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O conceito de fantasma possui uma importância crucial para o enquadramento da experiência em psicanálise. Este artigo pretende situar o lugar e a função do fantasma neurótico na experiência analítica partindo da função da fala, tal como proposto por Lacan. Para tanto, selecionamos alguns textos e seminários de Lacan situados entre os anos de 1953 a 1964. Nossa hipótese de trabalho consiste na suposição de que, ao enquadrar uma realidade constituída inconscientemente enquanto resposta ao desejo do Outro, o fantasma serve para perpetuar ao neurótico um senso de ser idêntico a si mesmo à medida em que tende a promover um apagamento de contradições provenientes da posição que, como sujeito, ocupa em relação a este desejo. Ao ser concebida como irrupção de um objeto com valor de não-eu no enquadre fantasmático, a angústia produz um efeito reverso, constituindo, por conseguinte, tanto uma contraprova quanto um apoio na demonstração dessa hipótese.
Le concept de fantôme revêt une importance cruciale pour encadrer l'expérience en psychanalyse. Cet article veut situer la place et la fonction du fantasme névrotique dans l'expérience analytique à partir de la fonction de la parole, comme le propose Lacan. Pour cela, nous avons sélectionné quelques textes et séminaires de Lacan situés entre les années 1953 et 1964. Notre hypothèse de travail est qu'en encadrant une réalité inconsciemment constituée en réponse au désir de l'Autre, le fantôme sert à perpétuer chez le névrosé un sentiment d'être identique à lui-même dans la mesure où il tend à favoriser un effacement des contradictions nées de la position qu'il occupe, en tant que sujet, par rapport à ce désir. Conçue comme l'irruption d'un objet ayant valeur de non-moi dans le cadre fantasmatique, l'angoisse produit un effet inverse, constituant donc à la fois une contre-preuve et un support à la démonstration de cette hypothèse.
The concept of the phantasm holds a crucial importance for framing the experience in psychoanalysis. This article aims to situate the place and function of the neurotic phantasm in the analytical experience, starting from the function of speech as proposed by Lacan. To do so, we have selected some texts and seminars by Lacan between the years of 1953 to 1964. Our working hypothesis is that by framing an unconsciously constituted reality as a response to the Other's desire, the phantasm serves to perpetuate in the neurotic subject a sense of being identical to themselves as it tends to promote an erasure of contradictions arising from the subject's position in relation to this desire. When conceived as the irruption of an object with a non-ego value in the phantasmatic frame, anxiety produces a reverse effect, thereby constituting both a counterproof and a support in demonstrating this hypothesis.
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Ansiedad , Psicoanálisis , Inconsciente en PsicologíaRESUMEN
Objective@#To evaluate the clinical efficacy of invisible orthodontic appliances without brackets for the distal movement of maxillary molars to improve the ability of orthodontists to predict treatment outcomes.@*Methods@#Web of Science, Cochrane Library, Embase, PubMed, Wanfang Database, CNKI Database, and VIP Database were searched for studies investigating the efficacy of invisible orthodontic appliances for distal movement of maxillary molars in adult patients and published from database inception to August 1, 2023. A total of three researchers screened the studies and evaluated their quality and conducted a meta-analysis of those that met quality standards.@*Results@#This study included 13 pre- and postcontrol trials with a total sample size of 281 patients. The meta-analysis revealed no significant differences in the sagittal or vertical parameters of the jawbone after treatment when compared with those before treatment (P>0.05). The displacement of the first molar was MD=-2.34, 95% CI (-2.83, -1.85); the displacement was MD=-0.95, 95% CI (-1.34, -0.56); and the inclination was MD=-2.51, 95% CI (-3.56, -1.46). There was a statistically significant difference in the change in sagittal, vertical, and axial tilt of the first molar before and after treatment. After treatment, the average adduction distance of the incisors was MD=-0.82, 95% CI (-1.54, -0.09), and the decrease in lip inclination was MD=-1.61, 95% CI (-2.86, -0.36); these values were significantly different from those before treatment (P<0.05).@*Conclusion@#Invisible orthodontic appliances can effectively move the upper molars in a distal direction and control the vertical position of the molars. When the molars move further away, there is some degree of compression and distal tilt movement, which is beneficial for patients with high angles. The sagittal movement of incisors is beneficial for improving the patient's profile.
