投入:工作倦怠研究的新视角

目的 对工作投入的相关研究进行综述.方法 文献整理法.结果 投入是雇员持续的、积极的情感激活状态,其特征为活力、奉献和专注;国外关于投入的测量方法主要有两种;倦怠和投入是可以相互区分的两个心理学概念.结论 投入是倦怠未来研究的新方向,应当对工作投入问题加以关注.     

耳廓软骨膜炎1例

1 临床资料患者女,19岁.主因"左耳水肿红斑3 d"于2007年10月9日来空军总医院门诊就诊.患者3 d前无明显诱因自觉左耳烧灼、痒痛,次日晨耳前上部位突然高度水肿、胀痛难忍,自服"扑尔敏"、外用"肤轻松",症状不能缓解,为进一步治疗来我院就诊.患者病程中无发热,精神饮食睡眠均正常.既往及家族史无特殊.体格检查;系统检查未见异常.皮肤科检查:左耳廓前部红肿,触之坚硬,压痛明显,表面无破溃、渗出糜烂,耳垂正常.     

疣状皮肤结核1例

1 临床资料患者, 女性, 11岁.右膝斑块7年就诊.7年前无诱因患者右膝部出现豆粒大小红色丘疹, 圆形, 边界清楚, 表面无鳞屑, 无水疱、 大疱, 无出血、渗出、溃破, 自觉微痒, 当时未介意.此后皮损渐增至鸡蛋大小, 偶感瘙痒, 无其他任何不适, 按"湿疹"在多家医院诊治, 皮损从未消退.     

应用Microsoft Excel软件进行《组织学与胚胎学》考卷组织的体会

考试是教学活动中的一个重要环节,目前考试成绩仍然是衡量教学质量最常用的指标,而考卷的质量直接影响到学生的考试成绩。为了更好地组织出符合教学大纲要求,既能涵盖《组织学与胚胎学》主要内容,又能够有一定区分度的试卷,我们将Microsoft Excel软件应用到其中,具体体会报道如下。     

有限自制力的理论假设及相关研究

自我控制与理性和谐的生活秩序息息相关。近十年来关于自我控制的研究表明．自制力类似于肌肉的力量，是有限而易消耗的，休息后能自动恢复；为了克服有限的资源与无限的需要的矛盾．个体倾向于有选择地使用宝贵的自制力资源；通过预期、启动等途径能在一定程度上降低自制力消耗的效应．通过锻炼能够有效地提升自制力的强度。未来的研究最重要的是找到直接测量自制力资源的途径．确立有限自制力理论的说服力。     

大学生消费心理及消费行为的调查与分析

目的 探讨大学生的实际消费心理及消费行为并进行分析.方法 采用问卷调查的方法,并结合一定量的访谈.结果 绝大多数大学生具有健康的消费心理,只有5%左右的大学生具有病态的消费心理,但却有约20%的大学生对消费意义的认知不清.结论 大学生的消费心理及消费行为应受到关注,学校应加强这方面的教育.     

疫苗接种网上交流虚拟社区平台的搭建

伴随着互联网技术的飞速发展,特别是Web2.0技术的出现,给众多网站带来了新的活力.这些网站更加的注重与用户的交互性,让用户也成为了网上信息的提供者,网上虚拟社区也如雨后春笋迅速发展.本文着重介绍了疫苗接种网上虚拟社区的建设,这种专注于特定领域的虚拟社区,将吸引想从该网站--疫苗接种大众资讯网获取各种疫苗接种信息的专业与非专业人士,在这里可以充分的与他人在这个虚拟的环境里尽情交流疫苗接种知识.     

