Objective To evaluate the effect of auto adjusted triggering mechanism on the triggering balance of sensitivity and anti-interference in non invasive ventilator field. Methods Taking the breathing simulator as the experimental platform, for the same ventilator, the experiments of "automatic adjustment mode" and "manual adjustment mode" were carried out in a self-control manner, comparing the sensitivity and anti-interference indexes of the experimental group and the control group in the triggering stage. The results were statistically analyzed. Results In case of large air leakage, for ventilator of "A40", the group of "automatic adjustment mode" presented auto-triggered cycle and the group of "manual adjustment mode" (the inspiratory trigger sensitivity was adjusted to 5 to 9 L/min) could provide breathing assistance ventilation. While for ventilator of "VENT", both the group of "automatic adjustment mode" and the group of "manual adjustment mode" (the inspiratory trigger sensitivity was adjusted to 1 to 8 arbitrary unit) appear auto-triggered cycle. In case of medium air leakage, for ventilator of "A40", the trigger delay time, trigger pressure and trigger work of the "manual adjustment mode" group (the inspiratory trigger sensitivity was adjusted to 3 to 5 L/min) were significantly less than those of the "automatic adjustment mode" group, and the trigger delay time, trigger work of the "manual adjustment mode" group (the inspiratory trigger sensitivity was adjusted to 8 to 9 L/min) were significantly higher than those of the "automatic adjustment mode" group; While for ventilator of "VENT", compared with the inspiratory trigger sensitivity of the "automatic adjustment mode" group and the "manual adjustment mode" group (the inspiratory trigger sensitivity was adjusted to 4 arbitrary unit), the trigger delay time, trigger pressure and trigger work were not statistically significant. In case of small air leakage, for ventilator of "A40", the trigger delay time and trigger work of the "manual adjustment mode" group (the inspiratory trigger sensitivity was adjusted to 2 to 6 L/min) were significantly less than those in the "automatic adjustment mode" group, and the trigger pressure of "manual adjustment mode" group (the inspiratory trigger sensitivity was adjusted to 2 to 5 L/min and 7 L/min) was significantly lower than that of "automatic adjustment mode" group. While for ventilator of "VENT", the trigger delay time, trigger pressure and trigger work of the "manual adjustment" group (the inspiratory trigger sensitivity was adjusted to 1 to 2 arbitrary unit) were less than those of the experimental group, and they were statistically significant. Conclusions In case of large air leakage, ventilator of "VENT" can not provide breathing assistance ventilation no matter which inspiratory trigger mode. While ventilator of "A40" should be used the "manual adjustment mode", and adjust the inspiratory trigger sensitivity to the less sensitive arbitrary unit to increase its performance of anti-interference. In case of medium air leakage, for both ventilator of "A40" and ventilator of "VENT", it is better to use "automatic adjustment" mode for breathing assistance ventilation. In case of small air leakage, for both ventilator of "A40" and ventilator of "VENT", it is better to use "manual adjustment" mode for breathing assistance ventilation and we should adjust the inspiratory trigger sensitivity to the higher sensitive arbitrary without auto-triggered cycle.
Spanning two decades since the 1st generation spinal robotics inception, the robot-assisted spine surgery (RSS) technology has evolved through generations, culminating in the 4th generation characterized by real-time visual navigation and wire-free screw placement. The fundamental principles of RSS technology include surgical planning, tracking, image registration, and robotic arm control technologies. Currently, RSS technology is maturely employed in thoracolumbar procedures and is progressively being applied in cervical surgeries, spinal tumor resections, and percutaneous operations, offering advantages in reducing tissue trauma and exposure to radiation, thereby improving patient outcomes. Emerging research also focuses on the cost-effectiveness of clinical applications and robot-specific complications. With the integration of artificial intelligence into surgical planning, RSS technology is poised to further incorporate emerging technologies and expand its application across a broader clinical spectrum.
