简介：无

简介：AbstractBackground:Stroke is a principal cause of mortality and disability globally. Numerous studies have contributed to the knowledge base regarding self-management interventions among chronic disease patients, but there are few such studies for patients with stroke. Therefore, it is necessary to analyze self-management interventions among stroke patients. This scoping review aimed to systematically identify and describe randomized controlled trials (RCTs) of self-management interventions for adults with stroke.Methods:A review team carried out a scoping review on stroke and self-management interventions based on the methodology of Arksey and O'Malley, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). PubMed, Embase, Web of Science, CINAHL Plus Full Text, Medline Plus Full Text, and Cochrane Central Register of Controlled Trials were searched from inception to July 2020.Results:Fifty-four RCTs were included. The most popular study design is comparing a self-management intervention to usual care or waitlist control condition. Physical activity is the most common intervention topic, and interventions were mainly delivered face to face. The majority of interventions were located in inpatient and multiple settings. Interventions were conducted by various providers, with nurses the most common provider group. Symptom management was the most frequently reported outcome domain that improved.Conclusions:Self-management interventions benefit the symptom management of stroke patients a lot. The reasonable time for intervention is at least 6-12 months. Multifarious intervention topics, delivery formats, and providers are adopted mostly to meet the multiple needs of this population. Physical activity was the most popular topic currently. Studies comparing the effect of different types of self-management interventions are required in the future.

简介：

简介：Themyelodysplastic/myeloproliferativeneoplasms(MDS/MPNs)areauniquegroupofhematologicmalignanciescharacterizedbyconcomitantmyelodysplasticandmyeloproliferativefeatures.Accordingtothe2008WHOclassification,thecategoryincludesatypicalchronicmyeloidleukemia(aCML),chronicmyelomonocyticleukemia(CMML),juvenilemyelomonocyticleukemia(JMML),MDS/MPN-unclassifiable(MDS/MPN-U),andtheprovisionalentityrefractoryanemiawithringsideroblastsandthrombocytosis(RARS-T).Althoughdiagnosiscurrentlyremainsbasedonclinicopathologicfeatures,theincorporationofnextgenerationplatformshasallowedfortherecentmolecularcharacterizationofthesediseaseswhichhasrevealeduniqueandcomplexmutationalprofilesthatsupporttheirdistinctbiologyandisanticipatedtosoonplayanintegralroleindiagnosis,prognostication,andtreatment.Futuregoalsofresearchshouldincludethedevelopmentofdisease-modifyingtherapies,andfurthergeneticunderstandingofthecategorywilllikelyformthefoundationoftheseefforts.

简介：Braintumorsincidenceinpediatricagehasbeenestimatedbetween1.3to5%witharelativeincidenceof1.4to11%duringthefirstyearoflife;theimprovementininstrumentaldeviceshasleadtoarelativeincreaseinprecociousdiag-nosis.Thechoicetostudybraintumorsofthefirstyearoflifeasaseparatetopicfrompediatricageonesdependsontheobservationthatthesele-sionshavepeculiarclinical,topographicandtis-sularcharacteristics.Thesurvivalrateofthesepatientsisverypoorifcomparedwiththatfound

简介：Objective:Toinvestigatetheapproachofemergencymanagementforseverepelvicfractureassociatedwithinjuriesofadjacentvisceraandevaluatethetherapeuticeffect.Methods:Thedataof79patientswithseverepelvicfractureassociatedwithinjuriesofadjacentviscerawereretrospectivelystudied,andthestudycoveredaperiodof14years.Results:Toceasemassivebleedingduetopelvicfracture,ligationofinternaliliacarterieswasperformedon33cases,andangioembolizationon8.Of42patientswithcysticor/andurethralinjury,35underwentcystostomyanddelayedreconstruction,and7receivedaprimaryrealignment.Allof17patientswithinjuryofretroperitonealrectumunderwentdivertingcolostomyoftheproximalendofsigmoidwithpresacraldrainage,but4receivedprimaryrepairwithoutcolostomy.In22patientswithintraperitonealcolorectalinjury,19weremanagedwithprimaryrepairoranastomosiswhile3receivedacolostomy.Theoverallmortalityratewas8.86%(7/79);themaincauseswerehemorrhagicshockandassociatedinjury.Thecomplicationsincludedurethro-rectalfistulain4cases,thrombosisofrightcommoniliacarteryin1,ARDSfollowingchesttraumain1,andparaplegiain1.Exceptthepatientwithparaplegia,allofthemwerecured.Conclusions:Promptdiagnosisandpropertreatmentarethekeytosuccess.Devascularizationofinternaliliacarterieswithexternalfixationcageofthepelvis,cystostomyandproximalsigmoidostomyareeffectiveproceduresinemergencytreatmentofthecriticalpatients.