骨科创伤病人引发血栓的治疗

目的 通过研究骨科创伤患者引发的血栓栓塞及肺动脉栓塞,以探讨对其发病机制、临床特征、高危因素及病死率的早期治疗及预防.方法 统计自2000年2月～2006年1月的骨科创伤患者,合并血栓栓塞及肺动脉栓塞共18例(960人).进行临床资料回顾性研究分析.结果 血栓栓塞占骨科创伤病人并发症的2.76%.肺动脉栓塞占血栓栓塞的10.02%(3人).且全部死亡.其中年龄大于50岁,合并腰椎、骨盆或下肢外伤的病例占所有血栓栓塞病例的56.31%(11人).结论 年龄大于50岁,肥胖病合并腰椎、骨盆或下肢外伤,合并心血管病患,长期制动的患者,引发血栓栓塞发病率明显增高.病人可因下床,排便,咳嗽等而突然导致肺动脉栓塞死亡.诊治和预防血栓栓塞应引起骨科医生的高度重视.     

乙肝病毒血清标记物与血清HBV-DNA的关系

目的:探讨不同乙肝感染模式的患者与HBV-DNA定量结果进行对比分析.方法:采用ELISA方法检测乙肝病毒血清标记物, 荧光定量PCR (FQ-PCR) 检测HBV-DNA, 比较二者之间的关系.结果:HBsAg、 HBeAg、 HBcAb阳性组和HBsAg、 HBeAg阳性组 HBV-DNA检出率较高, 分别为96.61%和100%.HBsAg、 HBeAg、 HBcAb阳性组HBV-DNA含量平均水平为3.86×108, HBsAg、 HBeAg阳性组HBV-DNA含量平均水平为1.73×108;HBsAg、 HBeAb、 HBcAb阳性组和HBsAg、 HBcAb阳性组检出率也较高, 达45% 以上, HBV-DNA含量平均水平分别为1.30×107和1.31×106.结论:FQ-PCR检测HBVDNA能准确地反映体内的HBV真实感染和复制情况, 在乙肝的诊断和治疗中, 不能单凭两对半的检测, 同时应做HBV-DNA的定量测定.     

中药饮片质量管理的体会

目的 探讨影响中药饮片质量的因素以及保证质量的方法.方法 对本院常用中药饮片进行分析,总结其特性.结果 由于标准的不统一,产地和加工的不同,使同一种饮片质量会产生较大的差异.结论 要从立法、标准的制定、生产和加工各个环节入手.才能确保饮片的质量.     

无症状成人颈胸交界区脊柱矢状面参数的相关性

背景:颈胸交界区脊柱矢状面平衡不仅与全脊柱矢状面平衡相关,还与颈椎矢状面平衡相关。目的:探讨无症状成人颈胸交界区脊柱矢状面参数的相关性。方法:选择2017年1月至2018年12月在河北医科大学第二医院体检中心行健康体检且无颈椎病相关临床症状者120名,年龄23-79岁,根据年龄分为21-40岁组、41-60岁组、61-80岁组,每组40名,均拍摄颈椎侧位DR影像,测量下面影像学参数:C2-C7矢状面轴向垂直距离、头部重心到C7椎体矢状面轴向垂直距离、胸廓入口角、颈倾角、T1倾斜角、颅倾角。结果与结论:①3组间C2-C7矢状面轴向垂直距离、头部重心到C7椎体矢状面轴向垂直距离、胸廓入口角、颈倾角、T1倾斜角、颅倾角比较差异均有显著性意义(P<0.05),并且组间两两比较差异亦有显著性意义(P<0.05);胸廓入口角、颈倾角、T1倾斜角随着年龄的增大而增大;②相关性分析显示胸廓入口角、颈倾角、T1倾斜角与年龄呈正相关(r=0.622,r=0.439,r=0.533,P均<0.001);胸廓入口角与T1倾斜角呈正相关(r=0.569,P<0.001);胸廓入口角、T1倾斜角均与C2-C7矢状面轴向垂直距离呈负相关(r=-0.725,r=-0.352,P均<0.001);③结果表明,无症状成人胸廓入口角、颈倾角、颅倾角、T1倾斜角呈随年龄增大而增大的趋势,且胸廓入口角、颈倾角、T1倾斜角与年龄呈正相关。     

