The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the nation's medical research agency-making important discoveries that improve health and save lives.Thanks in...The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the nation's medical research agency-making important discoveries that improve health and save lives.Thanks in large part to NIH-funded medical research, Americans today are living longer and healthier. Life expectancy in the United States has jumped from 47 years in 1900 to 78 years as reported in 2009, and disability in people over age 65 has dropped dramatically in the past 3 decades. In recent years, nationwide rates of new diagnoses and deaths from all cancers combined have fallen significantly.展开更多
Introduction The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services is the nation's medical research agency-making important discoveries that improve health and save liv...Introduction The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services is the nation's medical research agency-making important discoveries that improve health and save lives.Thanks in large part to NIH-funded medical research, Americans today are living longer and healthier. Life expectancy in the United States has jumped from 47 years in 1900 to 78 years as reported in 2009, and disability in people over age 65 has dropped dramatically in the past 3 decades. In recent years, nationwide rates of new diagnoses and deaths from all cancers combined have fallen significantly.展开更多
目的探讨美国国立卫生研究院卒中量表(NIHSS)评分<6分的合并大血管闭塞的急性缺血性卒中(AIS-LVO)患者行血管内治疗(EVT)的预后影响因素。方法回顾性选取2021年1月至2023年1月在浙江省台州医院接受EVT的42例NIHSS评分<6分的AIS-LV...目的探讨美国国立卫生研究院卒中量表(NIHSS)评分<6分的合并大血管闭塞的急性缺血性卒中(AIS-LVO)患者行血管内治疗(EVT)的预后影响因素。方法回顾性选取2021年1月至2023年1月在浙江省台州医院接受EVT的42例NIHSS评分<6分的AIS-LVO患者为研究对象。根据术后90 d改良Rankin量表(mRS)评分评估患者预后,比较预后良好组与预后不良组患者的临床资料,采用多因素logistic回归分析预后影响因素。结果所有患者均成功实现血管再通(100.0%),术中均未发生血栓逃逸、血管损伤、夹层、出血事件;术后发生24 h症状性颅内出血1例(2.4%),恶性脑水肿1例(2.4%)。随访90 d mRS评分显示预后良好33例,预后不良9例(未发生死亡病例)。预后良好组与预后不良组在年龄、术前舒张压、穿刺至再灌注时间等方面比较,差异均有统计学意义(均P<0.05)。穿刺至再灌注时间是影响NIHSS评分<6分的AIS-LVO患者行EVT预后的独立危险因素(OR=1.026,P=0.029)。结论NIHSS评分<6分的AIS-LVO患者行EVT可能是安全有效的,缩短穿刺至再灌注时间可能改善患者预后。展开更多
目的通过对美国国立卫生研究院卒中量表(NIHSS)评分变化率的分析试图为脑梗死临床结局评价方法的选择提供一种新的思路与方法。方法本项研究采取前瞻性设计对来自10个临床研究中心急性期脑梗死住院患者的数据内容进行分析,筛选出入院...目的通过对美国国立卫生研究院卒中量表(NIHSS)评分变化率的分析试图为脑梗死临床结局评价方法的选择提供一种新的思路与方法。方法本项研究采取前瞻性设计对来自10个临床研究中心急性期脑梗死住院患者的数据内容进行分析,筛选出入院当天NIHSS评分、发病90 d NIHSS评分和BI数据资料完整患者953例,将患者按入院时NIHSS评分分为3级:轻度(〈7分)、中度(7分-15分)、重度(〉15分),以BI作为功能残疾的疗效判定"金标准",发病90 d BI≥95分为预后良好、BI〈95分为预后不良的分界点将BI转换为二分类变量(残疾与否),应用ROC曲线了解NIHSS的变化率对脑梗死患者发病90天功能残疾的判断价值。结果本研究发现NIHSS变化率预测脑梗死患者发病90 d功能残疾的AUC曲线下面积均〉0.70,轻度患者为0.76、中度患者为0.85,重度患者为0.97,与AUC曲线下面积=0.50进行比较,差异有统计学意义(P≤0.001)。预测脑梗死患者良好功能结局的最佳NIHSS变化率的截断值在轻度、中度、重度神经功能缺损的患者分别为70.8%、74.7%、84.9%;其灵敏度在三者分别为63.0%、81.8%、100.0%,特异度分别为78.1%、75.4%、94.3%。结论 NIHSS的变化率对脑梗死患者发病90 d功能残疾具有较好的预测能力,且这种预测能力随着神经功能缺损程度的增加而增大。展开更多
美国国立卫生院卒中量表(National Institute Health stroke scale,NIHSS)评分是临床上常用的脑卒中神经功能缺损评估量表,正确的NIHSS评分有助于更好地评估卒中严重程度和指导临床治疗决策,但现实中NIHSS评分临床使用中存在异质性。如...美国国立卫生院卒中量表(National Institute Health stroke scale,NIHSS)评分是临床上常用的脑卒中神经功能缺损评估量表,正确的NIHSS评分有助于更好地评估卒中严重程度和指导临床治疗决策,但现实中NIHSS评分临床使用中存在异质性。如何建立合格的培训模式、助力医务人员规范进行NIHSS评分具有重要意义。文章总结采取“线上+线下”“理论+实践”“案例+思政”“实时+延伸”的教学思路进行“线上+线下+思政+延伸”混合式教学模式的经验,探讨NIHSS评分教学方法,认为该混合式教学模式通过多渠道、多维度的培训模式,使得教学主导、学生主动相结合,并注重思政教育融入,且有助于提高教师教学效率,顺应了信息化时代的教育改革,符合未来教育课程发展的趋势,是NIHSS评分技能培训和改革的新思路和新方法。展开更多
文摘The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the nation's medical research agency-making important discoveries that improve health and save lives.Thanks in large part to NIH-funded medical research, Americans today are living longer and healthier. Life expectancy in the United States has jumped from 47 years in 1900 to 78 years as reported in 2009, and disability in people over age 65 has dropped dramatically in the past 3 decades. In recent years, nationwide rates of new diagnoses and deaths from all cancers combined have fallen significantly.
