Stem cell transplantation in cerebrovascular accidents:A global bibliometric analysis(2000-2023)

BACKGROUND Cerebrovascular accident(CVA)is a major global contributor to death and disability.As part of its medical management,researchers have recognized the importance of promising neuroprotective strategies,where stem cell transplantation(SCT)is thought to confer advantages via trophic and neuroprotective effects.AIM To evaluate the current state of research on SCT in patients with CVA,assess key trends and highlight literature gaps.METHODS PubMed was screened for SCT in CVA-related articles in October 2023,for each country during the period between 2000 and 2023.Using the World Bank data,total population and gross domestic product were collected for comparison.VOSviewer_1.6.19 was used to create the VOS figure using the results of the same query.Graphs and tables were obtained using Microsoft Office Excel.RESULTS A total of 6923 studies were identified on SCT in CVA,making 0.03%of all published studies worldwide.Approximately,68%were conducted in high-income countries,with a significant focus on mesenchymal stem cells.The journal“Stroke”featured the largest share of these articles,with mesenchymal SCT having the highest rate of inclusion,followed by hematopoietic SCT.Over time,there has been a noticeable shift from in vitro studies,which assess stem cell proliferation and neurogenesis,to in vivo studies aimed at evaluating efficacy and safety.Additionally,the number of reviews increased along this approach.CONCLUSION This bibliometric analysis provides a comprehensive guide for physicians and researchers in the field through an objective overview of research activity,and highlights both current trends and gaps.Having a potential therapeutic role in CVA,more research is needed in the future to focus on different aspects of SCT,aiming to reach a better treatment strategy and improve life quality in patients.

Acupuncture combined with Buyang Huanwu decoction in the treatment of sequelae of cerebrovascular accident:a systematic review and meta-analysis

Background:Cerebrovascular accident has high morbidity,high disability,and high mortality,possibly causing several serious sequelae and bringing a heavy burden to the patient,the family,and the society.Buyang Huanwu decoction,a classic ancient prescription of traditional Chinese medicine,and acupuncture are often used in combination to treat the sequelae of cerebrovascular accident.In the present study,we systematically evaluated the clinical efficacy and safety of acupuncture combined with Buyang Huanwu decoction in treating the sequelae of cerebrovascular accident.Methods:Relevant randomized controlled trials of acupuncture combined with Buyang Huanwu decoction in treating the sequelae of cerebrovascular accident were comprehensively retrieved from electronic databases from inception to May 8,2020,including PubMed,Embase,The Cochrane Library,China National Knowledge Infrastructure,WanFang Data,and China Science and Technology Journal Database.The main outcomes of clinical efficacy,degree of nerve function impairment,daily self-care capacity,Fugl-Meyer locomotor function score,life quality score,and occurrence of adverse reactions were subjected to meta-analysis.Results:The 28 randomized controlled trials included 2,341 patients with the sequelae of cerebrovascular accident.Systematic review and meta-analysis indicated that compared with acupuncture alone,its combined treatment with Buyang Huanwu decoction significantly increased clinical efficacy(RR=1.19,95%CI(1.14,1.23),P<0.001),improved nerve function impairment(WMD=−4.89,95%CI(−8.25,−1.53),P=0.004),promoted daily self-care capacity(WMD=15.87,95%CI(11.22,20.51),P<0.001),strengthened Fugl-Meyer locomotor function(WMD=20.89,95%CI(13.79,27.98),P<0.001),enhanced physical functioning(WMD=16.99,95%CI(6.01,27.96),P<0.001)and mental health(WMD=16.91,95%CI(9.14,24.69),P<0.001)in terms of life quality score(SF-36 scale)of patients with sequelae of cerebrovascular accident,with few adverse reactions.Conclusion:Compared with acupuncture alone,its combination with Buyang Huanwu decoction had better comprehensive effects on sequelae of cerebrovascular accident without obvious adverse reactions.

