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简介：AbstractBackground:Intravenous thrombolysis (IVT) is an effective way for treating acute ischemic stroke (AIS). However, its effects have not been established among AIS patients with unclear stroke symptoms or with stroke onset for >4.5 h.Methods:We searched PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials and Google Scholar databases for randomized controlled trials that compared IVT (IVT group) and placebo or usual care (control group [CG]) in AIS patients with disease onset for >4.5 h. The outcomes of interest included the favorable functional outcome (defined as modified Rankin Scale [mRS] scores 0-1) at 90 days, the functional independence (defined as mRS scores 0-2) at 90 days, proportion of patients with symptomatic intracerebral hemorrhage (sICH) and death at 90 days. We assessed the risk of bias using the Cochrane tool. Pre-specified subgroup analyses were performed by age (≤70 years or >70 years), National Institute of Health Stroke Scale (NIHSS, ≤10 or >10) and time window (4.5-9.0 h or >9.0 h).Results:Four trials involving 848 patients were eligible. The risk of bias of included trials was low. Patients in the IVT group were more likely to achieve favorable functional outcomes (45.8% vs. 36.7%; OR 1.48, 95% CI 1.12-1.96) and functional independence (63.8% vs. 55.7%; OR 1.43, 95% CI 1.08-1.90) at 90 days, but had higher risk of sICH (3.0% vs. 0.5%; OR 5.28, 95% CI 1.35-20.68) at 90 days than those in the CG. No significant difference in death at 90 days was found between the two groups (7.0% vs. 4.1%; OR 1.80; 95% CI 0.97-3.34).Conclusions:Use of IVT in patients with extended time window may improve their functional outcomes at 90 days, although IVT may induce increased risk of sICH. Care of these patients should well balance the potential benefits and harms of IVT.

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简介：AbstractPurpose:This study aimed at exploring the application of trauma time axis management in the treatment of severe trauma patients by using the Medicalsystem trauma system.Methods:We performed a retrospective cohort study involving patients with severe trauma. Patients who were admitted before the application of the Medicalsystem trauma system were divided into before system group; patients who were admitted after the application of the system were divided into after system group. Comparison was made between the two groups. For normally distributed data, means were reported along with standard deviation, and comparisons were made using the independent samples t test. Categorical data were compared using the Chi-square test. The Mann-Whitney U test was used to compare nonparametric variables.Results:There were 528 patients admitted to the study during the study period. There was no significant statistical difference in the time from the start of trauma team to arrive at the resuscitation room between the two groups. The time from arrival at hospital to endotracheal intubation, to ventilator therapy, to blood transfusion, to completion of CT scan, to completion of closed thoracic drainage, to the start of operation, as well as the length of stay in resuscitation room and hospital were significantly lower after the application of the Medicalsystem trauma system. The mortality was decreased by 8.6% in the after system group compared with that in the before system group, but there was no statistical difference.Conclusion:The Medicalsystem trauma system can optimize diagnosis and treatment process for trauma patients, and accordingly improve the treatment efficiency and shorten the treatment time. Therefore, the Medicalsystem trauma system deserves further popularization and promotion.

简介： 【摘要】译林版小学《英语》中，教材各个单元的均增设了Ticking time自我评价板块，通过多元评价，引导学生了解自己对所学主要内容的掌握情况，反思和调控自己的学习过程，体验进步与成功，认识自我，明确方向。

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简介：摘要：本文立足于Story time板块教学，从激发阅读兴趣、提高阅读能力、演绎阅读精彩和提升阅读品格四个方面来提升学生的阅读素养。

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简介：摘要：目的：探讨不同的翻身时间间隔对患者压力性损伤发生的影响。方法：选取在我院骨科收治入院的患者180例，随机分为Ⅰ、Ⅱ、Ⅲ、Ⅳ四组，每组患者45例，其中入组患者均卧在气垫床上，对于上述四组患者分别间隔2h、4h、8h、16h进行翻身。观察患者受

简介：【摘要】在译林版《英语》教材中，Checkout time板块是每个单元的综合检测板块。教师可以选择贴合主题的绘本，与该板块相结合，设计融听、说、读、写于一体的教学活动，充分利用绘本的育人价值，深化单元主题意义。

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简介：摘要：在双减政策的背景下，对小学英语的教学提出了更高的要求，小学英语属于基础英语教学，能够为学生以后学习英语创造条件，教师要把握好时机，充分利用好英语教材中每一环节的教学内涵，文章为教师探究小学英语中story time部分的教学提出了相关策略。

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简介：摘 要：Fun time板块是指通过趣味性、互动性强的活动，能够让学生的单词和语法能够快速掌握，并且在生活中也能够得到应用。本篇文章结合一些授课中常见的案例，进行对Fun time板块授课方法及授课效果的一些分析。

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简介：AbstractBackground:Male sex workers are at high-risk for acquisition of sexually transmitted infections (STIs), including human immunodeficiency virus (HIV). We quantified incidence rates of STIs and identified their time-varying predictors among male sex workers in Mexico City.Methods:From January 2012 to May 2014, male sex workers recruited from the largest HIV clinic and community sites in Mexico City were tested for chlamydia, gonorrhea, syphilis, hepatitis, and HIV at baseline, 6-months, and 12-months. Incidence rates with 95% bootstrapped confidence limits were calculated. We examined potential time-varying predictors using generalized estimating equations for a population averaged model.Results:Among 227 male sex workers, median age was 24 and baseline HIV prevalence was 32%. Incidence rates (per 100 person-years) were as follows: HIV [5.23; 95% confidence interval (CI): 2.15-10.31], chlamydia (5.15; 95% CI: 2.58-9.34), gonorrhea (3.93; 95% CI: 1.88-7.83), syphilis (13.04; 95% CI: 8.24-19.94), hepatitis B (2.11; 95% CI: 0.53-4.89), hepatitis C (0.95; 95% CI: 0.00-3.16), any STI except HIV (30.99; 95% CI: 21.73-40.26), and any STI including HIV (50.08; 95% CI: 37.60-62.55). In the multivariable-adjusted model, incident STI (excluding HIV) were lower among those who reported consistently using condoms during anal and vaginal intercourse (odds ratio= 0.03, 95% CI: 0.00-0.68) compared to those who reported inconsistently using condoms during anal and vaginal intercourse.Conclusions:Incidence of STIs is high among male sex workers in Mexico City. Consistent condom use is an important protective factor for STIs, and should be an important component of interventions to prevent incident infections.

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简介：【摘要】“读后续写””对广东高考考生是一种全新的题型，这种题型把阅读与写作紧密结合了起来，不仅考察学生的阅读理解能力还检验其写作运用能力，在日常教学过程必须加强对学生语言能力、文化意识、思维品质、学习能力四大核心素养的培养，以增强其续写的合理性、逻辑性、丰富性和创新性。

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