Predictors of Catheter-related Bladder Discomfort after Urological Surgery

The aim of this study was to figure out the predictors of early postoperative catheter-related bladder discomfort（CRBD） after urological surgery. We designed a prospective observational study in our hospital. Consecutive adult patients undergoing surgery under general anaesthesia or epidural anaesthesia necessitating urinary catheterization were included during a 3-month period. severity of bladder discomfort was assessed on a 4-point scale：（1） no pain,（2） mild pain（revealed only by interviewing the patient）,（3） moderate（a spontaneous complaint by the patient of a burning sensation in the urethra and/or an urge to urinate and/or sensation of urethral foreign body without any emotional agitation） and（4） severe discomfort（agitation, loud complaints and attempt to remove the bladder catheter associated with a burning sensation in the urethra）. Predictors of CRBD were identified by univariate and multivariate analysis. Totally, 116 patients were included, of which 84.5% had CRBD（mild CRBD： 40.5%; moderate or severe CRBD： 44.0%） at day 1, while 31.9% developed CRBD（mild CRBD： 29.3%; moderate or severe CRBD： 2.6%） at day 3. We evaluated 9 potential forecast factors of CRBD, and univariate Chi-square test showed male gender [OR=2.4, 95%CI（1.1–5.6）, P〈0.05], abdominal open surgery compared with transurethral surgery [OR=0.3, 95%CI（0.1–0.6）, P〈0.05], abdominal surgery compared with laparoscopic surgery [OR=3.3, 95%CI（1.2–8.9）, P〈0.05] and history of catheterization [OR=0.5, 95%CI（0.2–0.9）, P〈0.05] were independent predictors of moderate or severe CRBD in the patients after surgery. While multivariate logistic regression analysis showed that the abdominal open surgery [EXP（B）=3.074, 95%CI（1.3–7.4）, P〈0.05] and the history of catheterization [EXP（B）=2.458, 95%CI（1.1–5.9）, P〈0.05] might contribute more to the occurrence of moderate or severe CRBD. In conclusion, this observational study identified that the type of surgery and the history of catheterization might be predictive factors of moderate and severe CRBD after urological surgery.

Detection and Attribution of Changes in Thermal Discomfort over China during 1961-2014 and Future Projections

In this study, variation in the frequency of thermal discomfort days over China during the period of 1961-2014,including heat discomfort days(HDDs) and cold discomfort days(CDDs), and the influence of external forcings on it are discussed. HDDs are the conditions of overheating and overhumidity(represented by humidity index), and CDDs reflect the dangers from cold temperatures and winds(represented by wind chill index). Observations show significant increases(decreases) in the frequency of HDDs(CDDs) over China from 1961 to 2014, with clear regional distinctions. The historical ALL and greenhouse gas(GHG) simulations can sufficiently reproduce the spatial patterns of the observational trend in the frequency of both HDDs and CDDs over China. Further, the impacts of GHG and anthropogenic forcings on the HDDs(CDDs) are detectable over China, except for central and eastern China, based on the optimal fingerprinting method. GHG forcing is identified as a dominant factor for the observational changes in the frequency of HDDs over southern China;GHG and anthropogenic forcings have dominant effects on the variation in the frequency of CDDs over southwestern China. Although trends in the frequency of HDDs and CDDs in historical aerosol forcing simulations seems to be opposite to observations, an aerosol signal fails to be detected. Natural forcing contributes to the observational variation in the frequency of HDDs over northwestern China. In addition, the future projections of thermal discomfort days indicate that Chinese residents will face more threats of heat discomfort and fewer threats of cold discomfort in the future under global warming.

