Effect of Mouth Opening Training Stick Combined with Oral Massage on Mouth Opening Difficulty in Head and Neck Cancer Patients after Treatment

Objective: To study the application effect of mouth-opening training sticks combined with oral massage on patients with mouth-opening difficulty after treatment for head and neck cancer. Methods: Using convenient sampling, 60 patients with mouth-opening difficulty after treatment for head and neck cancer admitted to the Oncology Department from February 2022 to October 2023 were selected for a 2-week exercise and nursing program. The patients were divided into a control group (February 1, 2022 to November 30, 2022) and an observation group (December 1, 2022 to October 31, 2023), with 30 patients in each group. The control group underwent routine mouth-opening functional exercises combined with cork for oral support training, while the observation group underwent routine mouth-opening functional exercises combined with oral massage and mouth-opening training sticks for oral support training. The mouth-opening degree, mouth-opening difficulty level, comfort level, compliance, and quality of life were observed in both groups. Results: Before the intervention, there were no statistically significant differences in mouth-opening degree and mouth-opening difficulty level between the two groups (P > 0.05). After the intervention, the mouth-opening degree, mouth-opening difficulty level, oral comfort level, compliance, and QLICP-HN scores in the observation group were all better than those in the control group, with statistically significant differences (P < 0.05). Conclusion: The combination of mouth-opening training sticks and oral massage with mouth-opening functional exercises can effectively improve the degree of mouth-opening difficulty, enhance oral comfort, increase compliance with mouth-opening exercises, and improve quality of life.

Use of McGrath^(■) MAC Video Laryngoscope for Nasotracheal Intubation in Patients for Whom Intubation Was Expected to Be Difficult Due to the Limited Mouth Opening

McGrath? MAC video laryngoscope (McG) has been used for orotracheal intubation in both normal patients and patients for whom intubation was expected to be difficult, and has been reported to provide improved visibility of the glottis during tracheal intubation. There are some reports that normal nasotracheal intubation is easier with McG than with macintosh laryngoscope (ML). The usefulness of McG for nasotracheal intubation is beginning to be recognised. We experienced three cases using McG in patients for whom intubation was expected to be difficult due to the limited mouth opening and using McG for those patients enabled smooth nasotracheal intubation. McG provides good visual field during nasotracheal intubation, and is less invasive to the patient.

Exclusive Fibula Osteosynthesis for Treating Open Fractures Gustillo I-III B of the Distal Half of the Leg Bones in a Resources-Limited Setting

Introduction: Management of open leg bones fractures is a challenging health issue for the surgeon, particularly true in resource-limited settings. In this study, we evaluate exclusive fibular osteosynthesis in the treatment of open fractures of the distal half of the leg bones as a therapeutic option in our context. Methods: This is a prospective, experimental, multicenter study of 30 open fractures of the distal half of the leg bones treated with exclusive fibula osteosynthesis, conducted in 3 hospitals in the DRC from January 1, 2013 to September 30, 2016. Results: The age range of 20 to 40 years grouped 22 (73.4%) patients, the sex ratio was 1:1 and the unemployed were the most involved with 16 (53.3%) cases. The Gustilo II, I, III B and III A types represented 40%, 33.3%, 20% and 6.7%, respectively. The fractures were located in the distal third in 12 (40%) cases, in the middle third in 11 (36.7%) cases, and in both malleoli in 7 cases (23.3%). Osteosynthesis of the fibula by screw plate was applied in 22 (73.3%) patients and pinning in 8 (26.7%). Satisfactory reduction of the tibial fracture site was achieved in 29 (96.7%) cases and 100% bone healing was achieved within an average of 10 weeks. Four (13.3%) loss of alignment, 1 (3.3%) infection, 1 (3.3%) skin necrosis and 2 (6.7%) ankle stiffness complicated our fractures. Conclusion: Exclusive osteosynthesis of the fibula as a common technique for fractures of the distal half of the leg bones allowed us to reduce, immobilize and consolidate the tibial fracture in the required time and to preserve the mobility of the ankle.