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RESUMO Objetivo: Identificar e analisar estudos internacionais que façam uma investigação a respeito do foco da atenção, da atenção compartilhada e sua relação com faces emocionais. Métodos: Foi realizada uma revisão sistemática com base nas diretrizes do método PRISMA. As bases PubMed e PsycInfo (APA) foram utilizadas para a identificação dos estudos, com base nos descritores em inglês: "joint attention", "attentional network", "gaze", "emotion" e "experimental", combinados com o booleano AND. Resultados: Foram localizados 249 artigos; desses, 223 foram excluídos no processo de seleção e 26 foram lidos na íntegra e selecionados como elegíveis para compor essa amostra. A atenção compartilhada tem um importante papel no desenvolvimento infantil, repercutindo até a fase adulta. Na atenção compartilhada, não apenas o foco da atenção é compartilhado, mas também os objetivos imediatos e de curto prazo, fornecendo dados a respeito das intenções em relação a outros objetos e pessoas no ambiente. Mudanças físicas no rosto, como mudanças de olhar, desempenham um papel na classificação de confiança. Quando o contato visual acontece, ele modula os circuitos neurais relacionados à recompensa, que são expressos quando rostos agradáveis são apresentados. Conclusão: A atenção compartilhada recebe influência das expressões faciais esboçadas por outro sujeito. Os estímulos agradáveis (felizes) são respondidos mais rapidamente do que os estímulos raivosos, isso porque há uma ativação dopaminérgica ativada por esses estímulos, e a expressão de medo aumenta o efeito do olhar de outra pessoa em direção à atenção do observador, o que pode ser explicado por meio do aprendizado ou da seleção natural.
ABSTRACT Objective: To identify and analyze international studies that investigate the focus of attention, shared attention and its relationship with emotional faces. Methods: A systematic review was performed based on the PRISMA method guidelines. The bases: PubMed and PsycInfo (APA), were used to identify the studies, based on the descriptors in English: "joint attention", "attentional network", "gaze", "emotion" and "experimental" combined with the Boolean AND. Results: 249 articles were located, of which 223 were excluded in the selection process, 26 were read in full and selected as eligible to compose this sample. Shared attention plays an important role in child development that reverberates into adulthood. In shared attention, not only the focus of attention is shared, but also the immediate and short-term goals, providing data regarding intentions towards other objects and people in the environment. Physical changes to the face, such as changes in gaze, play a role in the confidence rating. When eye contact happens, it modulates reward-related neural circuits that are expressed when pleasant faces are presented. Conclusion: Shared attention is influenced by facial expressions outlined by another subject. Pleasant (happy) stimuli are responded to more quickly than angry stimuli, because there is a dopaminergic activation activated by these stimuli, and the expression of fear increases the effect of another person's gaze towards the observer's attention, which can be explained by through learning or natural selection.
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Implant treatment in the esthetic area requires stable osseointegration and successful esthetic outcomes. Achieving this goal requires careful consideration of accurate implant axis and ideal three-dimensional position. Owing to the high esthetics and the special anatomical structure of the maxillary, a successful implant means a synthesized deli-beration of the residual bone dimensions, soft-tissue thickness, and the relationship of the residual alveolar ridge with the planned restoration. This article offers an in-depth analysis of the clinical decisions and key factors affecting the implant direction in the esthetic area.
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Implantación Dental Endoósea/métodos , Implantes Dentales , Estética Dental , Aumento de la Cresta Alveolar/métodos , Oseointegración , Maxilar/cirugía , Implantes Dentales de Diente ÚnicoRESUMEN
The perception of motion is an important function of vision. Neural wiring diagrams for extracting directional information have been obtained by connectome reconstruction. Direction selectivity in Drosophila is thought to originate in T4/T5 neurons through integrating inputs with different temporal filtering properties. Through genetic screening based on synaptic distribution, we isolated a new type of TmY neuron, termed TmY-ds, that form reciprocal synaptic connections with T4/T5 neurons. Its neurites responded to grating motion along the four cardinal directions and showed a variety of direction selectivity. Intriguingly, its direction selectivity originated from temporal filtering neurons rather than T4/T5. Genetic silencing and activation experiments showed that TmY-ds neurons are functionally upstream of T4/T5. Our results suggest that direction selectivity is generated in a tripartite circuit formed among these three neurons-temporal filtering, TmY-ds, and T4/T5 neurons, in which TmY-ds plays a role in the enhancement of direction selectivity in T4/T5 neurons.