Role of artificial tears with and without hyaluronic acid in controlling ocular discomfort following PRK: a randomized clinical trial

AIM:To compare outcomes of applying preservative free artificial tears(PFAT)with and without hyaluronic acid(HA)in early postoperative course following photorefractive keratectomy(PRK).METHODS:In this triple-blinded randomized clinical trial,PRK procedure was performed on both eyes of 230 patients.Following PRK,patients were divided into three groups:the HA^(+)group,44 patients PFAT containing HA;the HA-group,71 patients PFAT without HA were administered 5 times per day(every 4 h);the third group,115 patients received no PFAT before lens removal.On the 1st and 4th postoperative day,Visual Analogue Score(VAS)was utilized to evaluate patient’s level of pain.Participants were asked to complete a questionnaire about the severity of eye discomfort ranked from 0 to 10(0=no complaint;10=most severe complaint experienced).RESULTS:In eyes receiving PFAT with or without HA(Drop group),mean scores for epiphora,foreign body sensation,and blurred vision on the 1st postoperative day were statistically lower(P<0.05).Filamentous keratitis(FK)was detected in 11(4.7%)eyes,and recurrent corneal erosion(RCE)was observed in 5(2.1%)eyes.In the control group,FK was noted in 16(6.9%)eyes while 13(5.6%)eyes had RCE and 5(2.1%)eyes had corneal haze.The rate of complications was statistically lower in Drop group(P=0.009).However,the aforementioned scores were not statically different between HA^(+)and HA-group one and two(P=0.29).CONCLUSION:Following PRK,applying PFAT with and without HA yields faster visual recovery,decreases postoperative ocular discomfor t and haze formation;however there is no additive effect for HA.

Ultrathin endoscope flexibility can predict discomfort associated with unsedated transnasal esophagogastroduodenoscopy

AIM: To evaluate the effects of choice of insertion route and ultrathin endoscope types. METHODS: This prospective study (January-June 2012) included 882 consecutive patients who underwent annual health checkups. Transnasal esophagogastroduodenoscopy (EGD) was performed in 503 patients and transoral EGD in 235 patients using six types of ultrathin endoscopes. Patients were given a choice of insertion route, either transoral or transnasal, prior to EGD examination. For transoral insertion, the endo-scope was equipped with a thin-type mouthpiece and tongue depressor. Conscious sedation was not used for any patient. EGD-associated discomfort was assessed using a visual analog scale (VAS; no discomfort 0maximum discomfort 10). RESULTS: Rates of preference for transnasal insertion were significantly higher in male (male/female 299/204 vs 118/117) and younger patients (56.8 ± 11.2 years vs 61.3 ± 13.0 years), although no significant difference was found in VAS scores between transoral and transnasal insertion (3.9 ± 2.3 vs 4.1 ± 2.5). Multivariate analysis revealed that gender, age, operator, and endoscope were independent significant predictors of VAS for transnasal insertion, although gender, age, and endoscope were those for transoral insertion. Further analysis revealed only the endoscopic flexibility index (EFI) as an independent significant predictor of VAS for transnasal insertion. Both EFI and tip diameter were independent significant predictors of VAS for transoral insertion. CONCLUSION: Flexibility of ultrathin endoscopes can be a predictor of EGD-associated discomfort, especially in transnasal insertion.

Does music reduce anxiety and discomfort during flexible sigmoidoscopy?A systematic review and meta-analysis

To investigate the role of music in reducing anxiety and discomfort during flexible sigmoidoscopy. METHODSA systematic review of all comparative studies up to November 2016, without language restriction that were identified from MEDLINE and the Cochrane Controlled Trials Register (1960-2016), and EMBASE (1991-2016). Further searches were performed using the bibliographies of articles and abstracts from major conferences such as the ESCP, NCRI, ASGBI and ASCRS. MeSH and text word terms used included “sigmoidoscopy”, “music” and “endoscopy” and “anxiety”. All comparative studies reporting on the effect of music on anxiety or pain during flexible sigmoidoscopy, in adults, were included. Outcome data was extracted by 2 authors independently using outcome measures defined a priori. Quality assessment was performed. RESULTSA total of 4 articles published between 1994 and 2010, fulfilled the selection criteria. Data were extracted and analysed using OpenMetaAnalyst. Patients who listened to music during their flexible sigmoidoscopy had less anxiety compared to control groups [Random effects; SMD: 0.851 (0.467, 1.235), S.E = 0.196, P < 0.001]. There was no statistically significant heterogeneity (Q = 0.085, df = 1, P = 0.77, I2 = 0). Patients who listened to music during their flexible sigmoidoscopy had less pain compared to those who did not, but this difference did not reach statistical significance [Random effects; SMD: 0.345 (-0.014, 0.705), S.E = 0.183, P = 0.06]. Patients who listened to music during their flexible sigmoidoscopy felt it was a useful intervention, compared to those who did not (P < 0.001). There was no statistically significant heterogeneity (P = 0.528, I2 = 0). CONCLUSIONMusic appeared to benefit patients undergoing flexible sigmoidoscopies in relation to anxiety and was deemed a helpful intervention. Pain may also be reduced however further investigation is required to ascertain this.

