Restablecimiento de guía anterior con restauraciones adhesivas / Reestablishing of anterior guidance with adhesive restorations

La estética ha llegado a formar una parte muy importante en la odontología actual. Sin embargo, no debemos sobreponer las necesidades estéticas sobre las necesidades funcionales. La pérdida de estructura dental asociada a bruxismo puede ser considerada patológica cuando compromete la guía anterior, la cual es la influencia en los movimientos mandibulares que proveen las superficies contactantes de los dientes maxilares anteriores con los mandibulares anteriores y evita contactos excéntricos dañinos en los dientes posteriores. El objetivo de este reporte de caso es presentar una alternativa conservadora para restablecer tanto la estética como la funcionalidad de una paciente de 34 años de edad que acudió a la Clínica de Prostodoncia de la Universidad Autónoma de Guadalajara en busca de rehabilitación estética de dientes anteriores. Una vez realizada su evaluación inicial se llegó al diagnóstico de pérdida de guía anterior por desgaste patológico asociado a bruxismo. El tratamiento incluyó tratamientos de conductos, remoción de caries y restauraciones mal ajustadas, coronas y carillas para restablecer la guía anterior. Se cumplieron con las expectativas estéticas que tenía la paciente al igual que con las necesidades funcionales que fueron objetivo desde el inicio, logrando un restablecimiento de la guía anterior de manera conservadora (AU)

Esthetics has become a very important part of dentistry today. However, we should not superimpose esthetic needs over functional needs. The loss of tooth structure associated with bruxism can be considered pathologic when it compromises the anterior guidance, which is the influence on mandibular movements that provides the contacting surfaces of the maxillary anterior teeth with the mandibular anterior teeth and avoids damaging eccentric contacts in the posterior teeth. The aim of this case report is to present a conservative way to restore both esthetics and function in a 34-year-old patient who came to the Prosthodontics Clinic of the Universidad Autónoma de Guadalajara in search of an esthetic appearance of her anterior teeth. After her initial evaluation, a diagnosis of anterior guide loss due to pathological wear associated with bruxism was made. Treatment included root canal treatment, removal of caries, and ill-fitting restorations, crowns, and veneers to reestablish the anterior guidance. The aesthetic expectations of the patient have met as well as the functional needs that were aimed from the beginning, achieving a conservative reestablishment of the anterior guidance system (AU)

Trueness of different digital design methods for incisal guidance of maxillary anterior implant-supported single crowns / 北京大学学报(医学版)

Objective:To compare the trueness of incisal guidance of implant-supported single crowns designed by patient-specific motion(PSM)with that designed by average-value virtual articulator(AVA).Methods:The study had recruited 12 participants with complete dentition and stable incisal guidance.An intraoral scanner was used to scan digital casts and record two types of patient-specific mo-tion(data only including protrusive movement,and data including protrusive movement and lateral pro-trusive movement).The lingual surfaces of the maxillary incisors which guided the protrusive movement was selected and elevated to create a reference cast.A maxillary central incisor of original casts was vir-tually extracted and implanted to generate a working cast.The Dental system software program was used to design implant-supported single crowns with the anatomical coping design method.The incisal guidance was designed by different methods.The incisal guidance in control group was designed by the average-value virtual articulator.The incisal guidance in experiment groups was designed by the patient-specific motion only including protrusive movement(PSM1)and with the patient-specific motion including protru-sive movement and lateral protrusive movement(PSM2).The incisal guidance of prosthesis designed by these 3 methods were compared with the original incisal guidance in Geomagic Control 2015(3DSystem,America).The measurements included:Average of positive values,ratio of positive area and maximum value reflecting supra-occlusion;average of negative values,ratio of negative area and minimum value re-flecting over-correction;and root mean square reflecting overall deviation.Results:Statistical data were collected using the median(interquartile range)method.The average of positive values,ratio of positive area and average of negative values of the PSM2 group were smaller than those of the control group[8.0(18.8)μm vs.37.5(47.5)μm;0vs.7.2％(38.1％);-109.0(63.8)μm vs.-66.5(64.5)μm],and the ratio of negative area of PSM2 group was larger than those of the control group[52.9％(47.8％)vs.17.3％(45.3％)],with significant differences(P all＜0.05).The ratio of positive area[0.1％(7.0％)]and average of negative values[-97.0(61.5)μm]of PSM1 group,were smaller than those of the control group,and the ratio of negative area[40.7％(39.2％)]of the PSM1 group was larger than that of the control group,with significant differences(P＜0.05).The average of positive values[20.0(42.0)μm]and ratio of positive area of PSM1 group was larger than that of the PSM2 group with significant differences(P＜0.05).Conclusion:To establish the incisor guidance of implant-supported single crowns,compared with the average-value virtual articulator and the patient-specific motion only including protrusive movement,the patient-specific motion including protrusive movement and lateral protrusive movement is more conducive to reducing the protrusive interference of prosthesis and improving the occlusal fit.