脊柱-骨盆矢状面平衡及其在脊柱疾病治疗中的作用

背景：相关临床研究显示,脊柱相关退行性疾病患者的脊柱-骨盆矢状面平衡参数均有不同程度的特征性变化。 目的：探讨脊柱-骨盆矢状面平衡及其在脊柱疾病治疗中的作用。 方法：分析脊柱-骨盆矢状面平衡的测量参数与测量方法及在成人脊柱疾病诊治中的量化及重要参数,以及各参数与生存质量之间的关系,评价脊柱疾病矫治后效果及脊柱-骨盆矢状面平衡在脊柱疾病治疗中的作用。 结果与结论：脊柱矢状面形态与骨盆参数密切相关,脊柱矢状面曲线分型也采用骨盆参数,骨盆矢状面参数与脊柱矢状面参数存在明显的统计学的相关性,脊柱-骨盆矢状面平衡参数是评价脊柱疾病及治疗预后的重要指标,评价脊柱-骨盆矢状面平衡变化时应包括对骨盆和脊柱形态等参数的研究。     

骨盆入射角和腰椎前凸角失匹配机体矢状面平衡代偿机制研究进展

目的 探讨骨盆入射角(PI)和腰椎前凸角(LL)失匹配时,机体维持矢状面平衡的代偿机制的研究进展。方法 在中国知网、万方数据、PubMed、Cochrane Library、Web of Science等数据库,以“骨盆入射角”“腰椎前凸角”“矢状面平衡”“代偿机制”和“pelvic incidence”“ lumbar lordosis”“sagittal balance”“compensatory mechanism”为中英文关键词,查阅2000年1月—2017年10月有关PI和LL关系的研究文献,对PI与LL失匹配机体维持矢状面平衡代偿机制的研究进展进行总结。结果 脊柱-骨盆矢状面力线参数主要包括LL、PI、骨盆倾斜角(PT)、胸椎后凸角(TK)等,各参数之间存在一定的量化关系,但因种族、年龄等差异,不同群体间参数的量化关系存在差异。PI值存在性别、种族差异,适合国人的PI-LL差值的范围尚有争议。PI和LL失匹配矢状面失平衡的代偿机制主要包括胸椎段过伸代偿、骨盆后倾代偿、膝关节屈曲代偿。矢状面失平衡时,三种代偿机制相继进入代偿状态,并相互作用,共同维持机体的矢状面平衡。结论 PT和LL失匹配时脊柱、骨盆、下肢三者共同维持机体矢状面平衡。然而脊柱参数、骨盆参数及下肢参数之间的具体量化关系尚未明确。适合国人的PI-LL差值范围仍需进一步研究探讨。     

腰椎退变性后凸截骨矫形内固定后矢状面的平衡变化

BACKGROUND: At present, more and more scholars pay attention to the influence of spine and pelvis sagittal balance on the quality of life of patients. Postoperative changes in spine imaging parameters following corrective osteotomy for lumbar degenerative kyphosis have not been reported. OBJECTIVE: To evaluate postoperative changes in sagittal balance following corrective osteotomy for lumbar degenerative kyphosis. METHODS: We retrospectively analyzed 35 consecutive lumbar degenerative kyphosis patients treated with posterior osteotomy fixation in the First Affiliated Hospital of Xinjiang Medical University from February 2012 to December 2014. Imaging parameters were measured before fixation, immediately after fixation and during final follow-up. RESULTS AND CONCLUSION: (1) There were significant differences between preoperative and postoperative parameters except for pelvic incidence angle (P < 0.05). (2) There were significant differences between postoperative and last follow-up parameters except for Cobb angle, pelvic incidence angle, thoracic kyphosis angle and the thoracolumbar kyphosis (P < 0.05). (3) Pelvic tilt angle was negatively correlated with lumbar lordosis after fixation (r=-0.610, P < 0.001). Thoracic kyphosis was positively correlated with lumbar lordosis (r=0.598, P < 0.001). (4) Results suggested that lumbar sagittal contour can be significantly improved by corrective osteotomy for lumbar degenerative kyphosis. Simultaneously, reciprocal changes in the adjacent areas such as thoracic spine and pelvis occur to adapt to the new sagittal balance.      

