导航技术在手术治疗寰椎骨折中的临床应用及意义

探讨导航技术在手术治疗寰椎骨折中的应用问题及其,临床意义。使用c臂透视导航设备对22例不稳定性寰椎骨折的患者行导航下螺钉内固定术。9例骨折采用寰椎侧块螺钉固定,13例骨折采用枕颈融合。导航下共植入椎弓根螺钉70枚,侧快螺钉18枚。68枚（97．7％）椎弓根螺钉为1类螺钉,2枚（2．3％）椎弓根螺钉为2类螺钉,没有3类螺...     

关节周围骨折手术入路探索的哲学思考

关节周围骨折多属于高能量损伤,临床处理相当困难,术后疗效差,现运用科学认识的规律,以康复理念为指导探索新的手术入路,并阐述新的手术入路与功能康复的辩证关系。     

对颌骨骨折坚固内固定术患者心身感受的质性研究

了解颌骨骨折坚固内固定术患者不同阶段的心理和躯体感受,以便为其提供人性化的人文护理服务,使患者满意,使优质护理服务得到落实。采用立意取样法选取研究对象,对选取的31例颌骨骨折坚固内固定术患者采用质性研究中的现象学方法进行深度访谈,并对资料进行整理和分析。结果发现患者在三个阶段中的护理问题如下：（1）手术前;自我形象紊乱、功能障碍和焦虑。（2）手术后：舒适受到影响和愧疚感等。（3）出院时：渴求信息。本研究能规范颌骨骨折坚固内固定术患者人文护理的具体内容,改善其护理问题。     

Psychological support needs of patients with head and neck cancer and their caregivers: A qualitative study

Objective: The aim of this study was to explore the psychological support needs of patients with head and neck cancer (HNC) and their caregivers. The appropriate timing, length, format and content of sessions were also investigated.

Design: Eighty-three patients with HNC and 73 of their caregivers completed questionnaires at diagnosis. Follow-up questionnaires were mailed to patients six months later.

Main outcome measures: Free text-comments to open-ended questions in the questionnaires were analysed using an inductive thematic approach with coding and theme development directed by the content of responses. This was used to determine psychological support needs both at diagnosis and at six month follow-up.

Results: Patients described ‘just being there’, empathy, maintaining normality and practical support as helpful from family/friends. They desired information, honesty, positivity and empathy from clinical staff. Formal psychological support was desired by approximately 40% of patients and caregivers, particularly early after diagnosis and during treatment. Most participants desired face to face sessions, providing individualised information and coping strategies.

Conclusion: The results of this study suggest that psychological interventions for patients with HNC and their caregivers should be delivered early after diagnosis in face to face sessions, presenting honest and factual information about the disease and coping strategies.     

Micro-mechanical measurements of fracture toughness of bismuth embrittled copper grain boundaries

Measuring the fracture properties of single grain boundaries has until now required macroscopic bi-crystals which are expensive and not always available. We describe a method for fracture testing using micro-cantilevers, manufactured using focussed ion beam machining and tested using a nanoindenter. We have used the method to measure the fracture toughness of selected grain boundaries in bismuth-embrittled copper. This technique is applicable to grain boundaries in other brittle polycrystalline samples for which large bi-crystals cannot be produced for conventional testing.     

Arsenic adsorption onto silicon stepped surfaces: a study at semiempirical level

As adsorption onto Si surfaces vicinal to (100) has been studied using the Hartree–Fock method at a semiempirical level and a cluster model of the surface steps. The simulation conditions apply to the dilute limit of the adsorbate concentration. Accordingly, one As atom is placed on the step in a substitutional or interstitial location, either above or below the surface. The optimal configuration of the system is evaluated from a steepest-descent energy minimization. The central finding is that As is preferably adsorbed in the interstitial location and the physical explanation is that this location allows both a stronger electrostatic coupling with the surface and a lower stress than in the case of the substitutional impurity. This result represents a significant divergence with respect to the known properties of the bulk impurity. It can, however, consistently account for known features of heteroepitaxial growth of As on Si(100).     

Low-temperature mechanical properties of Ce68Al10Cu20Co2 bulk metallic glass

Although it is well known that traditional metals and alloys will become brittle at low temperatures, the effect of low temperature on the mechanical properties of bulk metallic glasses (BMGs) is yet to be fully understood. In this research, the mechanical properties of Ce₆₈Al₁₀Cu₂₀Co₂ BMG are investigated at low temperatures. It is found that the yield strength of the Ce-based BMG increases significantly with the decrease of temperature. The elastic moduli of the BMG also increase monotonically with the drop of temperature, indicating the continuous stiffening of the BMG, while both Poisson's ratio and global plasticity decline at low temperatures. It is considered that the stiffer atomic bonds of the Ce-based BMG at low temperatures result in the increase of strength, and the higher energy required for nucleation of shear bands also leads to the increase in yield strength.     

Nanocrystallization induced by quasi-static fracture of metallic glasses at room temperature

Nanoparticles on the fracture surfaces of Co- and Fe-based metallic glasses during quasi-static compression at room temperature have been observed using a high-resolution scanning electron microscope. In terms of the differential scanning calorimeter, those nanoparticles were identified to be a result of nanocrystallization induced by the rapid fracture. Finally, the nanocrystallization behavior was evaluated by taking into account the super-high crack propagation rate and high elastic energy, which contributed to the local temperature rise up to the onset of crystallization, T _x.     

Screw dislocation in functionally graded magnetoelectroelastic solids

A screw dislocation in a functionally graded magnetoelectroelastic material is investigated. The material properties exponentially changing along both x and y directions are considered and the mechanical–electric–magnetic coupling is discussed. Closed-form expressions for the mechanical, electric and magnetic components are derived using the general stress function method. The solutions can be applied as a fundamental result and reduced into the classic and piezoelectric cases. The study puts forth a direct way for screw dislocation analysis in inhomogeneous structures with multifield coupling.     

Involuntary Rotations of a Steering Device Induced by Voluntary Rotations of the Head and Maintained Eccentric Head Positions

In a series of 4 experiments, the authors examined involuntary rotations of a steering device (handlebar or wheel) that were associated with periodic head rotations and eccentric head positions. Periodic head rotations resulted in isodirectional involuntary rotations of a horizontally arranged steering device of very small amplitude. When the orientation of a steering wheel was changed to vertical and to a backward tilt, the involuntary rotations were in the opposite direction. That pattern of results is consistent with the assumption that small movements of the shoulder girdle, which are associated with head turns and which cannot be prevented by mechanical immobilization of the shoulder, are propagated to the wheel, but is not consistent with previous suggestions that involuntary rotations of a steering device can result from the action of the tonic neck reflex. Effects that correspond to the pattern of the tonic neck reflex were found only when a spring-centered handlebar was held in an eccentric position; maintenance of the eccentric position was facilitated when the participant's head was turned in the opposite direction. The findings strongly suggest that head movements can result in involuntary movements of a steering device via different mechanisms.