Objective: To compare the effectiveness and safety of two surgical methods for lumbar degenerative diseases;the combination of the concept of accelerated rehabilitation with the assistance of Tianji Robotics and the c...Objective: To compare the effectiveness and safety of two surgical methods for lumbar degenerative diseases;the combination of the concept of accelerated rehabilitation with the assistance of Tianji Robotics and the concept of accelerated rehabilitation combined with manual pedicle screw placement assisted by conventional C-arm fluoroscopy. Methods: A retrospective analysis was performed on 70 patients who received the concept of accelerated rehabilitation combined with spinal surgery for lumbar degenerative diseases in Baise People’s Hospital from January 2022 to January 2024. Among them, 35 patients in the robot group received accelerated rehabilitation concept combined with robot-assisted surgery;In the conventional C-arm group, 35 patients received the accelerated rehabilitation concept combined with manual pedicle screw placement assisted by conventional C-arm fluoroscopy. VAS score (preoperative/postoperative), ODI score (preoperative/postoperative), intraoperative bleeding volume, postoperative hospital stay, postoperative complications and the accuracy rate of screw placement were compared between the two groups. Result: There was no statistically significant difference in preoperative VAS scores between the robot group and the conventional C-arm group (6.45 ± 0.82 VS 6.63 ± 0.81, P = 0.6600). The postoperative VAS score of the robot group was better than that of the conventional C-arm group (1.69 ± 0.80 VS 2.45 ± 0.85, P = 0.0000*). There was no statistically significant difference in preoperative ODI scores between the robot group and the conventional C-arm group (32.11 ± 3.18 VS 31.66 ± 2.25, P = 0.4900). The postoperative ODI score of the robot group was better than that of the conventional C-arm group (22.68 ± 1.94 VS 24.57 ± 2.25, P = 0.0000*). The postoperative complications in the robot group were less than those in the conventional C-arm group (2.7778% VS 28.5724%, P = 0.0030*). The intraoperative bleeding in the robot group was lower than that in the conventional C-arm group (320.85 ± 276.28 VS 490.00 ± 395.34, P = 0.0420*). The postoperative hospital stay of the robot group was shorter than that of the conventional C-arm group (10.00 ± 9.32 VS 14.49 ± 7.55, P = 0.0300*). The screw placement inaccuracy score of the robot group was lower than that of the conventional C-arm group (0.17 ± 0.51 VS 1.45 ± 1.46, P = 0.0000*). Conclusion: The combination of the concept of accelerated rehabilitation and Tianji Orthopedic robot-assisted surgery is more effective and safer in posterior lumbar decompression and internal fixation surgery with a screw rod system, and is worthy of promotion and application.展开更多
Diffuse changes in white matter resulting from cerebral microvascular disease contribute to cognitive impairment （Jokinen et al., 2011）, declines in global functionality （Inzitari et al., 2009）, and even death （D...Diffuse changes in white matter resulting from cerebral microvascular disease contribute to cognitive impairment （Jokinen et al., 2011）, declines in global functionality （Inzitari et al., 2009）, and even death （Debette and Markus, 2010）. Twenty years ago, estimations of the clinical incidence of ce- rebral microvascular disease approached 11 million per year in the US alone （Leary and Saver, 2003）. More recent estima- tions suggest the prevalence of diffuse white matter disease and silent brain infarction approaches 20% and increases dramatically in the presence of cardiovascular risk factors （Fanning et al., 2014）.展开更多
