新时代检验医学发展定位与思考

检验医学作为医学科学的重要支撑学科,在疾病早期诊断、病情监测、预后判断与风险评估等方面发挥着重要作用。21世纪是数字信息时代,高新检测技术、计算机科学及互联网大数据等,为检验医学的发展带来巨大的机遇与挑战,新时代下如何借助信息科技革命实现检验医学新发展是检验工作者面临的重要课题。该文回顾检验医学的发展历程,重点关注检验医学在新时代的发展定位及未来发展方向,以求开创检验医学发展新局面。     

肌骨超声在腰痛诊断中的应用

腰痛已成为世界范围内主要的公共健康问题,常规的腰痛影像学检查会反复地对患者造成辐射伤害,并且存在一定的漏诊、误诊的可能性,延误治疗时机。肌骨超声是一种非侵入性的成像方法,具有安全、无创的特点,并且价格低廉,已经作为常用的腰痛辅助筛查手段。通过对腰痛的常规影像学检查手段进行分析比较,全面阐述肌骨超声在腰痛的诊断及康复过程中的价值,为更好地促进腰痛的诊断和康复提供理论基础。     

PBL教学法在临床实习护士查房中的应用

目的探讨PBL教学法在临床实习护士查房中的应用。方法选取2018年1月-2018年11月于本院实习的42例护士作为研究对象,按照查房方法的差异分为对照组(21例)与观察组(21例),对照组采用传统查房法,观察组采用PBL教学法。比较两组护理业务成绩、临床各项评价指标得分情况以及对护理查房业务的掌握程度。结果观察组临床护理业务兴趣、自主学习能力、学习效率、回答问题踊跃程度等各项指标得分高于对照组,差异有统计学意义(P<0.05)。观察组理论考试、实操训练、病历书写等临床各项评价指标得分高于对照组,差异有统计学意义(P<0.05)。观察组对护理查房业务的掌握程度为95.2%,高于对照组的61.9%,差异有统计学意义(P<0.05)。结论在临床护理业务查房中应用教学法,建议采纳PBL教学法,在提高实习护士理论知识、提升业务水平和综合能力方面价值显著。     

Reliability of Cervicocephalic Proprioception Assessment: A Systematic Review

ObjectiveThe purpose of this systematic review was to determine the reliability and, where possible, the validity of cervicocephalic proprioceptive (CCP) tests in healthy adults and clinical populations.MethodsA systematic search, utilizing 7 databases from the earliest possible date to April 14, 2021, identified studies that measured reliability of CCP tests. Studies were screened for eligibility, and included studies were appraised using Quality Appraisal Tool for Studies of Diagnostic Reliability (QAREL) and Quality Assessment and Diagnostic Accuracy Studies-2 Tool (QUADAS-2) tools. Validity outcomes were assessed for included studies.ResultsOf 34 included studies, 29 investigated reliability for sense of position tests, 10 involved sense of movement tests, and 1 used a sense of force test. The head to neutral test was reliable and valid when 6 or more repetitions were performed within the test, discriminating between those with and without neck pain. Head tracking tests were reliable with 6 repetitions, and 1 study found discriminative validity in a whiplash population. Studies that found discriminative validity in sense of position reported mean joint position error generally >4.5° in the neck pain group and <4.5° in the asymptomatic group. No sense of force test was applied to a clinical population. Convergent validity analysis showed that these proprioceptive tests have low correlations with each other.ConclusionThe reliability and validity of CCP tests for sense of position and movement are dependent upon equipment and repetitions. Six repetitions are generally required for good reliability, and joint position error >4.5° is likely to indicate impairment in sense of position.