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《Journal of hand therapy》2019,32(4):426-434.e1
Study DesignSystematic review.IntroductionChildren with cerebral palsy (CP) may have limited use of their hands for functional activities and for fine motor skills. Virtual reality (VR) is a relatively new and innovative approach to facilitate hand function in children with CP.Purpose of the StudyThe primary purpose of this study was to determine the effectiveness of VR as an intervention to improve hand function in children with CP compared to either conventional physiotherapy or other therapeutic interventions. The secondary purpose was to classify the outcomes evaluated according to the International Classification of Functioning, Disability and Health (ICF) dimensions.MethodsA International prospective register of systematic reviews (PROSPERO)-registered literature search was carried out in August 2015 in MEDLINE, CINAHL, ERIC, HealthSTAR, AMED, BNI, Embase, PsycINFO, PEDro, Cochrane Central Register, DARE, OTSeeker, REHABDATA, HaPI, CIRRIE, and Scopus. PRISMA guidelines were followed. Only randomized controlled trials (RCTs) were included, and their methodological qualities were examined using the Cochrane collaboration's risk of bias (RoB) tool. A narrative synthesis was performed.ResultsThe 6 RCTs published on this topic provide conflicting results. Four studies reported improved hand function (2 low RoB, 1 high RoB, and 1 unclear RoB), whereas 2 studies reported no improvement. All of the RCTs reported the activity element of ICF, but no study explicitly described the effect of VR intervention based on the ICF model.ConclusionThe role of VR ti imrpove hand fucntion in children with CP is unclear due to limited evidence; use as an adjunct has some support. 相似文献
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Objective To prove the efficacy of peritoneal dialysis on shock wave-induced acute lung injury of rats, and analyze its mechanisms. Methods Forty-five adult Sprague-Dawley rats were randomly divided into three groups: control group, sham operation (Sham) group and peritoneal dialysis (PD) group. Sham group and PD group did abdominal catheterization before blast injury. The 55 kg shock wave (bst-I) was used to induce lung blast injury. After one hour of blast injury, PD group was given 2.5% peritoneal dialysate 20 ml to stay abdomen, which was released 30 min posted, repeated 12 cycles. After 6 hours of peritoneal dialysis, all of the rats were sacrificed. Partial damaged tissues in lung were used to evaluate the pathomorphologic changes by HE staining, and the remnants were used to measure the lung water content. Lung function was detected by blood gas analyzer and small animal detector from the arterial blood gas. The levels of serum inflammatory factors, such as tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, IL-6 and monocyte chemoattractant protein-1 (MCP-1) were tested by ELISA. Results The relative integrity of alveolar structure, interstitial edema and inflammatory cell infiltration in PD group were significantly improved than those in control group. The lung water content of PD group was significantly lower than that of control group (P<0.05). The levels of TNF-α, IL-1β, IL-6 and MCP-1 in serum of PD group were significantly lower than those in control group (all P<0.05). The blood oxygen saturation, oxygen partial pressure, oxygenation index, vital capacity, functional residual volume and maximum mid-expiratory flow rate in PD group were significantly higher than those in control group (all P<0.05). Conclusions Through reducing pulmonary edema and inflammatory factors, peritoneal dialysis can improve lung function in shock wave -induced acute lung injury of rats. 相似文献
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David M. Glassman Erik Magnusson Julie Agel Carlo Bellabarba Richard J. Bransford 《The spine journal》2019,19(4):687-694
BACKGROUND CONTEXT
Although facet dislocations account for only 6% of cervical trauma, the consequences are often devastating. Cervical facet dislocations are associated with a disproportionate amount of spinal cord injuries; however, neurologic examination of patients is often difficult, as patients commonly present with reduced levels of consciousness. There are limited studies that have investigated the impact of spinal canal diameter and translation on neurologic injury following facet dislocations.PURPOSE
Review a consecutive series of patients with facet dislocations to assess the impact of sagittal diameter and translation on Spinal Cord Injury (SCI).STUDY DESIGN
Retrospective review at a level I trauma center identified 97 patients with facet dislocations.METHODS
Between 2004 and 2014, a retrospective review at a level I trauma center identified patients with traumatic facet dislocation. Demographic data, neurologic exams, and radiographic findings were reviewed. We assessed sagittal diameter at the injury level, as well as above and below, and translation. This study has no funding source and its authors have no potential conflicts of interest-associated biases.RESULTS
Ninety-seven patients presented with facet dislocations. Fifty-nine (61%) presented with a SCI. Those with ASIA A averaged 8.0 mm of injury level canal diameter, and ASIA E averaged 12.6 mm (p < .001). Additionally, those with ASIA A averaged 8.0 mm of translation, and ASIA E averaged 4.2 mm (p < 0.001). Two groups were created based on their general motor function. Those with ASIA A–C averaged 8.4 mm of injury level canal diameter, and ASIA D–E averaged 12.3 mm (p < .001). Those with ASIA A–C averaged 7.8 mm of translation, and ASIA D–E averaged 4.4 mm (p < .001). Receiver operating characteristic (ROC) curves demonstrated that translation was a good predictor of ASIA A–C and canal diameter was an almost perfect predictor of ASIA D–E.CONCLUSIONS
Our data indicate that patients with greater translation and/or a smaller canal diameter at the injury level have a higher rate of SCI. Adjacent canal diameter did not correlate with neurologic injury. 相似文献98.