Automated Patient Discomfort Detection Using Deep Learning

The Internet of Things(IoT)has been transformed almost all fields of life,but its impact on the healthcare sector has been notable.Various IoTbased sensors are used in the healthcare sector and offer quality and safe care to patients.This work presents a deep learning-based automated patient discomfort detection system in which patients’discomfort is non-invasively detected.To do this,the overhead view patients’data set has been recorded.For testing and evaluation purposes,we investigate the power of deep learning by choosing a Convolution Neural Network(CNN)based model.The model uses confidence maps and detects 18 different key points at various locations of the body of the patient.Applying association rules and part affinity fields,the detected key points are later converted into six main body organs.Furthermore,the distance of subsequent key points is measured using coordinates information.Finally,distance and the time-based threshold are used for the classification of movements associated with discomfort or normal conditions.The accuracy of the proposed system is assessed on various test sequences.The experimental outcomes reveal the worth of the proposed system’by obtaining a True Positive Rate of 98%with a 2%False Positive Rate.

Acupuncture transcutaneous electrical nerve stimulation reduces discomfort associated with barostat-induced rectal distension:A randomized-controlled study

AIM:To explore the effectiveness of acupuncture transcutaneous electrical nerve stimulation(Acu-TENS), a non-invasive modality in reduction of rectal discomfort during barostat-induced rectal distension. METHODS:Forty healthy subjects were randomized to receive 45 min of either Acu-TENS or placebo-TENS(no electrical output)over acupuncture points Hegu(largeintestine 4),Neiguan(pericardium 6)and Zusanli(stomach 36).A balloon catheter attached to a dual-drive barostat machine was then inserted into the subjects'rectum.A step-wise(4 mmHg)increase in balloon pressure was induced until maximal tolerable or 48 mmHg.Visual analogue scale and a 5-point subjective discomfort scale(no perception,first per-ception of distension,urge to defecate,discomfort/ pain and extreme pain)were used to assess rectal discomfort at each distension pressure.Blood beta-endorphin levels were measured before,immediately after intervention,at 24 mmHg and at maximal toler- able distension pressure. RESULTS:There was no difference in the demographic data and baseline plasma beta-endorphin levels between the two groups.Perception threshold levels were higher in the Acu-TENS group when compared to the placebo group,but the difference reached statistical significance only at the sensations"urge to defecate"and"pain".The distension pressures recorded at the"urge to defecate"sensation for the Acu-TENS and placebo-TENS groups were 28.0±4.5 mmHg and 24.6±5.7 mmHg,respectively(P=0.043);and the pressures recorded for the"pain"sensation for these two groups were 36.0±4.2 mmHg and 30.5± 4.3 mmHg respectively(P=0.002).Compared to the placebo group,a higher number of participants in the Acu-TENS group tolerated higher distension pressures (>40 mmHg)(65%in Acu-TENS vs 25%in placebo, P=0.02).The plasma beta-endorphin levels of the Acu-TENS group were significantly higher than that of the placebo group at barostat inflation pressure of 24 mmHg(1.31±0.40 ng/mL vs 1.04±0.43 ng/mL,P= 0.044)and at maximal inflation pressure(1.46±0.53 ng/mL vs 0.95±0.38 ng/mL,P=0.003). CONCLUSION:Acu-TENS reduced rectal discomfort during barostat-induced rectal distension and concur-rently associated with a rise in beta-endorphin level.

