简介：AbstractObjective:Nasopharyngeal carcinomas (NPC) are tumors arising from epithelium of the nasopharynx. The 5-year survival rate of primary NPC is 80% with significant risks of recurrence. The objective here is to provide an evidence-based systemic review of the diagnostic value of different modalities in detecting local, regional, and distal recurrent NPC, as well as the associated costs with these modalities.Methods:MEDLINE, EMBASE, and the Cochrane review database were queried. Two hundred and twenty-three abstracts were generated using the inclusion criteria: patients >18 years of age; histopathological reference standard; and modalities pertaining to imaging or microbiology.Results:Twenty-four manuscripts fulfilled the inclusion criteria and 5 surveillance tools identified: endoscopy, MR, FDG-PET, Tc-99m MIBI and 201TI SPECT, and EBV DNA.Conclusions:For local surveillance, endoscopy is the gold standard recommendation, with increased efficacy if Narrow Band Imaging or contact endoscopy are utilized. MRI and FDG-PET is also recommended to help with local to distal spread; however, Tc-99m MIBI and 201TI SPECT are options as well. EBV DNA is recommended as a cheap and accessible adjunct surveillance tool if an available as an option.

简介：摘要OBJECTIVEThe COVID-19 pandemic is rapidly evolving and has led to increased numbers of hospitalizations worldwide. Hospitalized patients with COVID-19 experience a variety of symptoms, including fever, muscle pain, tiredness, cough, and difficulty breathing. Elderly people and those with underlying health conditions are considered to be more at risk of developing severe symptoms and have a higher risk of physical deconditioning during their hospital stay. Physical therapists have an important role in supporting hospitalized patients with COVID-19 but also need to be aware of challenges when treating these patients. In line with international initiatives, this article aims to provide guidance and detailed recommendations for hospital-based physical therapists managing patients hospitalized with COVID-19 through a national approach in the Netherlands.METHODSA pragmatic approach was used. A working group conducted a purposive scan of the literature and drafted initial recommendations based on the knowledge of symptoms in patients with COVID-19, and current practice for physical therapist management for patients hospitalized with lung disease and patients admitted to the intensive care unit (ICU). An expert group of hospital-based physical therapists in the Netherlands provided feedback on the recommendations, which were finalized when consensus was reached among the members of the working group.RESULTSThe recommendations include safety recommendations, treatment recommendations, discharge recommendations, and staffing recommendations. Treatment recommendations address 2 phases of hospitalization: when patients are critically ill and admitted to the ICU, and when patients are severely ill and admitted to the COVID ward. Physical therapist management for patients hospitalized with COVID-19 comprises elements of respiratory support and active mobilization. Respiratory support includes breathing control, thoracic expansion exercises, airway clearance techniques, and respiratory muscle strength training. Recommendations toward active mobilization include bed mobility activities, active range-of-motion exercises, active (-assisted) limb exercises, activities-of-daily-living training, transfer training, cycle ergometer, pre-gait exercises, and ambulation.

简介：Bytheendof1998Chinaboasted220refinerieswithatotalcrudeprocessingcapacityof262Mt/a.Theaveragerefinerysizeatthattimewas1.194Mt/a.Refinerieswithprocessingcapacityexceeding5.0Mt/aaccountedforonly21.26%,whilethecapacityofsinglerefiningunitswerealsosmallthatcouldnotconformwiththeeconomyofscale.China'srefiningindustryisfacedwithatoughtaskofstructureadjustment.

简介：Despitetheacceptanceofphysicalactivity(PA)beingintegraltoayoungperson'shealth,childrenwithdisabilityoftenexhibitlowlevelsofPA.Inyoungpeoplewithcysticfibrosis(CF)theimportanceofexerciseanddailyPAisacknowledgedbycliniciansandtheirsupportteams,however,thereisalackofknowledgerelatedtoitsprescription.CFisarecessivegeneticdisorderaffectingthelung,pancreasandsweatglands.CFisthemostcommonlifeshorteninggeneticdiseaseintheCaucasianpopulationforwhichthereisnocure.IntheUK,CFaffectsover9000people,with4000under16yearsofage.OnlyabouthalfoftheCFpopulationcanexpecttolivebeyond40yearsofage.Besidesdrugtherapies,rehabilitativeexerciseprogrammesformanimportantcomponentoftreatmentandlongtermexerciseprogrammesareconsideredpositivetreatmentstrategies,butalllackanydetailedprescriptiveinformation.SeveralreviewsandeditorialshavehighlightedthelackofevidencebasedresearchinPAandexercisetraininginyoungpeoplewithCF;butadvocateagreaterneedforunderstandingtheroleofexerciseintherapeuticinterventions.ThepurposeofthisreviewistoupdatethereaderonthecurrentrecommendationsandevidenceinPAandexercisetrainingforyoungpeoplewithCF.ThesedevelopmentshaveextendedourunderstandingofPAandexercisetraininginchildrenandadolescentswithCF,anditsimplementationinthemanagementofthischronicdisease.

