【摘要】 目的 〖JP2〗探讨护理干预对前臂游离皮瓣移植修复口腔癌围手术期软组织缺损患者的经验。 方法 2005年6月—2009年6月，对收治的63例口腔癌术后软组织缺损应用前臂桡侧游离皮瓣修复患者的围手术期护理方法进行回顾性分析，并做好术前心理护理及相关准备，术后严密观察皮瓣移植情况，以便及时发现血管危象，同时做好口腔、呼吸道、体位及皮瓣供受区护理。 结果 通过精心护理，密切观察移植皮瓣，及早发现、及时处理血管危象，从而确保63例患者皮瓣移植一次性成活率达95.24%，疗效满意。 结论 科学合理的围手术期护理是前臂游离皮瓣移植修复口腔癌术后软组织缺损成功的重要保证。【Abstract】 Objective To investigate the perioperative nursing experiences of the transplanted forearm free flaps for reconstruction of soft tissue defects after oral cancer operation. Methods We retrospectively analyzed the clinical data of perioperative nursing care for 63 patients with soft tissue defects after oral cancer reconstructed with radial forearm free flaps. Psychological care and related preparation work was well carried out before operation. After operation, we closely monitored the outcome of transplantation of skin flaps to detect vascular crisis as early as possible, and at the same time, intensive care for oral cavity, respiratory tract, flap position and the affected areas was done. Results By intensive care, closely monitoring the transplanted flaps, and early discovery and management of the vascular crisis, we achieved a satisfying one-time transplantation survival rate of 95.24% for the 63 patients. Conclusion Scientific and proper perioperative care is an important factor in the successful reconstruction of soft tissue defects with free forearm flaps after oral cancer operation.
目的:探讨液相芯片检测胰腺炎患者外周血中细胞因子浓度的可行性,及其在胰腺炎中的临床应用价值。方法: 收集90例胰腺炎患者(包括重症和轻症)和30例正常对照者的外周血,离心提取血清,利用液相芯片检测血清中细胞因子IL10,IL6,TNFα的浓度,比较不同程度炎症患者以及与对照之间细胞因子的浓度差异,分析血清中细胞因子浓度差异与临床表现之间的关系。结果:液相芯片可以方便地在仅25 μl的血清样本中同时准确检测这三种细胞因子的含量,检测的有效范围为0.10～2000 pg/mL。IL10 的浓度在对照、轻型和重型胰腺炎组中分别为51.97±31.72 pg/mL, 32.88±9.70 pg/mL和3.57±0.99 pg/mL, 轻型组与重型组间以及重型组和对照间差异有显著性(P lt; 005)。IL10在发病三天内和三天后的浓度分别为 42.47±10.15 pg/mL和12.28±5.04 pg/mL, 两者间差异有显著性(P lt; 0.01). Il6 的浓度在三天后从60.90±24.37 pg/mL下降到34.52±13.57 pg/mL,但差异没有显著性(Pgt;0.05);TNF-α的浓度在各组间没有显著差异(Pgt;0.05)。结论:液相芯片检测技术可以快速准确的检测少量血样标本中IL10,IL-6,TNFα等细胞因子的浓度,在胰腺炎患者中细胞因子IL-10的浓度与胰腺炎轻重程度以及患病时间密切相关,IL-10的浓度可以作为该病临床处理的依据和药物疗效的监测指标。
How to realize the control of limb movement and apply it to intelligent robot systems at the level of cerebellar cortical neurons is a hot topic in the fields of artificial intelligence and rehabilitation medicine. At present, the cerebellar model usually used is only for the purpose of controlling the effect, borrowing from the functional mode of the cerebellum, but it ignores the structural characteristics of the cerebellum. In fact, in addition to being used for controlling purposes, the cerebellar model should also have the interpretability of the control process and be able to analyze the consequences of cerebellar lesions. Therefore, it is necessary to establish a bionic cerebellar model which could better express the characteristics of the cerebellum. In this paper, the process that the cerebellum processes external input information and then generates control instructions at the neuron level was explored. By functionally segmenting the cerebellum into homogeneous structures, a novel bionic cerebellar motion control model incorporating all major cell types and connections was established. Simulation experiments and force feedback device control experiments show that the bionic cerebellar motion control model can achieve better control effect than the currently widely used cerebellar model articulation controller, which verifies the effectiveness of the bionic cerebellar motion control model. It has laid the foundation for real brain-like artificial intelligence control.
Objective To explore the inducing factors, the serum total immunoglobulin E (IgE) and specific IgE of bronchial asthma in Mianyang children, for better control of childhood asthma. Methods A total of 1 288 cases of asthma who were hospitalized in pediatric respiratory ward or asthma clinic from March 2013 to February 2016 were enrolled in the study. All cases complied with the diagnostic criteria for acute episode of childhood bronchial asthma revised in 2008 by the National Children’s Asthma Cooperative Group. The causes of asthma attack were asked by doctors, and the patient’s serum total IgE and specific IgE was tested. Results Respiratory tract infections were the most common cause (1 057 cases, 82.1%), which was followed by weather changes and exposure to cold air (694 cases, 53.9%), and then food (304, 23.6%). The risk of asthma induced by respiratory infections was highest in <2-year old group (358 cases, 97.5%), and lowest in 10-14-year old group (42 cases, 33.3%), with a decreasing trend with age (χ2trend=239.865, P<0.001). Food was also an important inducing factor, and seafood was the most frequent (121 cases, 39.8%). Total serum IgE was positive in 868 cases (67.4%). The positive rate in <2-year old group (52.6%) was the lowest, and the positive rate in 10-14-year old group (89.7%) was the highest, with an increasing trend with age (χ2trend=88.055, P<0.001). Serum specific IgE was positive in 733 cases (56.9%). The positive rate in <2-year old group (37.1%) was the lowest, and the positive rate in 10-14-year old group (92.6%) was the highest, with an increasing trend with age (χ2trend=150.361, P<0.001). The progressive rate of dust mites in inhalation and dietary allergens was highest (668 cases, 51.8%), which was followed by house dust (431 cases, 33.4%). Conclusions The most common inducing factor for bronchial asthma in Mianyang children is respiratory tract infection, followed by the weather changes and cold air exposure, and then food. Detection of serum total IgE and specific IgE is more valuable in elderly children with bronchial asthma.