Effect of different puncture needle models on the risk of bleeding after renal puncture / 重庆医学

Objective To study the effect of different types of renal puncture needles on the risk of bleeding after renal puncture.Methods A retrospective analysis was performed on 428 patients who under-went renal biopsy in the Third Affiliated Hospital of Chongqing Medical University and Jiulongpo District People's Hospital of Chongqing from January 2020 to December 2022.Different types of puncture needles were used to compare the occurrence of postoperative bleeding complications(hematoma,hematuria).Results The incidence of bleeding complications after renal puncture in 428 patients was 21.0％(90/428),of which the incidence of hematoma was 18.9％(81/428),the incidence of hematuria was 2.1％(9/428),the median decrease in hemoglobin(Hb)was 5 g/L,and the incidence of serious complications such as blood transfusion and interventional therapy was 0.7％(4/428).The patients with different types of renal puncture needles were grouped(16G group,18G group).There was no significant difference in baseline data and distri-bution of renal pathological types between the two groups(P＞0.05).The incidence of postoperative bleeding in 16G group and 18G group was 22.4％(52/232)and 19.4％(38/196),respectively.The incidence of hema-toma was 20.6％(48/232)and 16.8％(33/196),respectively.The incidence of hematuria was 1.7％(4/232)and 2.6％(5/196),respectively.The decrease of Hb was 6(0,16)g/L and 4(0,17)g/L,respectively.There was no significant difference(P＞0.05).There was no significant difference in the incidence of serious compli-cations such as blood transfusion,interventional therapy and Hb decrease＞10 g/L between the two groups(P＞0.05).Conclusion Ultrasound-guided renal biopsy is safe and has a low incidence of serious complica-tions.There was no significant relationship between different puncture needle types and postoperative bleeding risk.

Clinical Efficacy of Abdominal Ultrasound-guided Endoscopic Retrograde Appendicitis Therapy for Acute Uncomplicated Appendicitis / 昆明医科大学学报

Objective To compare the clinical efficacy of abdominal ultrasound-guided endoscopic retrograde appendicitis therapy(ERAT)with laparoscopic appendectomy(LA)for acute uncomplicated appendicitis using propensity score matching.Methods The clinical data of 441 patients with acute uncomplicated appendicitis admitted to the Third People's Hospital of Yunnan Province from March 2020 to April 2023 were collected.The cases were classified based on the differences in surgical method and divided into the ERAT group(n = 30)and LA group(n = 411).The clinical efficacy of patients was compared between the two groups after reducing confounding bias by propensity score matching(PSM).Results After PSM,a total of 30 pairs of patients in the two groups were successfully matched,and the baseline data of the two groups met the requirements for comparability.At 24 hours after the operation,the ERAT group exhibited lower white blood cells,neutrophil counts,and C-reactive protein levels compared to the LA group,and these differences were statistically significant(P<0.05).There was no significant difference in the operation time and total effective rate between the ERAT group and the LA group(P>0.05).However,the ERAT group had lower intraoperative blood loss and shorter pain relief time compared to the LA group,and these differences were statistically significant(P<0.05).Conclusion Abdominal ultrasound-guided endoscopic retrograde appendicitis treatment is an effective,safe,and feasible technique with good prospects for the treatment of acute uncomplicated appendicitis.

Effects of ultrasound guided pericapsular nerve group combined with lateral femoral cutaneous nerve block on analgesia,stress response and postoperative cognitive function in patients undergoing hip replacement / 临床外科杂志

Objective To investigate the effect of ultrasound guided block of pericapsular nerve(PENG)combined with lateral femoral cutaneous nerve(LFCN)on analgesia,stress response and postoperative cognitive function in patients undergoing hip replacement.Methods 102 patients who underwent hip Joint replacement in our hospital from September 2020 to September 2022 were selected and randomly divided into control group(51 cases)and study group(51 cases).The control group was given ultrasound guided iliac fascia space block(FICB),and the study group was given ultrasound guided PENG combined with LFCN block.The perioperative related indicators,postoperative analgesia effect,stress response indicators and postoperative cognitive function of the two groups were compared.Results There was no statistically significant difference in the comparison of surgical time between the two groups(P＞0.05).The amount of sufentanil used and the number of analgesic pump used within 48 hours after surgery in the study group were significantly lower than those in the control group(P＜0.05).The first postoperative time of getting out of bed and hospitalization in the study group were significantly shorter than those in the control group(P＜0.05).There was no statistically significant difference in VAS scores between the two groups at 6 h,12 h,24 h,and 48 h after surgery(P＞0.05).The VAS scores of the study group were significantly lower than those of the control group at 6 h,12 h,and 24 h after surgery(P＜0.05).The heart rate(HR)and Mean arterial pressure(MAP)of the control group were higher at the time of block(T1),30 min of block(T1)(T2),and the end of block(T3)than at the time of entry(T0)(P＜0.05).HR and MAP of the study group were significantly lower than those of the control group(P＜0.05).The MMSE scores of the two groups at 6 h,12 h,24 h,and 48 h after surgery were lower than those before surgery(P＜0.05),but the MMSE scores of the study group were significantly higher than those of the control group(P＜0.05).Conclusion Using ultrasound guided PENG combined with LFCN block for patients undergoing hip Joint replacement can more effectively reduce the amount of opioids and the number of use of analgesia pump,reduce postoperative pain in the exercise state,reduce stress reaction,and have less impact on cognitive function,so as to promote faster recovery of patients.