Objective To explore the effectiveness and safety of topical phenytoin for wound healing. Methods We searched MEDLINE (1966 to Oct. 2002), EMBASE (1984 to 2002), The Cochrane Library (Issue 4, 2002), Biological Abstracts (1993 to 1996), Cancerlit (1997 to Sept. 2002), Life Science Collection (1982 to Mar. 1995), International Pharmaceutical Abstracts (1970 to 2002), and CBMdisc (1978 to Jan. 2003). Controlled trials on topical phenytoin for wound healing were identified. The methodological quality of included studies was assessed, and a descriptive analysis was performed. Results Nine studies (507 cases) including 1 randomized controlled trials (RCT) and 8 non-randomized controlled trials were included. These studies were of poor methodological quality. Because there were a variety of etiology of ulcers, differnet interventions in control groups, and different outcome measures, for which meta-analysis was difficult to perform, a descriptive analysis of the results was presented. Most studies showed that topical phenytoin had better effects on improving healthy granulation appearance, increasing complete recovery rate, reducing time for complete recovery, and positive cases of bacterial culture than those of control groups. Mild side effects were observed in only one study.Conclusions The reviewers think that the inclusion studies less rigorous than randomized controlled trials could result in misleading findings.Some well designed randomized controlled trials of topical phenytoin for wound healing are warranted.
Attention deficit hyperactivity disorder and dyslexia are common neurodevelopmental disorders in children, with a comorbidity rate reaches as high as 25%-48%. Clinically characterised by inattention, hyperactivity-impulsivity, and impaired reading fluency, accuracy, and spelling, these conditions significantly impact children’s cognitive function, psychological state, and social behavioural development, increasing burdens on families and society. Nevertheless, research into their aetiology and treatment remains exploratory. This paper aims to review potential underlying mechanisms and therapeutic approaches for the co-occurrence of attention deficit hyperactivity disorder and dyslexia, providing guidance for clinical identification, diagnosis, treatment, and prevention of attention deficit hyperactivity disorder with dyslexia.
ObjectiveTo systematically review the efficacy of closed and open tracheal suction system on the prevention of ventilator-associated pneumonia.MethodsThe Cochrane Library, CNKI, WanFang Data, Airiti Library, PubMed, CINAHL and Proquest databases were electronically searched to collect randomized controlled trials (RCTs) on closed and open tracheal suction system on the prevention of ventilator-associated pneumonia. Two reviewers independently screened literature, extracted data, and assessed the risk bias of included studies. Then, meta-analysis was performed by RevMan 5.3 software.ResultsA total of 11 RCTs involving 1 187 patients were included. The results of meta-analysis showed that compared with open tracheal suction system, closed tracheal suction system was associated with a reduced incidence of ventilator-associated pneumonia (RR=0.55, 95%CI 0.44 to 0.67, P<0.000 01), late-onset ventilator-associated pneumonia (RR=0.47, 95%CI 0.28 to 0.80, P=0.005), length of stay in intensive care unit (MD=?0.85, 95%CI ?1.66 to ?0.04, P=0.04) and rate of microbial colonization (RR=0.69, 95%CI 0.56 to 0.86, P=0.000 9). However, there were no significant differences between two groups in time to ventilator-associated pneumonia development (MD=0.96, 95%CI ?0.21 to 2.12, P=0.11), length of mechanical ventilation (MD=?2.24, 95%CI ?4.54 to 0.06, P=0.06), and rate of mortality (RR=0.88, 95%CI 0.73 to 1.05, P=0.15).ConclusionsCurrent evidence shows that compared with open tracheal suction system, closed tracheal suction system can reduce the incidence of ventilator-associated pneumonia and late-onset ventilator-associated pneumonia, shorten the hospital stay in intensive care unit, and reduce rate of microbial colonization. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
阻塞性睡眠呼吸暫停低通氣綜合征( OSAHS) 是心血管疾病的獨立危險因素[1,2 ]。睡眠過程中反復發生氧飽和度降低和頻繁覺醒是心血管損傷的病理生理基礎。OSAHS 血管損害的早期改變可表現為血管僵硬度增加, 對亞臨床血管病變患者開展早期動脈彈性功能檢測及早進行干預, 可有效預防心血管疾病的發生。本文就常用的無創動脈硬化檢測lt;br /gt;技術及其對OSAHS 心血管損傷的評估相關研究進展進行綜述。
Objectives To investigate the employment situation of graduates of West China School of Medicine in Sichuan University. Methods The employment situation of graduates from West China School of Medicine, Sichuan University from 2013 to 2017 were investigated. Student’s information, employment rate, employment satisfaction, self-evaluation of graduates and employment satisfaction were investigated. A descriptive analysis was used. Results A total of 1 789 graduates, including 602 academic degree graduates and 1 187 professional degree graduates, were surveyed. The one-time employment rate of graduates was over 90%, and the employment rate at the end of first year was 100%. The rate of academic degree graduates engaging in medical-related work was on the decline. The top 3 items of graduates' professional competence self-evaluation were professional knowledge and practical skills, teamwork awareness, and pioneering spirit. Graduates' job satisfaction was increased annually. Conclusions The employment satisfaction of graduates of West China School of Medicine, Sichuan University is increasing year by year, while the guidance and service for graduate students should be further strengthened.
