简介：摘要Background and objectivesIn many patients after stroke, spasticity develops over time, resulting in a decrease in the patient′s independence, pain, worsening mood, and, consequently, lower quality of life. In the last ten years, a rich arsenal of physical agents to reduce muscle tone such as extracorporeal shock therapy (ESWT) wave has come through. The aim of this narrative review article is to present the current state of knowledge on the use of ESWT as a supplement to the comprehensive rehabilitation of people after stroke suffering from spasticity.MethodsThe PubMed and PEDro databases were searched for papers published in English from January 2000 to December 2020, 22 of which met inclusion criteria for clinical studies related to post-stroke spasticity management with ESWT.ResultsA total of 22 studies including 468 post-stroke patients-11 reports with the upper limb (267 patients) and 10 reports within the lower limb (201 patients), as well as one report including both upper and lower limb. We focused our attention on clinical and methodological aspects. Therefore, we performed the assessment of enrolled studies in terms of methodological quality using the PEDro and level of evidence using the National Institute for Health and Clinical Excellence (NICE) guidelines. Furthermore, we indicated implications for clinical practice in using ESWT for post-stroke spasticity management. Moreover, we discussed a suggestion for future research directions.ConclusionsIn conclusion, an ESWT effectively reduces muscle tone in people with spastic limb after stroke. Further, ESWT is safe and free of undesirable side effects.The mechanism of action of ESWT on muscles affected by spasticity is still unknown.To date, no standard parameters of ESWT in post-stroke spasticity regarding intensity, frequency, location, and the number of sessions has been established. Further research, meeting the highest standards, is needed to establish uniform muscle stimulation parameters using ESWT.

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简介：AbstractBackground:Nasal insertion is the preferred method for non-intubated patients in flexible bronchoscopy; however, the relatively narrow nasal cavity results in difficulties related to bronchoscope insertion. This study aimed to investigate whether pre-operative nasal probe tests could reduce the time to pass the glottis, improve the first-pass success rate and patients’ tolerance, and reduce postoperative bleeding.Methods:This three-arm prospective randomized controlled trial was conducted in a tertiary hospital between May and October 2020. Three hundred patients requiring diagnosis and treatment using flexible bronchoscopy were randomly allocated to three groups: control group, simple cotton bud detection group (CD group), and adrenaline + lidocaine detection group (AD group). The primary outcome was the time to pass the glottis. Secondary outcomes included the first-pass success rate, the patients’ tolerance scores, and post-operative bleeding. One-way analysis of variance, Kruskal-Wallis H test, Chi-squared test, Fisher’s exact test, and Bonferroni’s multiple comparison tests were used in this study.Results:In total, 189 men and 111 women were enrolled in this study, with a mean age of 55.72 ± 12.86 years. The insertion time was significantly shorter in the AD group than in the control group (18.00 s [12.00–26.50 s] vs. 24.00 s [14.50–45.50 s], P = 0.005). Both the AD (99% vs. 83%, χ2 = 15.62, P < 0.001) and CD groups (94% vs. 83%, χ2 = 5.94, P = 0.015) had a significantly higher first-pass success rate than the control group. Compared with the control group, post-operative bleeding (1% vs. 13%, χ2 = 11.06, P < 0.001) was significantly lower in the AD group. However, no significant difference was found in the patients’ tolerance scores.Conclusions:Pre-operative nasal cavity probe tests especially with adrenaline and lidocaine during flexible bronchoscopy can significantly reduce the time to pass the glottis, improve the first-pass success rate, and reduce post-operative nasal bleeding. Pre-operative nasal probe tests are recommended as a time-saving procedure for patients undergoing flexible bronchoscopy.Trial registration:Chinese Clinical Trial Registry (ChiCTR), ChiCTR2000032668; http://www.chictr.org.cn/showprojen.aspx?proj=53321.

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简介：摘要ObjectivesThe purpose of this systematic review and meta-analysis is to evaluate the long-term efficacy of Extracorporeal Shock Wave Therapy (ESWT) on reducing lower limb post-stroke spasticity in adults.MethodsA systematic electronic search of PubMed/ MEDLINE, Physiotherapy Evidence Database (PEDro), Scopus, Ovid MEDLINE(R), and search engine of Google Scholar was performed. Publications that ranged from January 2010 to August 2020, published in English, French, Spanish, Portuguese, and Italian language and available as full texts were eligible for inclusion and they were searched without any restrictions of country. The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and followed the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions. Two authors screened the references, extracted data, and assessed the risk of bias. The primary outcome was spasticity grade mainly assessed by the Modified Ashworth Scale (MAS). Secondary outcomes were passive range of motion (PROM), pain intensity, electrophysiological parameters, gait assessment, and adverse events.ResultsA total of seven recent randomized controlled trials (RCTs) were included in the systematic review and meta-analysis, and a beneficial effect on spasticity was found. The high level of evidence presented in this paper showed that ESWT ameliorates spasticity considering the parameters: MAS: standardized mean difference (SMD)＝0.53; 95% confidence interval (95% CI): (0.07-0.99); Modified Tardieu Scale (MTS): SMD＝0.56; 95% CI: (0.01-1.12); Visual Analogue Scale (VAS): SMD＝0.35; 95% CI: (-0.21-0.91); PROM: SMD＝0.69; 95% CI: (0.20-1.19).ConclusionsESWT presented long-term efficacy on lower limb post-stroke spasticity, reduced pain intensity, and increased range of motion. The effect of this novel and non-invasive therapy was significant and the intervention did not present adverse events, proving a satisfactory safety profile.