The concept, definition, and diagnosis of amyotrophic lateral sclerosis(ALS) currently present some problems. This article systematically reviews the literature on the history, current concepts, definition, and diagno...The concept, definition, and diagnosis of amyotrophic lateral sclerosis(ALS) currently present some problems. This article systematically reviews the literature on the history, current concepts, definition, and diagnosis of ALS, and discloses the present problems based on the retrieved literature and the authors' clinical experience. The current concepts and definitions of ALS have not yet been unified or standardized in clinical practice, and are sometimes vague or inaccurate, which can cause difficulties for neurologists in the clinical treatment of ALS. The concept and definition of ALS need to be further ascertained, and the current diagnostic criteria for ALS require further development. The identification of effective and objective biomarkers may be a feasible method for the early and accurate diagnosis of ALS. Therefore, future research should focus on the identification of reliable biomarkers—especially neuroimaging biomarkers—through autopsy. Standardizing the concept and definition of ALS and formulating clear diagnostic criteria will largely avoid many uncertainties in the future clinical research and treatment of ALS, which will greatly benefit patients.展开更多
Objectives:There is extensive literature from various disciplines on self-care,an important aspect of nursing intervention via evaluation and education,but its meaning remains unprecise due to the difficulty integrati...Objectives:There is extensive literature from various disciplines on self-care,an important aspect of nursing intervention via evaluation and education,but its meaning remains unprecise due to the difficulty integrating the diverse definitions developed over time across disciplines.Therefore,it is vital to clarify the meaning of self-care and formulate the defining attributes,antecedents,and consequences to self-care.Methods:Walker and Avant’s concept analysis approach was used to analyze the concept of self-care.A search of the literature was completed using the databases CINAHL,PubMed,and EBSCOhost for years 1975e2020;literature search included peer-review articles,full-text publications,and available in English.A total of 31 articles were reviewed,and saturation was reached.Results:An extensive review of the literature revealed salient characteristics that reflected the most frequently used terms associated with the concept.Guided byWalker and Avant’s method,three defining attributes emerged as common themes:awareness,self-control,and self-reliance.Conclusions:A clarified definition was identified:the ability to care for oneself through awareness,selfcontrol,and self-reliance in order to achieve,maintain,or promote optimal health and well-being.展开更多
One of the predominant effects of PD is alteration of motor skills, which leads to compromised posture and physical balance. Aquatic physical therapy, performed in a heated pool, can serve as one of intervention alter...One of the predominant effects of PD is alteration of motor skills, which leads to compromised posture and physical balance. Aquatic physical therapy, performed in a heated pool, can serve as one of intervention alternatives for PD carriers. Aim: To analyze the effects of the Halliwick Concept hydrotherapy in acquisition of motor skills in Parkinson’s disease (PD) patients. Methods: A clinical, qualitative method was used to evaluate 7 volunteers (59.85 ± 7.92 years of age, both male and female), who were in II and III stages of PD according to the Hoehn & Yar Scale. The participants were evaluated in the start and end of the interventions phase, and then the evaluation was conducted interventions in a heated pool (32?C - 34?C) twice a week, each session lasting approximately 30 minutes, totaling 10 sessions. The Halliwick Principles’ 3-phase 10-point methods were used for acquisition of aquatic motor skills. Results: They indicate an improvement in their ability to float in prone and supine positions (P = 0.04*) and longitudinal rotation in the bipedal position. Conclusion: The activation of motor control improved the motor skills of the participants.展开更多
