简介：美国文化中有一个特点，几乎成了传统，就是他们称颂靠自己的本事奋斗出来的人。这种人通常是一开始靠自己的双手苦干，然后升迁到很高的地位。工商界的领袖或大学教授比普通的劳动者或技术工人的社会地位高，并受到同一个社区的人们更多的尊敬。但他会原原本本地告诉你。他的父亲却是在农场上当雇工或当其他什么劳动者起家的。

简介：BackgroundDuringprimarypercutaneouscoronaryintervention(PCI),manualthrombectomymayreducedistalembolizationandthusimprovemicrovascularperfusion.Smalltrialshavesuggestedthatthrombectomyimprovessurrogateandclinicaloutcomes,butalargertrialhasreportedconflictingresults.MethodsWerandomlyassigned10,732patientswithST-segmentelevationmyocardialinfarction(STEMI)undergoingprimaryPCItoastrategyofroutineupfrontmanualthrombectomyversusPCIalone.Theprimaryoutcomewasacompositeofdeathfromcardiovascularcauses,recurrentmyocardialinfarction,cardiogenicshock,orNewYorkHeartAssociation(NYHA)classIVheartfailurewithin180days.Thekeysafetyoutcomewasstrokewithin30days.ResultsTheprimaryoutcomeoccurredin347of5033patients(6.9%)inthethrombectomygroupversus351of5030patients(7.0%)inthePCI-alonegroup(hazardratiointhethrombectomygroup,0.99;95%confidenceinterval[CI],0.85to1.15;P=0.86).Theratesofcardiovasculardeath(3.1%withthrombectomyvs.3.5%withPCIalone;hazardratio,0.90;95%CI,0.73to1.12;P=0.34)andtheprimaryoutcomeplusstentthrombosisortarget-vesselrevascularization(9.9%vs.9.8%;hazardratio,1.00;95%CI,0.89to1.14;P=0.95)werealsosimilar.Strokewithin30daysoccurredin33patients(0.7%)inthethrombectomygroupversus16patients(0.3%)inthePCI-alonegroup(hazardratio,2.06;95%CI,1.13to3.75;P=0.02).ConclusionsInpatientswithSTEMIwhowereundergoingprimaryPCI,routinemanualthrombectomy,ascomparedwithPCIalone,didnotreducetheriskofcardiovasculardeath,recurrentmyocardialinfarction,cardiogenicshock,orNYHAclassIVheartfailurewithin180daysbutwasassociatedwithanincreasedrateofstrokewithin30days.

简介：目的：提高高职类体育院校推拿手法学的教学质量。方法：进行了多项教学改革，包括按认知规律重新安排教学内容，引入PBL教学理念，改善教学条件，增加了多媒体及实践教学，丰富了教学资源，改革了考核评价方案等。结果与结论：通过各项改革，学生不仅学到了专业技能，还提高了分析、解决问题的能力。

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简介：目的：研究手法对于颈本体觉紊乱的眩晕患者的头颅空间回复能力的影响。方法：利用头颅三维空间运动测量仪，临床观察72例颈本体觉紊乱的眩晕患者手法治疗前后其头颅空间回复能力的变化。另外选取51颈椎动脉供血不足的眩晕患者及138例正常人作对照组。结果：手法治疗后本体觉组在三个运动轴线上的头颅空间偏移度均有明显减小，结论手法有即刻改善颈本体觉功能的作用，在临床椎动脉供血不足型眩晕的发病也存在着本体觉紊乱的因素。

简介：精子disomy的层次相关到不孕的层次，现在是众所周知的(象另外的因素一样)。永久维持aneuploidy到经历intracytoplasmic精子注射(ICSI)的不肥沃的男性的后代的风险在帮助复制成为了一个暑热地辩论的问题；然而，在那里仍然是障碍到为精子提供在一个临床的背景屏蔽的disomy的实际实现。主要障碍是花到分析的操作员时间一统计上有意义(足够)房间的数字。“自动化点数”的介绍软件鈥揾ardware联合介绍一个潜在的解决方案给这个问题。在这初步的确认研究，我们分析了10个病人，手工地并且用一个商业地可得到的点阻止。结果显示出在两条途径之间的统计上重要的关联因为当为双精子得分时，精子disomy，而是没有关联得分被发现。对后者的最可能的解释作为一个单个双房间是二个仔细联系的精子头的明显的overscoring。这些结果，和将续起的类似的进一步的研究，通知费用鈥揵enefit的帮助分析那单个诊所需要执行以便决定是否采用从要求ICSI治疗的人为对精子的评价作为一个平淡的工具屏蔽的精子aneuploidy。

