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Interventional Radiology in China： Current Status and Future Prospects

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Chinese Medical Journal 2017年第11期130卷 1371-1375页

作者： He Zhao Jiay-Wei Tsauo Xiao-Wu Zhang Xiao Li Department of Interventional Therapy National Cancer Center/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100021 China

INTRODUCTION Interventional radiology （IR） is a clinical specialty providing minimally invasive image-guided diagnosis and treatment of diseases in various organ systems, Since Charles Dotter performed the first balloon angioplasty on patients with stenosis of the superficial femoral artery in 1964, IR has been applied in numerous aspects of modern medicine However, the development of IR also presents many problems such as the relationship with other disciplines and turf wars. These problems puzzle many interventionists, and no solution has been proven to be applicable to every country.

关键词： China clinical practice Disciplinary Development Education Interventional Radiology Scientific Research

Can propensity score matching replace randomized controlled trials?

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World Journal of Methodology 2024年第1期14卷 58-70页

作者： Matthias Yi Quan Liau En Qi Toh Shamir Muhamed Surya Varma Selvakumar Vishalkumar Girishchandra Shelat Lee Kong Chian School of Medicine Nanyang Technological UniversitySingapore 308232Singapore Department of General Surgery Tan Tock Seng HospitalSingapore 308433Singapore Surgical Science Training Centre Tan Tock Seng HospitalSingapore 308433Singapore

Randomized controlled trials(RCTs)have long been recognized as the gold standard for establishing causal relationships in clinical *** that,various limitations of RCTs prevent its widespread implementation,ranging from the ethicality of withholding potentially-lifesaving treatment from a group to relatively poor external validity due to stringent inclusion criteria,amongst ***,with the introduction of propensity score matching(PSM)as a retrospective statistical tool,new frontiers in establishing causation in clinical research were opened *** predicts treatment effects using observational data from existing sources such as registries or electronic health records,to create a matched sample of participants who received or did not receive the intervention based on their propensity scores,which takes into account characteristics such as age,gender and *** its retrospective nature and its use of observational data from existing sources,PSM circumvents the aforementioned ethical issues faced by *** of RCTs exclude elderly,pregnant women and young children;thus,evidence of therapy efficacy is rarely proven by robust clinical research for this *** the other hand,by matching study patient characteristics to that of the population of interest,including the elderly,pregnant women and young children,PSM allows for generalization of results to the wider population and hence greatly increases the external *** of replacing RCTs with PSM,the synergistic integration of PSM into RCTs stands to provide better research outcomes with both methods complementing each *** example,in an RCT investigating the impact of mannitol on outcomes among participants of the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial,the baseline characteristics of comorbidities and current medications between treatment and control arms were significantly different despite the randomization ***,PS

关键词： Propensity score matching Randomized controlled trials Randomization clinical practice Validity Ethics

Validation of Stressors in Nursing Students Scale-Chinese Version (SINS-CN) in a Population of Macao Nursing Students

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Chinese Nursing Research 2014年第1期1卷 25-29,35页

作者： Ming Liu Qin Gu Thomas K.S.Wong Roger Watson School of Health Sciences Macao Polytechnic Institute Knowledge Transfer and Consultancy Company Limited University of Hull

Objective： To validate the Stressors in Nursing Students Scale-Chinese Version（SINS-CN） in a population of Macao nursing students. Methods： A methodological study was designed with 2 phases. In phase 1, a three-expert panel was invited to evaluate the content validity of SINS-CN, and then its test-retest reliability was examined over a 2-week interval. In phase 2,211 undergraduate nursing students were recruited, and 203 valid responses to the questionnaire were obtained. A principal component analysis with varimax rotation was applied to validate the structure of the instrument. Results： The content validity index（CVI） was 0.89. The correlation coefficient of the test-retest reliability was 0.82 for the overall instrument and 0.70-0.88 for the instrument＇s sub-dimensions. Based on the 43 items of the instrument, five components were identified and accounted for 60. 28% of the variance with eigenvalues ranging from 1.32 to 10. 18. The factor loadings were 0.42-0.79. The internal consistency reliability of Cronbach＇s ot was 0.96 for the overall scale and 0.67-0.94 for its sub-dimensions. Conclusion： The study findings indicated that SINS-CN had acceptable psychometric properties in terms of content validity, stability and internal consistency reliability. The principal component analysis generated a 5-component structure with 43 items; this was slightly different from the origi- nai structure but was more applicable to the studied population, which suggests that this instrument has cross-cultural sensitivity.