目的探讨患者积极度概念的定义及内涵。方法系统检索中国知网、万方数据、维普网、PubMed、SinoMed、CINAHL、Cochrane Library、Web of Science、Embase数据库中患者积极度的相关文献,采用Walker和Avant的概念分析法对纳入文献进行分...目的探讨患者积极度概念的定义及内涵。方法系统检索中国知网、万方数据、维普网、PubMed、SinoMed、CINAHL、Cochrane Library、Web of Science、Embase数据库中患者积极度的相关文献,采用Walker和Avant的概念分析法对纳入文献进行分析。结果共纳入41篇文献。患者积极度的定义属性为参与自我健康管理意愿、参与自我健康管理知识、参与自我健康管理行动和参与自我健康管理信心;其前因为人口学特征、疾病相关因素、心理因素、社会因素;后果为促进健康行为、改善临床结局、降低医疗使用率与成本。测量工具包括患者积极度量表、医疗消费者参与度量表、医疗消费者健康积极指数、糖尿病患者积极度影响和动机量表。结论该研究明确了患者积极度的定义属性、前因及后果,可为以后国内研制不同疾病患者积极度特异性评估工具,构建本土化的患者积极度干预方案等提供参考。展开更多
文摘Objective: To compare the effectiveness and safety of two surgical methods for lumbar degenerative diseases;the combination of the concept of accelerated rehabilitation with the assistance of Tianji Robotics and the concept of accelerated rehabilitation combined with manual pedicle screw placement assisted by conventional C-arm fluoroscopy. Methods: A retrospective analysis was performed on 70 patients who received the concept of accelerated rehabilitation combined with spinal surgery for lumbar degenerative diseases in Baise People’s Hospital from January 2022 to January 2024. Among them, 35 patients in the robot group received accelerated rehabilitation concept combined with robot-assisted surgery;In the conventional C-arm group, 35 patients received the accelerated rehabilitation concept combined with manual pedicle screw placement assisted by conventional C-arm fluoroscopy. VAS score (preoperative/postoperative), ODI score (preoperative/postoperative), intraoperative bleeding volume, postoperative hospital stay, postoperative complications and the accuracy rate of screw placement were compared between the two groups. Result: There was no statistically significant difference in preoperative VAS scores between the robot group and the conventional C-arm group (6.45 ± 0.82 VS 6.63 ± 0.81, P = 0.6600). The postoperative VAS score of the robot group was better than that of the conventional C-arm group (1.69 ± 0.80 VS 2.45 ± 0.85, P = 0.0000*). There was no statistically significant difference in preoperative ODI scores between the robot group and the conventional C-arm group (32.11 ± 3.18 VS 31.66 ± 2.25, P = 0.4900). The postoperative ODI score of the robot group was better than that of the conventional C-arm group (22.68 ± 1.94 VS 24.57 ± 2.25, P = 0.0000*). The postoperative complications in the robot group were less than those in the conventional C-arm group (2.7778% VS 28.5724%, P = 0.0030*). The intraoperative bleeding in the robot group was lower than that in the conventional C-arm group (320.85 ± 276.28 VS 490.00 ± 395.34, P = 0.0420*). The postoperative hospital stay of the robot group was shorter than that of the conventional C-arm group (10.00 ± 9.32 VS 14.49 ± 7.55, P = 0.0300*). The screw placement inaccuracy score of the robot group was lower than that of the conventional C-arm group (0.17 ± 0.51 VS 1.45 ± 1.46, P = 0.0000*). Conclusion: The combination of the concept of accelerated rehabilitation and Tianji Orthopedic robot-assisted surgery is more effective and safer in posterior lumbar decompression and internal fixation surgery with a screw rod system, and is worthy of promotion and application.
基金support from the Larry L.Hillblom Foundation (GX)NIH NS083740 (JDH)the United States Department of Veterans Affairs Greater Los Angeles Healthcare System (JDH)
文摘Diffuse changes in white matter resulting from cerebral microvascular disease contribute to cognitive impairment （Jokinen et al., 2011）, declines in global functionality （Inzitari et al., 2009）, and even death （Debette and Markus, 2010）. Twenty years ago, estimations of the clinical incidence of ce- rebral microvascular disease approached 11 million per year in the US alone （Leary and Saver, 2003）. More recent estima- tions suggest the prevalence of diffuse white matter disease and silent brain infarction approaches 20% and increases dramatically in the presence of cardiovascular risk factors （Fanning et al., 2014）.