简介：无

简介：AbstractPemphigus vulgaris (PV) is a life-threatening autoimmune bullous disease that causes blisters and erosions on the skin and mucous membranes to standardize the diagnosis and treatment of PV, Chinese experts in this field were invited to make recommendations which are presented in this article. Pemphigus vulgaris can be divided into cutaneous mucous type, cutaneous type and mucous mucous dominant type according to the different clinical manifestations. The pathological manifestations of PV are acantholysis above the basal layer. The diagnosis of PV and the assessment of the severity of the disease are made in accordance with the clinical manifestations, histopathological features, immunofluorescence assay results, and detection of pathogenic serum antibodies. The first-line treatment of PV comprises systemic glucocorticoids. Early combination with immunosuppressive agents or rituximab is recommended for moderate and severe PV. Intravenous immunoglobulin administration is recommended for patients being treated with rituximab. Plasma exchange and stem cell transplantation can be performed if necessary. During the course of therapy, the disease activity should be closely monitored, and actions should be taken to prevent adverse reactions.

简介：根据文学，仅仅关于渗透胸的主动脉的损伤的出现的一个小比例能成功地被对待。此处，我们报导我们缺乏的一所农村医院里的如此的一个病人的最近的营救的经验推进了仪器为心肺绕过操作。20岁的男性在在无名的动脉和左普通颈动脉动脉之间的大动脉的拱门上和1.5厘米的撕裂与破坏无名的静脉和恰好普通的颈动脉动脉为渗透的损害被招收。没有实现，病人成功地被救心肺绕过。在这种情况中的表示和管理被讨论。

简介：ObjectivesToreportauthors'experiencesinthediagnosisandtreatmentsofcongenitalfirstbranchialfistula(congenitalauriculocervicalfistula).MaterialsandMethodsTwelvecasesofcongenitalfirstbranchialfistulawerereviewed.Ofthese,8underwentfistulectomywithfacialnervedissectionandpartialparotidectomyand4underwentsimplefistulectomy.ResultsTheinneropenings(upperopening)offistulaelayinthefollowingsites:inferioposteriorwallatthejunctionofcartilaginousandbonysegmentsoftheauricularcanalandinferiorwallofcartilaginousauricularcanal.Theouteropenings(loweropening)layalongtheanteriorborderofuppersternocleidomastoidmuscle,atthemastoidtipandposteriortothemandibularangle.Completefistulaeresectionwasachievedinallbutonecase.Elevencaseswerefollowedfor5yearwithnorecurrence.Recurrenceoccurredin1case6monthsaftertheprimarysurgeryandrevisionsurgerywasperformed.ConclusionsPre-operativeradiographyforthelocationandcourseofthefistulaiscrucialforsuccessfulfistularesection,especiallyincaseswithpastinfections.Facialnervedissectionshouldbedoneroutinelyfordeeplylocatedfistulae.

简介：无

简介：AbstractIrritable bowel syndrome (IBS) is a common functional gastrointestinal disease worldwide. Current guidelines of IBS are mostly based on the western populations and expected to vary in different communities. China has a large population and a vast literature is available on IBS. Due to linguistic variations in the literature, the studies are not widely known and their conclusions thus remain largely obscured to the western medical literature. In this article, we reviewed the published literatures on the investigations of IBS epidemiology, diagnosis, and management in the Chinese population and emphasized the different findings gleaned from the western publications. The detailed literature review will benefit understanding of and promote future study on IBS.