Stroke (Cerebrovascular Accident): Epidemiological, Clinical and Evolving Aspects in the Internal Medicine Department of the Public Health Establishment 1 (EPS1) of Tivaouane

Introduction: The frequency, severity, cost of treatment, morbidity and mortality of stroke make it a real public health problem. In industrialized countries, strokes are the leading cause of physical disability in adults, the second leading cause of dementia (after Alzheimer’s disease), and the third leading cause of death (after cancer and cardiovascular disease). It’s also a major cause of depression. The objective of our study was to describe the epidemiological, clinical and evolutionary aspects of stroke in the internal medicine department of Tivaouane Hospital. Material and Method: This is a retrospective study carried out from January 1, 2015 to December 31, 2018 on the files of patients hospitalized for stroke in the medical department of the EPS1 in Tivaouane. We took into account all the patients who had a brain CT (computed tomography) scan. We collected data related to socio-demographic characteristics, history, risk factors, reasons for admission, clinical signs, paraclinical examinations, as well as evolution. Results: Out of 1999 patients, 206 files of patients with stroke were collected, i.e. a proportion of 10.3%. Our study population had a mean age of 65.53 years [16 - 97 years]. We noted a clear predominance of women (50.5%). The majority of the population came from the outskirts of Tivaouane (56.7%). Risk factors for stroke were dominated by hypertension (90.3%), dyslipidemia (19.4%), previous stroke (18.9%), and diabetes (16%). The clinical signs were dominated by a motor deficit (94.1%), speech disorders (67.4%) and consciousness disorders (47%). Ischemic strokes were predominant (65%) over hemorrhagic strokes (34.5%). The outcome was generally unfavorable with 14.6% total recovery, 58.7% recovery with sequelae and a case fatality of 26.7%. Conclusion: It emerges from this study that strokes still remain a real public health problem. Knowledge of populations of risk factors as well as their proper management is fundamental in primary prevention strategies, the only guarantee for a reduction in the still very high morbidity and mortality of this disease.

Medical Direct Cost of Hospital Admission for Cerebrovascular Accident on Medical Recovery at the Sylvanus Olympio Teaching Hospital of Lomé

Objectives: Appreciate the Medical direct cost for cerebrovascular accident on medical recovery at the Sylvanus Olympio Teaching Hospital of Lomé. Patients and method: This was a prospective and cross study that took place from 01st October 2015 to 31st July 2016 in the medical recovery Unit of Sylvanus Olympio Teaching Hospital of Lomé. Results: Of the 91 stroke patients surveyed, the average age was 55.1 years;the sex-ratio (Men/women) was 1.3 and only 8.8% of patients had benefited from INAM (National Institute of Health Insurance) granting of benefits. The proportion of ICVA was 73.6% compared to 26.4% for the MCVA. The average overall cost of granting benefits of a CVA patient was 312,245 FCFA for an average stay of 18.6 days. This cost was 399.115 FCFA in MCVA for an average stay of 19.0 days against 281.130 FCFA in ICVA for an average stay of 16.1 days. Conclusion: CVAs on the one hand inflict losses of national productivity by its handicap, and a heavy economic burden for both patients and their families on the other hand, by its high cost of granting of benefits;Hence there is the need for assistance of all kinds by national and international health actors.

RESEARCH ON SEQUELAE OF CEREBROVASCULAR ACCIDENT TREATED BY THREE DIFFERENT NEEDLING TECHNIQUES

One hundred and sixty cases of sequelae of cerebrovascular accident (CVA) wererandomly divided into three groups: The temporal point group (TG), 58 cases; the scalp acupuncturegroup(SG), 52 cases; the body acupuncture group(BG), 50 cases. It was shown that after 30 treat-ments the curative effects were significantly different (P【0. 01) among the three groups. The effectin TG was better than those in SG and BG. There was no difference in curative effects between SGand BG. It is indicated that all the three needling techniques can improve encephalic blood flow in pa-tients. It seems that the effects of the three needling techniques are as follows: TG】SG】BG.

