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Expert consensus on difficulty assessment of endodontic therapy
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作者 Dingming Huang Xiaoyan Wang +33 位作者 Jingping Liang Junqi Ling Zhuan Bian Qing Yu Benxiang Hou Xinmei Chen Jiyao Li Ling Ye Lei Cheng Xin Xu Tao Hu Hongkun Wu Bin Guo Qin Su Zhi Chen Lihong Qiu Wenxia Chen Xi Wei Zhengwei Huang Jinhua Yu Zhengmei Lin Qi Zhang Deqin Yang Jin Zhao Shuang Pan Jian Yang Jiayuan Wu Yihuai Pan Xiaoli Xie Shuli Deng Xiaojing Huang Lan Zhang Lin Yue Xuedong Zhou 《International Journal of Oral Science》 SCIE CAS CSCD 2024年第1期15-25,共11页
Endodontic diseases are a kind of chronic infectious oral disease. Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha. However, it is ... Endodontic diseases are a kind of chronic infectious oral disease. Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha. However, it is very essential for endodontic treatment to debride the root canal system and prevent the root canal system from bacterial reinfection after root canal therapy(RCT). Recent research, encompassing bacterial etiology and advanced imaging techniques, contributes to our understanding of the root canal system’s anatomy intricacies and the technique sensitivity of RCT. Success in RCT hinges on factors like patients, infection severity, root canal anatomy, and treatment techniques. Therefore, improving disease management is a key issue to combat endodontic diseases and cure periapical lesions. The clinical difficulty assessment system of RCT is established based on patient conditions, tooth conditions, root canal configuration, and root canal needing retreatment, and emphasizes pre-treatment risk assessment for optimal outcomes. The findings suggest that the presence of risk factors may correlate with the challenge of achieving the high standard required for RCT. These insights contribute not only to improve education but also aid practitioners in treatment planning and referral decision-making within the field of endodontics. 展开更多
关键词 ANATOMY difficulty TREATMENT
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Construction of a nomogram model to predict technical difficulty in performing laparoscopic sphincter-preserving radical resection for rectal cancer
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作者 Xiao-Cong Zhou Shi-Wei Guan +3 位作者 Fei-Yue Ke Gaurav Dhamija Qiang Wang Bang-Fei Chen 《World Journal of Gastroenterology》 SCIE CAS 2024年第18期2418-2439,共22页
BACKGROUND Colorectal surgeons are well aware that performing surgery for rectal cancer becomes more challenging in obese patients with narrow and deep pelvic cavities.Therefore,it is essential for colorectal surgeons... BACKGROUND Colorectal surgeons are well aware that performing surgery for rectal cancer becomes more challenging in obese patients with narrow and deep pelvic cavities.Therefore,it is essential for colorectal surgeons to have a comprehensive understanding of pelvic structure prior to surgery and anticipate potential surgical difficulties.AIM To evaluate predictive parameters for technical challenges encountered during laparoscopic radical sphincter-preserving surgery for rectal cancer.METHODS We retrospectively gathered data from 162 consecutive patients who underwent laparoscopic radical sphincterpreserving surgery for rectal cancer.Three-dimensional reconstruction of pelvic bone and soft tissue parameters was conducted using computed tomography(CT)scans.Operative difficulty was categorized as either high or low,and multivariate logistic regression analysis was employed to identify predictors of operative difficulty,ultimately creating a nomogram.RESULTS Out of 162 patients,21(13.0%)were classified in the high surgical difficulty group,while 141(87.0%)were in the low surgical difficulty group.Multivariate logistic regression analysis showed that the surgical approach using laparoscopic intersphincteric dissection,intraoperative preventive ostomy,and the sacrococcygeal distance were independent risk factors for highly difficult laparoscopic radical sphincter-sparing surgery for rectal cancer(P<0.05).Conversely,the anterior-posterior diameter of pelvic inlet/sacrococcygeal distance was identified as a protective factor(P<0.05).A nomogram was subsequently constructed,demonstrating good predictive accuracy(C-index=0.834).CONCLUSION The surgical approach,intraoperative preventive ostomy,the sacrococcygeal distance,and the anterior-posterior diameter of pelvic inlet/sacrococcygeal distance could help to predict the difficulty of laparoscopic radical sphincter-preserving surgery. 展开更多