简介：AIMTo由高分辨率的Placido基于磁盘的地形学把测量的重覆性/重制度与一个高分辨率的旋转Scheimpflug照相机的作比较并且在与keratoconus在眼睛测量角膜的力量估计在二台仪器之间的协议并且在situkeratomileusis(LASIK)激光以后.METHODSOne眼睛每经历了的36个keratoconic病人和20个题目LASIK在这未来的观察研究被包括。二个独立检查人在一份随机的订单工作了与两台仪器拿每只眼睛的三大小。四个参数在前面的角膜上被测量：陡峭的角膜散光计(K)，扁平的角膜散光计(Kf)，吝啬的角膜散光计(Km)，和散光(Ks-Kf)。Intra检查人重覆性和内部检查人的重制度被计算在内题目标准差(Sw)评估重覆性(R)，变化(CoV)的系数，和intraclass关联系数(国际计算中心)的系数。在仪器之间的同意被计算.RESULTSInkeratoconic眼睛，intra检查人和内部检查人的国际计算中心是的同意(95%LoA)的95%限制与Bland-Altman方法测试>0.95。作为与由高分辨率的Placido基于磁盘的地形学的测量相比，高分辨率的旋转Scheimpflug照相机的intra检查人R是更低的为Kf(0.32对0.88)，K(0.61对0.88)，和Km(0.32对0.84)但是为Ks-Kf(0.70对0.57)更高。内部检查人的R值为用高分辨率的旋转Scheimpflug照相机测量的所有参数是更低的。95%LoA是到为Kf，到为K的+0.99的-1.36，到为Km的+0.50的-1.08，和到为Ks-Kf的+1.48的-1.11的+0.55的-1.28。在post-LASIK眼睛，intra检查人和内部检查人的国际计算中心是>0.87为所有参数。intra检查人和内部检查人的R为用高分辨率的旋转Scheimpflug照相机测量的所有参数是更低的。intra检查人R为Kf是0.17对0.88，0.21对0.88为K，0.17对0.86为Km，并且0.28对0.33为Ks-Kf。内部检查人的R为Kf是0.09对0.64，0.15对0.56为K，0.09对0.59为Km�

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简介：Nutrient-poor,sandysoilsformtheprevailingsubstrateatpost-miningsitesoftheLusatianregion(Brandenburg,Germany)andpresentachallengeforvegetationdevelopment.Westudiedtheorganicacidquantityandcompositionofthreecommonlyoccurringpioneerplantspecies,thelegumesLotuscorniculatusL.andTrifoliumarvenseL.andthegrassCalamagrostisepigeios(L.)Roth,todetermineifplantgrowthandexudationdifferedwith(non-sterilizedsoil)andwithout(sterilizedsoil)anindigenoussoilmicrobialcommunity.Weinvestigatedwhetherorganicacidswerefoundintherhizosphereandsurroundingsoilandwhetherthisinfluencednutrientmobilization.Thisstudyconsistsoflinkedfieldinvestigationsandagreenhouseexperiment.Plantsweregrowninthegreenhouseineithersterilizedornon-sterilizedsandysoilfromareclamationsiteintheLusatianmininglandscape(WelzowSu¨d,EastGermany).Aftersevenmonths,theplantbiomass,rootmorphology,organicacids,andwater-solublenutrientsandrootcolonizationwitharbuscularmycorrhizalfungi(AMF)anddarkseptateendophytes(DSE)wereanalyzed.RootsofallthreeplantsinthefieldandgreenhouseexperimentswerehighlycolonizedwithAMF.CalamagrostisepigeiosandT.arvensehadasignificantlyhighercolonizationfrequencywithDSEthanL.corniculatus.Thequantityandcompositionoforganicacidsstronglydifferedamongplantspecies,withthehighestnumberoforganicacidsfoundforL.corniculatusandlowestforC.epigeios.Thequantityoforganicacidswasgreatlyreducedinallplantsundersterilizedsoilconditions.However,thecompositionoforganicacidsandplantgrowthinsterilizedsoilwerereducedforbothlegumes,butnotforC.epigeios,whichhadahigherbiomassundersterilizedconditions.Changesinnutrientconcentrationsinthefieldrhizospheresoilrelativetothoseinthecontrolweremeasurableaftersevenmonths.Whilethespectrumoforganicacidsandthegrowthoflegumesseemedtobedependentonahighly