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Animales , Neuritas , Drosophila , Neuronas , ConectomaRESUMEN
@#Objective To investigate the short-term quality of life in patients after single-direction video-assisted thoracic surgery (VATS) for lung cancer, and explore the related influencing factors. Methods Patients who underwent single-direction VATS for lung cancer in the Department of Thoracic Surgery, West China Hospital, Sichuan University from July 2020 to August 2021 were continuously selected. The QLQ-C30 and QLQ-LC13 were used to evaluate the quality of life of the patients after the surgery, and the influencing factors were analyzed. Results A total of 193 patients were collected. There were 73 males aged 59.44±11.40 years, and 120 females aged 53.73±11.15 years. The QLQ-C30 score of the patients after single-direction VATS for lung cancer was 69.09±20.21 points. Univariate analysis and Pearson correlation analysis showed that age, occupation, anesthesia time, postoperative complications, postoperative antibiotic use time, postoperative hospital stay, insomnia, economic stress, hemoptysis, chest pain, dysphagia, arm or shoulder pain were associated with the quality of life (P≤0.05). The results of multiple regression analysis showed that anesthesia time, economic pressure, insomnia and chest pain had a significant impact on the overall quality of life 30 days after the surgery (P≤0.05). Conclusion The anesthesia time, economic pressure, insomnia and chest pain are independent influencing factors for the quality of life after the VATS lung cancer surgery.
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Objective:To analyze the employment directions of full-time health management postgraduates in a scientific research institute in Beijing in recent five years and put forward relevant suggestions.Methods:Taking full-time masters of health management from 2015 to 2019 as the research objects, descriptive analysis was used to analyze the distribution of graduates' employment, and chi-square test was used to compare different training types and genders.Results:The employment rate remained at a high level of 100.0%, and there was no significant difference in the employment direction of the professional master and academic master. Hospitals and medical and health institutions were the main choices, and the trend was increasing in recent years. The employment direction of the graduates with different genders was significantly different due to the influence of income and stability.Conclusion:We should improve the professional training program, reflect the professional characteristics and advantages, strengthen the education of graduate career planning, and guide and help graduate employment.
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Objective:To evaluate the feasibility of measurement and characteristics of intraocular lens (IOL) tilt using the swept-source optical coherence tomography (SS-OCT) biometer (IOLMaster 700) and to explore its potentially relevant parameters.Methods:A cross-sectional study was conducted.Two hundred and forty-two eyes (119 right eyes, 123 left eyes) of 185 patients after phacoemulsification and IOL implantation were included in Beijing Tongren Hospital from July to September 2018.The IOL position, angle κ, angle α, corneal curvature, anterior chamber depth (ACD), pupil diameter (PD), and axial length (AL) were obtained by IOLMaster 700, and the IOL tilt direction and magnitude were calculated.The within-subject standard deviation and intraclass correlation coefficient were used to evaluate the repeatability of three IOL tilt measurements.Binocular symmetry of IOL tilt and the correlation between IOL tilt and different influencing factors were evaluated by Pearson linear correlation analysis or Spearman rank correlation analysis.Influencing factors for IOL tilt were assessed by multiple linear regression analysis.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Beijing Tongren Hospital, Capital Medical University (No.TRECKY2018-049). Patients were informed of the purpose and methods of this study and signed the written informed consent.Results:The repeatability of IOL tilt measurements was excellent with a within-subject standard deviation of 5.16° for IOL tilt direction and 0.13° for IOL tilt magnitude.IOL tilt was mirror symmetric in both eyes.The IOL tilt direction in right eyes ranged from -89.60° to 87.53° with a mean of (18.85±29.65)°, and the tilt magnitude ranged from 1.32° to 7.05° with a mean of (4.16±1.26)°.The IOL tilt direction in left eyes ranged from -84.30° to 89.44° with a mean of (21.17±32.38)°, and the tilt magnitude ranged from 0.58° to 7.40° with a mean of (3.80±1.31)°.There were moderate and weak positive correlations of IOL tilt direction and tilt magnitude between both eyes ( r=0.473, P<0.001; r=0.335, P=0.011). IOL tilt magnitude was weakly positively correlated with angle α and IOL diopter ( rs=0.272, P=0.003; r=0.285, P=0.002), and was weakly negatively correlated with ACD, PD and AL ( r=-0.303, P=0.001; r=-0.233, P=0.011; rs=-0.331, P<0.001). In backward stepwise regression analysis, the regression equation of IOL tilt magnitude, angle α, ACD, PD, AL and IOL diopter in multiple linear regression analysis was as follows: IOL tilt magnitude=10.503+ 1.456×angle α-0.532×ACD-0.196×AL ( R2=0.400; F=8.588, P<0.001). Conclusions:The SS-OCT biometer can be an effective method to assess IOL tilt.IOL tilt is mirror symmetric between the right eyes and left eyes.
