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Objective:To explore the effect of regional nerve block anesthesia for elderly patients with traumatic tibia and fibula fractures.Methods:Ninety-three elderly patients with tibia and fibula fractures undergone surgical treatment were randomly divided into an observation group and a control group, with 47 and 46 patients, respectively, in each group.The control group received general anesthesia and the observation group received a regional nerve block.Results:There was no difference in operative time between the two groups[(42.2±5.4)min and(43.3±5.7)min, t=0.953, P=0.343].The time to recovery of consciousness[(11.2±2.6)min and(14.5±2.8)min, t=5.714, P<0.001]and the volume of intraoperative infusion[(415.6±27.5)ml/L and(686.6±36.3)ml/L, t=40.626, P<0.001]were lower and patients' blood pressure and respiratory rate were also lower at skin incision, fracture fixation, end of surgery and 30 min after surgery in the observation group than in the control group.The levels of Glu, IL-6 and COR were higher than those in the control group(all P<0.05).The incidence of complications was 2.13% in the observation group and 15.22% in the control group( χ2=5.07, P<0.05). Conclusions:Elderly patients with traumatic tibia and fibula fractures receive beneficial anesthetic effects with the regional nerve block technique, with stable hemodynamics, mild stress response and minor adverse reactions.
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Objective@#To explore character strengths of college students who sought counseling, and its relationship with mental health.@*Methods@#A total of 180 college students who sought counseling were investigated by using the short version of Character Strengths Questionnaire and the Symptom Checklist 90 (SCL-90) during March 2020 to October 2021.@*Results@#The top five character strengths of college students who sought counseling were appreciation, authenticity, gratitude, humor, love of learning ( 8.39± 1.64, 7.82±1.74, 7.73±1.57, 7.29±1.81, 7.17±1.88); The bottom five character strengths were kindness, bravery, persistence, zest, leadership (5.59±1.75, 5.81±1.30, 5.86±1.72, 5.98±1.59, 6.06±1.60). Linear regression analysis found love, social intelligence and insight showed associations with different dimensions of mental health, with correlation coefficient of each regression equation between -0.12 and 0.16, and the coefficient of determination between 0.05 and 0.19 ( P <0.01). Love had a negativeassociation with all factors of SCL- 90 ( β=-0.314--0.159, P <0.05), which could explain 3.3%-12.5% of the variation of each factor. Social intelligence had a negative association with obsessive compulsive, interpersonal sensitivity and anxiety ( β=-0.200--0.150, P <0.05), which can explain 1.6%-3.2% of the variation. Insight had a positive association with somatization, hostility and paranoia ( β=0.168-0.279, P <0.05), which can explain 2.3%-3.8% of the variation.@*Conclusion@#The lack and excess of character strengths is associated with mental health problems. Therefore, it would be more effective to help counseling cases build an appropriate and balanced character in the context of a strengths based approach.
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To solve the problem of stent malapposition of intravascular stents, explore the design method of intravascular body-fitted stent structure and to establish an objective apposition evaluation method, the support and apposition performance of body-fitted stent in the stenotic vessels with different degrees of calcified plaque were simulated and analyzed. The traditional tube-mesh-like stent model was constructed by using computational aided design tool SolidWorks, and based on this model, the body-fitted stent model was designed by means of projection algorithm. Abaqus was used to simulate the crimping-expansion-recoil process of the two stents in the stenotic vessel with incompletely calcified plaque and completely calcified plaque respectively. A comprehensive method for apposition evaluation was proposed considering three aspects such as separation distance, fraction of non-contact area and residual volume. Compared with the traditional stent, the separation distances of the body-fitted stent in the incompletely calcified plaque model and the completely calcified plaque model were decreased by 21.5% and 22.0% respectively, the fractions of non-contact areas were decreased by 11.3% and 11.1% respectively, and the residual volumes were decreased by 93.1% and 92.5% respectively. The body-fitted stent improved the apposition performance and was effective in both incompletely and completely calcified plaque models. The established apposition performance evaluation method of stent considered more geometric factors, and the results were more comprehensive and objective.
