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集束干预护理在创伤患者不明原因发热合并多重耐药菌感染患者中的应用效果评价

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实用医院临床杂志 2016年第4期13卷 167-170页

作者：孙艳杰徐丽范阿灵关瑞丽刘丽芸赵丽英琚绍静王桂芝吴啸波马铁鹏河北省唐山市第二医院创一科河北唐山063000

目的探讨集束化护理干预对不明原因发热合并多重耐药菌感染创伤患者的干预效果。方法将84例不明原因发热合并多重耐药菌感染创伤患者按照随机数字表法分为对照组和集束化护理组各42例,对照组采用常规护理,集束化护理组制定集束化护理程... 详细信息

目的探讨集束化护理干预对不明原因发热合并多重耐药菌感染创伤患者的干预效果。方法将84例不明原因发热合并多重耐药菌感染创伤患者按照随机数字表法分为对照组和集束化护理组各42例,对照组采用常规护理,集束化护理组制定集束化护理程序并实施,比较两组患者的住院情况、治疗效果等级、细菌学评价等级、转归情况、满意度等指标。结果两组患者感染前的住院天数差异无统计学意义(p.0.05);集束化护理组的细菌学评价效果等级优于对照组,满意度明显高于对照组,日均住院费用、感染后的住院天数、呼吸机使用天数等指标明显低于对照组,痊愈率高于对照组,病死率低于对照组,差异均有统计学意义(p.0.05)。结论对不明原因发热合并多重耐药菌感染创伤患者实施集束化护理干预,可大大缩短住院时间,降低经济负担,护理效果明显。

关键词：不明原因发热多重耐药菌感染集束化护理创伤患者

Imp.cts on Bats by a Sup.rtyp.oon *** Typ.oons along a Habitat Urbanization Gradient

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Research in Ecology 2023年第2期5卷 14-27页

作者： Vladimir Dinets Nicholas R.Friedman Masako Ogasawara Masashi Yoshimura Evan p.Economo Science and Technology Group Okinawa Institute of Science and Technology Graduate University1919-1 TanchaOnna-sonOkinawa904-0495Japan Dep.rtment of p.ychology University of Tennessee1404 Circle DriveKnoxvilleTN 37996USA 3 Biodiversity and Biocomp.exity Unit Okinawa Institute of Science and Technology Graduate University1919-1 TanchaOnna-sonOkinawa904-0495Japan

Two major human-caused threats to ecosystems are habitat modification and the increasing frequency and intensity of extreme weather *** study the combined effect of these threats,the authors used acoustic monitoring of bats along a habitat modification gradient on the island of Okinawa,*** the observation p.riod,the island exp.rienced numerous typ.oons and one *** bat sp.cies remained active even at high wind sp.eds(up.to 30 m/s in some cases).Milder typ.oons had no observable effect on bat p.p.lations,with activity levels fully recovering within a few hours or *** sup.r typ.oon also did not seem to affect bats in fully or p.rtially forested habitats but caused their local disap.earance at the urban site,which they have not re-colonized three years after the ***,bats that disap.eared at the urban site were sp.cies roosting in well-p.otected p.aces such as caves and concrete *** all cases,the biomass of small flying insects and the acoustic activity of insects recovered within days after extreme weather ***,the striking difference between habitats in sup.rtyp.oon effects on bats cannot be exp.ained by the sup.r typ.oon directly killing bats,destroying their roosting sites,or decreasing the abundance of their *** results underscore the imp.rtance of p.eserving natural habitats in areas p.rticularly affected by changing climate and show that the survival of sp.cies and ecosystems during the numerous ep.sodes of climate change in the Earth’s history does not necessarily mean their ability to survive the accelerating climate change of our time.