简介：Objective:Toclarifytheprognosticvalueofpost-treatment18F-fluorodeoxyglucose(FDG)positronemissiontomography(PET)/computedtomography(CT)inpatientswithadvancedheadandnecksquamouscellcarcinoma(HNSCC)aftercombinedintra-arterialchemotherapyandradiotherapy(IACR).Methods:Thirty-sixpatientswithHNSCCwhounderwentIACRwererecruited.TheperiodfromtheendofIACRtothelastpost-treatment18F-FDGPET/CTexaminationwas8-12weeks.Bothpatient-basedandlesion-basedanalyseswereusedtoevaluatethePET/CTimages.Forlesion-basedanalysis,36regions(12lesionsofrecurrencesand24scarsatprimarysites)wereselected.TheKaplan-Meiermethodwasusedtoassesstheoverallsurvival(OS)stratifiedby18F-FDGuptakeorvisualinterpretationresults.Results:TwelvepatientswithrecurrencewereidentifiedbysixmonthsafterIACR.Thesensitivityandspecificityinthepatient-basedanalysiswere67%(8/12)and88%(21/24),respectively.ThemeanOSwasestimatedtobe12.1months(95%CI,6.3-18.0months)forthehighermaximumstandardizeduptakevalue(SUVmax)group(n=7)and44.6months(95%CI,39.9-49.3months)forthelowerSUVmaxgroup(n=29).OSinthehigherSUVmaxgroup(cut-offpoint,6.1)orpositivevisualinterpretationgroupwassignificantlyshorterthanthatinthelowerSUVmaxornegativevisualinterpretationgroup(P<0.001andP<0.05,respectively).Conclusions:TheSUVmaxandvisualinterpretationofHNSCConpost-IACR18F-FDGPET/CTcanprovideprognosticsurvivalestimates.

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简介：摘要BACKGROUNDPatients with COVID-19 or post-COVID-19 will most probably have a need for rehabilitation during and directly after the hospitalisation. Data on safety and efficacy are lacking. Healthcare professionals cannot wait for published randomised controlled trials before they can start these rehabilitative interventions in daily clinical practice, as the number of post-COVID-19 patients increases rapidly. The Convergence of Opinion on Recommendations and Evidence process was used to make interim recommendation for the rehabilitation in the hospital and post-hospital phase in COVID-19 and post-COVID-19 patients, respectively.METHODS93 experts were asked to fill out 13 multiple choice questions. Agreement of directionality was tabulated for each question. At least 70% agreement on directionality was necessary to make consensus suggestions.RESULTS76 experts (82%) reached consensus on all questions based upon indirect evidence and clinical experience on the need for early rehabilitation during the hospital admission, the screening for treatable traits with rehabilitation in all patients at discharge and 6-8 weeks after discharge, and around the content of rehabilitation for these patients. It advocates for assessment of oxygen needs at discharge and more comprehensive assessment of rehabilitation needs including physical as well as mental aspects 6-8 weeks after discharge. Based on the deficits identified multidisciplinary rehabilitation should be offered with attention for skeletal muscle and functional as well as mental restoration.CONCLUSIONSThis multinational task force recommends early, bedside rehabilitation for patients affected by severe COVID-19. The model of pulmonary rehabilitation may suit as a framework, particularly in a subset of patients with long term respiratory consequences.

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简介：High-performancethin-filmtransistors(TFTs)withalowthermalbudgetarehighlydesiredforflexibleelectronicapplications.Inthiswork,theTFTswithatomiclayerdepositedZnO-channel/Al_2O_3-dielectricarefabricatedunderthemaximumprocesstemperatureof200℃.First,weinvestigatetheeffectofpost-annealingenvironmentsuchasN_2,H_2-N_2(4%)andO_2onthedeviceperformance,revealingthatO_2annealingcangreatlyenhancethedeviceperformance.Further,wecomparetheinfluencesofannealingtemperatureandtimeonthedeviceperformance.Itisfoundthatlongannealingat200℃isequivalenttoandevenoutperformsshortannealingat300℃.ExcellentelectricalcharacteristicsoftheTFTsaredemonstratedafterO_2annealingat200℃for35min,includingalowoff-currentof2.3×10~(-13)A,asmallsub-thresholdswingof245mV/dec,alargeon/offcurrentratioof7.6×10~8,andahighelectroneffectivemobilityof22.1cm~2/V·s.Undernegativegatebiasstressat—10V,theabovedevicesshowbetterelectricalstabilitiesthanthosepost-annealedat300℃.Thusthefabricatedhigh-performanceZnOTFTwithalowthermalbudgetisverypromisingforflexibleelectronicapplications.