关键词： Nursing student Stress Stressors clinical practice

Gynecological malignancies and hormonal therapies: clinical management and recommendations

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World Journal of Obstetrics and Gynecology 2014年第4期3卷 162-170页

作者： Anna Myriam Perrone Federica Pozzati Donatella Santini Martina Rossi Martina Procaccini Lucia Casalini Erica Santi Marco Tesei Claudio Zamagni Pierandrea De Iaco Oncologic Gynecology Unit Sant’Orsola-Malpighi Hospital40138 BolognaItaly Pathology Unit Sant’Orsola-Malpighi University Hospital40138 BolognaItaly Medical Oncology Unit Sant’Orsola-Malpighi University Hospital40138 BolognaItaly

Every year in the world a large number of women receive a diagnosis of gynecological cancer and undergo a therapy such as surgery, chemotherapy and radiotherapy to the pelvic region. A large portion of these patients are already in menopause, but for younger patients therapies are responsible of early menopause. The physical and psychological symptoms due to iatrogenic menopause significantly reduce the quality of life; however hormone replacement therapy(HRT) has a high efficacy in reducing menopausal symptoms. The prescription of HRT in patients with story of gynecological cancer is debated because its safety has not been completely proven. The main criticism is based on the theory that the hormone replacement could stimulate growth of residual cancer cells increasing the risk of recurrence.

关键词： Iatrogenic menopause Gynecological cancer Hormone replacement therapy Risk of recurrence Climateric symptoms Cardiovascular benefits clinical practice

Developing Skills in Intra-Workplace Rehabilitation Education: Paper III

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Open Journal of Therapy and Rehabilitation 2024年第1期12卷 70-100页

作者： Fukumi Hiragami Research Institute of Health and Welfare Kibi International University Takahashi Japan

Rehabilitation is a medical discipline which is needed wherever people have lost full functionality, and it is needed increasingly in noncommunicable diseases, such as neurological problems, but also, and perhaps more importantly, in middle- and high-income countries, where populations are growing more aged. The burden is borne by the health care systems, especially where family cannot take the full load of care. Rehabilitation is also a discipline which is carried out most effectively in multi- or interdisciplinary teams, which carry their own weight of learning and group tensions. They are also bound to consider best practice guidelines. Furthermore, there is also a wide gap between learning in college or university and practice in the ward which leads to a loss of confidence in newly trained medical and paramedical personnel such as doctors, nurses, physiatrists, occupational therapists and physiotherapists. There is a genuine need for expert rehabilitation specialists who can mediate within teams as well as between groups and patients and their families. This paper lays out the range of considerations such a rehabilitation therapist must have under their belt. A model is presented. There are also two sets of parameters when using the model in practice. The first is the levels at which it works: hospital, departmental and individual. Then there are the specific challenges. Curriculum practice guidelines work at the hospital and departmental and professional levels;teamwork with its intrinsic challenges is of paramount importance;finally, the individuals will learn how to represent their insights in writing, most specifically represented in full-blown case reports. If the levels and roles coordinate, rehabilitation medicine should develop favourably.

关键词： Rehabilitation clinical practice Teamwork Case Studies Writing up Case Reports

Developing evidence-based medicine in Persian medicine: obstacles, challenges, and solutions andsolutions

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TMR Integrative Medicine 2022年第27期6卷 1-7页

作者： Fataneh Hashem-Dabaghian Aida Asghari Marzieh Qaraaty Department of Traditional Medicine Institute for Studies in Medical HistoryPersian and Complementary MedicineSchool of Persian MedicineIran University of Medical SciencesTehran ***Iran. Student in Health Services Management School of HealthTehran University of Medical SciencesTehranIran. Education Development Center Golestan University of Medical SciencesGorganIran. Department of Persian Medicine Golestan University of Medical SciencesGorganIran.

Introduction:Considering the importance of evidence-based medicine(EBM)and the emphasis of Persian medicine(PM)experts on its use,this study was designed;to investigate the practice of PM specialists,the obstacles,challenges,and solutions of developing and using EBM in PM were also the aims of the present ***:In the present study,98 PM specialists,who work in Iran completed the electronic Persian version of the evidence-based *** effective factors in the practice of specialists were assessed by Spearman correlation and Mann-Whitney U ***:The mean±standard deviation of age,graduation time,and clinical experience were 44.52±6.45,3.26±2.28,and 6.76±5.27 years,*** the data showed,that 52 participants(53.1%)had not passed any EBM training *** media,general and medical databases,textbooks,colleagues,and journal articles were used frequently in clinical practices,but the specific EBM-specific resources were ***:More attention must be paid to produce scientific evidence,improving the infrastructures and health policies,and empowering PM specialists to apply EBM in their clinical practices.