关键词 NOMOGRAM Rectal cancer Laparoscopic operation Sphincter-preserving surgery Technical difficulty
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Effect of Mouth Opening Training Stick Combined with Oral Massage on Mouth Opening Difficulty in Head and Neck Cancer Patients after Treatment
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作者 Jinhua Liu Qiong Wen 《Journal of Biosciences and Medicines》 2024年第6期43-51,共9页
Objective: To study the application effect of mouth-opening training sticks combined with oral massage on patients with mouth-opening difficulty after treatment for head and neck cancer. Methods: Using convenient samp... Objective: To study the application effect of mouth-opening training sticks combined with oral massage on patients with mouth-opening difficulty after treatment for head and neck cancer. Methods: Using convenient sampling, 60 patients with mouth-opening difficulty after treatment for head and neck cancer admitted to the Oncology Department from February 2022 to October 2023 were selected for a 2-week exercise and nursing program. The patients were divided into a control group (February 1, 2022 to November 30, 2022) and an observation group (December 1, 2022 to October 31, 2023), with 30 patients in each group. The control group underwent routine mouth-opening functional exercises combined with cork for oral support training, while the observation group underwent routine mouth-opening functional exercises combined with oral massage and mouth-opening training sticks for oral support training. The mouth-opening degree, mouth-opening difficulty level, comfort level, compliance, and quality of life were observed in both groups. Results: Before the intervention, there were no statistically significant differences in mouth-opening degree and mouth-opening difficulty level between the two groups (P > 0.05). After the intervention, the mouth-opening degree, mouth-opening difficulty level, oral comfort level, compliance, and QLICP-HN scores in the observation group were all better than those in the control group, with statistically significant differences (P < 0.05). Conclusion: The combination of mouth-opening training sticks and oral massage with mouth-opening functional exercises can effectively improve the degree of mouth-opening difficulty, enhance oral comfort, increase compliance with mouth-opening exercises, and improve quality of life. 展开更多
关键词 Head and Neck Cancer difficulty in Opening the Mouth Open Mouth Training Stick Oral Massage Rehabilitation Effect
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Ableism and (Neo)Racism in School Placement Processes in Quebec: School Personnel Interpretations of Immigrant Student Difficulties - A Secondary Publication
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作者 Tya Collins Corina Borri-Anadon 《Journal of Contemporary Educational Research》 2024年第3期148-160,共13页
The school placement processes of students from immigrant backgrounds considered to be in“difficulty”is an international concern at the intersection of works relating to special education and those concerning the sc... The school placement processes of students from immigrant backgrounds considered to be in“difficulty”is an international concern at the intersection of works relating to special education and those concerning the school experiences of students from immigrant backgrounds or racialized groups.The research problem of this article concerns the identification of these students as disabled or as having adjustment or learning difficulties.From a perspective anchored in Disability Critical Race Studies,this ethnographic study documents different interpretations of perceived difficulties made by school actors with regard to seven primary school students from immigrant backgrounds.Five interpretation types are presented:(1)medicalization by dismissal of cultural markers,(2)medicalization by professional constraint,(3)medicalization by cultural deficit,(4)precautionary wait,and(5)cultural differentialism.Our results help to shed light on the special education overrepresentation phenomenon regarding these students and to understand how ableism and(neo)racism contribute to it. 展开更多