A randomized controlled trial of acupuncture at Jiaji points for treatment of lumbar disc herniation under ultrasonic guidance / 中国组织工程研究

BACKGROUND:In the research on acupuncture treatment for lumbar disc herniation,most acupuncture treatments are performed under CT guidance or without guidance.The precise control of the target site and the effective acupuncture location are not clear. OBJECTIVE:To observe the clinical effects of acupuncture at Jiaji points under ultrasonic guidance in treating lumbar disc herniation. METHODS:A total of 70 cases of lumbar disc herniation,36 males and 34 females aged 18-65 years old,were selected from Chinese PLA General Hospital and Third Affiliated Hospital of Beijing University of Chinese Medicine.They were divided into trial group and control group by random number table method,with 35 cases in each group.The control group received acupuncture at Jiaji points.The trial group received acupuncture at Jiaji points under ultrasonic guidance.The patients were treated once on the day of treatment and 4,7 days after treatment.Visual analog scale score,Oswestry disability index,Japanese Orthopaedic Association score,and MOS 36-Item Short-Form Health Survey(SF-36)were evaluated before and after treatment. RESULTS AND CONCLUSION:(1)Compared with before treatment,the visual analog scale scores of both groups were decreased after treatment(P<0.01).Compared with the control group,the visual analog scale scores of the trial group were decreased on days 2,3,6,7 of treatment and 1,2 weeks after the end of treatment(P<0.05,P<0.01).(2)Compared with before treatment,Oswestry disability index after treatment was decreased in both groups(P<0.01).Compared with the control group,Oswestry disability index of the trial group was decreased from days 1 to 7 of treatment and 1,2 weeks after treatment(P<0.01).(3)Compared with before treatment,the Japanese Orthopaedic Association scores of both groups were increased after treatment(P<0.01).Compared with the control group,the Japanese Orthopaedic Association scores of the trial group were increased on days 3,7 of treatment and 1,2 weeks after treatment(P<0.05,P<0.01).(4)Compared with before treatment,SF-36 scores in both groups were increased after treatment(P<0.01).There was no significant difference in SF-36 scores between the two groups after treatment(P>0.05).(5)These results show that acupuncture at Jiaji points has curative effect on lumbar disc herniation,and ultrasonic guidance could improve the clinical curative effect of acupuncture at Jiaji points for lumbar disc herniation.

Application research of ultrasound oblique axis plane guidance technique in PICC puncture / 中华护理杂志

Objective To explore the application efficacy and safety of oblique ultrasound-guided techniques in PICC puncture,in order to provide guidance and references for clinical application.Methods Through convenient sampling,654 patients from a tertiary A hospital in Zhejiang Province from March to December 2022 were selected as the study subjects.The random numbers were generated through Excel table functions and they were randomly grouped into 3 groups:A,B,and C.The ultrasound short axis method,long axis method,and oblique axis method were employed to guide PICC puncture catheterization,respectively.The success rate of PICC puncture,the number of subcutaneous adjustments of the puncture needle,puncture time,and the occurrence of puncture complications(such as hematoma,puncture of the posterior wall of blood vessels,accidental injury to arteries,and accidental injury to nerves)were recorded during the catheterization process in 3 groups.Results A total of 654 patients completed the study,including 215 in group A,219 in group B,and 220 in group C.The success rate of first-time puncture in the group C(86.36％)was higher than that in group A(73.95％)and group B(63.93％),and there was a statistically significant difference among 3 groups(P＜0.001).The subcutaneous adjustment frequency of the puncture needle was 1(1,1)in group C,1(1,2)in group A,and 1(1,2)in group B.The difference between 3 groups was statistically significant(P＜0.001);the puncture time of group C was shorter than that of group A and group B,and the difference was statistically significant(P＜0.001).There was a statistically significant difference in the puncture time between 3 groups(P＜0.017);the pairwise comparison of the number of subcutaneous needle adjustments and the success rate of a puncture between 3 groups showed that there was a statistical difference between group C and group A,and between group C and group B(P＜0.017),while there was no statistical difference between group A and group B(P＞0.017).There was statistical significance(P＜0.05)among 3 groups in terms of complications such as accidental nerve injury and puncture of the contralateral vascular wall by puncture needle,but there was no statistical significance in terms of accidental arterial injury and hematoma occurrence among 3 groups.Conclusion Compared with the short axis approach and the long axis approach,the ultrasound oblique axis approach guided PICC puncture has statistical differences in the success rate of a puncture and the incidence of puncture complications,etc.It is recommended to use the ultrasound oblique axis approach during PICC puncture.

The latest progress of prostate targeted biopsy / 现代泌尿外科杂志

Image-guided targeted biopsy is currently the mainstream method of prostate cancer puncture biopsy, while risk stratification based on imaging and biochemical markers may become the new standard. This paper comprehensively reviews the latest advancements in various imaging techniques and strategies of targeted prostate biopsy. Ultrasound-assisted prostate biopsy mainly includes transrectal ultrasound (TRUS), transrectal-contrast enhanced ultrasound (TR-CEUS), and transrectal real-time elastography (TRTE), which can significantly increase the diagnosis rate of prostate cancer when combined with biopsy. Three-dimensional transrectal ultrasound (3D-TRUS) technology may be used in patients with a negative previous biopsy. At present, micro-ultrasound (Micro-US), the latest ultrasound method, is not inferior to mp-MRI in targeted biopsy of the prostate. Targeted biopsy by mp-MRI has improved the detection rate of clinically significant prostate cancer (csPCa), and the common NMR targeted technologies are magnetic resonance imaging-visual-targeted biopsy (MRI-visual-TB), magnetic resonance imaging-fusion-targeted biopsy (MRI-fusion-TB), and in-bore magnetic resonance imaging-target biopsy (MRI-TB). The fusion of MRI and Micro-US imaging for targeted biopsy has also become a new targeted biopsy method, and MR robot-assisted biopsy is gradually being applied. PET/CT improves localization of tumors and may be valuable for initial staging, re-staging after biochemical recurrence, even in patients with MRI-negative prostate cancer. PET/CT targeted biopsy using tracer has been shown to yield good diagnostic efficacy. PET/MRI technology has the potential to be the imaging test for needle-free biopsies in the future. The development of technology has led to the adaptation and optimization of biopsy strategies in clinical practice.

