简介:为了从期刊文献的学科属性实现族性检索,为文章的分类统计创造条件,本刊2005起均对具有文献标识码的文章采用《中国图书馆分类法》(第四版)进行分类后。标识分类号文章一般标识1个分类号,多个主题的文章可标识2个或3个分类号;主分类号排在第一位,多个分类号之间应以分号分隔。希望有条件查询的作者在来稿时自行标明中图分类号。
简介:摘要急性缺血性脑卒中(AIS)是中枢神经系统的危急重症。近年来,国内外学者高度重视AIS的移动卒中单元院前诊疗管理能力提升,缩短CT检查、诊断及溶栓治疗时间,以提高溶栓效率,改善临床结局。2019年,国家脑卒中防治工程委员会等制定了《移动卒中单元中国专家共识2019》和《移动卒中单元技术规范中国专家共识2019》。近3年,国内外在移动卒中单元院前诊疗管理领域进一步融合了5G信息和人工智能(AI)技术,在卒中院前诊疗管理理念和治疗方法上取得了显著进步,为了更好地适应其发展,指导临床实践,本指南编辑委员会在中国专家共识的基础上制定了中国5G移动卒中单元院前诊疗管理指南。
简介:【摘要】 我国信息科技在最近几年得到了快速进步和完善,“医疗健康+互联网”工作的逐渐深入和推广,也促进了信息化建设在院前急救工作中的大力发展。在物联网、人工智能、大数据、云计算等技术的不断完善和更新,对于现代信息化的实际需求,传统移动网络模式已不能有效满足,5G网络这一新型移动网络技术应运而生。在院前急救工作中融入5G智能技术,不仅能让院前急救工作的信息化水平明显提高,而且能促进院内与院前的有效衔接,为人民群众提供更加高效和优质的急救服务,也是院前急救工作信息化建设今后发展的主要趋势。本文从院前急救的现状及5G技术的发展现状着手,分析了5G智能救护系统在院前急救中的应用情况。
简介:ObjectiveToinvestigatetheadvantagesofcanalwallreconstruction(CWR)mastoidectomy,asingle-stagetechniqueforcholesteatomaremovalandposteriorexternalcanalwallreconstruction,overtheopenandclosedproceduresintermsofcholesteatomarecurrence.Methods:BetweenJune2002andDecember2005,38patients(40ears)withcholesteatomawereadmitedtoSunYat-SenMemorialHospitalandreceivedsurgicaltreatments.Ofthesepatients,25weremalewithagesrangingbetween11and60years(mean=31.6years)and13werefemalewithagesrangingbetween20and65years(mean=38.8years).Canalwallreconstruction(CWR)mastoidectomywasperformedin31earsandcanalwalldown(CWD)mastoidectomyin9ears.Conchacartilagewasusedforearcanalwallreconstructionin22ofthe31CWRproceduresandcorticalmastoidbonewasusedintheremaining9cases.ResultsAt0.5to4yearsfollowup,allbutonepatientsremainedfreeofsignsofcholesteatomarecurrence,i.e.,noretractionpocketorcholesteatomamatrix.Onepatient,asmoker,neededrevisionsurgeryduetocholesteatomarecurrence1.5yearaftertheinitialoperation.Therecurrenceratewastherefore3.2%(1/31).CholesteatomarecurrencewasmonitoredusingpostoperativeCTscanswheneverpossible.Inthecasethatneededarevisionprocedure,aretractionpocketwasidentifiedbyotoendoscopyintheparsflacidaareathateventuallyevolvedintoacholesteatoma.Apocketextendingtotheepitympanumfilledwithcholesteatomamatrixwasconfirmedduringtherevisionoperation,Adecisiontoperformamodifiedmastoidectomywasmadeasthepatientrefusedtoquitsmoking.Themeanair-bonegapinpuretonethresholdwas45dBbeforesurgeryand25dBafter(p<0.05).Therewasnodifferencebetweenusingconchacartilageandcorticalmastoidboneforthereconstructionregardingair-bonegapimprovement,CTfindingsandotoendoscopicresults.ConclusionCWRmastoidectomycanbeusedformostpatientswithacquiredmiddleearcholesteatoma,inc
简介:ObjectiveToreporttympanoplastycasescompletedwithSheehyPartialOssicularReplacementProstheses(PORP).MethodsSeventyeight(83ears)of89caseswhoreceivedSheehyPORPforossicularchainreconstructionwerereviewed.Thesecaseswerefollowedformorethan6months(mean:21.3months).Thepreandpost-operativeaverageairconductionthresholdsandAir-BoneGap(ABG)at0.5,1and2kHzwerecompared.ResultsAll83earsshoweduneventfulhealingat1monthpostoperatively.PORPsin2earswithoutcartilagereinforcementwerefounddislocatedat3months.Preoperativehearingthresholdswerefrom35.75to68.5dBHL(mean:59.13±15.23dBHL).Postoperativemeanhearingthresholdimprovedto32.23±13.21dBHL(P<0.01).Meanair-bonegap(ABG)improvedfrom36.95±12.19dBpreoperativelyto21.71±12.05dBaftersurgery(P<0.01).In68ears(81.9%),postoperativeABGswereeither≤20dBorimprovedby15dBormorecomparedtobeforesurgery(definedassatisfactory).ConclusionPORPasaossicularreconstructionmaterialappearstoprovidesatisfactoryresults.Attentionshouldbepaidtoavoidofpostoperativedislocation.Long-termoutcomesremaintobeassessed.
