简介:AbstractWide-awake local anesthesia has many advantages. We describe a new method to use wide-awake local anesthesia with more flexibility. A 32-year-old man with a severe right-hand contracture after an iatrogenic tourniquet accident during an anterolateral thigh flap for a partial hand amputation underwent contracture release using external fixation after proximal row carpectomy and subsequent tenolysis. We performed most of the tenolysis procedure under general anesthesia and the final stage with an intra-operative assessment of active finger movement and dissection under local anesthesia. He regained his grip strength 2.5 years post-injury. General anesthesia is useful to treat a surgical site with extensive hard scars, whereas local anesthesia is useful for adjusting tension in an awake patient. The indication for wide-awake surgery is yet to be established; our method of combining general and local anesthesia in the tenolysis procedure illustrates the possibilities in expanding this method.
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简介:AbstractBackground:The combination of high-frequency oscillations (HFOs) with single-mode imaging methods has been proved useful in identifying epileptogenic zones, whereas few studies have examined HFOs combined with multimodal imaging methods. The aim of this study was to evaluate the prognostic value of ripples, an HFO subtype with a frequency of 80 to 200 Hz is combined with multimodal imaging methods in predicting epilepsy surgery outcome.Methods:HFOs were analyzed in 21 consecutive medically refractory epilepsy patients who underwent epilepsy surgery. All patients underwent positron emission tomography (PET) and deep electrode implantation for stereo-electroencephalography (SEEG); 11 patients underwent magnetoencephalography (MEG). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in predicting surgical outcome were calculated for ripples combined with PET, MEG, both PET and MEG, and PET combined with MEG. Kaplan-Meier survival analyses were conducted in each group to estimate prognostic value.Results:The study included 13 men and 8 women. Accuracy for ripples, PET, and MEG alone in predicting surgical outcome was 42.9%, 42.9%, and 81.8%, respectively. Accuracy for ripples combined with PET and MEG was the highest. Resection of regions identified by ripples, MEG dipoles, and combined PET findings was significantly associated with better surgical outcome (P < 0.05).Conclusions:Intracranial electrodes are essential to detect regions which generate ripples and to remove these areas which indicate good surgical outcome for medically intractable epilepsy. With the assistance of presurgical noninvasive imaging examinations, PET and MEG, for example, the SEEG electrodes would identify epileptogenic regions more effectively.
简介:【摘要】在全面倡导构建资源节约型和环境友好型社会的背景下,医院作为一类人流量大、用水量高的公共机构,其节水问题一直是社会关注的热点话题。本文主要对医院的用水特点和广泛存在的用水问题展开分析,并针对问题提出了管理节水、技术节水和运维节水三种节水方式,旨在为医院管理者提供节水建议,助力医院的节水事业发展。
简介: 摘要:目前的小学已经不同程度的开设了英语课程。小学英文写作也被列入了英语期末的考试范围。这个阶段发挥小学生的英语知识水平和英语学习的特点,写出优秀的小学生英语作文是十分困难的。传统的英语写作教学步骤分为,“命题写作—讲解—改错—评分”,多数学生对写作不够重视,缺乏动力,因此教学成效不大。2018年3月,我校开始使用了口语100人工智能学习平台,为学生创设英语学习环境,提供纠错、沟通和交流平台。运用这个平台的智能跟读、单词作业、微视频/图文作业、命题作文作业等,提高学生学习英语的兴趣,提高了学生的听说读写能力,从而大大促进了写作能力的提升。
简介:摘要:随着智能电网建设的推进,信息化应用的需求不断增加,电力通信系统的带宽扩展建设进一步加快。各种信息应用系统在电力市场已进入建设阶段或实际应用阶段,这类系统应用范围广泛,实时性、可靠性要求高,对带宽的要求也越来越高。目前仅依靠现有的基于同步数字系统技术的主干传输网络,显然已经不能满足我国电力发展的需要。利用OTN光分复用设备(FIROADM)实现多路网络。以光交叉OTN网络为础,利用G709规范的封装规程映射,在光层实现波长级交叉调度和信号传输。能够进行波长级端到端业务的交叉调度,调度能力比电交叉连接强;服务可以在光层中运行,无须在电层中处理;光交叉连接可以实现灵活的组网,支持网状网络;设定光通道、多路等多种光层保护方式。但是存在着波长一致性的限制,必须采取措施来避免资源冲突,长距离传输会导致信号衰减和色散,需要增加光放大器和色散补偿,这会带来截面距离较短、光交叉装置的成本比电交叉装置高的问题。因此在电力通信网中应用OTN设备可以综合考虑,引入多个设备,各个设备互相配合、彼此协作,从而达到扩大其传输网络结构、增大其传输距离的目的。基于此,本篇文章对100GOTN系统架构和建设应用进行研究,以供参考。
简介:摘要:100米短跑具备距离短, 强度大, 速度快等特征, 它要求学生既要跑得最快, 又要求他们把这种能力维持一定时间或距离, 实质上是对人体极限的挑战, 而在高中体育中采取什么样的方式方法, 才能有效提高学生的100米短跑速度呢?这就需要广大高中体育教师深入思考和探索。
简介:【摘要】 本文针对不同于设计使用年限为50年,设计使用年限为100年具有相同概率保证的建筑,其地震作用的确定方法作出探讨。
简介:摘要 目的 分析羊水过少患者的临床情况;方法 我院医学伦理委员会审批,并经患者同意的基础上。随机数字选取我院于2020年3月至2021年4月收治的羊水量过少的患者100例为观察组。并选取同期健康产妇100例为对照组,对所有患者进行B超检查,通过B超测定患者的羊水情况。统计羊水量过少对胎儿的影响,并统计不同羊水量过少情况对胎儿影响情况;结果 观察组患者胎儿窘迫、脐带绕颈及羊水粪污情况发生率超过30%,脐带过短发生率超过20%,新生儿窒息的情况超过10%。观察组胎儿窘迫、脐带过短、脐带绕颈、羊水粪污及新生儿窒息情况的发生率均显著高于对照组,差异均具有统计学意义(P