简介：ThisstudyreportszirconU-PbandHfisotopesandwhole-rockelementaldataforgranodioritesfromtheEastKunlunorogen.ThezirconU-Pbdatingdefinestheircrystallizationageof235Ma.Therocksarecharacterizedbyhigh-Kcalc-alkaline,magnesianandmetaluminouswith（K2O+Na2O）=6.38wt.%–7.01wt.%,Mg#=42–50[Mg#=100×molarMg/（Mg+FeOT）],A/CNK=0.92–0.98,coupledwithhighεHf（t）valuesfrom-0.65to-1.80.Therockswerederivedfrompartialmeltingofajuvenilemaficcrustalsourcewithinnormalcrustthickness.Thejuvenilelowercrustwasgeneratedbymixinglithosphericmantle-derivedmelt（55%–60%）andsupracrustalmelt（40%–45%）duringtheseafloorsubduction.TogetherwithavailabledatafromtheEastKunlun,itisproposedthatthestudiedMiddleTriassicgranodioriteswereformedinpost-collisionalextensionsetting,inwhichmeltingofthejuvenilelowercrustinresponsetothebasalticmagmaunderplatingresultedintheproductionofhigh-Kgranodioriticmelts.

简介：随着高清时代的到来,电视节目无论从视觉上还是听觉上都有了比以往更大的表现空间,粗编节目精编化,精编节目包装化,包装节目精品化。这就对电视节目制作的工艺水平提出了更高的要求。与此同时,留给后期制作的时间却越来越紧迫，

简介：摘要BACKGROUNDCorona Virus Disease-2019 (COVID-19) pandemic is quickly spreading, putting under heavy stress health systems worldwide and especially Intensive Care Units (ICU). Rehabilitation Units have a crucial role in reducing disability in order to reintroduce patients in the community.OBJECTIVETo characterize pulmonary function and disability status and to propose an early rehabilitation protocol in a cohort of post-acute COVID-19 patients admitted to an Italian Rehabilitation Unit.METHODSDemographic, anamnestic and clinical characteristics, laboratory exams and medical imaging findings were collected for the entire cohort. Outcome measures evaluated at the admission in Rehabilitation Unit were: type of respiratory supports needed, fraction of inspired oxygen (FIO2), partial pressure of oxygen (PaO2), FIO2/PaO2, Barthel Index (BI), modified Medical Research Council (mMRC) Dyspnoea Scale, and 6-Minute Walking Test (6-MWT). Furthermore, we proposed an early rehabilitation protocol for COVID-19 patients based on baseline FiO2.RESULTSWe included 32 post-acute COVID-19 patients (22 male and 10 female), mean aged 72.6±10.9 years. BI was 45.2±27.6, with patients in need of higher FIO2 (≥ 40%) showing lower values: 39.6±25.7 vs 53.3±29.3. All patients had grade 4 or 5 on the mMRC Dyspnoea Scale. Only 14 COVID-19 patients were able to walk (43.7%). 6-MWT was feasible in 6 (18.8%) patients with a mean distance of 45.0±100.6 meters.CONCLUSIONSTaken together, our findings suggest that post-acute COVID-19 patients suffered from dyspnoea and shortness of breath even for minimal activities, with a resulting severe disability, and only a few of them were able to perform 6-MWT with poor results. An early rehabilitation protocol was proposed according to the baseline conditions of the patients.

简介：摘要: 2019年末，突然暴发的新冠肺炎疫情暴露出我国医疗基础设施严重不足、重大突发公共卫生事件应急体系不健全、医疗救治服务能力较弱等问题，对公立医院建筑未来的转变和发展持续受到社会关注。“新基建”的本质特征对我国公立医院基础设施建设发展趋势进行分析，通过BIM 技术在方舱医院的设计阶段、生产阶段、施工阶段的具体应用进行阐述。实现5G绿色智慧医院将趋势融入到医院建设发展中，打造三位一体的新型智慧型医院。提出方舱医院在人性化设计、快捷转换、“平疫结合”和模块化设计等方面的方法。

简介：摘要:新冠肺炎疫情爆发以来,到目前为止基本已经进入常态化趋势,后疫情表示疫情正处于起伏阶段,同样具有潜在危险性,作为这场无硝烟战争的战时青年力量,高校大学生时刻备受关注。融媒体环境下如何突破传统教育模式的思维定式,通过创新教育方法,在后疫情时代引领学生正确思想,发挥教育最大化,都成了不可避免的问题。本研究在后疫情时代的高校思政中结合融媒体为着力点探寻新的路径并提出相关方法,希望为后疫情下高校思政教学体系的完善提供相关参考,使高校思政教育焕发新的生机与活力。