Gastrointestinal discomforts and dietary intake in Chinese urban elders:A cross-sectional study in eight cities of China

BACKGROUND Gastrointestinal(GI)discomforts are common in the elderly population;however,whether such discomforts are associated with dietary intake has not been studied.AIM To evaluate GI discomforts in Chinese urban elders and the associated factors.METHODS The gastrointestinal symptom rating scale(GSRS)was used to identify GI discomforts in 688 elders from eight cities of China.The semi-quantitative food frequency questionnaire and one time of 24 h dietary recall were used to access the food intake,identify dietary pattern,and calculate the nutrients intake.RESULTS About 83%of studied elders experienced at least one of GI discomforts in the past 6 mo;dyspepsia was the most commonly reported(66.7%),followed by reflux(44.8%),abdominal pain(35.9%),constipation(35.8%),and diarrhea(34.7%).Female gender,lower education level,and lower family income were associated with a higher GSRS score.Participants who were diagnosed with a GI-related disease had a higher score of constipation,but a lower score of reflux.Chronic diseases were positively associated with certain GI discomforts.Three dietary patterns were identified by the method of principal component analysis,which were characterized as high intake of salt and tea;more frequent intake of tubers,fruits,aquatic products,and soybeans;and high intake of cereal,vegetables,and meat,respectively.However,no associations between dietary patterns and GSRS score were found.The elders with a higher GSRS score had significantly lower intake of bean products.The elders whose GSRS score was≥21 and 18-20 decreased their bean production intake by 7.2(0.3,14.3)g/d and 14.3(1.2,27.3)g/d,respectively,compared with those who had a GSRS score≤17.There were no differences in other food categories,calories,or nutrients intake among elders with different GSRS scores.CONCLUSION GI discomforts are common in Chinese urban elders.GI discomforts might be associated with the choice of food.

Causative factors of discomfort in esophagogastroduodenoscopy: A large-scale cross-sectional study

BACKGROUND It is important to reduce patient discomfort in esophagogastroduodenoscopy.Remedial measures can be taken to alleviate discomfort if the causative factors are determined;however,all the factors have not been elucidated yet.AIM To clearly determine the factors influencing discomfort in transoral esophagogastroduodenoscopy using a large-size cross-sectional study with readily available data.METHODS Consecutive patients who underwent screening transoral esophagogastroduodenoscopy consecutively between August 2017 and October 2017 at a health check-up center were included.Discomfort was evaluated using a face scale between 0 and 10 with a 6-level questionnaire.Univariate and multiple regression analyses were performed to investigate the factors related to the discomfort in esophagogastroduodenoscopy.Univariate analysis was performed in both the unsedated and sedated study groups.Age,sex,height,body mass index,smoking status,alcohol intake,hiatal hernia,history of gastrectomy,biopsy during examination,Lugol’s solution usage,administration of butylscopolamine with/without a sedative(pethidine,midazolam,or both),endoscope model,history of endoscopy,and endoscopists were considered as possible factors of discomfort.RESULTS Finally,1715 patients were enrolled in this study.Overall,the median discomfort score was 2 and the interquartile range was 2-4.High discomfort(score≥6)was recorded in 18%of the participants.According to univariate analysis,in the unsedated group,young age(P<0.001),female sex(P<0.001),and no history of endoscopy(P<0.001)were factors associated with increased discomfort.Significant differences were also noted for height(P=0.007),smoking status(P=0.003),and endoscopists(P<0.001).In the sedation group,young age(P<0.001),female sex(P<0.001),and no history of endoscopy(P=0.004)were associated with increased discomfort;additionally,significant differences were found in smoking status(P<0.001),type of sedation(P<0.001),and endoscopists(P=0.027).There was also a marginal difference due to alcohol intake(P=0.055).Based on multiple regression analysis,young age,female sex,less height,current smoking status,and presence of hiatal hernia[regression coefficients of 0.08,P<0.001(for-1 years);0.45,P=0.013;0.02,P=0.024(for-1 cm);0.35,P=0.036;and 0.34,P=0.003,respectively]were factors that significantly increased discomfort in esophagogastroduodenoscopy.Alternatively,sedation significantly reduced discomfort and pethidine(regression coefficient:-1.47,P<0.001)and midazolam(regression coefficient:-1.63,P=0.001)significantly reduced the discomfort both individually and in combination(regression coefficient:-2.92,P<0.001).A difference in the endoscopist performing the procedure was also associated with discomfort.CONCLUSION Young age,female sex,and smoking are associated with esophagogastroduodenoscopy discomfort.Additionally,heavy alcohol consumption diminished the effects of sedation.These factors are easily obtained and are thus useful.