关键词 Categorization in education Learning difficulties and students in difficulty Immigration and ethnicity Educational inclusion and exclusion Canada
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Proteomic analysis of overweight/obesity and related abnormal glucose and lipid metabolism caused by phlegm-dampness retention 被引量:1
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作者 Jiayi Ma Shuxian Sun +7 位作者 Cheng Ni Lingru Li Jing Xia Houqin Li Huirong Song Xujun Heng Dandan Hu Yuanyuan Li 《Journal of Traditional Chinese Medical Sciences》 2021年第3期224-237,共14页
Objective:To investigate the proteomic characteristics of overweight/obesity and related abnormal glucose and lipid metabolism caused by phlegm-dampness retention to identify related biomarkers.Methods:Seventy-one sub... Objective:To investigate the proteomic characteristics of overweight/obesity and related abnormal glucose and lipid metabolism caused by phlegm-dampness retention to identify related biomarkers.Methods:Seventy-one subjects were enrolled in the study.We assessed blood glucose,blood lipids,body mass index(BMI),and phlegm-dampness pattern,which was confirmed by a traditional Chinese medicine clinician.Of the participants,we included healthy participants with normal weight(NW,n=23),overweight/obese participants with normal metabolism(ONM,n=19),overweight/obese participants with pre-diabetes(OPD,n=12),and overweight/obese participants with marginally-elevated blood lipids(OML,n=17).Among them,the ONM,OPD,and OML groups were diagnosed with phlegmdampness pattern.The data-independent acquisition(DIA)method was first used to analyze the plasma protein expression of each group,and the relevant differential proteins of each group were screened.The co-expressed proteins were evaluated by Venn analysis.The pathway analyses of the differential proteins were analyzed using Ingenuity Pathway Analysis(IPA)software.Parallel reaction monitoring(PRM)was used to verify the differential and common proteins in each group.Results:After comparing ONM,OPD,and OML groups with NW group,we identified the differentially expressed proteins(DEPs).Next,we determined the DEPs among OPD,OML,and ONM groups.Using Venn analysis of the DEPs in each group,24 co-expressed proteins were screened.Two co-expressed proteins were verified by PRM.IPA analysis showed that pathways including LXR/RXR activation,acute phase response signaling,and FXR/RXR activation were common to all three groups of phlegmdamp overweight/obesity participants.However,the activation or inhibition of these pathways was different among the three groups.Conclusion:Participants with overweight/obesity have similar proteomic characteristics,though each type shows specific proteomic characteristics.Two co-expressed proteins,VTN and ORM1,are potential biomarkers for glucose and lipid metabolism diseases with overweight/obesity caused by phlegmdampness retention. 展开更多
关键词 phlegm-dampness retention OVERWEIGHT OBESITY Abnormal glucose and lipid metabolism Biomarkers
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Clinical Efficacy of Modified Erchen Decoction on Cervical Spondylotic Vertebral Arteriopathy with Stagnation and Blockade of Phlegm-dampness Syndrome and Effects on Cerebral Blood Flow Parameters 被引量:1
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作者 唐强 《World Journal of Integrated Traditional and Western Medicine》 2018年第4期21-26,共6页