文摘Introduction The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services is the nation's medical research agency-making important discoveries that improve health and save lives.Thanks in large part to NIH-funded medical research, Americans today are living longer and healthier. Life expectancy in the United States has jumped from 47 years in 1900 to 78 years as reported in 2009, and disability in people over age 65 has dropped dramatically in the past 3 decades. In recent years, nationwide rates of new diagnoses and deaths from all cancers combined have fallen significantly.
文摘目的探讨美国国立卫生研究院卒中量表(NIHSS)评分<6分的合并大血管闭塞的急性缺血性卒中(AIS-LVO)患者行血管内治疗(EVT)的预后影响因素。方法回顾性选取2021年1月至2023年1月在浙江省台州医院接受EVT的42例NIHSS评分<6分的AIS-LVO患者为研究对象。根据术后90 d改良Rankin量表(mRS)评分评估患者预后,比较预后良好组与预后不良组患者的临床资料,采用多因素logistic回归分析预后影响因素。结果所有患者均成功实现血管再通(100.0%),术中均未发生血栓逃逸、血管损伤、夹层、出血事件;术后发生24 h症状性颅内出血1例(2.4%),恶性脑水肿1例(2.4%)。随访90 d mRS评分显示预后良好33例,预后不良9例(未发生死亡病例)。预后良好组与预后不良组在年龄、术前舒张压、穿刺至再灌注时间等方面比较,差异均有统计学意义(均P<0.05)。穿刺至再灌注时间是影响NIHSS评分<6分的AIS-LVO患者行EVT预后的独立危险因素(OR=1.026,P=0.029)。结论NIHSS评分<6分的AIS-LVO患者行EVT可能是安全有效的,缩短穿刺至再灌注时间可能改善患者预后。
文摘目的通过对美国国立卫生研究院卒中量表(NIHSS)评分变化率的分析试图为脑梗死临床结局评价方法的选择提供一种新的思路与方法。方法本项研究采取前瞻性设计对来自10个临床研究中心急性期脑梗死住院患者的数据内容进行分析,筛选出入院当天NIHSS评分、发病90 d NIHSS评分和BI数据资料完整患者953例,将患者按入院时NIHSS评分分为3级:轻度(〈7分)、中度(7分-15分)、重度(〉15分),以BI作为功能残疾的疗效判定"金标准",发病90 d BI≥95分为预后良好、BI〈95分为预后不良的分界点将BI转换为二分类变量(残疾与否),应用ROC曲线了解NIHSS的变化率对脑梗死患者发病90天功能残疾的判断价值。结果本研究发现NIHSS变化率预测脑梗死患者发病90 d功能残疾的AUC曲线下面积均〉0.70,轻度患者为0.76、中度患者为0.85,重度患者为0.97,与AUC曲线下面积=0.50进行比较,差异有统计学意义(P≤0.001)。预测脑梗死患者良好功能结局的最佳NIHSS变化率的截断值在轻度、中度、重度神经功能缺损的患者分别为70.8%、74.7%、84.9%;其灵敏度在三者分别为63.0%、81.8%、100.0%,特异度分别为78.1%、75.4%、94.3%。结论 NIHSS的变化率对脑梗死患者发病90 d功能残疾具有较好的预测能力,且这种预测能力随着神经功能缺损程度的增加而增大。
文摘美国国立卫生院卒中量表(National Institute Health stroke scale,NIHSS)评分是临床上常用的脑卒中神经功能缺损评估量表,正确的NIHSS评分有助于更好地评估卒中严重程度和指导临床治疗决策,但现实中NIHSS评分临床使用中存在异质性。如何建立合格的培训模式、助力医务人员规范进行NIHSS评分具有重要意义。文章总结采取“线上+线下”“理论+实践”“案例+思政”“实时+延伸”的教学思路进行“线上+线下+思政+延伸”混合式教学模式的经验,探讨NIHSS评分教学方法,认为该混合式教学模式通过多渠道、多维度的培训模式,使得教学主导、学生主动相结合,并注重思政教育融入,且有助于提高教师教学效率,顺应了信息化时代的教育改革,符合未来教育课程发展的趋势,是NIHSS评分技能培训和改革的新思路和新方法。