Social functions of relaxed open-mouth display in golden snub-nosed monkeys(Rhinopithecus roxellana)

Relaxed open-mouth display serves important social functions in relation to submission, reconciliation affiliation and reassurance among non-human primate societies; however, quantitative evidence on this behavior remains insufficient among multi-level social groups. From July to November 2016, we examined four potential functions of the relaxed open-mouth display during pairwise, intra-unit social interactions among 18 free-ranging adult and sub-adult golden snub-nosed monkeys(Rhinopithecus roxellana) who belonged to three one-male, multi-female units(OMU) at Dalongtan, Shennongjia National Park China. Results showed that: compared with no relaxed open-mouth display,(1) the occurrence of displacement by a dominant individual approaching a subordinate was lower and the distance of the subordinate to the approaching dominant was shorter when the subordinate showed open-mouth display;(2) relaxed open-mouth display reduced the probability of continued attack for victims of aggression and allowed victims to achieve closer proximity to the aggressor during post-conflict periods;(3) relaxed open-mouth display by dominant individuals allowed them to achieve closer proximity to subordinates; and(4) the exchange of relaxed open-mouth display had a greater impact on the outcome of interactions than one individual alone giving this signal. These findings suggest that relaxed open-mouth display serves important functions regarding submission, reconciliation, affiliation and reassurance in coordinating social interactions within OMUs in golden snub-nosed monkeys.

Non-Markovian speedup dynamics control of the damped Jaynes-Cummings model with detuning

For a two-level atom in a lossy cavity, a scheme to manipulate the non-Markovian speedup dynamics has been pro- posed in the controllable environment （the lossy cavity field）. We mainly focus on the effects of the qubit--cavity detuning A and the qubit-cavity coupling strength k on the non-Markovian speedup evolution of an open system. By controlling the environment, i.e., tuning zl and , two dynamical crossovers from Markovian to non-Markovian and from no-speedup to speedup are achieved. Furthermore, it is clearly found that increasing the coupling strength k or detuning A in some cases can make the environmental non-Markovianity stronger and hence can lead to faster evolution of the open system.

Intracortical screw insertion plus limited open reduction in treating type 31A3 irreducible intertrochanteric fractures in the elderly

BACKGROUND In most elderly patients with intertrochanteric fractures,satisfactory fracture reduction can be achieved by closed reduction using a traction table.However,intertrochanteric fractures cannot achieve satisfactory reduction in a few patients,which is called irreducible intertrochanteric fractures.Especially for type 31A3 irreducible intertrochanteric fractures,limited open reduction of the broken end with different intraoperative reduction methods is required to achieve satisfactory reduction and fixation.AIM To discuss clinical efficacy of intracortical screw insertion plus limited open reduction in type 31A3 irreducible intertrochanteric fractures in the elderly.METHODS A retrospective analysis was performed on 23 elderly patients with type 31A3 irreducible intertrochanteric fractures(12 males and 11 females,aged 65-89-yearsold)who received treatment at the orthopedics department.After type 31A3 irreducible intertrochanteric fractures were confirmed by intraoperative C-arm,all of these cases received intracortical screw insertion plus limited open reduction in the broken end with intramedullary screw internal fixation.The basic information of surgery,reduction effects,and functional recovery scores of the hip joint were assessed.RESULTS All patients were followed up for 13.8 mo on average.The operation time was 53.8±13.6 min(40-95 min).The intraoperative blood loss was 218.5±28.6 mL(170-320 mL).The average number of intraoperative X-rays was 22.8±4.6(18-33).The average time to fracture union was 4.8±0.7 mo.The reduction effect was assessed using Kim’s fracture reduction evaluation.Twenty cases achieved grade I fracture reduction and three cases grade II fracture reduction.All of them achieved excellent or good fracture reduction.Upon the last follow-up,the functional recovery scores score was 83.6±9.8,which was not significantly different from the functional recovery scores score(84.8±10.7)before the fracture(t=0.397,P=0.694).CONCLUSION With careful preoperative preparation,intracortical screw insertion plus limited open reduction contributed to high-quality fracture reduction and fixation.Good clinical outcomes were achieved without increasing operation time and intraoperative blood loss.

Quantum speed limit time and entanglement in a non-Markovian evolution of spin qubits of coupled quantum dots

Quantum speed limit time and entanglement in a system composed of coupled quantum dots are investigated.The excess electron spin in each quantum dot constitutes the physical system(qubit).Also the spin interaction is modeled through the Heisenberg model and the spins are imposed by an external magnetic field.Taking into account the spin relaxation as a non-Markovian process,the quantum speed limit and entanglement evolution are discussed.Our findings reveal that increasing the magnetic field leads to the faster quantum evolution.In addition,the temperature increment causes the longer quantum speed limit time as well as the entanglement degradation.

