Has the time to reinstate elective orthopedic procedures come?

BackgroundThe coronavirus pandemic changed how we manage and operate patients in orthopaedic practice. Although elective orthopaedic procedures were halted to prevent spread of the disease as well as sustain supplies of essential protective equipment and healthcare workers, trauma services were continued. We studied the orthopaedic trauma cases operated over 6 months of the pandemic, and discuss the protocols used to minimize disease spread.MethodsData was collected for all orthopaedic emergency cases operated at our centre from 1 st March – 10 th August 2020. During this time specific protocols were used for first aid, pre-operative care, inside the operation theatre, post-operative stay as well as for follow ups.ResultsA total of 851 patients were operated. A sharp decline in surgeries was seen during the lockdown. Average stay in the hospital was 4 days. Only 44% of the patients came for follow-up visits. None of the contacted patients or their relatives developed symptoms or tested positive for COVID after discharge.ConclusionMultiple waves and various mutant strains of COVID-19 have made this pandemic longer than expected. Elective orthopaedic cases cannot be ignored for forever, as it leads to poor quality of life and an increasing burden of such patients. We suggest, that using the protocols used at our centre, we have successfully operated on cases without risking spread of the virus. Thus, we believe it’s time to reinstate elective orthopaedic procedures, in a phased manner.     

术中及术后放疗对骨巨细胞瘤治疗的临床研究

目的：研究术中和术后放疗对骨巨细胞瘤的疗效。方法：采取手术切除结合术中和术后放疗治疗14例骨巨细胞瘤患者，平均随访24．2个月，其结果与采用单纯手术治疗的患者进行比较分析。同时将采取的骨巨细胞瘤的细胞株进行实验室的培养后通过放疗后检验该方法对该细胞株的杀伤作用。结果：采用该方法对患者伤口的愈合，症状改善及功能的恢复方面结果与传统的单纯手术的方法相似，而在术后复发、转移和恶变方面有着更为明显的疗效。结论：手术切除病灶结合术中和术后放疗治疗骨巨细胞瘤有着较为理想的疗效，是一种值得相信的治疗方法。     

纤维乳管镜治疗急性乳腺炎临床分析

目的:探讨应用纤维乳管镜治疗哺乳期急性乳腺炎的临床价值。方法:将31例哺乳期急性乳腺炎患者随机分为纤维乳管镜治疗组19例和对照组12例。纤维乳管镜治疗组患者应用纤维乳管镜行乳管灌洗治疗,对照组患者进行常规理疗和抗生素治疗。结果:以治疗24 h为观察时间点,将患者乳房包块消失,体温恢复正常作为治疗有效的标准。纤维乳管镜组19例患者中有15例患者达到上述标准,达标率为79.0%,对照组12例患者中达标4例,达标率为33.0%,组间比较,差异具有统计学意义(P<0.05)。结论:纤维乳管镜可作为哺乳期急性乳腺炎患者的有效治疗措施,在临床上广泛应用。     

监护仪应用于569例骨科手术患者的护理效果分析

目的探讨监护仪应用于骨科手术中病人的护理体会。方法入选我院骨科2005年1月至2013年1月手术中应用心电监护仪的569例患者做为观察组,与同期应用传统血压计和听诊器等监测的560例骨科手术患者进行比较。对比两组患者术中各项生命体征的变化情况、护理时间和不良反应等。结果观察组术中2h和4h生命体征较对照组平稳．差异均具有统计学意义（均P〈0．05）;观察组用于生命体征监测的护理时间显著低于对照组,因未及时观测到生命体征而产生的不良反应率也显著低于对照组,差异均具有统计学意义（均P〈0．05）。结论监护仪应用于骨科手术病人中可直观、动态且持续地观察到生命体征．随时了解病情变化,缩短护理时间和减少不良反应。     

Changes in (poly)phenols intake and metabolic syndrome risk over ten years from adolescence to adulthood