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Objective@#To analyze and investigate the effects of implant location and axial direction on the stress distribution of implants, abutments, central screws, and crowns during immediate loading of maxillary mesial incisors with different alveolar fossa morphology based on three-dimensional finite element method.@*Methods@#Referring to the oral CBCT images of a healthy adult, a three-dimensional finite element model was established for immediate implant loading of maxillary central incisors with three alveolar fossa morphs: labial, intermediate, and palatal; different implant sites(apical site, palatal/labial site) and axes(tooth long axis, alveolar bone long axis) were simulated; the established model was loaded with a force of 100 N. ANSYS software was applied to analyze the stress values of the implants, abutments, central screwss, and crownss. @*Results@#The 3D finite element models of 12 maxillary central incisors with different alveolar sockets were successfully established;the implants and their superstructures were least stressed when the maxillary central incisors with partial labial and partial palatal shape were placed along the long axis of the alveolar bone in the palatal/labial position for immediate implant loading;the implants and their superstructures were least stressed when the maxillary central incisors with central shape were placed along the long axis of the tooth in the palatal position for immediate implant loading. The implant and its superstructure were subjected to the least stress when the implant was placed along the long axis of the tooth in the immediate loading position. @*Conclusion@#The bio-mechanical characteristics of the implant and its superstructure are influenced by the different socket morphology, implantation sites and axes. Therefore, in clinical practice, different implantation axes and implantation sites should be developed for different socket morphs.
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@#Objective To explore the feasibility of early chest tube removal following single-direction uniportal video-assisted thoracoscopic surgery (S-UVATS) anatomical lobectomy. Methods The clinical data of consecutive VATS lobectomy by different surgeons in Xuzhou Central Hospital between May 2019 and February 2022 were retrospectively reviewed. Finally, the data of 1 084 patients were selected for analysis, including 538 males and 546 females, with a mean age of 61.0±10.1 years. These patients were divided into a S-UVATS group with 558 patients and a conventional group (C-UVATS) with 526 patients according to the surgical procedures. The perioperative parameters such as operation time, blood loss were recorded. In addition, we assessed the amount of residual pleural effusion and the probability of secondary thoracentesis when taking 300 mL/d and 450 mL/d as the threshold of chest tube removal. Results Tumor-negative surgical margin was achieved without mortality in this cohort. As compared with the C-UVATS group, patients in the S-UVATS group demonstrated significantly shorter operation time (P<0.001), less blood loss (P=0.002), lower rate of conversion to multiple-port VATS or thoracotomy (P=0.003), but more stations and numbers of dissected lymph nodes as well as less suture staplers (P<0.001). Moreover, patients in the S-UVATS demonstrated shorter chest tube duration, less total volume of thoracic drainage and shorter postoperative hospital stay, with statistical differences (P<0.001). After excluding patients of chylothorax and prolonged air leaks>7 d, subgroup analysis was performed. First, assuming that 300 mL/d was the threshold for chest tube removal, as compared with the C-UVATS group, patients in the S-UVATS group would report less residual pleural effusion and less necessitating second thoracentesis with residual pleural effusion>500 mL (P<0.05). Second, assuming that 450 mL/d was the threshold for chest tube removal, as compared with the C-UVATS group, the S-UVATS group would also report less residual pleural effusion and less necessitating second thoracentesis with residual pleural effusion>500 mL (P<0.05). Further multivariable logistic regression analysis indicated that S-UVATS was significantly negatively related to drainage volume>1 000 mL (P<0.05); whereas combined lobectomy, longer operation time, more blood loss and air leakage were independent risk factors correlated with drainage volume>1 000 mL following UVATS lobectomy (P<0.05). Conclusion The short-term efficacy of S-UVATS lobectomy is significantly better than that of the conventional group, indicating shorter operation time and less chest drainage. However, early chest tube removal with a high threshold of thoracic drainage volume probably increases the risk of secondary thoracentesis due to residual pleural effusion.