GIS-based 3D limit equilibrium analysis for design optimization of a 600 m high slope in an open pit mine

Combining the GIS （geographic information systems） grid-based data with four proposed column-based 3D slope stability analysis models, a comprehensive solution of a high-steep open-pit slope has been obtained. For six searching ranges, 19 critical slip surfaces of different sizes have been studied, in which the minimum 3D safety factor is 1.33. Comparison of 3D safety factors of designed and proposed slope plans shows for all the critical slip surfaces for the proposed plan, the smallest 3D safety factor is 1.33 under the most unfavorable condition. This means that the proposed plan of the high slopes, about 600 m, of an open pit （2-5° steeper than designed plan） is feasible.

Open pit limit optimization considering economic profit,ecological costs and social benefits

Pit limit design has,up to date,focused mainly on maximization of economic profit alone,with environmental and social issues largely ignored.This paper focuses on incorporating both environmental and social issues in the pit limit design process and provides an approach to pit limit optimization that is in compliance with sustainable development.The case study demonstrates that ecological costs have a substantial down-sizing effect and social benefits have a substantial up-sizing effect on the optimal pit limit.When the ecological costs are factored in,the optimal pit limit is 37.5%smaller than the economically optimal pit limit.However,when the social benefits are factored in,the optimal pit limit is 48.3%larger than the economically optimal one.The overall optimal pit limit,with the economic profit,ecological costs and social benefits simultaneously considered,is a result of balancing conflicting goals of maximizing economic profit,minimizing ecological cost,and maximizing social benefit.

Influences of spin-orbit interaction on quantum speed limit and entanglement of spin qubits in coupled quantum dots

Quantum speed limit and entanglement of a two-spin Heisenberg XYZ system in an inhomogeneous external magnetic field are investigated.The physical system studied is the excess electron spin in two adjacent quantum dots.The influences of magnetic field inhomogeneity as well as spin-orbit coupling are studied.Moreover,the spin interaction with surrounding magnetic environment is investigated as a non-Markovian process.The spin-orbit interaction provides two important features:the formation of entanglement when two qubits are initially in a separated state and the degradation and rebirth of the entanglement.

牛碱性成纤维细胞生长因子联合盐酸金霉素眼膏对正颌外科术后口角黏膜压力性损伤愈合的效果

目的:研究外用牛碱性成纤维细胞生长因子联合盐酸金霉素眼膏用于正颌外科术后口角黏膜压力性损伤愈合的临床效果。方法:选取温州医科大学附属口腔医院2018年6月—2023年9月行正颌外科术后发生口角黏膜压力性损伤的患者为研究对象,根据用药方式不同,将患者分为盐酸金霉素眼膏组(30例)、外用牛碱性成纤维细胞生长因子组(30例)和外用牛碱性成纤维细胞生长因子联合盐酸金霉素眼膏组(简称联合组)(30例)。比较3组患者的疼痛程度、张口度、愈合时间及满意度。结果:用药第5天,3组VAS评分均较用药前显著下降(P<0.05),张口度均较用药前明显增大(P<0.05)。用药第5天,3组VAS评分和张口度差异有统计学意义(H=13.921,P=0.001;F=8.569,P<0.001),其中与金霉素眼膏和外用牛碱性成纤维细胞生长因子组相比,联合组的VAS评分最低、张口度最大(P<0.05)。3组用药前后VAS评分和张口度的差值差异有统计学意义(H=18.292,P<0.001;F=6.720,P=0.002),且联合组的差值均为最大。3组愈合时间和满意度差异均有统计学意义(F=9.510,P<0.001;χ^(2)=8.940,P=0.011),其中联合组的愈合时间最短、满意度最高(P<0.05)。结论:外用牛碱性成纤维细胞生长因子联合盐酸金霉素眼膏可促进正颌外科术后口角黏膜压力性损伤的愈合,减轻术后疼痛,增大张口度,缩短愈合时间,从而提高患者的满意度。

口腔黏膜下纤维性变的治疗研究进展

口腔黏膜下纤维性变(OSF)是一种慢性、潜伏性疾病,被归类为口腔潜在恶性疾病,是一个全球性和区域性的公共卫生问题。它被认为是一种多因素疾病,如咀嚼槟榔、微量元素紊乱和遗传易感性等。本文回顾总结近年来国内外治疗OSF的各种方法,包括药物治疗、手术治疗、物理治疗等,以上治疗方法主要是减轻疾病的体征和症状,尚缺乏单一有效的治疗方法。此外,有部分研究者提出新的治疗方法-干细胞治疗,但是观察病例量较少,疗效和安全性有待进一步研究。