无症状成人颈椎管狭窄年龄相关性参数的研究

目的　研究无症状成人颈椎侧位X线片上椎管狭窄相关参数与年龄的相关性及其变化规律。 方法　选取无颈椎症状成人100例,按初次检查时年龄分为3组：第1组（20~39岁）,第2组（40~59岁）,第3组（60岁以上）,分别在2011年与2017年进行标准颈椎侧位X片检查。测量椎管狭窄参数：椎管矢状径,椎体中矢径,退变椎体矢状径,颈椎管率及有效颈椎管率。分析颈椎管率及有效颈椎管率与年龄之间的相关性,比较各组所有参数两次检查结果的差异。 结果　C3~7节段颈椎管率及有效颈椎管率均与年龄之间存在负相关;各组所有参数前后两次检查结果比较：椎管矢状径仅在组3中C3节段有统计学差异;椎体中矢径仅在组2中C5节段及组3中C6节段有统计学差异;退变椎体矢状径在组1中C5节段、组2中C3~7节段及组3中C4~6节段有统计学差异;颈椎管率在组1中C5节段、组2中C3~5节段及组3中C3~7节段有统计学差异;有效颈椎管率在组1中C5节段、组2及组3中C3~7节段均有统计学差异,其余无统计学差异。 结论　成人颈椎管率及有效颈椎管率与年龄相关,其在60岁以上人群中随年龄增长变化明显;有效颈椎管率判断椎管狭窄的进展更敏感。     

Age dependent changes in cervical region of the spine according to data of nuclear magnetic tomography

Morphological characteristics of spine cervical region were studied in 132 patients (62 female and 70 male) aged 12-76 years using magnetic resonance tomography. The imaging was performed with the use of T1 and T2--weighting regimes. The study revealed sex- and age-dependent differences in the dimensions of cervical vertebrae. Height and sagittal dimensions of vertebral bodies were significantly smaller in females than in males. With advancing age the reduction in vertebral body height was more expressed in women, while the increase of vertebral body sagittal dimensions was similar in both males and females. The sagittal dimension of vertebral canal was correlated with sagittal dimension of vertebral body (r = 0.69) in males and with transverse dimension of vertebral body (r = 0.82) in females. The data obtained should be taken into consideration during evaluation of the state of bony structures of cervical vertebrae, intervertebral discs and in the diagnosis of pathological processes in the spine cervical region.     

Anterior Cervical Discectomy and Fusion Alters Whole-Spine Sagittal Alignment

Purpose

Anterior cervical discectomy and fusion (ACDF) has become a common spine procedure, however, there have been no previous studies on whole spine alignment changes after cervical fusion. Our purpose in this study was to determine whole spine sagittal alignment and pelvic alignment changes after ACDF.

Materials and Methods

Forty-eight patients who had undergone ACDF from January 2011 to December 2012 were enrolled in this study. Cervical lordosis, thoracic kyphosis, lumbar lordosis, sagittal vertical axis (SVA), and pelvic parameters were measured preoperatively and at 1, 3, 6, and 12 months postoperatively. Clinical outcomes were assessed using Visual Analog Scale (VAS) scores and Neck Disability Index (NDI) values.

Results

Forty-eight patients were grouped according to operative method (cage only, cage & plate), operative level (upper level: C3/4 & C4/5; lower level: C5/6 & C6/7), and cervical lordosis (high lordosis, low lordosis). All patients experienced significant improvements in VAS scores and NDI values after surgery. Among the radiologic parameters, pelvic tilt increased and sacral slope decreased at 12 months postoperatively. Only the high cervical lordosis group showed significantly-decreased cervical lordosis and a shortened SVA postoperatively. Correlation tests revealed that cervical lordosis was significantly correlated with SVA and that SVA was significantly correlated with pelvic tilt and sacral slope.