Contrast of the therapeutic effect of CT/MRI image fusion technology and CT guided radiofrequency thermocoagulation of trigeminal semilunar ganglion / 安徽医科大学学报

Objective @#To evaluate the therapeutic effect of CT/MRI image fusion and usual CT guided percutaneous radiofrequency thermocoagulation of trigeminal semilunar ganglion . @*Methods @#The medical information of 88 patients diagnosed with primary trigeminal neuralgia were assembled . In accordance with different imaging guidance means , they were equally divided into the control group ( trigeminal semilunar ganglion radiofrequency thermo coagulation with CT guidance ) and the fusion group ( trigeminal semilunar ganglion radiofrequency thermocoagula tion with assistance of CT/MRI image fusion technology) at random. The puncture time , intraoperative discomfort rate , preoperative , intraoperative and postoperative visual analogue scale (VAS) score , Barrow neurological insti tute (BNI) pain score and postoperative complication rate were contrasted . @*Results @#The puncture operation time of the fusion group was shorter than that of the control group (P < 0 05) ; the intraoperative and postoperative VAS and BNI scores , occurrence rate of intraoperative discomfort and postoperative complications in the fusion group were lower than those in the control group (P < 0.05) .@*Conclusion @#In respect of improving therapeutic effect and diminishing intraoperative discomfort and postoperative complications , CT/MRI image fusion technique is superior to CT guidance .

Early clinical outcomes of the domestic KokaclipTM transcatheter edge-to-edge mitral valve repair system for severe degenerative mitral regurgitation: A single-arm, prospective, single-group target value clinical trial / 中国胸心血管外科临床杂志

@#Objective To summarize and analyze the preliminary clinical outcomes of the KokaclipTM transcatheter edge-to-edge mitral valve repair system for severe degenerative mitral regurgitation (DMR). Methods This study was a single-arm, prospective, single-group target value clinical trial that enrolled patients who underwent the KokaclipTM transcatheter edge-to-edge repair (TEER) system for DMR in the Department of Heart Surgery of Guangdong Provincial People's Hospital, Guangdong Cardiovascular Institute from June 2022 to January 2023. Differences in the grade of mitral regurgitation (MR) during the perioperative and follow-up periods were compared, and the incidences of adverse events such as all-cause death, thoracotomy conversion, reoperation, and severe recurrence of MR during the study period were investigated. Results The enrolled patient population consisted of 14 (50.0%) females with a mean age of 70.9±5.4 years. Twenty-eight (100.0%) patients were preoperatively diagnosed with typeⅡ DMR, with a prolapse width of 12.5 (11.0, 16.1) mm, a degree of regurgitation 4+ leading to pulmonary venous reflux, and a New York Heart Association cardiac function class≥Ⅲ. All patients completed the TEER procedure successfully, with immediate postoperative improvement of MR to 0, 1+, and 2+ grade in 2 (7.1%), 21 (75.0%), and 5 (17.9%) patients, respectively. Mitral valve gradient was 2.5 (2.0, 3.0) mm Hg. Deaths, thoracotomy conversion, or device complications such as unileaflet clamping, clip dislodgement, or leaflet injury were negative. Twenty-eight (100.0%) patients completed at least 3-month postoperative follow-up with a median follow-up time of 5.9 (3.6, 6.8) months, during which patients had a mean MR grade of 1.0+ (1.0+, 2.0+) grade and a significant improvement from preoperative values (P<0.001). There was no recurrence of ≥3+ regurgitation, pulmonary venous reflux, reoperation, new-onset mitral stenosis, or major adverse cardiovascular events. Twenty-two (78.6%) patients’ cardiac function improved to classⅠorⅡ. Conclusion The domestic KokaclipTM TEER system has shown excellent preliminary clinical results in selected DMR patients with a high safety profile and significant improvement in MR. Additional large sample volume, prospective, multicenter studies, and long-term follow-up are expected to validate the effectiveness of this system in the future.

Advances in Head-and-Neck Interventional Radiotherapy (Brachytherapy)

@#Interventional radiotherapy, also known as brachytherapy, is the use of sealed radioactive sources that directly deliver radiation to the tumor or tumor bed. Its unique dose distribution profile allows for high conformality, making it a very useful modality in the treatment of cancers in the head and neck, where different organs and substructures that serve various but related functions are situated close to each other. In recent years, we have seen several important technological breakthroughs in the field, especially regarding its application in head and neck cancers. These include advances in treatment delivery, dosimetry planning , image guidance , and catheter positioning techniques . These innovations, which often require interdisciplinary interventions, have resulted in enhanced treatment accuracy, and therefore, major clinical advantages in terms of increased local control and decreased toxicity, as well as economic benefits. In order to highlight the differences from old brachytherapy techniques, a more appropriate terminology should perhaps be adopted, to signify these advancements that resulted in new opportunities, approaches and better outcomes – interventional radiotherapy (IRT). Such a change in terminology will not only allow recognition of these advances, but also a meaningful distinction from obsolete techniques and suboptimal outcomes that are associated with traditional brachytherapy. This is very important in increasing awareness among professionals outside the field of radiation oncology. We briefly review these recent advances, the current indications, and future directions for IRT in head-and-neck cancers.