OBJECTIVE: To observe the effect of Modified Erchen Decoction on cervical spondylotic vertebral arteriopathy with stagnation and blockade of phlegm-dampness syndrome and effects on cerebral blood flow parameters. METH... OBJECTIVE: To observe the effect of Modified Erchen Decoction on cervical spondylotic vertebral arteriopathy with stagnation and blockade of phlegm-dampness syndrome and effects on cerebral blood flow parameters. METHODS: A total of 80 cervical spondylotic vertebral arteriopathy(CSA) patients with stagnation and blockade of phlegmdampness syndrome admitted to our hospital from October 2016 to April 2017 were selected and randomly divided into observation group and control group, with 40 cases in each group. The observation group was treated with Modified Erchen Decoction and the control group was given conventional treatment with Western medicine. After 4 weeks of treatment, the main clinical symptoms and signs(vertigo, neck and shoulder pain, headache, psychological and social adjustment, daily life and work) and cerebral blood flow parameters [the peak values of intracranial vertebral-basal artery diastolic blood flow velocity(Vd) and systolic blood flow velocity(Vp)] were compared between the 2 groups. The total clinical effective rate and adverse reactions during treatment were also compared. RESULTS: After treatment, the total effective rate of the observation group was 90.0%, which was significantly higher than that of the control group(77.5%). The difference between the two groups was statistically significant(P < 0.05). After treatment, The scores of vertigo, neck and shoulder pain, headache, psychology and society adaptation, daily life and work were significantly increased(P < 0.05), and the above scores of the observation group were increased more obviously. The difference between the groups was statistically significant(P < 0.05). After treatment, the levels of Vd and Vp were significantly increased(P < 0.05), and the increase of the above indexes was more obvious in the observation group. The difference between the 2 groups was statistically significant(P < 0.05). There were no significant abnormalities in blood routine, urine routine, liver function and renal function. There was no significant difference in the incidence of adverse reactions between the 2 groups.(P > 0.05). CONCLUSION: The treatment of vertebral artery type cervical spondylopathy with stagnation and blockade of phlegm-dampness syndrome by Modified Erchen Decoction can effectively relieve the main clinical symptoms and signs, improve cerebral blood flow parameters, and improve the peak values of vertebral-basal artery diastolic blood flow velocity(Vd) and systolic blood flow velocity(Vp), which is safe and effective, and helps to promote the recovery of cervical function. 展开更多
关键词 VERTEBRAL artery type CERVICAL spondylopathy STAGNATION and BLOCKADE of phlegm-dampness Modified Erchen Decoction Cerebral blood flow PARAMETERS
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Fecal-associated microbiome differences between phlegm-dampness constitution and balanced constitution
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作者 Yini Li Pengfei Zhao +5 位作者 Yunan Zhang Jianhua Zhen Lu Zhao Yanan Cai Qingyi Lu Guangrui Huang 《Journal of Traditional Chinese Medical Sciences》 CAS 2022年第3期257-266,共10页
Objective: This study aimed to explore the structural and functional characteristics of the fecalassociated microbiome(FAM) between the phlegm-dampness constitution(PDC) and balanced constitution(BC), and to screen th... Objective: This study aimed to explore the structural and functional characteristics of the fecalassociated microbiome(FAM) between the phlegm-dampness constitution(PDC) and balanced constitution(BC), and to screen the related specific operational taxonomic unit(OTU) biomarkers.Methods: This was a cross-sectional study. After strictly identifying the constitution of subjects, their clinical index was recorded and counted. Fecal samples were collected for 16S rDNA sequencing. Alpha diversity, beta diversity, and the relative abundance of dominant bacterial taxa were used to describe the FAM structure, and the Wilcoxon rank-sum test, Metagenome Seq, and linear discriminant analysis effect size(LEf Se) were used to screen specific bacterial taxa. Specific OTUs were screened to construct receiver operating characteristic(ROC) curves.Results: Thirty-two subjects were enrolled, including 22 subjects with BC and 10 subjects with PDC.There were significant differences in cold preference, levels of aspartate transaminase, β2-microglobulin,and