检索结果-南通市图书馆

Chinese Medical Journal 2019年第12期132卷 1478-1481页

作者： U Po Lam Edmundo Patricio Lopes Lao Kan Chit Lam Mario Evora Na-Qiong Wu Department of Cardiology Centro Hospital Conde de Sao JanuarioMacaoChina University of Michigan Ann ArborMichigan 48104USA Department of Cardiology Center of Endocrinology & CardiometabolismNational Center for Cardiovascular DiseasesFuwai HospitalBeijing 100037China

Compared with trans-femoral artery access (TFA), trans-radial artery access (TRA) for percutaneous coronary interventions (PCI) has been shown to significantly reduce 30-day mortality, in-hospital major adverse cardiac and cardiovascular events (a composite of 30-day mortality and in-hospital myocardial re-infarction, target vessel revascularization, and cerebrovascular events), major bleeding, and access site complications.[1] TRA is more easily compressible, minimizing hematoma risk, and lower crossover rates to another access. Patients may ambulate immediately after procedure, that hospitalization can be shortened significantly. In some centers, patient with TRA can be discharged on the same day of procedure. It is also superior to TFA with closure devices, and becomes the preferred access site for recent PCI.[2]

关键词： Trans-brachial artery access coronary artery procedures

Radiation exposure during image-guided endoscopic procedures: The next quality indicator for endoscopic retrograde cholangiopancreatography

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

World Journal of Clinical Cases 2018年第16期6卷 1087-1093页

作者： Shiro Hayashi Mamoru Takenaka Makoto Hosono Tsutomu Nishida Department of Gastroenterology and Internal Medicine Hayashi Clinic Department of Gastroenterology Toyonaka Municipal Hospital Department of Gastroenterology and Hepatology Kindai University Faculty of Medicine Department of Radiology Kindai University Faculty of Medicine

Endoscopic retrograde cholangiopancreatography(ERCP) is one of the most frequently used image-guided procedures in gastrointestinal endoscopy. Post-ERCP pancreatitis is an important concern, and prophylaxis, cannulation and other related technical procedures have been well documented by endoscopists. In addition, medical radiation exposure is of great concern in the general population because of its rapidly increasing frequency and its potential carcinogenic effects. International organizations and radiological societies have established diagnostic reference levels, which guide proper radiation use and serve as global standards for all procedures that use ionizing radiation. However, data on gastrointestinal fluoroscopic procedures are still lacking because the demand for these procedures has recently increased. In this review, we present the current status of quality indicators for ERCP and the methods for measuring radiation exposure in the clinical setting as the next quality indicator for ERCP. To reduce radiation exposure, knowledge of its adverse effects and the procedures for proper measurement and protection are essential. Additionally, further studies on the factors that affect radiation exposure, exposure management and diagnostic reference levels are necessary. Then, we can discuss how to manage medical radiation use inthese complex fluoroscopic procedures. This knowledge will help us to protect not only patients but also endoscopists and medical staff in the fluoroscopy unit.

关键词： Quality indicator Fluoroscopic procedures Endoscopic retrograde cholangiopancreatography Diagnostic reference levels Radiation exposure

Study on the facilities and procedures for meltwater erosion of thawed soil

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

International Soil and Water Conservation Research 2016年第2期4卷 142-147页

作者： Yunyun Ban Tingwu Lei Chao Chen Zhiqiang Liu China Agricultural University Beijing 100083PR China State Key Laboratory of Soil Erosion and Dryland Farming on the Loess Plateau Institute of Soil and Water ConservationCAS and MWRYangling 712100PR China