Effect of ultrasound-guided intraparathyroid injection of vitamin D3 on calcium-phosphorus metabolism and muscle function of patients with hyperparathyroidism associated with Vitamin D deficiency and(or)insufficiency / 中国医学装备

Objective:To explore the effect of intraparathyroid injection of 1,25 bishydroxyvitamin D3[1,25(OH)2D3]under the guidance of B-mode ultrasound on calcium-phosphorus metabolism and muscle function of patients with hyperparathyroidism associated with vitamin D deficiency and(or)insufficiency.Methods:A total of 60 patients with hyperparathyroidism associated with vitamin D deficiency and(or)insufficiency who were diagnosed at the 904th hospital of People's Liberation Army Joint Service Support Force from January 2020 to June 2022 were selected,and they were divided into observation group and control group according to random number table,with 30 cases in each group.Patients in the observation group received intraparathyroid injection of 1,25(OH)2D3,and those in the control group received oral 1,25(OH)2D3.Before and after 2 weeks of treatment,the characteristics of ultrasound images of two groups were observed,and the calcium-phosphorus level,parathyroid hormone(PTH),alkaline phosphatase(ALP),25 hydroxyvitamin D(25 OHD),1,25(OH)2D3,and urinary calcium(UCa)and urinary phosphorus(UP)at 24h of them were detected.In addition,the skeletal muscle strengths and functions of the two groups were measured.Results:Before treatment,ultrasound images showed the dorsal side of the inferior pole of left lobe of thyroid gland were hypoechoic lesion,and they appeared uniform high enhancement at the arterial phase.After treatment,there was no significant enhancement in the arterial phase of the lesion,which appeared"cavity".The blood calcium levels[(2.06±0.11)mmol/L and(2.21±0.12)mmol/L]of observation group and control group after treatment were significantly higher than those[(1.92±0.02)mmol/L and(1.93±0.03)mmol/L]before treatment,while the blood phosphorus levels[(0.92±0.11)mmol/L and(1.11±0.07)mmol/L]of them after treatment were significantly lower than those[(1.24±0.02)mmol/L and(1.25±0.03)mmol/L]before treatment,and the differences were significant(t=6.859,12.399,15.677,10.069,P<0.05),respectively.Both blood calcium level and blood phosphorus level after treatment of observation group were significantly lower than those of control group,and the differences were statistically significant(t=5.047,7.982,P<0.05),respectively.The PTH and ALP levels of two groups after treatment were significantly lower than those before treatment,and the PTH and ALP levels after treatment of observation group were significantly lower than those of control group,and the differences were statistically significant(t=28.125,12.605,P<0.05),respectively.The blood 25OHD,1,25(OH)2D3 and UCa level at 24 h of two groups after treatment were significantly higher than those before treatment,while the UP level at 24-hour after treatment was lower than that before treatment.The blood 25OHD,1,25(OH)2D3 and UCa at 24 h after treatment in observation group were significantly higher than those in control group,while the UP level at 24h after treatment in observation group was significantly lower than that in control group,with statistical significance(t=9.6763,5.269,45.086,3.387,P<0.05),respectively.The bone density values of L1-4 and femoral neck of two groups after treatment were significantly higher than those before treatment,and the bone density values of L1-4 and femoral neck after treatment in observation group were significantly higher than those in control group,with statistical significance(t=26.944,2.355,P<0.05).The grip strength and walking speed of the skeletal muscles of two groups after treatment were significantly higher than those before treatment,and the above indicators after treatment in the observation group were significantly higher than those in the control group,with statistical significance(t=2.711,3.093,P<0.05),respectively.Conclusion:There will be calcification in the gland of patient with hyperparathyroidism associated with vitamin D deficiency and(or)insufficiency,whose ultrasound appearance is strong echo with different shapes.B-mode ultrasound-guided intraparathyroid injection of 1,25(OH)2D3 can reduce the incidence of fracture.

Clinical application of magnetic resonance imaging-guided radiation therapy in the treatment of pancreatic cancer / 中华放射肿瘤学杂志

At present, pancreatic cancer is a solid tumor with the worst prognosis. Compared with surgery and chemotherapy, radiotherapy plays an auxiliary role in the treatment of pancreatic cancer. In recent years, significant advances have been achieved in radiotherapy technology, which have been gradually applied in the diagnosis and treatment of pancreatic cancer. In this article, the progress in radiation therapy in the treatment of pancreatic cancer was reviewed, especially the clinical application of magnetic resonance imaging-guided radiation therapy in the treatment of pancreatic cancer, aiming to deepen the understand of the progress in radiation therapy for pancreatic cancer, and providing reference for improving the survival rate of pancreatic cancer patients.

Application value of ultrasound-guided unilateral subarachnoid block with bupivacaine in hip replacement surgery for elderly patients with femoral neck fractures / 中国现代医生

@#Objective To explore the application value of ultrasound-guided use of bupivacaine for subarachnoid block in hip replacement surgery for elderly femoral neck fractures.Methods A total of 108 elderly patients who underwent hip replacement surgery at Ganzhou Traditional Chinese Medicine Hospital from March 2020 to March 2022 were selected as the study subjects.They were divided into conventional anesthesia group and ultrasound guided anesthesia group by means of random number table,54 cases in each group.Patients in the conventional anesthesia group received routine general anesthesia;Patients in the ultrasound guided anesthesia group received unilateral lumbar anesthesia with bupivacaine under ultrasound-guided guidance.Compare the effectiveness of two anesthesia methods during surgery.Results Compared with the conventional anesthesia group,the anesthesia effect of the ultrasound guided anesthesia group was better(P<0.05);The surgery time,amount of bleeding during surgery,postoperative recovery time,and length of hospital stay in the ultrasound guided anesthesia group were all lower than those in the conventional anesthesia group(P<0.05).The ultrasound guided anesthesia group performed better in terms of hemodynamic stability,with a smaller range of changes,and significantly lower pain scores at different postoperative time points compared to the conventional anesthesia group(P<0.05).Conclusion In elderly patients undergoing hip replacement surgery,using ultrasound-guided bupivacaine for subarachnoid block can achieve ideal anesthesia and analgesic effects compared to traditional general anesthesia,shorten drug onset time,alleviate pain in elderly patients,maintain hemodynamic stability,and have significant clinical application effects.

