these cells. Whereas A-fibres have strong inhibitory effects on C-fibre input to large projection cells in the spinal cord, this is not true for substantia gelatinosa cells.The results do not support the idea of substantia geletinosa as a simple relay between primary afferent inputs and spinal cord projection systems.     

Novel approach for understanding the neural mechanisms of auditory-motor control: Pitch regulation by finger force

Music performance and speech production require neural circuits to integrate auditory information and motor commands to achieve rapid and accurate control of sound properties. This article proposes a novel approach for investigating neural substrates related to audiomotor integration. An experiment examined the brain activities involved in sensorimotor integration in a simplified audiomotor task: pitch regulation using finger-pinching force. The brain activities of the participants were measured using functional magnetic resonance imaging (fMRI) while they were performing the task. Two additional tasks were performed: an auditory-only task in which subjects listened to sound stimuli without any motor action and a motor-only task where they applied their finger force to the sensor in the absence of auditory feedback. The fMRI results showed the brain activities related to the online pitch regulation in the dorsal premotor cortex (dPMC), planum temporale (PT), primary auditory cortex, and part of the midbrain. The involvement of dPMC and PT was consistent with findings in previous studies on other audiomotor systems, implying that these regions appeared to be important for connecting the auditory feedback to motor actions.     

捏脊疗法对脑卒中患者并发症的影响

目的:探讨捏脊疗法对脑卒中患者护理质量的影响。方法:将200例患者随机分为观察组107例和对照组93例,对照组给予常规治疗,观察组在常规治疗的基础上给予捏脊疗法。结果:观察组便秘、腹胀、尿失禁症状消失时间短于对照组(P<0.05),患者满意度高于对照组(P<0.01)。结论:捏脊疗法可缩短患者便秘、腹胀、尿失禁症状消失时间,提高患者满意度。     

The effect of pentadecapeptide BPC 157 on inflammatory,non-inflammatory,direct and indirect pain and capsaicin neurotoxicity

The anti-nociceptive effects of a newly synthesized pentadecapeptide coded BPC 157 (an essential fragment of new organoprotective gastric juice peptide BPC) was evaluated in comparison with aspirin and morphine reference standards, in various experimental models of indirect/direct nociception and neurotoxicity: writhing (acetic acid/magnesium sulphate), tail pinching, hot-plate, and capsaicin application. BPC 157 administered either in the ng or μg per kg range, intraperitoneally, significantly reduced the reactions in the writhing (inflammatory and non-inflammatory, prostaglandin-dependent and independent) and tail pinching tests. In the hot-plate test, unlike morphine, BPC 157 had no effect on normal animals. However, when given to capsaicin treated rats, BPC 157 strongly reduced capsaicin-allodynia, either given as pretreatment or once daily for 14 days after the capsaicin injection. This reduction in capsaicin’s effect could not be obtained when BPC 157 was applied in the presence of established capsaicin-somatosensory neuron degeneration (application only on the 14th day after capsaicin), so it is possible that the effects of BPC 157 could be related specifically to the integrity of capsaicin-sensitive somatosensory neurons and their protection (e.g. primary afferent neurons having small-diameter somata and unmyelinated (C-) or thinly myelinated (A6-) fibres).     

Force model for laparoscopic graspers: implications for virtual simulator design

Introduction: Laparoscopic graspers limit haptic perception, which in turn leads to tissue damage. Using virtual simulators to train surgeons in handling these instruments would ensure safer grasp. The design of a laparoscopic virtual simulator with force feedback depends on effective implementation of the grasper force model.

Objective: To develop a laparoscopic grasper tip force model theoretically from grasper mechanics and validate the same experimentally during laparoscopic pinching.

Materials and methods: We developed a force model for double and single jaw action graspers using grasper mechanics. For experimental validation, the handle angle and the forces at the tip and the handle of the instrumented graspers during laparoscopic pinching of porcine abdominal tissues were measured. The intra-class correlation coefficient (ICC) between experimental and calculated tip force was calculated.

Result: Excellent ICC (ICC?≥0.8, p<.001) between calculated and experimental tip force was obtained for both graspers for all grasped tissues. Mean absolute forces for all trials while using double and single jaw action graspers were ((F_Tc?=?1.7N, F_Te?=?1.8N) and (F_Tc?=?2.2N, F_Te?=?2.8N)) for gall bladder, ((F_Tc?=?3.4N, F_Te?=?4.4N) and (F_Tc?=?3.3N, F_Te?=?3.4N)) for liver and ((F_Tc?=?4.2N, F_Te?=?4.5N) and (F_Tc?=?2.3N, F_Te?=?2.6N)) for spleen, respectively.

Conclusion: The proposed model may be used for the design of laparoscopic pinching action in a virtual simulator with force feedback and also for better ergonomic design of laparoscopic graspers.