creatine kinase MB, and alpha diversity indices(Shannon and Shannoneven) between the two groups. In principal coordinate analysis by abund-jaccard distance measure and partial least squares discriminant analysis, bacterial communities clustered separately between the two groups. Furthermore,based on Metagenome Seq, LEf Se, and the Wilcoxon rank-sum test, a total of 43, 18, and 130 OTUs were differentially distributed between BC group and PDC group, respectively, and OTU200, OTU133, and OTU353 were screened when P≤.01. The area under the ROC curve constructed from the 3 selected OTUs was 0.93.Conclusion: The FAM structure and related functional characteristics of the PDC group differed from those of the BC group. In particular, OTU200, OTU133, and OTU353 can be used as unique markers of PDC to assist clinical diagnosis. 展开更多
关键词 Fecal-associated microbiome Traditional Chinese medicine constitution phlegm-dampness constitution Balanced constitution Biomarkers 16S rDNA Metabolic diseases Intestinal flora
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Morbi-Mortality Linked to Unsafe Abortions—Difficulties in Accessing Safe Abortions in Cameroon: Meta-Analysis and Systematic Review
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作者 Florent Ymele Fouelifack Mosman Anyimbi Ofeh +5 位作者 Jenny Ornella Manewoun Nsen Abeng Christophe Saha Lontsi Mvong Vendeline Amaelle Goretti Guy Sadeu Wafeu Robinson Enow Mbu 《Open Journal of Obstetrics and Gynecology》 CAS 2023年第2期342-359,共18页
Background: Unsafe abortions are one of the leading causes of maternal mortality, especially in developing countries. In Cameroon, the maternal mortality rate remains high, and the scarcity of data on abortions leads ... Background: Unsafe abortions are one of the leading causes of maternal mortality, especially in developing countries. In Cameroon, the maternal mortality rate remains high, and the scarcity of data on abortions leads to a lack of solid evidence to advocate on the extent of the abortions related complications. Our objective was to evaluate the unsafe abortions related complications, and to assess the difficulties of accessing safe abortions in our setting. Methods: We carried out a meta-analytic and systematic review in the biomedical databases MEDLINE (Pubmed), Google Scholar and African Journal Online concerning unsafe abortions and/or difficulties in accessing safe abortions in Cameroon. The keywords used for the search are seen in table I. Selection of studies was simultaneously done by two authors. Data were extracted through a form designed on Google Form. We used a random-effect model for proportion estimation, and The I<sup>2</sup> and Q statistics to assess the extent of heterogeneity. Results: A total of 430 studies were identified, from which 28 were included and analysed. About 5% (95% CI: 3 - 7) of unsafe abortions leads to death. The contribution of unsafe abortions in maternal deaths was 23% (95% CI: 20 - 27). The rate of severe bleeding and/or anemia were 40% (95% CI: 18 - 63) and the rate of infection was 17% (95% CI: 7 - 28), dominated by pelvic infections, pelviperitonitis, severe sepsis, and septic shock. Case reports described uterine perforations, uterine rupture during the following pregnancy. Abortion was performed in the practitioner’s or patient’s home in 41.4% of cases, in a health center in 35.1% of cases, in a private clinic in 21.2% of cases, drugs selling places and in traditional healer clinics. The restriction of abortion laws, the stigma surrounding abortion and its consequences at any level of the society, lead to the underreporting of unsafe abortions and a deep reluctance to advocate for safe abortion services. Conclusion: The strengthening of awareness campaigns for provider behavior change communication, family planning, the de-stigmatization of abortions, the training of health personnel in post-abortion care, a multidisciplinary and multicentric action would contribute to the reduction in morbidity and mortality due to abortions. 展开更多
关键词 Morbi-Mortality Unsafe DIFFICULTIES Access SAFE ABORTION Cameroon
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Observation on the Curative Effect of"Hand and Foot 12 Needle Acupuncture"on Stroke in Convalescent Period of Phlegm-Dampness Constitution