Are bowel symptoms and psychosocial features different in irritable bowel syndrome patients with abdominal discomfort compared to abdominal pain?

BACKGROUND The Rome IV criteria eliminated abdominal discomfort for irritable bowel syndrome(IBS), which was previously included in Rome III. There are questions as to whether IBS patients with abdominal discomfort(seen in Rome III but not Rome IV) are different from those with abdominal pain(Rome IV).AIM To compare bowel symptoms and psychosocial features in IBS patients diagnosed with Rome III criteria with abdominal discomfort, abdominal pain, and pain &discomfort.METHODS We studied IBS patients meeting Rome III criteria. We administered the IBS symptom questionnaire, psychological status, and IBS quality of life. Patients were classified according to the predominant abdominal symptom associated with defecation into an only pain group, only discomfort group, and pain & discomfort group. We compared bowel symptoms, extraintestinal symptoms, IBS quality of life, psychological status and healthcare-seeking behaviors, and efficacy among the three groups. Finally, we tested risk factors for symptom reporting in IBS patients.RESULTS Of the 367 Rome III IBS patients enrolled, 33.8%(124 cases) failed to meet Rome IV criteria for an IBS diagnosis. There were no meaningful differences between the pain group(n = 233) and the discomfort group(n = 83) for the following:(1) Frequency of defecatory abdominal pain or discomfort;(2) Bowel habits;(3) Coexisting extragastrointestinal pain;(4) Comorbid anxiety and depression;and(5) IBS quality of life scores except more patients in the discomfort group reported mild symptom than the pain group(22.9% vs 9.0%). There is a significant tendency for patients to report their defecatory and non-defecatory abdominal symptom as pain alone, or discomfort alone, or pain & discomfort(all P < 0.001).CONCLUSION IBS patients with abdominal discomfort have similar bowel symptoms and psychosocial features to those with abdominal pain. IBS symptoms manifesting abdominal pain or discomfort may primarily be due to different sensation and reporting experience.

Peak stent discomfort occurs early and ureteral stent with distal loop design has less paineA pilot prospective randomised singleblinded trial over 2 weeks

Objectives:The Polarisloop ureteric stent reduces the severity of stent discomfort by minimising stent material in the bladder.Early impact of ureteral stenting on quality of life(QoL)within 1 week remains unclear.The usefulness of the patient-administered ureteral stent symptoms questionnaire(USSQ)during this period of stent insertion was assessed.In this pilot single-blinded prospective randomised study,we investigate 1)the presence of early(within the 1st week)stent discomfort via the visual analog scale(VAS);2)determine the QoL of the loop stent against conventional stent.Methods:Forty adults requiring retrograde unilateral ureteral stent placements were enrolled.Patients with single ureteric stone or benign stricture were selected.Patients were randomised in 1:1 ratio to the loop and pigtail arm.The USSQ was administered before placement(baseline),USSQ and VAS were administered on Day 3,7,and 14.Results:There were no significant differences between the USSQ scores.Median pain scores on Day 3 were lower in the loop stent group(2.9 vs.4.0,pZ0.047).There was a significant reduction in pain from Day 3e7(0 vs.1,pZ0.016)in the pigtail group.Conclusions:Our results suggest that peak stent discomfort occurs but resolves quickly within 1 week of post-stent insertion.The loop stent offers a better pain profile compared with conventional stents at Day 3 but no difference in QoL.The loop stent reduces early pain experience post-stent insertion and may have a role in the care of patients who experience significant stent discomfort previously.

Effect of vaginal speculum lubrication on cervical cytology and discomfort during smear examination

AIM: To evaluate the role of lubricant gel in the cytology of a Pap smear and whether it results in an improvement in the discomfort experienced by women while undergoing Pap smear screening.METHODS: A total of 151 women were analyzed in the study. After screening for inclusion criteria, a Pap smear was taken with no lubricant in all the women and the discomfort experienced was rated on a visual analogue scale. The women underwent a second Pap smear on the next visit using a lubricant gel and were again rated on a visual analogue scale for the discomfort felt. The pathologist was blinded to the fact of whether the lubricating gel was used.RESULTS: The number of unsatisfactory smears in the no gel group was 3 vs 5 in the gel group, P < 0.05. However, a significant difference(P = 0.00) was observed in the visual analogue pain score in both groups, suggesting that application of lubricant gel over the speculum improves the pain experienced by women. CONCLUSION: Using a small amount of lubricant overthe speculum does not impair cervical cytology but significantly improves the discomfort experienced by women while undergoing a Pap smear.