Predictors of a Cerebrovascular Accident in a Population of Systemic Sclerosis Patients Followed at a Large Academic Center with a Dedicated Scleroderma Center

Aim: The aim of this study is to describe the clinical characteristics of patients with a diagnosis of systemic sclerosis who later suffer a stroke and to identify associations for this relationship. Background: Prior studies have showed an increased risk of cardiovascular disease among patients with chronic inflammatory disorders, with chronic inflammation leading to atherosclerosis believed to be the culprit. Systemic sclerosis (SSc) is a chronic inflammatory disease characterized by diffuse fibrosis of the skin and internal organs. Previous studies have suggested a possible link between systemic sclerosis and macrovascular complications such as stroke. Methods: This is a retrospective chart review of patients treated within the University of Pennsylvania Health System from October 2015 to April 2019 with a diagnosis of SSc. Using ICD10 codes, we identified a cohort of SSc patients who suffered a stroke. Information regarding demographics and stroke risk factors were gathered from the charts of patients with a diagnosis of both SSc plus stroke and compared to a control group of randomly selected patients with SSc who never suffered a stroke. Continuous variables were conveyed using a mean plus a standard deviation. A two-sample t-test was used to compare the two groups of patients. Qualitative variables were compared using a two-tailed Fisher’s exact test. Results: Based on a large cohort of SSc patients (n = 2080) followed between October 2015 and April 2019, we identified 36 SSc patients who developed a subsequent stroke (1.7% of cohort). When looking at risk factors for stroke in SSc patients, we identified hypertension and atrial fibrillation to be associated with the diagnosis of stroke in such patients. Specifically, 28 of the 36 patients with both SSc and stroke also had a diagnosis of hypertension while in the control group, only 17 of 36 patients had hypertension. Atrial fibrillation was seen in 9 of 36 patients with both SSc and CVA while it was seen in only 2 of 36 patients in the control group. Conclusions: This case control study demonstrated that the presence of hypertension and atrial fibrillation had a statistically significant association with the diagnosis of CVA in patients with SSc.

Characteristics and risk factors of cerebrovascular accidents after percutaneous coronary interventions in patients with history of stroke

Background Percutaneous coronary intervention （PCI） is a well-established method for managing coronary diseases. However, the increasing use of PCI has led to an increased incidence of acute cerebrovascular accidents （CVA） related to PCI. In this study, we investigated the characteristics and risk factors of CVA after PCI in patients with known stroke history. Methods Between January 1, 2005 and March 1, 2009, 621 patients with a history of stroke underwent a total of 665 PCI procedures and were included in this retrospective study. Demographic and clinical characteristics, previous medications, procedures, neurologic deficits, location of lesion and in-hospital clinical outcomes of patients who developed a CVA after the cardiac catheterization laboratory visit and before discharge were reviewed. Results Acute CVA was diagnosed in 53 （8.5%） patients during the operation or the perioperative period. Seventeen patients suffered from transient ischemic attack, thirty-four patients suffered from cerebral infarction and two patients suffered from cerebral hemorrhage. The risk factors for CVA after PCI in stroke patients were： admission with an acute coronary syndrome, use of an intra-aortic balloon pump, urgent or emergency procedures, diabetes mellitus, and poor left ventricular systolic function, arterial fibrillation, previous myocardial infarction, dyslipidemia, tobacco use, and no/irregular use of anti-platelet medications. Conclusions The incidence of CVA during and after PCI in patients with history of stroke is much higher than that in patients without history of stroke. Patients with atrial fibrillation, previous myocardial infarction, diabetes mellitus, dyslipidemia, tobacco use, and no or irregular use of anti-platelet medications were at higher risk for recurrent stroke. This study showed a strong association between acute coronary svndromes and in-hospital stroke after PCI.