简介：Sinceitsoriginaldescription,theFontanoperationhasbeenwidelyusedforthepalliationofchildrenwithsingleventriclephysiologyandhasresultedinanincreasingnumberofthesepatientssurvivingtoadulthood.TheFontanoperationisauniqueapproachtocreateacirculationinserieswithouttwodistinctpumpingchambers.AlthoughtheFontanoperationincreasedthesurvivalratesofpatientswithsingleventriclephysiology,itcarriesaninevitableriskoflong-termmorbiditiesthatimpactstheoutcomesandqualityoflifeinthesepatients.Inthisreview,wediscussthechallengesresultingfromtheuniquepathophysiologyofFontancirculationandproposemanagementstrategies.

简介：

简介：无

简介：客观：调查成年钝脾的损害的非起作用的管理的指示。方法：回顾的评论在所有成年病人(年龄>15年)上被执行，钝脾的损害从1999～2003在法国承认了到Pellegrinhospital的脉管的外科的部门。我们不管年龄在所有适当病人non-operatively管理了脾的损害。结果：在4年期间，有钝脾的损害的54个连续成年病人在医院里被对待。有稳定的血液动力学的地位的27个病人的一个总数起初non-operatively被对待，哪个2个病人被辜负到non-operativetreatment。非起作用的管理的成功的百分比是92.6%。在54个病人，比55年老的7个of8病人与非起作用的管理被对待。二个案例developingpostoperatively代替膈的感染被合适的治疗愈合。在系列，没有死亡。结论：低档的非起作用的管理脾的损害能与可接受的低失败的率被完成。如果临床并且对外科医生到困难的实验室参数作决定，他们能取决于Resciniti“获得系统与脾的损伤选择成年人的一个子集的sCT(计算断层摄影术)是non-operativemanagement的试用的优秀候选人。比55年老的病人绝对没被禁止收到non-operativemanagement。

简介：Inordertofurtherpromotethestandardizationofdiagnosisandtreatmentofgastrointestinalstromaltumor(GIST)inChina,themembersofChineseSocietyofClinicalOncology(CSCO)ExpertCommitteeonGISTthoroughlydiscussedthekeycontentsoftheconsensusguidelines,andvotedonthecontroversialissue.Infinal,theChineseconsensusguidelinesforthediagnosisandmanagementofGIST(2017edition)wasformedonthebasisof2013editionconsensusguidelines,whichisherebyannounced.Theconsensusincludedthepathologicaldiagnosis,recurrenceriskclassificationevaluation,targetedagenttherapy,surgeryandprinciplesofsurveillanceofGIST.

简介：ObjectiveToevaluateefficacyofsurgicaltreatmentintraumaticfacialparalysis.Methods:Thirty-threecaseswerereviewed,includingtemporalbonefractureandiatrogenicfacialnerveinjury.Allthepatientsweretreatedwithvarioussurgicalmethodsaccordingtotheirpathogeny.ResultsThemeanpercentagefacialfunctionimprovement(House-BrackmannGradeⅠ-Ⅱ)was86%intemporalbonefractureandfunctionwasimprovedafterproperoperationtoiatrogenicfacialnerveinjury.ConclusionsPatientswithtraumaticfacialparalysisreceiveprovedoutcomesitreaedwithpropersurgicalmethodsaccordingtotheirparticularconditionofnerveinjury.

简介：

简介：摘要：合理配置专兼职感控人员，应做到医院有专职感控人员，科室有兼职感控人员，人人做感控工作的实践者。临床科室的“院感兼职人员”是临床院感质控重要一环，是由院感科定期培训管理，在各临床科室协助科室主任负责本科内院感控制的兼职人员。这些人员由临床科室管理却又是科室质控的管理人员，并参加院感科培训指导和质控会议，在工作中他们是院感控制三级网络中最基层的骨干，是院感科和临床科室之间的桥梁，是院感控制的有生力量。