简介：Background:Evidencesupportstheuseofexerciseforchroniclowbackpain(CLBP);however,adherenceisoftenpoorduetoongoingpain.Auricularacupunctureisaformofpainreliefinvolvingthestimulationofpointsontheouterearcorrespondingwithspecificbodyparts.Itmaybeausefuladjunct

简介：Manualacupunctureiswidelyusedforpainreliefandstresscontrol.Previousstudiesonacupuncturehaveshownitsmodulatoryeffectsonthefunctionalconnectivityassociatedwithoneorafewpreselectedbrainregions.Toinvestigatehowmanualacupuncturemodulatestheorganizationoffunctionalnetworksatawhole-brainlevel,weacupunctureatST36ofarightlegtoobtainelectroencephalograph(EEG)signals.Bycoherenceestimation,wedeterminethesynchronizationsbetweenallpairwisecombinationsofEEGchannelsinthreeacupuncturestates.Theresultingsynchronizationmatricesareconvertedintofunctionalnetworksbyapplyingathreshold,andtheclusteringcoefficientsandpathlengthsarecomputedasafunctionofthreshold.Theresultsshowthatacupuncturecanincreasefunctionalconnectionsandsynchronizationsbetweendifferentbrainareas.Forawiderangeofthresholds,theclusteringcoefficientduringacupunctureandpostacupunctureperiodishigherthanthatduringthepre-acupuncturecontrolperiod,whereasthecharacteristicpathlengthisshorter.Weprovidefurthersupportforthepresenceof'small-world'networkcharacteristicsinfunctionalnetworksbyusingacupuncture.Thesepreliminaryresultshighlightthebeneficialmodulationsoffunctionalconnectivitybymanualacupuncture,whichcouldcontributetotheunderstandingoftheeffectsofacupunctureontheentirebrain,aswellastheneurophysiologicalmechanismsunderlyingacupuncture.Moreover,theproposedmethodmaybeausefulapproachtothefurtherinvestigationofthecomplexityofpatternsofinterrelationsbetweenEEGchannels.

简介：Toinvestigatewhetherandhowmanualacupuncture(MA)modulatesbrainactivities,wedesignanexperimentwhereacupunctureatacupointST36oftherightlegisusedtoobtainelectroencephalograph(EEG)signalsinhealthysubjects.Weadopttheautoregressive(AR)BurgmethodtoestimatethepowerspectrumofEEGsignalsandanalyzetherelativepowersindelta(0Hz-4Hz),theta(4Hz-8Hz),alpha(8Hz-13Hz),andbeta(13Hz-30Hz)bands.OurresultsshowthatMAatST36cansignificantlyincreasetheEEGslowwaverelativepower(deltaband)andreducethefastwaverelativepowers(alphaandbetabands),whiletherearenostatisticaldifferencesinthetabandrelativepowerbetweendifferentacupuncturestates.InordertoquantifytheratioofslowtofastwaveEEGactivity,wecomputethepowerratioindex.ItisfoundthattheMAcansignificantlyincreasethepowerratioindex,especiallyinfrontalandcentrallobes.AlltheresultshighlightthemodulationofbrainactivitieswithMAandmayprovidepotentialhelpfortheclinicaluseofacupuncture.TheproposedquantitativemethodofacupuncturesignalsmaybefurtherusedtomakeMAmorestandardized.

简介：目的：观察针刺结合龙氏手法对腰椎间盘突出症患者功能的改善情况。方法：将60例患者随机分为观察组与对照组，每组各30例。观察组采用针刺结合龙氏手法治疗，对照组采用单纯针刺治疗。根据日本骨科学会（JapaneseOrthopaedicAssociation，JOA）评分系统评定腰椎功能，根据视觉模拟评分（VisualAnalogScale，VAS）进行疗效评定。结果：治疗后两组JOA差值及改善指数均有统计学差异（P〈0．05）。观察组的VAS较治疗前有非常显著性降低（P〈0．01），对照组有显著性降低（P〈0．05）；两组治疗后VAS比较有显著性差异（P〈0．05）。结论：针刺结合龙氏手法对腰椎间盘突出症患者的功能改善作用优于单纯针刺治疗。

简介：摘要：社区改造是当下城市更新的一种重要形式，而社区改造导则的编制处于起步阶段，最新的导则类成果是《广州市老旧小区微改造设计导则》；美国在社区设计导则方面起步较早，实践较多，本文通过对比研究美国纽约区域规划协会编制的《Design Your Town—A Community Design Manual》和国内的《广州市老旧小区微改造设计导则》，可借鉴之处为其社区分类逻辑和设计标准制定模式，希望可进一步完善和指导国内的社区改造导则编制。