Background and aims(Poly)phenols might contribute to prevent cardiovascular disease, but limited prospective studies exist among adolescents. This study aimed to evaluate within-subject longitudinal changes in (poly)phenols intakes and food group contributors while also exploring the association with metabolic syndrome risk (MetS) during 10 years of follow up in European adolescents becoming young adults.Methods and resultsIn 164 participants (58% girls, 13-18 y at baseline) from Ghent, Zaragoza and Lille, longitudinal data (2006–2016) on (poly)phenol intake was retrieved via 2 or 3 24 h recalls. Linear and logistic longitudinal regression tested the association of (poly)phenols intake (total and classes) with Mets risk or its components (waist-height-ratio, HDL cholesterol, LDL cholesterol, triglycerides, blood pressure and insulin resistance index), adjusted for age, sex, country and other nutrient intakes. The total (poly)phenols intake was 421 ± 107 mg/day (192 mg/1000 kcal/day) at baseline, while 610 ± 101 mg/day (311 mg/1000 kcal/day) at follow-up. The three major food sources for (poly)phenols were ‘chocolate’, ‘fruit and vegetable juices’, ‘cakes and biscuits’ during adolescence and ‘coffee’, ‘tea’ and ‘chocolate’ during adulthood. Phenolic acid intake was associated with less LDL increase over time, while stilbene intake with a steeper increase in triglycerides over time.ConclusionsDifferences in major (poly)phenols contributors over time were partially explained by age-specific dietary changes like increased coffee and tea during adulthood. Some significant (poly)phenols-MetS associations might argue for nutrition-based disease prevention during adolescence, especially since adolescents had low (poly)phenols intake.     

Effect of aging on treadmill exercise induced theta power in the rat

The effects of aging on the electroencephalogram (EEG) power spectra of 8- and 60-week-old Wistar–Kyoto rats were examined during the waking baseline and treadmill exercise. Using continuous and simultaneous recordings of EEG and electromyogram signals, this study demonstrated that the alpha (10–13 Hz), theta (6–10 Hz), and delta (0.5–4 Hz) powers of the EEG were significantly lower in older rats as compared with young rats during the waking baseline. In the young rats, treadmill exercise resulted promptly in a higher alpha power, higher theta power, and higher theta power percentage as compared with the waking baseline. In the aged rats, treadmill exercise only resulted in a higher theta power and higher theta power percentage. During the treadmill exercise, however, the aged rats still showed a significantly lower exercise-evoked theta power change than the young rats. These results suggested that aging is accompanied by lower EEG activities during waking and this also is accompanied by an attenuated response of the brain to exercise in the rat.     

复合心理疏导在全麻苏醒期患者中的应用研究

目的 探讨手术患者的临床心理干预模式,探索音乐疗法在临床应用中的价值,并开创新的应用领域.方法 60例患者分为实验组与对照组,2组患者于手术前1 d均接受术前心理干预,手术后,实验组患者在全麻苏醒期给予复合心理疏导,对照组患者术后只进行单纯音乐唤醒.对2组患者的心率、脉搏血氧饱和度、平均动脉压及汉密顿焦虑量表(HAMA)客观指标进行评价.结果 实验组与对照组的MAP分别为(79.80±7.76).(82.33±6.42)mm Hg(1 mm Hg=0.133 kPa)、SpO2差异无统计学意义(P＞0.05),HR分别为(80.76 ±13.92),(85.82±13.39)次/min,差异有统计学意义(P＜0.05).实验组焦虑程度(9.78±2.32)分明显低于对照组(11.08±2.97)分,差异有统计学意义(P＜0.01).结论 复合心理疏导是将术前心理干预、术后音乐唤醒,患者意识逐步恢复过程中音乐辅助下实施心理指导相结合,是对全麻患者进行全程、及时、个体化、针对性的帮助和心理指导,对减轻患者焦虑程度具有积极作用.     