简介：AbstractCoronavirus disease (COVID-19) was first diagnosed in Wuhan in December 2019. The World Health Organization defined the subsequent outbreak of COVID-19 worldwide as a public health emergency of international concern. Epidemiological data indicate that at least 20% of COVID-19 patients have severe disease. In addition to impairment of the respiratory system, acute kidney injury (AKI) is a major complication. Immune damage mediated by cytokine storms and concomitant AKI is a key factor for poor prognosis. Based on previous experience of blood purification for patients with severe acute respiratory syndrome and Middle East respiratory syndrome combined with clinical front-line practice, we developed a blood purification protocol for patients with severe COVID-19. This protocol is divided into four major steps. The first step is to assess whether patients with severe COVID-19 require blood purification. The second step is to prescribe a blood purification treatment for patients with COVID-19. The third step is to monitor and adjust parameters of blood purification. The fourth step is to evaluate the timing of discontinuation of blood purification. It is expected that blood purification will play a key role in effectively reducing the mortality of patients with severe COVID-19 through the standardized implementation of the present protocol.

简介：无

简介：

简介：同时的多元素抽取全球一直在增加改进测试质量和效率的土壤实验室。这研究寻求了为可得到的土壤的同时的抽取调查Mehlich-1，Mehlich-3，和树脂方法的适用性象为庄稼在滋养的建议上使用变换方程的效果一样的P，K，Ca，和Mg。表层土(0–；20厘米)样品从与大量化学、物理、矿物学的性质在南部的巴西为庄稼生产使用的最代表性的土壤类型被拿。土壤P，K，Ca，和Mg同时用1.0摩尔L−被提取；1KCl，Mehlich-1和Mehlich-3答案，和膜树脂。平均，与Mehlich-1方法提取的P的数量是50%比与树脂和Mehlich-3方法提取的那些低。然而，树脂方法提取了K，Ca，和Mg的最低数量。变换方程的使用是合适的，它没否定地为在南部的巴西的土壤上种的庄稼影响K建议。

简介：AbstractBehavioral health concerns are surging in pediatric practices. Fortunately, integrated behavioral/medical health clinics are growing and child psychiatrists/psychologists are increasingly embedded in these care settings to help shoulder the clinical load. Routine screening of behavioral health problems in primary care facilities enables early identification and treatment. However, deciding on sound, efficient, and scalable screening measures is sometimes arduous. Accordingly, this article presents a clinician-friendly review of three common instruments useful in screening pediatric behavioral health concerns including anxiety, depression, and conduct problems. Psychometric findings and clinical applications of the Pediatric Symptom Checklist-17 (PSC-17), the Patient Health Questionnaire-9 (PHQ-9), and the Screen for Child Anxiety Related Emotional Disorders (SCARED) are delineated. Finally, clinical implications and recommendations for practicing pediatricians and child psychiatrists are offered.

简介：AbstractSince October 2021 in Alabama, the United States, and March 2022 in central Scotland, the United Kingdom, the number of cases of severe acute hepatitis of unknown etiology/causes in children was found to increase, and the total number of cases has reached 920 worldwide by June 22 this year, 45 cases (5%) required liver transplantation, and 18 cases (2%) died according to World Health Organization (WHO). To understand the basic characteristics of this disease/syndrome, a literature search was performed at PubMed, websites of WHO, UK Health Security Agency, and US and European Centers for Disease Control and Prevention, and more than 20 reports were enrolled as references for this review. The main clinical manifestations are anorexia, vomiting, fatigue, jaundice, and so forth. Most of the cases seemed to have a self-limited course of the disease, about 6% of cases may develop life-threatening acute liver failure. The disease seems to be transmissible from person to person. Human adenovirus was detected in up to 75% of cases, but this virus seems not to be the only and major etiologic agent, other cofactors probably are involved. Researchers proposed many hypotheses concerning the etiology and pathogenesis, and many important works and studies are ongoing. This mini-review is aimed at summarizing, reviewing, and further understanding the characteristics of the disease, raising some clinically relevant questions, and trying to discuss some questions that may be related to the treatment of the disease for consideration.

简介：AbstractCOVID-19 has become a pandemic and it has already spread to at least 171 countries/regions. Chronic kidney disease (CKD) is a global public health problem with a total of approximately 850 million patients with CKD worldwide and 119.5 million in China. Severe COVID-19 infection may damage the kidney and cause acute tubular necrosis, leading to proteinuria, hematuria and elevated serum creatinine. Since the SARS-CoV-2 enters the cells by binding to the angiotensin-converting enzyme 2 receptor, some doctors question its ability to increase the risk and severity of developing COVID-19. Neither clinical data nor basic scientific evidence supports this assumption. Therefore, patients who take angiotensin-converting enzyme inhibitor or angiotensin receptor blocker are not advised to change their therapy. Patients with CKD are generally the elderly population suffering from multiple comorbidities. Moreover, some patients with CKD might need to take glucocorticoids and immunosuppressants. Dialysis patients are recurrently exposed to a possible contaminated environment because their routine treatment usually requires three dialysis sessions per week. Considering all the above reasons, patients with CKD are more vulnerable to COVID-19 than the general population. The development of COVID-19 may worsen the impaired kidney function and further lead to rapid deterioration of kidney function and even death. Strict comprehensive protocols should be followed to prevent the spread of COVID-19 among patients with CKD. In this review, we provide some practical management recommendations for health care providers, patients with CKD, dialysis patients and dialysis facilities.

简介：Osteoarthritis(OA)isthemostcommonformofarthritis.ThekneeandhipjointsarethemostcommonsitesforOA,andkneeOAismoreprevalentthanhipOA.1KneeOApatientsoftensufferpain,functionaldisability,articularcartilagewearandrelatedjointspacenarrowing.AmongU.S.adults,46.4millionhavephysician-diagnosedarthritisrepresenting

简介：

简介：无