Correlation of bone mineral density of infants over 6 months of age with the exclusive breastfeeding and gestational calcium nutrition guidance / 公共卫生与预防医学

Objective To analyze the relationship between bone mineral density (BMD) of infants over 6 months of age and exclusive breastfeeding and calcium nutrition guidance during pregnancy in Baoding area, and to provide evidence for clinical application. Methods A total of 308 infants over 6 months of age were selected from Baoding Maternal and Child Health Hospital from January 2020 to January 2023, and their BMD was measured by ultrasound. The level of 25 (OH) D3 in subjects' blood was detected. spearman correlation test was used to analyze the correlation between infant bone mineral density and exclusive breastfeeding and calcium nutritional guidance during pregnancy, and logistics regression model was used to analyze the independent factors affecting infant bone mineral density. Results The level of serum 25 (OH) D3 in normal BMD group was significantly higher than that in abnormal BMD group (P<0.05). The rate of exclusive breastfeeding and the guidance rate of calcium nutrition during pregnancy in normal BMD group were significantly higher than those in abnormal BMD group (P<0.05). There was a significant positive correlation between different bone mineral density and exclusive breastfeeding and calcium nutrition guidance during pregnancy (P<0.05). Serum 25 (OH) D3 level, exclusive breastfeeding rate and calcium nutritional guideline rate during pregnancy were independent protective factors for bone mineral density (P<0.05). Conclusion Bone mineral density (BMD) of infants over 6 months of age is positively correlated with exclusive breastfeeding and calcium nutrition guidance during pregnancy, and exclusive breastfeeding and calcium nutrition guidance during pregnancy are independent protective factors affecting BMD of infants over 6 months of age.

A prematuridade afeta as práticas maternas brasileiras relacionadas ao posicionamento de lactentes? / Does premature birth affect Brazilian parents' practices related to infant positioning?

Abstract Objective: To verify whether the time spent in prone, supine, or seated positions differed between term and preterm infants; and to determine whether a single verbal guidance session for parents changed the time spent in different positions, and, consequently, the motor development scores, after one month in preterm infants. Methods: Sixty-one infants from a full-term and preterm group from Brazil were included. Motor development was assessed by the Alberta Infant Motor Scale (AIMS) and the parents registered the time spent in each position on a 24-hour schedule. A month after verbal guidance, a second assessment was performed only on the preterm infants. Results: The positioning times awake determined for the full-term and preterm parents were similar. Preterm infants spent more time in the prone sleeping position (2.1 vs. 0.8 h; p=0.037) than full-term infants. The AIMS percentile scores did not differ significantly between the groups. For preterm infants, the time spent in all positions did not change during the second assessment (n=18). Conclusions: The fact that some parents position their infants in the prone posture during sleeping periods reinforce the importance of parental education approaches for sudden infant death syndrome (SIDS) prevention during the first months of life. The verbal guidance provided to parents of preterm infants did not influence the AIMS percentile and time spent in various positions but increased preterm parents' confidence in placing their infants in a prone position to play.

RESUMO Objetivo: Verificar se o tempo nas posições prono, supino ou sentado difere entre lactentes a termo e pré-termo; bem como determinar se uma única sessão de orientação verbal aos pais alterou o tempo despendido nas diferentes posições e, consequentemente, o escore de desenvolvimento motor, após um mês em lactentes pré-termo. Métodos: Foram incluídos 61 lactentes brasileiros nos grupos a termo e pré-termo. O desenvolvimento motor foi avaliado pela Alberta Infant Motor Scale (AIMS), e os pais registraram o tempo despendido em cada posição em uma linha do tempo de 24 horas. Um mês após a orientação verbal, uma segunda avaliação foi realizada apenas nos lactentes pré-termo. Resultados: O tempo de posicionamento acordado determinado pelos pais de lactentes a termo e pré-termo foi semelhante. Os lactentes pré-termo passaram mais tempo dormindo na posição prona (2,2 vs. 0,8 h; p=0,037) do que os lactentes a termo. Os escores de percentil AIMS não diferiram significativamente entre os grupos. Para lactentes pré-termo, o tempo despendido em todas as posições não se modificou durante a segunda avaliação (n=18). Conclusões: O fato de alguns pais posicionarem os lactentes em decúbito ventral durante os períodos de sono reforça a importância das abordagens educativas parentais para a prevenção da síndrome da morte súbita do lactente (SMSL) durante os primeiros meses de vida. A orientação verbal fornecida aos pais de prematuros não influenciou o percentil da AIMS e o tempo de permanência em várias posições, mas aumentou a confiança dos pais de lactentes prematuros em utilizar a posição prona para brincar.

Orientación profesional vocacional hacia la carrera de Medicina en estudiantes de preuniversitario

La elección de una profesión constituye un momento crítico en la vida de los adolescentes. Es un proceso complejo en el que intervienen factores personales y sociales relacionados con la adquisición de conocimientos, habilidades, valores, así como con oportunidades laborales. Con el objetivo de estructurar los referentes teóricos sobre la orientación profesional vocacional hacia la carrera de Medicina en estudiantes de preuniversitario, se realizó una búsqueda actualizada sobre el tema, consultándose 30 referencias bibliográficas. Se abordaron aspectos generales del desarrollo de la orientación profesional-vocacional, reseñas históricas, conceptos, y etapas y desarrollo de este en Cuba hacia la carrera de Medicina. La etapa de la preparación para la selección profesional se dirige a preparar al educando para la selección profesional autodeterminada, y juega un papel fundamental dentro del sistema de influencias educativas que intervienen en el estudiante de preuniversitario, propiciando, desde la orientación profesional, el desarrollo de la motivación e interés del estudiante a niveles superiores. La formación de profesionales competentes y comprometidos con el desarrollo social constituye hoy día una misión esencial de la educación superior. Esta actividad cobra un extraordinario valor en la universidad médica actual, para asumir el compromiso social y obtener graduados con un alto nivel profesional.

