Objective To invesligate the treatment of retinal de tachment(RD) after silicone oil tamponades(SOT)． Methods The records of a consecutive series of 32 eyes with redetachment of retina after SOT surgery between 1998 to 2000 were reviewed retrospectively． The surgical techniques used for these cases included remove of silicon oil,peeling of preretinal membrane, retinotomy, endolaser photocoagutation, secondary vitrectomy and C3 F8 tamponades． Results In 28 of 32 eyes the retina was reattached (87．6%)． The postoperative visual acuity was improved in 12 eyes, redused in 4 eyes and remained no change in 16 eyes． The postop erative complications in 6 eyes included secondary glaucoma(3 eyes), hypotony (1 eye) and hyphema (2 eyes)． Conclusion The techniques of preretinal membrane peeling, retinotomy, endophotocoagulation and C3 F8 tamponades can be effectively used in combination to treat the redetachment of retina after the silicone oil tamponades surgery． (Chin J Ocul Fundus Dis,2001,17:214-215)
Sensorimotor disorder can be easily caused by stroke, and there are many targeted movement rehabilitation therapies. With the development of rehabilitation robot technology, robot-assisted therapy combined with mechanical perturbations has become a more effective motor rehabilitation therapy. In this paper, the definition of mechanical perturbation and its physiological mechanism in stroke rehabilitation are introduced, the research progress on mechanical perturbation in the field of stroke rehabilitation therapy is mainly discussed, the application of mechanical perturbation in motor control, postural response and sensory evaluation of stroke rehabilitation is summarized, and the future development direction of mechanical perturbation rehabilitation therapy is also prospected.
睡眠呼吸暂停低通气综合征( SAHS) 是一种常见病症,临床上以阻塞性睡眠呼吸暂停低通气综合征( OSAHS) 最为常见[1] 。1993 年一项基于社区人群的研究中, Young 等[2] 发现年龄介于30 ～60 岁的人群中, 以睡眠呼吸暂停低通气指数( AHI) ≥5 次/h 定义的OSAHS在女性的患病率为9% ,在男性为24% , 2% 的女性和4% 的男性同时存在嗜睡症状。越来越多的证据表明睡眠呼吸暂停可导致许多并发症, 包括行为和躯体两方面。行为并发症包括日间嗜睡、注意力下降和神经心理异常, 而躯体并发症主要包括心脑血管疾病, 尤其是高血压[3, 4] 。OSAHS 是全身多个脏器功能损害的独立危险因素, 其中心血管并发症是主要死因[5] 。如何评价OSAHS 病情严重程度, 对患者的诊断、治疗及预后判断具有非常重要的意义。目前AHI 仍然是诊断OSAHS 的金标准,但其与靶器官损害的相关性存在诸多争议。
In recent years, photon-counting computed tomography (PCD-CT) based on photon-counting detectors (PCDs) has become increasingly utilized in clinical practice. Compared with conventional CT, PCD-CT has the potential to achieve micron-level spatial resolution, lower radiation dose, negligible electronic noise, multi-energy imaging, and material identification, etc. This advancement facilitates the promotion of ultra-low dose scans in clinical scenarios, potentially detecting minimal and hidden lesions, thus significantly improving image quality. However, the current state of the art is limited and issues such as charge sharing, pulse pileup, K-escape and count rate drift remain unresolved. These issues could lead to a decrease in image resolution and energy resolution, while an increasing in image noise and ring artifact and so on. This article systematically reviewed the physical principles of PCD-CT, and outlined the structural differences between PCDs and energy integration detectors (EIDs), and the current challenges in the development of PCD-CT. In addition, the advantages and disadvantages of three detector materials were analysed. Then, the clinical benefits of PCD-CT were presented through the clinical application of PCD-CT in the three diseases with the highest mortality rate in China (cardiovascular disease, tumour and respiratory disease). The overall aim of the article is to comprehensively assist medical professionals in understanding the technological innovations and current technical limitations of PCD-CT, while highlighting the urgent problems that PCD-CT needs to address in the coming years.
The Monte Carlo N-Particle (MCNP) is often used to calculate the radiation dose during computed tomography (CT) scans. However, the physical calculation process of the model is complicated, the input file structure of the program is complex, and the three-dimensional (3D) display of the geometric model is not supported, so that the researchers cannot establish an accurate CT radiation system model, which affects the accuracy of the dose calculation results. Aiming at these two problems, this study designed a software that visualized CT modeling and automatically generated input files. In terms of model calculation, the theoretical basis was based on the integration of CT modeling improvement schemes of major researchers. For 3D model visualization, LabVIEW was used as the new development platform, constructive solid geometry (CSG) was used as the algorithm principle, and the introduction of editing of MCNP input files was used to visualize CT geometry modeling. Compared with a CT model established by a recent study, the root mean square error between the results simulated by this visual CT modeling software and the actual measurement was smaller. In conclusion, the proposed CT visualization modeling software can not only help researchers to obtain an accurate CT radiation system model, but also provide a new research idea for the geometric modeling visualization method of MCNP.