Perceived Indoor Discomfort, Performance and Productivity

Even all indoor environmental standards are met the users are usually not satisfied and perceived discomfort is occurred in the smart office buildings. The most frequently cause of discomfort in smart buildings is overrun of intelligence. There are physical and psychological factors that influenced building users＇ comfort. An indoor air quality seems to be one of the main problems of smart office buildings. In Slovakia the office buildings relating to indoor environment European standard are mostly evaluated as the non-low polluting buildings. The pollution from building as well as the pollution from occupancy and using was respected. The odor intensity and indoor air acceptability were assessed by a sensory panel. The concentrations of total volatile organic compounds and carbon dioxide were measured. The odors from building materials studied under different air change rate are presented in this paper. The case study of indoor air acceptability concerning to indoor odors under occupancy and its affect on perceived air quality influenced by air change rate are also presented in this paper.

A Longitudinal Study of Patient Reported Positioning-Related Discomfort and Pain after Laparoscopic Surgery in the Lithotomy Position

Background: Our hypothesis was that only established and persistent injuries and complications after positioning in the Trendelenburg position are reported and detected, despite that patients may have great discomfort after surgery. Aim: The aim of this study was to explore patient reported discomfort, pain and functional decrease two hours, 24 hours and four weeks after laparoscopic resection of the colon in the prone lithotomy position, as well as factors potentially associated with reported pain. Methods: A longitudinal self-report questionnaire study was conducted at three time-points. Results: A total of 37 patients responded. Findings show that patients mostly reported pain in relation to the surgical area, but also related to other areas that may be linked to positioning. Conclusion: Even though patients reported mild pain, several of the patients still reported this, four weeks postoperatively, as well as some functional decrease. Our findings support the need to focus on preventing positioning injuries.

Research Progress of Moxibustion in Improving Postoperative Discomfort of Breast Cancer Patients

Moxibustion is one of the characteristics of Traditional Chinese medicine therapy.It has the effects of activating blood circulation and removing stasis,warming the meridians and strengthening and exorcising evil spirits.It shows unique advantages in improving postoperative symptoms of breast cancer patients.In this paper,the overview of moxibustion method,moxibustion method in improving postoperative upper limb dysfunction,cancer-related fatigue,nausea and vomiting,anxiety and depression of breast cancer patients were reviewed,and the existing deficiencies were summarized and analyzed,in order to provide reference for the clinical application of moxibustion method in improving postoperative discomfort symptoms of breast cancer patients and related research.

Short-term postoperative discomfort in patients receiving flapless contra open implant surgery

Purpose: The aim of this pilot study was to evaluate subjective and objective findings on short-term post-operative discomfort in patients receiving flapless implant surgery compared to traditional open flap surgery. Materials and Methods: A two-centre, prospective survey study was conducted, using a customized questionnaire. Between December 2010 and January 2012, 20 patients were consecutively included. Eleven received conventional open-flap surgery and nine received flapless surgery. Inflammatory signs, analgesic consumption and sleeping difficulties were evaluated up to seven days postoperatively. A clinical examination was made one week postoperatively. Results: Significantly less experienced swelling was noted 24 hours after flapless surgery compared to open flap surgery for patients receiving four implants or more, and at three days postoperatively for patients receiving single implants. No difference concerning sleeping difficulties, pain or analgesic consumption was found. Clinical examination one week postoperatively showed no differences in wound gaps, redness of the mucosa, or presence of pus between the groups. Conclusions: In conclusion, flapless surgery seems to have a limited effect on postoperative comfort and short-term post-operative signs of soft tissue healing compared to open flap surgery. There is a need for larger randomized trials for evaluating differences in postoperative discomfort between the two surgical techniques.