目的 观察对住院医师规范化培训部分学员使用Mini-CEX进行临床教学的效果。方法选取我院2015级住培学员40名,随机分为对照组和实验组,每组20人。2015年10月至2018年4月,对照组采用传统教学;实验组在传统教学基础上结合Mini-CEX活动,实验组每人在每个轮转科室至少进行2次Mini-CEX。毕业时应用改良的Mini-CEX评分量表、病例答辩和OSCE三种考核方法对两组学员进行测评。针对实施过Mini-CEX的教师和学员分别发放问卷,进行满意度调查。采用SPSS 18.0对数据进行统计分析,组间比较采用独立样本t检验,组内前后比较采用配对样本t检验。结果 Mini-CEX测评显示,两组学员各项临床能力毕业成绩均高于入学成绩,实验组学员毕业成绩优于对照组,实验组学员成绩提高分数大于对照组提高分数,差异均有统计学意义(P<0.05)。病例答辩显示,实验组学员平均成绩为(81.16±3.75)分,优于对照组的(70.13±3.88)分,差异有统计学意义(t= -9.140,P=0.000)。OSCE考核显示,实验组平均总分为(96.300±4.681),优于对照组的(91.775±3.227)分,差异有统计学意义(t=-3.559,P=0.001)。共发放调查问卷80份,其中教师40份、学员40份,结果显示教师满意率达95.0%、学员满意率达92.5%。结论 Mini-CEX应用于住院医师规范化培训临床带教中,有利于提高学员的临床思维、医患沟通和人文关怀能力。 相似文献
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Objective
It is useful for reviewers of economic evaluations to assess quality in a manner that is consistent and comprehensive. Checklists can allow this, but there are concerns about their reliability and how they are used in practice. We aimed to describe how checklists have been used in systematic reviews of health economic evaluations.Methods
Meta-review with snowball sampling. We compiled a list of checklists for health economic evaluations and searched for the checklists’ use in systematic reviews from January 2010 to February 2018. We extracted data regarding checklists used, stated checklist function, subject area, number of reviewers, and issues expressed about checklists.Results
We found 346 systematic reviews since 2010 that used checklists to assess economic evaluations. The most common checklist in use was developed in 1996 by Drummond and Jefferson, and the most common stated use of a checklist was quality assessment. Checklists and their use varied within subject areas; 223 reviews had more than one reviewer who used the checklist.Conclusions
Use of checklists is inconsistent. Eighteen individual checklists have been used since 2010, many of which have been used in ways different from those originally intended, often without justification. Different systematic reviews in the same subject areas would benefit from using one checklist exclusively, using checklists as intended, and having 2 reviewers complete the checklist. This would increase the likelihood that results are transparent and comparable over time. 相似文献100.
目的:探讨止消通脉清热饮对冠心病合并糖尿病患者心功能、血糖及血清孤独G蛋白偶联受体配体-12(Apelin-12)水平的影响。方法:选择冠心病合并糖尿病患者80例,随机分为观察组和对照组各40例。对照组给予辛伐他汀、单硝酸异山梨酯及盐酸二甲双胍治疗,观察组在对照组用药基础上给予止消通脉清热饮治疗。比较两组治疗前后心功能指标(LVEF、CO),血糖指标(FBG、2hPG),血清Apelin-12及BNP因子变化。结果:治疗1、2、4周后,两组中医症状积分下降,观察组更明显(P<0.05)。治疗前,两组LVEF、CO、FBG、2hPG、Apelin-12及BNP比较差异无统计学意义(P>0.05); 治疗后,两组LVEF、CO、Apelin-12均升高,FBG、2hPG、BNP均降低(P<0.05); 观察组治疗后LVEF、CO、Apelin-12均高于对照组,FBG、2hPG、BNP均低于对照组(P<0.05)。观察组治疗后生活质量明显优于对照组(P<0.05)。结论:止消通脉清热饮可显著改善冠心病合并糖尿病患者心功能,降低血糖水平,提高血清Apelin-12浓度。 相似文献