档案延期开放的判断依据与时限问题探究

文章聚焦档案延期开放判断依据与时限问题,在对现行法规性文件中档案延期开放的判断依据进行梳理后,将其分为六大类:(1)仍属于国家秘密的;(2)涉及可能危及国家安全和社会稳定信息的;(3)涉及知识产权的;(4)涉及个人信息的;(5)档案捐赠者要求延期开放或是不开放的;(6)其他按照有关法律、行政法规和国家有关规定应当延期开放的,并重点就第(2)(3)(4)类情形的延期时限问题展开了详细讨论。文章最后指出,基于避免出现永久性豁免开放情形的考虑,应设置在常规封闭时限到期后定期滚动再审的制度安排。

数字技术的司法应用:时空局限性的突破及其规制

数字技术在司法中的应用,实现了对时间与空间局限性的突破。犯罪行为已经率先借助数字技术实现远程、跨境的不接触犯罪,这种犯罪形态为公安司法机关侦查取证、诉讼证明和追赃挽损带来难题。数字技术对于司法时空局限性的突破,还影响到审判公开原则的适用范围、直接言词原则的实践状况,以及远程提审、律师会见、开庭审判的“到庭”概念、诉讼可视化等的方式或内涵。不仅如此,数字技术应用也带来一些隐忧,实体意义上的法庭是否会萎缩、消失,法官功能是否会被智能机器人取代,成为越来越不能回避的话题。数字技术的初步应用,如网上开庭与网络直播庭审,固然有其各自的优势,但也都有一定的弊端,针对这些弊端,需要以一定的原则、制度、规则加以规制,非必要不实行网上开庭以及实行有限的网络庭审直播等,应当是我国当前刑事司法的应对措施。

关节松动术配合针刺治疗颞下颌关节紊乱综合征

目的探讨关节松动术配合针刺治疗颞下颌关节紊乱综合征(TMJDS)临床疗效。方法选择颞下颌关节紊乱综合征患者144例,按照随机数表法分成观察组与对照组。对照组给予单纯针刺治疗,观察组在针刺治疗基础上配合关节松动术治疗4周。比较2组口腔健康影响程度量表(OHIP-14)评分、国际常用视觉模拟评分量表(VAS)评分、最大张口度、中文版颞下颌功能受损评分(MFIQ)及Fricton颞下颌关节紊乱指数,比较2组临床疗效和安全性。结果2组治疗后OHIP-14评分,VAS评分,MFIQ评分,功能障碍指数(DI)、肌肉触压痛指数(PI)、颞下颌关节指数(CMI)评分均降低(P<0.05),且观察组低于对照组(P<0.05);2组治疗后最大张口度均升高(P<0.05),且观察组高于对照组(P<0.05);观察组总有效率高于对照组(P<0.05);2组均未发生与治疗相关的不良事件。结论关节松动术配合针刺能够改善颞下颌关节紊乱综合征患者疼痛和颞下颌功能活动,提高最大张口度,疗效明显。

充填站荷载作用下露天坑边坡稳定性分析

某铁矿生态修复工程采用尾砂胶结固化方式对露天采坑进行回填,计划在露天坑周边建设充填站,为论证边坡及充填站安全可靠性,本文采用极限平衡分析和数值模拟方法,对充填站荷载作用下的边坡稳定性进行了计算分析。计算结果显示,该充填站所处的边坡在回填至-354 m时为基本稳定,在充填至-300 m工况下处于稳定状态,为确保边坡及充填站安全,建议加强该充填站所在区域边坡监测,确定所在区域边坡稳定前提下进行建设。