Choosing a profession is a critical moment in adolescent lives. It is a complex process involving personal and social factors related to the acquisition of knowledge, skills, values, as well as job opportunities. With the aim of structuring the theoretical references on vocational professional orientation towards a career in Medicine in pre-university students, an updated search on the topic was carried out, consulting 30 bibliographic references. General aspects of the development of professional-vocational guidance, historical reviews, concepts, stages and development of this topic in Cuba towards the career of Medicine were addressed. The stage of preparation for professional selection is aimed at preparing the student for self-determined professional selection, and plays a fundamental role within the system of educational influences which impact on the pre-university student, promoting the development of student motivation and interest at higher levels through professional guidance. The training of competent professionals committed to social development is today an essential mission of higher education. This activity has extraordinary value in the current medical university, to assume social commitment and to have graduates with a high professional level.

Diagnóstico del proceso de reafirmación profesional, en la carrera de Cultura Física, en Granma

La formación de profesionales, con elevada calidad, es tarea esencial de la Educación Superior, por lo que de manera permanente se demanda de graduados comprometidos con los procesos de desarrollo, donde quedan evidenciados los conocimientos, habilidades y valores en los que se han formado. El diagnóstico tuvo como objetivo caracterizar la situación de la orientación y reafirmación profesional (consolidación de los motivos e intenciones profesionales) en el proceso de estudio de la carrera Licenciatura en Cultura Física, en Granma; a partir de tres dimensiones: pedagógica, psicológica y sociológica. Se aplicaron métodos teóricos y empíricos que mostraron insuficiencias en las acciones planificadas en las estrategias educativas y en el plan de trabajo metodológico de las diferentes disciplinas, un limitado aprovechamiento de las potencialidades del contenido y las actividades extensionistas y bajos niveles de satisfacción por el estudio de la Carrera; lo que se manifestó en la no selección de una esfera de actuación para el futuro desempeño profesional, y en los elevados niveles de deserción de los estudiantes, en los dos primeros años de formación.

A formação de profissionais, com elevada qualidade, é uma tarefa essencial do Ensino Superior, razão pela qual existe uma procura permanente de licenciados comprometidos com processos de desenvolvimento, onde se evidenciam os conhecimentos, competências e valores em que foram formados. O objetivo do diagnóstico foi caracterizar a situação de orientação e reafirmação profissional (consolidação de motivos e intenções profissionais) no processo de estudo do Bacharelado em Cultura Física, no Granma; a partir de três dimensões: pedagógica, psicológica e sociológica. a corrida; o que se manifestou na não seleção de uma esfera de atuação para futura atuação profissional, e nos elevados índices de evasão estudantil, nos dois primeiros anos de formação.

The training of professionals, with high quality, is an essential task of Higher Education, which is why there is a permanent demand for graduates committed to development processes, where the knowledge, skills and values in which they have been trained are evidenced. The objective of the diagnosis was to characterize the situation of professional guidance and reaffirmation (consolidation of professional motives and intentions) in the process of studying the Bachelor's degree in Physical Culture, in Granma; from three dimensions: pedagogical, psychological and sociological. Theoretical and empirical methods were applied that showed insufficiencies in the planned actions in the educational strategies and in the methodological work plan of the different disciplines, a limited use of the potential of the content and extension activities and low levels of satisfaction with the study of the career; which was manifested in the non-selection of a sphere of action for future professional performance, and in the high levels of student dropout, in the first two years of training.

Relevancia de la orientación profesional

La importancia de la orientación profesional implica tomar en cuenta muchos elementos a nivel de procedimientos en las pruebas psicológicas para tener un resultado objetivo en la elección de la carrera profesional. El método de investigación es cuantitativo, de tipo descriptivo porque pretende analizar la relevancia del tema. El diseño es no experimental puesto que no se manipulo ninguna variable, con un carácter transversal, ya que la información se recolecto en un tiempo determinado. La población fue los cuatro paralelos (A - B - C - D) de sexto del nivel secundario, en un total de 128 estudiantes entre varones y mujeres. Se aplicaron las baterías de: Test de Aptitudes Diferenciales (DAT), test de inteligencia (RAVEN GENERAL), cuestionario de personalidad para adolescentes (H.S.P.Q) y la escala de preferencias vocacionales (KUDER forma "E"). Los resultados describen la falta de atención del estado para proponer programas de Orientación Profesional a todos los bachilleres a nivel nacional, y con la prueba experimental se demuestra la importancia de test con pruebas psicológicas, que permiten que los estudiantes puedan reconocer sus conocimientos y capacidades intelectuales para elegir una carrera acorde a sus probabilidades psicológicas, del entorno educativo y social, con el apoyo y participación de los profesores/as al brindar un espacio y tiempo determinado para los estudiantes de sexto de secundaria, y de los padres de familia para que puedan apoyar a sus hijos a realizarse en una profesión científica o técnica de acuerdo a su formación y conocimientos.

