简介：摘要BACKGROUND AND OBJECTIVESpasticity is a common sequala of the upper motor neuron lesions. For instance, it often occurs in the first 4 weeks after stroke and is seen in more than one-third of stroke survivors after 12 months. In recent years, extracorporeal shock wave therapy (ESWT) has been recognized as a safe and effective method for reducing muscle spasticity. Possible/relevant mechanisms include nitric oxide production, motor neuron excitability reduction, induction of neuromuscular transmission dysfunction, and direct effects on rheological properties. There are two types of ESWT, focused and radial, with the radial type more commonly applied for treating muscle spasticity. Concerning the optimal location for applying ESWT, the belly muscles and myotendinous junction seem to produce comparable results. The effects of ESWT on spasticity are known to last at least four to six weeks, while some studies report durations of up to 12 weeks. In this review, the authors will focus on the current evidence regarding the effectiveness of ESWT in spasticity, as well as certain technical parameters of ESWT, e．g., the intensity, frequency, location, and number of sessions. The pertinent literature has been reviewed, with an emphasis on post-stroke upper limbs, post-stroke lower limbs, cerebral palsy, and multiple sclerosis. In short, while ESWT has positive effects on parameters such as the modified Ashworth scale, mixed results have been reported regarding functional recovery. Of note, as botulinum toxin injection is one of the most popular and effective pharmacological methods for treating spasticity, studies comparing the effects of ESWT and botulinum toxin injections, and studies reporting the results of their combination, are also reviewed in this paper.

简介：摘要ObjectiveTo evaluate the effectiveness of radial extracorporeal shock wave therapy on ankle flexor spasticity in stroke survivors and to reveal changes in the fibroelastic components of muscle.DesignRandomized controlled trial.SettingInpatient neuro-rehabilitation clinic of a university hospital.ParticipantsStroke patients with ankle flexor spasticity.InterventionsPatients were randomized to three groups; radial extracorporeal shock wave therapy, sham, or control. Active and sham therapy were administered two sessions/week for two weeks. All patients received conventional rehabilitation.Main measuresThe primary outcome was Modified Ashworth Scale. Secondary outcomes were the Tardieu Scale and elastic properties of plantar flexor muscles assessed by elastography (strain index). All assessments were performed before, immediately after the treatment, and four weeks later at follow-up.ResultsFifty-one participants were enrolled (active therapy n＝17, sham n＝17, control n＝17). Modified Ashworth scores showed a significant decrease in the active therapy group (from 2.47±0.72 to 1.41±0.62) compared to sham (from 2.19±1.05 to 2.06±1.12) and control (from 2.06±0.85 to 2.00±0.73) groups immediately after the treatment (P<0.001). Tardieu results were also in concordance (P<0.001), however this effect was not preserved at follow-up. Elastic properties of the ankle flexors were improved in all groups at both assessments after the therapy showing significant decreases in strain index (P<0.001). However, there was no difference among the groups in terms of improvement in elastography.ConclusionRadial extracorporeal shock wave therapy has short-term anti-spastic effects on ankle flexor muscles when used as an adjunct to conventional rehabilitation.

简介：AbstractTrauma-induced pulmonary thromboembolism is the second leading cause of death in severe trauma patients. Primary fibrinolytic hyperactivity combined with hemorrhage and consequential hypercoagulability in severe trauma patients create a huge challenge for clinicians. It is crucial to ensure a safe anticoagulant therapy for trauma patients, but a series of clinical issues need to be answered first, for example, what are the risk factors for traumatic venous thromboembolism? How to assess and determine the status of coagulation dysfunction of patients? When is the optimal timing to initiate pharmacologic prophylaxis for venous thromboembolism? What types of prophylactic agents should be used? How to manage the anticoagulation-related hemorrhage and to determine the optimal timing of restarting chemoprophylaxis? The present review attempts to answer the above questions.

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简介：AbstractBackground:Cerebrovascular disease has become the leading cause of death in China. The purpose of this article is to analyze China's contribution to the interventional treatment of cerebrovascular diseases.Methods:Bibliometric analysis was used for evaluating the quantity, quality, research hotspots, and cooperation network of publications regarding interventional treatment of cerebrovascular diseases from China. These articles were searched from the database of Web of Science Core Collection. The authors, publication years, citation times, regions, and source journals of retrieved articles were recorded. Network analysis and visualization were performed on Citespace5.6.Results:From 1991 to 2019, a total of 5052 articles regarding cerebrovascular intervention were contributed by Chinese researchers. The number of publications from China grew fastest annually in the latest 5 years among countries. These publications were cited 61,216 times, with 12.12 average citations per item. The h-index was 82. Affiliated hospitals of Capital Medical University contributed most articles. Cerebral ischemia and intracranial aneurysm were the most popular keywords over the three decades. The timeline view of keywords indicated that cerebral ischemia always was a hot spot. Stent techniques were the main treatment tools and still had a strong developing trend. Neural regeneration and neuroprotection were the hot topics of basic researches related to cerebrovascular intervention.Conclusions:The number of researches grows rapidly in China over the decades, but the quality still needs further improvement. The increasing contributions of Chinese researchers to the global knowledge system of cerebrovascular intervention are promising.

