司法鉴定的眼外伤眼眶爆裂性骨折的临床决策

研究分析涉及司法鉴定的眼部钝力伤致眼眶爆裂性骨折临床决策的特殊性,依据医学原理,做出有益于伤者康复及纠纷解决的决策.选取眼眶爆裂性骨折49例(49眼).其中内侧壁骨折30例,下壁骨折19例.致伤原因:斗殴25例,交通肇事17例,运动伤5例,自己意外伤2例.30例2周内接受手术治疗,眼球运动不受限,眼位满意,功能位无复视,2例特定方位复视,3个月后消失.19例拒不接受手术治疗,3个月后眼球不同程度内陷,16例功能位复视,眼球转动疼痛.眼眶骨折早期手术治疗预后佳,后患少,对受伤者及肇事者均有益.     

Mixed-sided individuals with neuroticism sustain more unintentional injuries in India

Previous research has shown a positive association between unintentional injury liability and non‐right‐handedness (especially mixed‐handedness). Research has also shown neuroticism to be one of the main predictors of unintentional injuries. In the present study we investigated the relationship of the three variables—frequency of unintentional injuries, side bias, and neuroticism. Further, the study aimed at extending the findings of previous studies establishing a relationship between non‐right‐handedness and unintentional injuries to a similar pattern in other domains of side bias—footedness, eyedness, and earedness. Data were collected from a large sample (N = 3474) using the side bias questionnaire, the shorter version of Maudsley's Personality Inventory, and an unintentional injury checklist. Results revealed positive correlations between the frequency of unintentional injuries and mixed‐sidedness, followed by left‐sidedness and right‐sidedness in each of the four domains of side bias. Furthermore, an increase in the frequency of unintentional injuries was observed for mixed‐sided and left‐sided individuals with higher levels of neuroticism.     

BEHAVIORAL TREATMENT FOR PATHOLOGICAL GAMBLING IN PERSONS WITH ACQUIRED BRAIN INJURY

The present investigation examined a behavior‐analytic clinical treatment package designed to reduce the pathological gambling of 3 individuals with acquired brain injury. A prior history of pathological gambling of each patient was assessed via caregiver report, psychological testing, and direct observation of gambling behavior. Using an 8‐week one‐on‐one client—patient format, a treatment program was developed in which the patient learned about the antecedents, consequences, and motivating operations that controlled the emission of gambling behavior. Data were collected on both self‐report of gambling urges and behavior following therapy and during in situ gambling opportunities. The therapy program reduced urges to gamble and actual gambling for all patients. The potential of behavior‐analytic therapy for reducing the pathological gambling of patients with and without brain injury is discussed.     

Attention Bias for Threatening Information in Children Following a Distressing Medical Procedure

Attention bias is common in adults with post‐traumatic stress disorder (PTSD) but is less studied in children. Children (n = 22) who experienced a potentially distressing procedure in an outpatient clinic (removal of K‐wires from orthopaedic fractures) and a group of medically unwell children (illness group; n = 27) were compared with healthy controls (n = 32). Children's baseline level of PTS symptoms were indexed prior to the medical procedure, and again at 1‐week follow‐up. Immediately after the K‐wire removal, children completed a dot probe task using two categories of target words (medical threatening and emotionally threatening). While K‐wire children showed an overall bias away from negative words relative to healthy controls, the illness group did not significantly differ from healthy controls. Attention bias in K‐wire and illness groups was unrelated to later PTS symptoms.     

Time perception in severe traumatic brain injury patients: A study comparing different methodologies

In this study, we investigated time perception in patients with traumatic brain injury (TBI). Fifteen TBI patients and 15 matched healthy controls participated in the study. Participants were tested with durations above and below 1 s on three different temporal tasks that involved time reproduction, production, and discrimination tasks. Data variables analyzed included amount of errors, relative errors, and coefficient of variation. Both groups completed a neuropsychological battery that included measures of attention, working memory, and executive functions. Results revealed significant differences between groups on the time reproduction and discrimination tasks, whereas groups showed similar performance on the time production task. Correlation analyses showed involvement of attention, working memory and executive functions on the time reproduction and time discrimination tasks, but there was no involvement on the time production task. These findings suggest that TBI does not impact specific temporal function. Rather, impairments in attention, working memory and executive function abilities may explain lower temporal performance in people with TBI.     

Regional cortical volume and cognitive functioning following traumatic brain injury

There has been limited examination of the effect of brain pathology on subsequent function. The current study examined the relationships between regional variation in grey matter volume, age and cognitive impairment using a semi-automated image analysis tool. This study included 69 individuals with mild-to-severe TBI, 41 of whom also completed neuropsychological tests of attention, working memory, processing speed, memory and executive functions. A widespread reduction in grey matter volume was associated with increasing age. Regional volumes that were affected also related to the severity of injury, whereby the most severe TBI participants displayed the most significant pathology. Poorer retention of newly learned material was associated with reduced cortical volume in frontal, parietal, and occipital brain regions. In addition, poorer working memory and executive control performance was found for individuals with lower cortical volume in temporal, parietal, and occipital regions. These findings are largely in line with previous literature, which suggests that frontal, temporal, and parietal regions are integral for the encoding of memories into long-term storage, memory retrieval, and working memory. The present study suggests that automated image analysis methods may be used to explore the relationships between regional variation in grey matter volume and cognitive function following TBI.     

关于针对最小意识状态患者的促醒综合治疗体系的文献综述

急性脑外伤或非创伤性脑损伤常常导致患者进入一种缺乏意识及思维、对自身及周围的事物缺乏感知的严重意识障碍阶段,过去称之为＂植物状态＂.随着最小意识状态概念的提出,本文在国内外现有参考文献的基础上进行改良并结合自身经验建立了规范的促醒治疗方法,就此促醒治疗方法进行综述,旨在为国内此类患者的评估、诊断、治疗及后续康复提供更多的临床参考.     

舒芬太尼和七氟烷不同剂量组合对创伤患者心肌损伤的协同保护作用

创伤失血性休克患者在接受液体复苏和输血治疗时,由于再灌注可导致心肌和心脏功能进一步受损.在再灌注前应积极采取临床措施以保护心脏.阿片类药物和吸入麻醉药物后处理对创伤失血性休克患者心肌缺血-再灌注损伤具有良好的保护作用.此研究中,笔者将不同剂量的舒芬太尼和七氟烷联合应用,通过对患者心肌酶检测相比较,发现两种药物组对后处理是否对失血性休克患者心肌缺血-再灌注损伤具有协同保护作用.     

Refractoriness of on Extended Movement to Directional Change

An extended movement was used to compare the memory-drum and single-channel definitions of psychological refractoriness. The basic movement In response to the first signal (S₁) was a forward lunge and a concurrent arm swing through a target string. The response to the second signal (S₂) was a reversal of the original movement The interstimulus Interval (ISI) ranged from .10 – .70 sec. in .10-sec. steps. The hypothesis that refractoriness of the reversal movement would decrease as ISI shortened was confirmed by the fact that error frequencies decreased significantly and substantially with decreasing IS I. The availability of some residual capacity to deal with S₂ during the refractory period was also indicated by an examination of the relationship between RT₂ and the interval between S₂ and RT₁. This departure from the classical single-channel model shows some agreement with the neuromotor-programming theory.