简介:Objective:Tosummarizethereconstructionexperienceoftheelectricalinjuriesinemergency.Methods:All309woundsin105patientswhosufferedfromelectricalinjurieswerereviewedduringa10yearperiodfromJan.1st1986toDec.31st,1996.Treatmentmethod,patientdataandresultswerecomparedandanalyzed.Acomprehensiveurgentreconstructionalternativeusedinallcasesincludedthefollowings,1)debridingthewoundinemergency,2)preservingthevitaltissuesasmuchaspossible,evendevitalizedtissuesorlocalnecrosis,3)transplantingthesevitaltissuesduringthefirstsurgeryifthefunctionalreconstructionrequired,4)nourishingthewoundbedbytissueflapscoveringwithrichbloodsupply,5)improvingflapsurvivalbycontinuousirrigationfor24-720hoursbeneaththeflapswithacompoundmedicineaftersurgery.Results:Satisfactoryresultswereobtainedwiththeextremitylossratiooflessthan7%inthisgroupcomparedwith42.5%whichwas10yearsbefore1984inthesamehospital.Conclusions:Thisurgentcomprehensivereconstructionalternativeisaneffectiveandworkablemethodforreducingextremitylossofelectricalinjuries.
简介:Objective:Toevaluatetheclinicalefficacyofgreateromentuminreconstructionofrefractorywounds.Methods:FromAugust1988toMay2001,20patientswithrefractorywoundunderwentpedicleormicrovascularfreetransferofthegreateromentum.Indicationsofsurgerywereelectricalinjuryofthewristandhandin9patients,electricalinjuryofthescalpandcranialbonesin3,avulsioninjuryofthescalpin2,radiation-relatedulcerofthechestwallin2,ulcerandosteomyelitisfollowingresectionofthesternumsarcomain1,electricalinjuryoftheabdomenin1,boneandsofttissuedefectsfollowingcompoundfractureofthelegin1,andextensivescarandulcerofthelegandfootdropfollowingtraumain1.Severeinfectionandextensivetissuenecrosiswerepresentpriortosurgicaloperationin12patients.Elevenpatientsweretreatedwithpedicledomentalflaps,and9patientswithfreeomentalflaps.Thesizeoftheomentalflapsrangedfrom20cm×12cmto38cm×23cm.Results:Alltheomentalflapssurvived.Healingatthefirstintentionofthewoundswasachievedin17cases.Theon-topskingraftsresultedinpartialnecrosisoflipidliquefactiondevelopedintheomentumandhealedwithdressingchangein2cases.Asinustractofosteomyelitisoccurredinonecaseandhealedafterdelayedexcisionofthenecrosedbone.Follow-upstudyofallcasesfrom3to24monthsshowednorecurrentwoundsandpost-operativeabdominalcomplication.Recoverywithacceptableappearanceandrestorationoffunctionwassatisfactory.Conclusions:Greateromentumprovidesawell-vascularizedtissuewithlymphaticductsforwoundcoverage.Ithasstrongresistanceagainstinfection.Itisverymalleableandcanbemoldedeasily.Thereforeitisanidealtissueinfillingcavitiesandrepairingdefects,especiallyincoveringlargeandirregulardefectsthatcannotbetreatedwithskinormuscleflaps.
简介:目的将在更低的手足讨论ischemic挛缩的功能的重建的方法并且基于它的严厉和预后在更低的手足为ischemic挛缩建议一个分类协议。有在更低的手足的ischemic挛缩的42个病人全部的方法A在这研究被包括。根据骚乱的不同类型和严厉,由神经解压缩组成的外科的重建,腱变长或转移的度,内在的脚肌肉版本和小腿腹胫骨的神经吻合在每个病人被执行。手术后地结果,所有病人能走在扁平的地面上。落下脚在10个病人被改正,并且5个病人仍然在楼梯活动期间感到了一些困难。到屈肌hallucislongus腱的裂口跟腱转移在12个病人被执行,并且他们的走的稳定性被改进。七个病人接受了在5个病人在2个病人和S3到达到S2的ipsilateralsuraltibial神经吻合,和敏感恢复。在更低的手足的结论Ischemic挛缩是在更低的手足损伤以后的破坏复杂并发症。挛缩的预防比确定的挛缩的治疗更重要。到屈肌hallucislongus腱和小腿腹胫骨的神经吻合的裂口跟腱转移,被我们开始实现,能在更低的手足改进ischemic挛缩的功能的恢复,并且因此在更低的手足为ischemic挛缩的功能的重建提供一种新选择。