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RESUMEN Introducción: Los organismos internacionales y nacionales exigen un proceso de formación que facilite el acceso a los conocimientos técnicos, desde los métodos modernos de enseñanza, que sea inclusivo, equitativo y de calidad. Objetivo: En atención a ello, la investigación se orientó a diagnosticar el estado actual del proceso de formación técnica de las luchas olímpicas. Materiales y métodos: Con este propósito, se realizó un estudio longitudinal desde el año 2012 hasta 2021, seleccionándose como muestra a 18 directivos, 59 luchadores y 24 entrenadores. Se utilizaron dos teléfonos móviles para grabar y obtener las imágenes de los combates, desde donde se realizaron las observaciones de la técnica. Los métodos utilizados fueron el dialéctico-materialista, así como los de orden teórico y empíricos, se destacan la revisión de documentos, la entrevista, la encuesta y la observación, mientras como herramienta de constatación la triangulación metodológica, fundamental en el proceso de descripción del objeto de estudio. Resultados: Los procedimientos aplicados determinaron la existencia de dificultades en la dirección pedagógico-deportiva, el sistema de contenidos científico-técnicos y el análisis de factores claves de la técnica, en especial, con manejo del modelo acción (librería de video), el video-análisis (parámetros de ejecución), el factor común (selección de casos exitosos y no exitosos) y los documentos de trabajo (fichas técnicas y listado cotejo). Conclusiones: Finalmente, se declaran las pautas de un modelo didáctico para la formación de la técnica, con base en una elaboración sistémica de los contenidos científico técnicos y el análisis de factores claves, considerando las tecnologías de la información y las comunicaciones (Tic).
SÍNTESE Introdução: Organismos internacionais e nacionais exigem um processo de treinamento que facilite o acesso ao conhecimento técnico, a partir de métodos modernos de ensino, que seja inclusivo, equitativo e de qualidade. Objetivo: Em vista disto, a pesquisa teve como objetivo diagnosticar o estado atual do processo de treinamento técnico na luta livre olímpica. Materiais e métodos: Para este fim, foi realizado um estudo longitudinal de 2012 a 2021, selecionando 18 gerentes, 59 lutadores e 24 treinadores como amostra. Dois telefones celulares foram usados para gravar e obter as imagens dos surtos, de onde foram feitas as observações da técnica. Os métodos utilizados foram dialético-materialista, bem como métodos teóricos e empíricos, incluindo revisão de documentos, entrevista, levantamento e observação, enquanto que a triangulação metodológica foi utilizada como ferramenta de verificação, fundamental no processo de descrição do objeto de estudo. Resultados: Os procedimentos aplicados determinaram a existência de dificuldades na direção pedagógico-desportiva, o sistema de conteúdo técnico-científico e a análise de fatores-chave da técnica, em particular, com o manuseio do modelo de ação (videoteca), a vídeo-análise (parâmetros de execução), o fator comum (seleção de casos de sucesso e insucesso) e os documentos de trabalho (fichas técnicas e lista de verificação). Conclusões: Finalmente, são apresentadas as diretrizes de um modelo didático de treinamento técnico, baseado em uma elaboração sistêmica dos conteúdos técnico-científicos e na análise de fatores-chave, considerando as tecnologias de informação e comunicação (TIC).
ABSTRACT Introduction: International and national organizations demand a training process that facilitates access to technical knowledge, from modern teaching methods, that is inclusive, equitable and of quality. Objective: In response to this, the research was aimed at diagnosing the current state of the technical training process of Olympic wrestling. Materials and methods: For this purpose, a longitudinal study was carried out from 2012 to 2021, selecting 18 managers, 59 wrestlers and 24 coaches as a sample. Two mobile phones were used to record and obtain the images of the combats, from where the observations of the technique were made. The methods used were the dialectical-materialist, as well as those of a theoretical and empirical nature, highlighting the review of documents, the interview, the survey and the observation, while as a verification tool the methodological triangulation, fundamental in the process of describing the object of study. Results: The applied procedures determined the existence of difficulties in the pedagogical-sports direction, the scientific-technical content system and the analysis of key factors of the technique, especially, with handling of the action model (video library), the video -analysis (execution parameters), the common factor (selection of successful and unsuccessful cases) and working documents (technical sheets and comparison list). Conclusions: Finally, the guidelines of a didactic model for the trainig of the technique are declared, based on a systemic elaboration of the scientific-technical contents and the analysis of key factors, considering the information and communication technologies (ICT).
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The evaluation of labor is the clinical process by which variables are analyzed in order to determine whether the patient is in labor, which by definition includes regular uterine contractions that increase in frequency and intensity, associated with dilation cervical. This is done through the anamnesis and physical examination, specifically through the evaluation of contractions and vaginal examination, the latter is intended to specify the degree of dilation, cervical effacement that the patient presents and also allows to a certain degree, establish the presentation, attitude and variety of position in which the fetus is located. From this premise, it is proposed that vaginal examination, since it is operator dependent, is not an objective evaluation, therefore, there is a need to reach consensus on the evaluation, and in order to carry it out, evaluation with ultrasound is proposed, which has as a purpose to objectify the variety of position and presentation of the fetus. Due to the above, this article aims to capture the knowledge that is currently possessed about the uses and methodology that intrapartum ultrasound presents.