Traumatic Brain Injury and Cerebral Vascular Accident: Application of Rasch Analysis to Examine Differences in Disability and Outcome in Post-Hospital Rehabilitation

The purpose of this study was to demonstrate an application of Rasch analysis to identify differences in disability profiles resulting from traumatic brain injury (TBI) and cerebral vascular accident (CVA) and to examine outcome differences between the two groups following post-hospital residential rehabilitation. Participant data were collected from 32 facilities in 16 states. From 2990 neurologically impaired individuals with consecutive admissions from 2011 through 2017, 874 met inclusion criteria: TBI (n = 687) or CVA (n = 187), 18 years or older, minimum length of stay of one month, and maximum chronicity of 1 year. Participants were evaluated at admission and discharge on the Mayo Portland Adaptability Inventory-Version 4 (MPAI-4). Rasch analysis was performed to establish item reliability, construct validity and item difficulty. A Repeated Measures Multivariate Analysis of Covariance (RM MANCOVA) determined group differences and improvement from admission and discharge. Rasch Analysis demonstrated satisfactory construct validity and internal consistency (Person reliability > 0.90, Item reliability > 0.98 for admission and discharge MPAI-4s). Both groups showed significant improvement on the MPAI-4 (p 0.0005). The TBI group was more impaired on the adjustment scale at both admission and discharge (p 0.001). Rasch analysis identified two distinct impairment patterns. CVA participants exhibited deficits characteristic of focal impairment while the TBI group presented with deficits reflective of diffuse impairment. Rehabilitation was shown to be beneficial in reducing disability following neurologic injury in both groups. Importantly, Rasch Analysis accurately produced unique disability profiles that differentiated the treatment groups. This unique statistical technique offers a promising prescriptive hierarchical model for guiding neurological rehabilitation treatment.

Information-motivation-behavioral guided nursing for stroke patients with pulmonary dysfunction:A randomized controlled trial

BACKGROUND Patients with stroke frequently experience pulmonary dysfunction.AIM To explore the effects of information-motivation-behavioral(IMB)skills modelbased nursing care on pulmonary function,blood gas indices,complication rates,and quality of life(QoL)in stroke patients with pulmonary dysfunction.METHODS We conducted a controlled study involving 120 stroke patients with pulmonary dysfunction.The control group received routine care,whereas the intervention group received IMB-model-based nursing care.Various parameters including pulmonary function,blood gas indices,complication rates,and QoL were assessed before and after the intervention.RESULTS Baseline data of the control and intervention groups were comparable.Post-intervention,the IMB model-based care group showed significant improvements in pulmonary function indicators,forced expiratory volume in 1 sec,forced vital capacity,and peak expiratory flow compared with the control group.Blood gas indices,such as arterial oxygen pressure and arterial oxygen saturation,increased significantly,and arterial carbon dioxide partial.pressure decreased significantly in the IMB model-based care group compared with the control group.The intervention group also had a lower complication rate(6.67%vs 23.33%)and higher QoL scores across all domains than the control group.CONCLUSION IMB model-based nursing care significantly enhanced pulmonary function,improved blood gas indices,reduced complication rates,and improved the QoL of stroke patients with pulmonary dysfunction.Further research is needed to validate these results and to assess the long-term efficacy and broader applicability of the model.

Acute Colonic Pseudo-Obstruction (ACPO): An Expanding Colon with Unusual Risk Factors

The distention of the colon without mechanical or anatomical obstruction, Acute Colonic Pseudo-obstruction (ACPO), is a common condition occurring in the critically ill. ACPO in the setting of an acute pulmonary embolism and embolic stroke is a rarity. A 76-year-old female with shortness of breath, left hemiparesis and right-sided paresthesias presented with acute pulmonary embolism and acute infarcts of the left caudate nucleus, thalamus and occipital lobe. Her hospitalization was complicated with persistent distention of the large bowel without dilation of the small bowel. Empiric antibiotics were initiated without improvement and laboratory studies including Clostridium difficile were negative. She underwent nasogastric decompression and two decompressive colonoscopies with a resolution of her symptoms. This case illustrates an example of acute abdominal distension, without underlying etiology, in the setting of acute embolism of the pulmonary and cerebral vasculature. Early identification and action with decompressive colonoscopy were key to preventing further bowel damage or rupture.