简介：摘要：社区改造是当下城市更新的一种重要形式，而社区改造导则的编制处于起步阶段，最新的导则类成果是《广州市老旧小区微改造设计导则》；美国在社区设计导则方面起步较早，实践较多，本文通过对比研究美国纽约区域规划协会编制的《Design Your Town—A Community Design Manual》和国内的《广州市老旧小区微改造设计导则》，可借鉴之处为其社区分类逻辑和设计标准制定模式，希望可进一步完善和指导国内的社区改造导则编制。

简介：Purpose:Thepurposeofthisstudywastocomparethecoordinationbetweenthetrunkandthepelvisduringasustainedasymmetricrepetitiveliftingtaskbetweenagroupwithahistoryoflowbackpain(LBP;HBP)andagroupwithnohistoryofLBP(NBP).Methods:Volunteerslifteda11-kgboxfromankleheightinfronttoashelf45°off-centeratwaistheight,andloweredittothestartpositionat12cycles/minfor10min.Liftingsidewasalternatedduringthetrial.Continuousrelativephasewasusedtocalculatecoordinationbetweenthepelvisandtrunkrotationatthebeginning(Min1),middle(Min5),andendofthebout(Min9).Results:Whiletherewerenomaineffectsforgroup,asignificantinteractionbetweentimeandgroupindicatedthat,inthefrontalplane,theNBPgroupcoordinationwasmoreanti-phasetowardtheendofthebout,withnosuchdifferencesfortheHBPgroup.Analysisofsagittal-axial(bendandtwist)coordinationrevealedtheHBPgroupcoordinationwasmorein-phaseattheendoftheboutovertheentirecycleandfortheliftingphasealone,withnosuchdifferencesfortheNBPgroup.Conclusion:DifferencesbetweengroupsdemonstrateresidualconsequencesofLBPinanoccupationalscenario,eventhoughtheHBPgroupwaspain-freefor>6monthspriortodatacollection.Morein-phasecoordinationintheHBPgroupmayrepresentacoordinationpatternanalogousto'guardedgait'whichhasbeenobservedinotherstudies,andmaylendinsightastowhytheseindividualsareatincreasedriskforre-injury.

简介：AbstractPurpose:To evaluate the efficacy of closed reduction on the humeroradial joint in the treatment of Bado type I, II and III fresh Monteggia fractures in children and investigate the effect of clinical factors, including Bado classification, age and time of treatment on the success rate of closed reduction.Methods:We retrospectively studied the data of children ≤10 years old with fresh Monteggia fractures (injury within two weeks) treated by manual reduction with plaster immobilization from January 2014 to April 2019. All patients were followed up in the outpatient department every two weeks for 4-6 weeks until plaster removal and then 3, 6 and 12 months. Online or telephone interview was provided for some inconvenient patients after 6 months. Mackay criteria were used to evaluate the clinical effect. Radiographic data were collected and reviewed to assess the reduction of the humeroradial joint. Function of the elbow joint and forearm was evaluated and risk factors related to the failure of reduction were assessed. The successful manual reduction was analyzed from three aspects, respectively Bado fracture type (I, II, III), patient age (<3 year, 3-6 years, >6 years) and time interval from injury to treatment (group A, <1 day; group B, 1-3 days; group C, >3 days).Results:Altogether 88 patients were employed in this study, including 58 males (65.9%) and 30 females (34.1%) aged from 1 to 10 years. There were 29 cases (33.0%) of Bado type I Monteggia fractures, 16 (18.2%) type II and 43 (48.7%) type III. Successful manual reduction was achieved in 79 children (89.8%) at the last follow-up. The failed 9 patients received open surgery. Mackay criteria showed 100% goodexcellent rate for all the patients. The success rate of manual reduction was 89.7%, 87.5% and 90.7% in Bado type I, II and III cases, respectively, revealing no significant differences among different Bado types (χ2= 0.131, p = 0.937). Successful closed reduction was achieved in 13 toddlers (13/13, 100%), 38 preschool children (28/42, 90.5%) and 28 school-age children (28/33, 84.8%), suggesting no significant difference either (χ2= 2.375, p = 0.305). However time interval from injury to treatment showed that patients treated within 3 days had a much higher rate of successful manual reduction: 67 cases (67/71, 94.4%) in group A, 10 cases (10/11, 90.9%) in group B, and 2 cases (2/6, 33.3%) in group C (χ2= 22.464, p < 0.001). Fisher's test further showed significant differences between groups A and C (p = 0.001) and groups B and C (p = 0.028).Conclusion:Closed reduction is a safe and effective method for treating fresh Monteggia fractures in children. The reduction should be conducted as soon as possible once the diagnosis has been made.