咽喉部异物是耳鼻喉科常见的急症之一,患者症状明显,一般情况下可在间接喉镜下取出,但如果异物位置隐蔽,患者难以配合,则不易取出.随着医学技术的发展,可采用纤维喉镜检查发现异物并取出.纤维喉镜又称"软式内镜",镜身的屈曲度可达到180 ° ,能观察到咽喉部隐蔽位置,再利用其显示器放大功能,通过医师和护士的配合就能将异物取出.现将护理配合报告如下.

Background Working for long hours often leads to mental fatigue. There is evidence that mental fatigue is serious damage to cognitive function and behavior of the operator. Revealing the mechanism of continuous operation and sleep deprivation (SD) on cognitive function, will help to combat the fatigue caused by continuous operation and to improve capacity of operators. This functional magnetic resonance imaging (fMRI) study focused on the influence of sleep deprivation on digital memory in human brain. Methods Totally 6 healthy subjects underwent a digital memory encoding, maintenance and retrieval session during fMRI scanning before and after 48 h sleep deprivation. Results The digital memory test had the same error rate before and after sleep deprivation (P > 0.05, for all), but the reponse time of seven-number memory was longer after sleep deprivation (P = 0.005). During encoding trials decreased fMRI regions of significant activation between sleep control and sleep deprivation were in left parahippocampal gyrus Brodmann 30, left superior temporal gyrus Brodmann 42, left insular lobe Brodmann 41 and left frontal lobe Brodmann 6. During maintenance trials decreased fMRI regions of significant activation were at left superior temporal gyrus Brodmann 38, left middle temporal gyrus Brodmann 21, left parahippocampus and amygdaloid nucleus Brodmann 30, left middle frontal gyrus Brodmann 47, left lenticular nucleus and thalamus, right lenticular nucleus, left retrosplenial granular cortex Brodmann 30, right retrosplenial granular cortex Brodmann 30, bilateral cingulate gyrus Brodmann 24 and bilateral middle frontal gyrus, medial frontal gyrus Brodmann 6. During retrieval trials decreased fMRI regions of significantly positive activation were at bilateral hippocampus, right amygdaloid nucleus and inferior parietal lobule Brodmann 40, left precuneus Brodmann 19 and thalamus. Conclusion Different brain regions are activated at different stages of the digital memory to keep awake after sleep deprivation. The cerebral cortical and subcortical structures participated digital memory will be injured after 48 h of sleep deprivation.

Objective To estimate the psychological states and plasma amino acid content in chemical poisoning pa tients.Methods 34 patients of chemical poisoning in December 2012 in the 307th hospital of PLA were selected.The liquid chromatography-mass spectrometry(LC-MS/MS Q-TRAP) isotope internal standard method was used to deter mine the full spectrum of plasma amino acids of the 34 chemical poisoning patients.The contrast among the level of Taurine(Tau),glycine(Gly),glutamic acid(Glu),γ-aminobutyric acid(GABA),aspartic acid(Asp),alanine(Ala) and the standard values were analyzed by the rank sum test.The psychological assessment was made based on the relevant psychological tests.Results The Tau and Gly levels of chemical poisoning patients were higher than their standard val ues(the average of normal upper and lower limits of the amino acid),Glu and GABA levels were lower than their standard values,the differences were statistically significant(P < 0.05);the differences between Asp and Ala levels and their standard values were not statistically significant(P > 0.05);the majority of the 34 patients with ignificant anxiety and sleep disorders were found.Conclusion The psychological tests conducted during hospitalization show that most patients suffer from significant anxiety and severe sleep disorders.The patients' psychological situation is corre lated with the changes of plasma amino acid.

目的：探讨连续体力作业时对人脑注意力、记忆力等认知功能的影响。方法：以30例志愿者为研究对象，连续3天进行体力作业并限制夜间睡眠时间。采用数字划销测试、数字搜索测试检测持续体力作业受试者的第1天、第3天的注意力、记忆力等大脑认知功能的变化。组间计量资料比较采用完全设计随机资料的方差分析。结果：数字划销测试：连续作业第1天划对数为7.73±2.41，第3天下降至4.36±1.92，所得净分从第1天的4.99±2.03，降至第3天2.42±2.32，差异显著(P＜0.05)；第1天划错数是0.13±1.17、失误率是（32.43±15.65）％，连续体力作业第3天增加近1倍，划错数为0.33±1.06，而失误率则达到（60.73±25.67）％，差异显著(P＜0.05)。数字搜索测试：失误率在作业第1天为（37.54±25.90）％，低于连续体力作业第3天(48.91±30.40)％，差异显著(P＜0.05)。净分分值随着连续体力作业时间的增加而降低，但无显著差异。结论：连续体力作业能造成人脑认知功能的受损，随着连续体力作业时间的延长，作业人员短期注意力及记忆功能降低。