High erosion rate of seasonal thawed soils by snow-and ice-melting runoff in the high altitude and latitude cold regions has great impacts on ecological systems,industries,agriculture and various manmade infrastructures as well as people's lives.The facilities and procedures are of great importance for the studies on simulating erosion processes of melt-frozen soil.This study focuses on the method and facility for simulating the thawing process of frozen soil.The facility includes soil freezing system,meltwater supply system and experimental flume system for thawed soil erosion.The soil freezing system provides enough space to freeze soil columns in flumes.The water supply system deliveries snow-or icemelting water flow of constant-rate at 0℃.The soil flumes of 200 or 300 cm long,10 cm wide and 12 cm high are designed to be assemble and convenient for soil freezing before they are thawed in one-dimensional manner from top to bottom.The one-dimensional thawing process is realized as follows.The frozen soil flume is put on ice boxes and thermally insulated with heat-insulating materials all around to prevent frozen soil from being thawed from sidewalls and bottom.The soil thaws with this system shows that it can meet the requirements of simulating the process of soil thawing from top to bottom.The thawed soil flumes are connected from end to end to form rills of 6–8 m long to run the erosion experiments under different designed hydraulic condition.The equipment provides facility,method and operation process for simulating one-dimensional soil thawing to serve research on the effect of thawed soil depth on erosion process.

关键词： Melt-frozen Soil erosion Method Facilities procedures

Ultrasound-assisted musculoskeletal procedures:A practical overview of current literature

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Orthopedics 2011年第7期2卷 57-66页

作者： Nelson A Royall Emily Farrin David P Bahner Stanislaw PA Stawicki Department of Emergency Medicine The Ohio State University Medical CenterColumbusOH 43210United States Department of Orthopaedics The Ohio State University Medical CenterColumbusOH 43210United States Department of Surgery Division of Critical CareTrauma and BurnThe Ohio State Unviersity Medical CenterColumbusOH 43210United States

Traditionally performed by a small group of highly trained specialists,bedside sonographic procedures involving the musculoskeletal system are often delayed despite the critical need for timely diagnosis and treatment.Due to this limitation,a need evolved for more portability and accessibility to allow performance of emergent musculoskeletal procedures by adequately trained non-radiology personnel.The emergence of ultrasound-assisted bedside techniques and increased availability of portable sonography provided such an opportunity in select clinical scenarios.This review summarizes the current literature describing common ultrasound-based musculoskeletal procedures.In-depth discussion of each ultrasound procedure including pertinent technical details,indications and contraindications is provided.Despite the limited amount of prospective,randomized data in this area,a substantial body of observational and retrospective evidence suggests potential benefits from the use of musculoskeletal bedside sonography.

关键词： Musculoskeletal ultrasound-guided procedures Arthrocentesis Tendon injection Articular injection Fluid collection Abscess drainage Foreign body removal

Use of Bivalirudin for Anticoagulation in Interventional Cardiovascular procedures

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Cardiovascular Innovations and Applications 2018年第B07期3卷 163-174页

作者： Zhen Ge Jaya Chandrasekhar Roxana Mehran The Zena and Michael A.Wiener Cardiovascular Institute Icahn School of Medicine at Mount SinaiNew YorkNYUSA

Anticoagulation is imperative to reduce the incidence of thrombotic complications in patients undergoing percutaneous interventional cardiovascular procedures;however,this is at the expense of increased risk of bleeding.The optimal anticoagulation strategy for these procedures remains unclear.Unfractionated heparin is the most commonly used anticoagulant during interventional procedures,but has several limitations,such as relatively high incidence of bleeding events,occurrence of heparin-induced thrombocytopenia,and a paradoxical thrombotic effect.Contemporary studies have demonstrated that bivalirudin decreases the occurrence of bleeding complications,but potentially increases the risk of acute stent thrombosis.This review discusses the pharmacology of bivalirudin and its current clinical application in patients undergoing percutaneous coronary intervention and transcatheter aortic valve replacement procedures.