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Humanos , Femenino , Embarazo , Arterias Umbilicales/diagnóstico por imagen , Cesárea , Placenta/diagnóstico por imagen , Resultado del Embarazo , Ultrasonografía Prenatal , Ultrasonografía Doppler , Arteria Cerebral Media/diagnóstico por imagenRESUMEN
RESUMO: Parte-se da premissa da importância da pulsão invocante em relação ao retorno em direção ao eu e a reversão no contrário como uma função de torção no nível do Outro. Objetiva-se mostrar como esse movimento pulsional orienta a direção da análise, pois está na base das intervenções do analista. O artigo traz duas vinhetas clínicas que tentam operar no campo da torção do significante e da voz através da operação de chiffonnage. Conclui-se que o significante novo oriundo da intervenção do analista é guiado por uma torção no nível da voz, produzindo um efeito significativo na direção da análise.
Abstract: It starts from the premise of the importance of the invocative pulsion in relation to the return towards the self and the reversal to the contrary as a function of torsion at the level of the Other. The objective is to show how this pulsional movement guides the direction of analysis, as it is at the base of the analyst's interventions. The article brings two clinical vignettes that try to operate in the field of the torsion of the signifier and the voice through the chiffonnage operation. It is concluded that the new signifier arising from the analyst's intervention is guided by a torsion at the voice level, producing a significant effect in the direction of the analysis.
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Psicoanálisis , Sujetos de Investigación , TerapéuticaRESUMEN
@#AIM: To investigate the status of astigmatism in children and adolescents aged 7-19 years in some areas of Xinjiang, and to analyze the distribution of astigmatism in children and adolescents in Xinjiang.METHODS: Cross-sectional study. This study took a purposive sampling survey of 41 schools in some areas of Xinjiang, including 20 primary schools and 21 middle schools, from May 2019 to December 2019. A total of 71 838 children and adolescents were included as the survey objects for relevant eye examinations.RESULTS: Among 71 838 students, 35 888 were found to have astigmatism(column ≤ -0.50D), and the astigmatism detection rate was 49.96%. The differences of astigmatism detection rate among different ages, genders, education levels, regions and ethnic groups were statistically significant(all <i>P</i><0.001). The detection rate of astigmatism increased with age from 7-16 years old, and reached the highest rate of 57.60% at 16 years old. The detection rate of astigmatism decreased from 16-19 years old, and the overall detection rate of astigmatism increased with age. With the increase of education level, the detection rate of astigmatism increases, and the detection rate of male astigmatism(51.25%)is higher than that of female astigmatism(48.62%). The detection rate of astigmatism in provincial capital cities(50.99%)is higher than that in non-provincial capital cities(48.05%); the detection rate of astigmatism in Han(53.41%)was higher than that in Uyghur(40.17%), Kazakhs(48.23%), Kyrgys(45.56%)and Hui(48.87%). The astigmatism type was mainly with-the-rule astigmatism(74.53%), and with the increase of age, the composition ratio of with-the-rule astigmatism decreased, while the composition ratio of against-the-rule astigmatism and oblique astigmatism increased. The final results of Logistic regression analysis showed that age, gender, nationality, region and education level were all influential factors of astigmatism.CONCLUSION: The prevalence of astigmatism in children and adolescents aged 7-19 years in some areas of Xinjiang is 49.96%, and the astigmatism is mainly with-the-rule astigmatism(74.53%). Age, gender, nationality, region and education level are the influential factors of astigmatism.
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Objective:To understand the current situation of male nurses in Dalian area and explore its future development direction.Methods:From August to September in 2020, 189 male nurses who had been engaged in clinical nursing for more than one year in 29 hospitals in Dalian were selected by convenient sampling method, and they were investigated by questionnaire. SPSS 25.0 software was used for statistical analysis. The counting data were described by rate or constituent ratio. Logistic regression analysis was used to analyze the important factors influencing male nurses′ willingness to change profession.Results:A total of 189 male nurses were investigated, 137 of them were under 30 years old, accounting for 72.5%. They had high education background and low professional title, mainly concentrated in ICU, operation room and emergency department of public owned 3A or 3B hospitals, with a monthly income of 3 000 to 8 000 yuan. 33 nurses(17.5%) chose nursing profession because they couldn′t change careers by profession adjustment. 135 nurses (71.4%) considered that work pressure was high. 70 nurses (37.0%) had the idea of changing careers. The main influencing factors included:nursing career was not in accordance with individual interest, dislike of female boss, low income. The prominent problem in nursing career was "inconvenience in gender""the confusion of self-positioning".Conclusions:The hospital should improve the income of male nurses, reduce the work pressure, establish magnetic hospital, establish career planning for them, and expand the team of male nurses. Male nurses should take the initiative to improve their professional ability and professional title, so as to provide necessary conditions for the realization of nursing managers, educators, researchers and other professional goals.