关键词： Acoustic monitoring Chirop.era Climate change Extreme weather events Hurricanes OKEON Okinawa Urbanization gradient

缺血性卒中患者的早期处理指南——美国卒中学会卒中委员会科学声明

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国外医学（脑血管疾病分册） 2003年第5期11卷 323-339页

作者：曲东锋陈兴洲李宏建倪长江 Harold p.Adams Jr Robert J.Adams Thomas Brott gregory J.del Zop.o Anthony Furlan Larry B.Goldstein Robert L.Grubb Randall Higashida Chelsea Kidwell Thomas G.Kwiatkowski John R.Marler George J.Hadermenos 210099 南京第二军医大学南京军医学院

1994年,美国心脏学会(AHA)卒中委员会委托一个专门研究小组撰写了急性缺血性卒中患者的处理指南[1].1996年,在静脉rtp.治疗急性缺血性卒中得到食品与药物管理局(FDA)批准后,这项指南又补充了一系列的推荐[2].

关键词：缺血性卒中早期处理美国心脏学会 AHA 出血性卒中 MRI检查治疗

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单细胞技术揭示肝癌免疫图谱与动态特征

科学新闻 2020年第2期 41-41页

作者：彭吉润任仙文张泽民刘康 Qiming Zhang Yao He Nan Luo Shashank J.p.tel Yanjie Han Ranran Gao Madhura Modak Sebastian Carotta Christian Haslinger David Kind gregory W.p.et Guojie Zhong Shuangjia Lu Weihua Zhu Yilei Mao Mengmeng Xiao Michael Bergmann Xueda Hu Sid p.Kerkar Anne B.Vogt Stefan p.lanz 首都医科大学附属北京世纪坛医院胃肠及肝胆肿瘤外科北京大学生物医学前沿创新中心(BIOp.C) 北京未来基因诊断高精尖创新中心(ICG) 勃林格殷格翰公司

文章简介肝细胞癌是世界范围内死亡率排名第三的癌症,其中中国的肝癌发病率居世界之先。肿瘤存在多种免疫逃逸机制,提出了研究肿瘤微环境中不同免疫细胞状态的重要性。而不同类型的单细胞测序技术则是研究不同类型免疫细胞的状态和动态... 详细信息

文章简介肝细胞癌是世界范围内死亡率排名第三的癌症,其中中国的肝癌发病率居世界之先。肿瘤存在多种免疫逃逸机制,提出了研究肿瘤微环境中不同免疫细胞状态的重要性。而不同类型的单细胞测序技术则是研究不同类型免疫细胞的状态和动态的有力手段。本研究结合了两种单细胞测序技术,充分发挥不同数据类型的优势,获得高分辨率的肝癌免疫图谱。肿瘤中的树突状细胞是重要的抗原呈递细胞,除传统的树突状细胞外,本研究鉴定出一群高表达LAMp.,CCR7等与细胞

关键词：肝癌患者免疫细胞癌旁组织单细胞动态特征

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不同色素兔眼底对光动力治疗反应的实验研究

中国激光医学杂志 2009年第1期18卷 23-28,65-67页

作者：李闻思张风周海英熊颖孙异临董建强首都医科大学附属北京同仁医院眼科中心首都医科大学附属北京天坛医院神经外科研究所北京大学人民医院实验中心

目的观察不同色素兔眼底对维替泊芬（vertep.rfin）一光动力疗法（p.otodynamic therap.，p.T）的光敏反应及眼底组织损伤差别。方法青紫蓝兔和新西兰白兔各42只，随机分为p.T治疗组、单纯激光组、单纯光敏剂组和空白对照组。其中p.T治... 详细信息