鼻肠管及鼻胃管的营养干预护理对脑血管意外患者发生吸入性肺炎并发症及睡眠质量的影响

目的:探讨研究脑血管意外患者用鼻肠管营养干预效果。方法:选取2021年4月至2022年4月厦门大学附属第一医院神经内科收治的脑血管意外患者100例作为研究对象,按照随机数字表法分为对照组和观察组,每组50例。2组患者均予以常规护理,对照组给予常规鼻胃管营养干预,观察组给予鼻肠管营养干预。比较2组患者的吸入性肺炎发生率、睡眠质量评分及营养状况。结果:观察组吸入性肺炎发生率低于对照组,差异有统计学意义(P<0.05);观察组入睡潜伏期、PSQI评分低于对照组,实际睡眠时长高于对照组,差异有统计学意义(P<0.05);观察组血红蛋白(Hb)、血清白蛋白(Alb)、血清总蛋白(TP)均高于对照组,差异有统计学意义(P<0.05)。结论:鼻肠管营养干预护理可降低脑血管意外患者吸入性肺炎发生率,改善患者睡眠质量及营养状况,值得临床推广应用。

循证急诊护理联合预警分级对急性脑卒中患者抢救效果及神经功能的影响

目的探析急性脑卒中(CA)患者接受循证急诊护理+预警分级的抢救效果以及对神经功能影响。方法选取2020年12月—2023年1月本院收治的80例急性CA患者为研究对象,并按照抽签法分为对照组和观察组,每组40例。其中,对照组实行常规护理,观察组实行循证急诊护理+预警分级。对比两组神经功能、救治指标、精神状态。结果相较对照组,观察组神经功能、救治指标水平均更低(P<0.05);精神状态评分更高(P<0.05)。结论实施循证急诊护理与预警分级干预措施于CA患者,能够提升抢救成功率,促进神经功能恢复,并加速康复进程,因此值得广泛应用。

脑卒中患病影响因素的研究现状

随着脑卒中的发病率逐年升高,给社会、家庭和患者带来了巨大的痛苦、经济压力和社会负担,因而加强其疾病因素的分类、研究和预警,对降低发病率和死亡率具有重要意义。因此,本文从不可控因素(年龄、性别、遗传、环境等)、疾病因素(高血压、糖尿病、高血脂、冠心病、偏头痛等)、个人因素(生活习惯、心理因素、睡眠因素等)、其他因素等方面对脑卒中发病的影响因素进行综述,以期为脑卒中的预防、治疗和护理提供依据。

考虑因素异质影响的直升机事故严重性分析

提取美国国家运输安全委员会(National Transportation Safety Board, NTSB)数据库1241起直升机事故记录的关键信息,分析通用航空直升机事故后果严重性的影响因素及其影响异质性问题。首先,将事故记录中各项信息梳理为时间、飞行过程、飞行员、直升机和气象条件类因素,同时,采用卡方检验分析各因素在无伤事故、轻伤事故和重伤死亡事故分类下的分布差异;而后,基于不同先验概率分布的随机系数构建若干混合Logit模型,拟合事故严重性;最后,通过对比不同模型的拟合效果,根据最优模型的参数估计,分析不同事故严重性对应因素的影响机理和影响的异质性问题。结果表明:直升机事故严重性的统计建模存在明显的因素影响异质性问题;基于独立正态和多元正态分布的相关随机系数混合Logit模型拟合效果优于其他模型;影响因素中,出现仪表气象条件、空中失去控制、燃油问题、低空运行及挂载(含撞线/树)、运动及作业、进近、老年驾驶员、飞行员具有直升机仪表能力以及直升机起火爆炸等因素时,将显著增加重伤死亡事故的概率;异质性分析中,周末、老年飞行员和三点式座椅安全带等因素存在显著的影响异质性。

