It, from the perspective of cohesion, extracts three types of topic-shift markers used in this genre, namely 'change of narrators', 'change of objects being talked about', and 'temporal adverbials&...It, from the perspective of cohesion, extracts three types of topic-shift markers used in this genre, namely 'change of narrators', 'change of objects being talked about', and 'temporal adverbials' to analyze four journalistic reports from the network media and draws the conclusion that cohesion between two topic units is usually weaker than that within a specific topic fragment.展开更多
BACKGROUND Coronary intervention for bifurcation lesions is still challenging for interventional cardiologists.Left main(LM)bifurcation lesions have a higher risk due to the vast blood supply in this area and treatmen...BACKGROUND Coronary intervention for bifurcation lesions is still challenging for interventional cardiologists.Left main(LM)bifurcation lesions have a higher risk due to the vast blood supply in this area and treatment choice is difficult.Ostial compromise of the side branch decreases patient prognosis,and its management is still an issue despite the different strategies and devices available.CASE SUMMARY A 42-year-old male patient was admitted to hospital due to chest pain and syncope.Coronary angiography showed acute LM occlusion.Following thrombus aspiration,a LM bifurcation lesion remained.Coronary angiography was repeated one week later,and at the same time,3D optical coherence tomography(OCT)was carried out to better show the geometry of the bifurcation,which confirmed that the stenosis in the ostial left circumflex artery was caused by a long carina.After assessment of the plaque characteristics and the minimum lumen area,the cross-over strategy,kissing balloon inflation and proximal optimization technique were chosen to treat the bifurcation lesion.A“moving”carina was found twice during the intervention.Good stent apposition and expansion were confirmed by OCT after proximal optimization technique.The three-month follow-up showed good recovery and normal cardiac function.CONCLUSION 3D-OCT can facilitate decision-making for coronary interventions in patients with critical bifurcation lesions.展开更多
Objective: To propose approaches to improve nursing handoffs for surgical patients, including standardization. Background: Handoffs, or the transfer of accountability and patient information, can generate potential ri...Objective: To propose approaches to improve nursing handoffs for surgical patients, including standardization. Background: Handoffs, or the transfer of accountability and patient information, can generate potential risks for patient safety. Standardization has been proposed to help improve handoffs. Methods: After observing 333 nursing handoffs in the surgical wards of our institution, we conducted a thematic content analysis, comparing and contrasting the observations. Results: Handoff processes, including the use of support tools, varied among the observations. Common themes in the handoff content suggested possibilities of standardization. About half of the 51 interruptions occurring during the observed handoffs were by healthcare professionals. Conclusions: Standardization to improve handoffs should address both the content and the process. Interruptions were common and should be avoided whenever possible. Future studies should also consider the use of mobile applications to support handoffs and clinical documentation.展开更多
文摘It, from the perspective of cohesion, extracts three types of topic-shift markers used in this genre, namely 'change of narrators', 'change of objects being talked about', and 'temporal adverbials' to analyze four journalistic reports from the network media and draws the conclusion that cohesion between two topic units is usually weaker than that within a specific topic fragment.
基金Supported by National Natural Science Foundation of China,No.81570360Beijing Lisheng Cardiovascular Grant,No.LHJJ201612425
文摘BACKGROUND Coronary intervention for bifurcation lesions is still challenging for interventional cardiologists.Left main(LM)bifurcation lesions have a higher risk due to the vast blood supply in this area and treatment choice is difficult.Ostial compromise of the side branch decreases patient prognosis,and its management is still an issue despite the different strategies and devices available.CASE SUMMARY A 42-year-old male patient was admitted to hospital due to chest pain and syncope.Coronary angiography showed acute LM occlusion.Following thrombus aspiration,a LM bifurcation lesion remained.Coronary angiography was repeated one week later,and at the same time,3D optical coherence tomography(OCT)was carried out to better show the geometry of the bifurcation,which confirmed that the stenosis in the ostial left circumflex artery was caused by a long carina.After assessment of the plaque characteristics and the minimum lumen area,the cross-over strategy,kissing balloon inflation and proximal optimization technique were chosen to treat the bifurcation lesion.A“moving”carina was found twice during the intervention.Good stent apposition and expansion were confirmed by OCT after proximal optimization technique.The three-month follow-up showed good recovery and normal cardiac function.CONCLUSION 3D-OCT can facilitate decision-making for coronary interventions in patients with critical bifurcation lesions.
文摘Objective: To propose approaches to improve nursing handoffs for surgical patients, including standardization. Background: Handoffs, or the transfer of accountability and patient information, can generate potential risks for patient safety. Standardization has been proposed to help improve handoffs. Methods: After observing 333 nursing handoffs in the surgical wards of our institution, we conducted a thematic content analysis, comparing and contrasting the observations. Results: Handoff processes, including the use of support tools, varied among the observations. Common themes in the handoff content suggested possibilities of standardization. About half of the 51 interruptions occurring during the observed handoffs were by healthcare professionals. Conclusions: Standardization to improve handoffs should address both the content and the process. Interruptions were common and should be avoided whenever possible. Future studies should also consider the use of mobile applications to support handoffs and clinical documentation.
