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101.

Purpose

Suppression of respiratory movement of the liver would be desirable for high-precision radiation therapy for liver tumors. We aimed to investigate the effect of our original device-free compressed shell fixation method and breathing instruction on suppression of respiratory movement. The characteristics of liver motion based on the movement of a fiducial marker were also analyzed.

Methods and Materials

First, respiratory amplitudes of the liver with the device-free compressed shell were analyzed from the data of 146 patients. The effect of this shell fixing method on liver movement was evaluated. Second, as another cohort study with 166 patients, interfractional internal motion of the liver for patients fixed in the shell was calculated using the fiducial marker coordinate data of images for position setting before daily irradiation. Third, in another 12 patients, intrafractional internal motion was calculated from the fiducial marker coordinate data using x-ray images before and after irradiation.

Results

The median respiratory movement without the shell, after fixing with the shell, and after instructing on the breathing method with the shell was 14.2 (interquartile range, 10.7-19.8), 11.5 (8.6-17.5), and 10.4 mm (7.3-15.8), respectively. Systematic and random errors of interfractional internal motion were all ≤2 mm in the left-right and anteroposterior directions and 3.7 and 3.0 mm, respectively, in the craniocaudal direction. Systematic and random errors of intrafractional internal motion were all ≤1.3 mm in the left-right and anteroposterior directions and 0.8 and 2.4 mm, respectively, in the craniocaudal direction.

Conclusions

The device-free compressed shell fixation method was effective in suppressing the respiratory movement of the liver. Irradiation position matching using the fiducial marker can correct the interfractional internal motion on each day, which would contribute to the reduction of the margin to be given around the target.  相似文献   
102.

Objective

To describe the distribution of frequent attenders (FA) through the different primary care practices in Cordoba-Guadalquivir Health District (Córdoba, Spain).

Methods

An ecological study was performed, including data from 2011 to 2015. Defining FA as those subjects who made12 or more appointments per year; independently analysed for nursing, general practice and paediatrics. Prevalence of frequent attendance and FA/professional ratio were used as dependent variables. Demographic characteristics from district population, number of health professionals and use of general facilities were also examinated. Aiming to understand FA distribution, primary health settings were classified according to facility size and environmental location (urban, suburban and rural).

Results

The mean prevalence for FA was 10.86% (0.5 SE) for nursing; general practice 21.70% (0.7 SE) and for paediatrics 16.96% (0.7 SE). FA/professional ratios for the different professional categories were: 101.07 (5.0 SE) for nursing, 239.74 (9.0 SE) for general practice and 159.54 (9.8 SE) for paediatrics.

Conclusions

A major part of primary health care users make a high number of consultations. From this group, women overuse nursing and general practitioner services more compared to men. A higher prevalence of FAs was observed in smaller settings, in rural areas. Although taking the FAs:professional ratio as the bar, medium-size practices are more highly overused.  相似文献   
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104.
从武汉抗疫中医药的投入使用情况,反思现代临床和国人所呈现出的中医药文化认同和就医习惯,探索其历史文化根源及社会因素与医学发展的内在关联。回顾历史,中医屡次临危受命,不负重托,如今大疫当前,中医药再次发挥了重要作用。故新时代探讨如何遵循中医药发展规律,传承精华、守正创新,坚持中医药原创优势,形成中医药学科优势整体化呈现的新模式医学,对提升全社会的中医药认知度具有重要意义。  相似文献   
105.
鲍雨婷  王琴  陈金  魏力  郝雅楠 《天津护理》2020,28(6):648-652
目的: 应用文献计量学方法,分析国内外医用粘胶相关性皮肤损伤(Medical adhesive-related skin injuries,MARSI)文献的研究主题和热点。方法: 检索Cochrane Library、PubMed、EMbase、Web of science、sinoMed、CNKI、Wanfang、VIP等数据库MARSI相关文献,检索时限为建库至2019年5月。采用SPSS 22.0 软件进行文献计量分析,利用gCLUTO统计对国内外高频主题词进行聚类分析。结果: 共纳入论文103篇,其中外文文献占总文献量的27.18%,中文文献占总文献量的72.82%。聚类分析将国内外高频主题词聚为4大类,依次为皮肤损伤及损伤类型、相关危险因素、风险评估及风险管理、护理干预措施。结论: MARSI仍是国内外研究的热点,其发病机制研究仍处于探索阶段,目前尚缺乏有效的预防策略,研究领域较局限。在今后的研究中,应加强MARSI预防的研究、注重多学科合作。  相似文献   
106.
科研作图是展示研究数据的主要形式,也是科研素养的重要体现。口腔医学硕士研究生是接触科学研究的第一站,然而目前的研究生教育环节对科研作图能力缺乏系统性培养,许多研究生在科研作图中存在许多不规范的问题,本文针对这一问题进行初步探讨。本文分析比较了常用作图工具Microsoft Excel、Origin和Graphpad Prism的特点;以学校口腔医学硕士的培养过程为参考,分析目前硕士研究生科研作图方面存在的主要问题及应对策略。发现不同作图软件具有不同的风格特点,当前硕士研究生作图存在风格不统一、拼图不规范、图注不规范等问题,应当根据自身需求合理选择作图工具,提升作图能力。科研作图是科研能力的重要方面,应当加强口腔医学硕士研究生作图能力的培养。  相似文献   
107.
108.
《Vaccine》2020,38(52):8362-8370
BackgroundCommunity-acquired pneumonia (CAP) is one of the major global health problems worldwide. However, the epidemiological information of CAP is limited in China. This study aimed to estimate the incidence rate of CAP and describe the epidemiologic characteristics among the Chinese population.MethodsWe conducted a retrospective analysis of CAP incidence using the Chinese Urban Basic Medical Insurance database of 23 provinces in 2016, which covered 427.52 million urban beneficiaries of all age groups in Mainland China. CAP episodes were identified using a diagnosis-term-derived algorithm, and multiple CAP records of one single person within 90 continuous days were considered as one single episode. The incidence rates were calculated and described by sex, age, region, and season.ResultsA total of 1.42 million patients were identified as having one or more CAP episodes, and finally a sum of 1.48 million CAP episodes were counted. The overall incidence of CAP was 7.13 (95% CI: 6.11–8.15) per 1000 person-years, in males 7.32 (95% CI: 6.28–8.35) and females 6.93 (95% CI: 5.92–7.94) per 1000 person-years, respectively. The incidence varied by age with a U-shaped curve peaking in children aged < 5 years old [65.80 (95% CI: 62.52–69.08)] and elderly population aged ≥ 80 years old [14.98 (95% CI: 13.63–16.34)]. The incidence varied markedly by regions. Furthermore, the rate showed a clear seasonal trend, which peaked in spring, decreased in summer and autumn, and re-ascended in winter.ConclusionThis study reveals a relatively high level of CAP incidence in China. These findings provide baseline data for establishing effective prevention strategies, targeted at susceptible populations, regions, and seasons in China.  相似文献   
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110.
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