A comparison of visual discomfort experienced by surgeonsin wireless versus conventional endoscopy in laparoscopic surgery

Background:This study was performed to introduce a new wireless endoscopic system.Research and development were based on fifth-generation transmission technology.Eye symptoms and visual discomfort induced by the novel endoscopic system were compared with those induced by the conventional endoscopic system before and during laparoscopic pelvic surgery.Materials and methods:Twenty surgeons successfully conducted laparoscopic pelvic surgeries using a conventional endoscopic system and a wireless endoscopic system.Subjective and objective data were measured to evaluate visual discomfort before and 2 hours after surgery.Results:In the conventional endoscopic and wireless endoscopic system groups,no significant differences were found in the presurgical or postsurgical questionnaires.In both groups,tear film breakup times significantly decreased after surgery.However,after comparing the 2 groups,no statistically significant difference was found.Conclusions:Compared with the conventional endoscopic system,the novel wireless endoscopic system does not cause additional visual discomfort for experienced surgeons.

基于被动动态坐姿的健康坐垫设计

目的为缓解办公人群久坐肌肉疲劳和主观不适,研究一种基于被动动态坐姿的健康坐垫并进行创新应用。方法通过研究坐姿运动解剖学,以及被动动态坐姿相关理论,提出基于气囊坐垫的被动动态坐姿实现方式。再通过坐姿实验,利用表面肌电测试仪及主观不适量表对该产品进行测试,验证设计的可行性。实验结果表明实验组中位频率(Mean Frequency,MF)变化数值大于对照组,并且除左髂肋肌以外,在右髂肋肌,以及两侧多裂肌及两侧最长肌的效应量较大(Cohen'sf>0.40),并且实验组主观不适(Perceived Discomfort,PD)变化数值小于对照组,其中在下背、臀部、坐骨、座椅边缘以及总体上呈现较大效应量(Cohen's f>0.40)。在此基础上,提出一款智能被动动态健康座椅。结论使用气囊坐垫和其被动动态工作方式可以有效缓解使用者久坐产生的肌肉疲劳和主观不适,对提高用户久坐健康及久坐舒适具有意义。

无痛胃镜检查术后咽喉疼痛的发生情况和危险因素分析

目的探讨无痛胃镜检查术后咽喉疼痛的发生情况及其危险因素。方法选取2019年10月-2019年11月于该院内镜中心接受无痛胃镜检查术的连续门诊患者作为研究对象。采用课题组自行编订的调查问卷收集相关信息,从无痛胃镜检查术后24 h开始,每隔24 h进行一次电话随访,直至术后咽喉疼痛完全消失;采用数字分级评分法(NRS)评估术后咽喉疼痛严重程度,并记录持续时间;根据是否出现术后咽喉疼痛,将患者分为术后咽喉疼痛组(Ⅰ组)和非术后咽喉疼痛组(Ⅱ组),将两组组间比较差异有统计学意义的因素纳入多因素Logistic回归分析,筛选影响无痛胃镜检查术患者术后咽喉疼痛的独立危险因素。结果共608例患者完成研究,42例发生术后咽喉疼痛,发生率为6.91%,NRS评分为3.00(2.00,4.25)分,持续时间为24.0(10.0,48.0)h,最长时间为192 h(1例)。年龄及前3天疲劳程度是无痛胃镜检查术患者术后咽喉疼痛的独立影响因素:年龄每增加1岁,术后咽喉疼痛发生率减少2.60%;前3天疲劳程度为中度疲劳和重度疲劳,是术后咽喉疼痛的危险因素。结论无痛胃镜检查术后咽喉疼痛问题值得高度重视。年龄每增加1岁,无痛胃镜检查术后咽喉疼痛发生率减少2.60%;前3天疲劳程度为中度疲劳和重度疲劳,是无痛胃镜检查术后咽喉疼痛的危险因素。

以咽部不适为主要症状的弥漫性特发性骨肥厚综合征1例

本文报道1例以咽部不适为主要症状的DISH(弥漫性特发性骨肥厚)综合征。患者因咽部不适4个月来院就诊,电子喉镜见咽后壁明显隆起,触之较硬,颈部增强MR见C3-7颈椎前缘见片状短T1长T2影,符合DISH综合征的诊断。