区域海事事故治理效果动态综合评价

为准确评价区域海事事故治理效果,通过构建动态综合评价模型,为水上交通安全规划提供决策依据。首先,从事故的绝对指标与相对指标角度出发,建立包含8个指标的区域海事事故治理效果评价指标体系。其次,使用博弈赋权法对熵权法所得权重和指标相关性权重确定法(Criteria Importance Through Intercriteria Correlation, CRITIC)所得权重进行组合,以确定各时段评价指标组合权重,并采用逼近理想解排序法(Technique for Order Preference by Similarity to Ideal Solution, TOPSIS)对各地区海事事故治理效果进行各时段静态综合评价。再次,通过混合时序算子集结各时段静态综合评价值,求得各地区海事事故治理效果的动态综合评价值,进而判断各地区海事事故的治理效果。最后,运用所建评价模型对2017—2021年上海、浙江、广东和山东4个地区海事事故治理效果进行动态综合评价。研究结果显示:与单一赋权TOPSIS法相比,博弈赋权-TOPSIS法所得静态综合评价结果更为合理可靠;与单一时序算子相比,混合时序算子所得动态综合评价结果更为合理可靠;随着海事事故治理策略和治理强度不同,上海和广东地区海事事故治理效果呈上升趋势,而浙江和山东地区海事事故治理效果呈下降趋势;广东地区海事事故治理效果稳定性最强,而浙江地区海事事故治理效果稳定性最弱;上海地区海事事故治理效果最好,而浙江地区海事事故治理效果最差。

经食管超声心动图建立卵圆孔未闭致病风险因素模型

目的分析致病性卵圆孔未闭(PFO)的危险因素并构建风险评估模型,为制订临床护理方案提供依据。方法回顾性分析2022年7月至2023年7月徐州医科大学附属连云港医院收治的110例PFO患者临床资料,根据是否发生隐匿性脑血管意外(CVA)分为CVA组42例和非CVA组68例。收集患者临床资料及经食管超声心动图评估参数,采用单因素和多因素Logistic回归分析PFO患者发生CVA的危险因素并建立风险预测模型,通过绘制ROC曲线评价模型的预测效能。结果CVA组和非CVA组在高血压病、高脂血症、房间隔膨出瘤、房间隔高移动性发生率以及甘油三酯、半胱氨酸、PFO高度、PFO隧道长度等指标的差异有统计学意义(P<0.05)。以是否发生CVA作为因变量,将单因素分析中有统计学意义的指标作为自变量进行多因素Logistic回归分析,结果显示,高脂血症、PFO高度、房间隔膨出瘤、房间隔高移动性是PFO患者发生CVA的独立危险因素(P<0.05)。根据多因素分析结果,建立CVA风险预测模型为:Logit(P)=-2.613+1.442×高脂血症+2.610×PFO高度+1.194×房间隔膨出瘤+1.309×房间隔高移动性,模型中变量的意义分别为:高脂血症(0=无,1=是),PFO高度为实际测量值,房间隔膨出瘤(0=无,1=是),房间隔高移动性(0=无,1=是)。Hosmer-Lemeshow检验的P>0.05,说明预测模型的预测值与实际值差异无统计学意义,模型拟合优度较好。以CVA预测概率作为检验变量进行ROC分析,结果显示该预测模型的曲线下面积为0.866(95%CI:0.787~0.923,P<0.01),最佳临界值为0.635,特异性为77.9%,敏感性为81.0%,约登指数为0.589。结论基于危险因素建立的风险预测模型能预测PFO发生CVA风险,可成为医护人员评估有PFO致病风险的工具,有利于护理人员制订个体化的护理决策。

综合性康复疗法治疗脑血管意外偏瘫的临床疗效评价

目的分析脑血管意外偏瘫患者使用综合性康复疗法的临床疗效。方法方便选择宁津县人民医院于2021年8月—2023年6月收治的106例脑血管意外偏瘫患者作为研究对象,以随机数表法分为对照组和观察组,每组53例。对照组采用常规康复疗法,观察组采用综合性康复疗法,对比两组临床疗效、肢体运动功能评分、日常生活能力评分、神经功能缺损程度评分。结果治疗后,观察组临床总疗效(94.34%)高于对照组(79.25%),差异有统计学意义(χ^(2)=5.267,P<0.05);观察组肢体运动功能评分、日常生活能力评分、神经功能缺损程度评分均优于对照组,差异有统计学意义(P均<0.05)。结论综合性康复疗法对于提升脑血管意外偏瘫的临床疗效具有重要作用,且可以提升患者肢体运动功能、日常生活能力,改善神经功能缺损问题。

