Development of a Computerized Adaptive Testing System of the Functional Assessment of Stroke

Objective

To develop a computerized adaptive testing system of the Functional Assessment of Stroke (CAT-FAS) to assess upper- and lower-extremity (UE/LE) motor function, postural control, and basic activities of daily living with optimal efficiency and without sacrificing psychometric properties in patients with stroke.

Upper extremity pain in paraplegia北大核心CSCD

BACKGROUND AND OBJECTIVE As upper extremity (UE)function is critical to those with decreased function of the lower extremities,this study investigated the prevalence and patterns of pain in the UE among individuals with spinal cord injury (SCI). METHODS A university healthcare system database was searched for patients with accident related paraplegia,during a period spanning 17 years.Information regarding the level of injury was obtained.A questionnaire was sent with queries regarding medical status,demo- graphics and pain.The data were reviewed to determine relationships of pain with age,gender,time since injury,completeness of injury and neurologic level of injury (NLI).     

Glidescope视频喉镜在模拟颈椎活动受限病人气管插管中的应用

目的比较Glidescope视频喉镜和直接喉镜(Macintosh)在使用Ambu颈托固定模拟颈椎活动受限病人气管插管中的应用。方法选取拟行择期手术需全身麻醉气管插管的80例患者,随机分为Glidescope(G组,n=40)和Macintosh组(M组,n=40)。麻醉诱导后,使用Ambu颈托固定颈椎,由熟练掌握该两种工具的同一麻醉医师完成气管插管,记录各组成功插管所需要的时间、声门暴露时间、声门暴露分级(Cormack-Lehane分级)、一次插管成功率、总插管成功率、辅助措施次数等。同时记录诱导前(T0)、插管前30 s(T1)、插管后1 min(T2)、插管后2 min(T3)、插管后3min(T4)、插管后5 min(T5)的平均动脉压(MAP)和心率(HR)。结果完成插管所需时间:G组为53.78±7.84 s,M组为42.48±8.32 s,G组明显长于M组(P0.05);一次插管成功率:G组和M组分别为77.5%和97.5%,G组明显低于M组(P0.05);但两组间的总插管成功率比较,差异无统计学意义(90.00%vs.97.5%,P0.05);C-L分级:G组的C-L分级优于M组(P0.05)。两组气管插管期间血流动力学波动及并发症发生情况无显著差异(P0.05)。结论用于Ambu颈托固定模拟颈椎活动受限病人气管插管,Glidescope视频喉镜可改善该类病人的C-L分级,但一次插管成功率及完成插管时间与Macintosh喉镜比较无优势。     

老年性白内障患者行超声乳化加人工晶体植入的临床护理路径管理

目的：探讨行超声乳化加人工晶体植入术的老年性白内障患者实施临床护理路径管理的效果。方法对90例行超声乳化加人工晶体植入术的老年性白内障患者实施临床护理路径管理,统计患者住院时间、健康教育覆盖率及患者满意度。结果本组患者在预期时间内完成了诊疗与手术,提高了医疗效率,降低了患者的住院时间及住院费用;健康教育覆盖率达99．8％,患者满意率达97．6％。结论对行超声乳化加人工晶体植入术的老年性白内障患者实施临床护理路径管理,能显著提高健康教育效果及患者的满意度,提高护理质量。     

视频喉镜与普通喉镜用于鼾症患者经鼻气管插管的比较

目的比较视频喉镜与普通喉镜用于鼾症患者经鼻气管插管的临床效果。方法 ASA I或Ⅱ级的鼾症患者50例,Malamptti分类法为Ⅱ或Ⅲ级,随机均分为视频喉镜组（Glide Scope喉镜,G组）和普通喉镜（Macintosh喉镜,M组）。静注咪唑安定0.05 mg/kg、丙泊酚2 mg/kg、芬太尼3μg/kg、维库溴铵0.1mg/kg行麻醉诱导,2 min后行经鼻气管插管。记录两组患者经鼻气管插管成功所需的时间、插管时C/L分级、患者术前、麻醉诱导时、气管插管即刻、气管插管后1 min、插管后3 min、插管后5 min的SBp、DBp及HR。结果 G组C/L分级低于M组,插管时间短于M组;两组间SBp、DBp与HR无显著性差异。结论视频喉镜组用于鼾症患者经鼻气管插管较普通喉镜组暴露更佳,插管时间更短。     

Value of mammography and combined grey scale ultrasound and ultrasound elastography in the differentiation of solid breast lesions

Aim of the work

The aim of this work was to evaluate the value of ultrasound elastography (UE) in differentiating benign versus malignant solid breast lesions discovered in mammography and compare it with grey scale ultrasound (US) and mammography.

Methods

From May 2011 to May 2013, 114 solid lesions from 100 consecutive patients discovered during mammography were categorized into benign or malignant by mammography and US and further analyzed with UE. The diagnostic results of the cases were compared with histopathologic findings.

Results

Of 114 lesions, 33 were histologically malignant, and 81 were benign. UE was the most specific (95.1%) of the 3 modalities. The accuracy (81.7%) of UE was equal to mammography and was higher than those of US (82.5% and 71.9%, respectively). A combination of UE and US had the best sensitivity (90.9%) and accuracy (93.8%).

Conclusions

Ultrasound elastography is useful for breast lesion characterization and is an easier and cheaper method and more specific than mammography or US alone, but it is operator dependent. When combined with US, detection accuracy can be greatly improved and the combination potentially could reduce unnecessary biopsy.     

超声弹性成像联合BI-RADS-US分类对乳腺微小病灶的诊断价值

目的 探讨超声弹性成像技术(UE)联合乳腺超声影像报告和数据系统(BI-RADS-US)在鉴别诊断最大径≤10 mm乳腺微小病灶上的应用价值.方法 对2014年3月至2015年3月于上海交通大学医学院附属新华医院崇明分院普外科行乳腺手术的99例患者共113个最大径≤10 mm的乳腺微小病灶进行BI-RADS-US分类,联合弹性成像评分后对其进行调整,结果与手术病理对照,比较联合调整前后诊断效能.结果 联合UE评分对BI-RADS-US分类进行调整,联合调整前的诊断准确度、敏感度、特异度分别为70.8%、82.1%、64.9%,均低于调整后的82.3%、92.3%、77.0%,但两者比较只有诊断准确度差异有统计学意义(P<0.05).结论 UE联合BI-RADS-US分类能提高对乳腺微小病灶的良恶性鉴别能力.     

活血化瘀注射液对急性重型胰腺炎大鼠肺内皮细胞粘附分子表达的影响

目的 研究急性重型胰腺炎（SAP）大鼠胰腺、肺内皮细胞粘附分子ICAM-1、P-选择素、E-选择素的动态变化,并观察活血化瘀注射液（HHI-I）的作用。方法 应用胆胰管内逆行注射牛磺酸钠的方法引起大鼠SAP。将实验动物随机分为假手术对照组、SAP模型组、SAP HHI-I组、SAP 复方丹参注射液组,利用免疫组织化学方法观察了SAP大鼠1,3,6,12,24h胰腺、=肺内皮细胞粘附分子ICAM-1、P-选择素、E-选择素的表达情况。结果 SAP后肺ICAM-1、P-选择素、E-选择素表达明显增多,HHI-I能够有效抑制粘附分子的过度表达。结论 粘附分子在SAP发展过程中起重要作用。HHI-I通过抑制粘附分子的过度表达,从而影响白细胞内皮细胞的相互作用。减少白细胞在组织募集,发挥其对胰外脏器的保护作用。