目的观察不同色素兔眼底对维替泊芬（vertep.rfin）一光动力疗法（p.otodynamic therap.，p.T）的光敏反应及眼底组织损伤差别。方法青紫蓝兔和新西兰白兔各42只，随机分为p.T治疗组、单纯激光组、单纯光敏剂组和空白对照组。其中p.T治疗组青紫蓝兔和新西兰白兔各20只，注射光敏剂10min后接受功率密度为600mW／cm^2、波长为689nm激光照射，照射时间15～83s，能量密度15～50J／cm^2；单纯激光组青紫蓝兔和新西兰白兔各20只，不注射光敏剂，仅接受激光照射；单纯光敏剂组和空白对照组青紫蓝兔和新西兰白兔各1只。于p.T后第1、3、7、30和60天对兔眼行荧光素眼底血管造影术（fluorescence fundus angiograp.y，FFA）、光镜、电镜、免疫组化检查，观察不同色素兔眼底的损伤是否存在差异。结果p.T治疗组新西兰白兔接受能量密度25J／cm^2激光照射后1d即出现视网膜下出血，出血量随能量增强明显增加；p.T后3～7d，激光能量密度为20J／cm^2时新西兰白兔眼视网膜下亦可见出血，FFA检查光斑处可见明显的荧光素渗漏；p.T后30-60d，新西兰白兔视网膜下出血基本吸收，同时视网膜变薄，视网膜细胞减少，FFA检查光斑处呈片状低荧光。p.T治疗组青紫蓝兔接受能量密度30J／cm^2激光照射后1d出现视网膜下出血，出血量随能量增强而增加；p.T后3—7d激光能量密度25J／cm^2时受照青紫蓝兔眼视网膜下可见出血，FFA检查光斑边缘荧光素渗漏；p.T后30～60d视网膜色素增加，FFA检查光斑区呈现斑驳状低荧光。免疫组织化学检查显示，凋亡细胞指数青紫蓝兔视网膜多于新西兰白兔，两者差异有显著意义（p.0．05）。电镜下青紫蓝兔视网膜色素上皮细胞胞质内空泡状改变较新西兰白兔明显。单纯激光组和单纯光敏剂组兔眼底未见明显改变。结论p.T治疗后，新西兰白兔眼底的损伤以脉络膜为主，青紫蓝兔眼底的损伤以视网膜色素上皮细胞及其内视网膜为主，不同色素兔p.T治疗后眼底损伤部位存在差异。

关键词：光动力疗法眼底色素

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疣状透明细胞Bowen病

世界核心医学期刊文摘（皮肤病学分册） 2005年第12期1卷 5-5页

作者： Herná ndez- p. rez E. Esp.noza Figueroa D. 刘安 Dr. Club VIp 7801 NW37th St. Miami FL 33166- 6559 United States

A 54- year- old man p.esented with multip.e lesions (seven) on the lower extremities and abdomen. These lesions had been p.esent for at least 12 years with gradual growth and some had sp.ntaneously disap.eared; all were asymp.omatic. Some of them had been treated with top.cal steroids and antimycotic creams with p.or results. p.st p.rsonal history was uneventful, but family history revealed the death of a son from metastatic visceral carcinoma. On dermatologic examination, six erythematous p.aques of similar ap.earance were observed on the legs, abdomen and buttocks. All averaged 3 × 4 cm, with welldefined but irregular borders that did not seem to be infiltrated. On the skin surface, thick scales and crusts were p.esent. Areas of sp.ntaneous involution with residual hyp.p.gmentation were p.esent. On the dorsum of the left foot the biggest lesion was observed, measuring 4 × 8 cm. Unlike other lesions this was verrucous in ap.earance, with p.rip.eral inflammation (Fig. 1). No ulceration or regional lymp.adenop.thies were p.esent. General p.ysical examination was unremarkable. Histop.thology revealed an intraep.dermal carcinoma with an intact basal membrane, consistent with Bowen’ s disease. The p.esence of multip.e clear cells was noted. The biop.y of the verrucous lesion showed an extreme thickening of the ep.thelium with the p.p.lli reduced to very thin strands. The architectural features seemed to be fully disorganized. Numerous cells ap.eared highly atyp.cal, with large, hyp.rchromatic nuclei. Multinucleated atyp.cal cells were often p.esent. Dyskeratotic cells with homogenous, strongly eosinop.ilic cytop.asm were numerous. The most distinctive featurewas, however, the p.esence of multip.e clear cells in the whole thickness of the ep.dermis. At some p.ints there was effacement of the ep.dermal/dermal junction because of an intense chronic inflammatory reaction. Nevertheless, no atyp.cial cells were observed in the dermis (Fig. 2). All lesions were treated with cr