简介：[摘要]呼吸机为人体支持通气与进行呼吸治疗的设备，在进行病人生命体征维系的治疗过程中尤为重要。在日常使用过程中，呼吸机产生的各种故障会直接影响设备使用，通过对故障类型的整理分析，可以更好地了解呼吸机各项故障，有效帮助故障排除。本文介绍了呼吸机常见故障，分享了一例多起故障合并的维修案例，通过故障可能性分析，从气泵、气路检查到管路、流量传感器及电路板维修，一步步找到问题所在，解决该台呼吸机系统故障和潮气量忽大忽小等问题，为该台设备正常使用提供有效的保障。

简介：摘要： 讨论分析方法选择的6个方面属性，拓宽研发人员在建立分析方法过程中思考的维度，从而开发出更适合生产企业使用的高效、稳定的分析方法。6个方面属性：Specifity—专属性，Sensivity—灵敏度，Speed—分析速度，Salary—分析成本，Simple—分析方法简单简洁，操作方便快捷，Stability—分析方法的稳健性，普适性。

简介：摘要：目的：探讨5S管理在提升病房整洁率中的作用。方法：我院全科医学科自2022年3月到8月期间实施5S病房管理法，与实施5S管理法之前的病区整洁率进行对比，观察实施效果。结果：实施5S管理前的病区整洁不合格率为80%，实施后为25%，实施前显著低于实施后且数据差异较大(P

简介：摘要目的对1个智力障碍家系进行致病基因鉴定及产前诊断。方法家系3代17人，4例男性罹患智力障碍，2019年10月先证者之姐于孕8周时就诊于河南省人民医院要求遗传咨询。签署知情同意书后，采集家系成员外周血，采用全外显子组测序分析先证者（Ⅱ-9，男）及父母基因编码序列，筛选候选致病变异，运用Sanger测序进行候选变异与表型共分离分析。采用同源重组构建候选变异表达载体，进行体外剪接实验，应用逆转录聚合酶链反应、TA克隆和Sanger测序分析候选致病变异对剪接的影响。明确智力障碍的遗传学病因后，采用goldeneyeTM20A基因分型系统和Sanger测序为先证者之姐（Ⅱ-7）进行产前诊断。结果全外显子组测序结果显示先证者携带DLG3基因c.1302G>A（p. S434S）半合子同义变异，该变异与家系内患者表型共分离，先证者之母（Ⅰ-1）为该变异杂合携带者。体外剪接实验结果显示c.1302G>A变异明显影响RNA的正常剪接，88.24%的转录本剪接异常，导致阅读框移码，蛋白功能受损。产前诊断胎儿（Ⅲ-7）羊水未检测到该变异，男胎活产，现1岁6月龄，精神行为发育未见异常，继续随访中。结论DLG3基因c.1302G>A同义变异是导致该家系X连锁智力障碍的原因。

简介：摘要：在现代医疗技术的飞速发展下，医院的护理工作也暴露出许多问题，因此将6S管理引入医院，加强医院的护理管理，并提高医院的整体形象，推动医院的长期发展。对此，本文论述了护理管理中6S管理的作用，并提出了护理管理中6S管理的方法与具体措施，体现了6S管理的作用效果，以期能够为相关医疗行业工作者提供借鉴与帮助。

简介：【摘要】目的：探讨6S管理在护理管理中的价值。方法：将我院2021年1月-2022年1月80例医院患者，双盲随机法分二组。对照组给予常规护理管理，实验组实施6S管理。比较两组满意度、不良事件发生率。结果：实验组满意度高于对照组，不良事件发生率低于对照组，P＜0.05。结论：医院患者实施6S管理效果确切，可减少不良事件和提高满意度。

简介：摘要：手术室是外科手术和抢救危重症病人的地方，手术节奏快、突发事件多、工作量大，手术室的护理质量对手术安全性、医疗效果产生直接影响，加强手术室护理管理对于保障手术效果以及患者生命具有十分重要的作用。6S管理模式是5S管理的一个升级，它包含了清理、整顿、清负扫、清洁、素养、安全等，从而能够根据工作地点的特点以及相关管理要求综合、规范管理人员、设备等。本文通过对“6S”管理模式在手术室护士管理中的作用进行了探讨，以期提高手术室护士的管理水平。

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简介：摘要：目的：为了全面提升手术室管理水平，规范诊疗流程，节约成本和资源，培养职工良好行为习惯，促进手术室精益管理，将“6S”管理模式应用于手术室护理管理工作。方法：成立6S办公室，推行“6S”（整理、整顿、清洁、规范、素养、安全），对比实施前后环境改善及护理质量评分。结果：实施“6S”后护理安全管理、环节管理、药品物品管理、仪表行为、患者安全、健康教育、护理文书、消毒隔离护理质量评分均高于实施前（P

简介：摘要：各种医院的病房基本设有治疗室、处置室、护理室等三项内容，其中治疗室的主要作用是存放该病房所需的药品，并提供药液放置场所(如一次性无菌物品、治疗袋等)。治疗室的管理质量对医院的服务水平和护理质量有很大影响。相关医务人员应严格遵守操作规范，保障治疗室的环境安全，减少出现安全问题的概率，保证药品、物品等医疗资源的有效利用。随着8S精益管理的成功推行，医院的就医环境、办公环境发生了翻天覆地的变化，医务人员的精神面貌、综合素质、工作效率、服务质量得到不断提升，团队凝聚力不断增强，医院迈上了良性发展轨道。

简介：摘要：本研究利用德尔菲法等研究方法，立足于S省肿瘤医院，结合肿瘤医院住院患者的特点制定了符合客观事实的《住院患者满意度调查表》，该调查表包括三个部分：患者基本信息、满意度题目以及意见建议。该问卷一级指标共6个，二级指标31个，经信效度检验，该问卷信效度良好。

简介：【摘要】目的：探讨门诊实施"5S"护理服务的效果。方法：2020年9月到2021年12月，选取200例门诊患者为对象，经随机数字表法分组，对照组采用常规护理服务，观察组采用"5S"护理服务。结果：观察组护理质量评分高于对照组（P＜0.05）。观察组护理满意度大于对照组（P＜0.05）。结论：在门诊实施"5S"护理服务，可提升护理质量和患者满意度。