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作者 王磊 肖丁 徐寅平 《World Journal of Integrated Traditional and Western Medicine》 2022年第6期11-18,共8页
Objective:To observe the clinical effects of"hand and foot 12 needle acupuncture"on stroke in convalescent period of phlegm-dampness constitution.Methods:The 90 patients were divided into the treatment group... Objective:To observe the clinical effects of"hand and foot 12 needle acupuncture"on stroke in convalescent period of phlegm-dampness constitution.Methods:The 90 patients were divided into the treatment group(n=45)and the control group(n=45)according to the random number table method.The control group received basic Western medicine treatment+rehabilitation treatment of Western medicine,and the treatment group was additively treated with"hand and foot 12 needle acupuncture"on the basis of the control group.NIHSS score,MRS score and Barthel index(BI)before and after treatment were observed in the two groups,and the clinical efficacy of the two groups was compared.Results:The clinical efficacy of stroke patients in the convalescent period of phlegm-dampness constitution after treatment:the total effective rate of the treatment group was 93.33%,and the total effective rate of the control group was 66.67%.After statistical processing,the clinical efficacy of the treatment group was significantly better than the control group;NIHSS score,MRS score and Barthel index(BI)were better than the control group,and the differences were statistically significant(P<0.05).Conclusion:"Hand and foot 12 needle acupuncture"treatment of phlegm-dampness constitution convalescent stroke clinical effect is remarkable. 展开更多
关键词 Acupuncture treatment Filiform needle Hand and foot 12 needle acupuncture phlegm-dampness constitution Convalescent stroke Treatment effect
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Glucose-6-Phosphate Dehydrogenase Deficiency: Difficulties in Diagnosis at the Souro Sanou University Hospital, Burkina Faso
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作者 Salifo Sawadogo Koumpingnin Nébié +4 位作者 Jerôme Kouldiati Catherine Traoré Salam Sawadogo Aimée S. Kissou Eléonore Kafando 《Open Journal of Blood Diseases》 CAS 2023年第1期24-32,共9页
Glucose-6-phosphate dehydrogenase deficiency is the most common enzymopathy worldwide. The precise prevalence of G6PD is unknown in Burkina Faso. The objective of the study was to describe the difficulties to diagnose... Glucose-6-phosphate dehydrogenase deficiency is the most common enzymopathy worldwide. The precise prevalence of G6PD is unknown in Burkina Faso. The objective of the study was to describe the difficulties to diagnose this disease at the Souro Sanou University hospital (CHUSS) in Bobo-Dioulasso. It involved five patients comprising one child with homozygous SS sickle cell disease, one adolescent screened following a family investigation, and three adults including a man and two women. Blood smear stained with May Grunwald Giemsa was performed to look for specific signs of G6PD-deficient red blood cell and brilliant cresyl Blue for Heinz Bodies. A microscope Olympus BX53 equipped with a Camera (XC10) and connected to a computer was used to read blood smears and capture images. Genes sequencing by Sanger method were performed in a specialized laboratory in molecular genetics. For each analysis, the protocol and instructions of the equipment and reagent manufacturer were applied. Of the five patients, three had anemia and only one had hyperreticulocytosis. Two patients had biological signs of hemolysis and one patient had an elevated CRP. Blood smear stained with MGG and cresyl blue showed specific signs of G6PD-deficient red blood cells and Heinz bodies in all patients. Biochemical analysis and molecular typing confirmed G6PD deficiency. The presence of G6PD-deficient red blood cells in the blood smear guides the diagnosis of G6PD deficiency. The diagnosis is biochemical and is based on the combined measurement of G6PD plus pyruvate kinase and/or hexokinase. 展开更多
关键词 G6PD Deficiency G6PD-Deficient Red Cell Diagnosis Difficulties Burkina Faso