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@#Objective To explore the value of the single-direction lobectomy in the treatment of complicated pulmonary tuberculosis. Methods A retrospective analysis was performed on 88 patients with complicated pulmonary tuberculosis who received lobectomy in our hospital from 2017 to 2019. There were 64 males and 24 females, with an average age of 21-70 (47.67±13.39) years. According to the surgical procedure, patients who received single-direction lobectomy were divided into a single-direction group (n=32), and those who received traditional lobectomy were divided into a control group (n=56). Results The two groups had no statistical differences in gender, age, primary disease and complications, lesion morphology, clinical symptoms, operative site, interlobitis adhesion or hilar mediastinal lymph node calcification (P>0.05). Operation time [210.0 (180.0, 315.0) min vs. 300.0 (240.0, 320.0) min], intraoperative blood loss [200.0 (100.0, 337.5) mL vs. 325.0 (200.0, 600.0) mL], postoperative lung air leak time [3.0 (2.0, 5.0) d vs. 9.0 (6.8, 12.0) d] and the postoperative hospital stay [11.5 (8.0, 14.8) d vs. 18.0 (14.0, 22.0) d] of the single-direction group were less or shorter than those of the control group (P<0.05). There was no statistical difference between the single-direction group and the control group in the incidence of surgical complications [1 patient (3.12%) vs. 10 patients (17.86%)] or the cure rate [32 patients (100.00%) vs. 54 patients (96.43%)]. Conclusion The single-direction lobectomy can reduce lung injury and bleeding, shorten the duration of operation and accelerate the postoperative recovery in patients with complicated pulmonary tuberculosis, which has certain advantages compared with traditional lobectomy.
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El proceso de dirección académica de la Facultad de Medicina No. 1 de Santiago de Cuba, tuvo sus cimientos en el contexto de la Universidad de Oriente en 1962. Desde su fundación se ha concebido para redimensionar la academia, a tono con los problemas de salud de la población. Lo anterior posibilitó constatar, mediante la revisión de distintas publicaciones relacionadas con historia de la medicina, la carencia de estudios que analicen la dirección académica en la estructura de la facultad, como proceso integral e integrado, por lo cual se realizó el presente estudio con el objetivo de caracterizar las tendencias que distinguen el desarrollo de la dirección académica en el contexto educativo enunciado. Al respecto, se determinan los fundamentos que sustentan la necesidad de su perfeccionamiento. Se concluye, que se requiere de una gestión científico-metodológica pertinente, que impacte el entorno santiaguero, para satisfacer los problemáticas esenciales de salud, climáticas y sociales.
The process of academic direction of the Medicine Faculty No. 1 from Santiago de Cuba, had its foundations in the context of Oriente University in 1962. Since its foundation it has been conceived to resize the academy, according to the population health problems. The above-mentioned facilitated to verify, by means of the revision of different publications related to the history of medicine, the lack of studies that analyze the academic direction in the faculty structure, as integral and integrated process, reason why the present study was carried out aimed at characterizing the tendencies that distinguish the development of the academic direction in the enunciated educational context. In this respect, the foundations that sustain the necessity of its improvement are determined. It was concluded that a pertinent scientific-methodological administration that impacts the Santiago environment is required to satisfy the essential health, climatic and social problems.
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Facultades de Medicina , Historia de la Medicina , CubaRESUMEN
@#Objective To explore the safety and feasibility of the modified and improved thoracoscopic surgery for esophageal cancer using the concept of "single-direction" thoracoscopic technique. Methods The clinical data of 65 patients undergoing this modified minimally invasive esophagectomy based on "single-direction" thoracoscopic system between June 2018 and April 2019 were retrospectively analyzed, including 54 males and 11 females aged 62.5±7.8 years. Results The thoracoscopic operation time was 133.4±28.6 min, and intraoperative blood loss was 61.9±29.2 mL. No intraoperative blood transfusion was needed. One patient was transferred to open thoracotomy (due to severe pleural adhesion atresia). Major complications included anastomotic leak, pneumonia, chylothorax, incisional infection, recurrent laryngeal nerve paralysis and gastric emptying disorders, which were recovered by conservative treatment. No postoperative death occurred. The median number of lymph nodes and lymph node station harvested was 19 and 10, respectively. The median postoperative hospital stay was 10 days. The volume of chest drainage was 1 117.3±543.4 mL. Conclusion The minimally invasive operation mode of esophageal cancer based on "single-direction" thoracoscopic system is safe and feasible, and has good field vision and smooth and simplified procedure.