细节干预联合优质护理对脑血管意外后遗症患者生活质量、负面情绪的影响

目的探讨针对脑血管意外后遗症患者,采用细节干预联合优质护理的效果。方法抽取2021年5月—2023年5月江苏省无锡市康复医院收治的80例脑血管意外后遗症患者作为研究对象,依据随机数表法将其分为干预组和对照组,各40例,其中对照组给予常规护理干预措施,干预组给予细节干预+优质护理干预,采用焦虑(SAS)和抑郁(SDS)自评量表评价患者的心理状态,采用SF-36量表评估患者治疗后的生活质量,比较两组患者护理满意度。结果护理前两组患者的SAS、SDS评分比较,差异无统计学意义(P>0.05),护理干预后两组患者的SAS、SDS评分均降低,且干预组的SAS、SDS评分低于对照组,差异有统计学意义(P<0.05);护理前两组患者的生理功能、生理职能、躯体疼痛、活力评分比较,差异无统计学意义(P>0.05),干预后两组患者的生理功能、生理职能、躯体疼痛、活力评分均降低,且干预组的以上维度评分均高于对照组,差异有统计学意义(P<0.05);干预组护理满意度高于对照组,差异有统计学意义(P<0.05)。结论脑血管依赖后遗症,在治疗过程中联合细节干预、优质护理,可显著提高治疗的效果,帮助病人减轻负面情绪,提高生活水平,应用价值显著。

基于智能监测系统的水电厂混流式机组大修安全管理研究

随着我国水电行业的快速发展,作为水电站的核心发电设备,混流式水电机组的运行稳定性和安全性在水电站运营中占据重要地位。如何确保设备在混流式机组大修过程中的安全性与维修效率是关键问题。传统监测方法往往依赖人工巡检,存在实时性差、误判风险高等问题。随着智能监测技术的发展,基于智能监测系统的水电厂安全管理模式逐步成为主流。

中文版Barthel指数对多中心测评缺血性卒中患者预后的研究

目的评价中文版Barthel指数（BI）量表在我国卒中人群中的信度、效度和敏感度。方法将全国22家医疗中心符合纳入标准的537例中、重度缺血性卒中患者随机分为A组（274例）、B组（263例）,分别给予21d的不同治疗;由经过统一培训的研究人员于纳入研究第21、60、90天的3个时间点,采用中文版BI量表对卒中患者的日常生活活动能力进行测评。通过SPSS13.0统计软件包对有效的BI量表进行信度、效度和敏感度的评价,其中信度检验用Cronbach′sα系数、Guttman split-half和Spearson相关系数来评价。采用人为推理判断方法评价内容效度,采用因子分析法考核量表的结构效度;通过相关分析考察量表的效标效度。各领域敏感度通过配对t检验来评估。结果课题完成治疗共537例,在纳入研究第21、60、90天,分别回收的有效的BI量表为529（A组269份,B组260份）、526（A组269份,B组257份）、525（A组269份,B组256份）份。中文版BI量表内容一致信度的Cronbach′sα系数〉0.92,Guttman split-half系数在0.86-0.89之间,各领域的重测信度系数均〉0.82,显示了良好的信度。中文版BI量表与“准金标准”[（NIHSS）及改良Rankin量表（mRS）]呈适度的相关性（r=0.71-0.75,P〈0.001）,中文版BI量表各时间点的累计贡献率范围为75.03%-76.49%,显示了较好的效度。除A组第21与60天“可控制大便”（P=0.347）,B组“可控制大便”（P=0.095）、“可控制小便”（P=0.399）和B组第21与90天“可控制大便”（P=0.209）外,BI各项显示了良好的敏感度（P〈0.05）。结论中文版BI量表在中、重度卒中患者中,具有良好的信度、效度及敏感度,可作为卒中患者预后的评价指标。