关键词： bivalirudin anticoagulation interventional cardiovascular procedures

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

乡土文化教育开发：模式与流程

Surgical procedures,Pathological Features and Prognosis in Young Women with Breast Cancer in China--a Single Institute Experience

中小学教育 2018年第6期 20-27页

作者：纪德奎刘灵鸽

乡土文化教育开发是对乡土文化教育实践的系统化和理论化提升，为乡土文化教育能够深入和科学的开展奠定基础。通过对乡土文化教育实践案例的梳理和提炼，乡土文化教育开发一般有“整体推进式”“植根式”“以点带面式”三种模式，具体... 详细信息

乡土文化教育开发是对乡土文化教育实践的系统化和理论化提升，为乡土文化教育能够深入和科学的开展奠定基础。通过对乡土文化教育实践案例的梳理和提炼，乡土文化教育开发一般有“整体推进式”“植根式”“以点带面式”三种模式，具体流程可分为基础分析、目标定位、方案设计、实践推广等四个步骤。

关键词：乡土文化乡土文化教育乡土文化教育开发模式流程　　local culture local culture education the development of local culture education model procedures

来源：人大复印报刊资料评论

在线全文

人大复印报刊资料

学校读者我要写书评

暂无评论

Advances in Modern Oncology Research 2018年第5期4卷 5-10页

作者： Hai-li Lu Tatsiana Paliyenka Jing Han Breast Surgery Department Shanghai East HospitalShanghai200120 China

Objective:To compare the differences in surgical procedures,pathological features and prognosis between young and elderly women with breast cancer in China.Methods:A retrospective study compared the data of surgical procedures,pathological features and prognosis of 61 cases of young females(≤40 years)and 507 cases of elderly females(>40 years),treated in our department from August 2011 to July 2018.This data was analyzed using SPSS 23.0 program.Results:10.74% of total cases,in this period of time,involve young females.In terms of surgical procedures,24.59%of young patients underwent breast conserving surgery(8.48% elderly,respectively),and 13.11%underwent reconstruction surgery(1.18% elderly,respectively),with statistically significant differences existing between the two groups(P<0.05).Progesterone receptor(PR)expression in young women was significantly higher than in elderly females(P<0.05).There were no significant differences between the two groups in the proportion of invasive ductal carcinoma(IDC),axillary lymph node metastasis(ALNM),expression of estrogen receptor(ER),human epidermal growth factor receptor-2(HER-2)and Ki-67,but the lymphatic metastasis stage showed an increasing rate with younger age.No significant difference was found in 3-year disease-free survival(DFS)and overall survival(OS).Conclusion:The selection rate of breast conserving and reconstructive surgery in young women with breast cancer is significantly higher than that in elderly women.The younger the patient,the more frequently the PR positive expression,and the more likely ALNM to occur.The 3-year prognosis of the young and elderly patients is similar.

关键词： Breast neoplasm young women surgical procedures pathological features prognosis

Psychological Preparation of Children for Medical procedures: An Awareness Survey Targeting Nurses in Japan

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Open Journal of Nursing 2015年第7期5卷 613-621页

作者： Naomi Matsumori Ryoko Ito Aya Kawano Yukiko Hyakuta Department of Nursing Faculty of Health and Welfare Prefectural University of Hiroshima Hiroshima Japan Department of Obstetrics and Gynecology Outpatient Onomichi General Hospital Hiroshima Japan Graduate School of Comprehensive Scientific Research Prefectural University of Hiroshima Hiroshima Japan

Preparation is a means to support the psychological readiness and autonomy of children undergoing medical treatment. In this study, to understand the current practice and application of psychological preparation, using “explaining medical information to a child” as an indicator of respect for children’s rights, we investigated the effect of psychological preparation since 2002. The present study aimed to clarify the current status and awareness of psychological preparation for children undergoing medical procedures in pediatric nursing in Japan. An original questionnaire regarding psychological preparation for children in hospitals was sent by mail to nurses who were working in Japanese pediatric wards in 2010. Based on results from a previous study, nurses’ awareness of psychological preparation for children undergoing medical procedures seems to have improved. However, it was evident that nursing staff working in mixed wards require more specialized knowledge regarding child care, especially in terms of preparation. Furthermore, Japanese nurses recognized a need for improvement concerning their duties. It was also clear that the meaning of preparation remains ambiguous for many nurses. These results suggest that preparation has both psychological and ethical meanings.