ObjectivesTo systematically review the efficacy and safety of palifermin on oral mucositis (OM) and acute graft versus host disease (aGVHD) for hematological malignancy patients undergoing hematopoietic stem cell transplantation (HSCT).MethodsPubMed, The Cochrane Library, Web of Science, EMbase, Clinicaltrials.gov, CNKI and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) of the efficacy of palifermin on OM and aGVHD for hematological malignancy patients undergoing HSCT from inception to September 30th, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 7 RCTs involving 904 patients were included. The results of meta-analysis showed that: palifermin could reduce the duration of OM grade 2 to 4 (MD=−4.21, 95%CI −7.83 to −0.58, P=0.02), OM grade 3 to 4 (MD=−2.54, 95%CI −4.61 to −0.46, P=0.02) significantly for hematological malignancy patients undergoing HSCT. However, no significant difference was found in the prevalence of aGVHD grade 2 to 4 (RR=1.29, 95%CI 0.95 to 1.75, P=0.11), aGVHD grade 3 to 4 (RR=0.99, 95%CI 0.55 to 1.77, P=0.97), OM grade 2 to 4 (RR=0.86, 95%CI 0.72 to 1.03, P=0.11) and OM grade 3 to 4 (RR=0.82, 95%CI 0.65 to 1.03, P=0.08) between palifermin group and placebo group. The prevalence of paresthesia (RR=4.24, 95%CI 1.24 to 14.56, P=0.02) and erythema (RR=1.49, 95%CI 1.06 to 2.09, P=0.02) were significantly higher in palifermin group.ConclusionsThe durations of OM grade 2 to 4, 3 to 4 are significantly reduce in patients receiving palifermin compared with those receiving a placebo, however, no statistically significant difference are found in the incidence of aGVHD grade 2 to 4, 3 to 4, OM grade 2 to 4, 3 to 4. Parethesia and erythema are more prevalent among patients using palifermin. Therefore, advantages and disadvantages of palifermin should be considered when used in clinical.
Objective To analyze the dynamic efficiency of township hospitals. Methods Based on the DEA-Malmquist index, this research analyzed the change of the total factor productivity indices and the decomposition items of 281 township hospitals in Hunan province with panel data from 2000 to 2008. Results Among 281 township hospitals, less than half increased their scale efficiency, while more than half increased their total factor productivity, technology, whole efficiency and technical efficiency. Increasing technology and whole efficiency was the best way to improve total factor productivity. Besides, increasing technical efficiency and scale efficiency was the best way to improve whole efficiency. Conclusions The improvement of scale efficiency is key to developing the central township hospitals, while the improvement of technology is the key to developing general township hospitals.
Objective To develop a multidisciplinary nursing program for Prader-Willi syndrome with spinal deformity and evaluate its effectiveness in clinical practice. Methods In July 2016, a multidisciplinary collaborative team was established before the treatment of children with Prader-Willi syndrome complicated with spinal deformity. For the nursing difficulties in the perioperative period, relevant literature was consulted, and a multidisciplinary collaborative nursing plan was formulated, which included nutrition management and blood glucose control, management of obstructive sleep apnea hypopnea syndrome, behavioral intervention related to mental change, and early identification and management of complications. The developed multidisciplinary collaborative nursing program was applied to three children with Prader-Willi syndrome complicated with spinal deformity in Peking Union Medical College Hospital from July 2016 to October 2018, and their postoperative recovery was evaluated. Results One child had inguinal skin ulceration when admitted to hospital, which was significantly improved after active treatment. The perioperative blood glucose level control of the three children was satisfactory, and there was no postoperative gastrointestinal dysfunction, deep wound infection, respiratory complications, internal fixation failure or other complications, and no asphyxia, fall, loss, or other adverse events. The follow-up compliance after discharge was 100%. Conclusions Multidisciplinary collaboration programs can escort patient’ safety and promote their recovery, improve the professional level of nursing staff, and reflect the nursing value. As a working mode, it can be further popularized and used for reference in the nursing of other difficult diseases.
目的 提高临床医生对甲状腺功能减退症（甲减）并发急性呼吸衰竭的认识，减少误诊，提高救治率。方法 对2002年11月－2011年6月收治的6例甲减并发急性呼吸衰竭患者予以有创机械通气及早期使用左旋甲状腺素治疗，使病症得以控制和治愈。 结果 患者使用有创机械通气治疗平均7 d，住院治疗14～43 d，平均（28.6 ±14.4）d， 5例治愈，1例死亡。 结论 甲减并发呼吸衰竭早期使用机械通气及甲状腺激素替代治疗可提高抢救成功率。
ObjectivesTo assess the characteristics, methodological and reporting qualities of systematic reviews on community interventions in China.MethodsThe Cochrane Library, PubMed, EMbase, Web of Science, CNKI, VIP, WanFang Data and CBM databases were searched for studies of community interventions from inception to August 2017. Two reviewers independently screened literature, extracted data and assessed the methodological and reporting quality by AMSTAR tool and PRISMA checklist. Data analysis was performed by SPSS 20.0 software.ResultsA total of 18 systematic reviews of community interventions were included. The average AMSTAR score was 4.67±1.68, and all studies did not provide the list of included and excluded studies or a statement on conflict of interests. The average PRISMA score was 16.42±3.65, and over 50.0% of the included systematic reviews did not perform protocol and registration, search, additional analyses, risk of bias of included studies and funding.ConclusionsThe evidence shows that the reporting and methodological quality of meta-analyses of community interventions in China is insufficient. The combination of results, quality of individual research and the evaluation of publication bias should be paid more attention to improve methodological quality. The reporting of meta-analyses of community interventions in China should follow the PRISMA checklist.