基金supported by the National Natural Science Foundation of China,No.30560042,81160161 and 81360198(all to RSX)grants from the Education Department of Jiangxi Province,No.GJJ13198 and GJJ170021(both to RSX)+3 种基金grants from Jiangxi Provincial Department of Science and Technology,No.2014-47,20142BBG70062,and 20171BAB215022(all to RSX)a grant from Health and Family Planning Commission of Jiangxi Province,No.20181019(to RSX)a grant from Jiangxi Provincial Department of Science and Technology Gan Po Elite 555,No.2015108(to RSX)the Innovation Fund Designated for Graduate Students of Jiangxi Province,No.YC2016-B027 and YC2015-S097(both to RSX)。
文摘The concept, definition, and diagnosis of amyotrophic lateral sclerosis(ALS) currently present some problems. This article systematically reviews the literature on the history, current concepts, definition, and diagnosis of ALS, and discloses the present problems based on the retrieved literature and the authors' clinical experience. The current concepts and definitions of ALS have not yet been unified or standardized in clinical practice, and are sometimes vague or inaccurate, which can cause difficulties for neurologists in the clinical treatment of ALS. The concept and definition of ALS need to be further ascertained, and the current diagnostic criteria for ALS require further development. The identification of effective and objective biomarkers may be a feasible method for the early and accurate diagnosis of ALS. Therefore, future research should focus on the identification of reliable biomarkers—especially neuroimaging biomarkers—through autopsy. Standardizing the concept and definition of ALS and formulating clear diagnostic criteria will largely avoid many uncertainties in the future clinical research and treatment of ALS, which will greatly benefit patients.
基金This work was supported in part by the Achievement Rewards for College Scientists(ARCS)Foundation.
文摘Objectives:There is extensive literature from various disciplines on self-care,an important aspect of nursing intervention via evaluation and education,but its meaning remains unprecise due to the difficulty integrating the diverse definitions developed over time across disciplines.Therefore,it is vital to clarify the meaning of self-care and formulate the defining attributes,antecedents,and consequences to self-care.Methods:Walker and Avant’s concept analysis approach was used to analyze the concept of self-care.A search of the literature was completed using the databases CINAHL,PubMed,and EBSCOhost for years 1975e2020;literature search included peer-review articles,full-text publications,and available in English.A total of 31 articles were reviewed,and saturation was reached.Results:An extensive review of the literature revealed salient characteristics that reflected the most frequently used terms associated with the concept.Guided byWalker and Avant’s method,three defining attributes emerged as common themes:awareness,self-control,and self-reliance.Conclusions:A clarified definition was identified:the ability to care for oneself through awareness,selfcontrol,and self-reliance in order to achieve,maintain,or promote optimal health and well-being.
文摘One of the predominant effects of PD is alteration of motor skills, which leads to compromised posture and physical balance. Aquatic physical therapy, performed in a heated pool, can serve as one of intervention alternatives for PD carriers. Aim: To analyze the effects of the Halliwick Concept hydrotherapy in acquisition of motor skills in Parkinson’s disease (PD) patients. Methods: A clinical, qualitative method was used to evaluate 7 volunteers (59.85 ± 7.92 years of age, both male and female), who were in II and III stages of PD according to the Hoehn & Yar Scale. The participants were evaluated in the start and end of the interventions phase, and then the evaluation was conducted interventions in a heated pool (32?C - 34?C) twice a week, each session lasting approximately 30 minutes, totaling 10 sessions. The Halliwick Principles’ 3-phase 10-point methods were used for acquisition of aquatic motor skills. Results: They indicate an improvement in their ability to float in prone and supine positions (P = 0.04*) and longitudinal rotation in the bipedal position. Conclusion: The activation of motor control improved the motor skills of the participants.
文摘目的探讨患者积极度概念的定义及内涵。方法系统检索中国知网、万方数据、维普网、PubMed、SinoMed、CINAHL、Cochrane Library、Web of Science、Embase数据库中患者积极度的相关文献,采用Walker和Avant的概念分析法对纳入文献进行分析。结果共纳入41篇文献。患者积极度的定义属性为参与自我健康管理意愿、参与自我健康管理知识、参与自我健康管理行动和参与自我健康管理信心;其前因为人口学特征、疾病相关因素、心理因素、社会因素;后果为促进健康行为、改善临床结局、降低医疗使用率与成本。测量工具包括患者积极度量表、医疗消费者参与度量表、医疗消费者健康积极指数、糖尿病患者积极度影响和动机量表。结论该研究明确了患者积极度的定义属性、前因及后果,可为以后国内研制不同疾病患者积极度特异性评估工具,构建本土化的患者积极度干预方案等提供参考。