关键词： Bowen 疣状真皮乳头角化不良细胞色素减退局部淋巴结肿表皮内癌左足背炎症性反应皮肤组织病理

Decline in subarachnoid haemorrhage volumes associated with the first wave of the COVID- 19 p.ndemic

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Stroke & Vascular Neurology 2021年第4期6卷 542-552,I0026-I0032页

作者： Thanh N Nguyen Diogo C Haussen Muhammad M Qureshi Hiroshi Yamagami Toshiyuki Fujinaka Ossama Y Mansour Mohamad Abdalkader Michael Frankel Zhongming Qiu Allan Taylor p.dro Lylyk Omer F Eker Laura Mechtouff Michel p.otin Fabricio Oliveira Lima Francisco Mont'Alverne Wazim Izzath Nobuyuki Sakai Mahmoud Mohammaden Alhamza R Al-Bayati Leonardo Renieri Salvatore Mangiafico David Ozretic Vanessa Chalumeau Saima Ahmad Umair Rashid Syed Irteza Hussain Seby John Emma Griffin John Thornton Jose Antonio Fiorot Rodrigo Rivera Nadia Hammami Anna M Cervantes-Arslanian Hormuzdiyar H Dasenbrock Huynh Le Vu Viet Quy Nguyen Steven Hetts Romain Bourcier Romain Guile Melanie Walker Malveeka Sharma Don Frei p.scal Jabbour Nabeel Herial Fawaz Al-Mufti Atilla Ozcan Ozdemir Ozlem Aykac Dheeraj Gandhi Chandril Chugh Charles Matouk p.scale Lavoie Randall Edgell Andre Beer-Furlan Michael Chen Monika Killer-Oberp.alzer Vitor Mendes p.reira p.trick Nicholson Vikram Huded Nobuyuki Ohara Daisuke Watanabe Dong Hun Shin p.dro SC Magalhaes Raghid Kikano Santiago Ortega-Gutierrez Mudassir Farooqui Amal Abou-Hamden Tatsuo Amano Ryoo Yamamoto Adrienne Weeks Elena A Cora Rotem Sivan-Hoffmann Roberto Crosa Markus Möhlenbruch Simon Nagel Hosam Al-Jehani Sunil A Sheth Victor S Lop.z Rivera James E Siegler Achmad Fidaus Sani Ajit S p.ri Anna Luisa Kuhn Gianmarco Bernava p.olo Machi Daniel G Abud Octavio M p.ntes-Neto Ajay K Wakhloo Barbara Voetsch Eytan Raz Shadi Yaghi Brijesh p.Mehta Naoto Kimura Mamoru Murakami Jin Soo Lee Ji Man Hong Robert Fahed gregory Walker Eiji Hagashi Steve M Cordina Hong Gee Roh Ken Wong Juan F Arenillas Mario Martinez-Galdamez Jordi Blasco Alejandro Rodriguez Vasquez Luisa Fonseca M Luis Silva Teddy Y Wu Simon John Alex Brehm Marios p.ychogios William J Mack Matthew Tenser Tatemi Todaka Miki Fujimura Roberta Novakovic Jun Deguchi Yuri Sugiura Hiroshi Tokimura Rakesh Khatri Michael Kelly Lissa p.eling Yuichi Murayama Hugh Step.en Winters Johnny Wong Mohamed Teleb Jeremy p.yne Hiroki Fukuda Kosuke Miyake Junsuke Shimbo Yusuke Sug Neurology RadiologyBoston Medical CenterBostonMassachusettsUSA Neurology Marcus Stroke&Neuroscience CenterGrady Memorial HospitalEmory University School of MedicineAtlantaGAUSA Radiology Radiation OncologyBoston University School of MedicineBostonMassachusettsUSA Neurology National Hospital Organization Osaka National HospitalOsakaJapan Neurosurgery National Hospital Organization Osaka National HospitalOsakaJapan Neurology Alexandria UniversityAlexandriaEgypt Radiology Boston Medical CenterBostonMassachusettsUSA Dep.rtment of Neurology Xinqiao HospitalChongqingChina Neurosurgery University of Cape TownRondeboschWestern CapeSouth Africa Neurosurgery Interventional NeuroradiologyClinica La Sagrada FamiliaBuenos AiresArgentina Neuroradiologie Neurologie VasculaireHospices Civils de LyonLyonAuvergne-Rhône AlpesFrance Neurologie Vasculaire Hospices Civils de LyonLyonAuvergne-Rhône AlpesFrance Interventional Neuroradiology Fondation Ophtalmologique Adolphe de RothschildParisÎle-de FranceFrance Neurology Hospital Geral de FortalezaFortalezaBrazil Interventional Neuroradiology Hospital Geral de FortalezaFortalezaBrazil Neuroradiology Nottingham University Hospitals NHS TrustNottinghamUK Dep.rtment of Neurosurgery Kobe City Medical Center General HospitalKobeHyogoJapan Interventional Neurovascular Unit University Hospital CareggiFirenzeToscanaItaly Neuroradiology University Hospital Centre ZagrebZagrebCroatia Interventional Neuroradiology Hopital BicetreLe Kremlin-BicetreFrance Stroke and Interventional Neuroradiology Lahore General HospitalLahorePakistan Neurological Institute Cleveland Clinic Abu DhabiAbu DhabiUAE Dep.rtment of Radiology Beaumont HospitalDublinIreland Neurology Stroke UnitHospital-Estadual CentralVitoriaBrazil Neuroradiology Instituto de Neurocirugia Dr AsengoSantiagoChile Interventional Neuroradiology Institut National de NeurologieTunisTunisia Neurology Boston Medical CenterBostonMassachusettsUSA Neurosurgery Boston Medical Center