The importance of professional guidance implies taking into account many elements at the level of procedures in psychological tests to have an objective result in choosing a professional career. The research method is quantitative, of a descriptive type because it intends to analyze the relevance of the topic. The design is non-experimental since no variable was manipulated, with a transversal character, since the information was collected in a determined time. The population was the four parallels (A - B - C - D) of the sixth grade of the secondary level, in a total of 128 students between men and women. The batteries of: Differential Aptitudes Test (DAT), intelligence test (RAVEN GENERAL), personality questionnaire for adolescents (H.S.P.Q) and the scale of vocational preferences (KUDER form "E") were applied. The results describe the lack of attention of the state to propose Vocational Guidance programs to all high school graduates at the national level, and with the experimental test the importance of psychological tests is demonstrated, which allow students to recognize their knowledge and intellectual abilities. to choose a career according to their psychological probabilities, the educational and social environment, with the support and participation of teachers by providing a specific space and time for students in the sixth grade of secondary school, and of parents so that they can support their their children to perform in a scientific or technical profession according to their training and knowledge.

A importância da orientação profissional implica ter em conta muitos elementos ao nível dos procedimentos em testes psicológicos para ter um resultado objetivo na escolha de uma carreira profissional. O método de pesquisa é quantitativo, do tipo descritivo, pois pretende analisar a relevância do tema. O delineamento é não experimental já que nenhuma variável foi manipulada, com caráter transversal, já que as informações foram coletadas em um tempo determinado. A população foram os quatro paralelos (A - B - C - D) da sexta série do ensino médio, em um total de 128 alunos entre homens e mulheres. Foram aplicadas as baterias de: Teste Diferencial de Aptidões (DAT), teste de inteligência (RAVEN GENERAL), questionário de personalidade para adolescentes (H.S.P.Q) e escala de preferências vocacionais (KUDER forma "E"). Os resultados descrevem a falta de atenção do estado em propor programas de Orientação Profissional a todos os egressos do ensino médio em nível nacional, e com o teste experimental é demonstrada a importância dos testes psicológicos, que permitem aos alunos reconhecer seus conhecimentos e habilidades intelectuais. escolher uma carreira de acordo com suas probabilidades psicológicas, o ambiente educacional e social, com o apoio e participação dos professores ao fornecer um espaço e tempo específico para os alunos da sexta série do ensino médio e dos pais para que eles possam apoiar seus filhos exercer uma profissão científica ou técnica de acordo com a sua formação e conhecimentos.

Career Adapt-Abilities Scale (CAAS-Brasil): propriedades psicométricas, diferenças em função de variáveis sociodemográficas e padrões normativos / Career Adapt-Abilities Scale (CAAS-Brazil): psychometric properties, differences as a function of sociodemographic variables and normative standards / Career Adapt-Abilities Scale (CAAS-Brasil): propiedades psicométricas, diferencias en función de variables sociodemográficas y estándares normativos

O objetivo deste artigo foi propor padrões normativos para a Career Adapt-Abilities Scale (CAAS-Brasil) considerando diferenças em função das variáveis sociodemográficas: sexo, estado civil, faixa etária, escolaridade e faixa de rendimento. A amostra foi composta por 2.999 indivíduos, idades variando de 14 a 77 anos, maioria do sexo feminino (63%) e representantes de 21 estados brasileiros. As propriedades psicométricas da CAAS-Brasil foram investigadas por meio de Teoria de Resposta ao Item e coeficiente ômega. Os resultados evidenciaram invariância para a CAAS-Brasil e maiores diferenças de médias nas variáveis faixa etária, escolaridade e faixa de rendimento. A partir disso, foram apresentados padrões normativos para a amostra geral e dividida, considerando as variáveis que apresentaram diferenças. Os padrões normativos apresentados neste artigo possibilitarão que profissionais de orientação profissional e de carreira interpretem, com base em normas, os escores de adaptabilidade de carreira de seus orientandos, tornando a avaliação mais substantiva. (AU)

This article aimed to propose normative standards for the Career Adapt-Abilities Scale (CAAS-Brazil) considering differences in terms of sociodemographic variables: gender, marital status, age group, education level, and income. The sample consisted of 2999 individuals, within the age range of 14 to 77 years, mostly women (63%) from 21 Brazilian states. The psychometric properties of CAAS-Brazil were investigated using Item Response Theory and the Omega coefficient. Results showed invariance for the CAAS-Brazil and greater mean differences in the variables age group, education, and income. From this, normative standards for the overall sample were presented and divided considering the variables that showed differences. The normative standards presented in this article will enable career guidance professionals to interpret the career adaptability scores of their students, making the assessment more robust. (AU)

El objetivo de este artículo fue proponer estándares normativos para la Career Adapt-Abilities Scale (CAAS-Brasil) considerando diferencias en términos de variables sociodemográficas: género, estado civil, grupo de edad, escolaridad y rango de ingresos. La muestra estuvo constituida por 2.999 individuos, con edades comprendidas entre 14 y 77 años, en su mayoría mujeres (63%) y representantes de 21 estados brasileños. Las propiedades psicométricas de CAAS-Brasil se investigaron mediante la Teoría de Respuesta al Ítem y el coeficiente Omega. Los resultados mostraron invarianza para el CAAS-Brasil y mayores diferencias de medias en las variables edad, escolaridad e ingresos. A partir de esto, se presentaron estándares normativos para la muestra general y se dividieron considerando las variables que manifestaron diferencias. Los estándares normativos presentados en este artículo permitirán a los profesionales de la orientación profesional interpretar y la orientación interpretar, basándose en normas, las puntuaciones de adaptabilidad profesional de sus alumnos, haciendo que la evaluación sea más sustantiva. (AU)