Subject(s)
Humans , Constriction, Pathologic/surgery , Plaque, Atherosclerotic , StentsABSTRACT
The dynamic coupling of stent degradation and vessel remodeling can influence not only the structural morphology and material property of stent and vessel, but also the development of in-stent restenosis. The research achievements of biomechanical modelling and analysis of stent degradation and vessel remodeling were reviewed; several noteworthy research perspectives were addressed, a stent-vessel coupling model was developed based on stent damage function and vessel growth function, and then concepts of matching ratio and risk factor were established so as to evaluate the treatment effect of stent intervention, which may lay the scientific foundation for the structure design, mechanical analysis and clinical application of biodegradable stent.
Subject(s)
Humans , Biomechanical Phenomena , Constriction, Pathologic , StentsABSTRACT
Objective To analyze the views and perceptions of practicing physicians on the practicing environment in the province,in order to provide policy reference for improvement.Methods By means of equi-probability and multi-stage sampling, 3 570 valid questionnaires were collected and analyzed from site survey which consist of the subj ective evaluation,and measures to identify and prevent medical professional risk.Results Overall assessment of the practice environment of physicians in Shanxi province is low,as those holding the environment asniceandacceptableaccounting for 4.8% and 21.7%,only 47.0% of physicians in tertiary hospitals hold the environment as very bad,while only 6.1% of those in level-1 hospitals share this view.92.4% of the physicians surveyed hold compliance of laws and regulations and technical specifications as key to prevention of medical dispute,yet most of them do not expect the media to be obj ective,fair and accurate in their coverage of events.Conclusions It is recommended to strengthen communication with the media for obj ective coverage of the limits of medicine,and explore the mechanism to take care of medical disputes by physicians,and improve their medical risk control capabilities,for a better practicing environment.
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OBJECTIVE@#To study the diagnostic value of high-resolution computed tomography (HRCT) and multiplanar reconstruction (MPR) in assessment of semicircular canals disease.@*METHOD@#Eighty-three patients were scanned with HRCT and the original data were processed with MPR. The semicircular canals full length was respectively observed in one image of MPR in the normal ears. The abnormal location of the canal were observed.@*RESULT@#In one image the full length of the horizontal, superior and posterior semicircular canal can be respectively displayed in one image of MPR in normal ears. By this way ,1 superior semicircular canal dehiscence (SSCD)was found in precaution group, 1 superior and 2 horizontal semicircular canal blocked, 1 vestibular aqueduct (VA) joined into superior semicircular canal and 2 VAs joined into posterior semicircular canal and abnormity of the three semicircular canals were found in SNHL.@*CONCLUSION@#MPR canould display the three canals full length in one picture and have a high specificity in the diagnosis of the semicircular canal abnormity.
Subject(s)
Adolescent , Adult , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Young Adult , Hearing Loss, Conductive , Diagnostic Imaging , Image Processing, Computer-Assisted , Semicircular Canals , Congenital Abnormalities , Diagnostic Imaging , Tomography, X-Ray ComputedABSTRACT
OBJECTIVE@#To investigate the expressions of nuclear factor-kappa B ligand (RANKL), receptor activator of nuclear factor-kappa B(RANK)and osteoprotegerin (OPG) and the relation of RANKL with bone- erosion in human cholesteatoma tissue.@*METHOD@#Thirty cholesteatoma and twenty normal auditory canal skin specimens were investigated. The expressions of RANKL, RANK and OPG were examined by immunohistochemistry.@*RESULT@#The overexpressions of the cytokine RANKL and RANK were found in infiltrated lymphocytes in the cholesteatoma tissue comparing with normal external meatal skin( t = 7. 758,6. 482, P <0. 05); While, the expression of OPG was significantly higher in cholesteatoma tissue comparing with normal external meatal skin. the OPG/ RANKL was decreased in cholesteatoma tissue comparing with normal external meatal skin( t = 8. 183, P < 0. 05).@*CONCLUSION@#This study revealed that the expressions level of RANKL and RANK were markedly increased in the perimatrix of cholesteatoma, which is closely related to the bone- erosion induced by cholesteatoma.