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Transfer learning-based super-resolution in panoramic models for predicting mandibular third molar extraction difficulty: a multi-center study
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作者 Wen Li Yang Li +4 位作者 Xiao-Ling Liu Xiang-Long Zheng Shi-Yu Gao Hui-Min Huangfu Li-Song Lin 《Medical Data Mining》 2023年第4期1-7,共7页
Background:This study aims to predict the extraction difficulty of mandibular third molars based on panoramic images using transfer learning while employing super-resolution(SR)technology to enhance the feasibility an... Background:This study aims to predict the extraction difficulty of mandibular third molars based on panoramic images using transfer learning while employing super-resolution(SR)technology to enhance the feasibility and validity of the prediction.Methods:We reviewed a total of 608 preoperative mandibular third molar panoramic radiographs from two medical facilities:the First Affiliated Hospital of Zhengzhou University(n=509;456 in the training set and 53 in the test set)and the Henan Provincial Dental Hospital(n=99 in the validation set).We conducted a deep-transfer learning network on high-resolution(HR)panoramic radiographs to improve the longitudinal resolution of the images and obtained the SR images.Subsequently,we constructed models named Model-HR and Model-SR using high-dimensional quantitative features extracted through the Least Absolute Shrinkage and Selection Operator method.The models’performances were evaluated using the receiver operating characteristic curve(ROC).To assess the reliability of the model,we compared the results from the test set with those of three dentists.Results:Model-SR outperformed Model-HR(area under the curve(AUC):0.779,sensitivity:85.5%,specificity:60.9%,and accuracy:79.8%vs.AUC:0.753,sensitivity:73.7%,specificity:73.9%,and accuracy:73.7%)in predicting the difficulty of extracting mandibular third molars.Both Model-HR(AUC=0.821,95%CI 0.687–0.956)and Model-SR(AUC=0.963,95%CI 0.921–0.999)demonstrated superior performance compared to expert dentists(highest AUC=0.799,95%CI 0.671–0.927).Conclusions:Model-SR yielded superior predictive performance in determining the difficulty of extracting mandibular third molars when compared with Model-HR and expert dentists’visual assessments. 展开更多
关键词 SUPER-RESOLUTION transfer-learning mandibular third molar extraction difficulty panoramic radiographs
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视频喉镜结合综合困难气道训练考核系统在急诊规范化培训住院医师气管插管培训中的应用研究 被引量:1
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作者 李文 王长远 +2 位作者 翟文亮 贺明轶 韩英娜 《中国医学教育技术》 2024年第1期102-106,共5页
目的探讨视频喉镜结合综合困难气道训练考核系统在急诊规范化培训住院医师气管插管培训中的应用效果。方法选择2022年1月—2023年6月在首都医科大学宣武医院急诊科轮转的住院医师58人,随机分为对照组(n=28)和试验组(n=30)。对照组应用... 目的探讨视频喉镜结合综合困难气道训练考核系统在急诊规范化培训住院医师气管插管培训中的应用效果。方法选择2022年1月—2023年6月在首都医科大学宣武医院急诊科轮转的住院医师58人,随机分为对照组(n=28)和试验组(n=30)。对照组应用直接喉镜结合综合困难气道训练考核系统进行气管插管技能培训,试验组应用视频喉镜结合综合困难气道训练考核系统进行气管插管技能培训。培训结束后对两组住院医师进行气管插管技能考核,内容包括正常气道和困难气道的气管插管,分别比较两组住院医师气管插管时间、一次性插管成功率、喉镜对门齿的压力、气管插管位置正确率的区别。另外,分别对两组住院医师进行教学满意度问卷调查。结果普通气道气管插管中,试验组与对照组喉镜对门齿的压力和气管插管位置正确率的差异无统计学意义(P>0.05);一次性插管成功率试验组大于对照组,气管插管时间试验组小于对照组(均P<0.05)。在困难气道气管插管中,试验组的一次性插管成功率和气管插管位置正确率大于对照组(P<0.05),插管时间和喉镜对门齿的压力明显小于对照组(P<0.05)。调查问卷自评显示,试验组对气管插管自信心和学习兴趣大于对照组(P<0.05),满意度和技能评分两组差异无统计学意义(P>0.05)。结论应用视频喉镜结合综合困难气道训练考核系统对急诊规范化培训住院医师进行气管插管培训可以提高气管插管成功率,减少对门齿的损伤,提高住院医师的学习兴趣。 展开更多
关键词 可视喉镜 综合困难气道训练考核系统 气管插管 急诊住院医师
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归脾汤加减治疗儿童学习困难型多动症的临床研究
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作者 曲振廷 叶关毅 +2 位作者 李环 徐小磊 李素芬 《吉林医药学院学报》 2024年第3期200-203,共4页
目的观察归脾汤加减治疗儿童学习困难型多动症的临床疗效。方法91名符合DSM-Ⅳ儿童多动症标准的学习困难儿童,按照治疗方法分为两组,研究组45人,对照组46人。对照组进行心理行为矫正治疗,研究组在心理行为矫正治疗基础上口服加减归脾汤... 目的观察归脾汤加减治疗儿童学习困难型多动症的临床疗效。方法91名符合DSM-Ⅳ儿童多动症标准的学习困难儿童,按照治疗方法分为两组,研究组45人,对照组46人。对照组进行心理行为矫正治疗,研究组在心理行为矫正治疗基础上口服加减归脾汤治疗。治疗2个月后,对两组疗效进行观察,采用Conners儿童行为问卷和Weiss功能性缺陷量表对治疗结果进行分析。结果Conners评分结果发现,研究组总有效率(88.89%)明显高于对照组(65.22%)(P<0.01);与对照组比较,治疗前研究组Conners评分无明显差异(P>0.05),治疗2个月后,研究组Conners评分明显降低(P<0.01);治疗后研究组各项多动症问题得分明显降低,多动症儿童学习困难情况有明显改善(P<0.01)。Weiss评分结果发现,治疗后,研究组的Weiss功能性缺陷量表各项指标评分均低于对照组,差异有统计学意义(P<0.05)。结论归脾汤加减治疗儿童学习困难型多动症有显著疗效,值得进一步推广应用。 展开更多
关键词 归脾汤 多动症 学习困难