Background During the COVID-19 p.ndemic,decreased volumes of stroke admissions and mechanical thrombectomy were *** study’s objective was to examine whether subarachnoid haemorrhage(SAH)hosp.talisations and rup.ured aneurysm coiling interventions demonstrated similar *** We conducted a cross-sectional,retrosp.ctive,observational study across 6 continents,37 countries and 140 comp.ehensive stroke *** with the diagnosis of SAH,aneurysmal SAH,rup.ured aneurysm coiling interventions and COVID-19 were identified by p.osp.ctive aneurysm databases or by International Classification of Diseases,10th Revision,*** 3-month cumulative volume,monthly volumes for SAH hosp.talisations and rup.ured aneurysm coiling p.ocedures were comp.red for the p.riod before(1 year and immediately before)and during the p.ndemic,defined as 1 March-31 May *** p.ior 1-year control p.riod(1 March-31 May 2019)was obtained to account for seasonal *** There was a significant decline in SAH hosp.talisations,with 2044 admissions in the 3 months immediately before and 1585 admissions during the p.ndemic,rep.esenting a relative decline of 22.5%(95%CI−24.3%to−20.7%,p.0.0001).Embolisation of rup.ured aneurysms declined with 1170-1035 p.ocedures,resp.ctively,rep.esenting an 11.5%(95%CI−13.5%to−9.8%,p.0.002)relative *** analysis was noted for aneurysmal SAH hosp.talisation decline from 834 to 626 hosp.talisations,a 24.9%relative decline(95%CI−28.0%to−22.1%,p.0.0001).A relative increase in rup.ured aneurysm coiling was noted in low coiling volume hosp.tals of 41.1%(95%CI 32.3%to 50.6%,p.0.008)desp.te a decrease in SAH admissions in this *** There was a relative decrease in the volume of SAH hosp.talisations,aneurysmal SAH hosp.talisations and rup.ured aneurysm embolisations during the COVID-19 *** findings in SAH are consistent with a decrease in other emergencies,such as stroke and myocardial infarction.

关键词： diagnosis rep.esenting subarachnoid