目的:組織瓣修復缺損是頭頸部腫瘤切除術中的重要手段和必要環節。本研究總結65例頰癌和口咽癌不同范圍組織缺損用局部帶蒂組織瓣的修復方法。方法: 回顧2001~2009年我科65例口腔頰癌及口咽癌切除術后選擇腭瓣、頦下瓣、面動脈逆行皮瓣、頰脂墊頰肌復合瓣修復頰部及口咽部組織缺損,病變范圍和治療結果。結果: 65例皮瓣中,17例腭瓣全部成活,29例頦下瓣26例全部成活,2例部分壞死,1例表層皮膚壞死, 7例面動脈逆行皮瓣6例全部成活,1例壞死,12例頰脂墊或頰脂墊頰肌復合瓣全部成活11例,1例部分壞死,總成活率96.9％。31例患者術后有不同程度的張口受限,咀嚼和吞咽功能基本正常。結論: 根據頰癌和口咽癌的病變范圍決定采用不同的臨近帶蒂組織瓣修復缺損,修復效果確切,可以明顯減少手術創傷和術后并發癥,尤其適用于年老及較多基礎疾病患者,仍應作為頭頸部腫瘤術后缺損修復的重要方法。
The 2020 ACC/AHA Guideline for the Management of Patients with Valvular Heart Disease not only updates aortic valve stenosis, mitral regurgitation, prosthetic valves, infective endocarditis and antithrombotic treatment on the basis of the 2017 guidelines update for valvular heart disease, but also involves aortic valve regurgitation, bicuspid aortic valve, mitral stenosis, tricuspid regurgitation, combined valve disease, pregnancy with valvular disease, valve disease complicated with coronary heart disease, valve disease complicated with non-cardiac surgery and the prospect of comprehensive management of valve disease. It covers a wide range of contents, which are introduced in detail and comprehensively. This paper interprets some highlights and core issues, including the top 10 take-home messages, the severity of valvular heart disease, and the updates in the management of aortic valve stenosis, aortic valve regurgitation, bicuspid aortic valve, mitral stenosis and mitral regurgitation.
目的 探討新型玻璃化冷凍法對人卵巢組織超微結構的保存效果，尤其是對卵巢間質細胞的保存效果。 方法 收集2007年6月－2009年1月在我院行婦科手術的患者卵巢組織共8例，使用新型玻璃化冷凍法和慢速冷凍法保存，比較兩種冷凍方法對于始基卵泡卵母細胞、顆粒細胞、卵泡周圍間質細胞超微結構保存效果。 結果 對于始基卵泡卵母細胞和顆粒細胞，發現兩種冷凍方法之間無顯著差異（P＞0.05）；在間質細胞保存中，新型玻璃化冷凍法與慢速冷凍法相比較，正常間質細胞百分率增加（P＜0.05）。 結論 新型玻璃化冷凍法與慢速冷凍法相比能更好地保存卵泡周圍間質細胞，在深低溫保存人卵巢組織中具有較廣闊的應用前景。