标准型人工颞下颌关节假体在开口运动中的特征分析

目的:分析标准型人工颞下颌关节置换术后(alloplastic temporomandibular joint replacement,ATJR)开口运动的特征。方法:分别收集10例正常颞下颌关节志愿者和10例单侧Biomet标准型人工关节置换术后患者的下颌运动和颌面部CT数据。使用Proplan CMF 3.0进行颌骨三维重建并导出颌骨模型,在Geomagic Wrap 2021软件中与下颌运动数据配准结合,通过Anybody 7.0软件建立运动学模型,从髁突/假体顶点向下每5 mm取一点(P0~P-50),计算各点在开口运动中的轨迹及弧长。将人工关节假体模拟安装在正常人及患者的非置换侧髁突,比较开口运动中假体顶点之间的运动范围差异。采用SPSS 25.0软件包对数据进行统计学分析。结果:正常人髁突顶点的运动轨迹为凹向上的弧线,弧长为(15.18±2.31) mm,P-30处运动轨迹最短。人工颞下颌关节假体(alloplastic temporomandibular joint prosthesis,ATJP)顶点运动轨迹为凸向上的短弧线,相比正常髁突对应点(P-10)的轨迹弧长显著缩短[(3.55±0.45)mm∶(11.61±1.63)mm,P=0.00],P-20处运动轨迹最短;ATJP非置换侧髁突顶点的运动轨迹与正常髁突轨迹形态相似,弧长为(13.35±1.54)mm,无显著差异(P=0.07),P-40处运动轨迹最短。ATJP顶点的运动范围显著小于非置换侧髁突对应点和正常人髁突对应点P-10的运动范围(P=0.00)。结论:标准型人工颞下颌关节置换后髁突假体在开口运动中的滑动距离和范围显著小于有翼外肌附着的正常和非置换侧髁突对应点的运动距离和范围。

Kaltenborn及Maitland关节松动手法对不可复性关节盘前移患者开口度改善的临床疗效比较

目的:分析不可复性关节盘前移患者采用不同手法治疗后的效果。方法:40例不可复性关节盘前移患者分别采取Kaltenborn和Maitland关节松动手法治疗1个月。评估两组患者治疗前、治疗后1、3个月的最大开口度和颞下颌关节疼痛程度变化。结果:采用独立样本t检验,治疗前,两组最大开口度与VAS疼痛评分组间比较差异无统计学意义(P>0.05)。治疗后1、3个月,两组最大开口度依次增加且Kaltenborn组大于Maitland组,VAS疼痛评分依次降低且Kaltenborn组低于Maitland组(P<0.05)。结论:Kaltenborn关节松动手法在改善不可复性关节盘前移患者开口度上比Maitland手法效果更佳,且可减轻颞下颌关节疼痛感。

基于“脾开窍于口”探讨口腔微环境改变与大鼠胃幽门螺杆菌感染的相关性

目的:基于“脾开窍于口”探讨口腔微环境改变与大鼠胃幽门螺杆菌感染之间的相关性。方法:将30只雄性SD大鼠随机分为空白组(10只)、模型组(20只),空白组予以灭菌生理盐水灌胃,模型组予以常规标准幽门螺杆菌(Hp)菌液灌胃+口腔黏膜损伤并留少许菌液于口腔中,隔日1次,共6次。通过快速尿素酶检测法及HE染色法观察Hp定植及造模成功情况,采用酶联免疫吸附法(ELISA)检测血清、胃黏膜、口腔黏膜中TLR4、NLRP3的表达以及口腔黏膜与胃黏膜组织中Hp水平,采用Person相关性分析口腔黏膜和胃黏膜中TLR4、NLRP3、Hp水平的相关性。结果:胃Hp感染大鼠活动迟缓,反应迟钝,毛发疏松粗糙易脱落,食欲下降,精神不振,大便干稀。HE染色可见模型组大鼠口腔黏膜以及胃黏膜损伤明显;ELISA结果显示,模型组血清及口腔黏膜、胃黏膜中TLR4、NLRP3、Hp表达水平明显高于空白组(P<0.01);口腔黏膜与胃黏膜中TLR4、NLRP3、Hp水平呈正相关(P<0.05)。结论:口腔微环境改变是导致幽门螺杆菌反复感染的一个重要的因素,TLR4、NLRP3在大鼠胃幽门螺杆菌感染时表达上调,且口腔黏膜与胃黏膜中TLR4、NLRP3、Hp水平呈正相关。

限流型直流变压器拓扑结构及其暂态特性研究

能量路由器的核心元件为双有源桥(dual active bridge,DAB)直流变压器,针对其短路故障时电流上升速率快,峰值大,导致DAB内部电力电子器件闭锁的问题,该文提出一种具有限流型结构的直流变压器,限流装置结构为从DAB高压侧H桥连接单相整流桥,再与输出端口的限流电感相连。当直流系统发生短路故障时,限流型直流变压器采用混合控制算法进行整流,为限流电感提供钳位电压,限制故障电流的峰值,并与断路器配合实现无弧开断,该方法避免DAB中电力电子器件发生闭锁,快速实现故障限流和隔离。在仿真系统中搭建了基于10kV/750V直流变压器的限流型直流变压器的模型,仿真结果表明限流型直流变压器与断路器配合实现故障限流和隔离的有效性和可行性。