安静条件下语句识别表的等价性研究

目的 通过对解放军总医院研制的12张普通话儿童语句测听词表的难度等价性研究,判断该套材料是否符合言语测听材料的标准,以期挑选出具有难度一致性的词表应用于临床.方法 选取36名听力正常青年受试者,采用听说复述的方式,进行12组句表的测试(每组句表有50个关键词),以关键词计分,然后对各表得分进行统计学分析.结果 进行双因素(表号和强度)方差分析和Post-Hoc两两比较,12张测试表无统计学差异.结论 12张语句识别表具有较好的难度等价性,可应用于临床测试和实验研究.     

Shorter vs Longer Immobilization After Surgery for Thumb Carpometacarpal Osteoarthritis: A Propensity Score-Matched Study

ObjectiveTo investigate if shorter immobilization is noninferior to longer immobilization after Weilby procedure for thumb carpometacarpal osteoarthritisDesignProspective cohort study with propensity score matching.SettingData collection took place in 16 outpatient clinics for hand surgery and hand therapy.ParticipantsA total of 131 participants with shorter immobilization and 131 participants with longer immobilization (N=262).InterventionShorter immobilization (3-5 days plaster cast followed by a thumb spica orthosis including wrist until 4 weeks postoperatively) was compared with longer immobilization (10-14 days plaster cast followed by a thumb spica orthosis including wrist until 6 weeks postoperatively) after Weilby procedure for first carpometacarpal joint osteoarthritis. Propensity score matching was used to control for confounders.Main Outcome MeasuresOutcomes were pain measured with a visual analog scale and hand function measured with the Michigan Hand Outcomes Questionnaire at 3 and 12 months. Secondary outcomes were complications, range of motion, grip and pinch strength, satisfaction with treatment, and return to work.ResultsNo significant differences were found in visual analog scale pain (effect size, 0.03; 95% confidence interval [CI], −0.21 to 0.27) or the Michigan Hand Outcomes Questionnaire (effect size, 0.01; 95% CI, −0.23 to 0.25) between the groups at 3 months or at 12 months. Furthermore, no differences were found in complication rate or in other secondary outcomes.ConclusionsIn conclusion, shorter immobilization of 3-5 days of a plaster cast after Weilby procedure is equal to longer immobilization for outcomes on pain, hand function, and our secondary outcomes. These results indicate that shorter immobilization is safe and can be recommended, since discomfort of longer immobilization may be prevented and patients may be able to recover sooner, which may lead to reduced loss of productivity. Future studies need to investigate effectiveness of early active and more progressive hand therapy following first carpometacarpal joint arthroplasty.     

基于远程医疗的阻塞性睡眠呼吸暂停诊疗新模式的建立：一项非劣效随机对照试验研究方案

阻塞性睡眠呼吸暂停（OSA）是一种慢性病，其患病率高、并发症多、潜在危害大。流行病学研究显示，OSA与多种心血管疾病的发生发展密切相关。目前，我国中重度OSA患者达6 600万，然而约有80%的OSA潜在患者尚未得到及时诊断和治疗。当前OSA的诊断和治疗主要在医院的睡眠中心完成，此过程耗时费力，导致大量患者延误诊治。随着物联网和互联网等新兴技术的发展，远程医疗以其便捷、交互性、高效、共享、连贯及突破时空限制的优势越来越多的被应用于慢性病的诊治与管理中。目前，本中心已初步构建OSA的远程诊疗管理体系，但其临床效能及卫生经济学价值尚需进一步验证。本研究将设计随机对照试验比较OSA新型远程医疗模式和传统医疗模式下的临床效能和卫生经济效益，探讨OSA的远程诊疗模式在使用更低医疗成本中的临床获益是否不劣于传统诊疗模式，以期为医疗资源的高效利用、慢性病远程诊疗的进一步推广奠定基础。