关键词： Psychological Preparation Children Undergoing Medical procedures Pediatric Nursing Japan

Sono-Guided Endostripping: An Appropriate Alternative for Endovascular Varice procedures

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Surgical Science 2014年第12期5卷 526-532页

作者： Hossein Hemmati Mohammad Reza Asgary Mohammad Sadegh Esmaeli Delshad Davoud Mohammadi Sina Montazeri Cyrus Emir Alavi Vascular Surgery and Dialysis Research Center Guilan University of Medical Sciences Rasht Iran

Objective: This article is aimed at introducing Sono-Guided Endostripping Technique of the Great Saphenous vein and comparing it with radiofrequency ablation in 104 patients. Methods: 52 patients underwent Sono-Guided Endostripping and 52 patients had radiofrequency ablation with Celon Olympus device. They were followed for 3 months with physical examination and Doppler Sonography for possible complications and recanalization. Results: Recanalization rate was 11.5% in RFAs while it was 0.0% in the Endostripping group. There were no significant differences for other complications (hematoma, DVT, paresthesia) but pain, which had 1.21 and 3.15 VAS scores for RFA and Endostripping groups, respectively. Recanalization rate was more in RFA comparing with the Endostripping group (11.5% vs. 0.0%,?P?< 0.013). RFA was more expensive. Conclusion: Sono-Guided Endostripping is a safe and cost-effective method (due to no need for using RFA probe);however, the patient must be admitted to the hospital and take appropriate anesthesia. Cosmetic result of the technique is fairly comparable with RFA scars in the thigh and leg.

关键词： Catheter Ablation Saphenous Vein Surgical procedures Varicose Veins-Surgery

Physician-Rated Utility of Procedure Videos for Teaching procedures in the Emergency Department, Overall and during Emergency Department Crowding

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

International Journal of Clinical Medicine 2012年第7期3卷 758-764页

作者： Clare L. Atzema R. Alexandra Stefan Refik Saskin Greg Michlik Peter C. Austin Department of Emergency Services Sunnybrook Health Sciences Centre Toronto Canada Division of Emergency Medicine Department of Medicine University of Toronto Toronto Canada The Institute for Clinical Evaluative Sciences Toronto Canada

Background: Real-time use of procedure videos as educational tools has not been studied. We sought to determine whether viewing a video of a medical procedure prior to procedure performance in the emergency department improves the quality of teaching of procedures, and whether videos are particularly beneficial during periods of emergency department crowding. Methods: In this single-centre, prospective, before and after study standardized data collection forms were completed by both trainees and supervising emergency physicians (EPs) at the end of each emergency department shift in the before (August 2008-March 2009) and after (August 2009-March 2010) phase. Online procedure videos were introduced on emergency department computers in the after phase. The primary outcome measure was EP rating of the quality of teaching provided (5-point Likert scale). The interaction between crowding and videos was also assessed, to determine whether videos provide a specific additional benefit during periods of emergency department crowding. Results: There were 1159 procedures performed by 192 trainees. Median procedures performed per shift was 1.0 (IQR 0 - 2.0). Mean EP rating of teaching provided was significantly higher in the group that viewed videos, at 4.2 versus 3.7 (p 0.001). In the adjusted analysis, EP ratings increased by 0.5 with a video (p 0.001), while the odds of a score of 5.0 were 2.2 times greater if a video was viewed (p = 0.03). The interaction of crowding and procedure videos was not significant (the use of videos increased the average score by 0.24 in times of crowding compared to times of non-crowding, p = 0.19). Conclusions: Use of procedural videos was associated with EP perception of improved quality of teaching provided around procedures. While EPs rated the quality of their teaching as improved overall, the effect of videos on teaching quality was the same in crowded settings as it was in non-crowded setting.

关键词： Teaching Education procedures Emergency Department Video