Conclusion

ACDF affects whole spine sagittal alignment, especially in patients with high cervical lordosis. In these patients, alteration of cervical lordosis to a normal angle shortened the SVA and resulted in reciprocal changes in pelvic tilt and sacral slope.     

Coexisting Spine Lesions on Whole Spine T2 Sagittal MRI in Evaluating Spinal Degenerative Disease

BackgroundStudies have reported on the usefulness of whole spine magnetic resonance imaging (MRI) in evaluating specific diseases such as spinal tuberculosis, spinal trauma, spondyloarthropathies, and multiple myeloma. In studies concerning degenerative spinal disease, sample sizes were small and some did not provide information on how symptomatic coexisting lesions were treated. We evaluated the types and prevalence of coexisting spine lesions found on whole spine T2 sagittal screening performed at the time of routine cervical and lumbar spine MRI and evaluated the efficacy of such screening in degenerative diseases of the cervical and lumbar spine.MethodsWe reviewed 1,757 and 2,266 consecutive cases where whole spine T2 sagittal screening had been performed with routine cervical and lumbar spine MRI, respectively, in patients with cervical and lumbar spinal degenerative diseases. Coexisting spine lesions were documented and statistical analysis was performed to investigate significant differences according to sex, age, and initial diagnosis. Electronic medical records were reviewed to determine whether additional interventions were necessary following such findings.ResultsWe reviewed 1,252 and 1,689 consecutive cases of routine cervical and lumbar spine MRI respectively, with whole spine T2 sagittal screening. Of the 1,252, 419 (33.5%) patients with cervical spinal degenerative disease had coexisting lesions in the thoracolumbar spine. Patients with ligament ossification disease of the cervical spine showed a higher prevalence of coexisting spine lesions. Sixty of the 419 (14.3%) patients with coexisting spine lesions warranted additional intervention or surgical treatment. Four hundred and eighty-one of 1,689 (28.5%) patients with lumbar degenerative disease had coexisting spine lesions in the cervicothoracic spine. Forty-eight of the 481 (10.0%) patients with coexisting spine lesions warranted additional intervention. In both patient groups, older patients showed a significantly higher prevalence of coexisting spine lesions than younger patients.ConclusionConsidering the minimal extra time and cost in performing whole spine screening, its application to routine spine MRI can be considered in evaluating cervical and lumbar spinal degenerative diseases.     

青少年特发性脊柱侧弯矢状位平衡与足底压力的相关性

目的 探讨青少年特发性脊柱侧弯（adolescent idiopathic scoliosis, AIS）矢状位平衡与足底压力之间的相关性。方法 选取40名符合标准的AIS患者。对每位患者在X线片拍摄后进行足底压力测试。矢状位参数测量包括腰椎前凸（lumbar lordosis,LL）、胸椎后凸（thoracic kyphosis,TK）、骶骨倾斜角（sacral slope,SS）、骨盆入射角（pelvic incidence,PI）、骨盆倾斜角（pelvic tilt,PT）、脊柱骶骨角（spine sacral angle,SSA）和C7矢状位垂直距离（C7 sagittal vertical axis,C7 SVA）。足底压力参数测量包括双脚前后足的接触面积和压力占比。分析矢状位参数与足底压力参数之间的相关性。结果 矢状位参数之间,LL与SS、PI、PT、SSA均有相关性;PI与SS、PT、SSA均有相关性;SS与SSA强相关;C7 SVA与SSA有相关性。在主弯侧,LL与后足及整足的接触面积呈负相关,与后足及整足的压力占比呈正相关;TK与前足压力占比呈负相关;PT与前、后足及整足接触面积均呈正相关。其他矢状位参数如SS、PI、SSA及C7 SVA与足底压力无关。在主弯对侧,矢状位参数与足底压力均无相关性。结论 在AIS中,矢状位平衡参数与足底压力分布密切相关,尤其是矢状位参数LL、TK、PT与足底压力指标最相关。