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@#Objective To evaluate the safety, feasibility and short-term outcomes of single-direction gastric mobilization under 3D-laparoscopy in minimally invasive esophagectomy for the treatment of esophageal cancer. Methods From February 2018 to December 2019, 118 consecutive patients who underwent minimally invasive McKeown esophagectomy for esophageal squamous cell carcinoma in our hospital were included. There were 94 males and 24 females with an average age of 53.7 (41–77) years. They were divided into two groups based on the methods of gastric mobilization: a traditional dissociation (TD) group (n=55) and a single-direction mobilization (MD) group (n=63). The clinical data of the two groups were compared. Results Enbloc resection and a negative resection margin were obtained in all patients. There was no postoperative mortality or incision complication. The rate of postoperative complications was 22.9%. There was no significant difference in the spleen injury, gastric injury, conversion to open surgery, abdominal reoperation as well as cervical anastomotic leakage between the two groups (P>0.05). It took significantly less time in the MD group compared with the TD group (P<0.05). There was an obvious statistical difference in the incidence of gastric mobilization related complications between the MD group (1.6%, 1/63) and TD group (12.7%, 7/55, P<0.05). Conclusion Application of single-direction gastric mobilization under 3D-laparoscopy in minimally invasive esophagectomy for the treatment of esophageal cancer is safe and easy to perform with a satisfactory short-term outcome.
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Objective:To compare the effects of the fracture line direction in the sagittal profile on the Gartland type Ⅲ supracondylar humerus fractures in children.Methods:A total of 153 cases of Gartland type Ⅲ supracondylar humerus fractures treated in the Department of Pediatric Orthopedics, Qilu Hospital of Shandong University (Qingdao) from January 2017 to April 2019 were retrospectively analyzed.They were categorized into the traditional oblique type (the fracture line went downward in the front and upward in the back), transverse type (the fracture line went horizontally) and reverse oblique type (the fracture line went upward in the front and downward in the back). Gender, age, injury side, cause of injury, ecchymosis before elbow, preoperative neurological symptoms, operation time, incision ratio, and Flynn scores of the elbow joint at the last follow-up were compared among the 3 groups.Results:Patients were followed up for (8.65±2.47) months (6-15 months). There were 60, 64 and 29 patients in the traditional oblique type, transverse type and reserve oblique type groups, respectively.There were no differences in the gender, injury side, and injury causes among the 3 groups (all P>0.05). The age of the traditional oblique type, transverse type and reverse oblique type group were (4.76±2.51) years, (4.71±2.09) years and (6.32±1.98) years, respectively, which was significant different among the 3 groups ( F=5.826, P<0.05). There were 10, 7 and 11 cases of preoperative elbow ecchymosis occurred in children of the traditional oblique type, transverse type and reverse oblique type groups, respectively, which was significant different ( χ2=9.902, P<0.05). No significant differences were found in preoperative neurological symptoms of the 3 groups ( P>0.05). The operative time for the traditional oblique type, transverse type and reverse oblique type group were (43.28±24.25) min, (40.95±27.41) min and (58.66±34.08) min, which was significant different ( F=4.337, P<0.05). The traditional oblique type and transverse type groups had 1 failure case of closed reduction, respectively, and the incision was performed during the operation.There were 4 cases in the reverse oblique type group who underwent the open reduction.The reduction rate was significantly different among 3 groups ( χ2=6.883, P<0.05). There was no significant difference in the excellent to good rate of traditional oblique type (96.67%, 58/60 cases), transverse type(95.31%, 61/64 cases)and reserve oblique type (93.10%, 27/29 cases) among 3 groups ( P>0.05). Conclusions:The reverse oblique Gartland type Ⅲ supracondylar humerus fractures are relatively rare in clinical practice, which involves more severe soft tissue damages and more obvious antecubital ecchymosis.The conventional reduction methods seem to be ineffectual for the reverse oblique supracondylar humerus fractures.