关键词： evidence-based medicine clinical practice Persian medicine obstacles and solutions Iran

Hematologic Emergencies

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Open Journal of Internal Medicine 2016年第3期6卷 83-92页

作者： Gianfilippo Nifosì Hemato-Oncologic Clinic Department of Internal Medicine University Hospital Center Brugmann Bruxelles Belgium

Hematological emergencies are defined as acute life-threatening conditions in hematological diseases due to benign blood disorders or hematological malignancies or as a result of its treatment. This article deals of the most common emergencies encountered by hematologists. Emerging clinical situations, predictable or not, are common in the treatment of hematological diseases. However, the rapid development of new targeted drugs in cancer medicine has led to an increase in chronically ill cancer and hematology patients, who are being treated aggressively despite significant comorbidities and higher age. This development will lead to an increase in the number of hematologic emergencies, and these patients will be seen by various specialists. The knowledge of most hematological emergencies is crucial in daily practice. In this review, we discuss the epidemiology, pathophysiology and clinical with an emphasis on the early diagnosis and treatment of these conditions that can significantly affect the patient’s clinical outcome.

关键词： Urgency Hematological Diseases clinical practice

Micro-Computed Tomography Applications in Dentistry

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Open Journal of Stomatology 2024年第1期14卷 32-41页

作者： Ahmad Assari Maha Al Bukairi Reema Al Saif Oral Maxillofacial Surgery & Diagnostic Sciences Department College of Medicine and Dentistry Riyadh Elm University Ri-yadh Saudi Arabia Orthodontist Ministry of Health First Health Cluster Riyadh Saudi Arabia Periodontist Ministry of Health Third Health Cluster Riyadh Saudi Arabia

Micro-computed tomography (MCT) encompasses two primary scanning options: ex-vivo and in-vivo imaging. Ex-vivo scanning involves the examination of extracted teeth or dental specimens, allowing for detailed analyses of the microarchitecture of mineralized tissue. By analyzing the microarchitecture of dental tissues, MCT can provide valuable information about bone density, porosity, and microstructural changes, contributing to a better understanding of disease progression and treatment outcomes. Moreover, MCT facilitates the quantification of dental parameters, such as bone volume, trabecular thickness, and connectivity density, which are crucial for evaluating the efficacy of dental interventions. This present study aims to comprehensively review and explore the applications of MCT in dentistry and highlight its potential in advancing research and clinical practice. The results depicted that the quantitative approach of MCT enhances the precision and reliability of dental research. Researchers and clinicians can make evidence-based decisions regarding treatment strategies and patient management, relying on quantifiable data provided by MCT. The applications of MCT in dentistry extend beyond research, with potential clinical implications in fields such as dental implantology and endodontics. MCT is expected to play an increasingly significant role in enhancing our understanding of dental pathologies, improving treatment outcomes, and ultimately, benefiting patient care in the field of dentistry.

关键词： clinical practice Dentistry Ex-Vivo Scanning Micro-Computed Tomography

Shock index and its variants as predictors of mortality in severe traumatic brain injury

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World Journal of Critical Care Medicine 2024年第1期13卷 40-48页

作者： Randhall B Carteri Mateus Padilha Silvaine Sasso de Quadros Eder Kroeff Cardoso Mateus Grellert Department of Nutrition Centro Universitário CESUCAPorto Alegre 94935-630Brazil Department of Analysis and Systems Development Centro Universitário CESUCAPorto Alegre 94935-630Brazil Department of Nutrition Hospital Pronto Socorro de Porto AlegrePorto Alegre 90040-192Rio Grande do SulBrazil Department of Physiotherapy Hospital Pronto Socorro de Porto AlegrePorto Alegre 90040-192Rio Grande do SulBrazil Institute of Informatics Federal University of Rio Grande do Sul(UFRGS)Porto Alegre 91501-970Rio Grande do SulBrazil

BACKGROUND The increase in severe traumatic brain injury(sTBI)incidence is a worldwide phenomenon,resulting in a heavy disease burden in the public health systems,specifically in emerging *** shock index(SI)is a physiological parameter that indicates cardiovascular status and has been used as a tool to assess the presence and severity of shock,which is increased in *** the high mortality of sTBI,scrutinizing the predictive potential of SI and its variants is *** To describe the predictive potential of SI and its variants in *** This study included 71 patients(61 men and 10 women)divided into two groups:Survival(S;n=49)and Non-survival(NS;n=22).The responses of blood pressure and heart rate(HR)were collected at admission and 48 h after *** SI,reverse SI(rSI),rSI multiplied by the Glasgow Coma Score(rSIG),and Age multiplied SI(AgeSI)were *** comparisons included Shapiro-Wilk tests,and independent samples *** predictive analysis,logistic regression,receiver operator curves(ROC)curves,and area under the curve(AUC)measurements were *** No significant differences between groups were identified for SI,rSI,or *** AgeSI was significantly higher in NS patients at 48 h following admission(S:26.32±14.2,and NS:37.27±17.8;P=0.016).Both the logistic regression and the AUC following ROC curve analysis showed that only AgeSI at 48 h was capable of predicting sTBI *** Although an altered balance between HR and blood pressure can provide insights into the adequacy of oxygen delivery to tissues and the overall cardiac function,only the AgeSI was a viable outcome-predictive tool in sTBI,warranting future research in different cohorts.

关键词： Head trauma Critical patient Neuro-cardio axis Predictive tool clinical practice