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困难静脉评估量表在不同年龄血管通路管理中的应用进展
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作者 丁乾容 张晓卓 +3 位作者 赵利灿 刘欢 刘逸文 田永明 《现代临床护理》 2024年第2期77-81,共5页
困难静脉通路(difficult intravenous access,DIVA)是指因为多种因素,如患者肢体肥胖、肢体局部肿胀、血管反复穿刺、静脉使用高渗液、刺激性药物等,使患者的血管无法直视或触摸不到充盈的静脉,而造成临床护士在建立静脉通路时出现穿刺... 困难静脉通路(difficult intravenous access,DIVA)是指因为多种因素,如患者肢体肥胖、肢体局部肿胀、血管反复穿刺、静脉使用高渗液、刺激性药物等,使患者的血管无法直视或触摸不到充盈的静脉,而造成临床护士在建立静脉通路时出现穿刺困难的状态[1-2],且穿刺失败次数≥3次的情况[1,3-4]。2008年YEN等[5]研究发现,DIVA发生率为32.8%。DIVA带来的反复静脉穿刺会增加血管药物外渗、静脉炎、感染等并发症的风险,并增加患者痛苦及护士工作量,打击护士工作信心[6]。研究显示[7],12%的患者需要2次尝试才能成功建立静脉通路,而4%和3%的患者分别需要3次和4次及以上的穿刺来建立静脉通路。穿刺前有效识别DIVA对于降低反复静脉穿刺,提高穿刺成功率有重要意义。困难静脉量表是识别DIVA、降低反复穿刺率的有效工具[5],可协助临床护理人员对困难静脉进行评估和判断,并根据DIVA评分等级选择超声等可视化辅助工具,提高第一次穿刺成功率[4]。 展开更多
关键词 困难静脉通路 困难静脉评估量表 综述
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按病种分类的疾病诊疗难度测度及应用研究
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作者 段磊 张翔 张研 《中国卫生政策研究》 CSCD 北大核心 2024年第2期17-22,共6页
本研究首次界定了按病种分类的疾病诊疗难度的内涵,运用按病种的疾病发生概率、平均总费用与治愈好转率对病种诊疗难度系数进行测算。采用七县(市)区2017年新农合医保报销数据计算住院病种诊疗难度系数,并绘制“病例数—诊疗难度系数”... 本研究首次界定了按病种分类的疾病诊疗难度的内涵,运用按病种的疾病发生概率、平均总费用与治愈好转率对病种诊疗难度系数进行测算。采用七县(市)区2017年新农合医保报销数据计算住院病种诊疗难度系数,并绘制“病例数—诊疗难度系数”分布图与拟合曲线,结果符合病种发生的实际状况。对其中两个样本县分别计算相同病种的诊疗难度系数,并进行配对资料秩和检验,计算结果不存在显著差异(P=0.73),提示该算法结果稳健,能够较好地描绘病种的发生与分布规律。测度结果能够用于明确医疗机构病种诊疗范围,刻画医疗服务供给与需求行为,但也存在较为依赖样本量、权重确定较为主观等问题。 展开更多
关键词 病种 诊疗难度 测算模型 效用评价
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教育治理现代化视域下高校“双肩挑”制度的设置依据、运行困境与优化策略
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作者 董泽芳 袁秋菊 《现代教育管理》 北大核心 2024年第4期1-11,共11页
在高校人力资源优化配置中,“双肩挑”制度设置具有一定的理论与现实依据,其有利于优化人才选拔与队伍结构、降低管理与用人成本、提升教学与管理质量、克服行政意识和官僚作风、促进不同类型人员职业发展,但同时也面临着角色定位、时... 在高校人力资源优化配置中,“双肩挑”制度设置具有一定的理论与现实依据,其有利于优化人才选拔与队伍结构、降低管理与用人成本、提升教学与管理质量、克服行政意识和官僚作风、促进不同类型人员职业发展,但同时也面临着角色定位、时间冲突、岗位设置、资源配置、激励不足等现实困境。“双肩挑”制度的优化首先需要合理设置高校“双肩挑”岗位、科学制定“双肩挑”岗位目标以及有效匹配“双肩挑”岗位教师,同时在制度运行中重视对“双肩挑”干部的选拔和培育、建立合理的“双肩挑”干部考评机制、完善“双肩挑”干部的任期与转换制度和健全对“双肩挑”干部的激励机制。 展开更多
关键词 高校 双肩挑 岗位设置 运行困境 优化策略
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他诊与自诊维度下的高校辅导员队伍建设状况调研
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作者 胡丽伟 《药学教育》 2024年第2期69-74,共6页
加强辅导员队伍建设是高校思想政治教育的重要课题。新时代高校辅导员队伍建设得到了更高程度的重视,也取得了显著的成效,但依然存在一系列问题。加强辅导员队伍建设始终关系着高校立德树人根本任务的落实效果,文章从学工部门管理干部... 加强辅导员队伍建设是高校思想政治教育的重要课题。新时代高校辅导员队伍建设得到了更高程度的重视,也取得了显著的成效,但依然存在一系列问题。加强辅导员队伍建设始终关系着高校立德树人根本任务的落实效果,文章从学工部门管理干部、辅导员队伍自身两个视角开展调研,分析辅导员队伍建设的现状、困境及解决的路径,为进一步完善辅导员队伍建设提供一定的参考。 展开更多
关键词 视角 辅导员 困境 路径
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人与机器,谁的建议更容易被采纳?不同决策情境下建议者类型对建议采纳的影响研究
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作者 惠青山 赵俊峰 +3 位作者 姜红梅 苟思颖 易文璋 张慧君 《管理工程学报》 CSCD 北大核心 2024年第1期74-87,共14页
在数字经济时代,人类会更加面临“有限处理能力”和“无限增长信息”的矛盾,而利用机器帮助提高决策者决策质量是解决或缓解这一矛盾的途径之一。本研究从接纳建议的角度研究人们对于人机工作的态度,通过引入“机器”作为建议者,比较人... 在数字经济时代,人类会更加面临“有限处理能力”和“无限增长信息”的矛盾,而利用机器帮助提高决策者决策质量是解决或缓解这一矛盾的途径之一。本研究从接纳建议的角度研究人们对于人机工作的态度,通过引入“机器”作为建议者,比较人们在接纳机器和人提出建议上的差别以及重要的认知条件。研究的主要发现包括:(1)决策者在主观决策情境中会倾向于人的建议,而在客观决策情境中则倾向于机器的建议;(2)在客观决策情境中,高认知闭合需要的个体对人和机器建议的采纳无显著差异,而低认知闭合需要的个体会更倾向于采纳机器的建议;(3)在客观预测情境中,决策者在困难任务时更倾向于采纳机器的建议,而在简单任务时,对人和机器建议的采纳无显著差异;(4)在主观决策情境中,对人的建议的采纳不受建议框架的影响,但对于机器提出的建议在负性建议框架描述更容易采纳。研究的理论贡献在于:丰富和完善了不同决策情境下建议者类型(人/机器)对建议采纳的影响的理论体系;研究的实践意义是:帮助决策者更充分地利用机器来辅助决策,更全面地了解机器建议过程中的作用机制与路径,提高了决策质量。 展开更多
关键词 建议采纳 建议者类型 认知闭合需要 任务难度 建议框架
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高职高专院校高质量试点职教本科人才培养研究
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作者 林夕宝 余景波 朱少慧 《职教发展研究》 2024年第1期91-99,共9页
职教本科是职业教育改革发展的必然结果,是经济社会高质量发展的应然需求,也是满足人们追求高层次职业教育的有效路径。高职高专院校试点职教本科人才培养,是服务国家发展战略、增强职业教育社会影响力和探索新型高职人才培养模式的客... 职教本科是职业教育改革发展的必然结果,是经济社会高质量发展的应然需求,也是满足人们追求高层次职业教育的有效路径。高职高专院校试点职教本科人才培养,是服务国家发展战略、增强职业教育社会影响力和探索新型高职人才培养模式的客观需要。但是,由于受到政府、社会和学校等因素的影响制约,高职高专院校高质量试点职教本科教育面临着不少宏观层面和微观层面的现实性困境。对此,要完善政策体系建设,增强政策资源供给的有效性;引导社会树立正确职教观念,提升高职学生社会地位;深化产教协同育人,构建校企育人命运共同体;明确质量目标,强化专业特色发展;科学规划内部顶层设计,高效率使用育人资源;确立师资选拔培训机制,全面提升整体科研能力。 展开更多
关键词 职教本科 高职高专院校 困境 策略 人才培养
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民间武术生存困境的历史归因与应对策略研究
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作者 彭雪燕 崔怀猛 《武术研究》 2024年第6期33-36,共4页
文章主要运用文献资料法、逻辑推理法与背景分析法等研究方法,对导致困境的历史因素做详细探讨。结果表明:民间武术一直没有摆脱生存危机的困扰,但从未出现过类似于古希腊奥林匹克那种断代传承的现象。
关键词 民间武术 困境 策略 艺术暴力 尚武精神
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