军人急性心理应激反应的影响因素研究

目的 探讨战场应激源与战时急性心理应激反应之间存在的中介因素及其对军人战时心理应激反应的影响.方法 用心理测验法和试验法调查683名被试的心理中介因素和急性心理应激反应情况.结果 心理健康军人的应激反应总分[(59.21±5.42)分,(54.85±7.92)分,P=0.049]和情绪反应分量表[(17.21±1.36)分,(14.15±2.71)分,P=0.048]得分显著高于心理异常军人;心理健康并表现出积极心理应激反应军人的一些人格特征(H8、Pt、Sc、Si、Mas、Dy、Do、Re)明显比消极应激反应军人健全、消极应对(Nc)得分显著低于消极应激反应军人(t=2.148.P=0.035)、自我效能[(108.63±20.31)分,(94.65±17.10)分,P=0.001]和战争认知[(54.37±4.45)分,(50.95±6.06)分,P=0.005]显著高于消极应激反应军人;在影响急性应激反应诸因素中,人格的情绪稳定性(Pt、Mas)和战争认知进入回归方程.结论 证实了在战场应激源与急性应激心理反应之间存在心理健康、人格特征、自我效能、应对方式、战争认知5个中介因素,其中人格的情绪稳定性和战场认知是最核心的影响因素.     

椎动脉型颈椎病经颅多普勒检测与临床分析

目的：探讨椎动脉型颈椎病发作间歇期经颅多普勒（TCD）检测结果与临床关系。方法：2010年1月～2011年1月在开封市第一人民医院体检科进行健康体检时行TCD检测2799人中发现椎动脉型颈椎病患者468例,排除如高血压、糖尿病、脑动脉硬化、出血性及缺血性脑血管病、前日饮酒等可致脑血管收缩期血流速度改变的因素,选取418例作为研究对象,同时按照年龄分层抽取同期行TCD检测的健康者356例作为对照组。使用SPSS16.0软件包对TCD检测结果进行统计学处理。结果：观察组418例中,颈内动脉系统收缩期血流速度异常者131例;椎动脉（VA）收缩期血流速度异常者386例、基底动脉（BA）收缩期血流速度异常者356例。由统计学分析可知,在去除年龄因素后,男、女椎动脉型颈椎病患病均与椎动脉、基底动脉TCD检测异常有关,女性患者发生VA异常的优势比高于男性患者;女性患者发生BA异常的优势比高于男性患者。结论：TCD检测可作为椎动脉型颈椎病的辅助检查手段,在椎动脉型颈椎病的鉴别诊断及健康管理中发挥作用。     

护理干预对MP妊高症检测仪预测阳性的效果观察

目的:通过对采用MP妊高症检测仪进行桡动脉脉搏波预测妊高症阳性孕妇的护理干预,观察预测妊高症阳性的改善效果。方法:抽取2006年1月至2006年8月在我院作产检的孕妇120例,将体重偏重、下肢轻微水肿、测量血压接近120/80mmHg的孕妇进行MP妊高症预测阳性的32例为基线组;预测阴性的68例分为观察组。对基线组进行护理干预后复查MP妊高症预测(2~4周一次);对观察组则定期测量血压、体重和检查下肢水肿情况,观察MP复查,发现预测阳性也及时给予护理干预,观察其效果。结果:基线组:在给以护理干预后复查MP明显转为阴性和MP预测各项指标均呈下降趋势的29例,有效率90.6%,(P<0.5);观察组:MP妊高症预测阳性的36例,且都在孕晚期出现了体重异常增加(2周增加体重≥2kg)和下肢水肿,并及时给予护理干预,复查MP预测明显好转的26例,有效率72.2%。结论:使用MP妊高征检测系统可预测妊高征发生的可能,而且尽早地给予健康宣教和生活指导,能够有效地降低MP妊高征预测阳性的各项指标,对妊高症的发病有明显的预防作用。且MP妊高症检测仪监测方法简单,无创,耗时短。