电子教学网页与邮件信息在临床护生带教中的应用

笔报道电子教学网页与邮件信息在临床护生带教中的应用，阐述做法；（1）建立科室护生带教小组；（2）应用网络运行技术建立数学环境；（3）开展护理教学查房，完善网络运行下信息化教学模式；（4）通过护生临床实习问卷调查结果与效果评价，在计算机电子网页临床护生带教的方法，手段，内容，质量与效果方面，认为信息化临床带教模式优于传统护生临床带教，有效提高了护生临床实习的内在质量。     

Feature rich,but user-friendly: Speech pathologists’ preferences for computer-based aphasia therapy

Purpose: High-intensity language therapy has been shown to provide greater outcomes for people with aphasia (PWA). Unfortunately, a number of issues including the ageing population and a lack of rurally-based clinicians prevent high-intensity interventions. Computer-based therapies are a potential solution to the issues of intensity and accessibility; however, this service delivery model is not commonly used. A possible reason behind the poor uptake is that current computer-based aphasia therapy (CBAT) programs may not meet the needs of speech-language pathologists (SLPs). This study investigated the preferences of SLPs with regard to the features desired in their ideal CBAT program.

Method: Phenomenological research methodology was used to explore the preferences of 10 SLPs. Data were analysed using qualitative thematic analysis.

Result: Desired features were grouped into five themes: therapy activities, stimuli, cues, access and progress data. A range of sub-themes were also identified.

Conclusion: The wide range of desirable features found in this study may reflect the extent to which current CBAT programs are considered to be useful, but perhaps do not meet the needs of users. The study’s findings provide useful information for future CBAT developers to create programs with high clinician usability.     

Subclinical cardiovascular disease and Systemic Sclerosis: A comparison between risk charts,quantification of coronary calcium and carotid ultrasonography

Background and objectives

Recently published population-based cohort studies have shown a high prevalence of cardiovascular disease in Systemic Sclerosis (SSc) patients. The aim of this study is to compare three different methods to measure cardiovascular risk in patients with scleroderma.

Quality control after total arterial revascularisation: multislice computer tomography cannot replace coronary angiography

INTRODUCTION: Coronary angiography is regarded as the gold standard in evaluating graft patency, Multi-slice CT (MSCT) which enable rapid imaging of cardiac structures, including coronary arteries may be a less invasive technique. Therefore in our institution a prospective pilot study was performed combining these procedures. PATIENTS AND METHODS: Starting from July 2004 a study was done with 13 patients. They received TAR using composite left internal thoracic artery (LITA) and left radial artery (RA) as T-graft. Intra-operative angiography was performed in these patients to confirm graft patency. Follow-up control (9-21 months) was performed with exercise Ergometry and 64 slides MSCT. RESULT: Mean procedure time for intra-operative angiography was 13.7 +/- 7.3 min and mean fluoroscopy time was 6.2 +/- 4.6 min. In one patient, RA-marginal artery side to side anastomoses was stenosed and had to be revised. And in another, there was a kinking of the LITA and was corrected. At follow-up, exercise ergometry showed no signs of angina or ECG-changes in all patients. MSCT showed occluded radial artery grafts in two patients. In two other patients interpretation was difficult due to resolution reasons. In all patients the LITA graft was patent. CONCLUSION: The intra-operative graft angiography can be performed in patients undergoing TAR easily. MSCT can be used for post-operative less-invasive angiography with limitations in patients with small graft/coronary diameters and arrhythmias. However, this study shows that an interdisciplinary cooperation is a new possibility toward quality control during and after TAR.     

颈髓损伤患者计算机操作训练效果的观察

目的观察颈髓损伤患者对计算机基本操作的掌握情况.方法16例颈损患者通过手功能辅助具进行40课时的计算机操作和打字培训.根据模块式技能培训法（Modules of Employabl Skill,MES）,将Word软件操作及打字速度训练分成若干个模块和单元学习,按照每个模块和单元学习的测量标准进行训练.结果16例颈损患者对Word软件的学习进步明显;打字速度明显提高（P＜0.01）.结论通过职业训练,颈髓损伤患者可以基本掌握计算机操作.     

CT三维重建技术在脊柱疾病康复前期诊断中的应用

目的 探讨经多层螺旋CT（MSCT）扫描后CT三维重建技术在脊柱疾病康复前期诊断中的应用价值。方法 对15例颈椎和25例胸腰椎患者行MSCT后，用多平面重建（MPR）、表面积重建（SSD）及实时再现（VR）软件实现三维重建。结果 经重建的图像可显示颈椎后纵韧带钙化、椎间隙椎间孔狭窄、骨质增生等，胸腰椎可显示各种骨折及骨质增生、滑脱等病理改变。结论 CT三维重建技术在脊柱疾病及损伤中有独特的优越性。     

Computer-assisted capnogram analysis

Characteristic abnormal carbon dioxide waveforms from patients with mechanically ventilated lungs are observed when, for example, valves are incompetent, the airway is obstructed, the breathing circuit becomes disconnected, or a patient overrides mechanical ventilation with spontaneous breaths. Automated observation of the carbon dioxide waveform provides a uniform, concise, and consistent interpretation of the capnogram. This article describes a computer algorithm for analyzing and classifying capnograms as normal or as belonging to one of the categories above. The algorithm also generates a diagnostic message when the capnogram deviates from a learned norm for at least three consecutive waveforms (and thus reduces the influence of artifacts). Clinical experience shows reliable waveform recognition by the algorithm.Supported in part by a grant from Datascope Corporation.The authors thank David A. Paulus, MD, and Jeffrey M. Feldman, MD, for their assistance and advice.     

CT辅助下立体定向穿刺引流术治疗基底节区脑出血的疗效分析

目的探讨CT辅助下立体定向穿刺引流术治疗老年高血压基底节区脑出血的疗效及其并发症。方法将发病24 h内的80例老年高血压脑出血患者分为穿刺引流术组和对照组。两组患者分别采用CT辅助下立体定向穿刺引流术和药物保守治疗;观察比较两组患者的住院治疗时间、并发症、治疗后的神经功能恢复,以及治疗前、后的神经功能评分。结果引流术组患者的并发症发生率为12.5%,对照组则为32.5%。引流术组的住院时间(17.6 d)、最终NIHSS评分(3.28分)和总有效率(92.5%)均明显优于对照组(24.6 d,4.00分和77.5%)。结论 CT辅助下立体定向穿刺引流术治疗基底节区脑出血创伤小,可以明显减少各种并发症,缩短患者的住院时间减少花费。与保守治疗相比,能促进患者神经功能的早期恢复。     

Promises and pitfalls of machine scoring of the Index of Productive Syntax

The AC-IPSyn computerised system for scoring the Index of Productive Syntax (IPSyn) was evaluated. Twenty language samples, ten taken at 30 months and ten of the same children at 42 months, were each scored for the IPSyn by hand and by AC-IPSyn. Point differences and point-to-point reliability were examined at the levels of the total, subscale, and individual structure scores. Points missed and erroneously given at each level were also analysed. The difference in total scores between manual and AC-IPSyn scoring was relatively small; point-to-point agreement was lower than reported elsewhere. Age differences were also found. AC-IPSyn accuracy varied by subscale and structure, with results suggesting that AC-IPSyn be used at this point in conjunction with hand scoring of more error-prone and low frequency structures. The relatively small total point difference masked the lower reliability revealed by other measures, demonstrating the importance of detailed comparisons of manual and machine scoring.