简介：【摘要】 我国信息科技在最近几年得到了快速进步和完善，“医疗健康+互联网”工作的逐渐深入和推广，也促进了信息化建设在院前急救工作中的大力发展。在物联网、人工智能、大数据、云计算等技术的不断完善和更新，对于现代信息化的实际需求，传统移动网络模式已不能有效满足，5G网络这一新型移动网络技术应运而生。在院前急救工作中融入5G智能技术，不仅能让院前急救工作的信息化水平明显提高，而且能促进院内与院前的有效衔接，为人民群众提供更加高效和优质的急救服务，也是院前急救工作信息化建设今后发展的主要趋势。本文从院前急救的现状及5G技术的发展现状着手，分析了5G智能救护系统在院前急救中的应用情况。

简介：摘要：院前急救非常重要，通过及时对急危和重症患者急救，可有效保障患者生命安全。5G技术在医疗体系中应用，不但能加快医疗智慧化转型脚步，还能促进院前急救体系可得到优化与完善。本篇文章从5G技术应用出发，对于院前急救体系建构进行探讨，以供医疗领域参考。

简介：摘要C族链球菌(GCS)和G族链球菌(GGS)在生化反应、溶血特性、宿主物种、临床特性等方面与其他链球菌等不尽相同，人体分布上以皮肤、咽喉和女性泌尿生殖道较多见。GCS和GGS分类复杂，分类方法在过去几十年内不停地被纠正和修改。GCS和GGS暴发感染时环境因素所致可能性大，在致病力、细菌耐药特点、临床特点上与A族链球菌相似，可发生各种侵袭性感染，目前治疗仍首选青霉素。GCS和GGS的感染严重程度较其他链球菌更重。现就GCS与GGS的分类及临床特点进行阐述。

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简介：AbstractBackground:Intracranial aneurysm (IA) is a serious disease. Analyze and review the cases of anterior circulation ruptured IA by supraorbital lateral keyhole approach, and summarize the experiences of this approach.Methods:Retrospective analysis of 16 cases of ruptured anterior circulation IA in our department from January 2019 to June 2020, CT angiography (CTA) was performed before operation. Analyzing the IA's parameters by 3D-CT reconstruction. The IA was clipped by supraorbital lateral keyhole approach combined with the 3D-skull reconstruction. Extraventricular drainage was performed before craniotomy. Intraoperative neurophysiological monitoring was performed during the operation. After operation, fluorescein angiography and vascular ultrasound were performed to check the clipping effect. Intracranial pressure monitor was performed postoperatively. CTA was reexamined one week after operation. The modified Rankin Scale (MRS) was performed 6 months after operation.Results:There were 7 males (43.8%) and 9 females (56.2%), and the average age is 52.31 ± 11.12 years old. Among them, 11 patients (68.8%) were anterior communicating artery aneurysms and 5 (31.2%) were middle cerebral artery aneurysms. All patients were out of hospital within 10 days without any death, without cerebral infarction, cerebrospinal fluid leakage and neurological impairments. About mRS score, after 6 months follow-up, 8 cases (50%) had 0 point, 4 cases (25%) had 1 point, and 4 cases (25%) had 2 points.Conclusions:For ruptured anterior circulation IA, the supraorbital lateral keyhole approach combined with ventricular drainage, intraoperative electrophysiological monitoring, and intraoperative vascular ultrasound is a safe and minimally invasive treatment. The application of reconstruction clipping can reconstruct the diameter of parent vessel and reduce the recurrence rate of IA.

简介：AbstractBackground:The use of autologous free-tissue transfer is an increasingly utilized tool in the ladder of reconstructive options to preserve and restore function in patients with head and neck cancer. This article focuses on the evidence surrounding perioperative care that optimizes surgical outcomes and describes one tertiary center's approach to standardized free-flap care.Data Sources:This article examines English literature from PubMed and offers expert opinion on perioperative free-flap care for head and neck oncology.Conclusion:Free-flap reconstruction for head and neck cancer is a process that, while individualized for each patient, is best supported by a comprehensive and standardized care pathway. Surgical optimization begins in the preoperative phase and a thoughtful approach to intraprofessional communication and evidence-based practice is rewarded with improved outcomes.

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简介：【摘要】：院前急救是急诊患者临床救治中的重要环节之一，在急救护理时，医护人员需要尽快完善病史询问、体征检查等，从而协助临床救助，为后续院内急救提供支持。但是由于急诊患者突然发病，发病场所不固定，加上部分患者出现意识不清、语言障碍、昏迷等症状，医护人员很难获得患者相关信息，影响救治效率。院前急救护理流程的应用，可以提前做好急救准备，妥善安排救助措施，确保临床救治措施的有序开展，缩短急救时间，降低患者的死亡风险。文章主要针对院前急救护理流程在院前急救中的作用展开分析。

简介：AbstractPurpose:To retrospectively analyze the clinical outcomes of meniscus repair with simultaneous anterior cruciate ligament (ACL) reconstruction and explore the causes of failure of meniscus repair.Methods:From May 2013 to July 2018, the clinical data of 165 patients who were treated with meniscus surgery and simultaneous ACL reconstruction, including 69 cases of meniscus repair (repair group) and 96 cases of partial meniscectomy (partial meniscectomy group) were retrospectively analyzed. The exclusion criteria were as follows: (1) ACL rupture associated with fracture, collateral ligament injury, or complex ligament injury; (2) a history of knee surgery; or (3) a significant degree of osteoarthritis. The 69 patients in the repair group were divided into the non-failure group (62 cases) and the failure group (7 cases) depending on the repair effect. Postoperative outcomes of the repair group and the partial meniscectomy group were compared. General conditions and postoperative outcomes of the failure group and the non-failure group were compared. During the median follow-up period of 28 months (range, 4 - 65 months) after the second arthroscopy, postoperative outcomes of seven patients in the failure group were summarized. SPSS 25.0 statistical software was used for statistical analysis. A p value less than 0.05 was considered statistically significant.Results:Seven patients in the failure group who underwent the second arthroscopy were followed up for (30 ± 17.4) months and their postoperative outcomes were summarized. Compared with the partial meniscectomy group, the International Knee Documentation Committee scores of patients in the repair group improved significantly (p = 0.031). Compared with the non-failure group, more patients in the failure group were younger than 24 years (p = 0.030). The median follow-up period was 39.5 months. All patients recovered well after subsequent partial meniscectomy and relieved clinical symptoms. Visual analog scale scores decreased significantly (p = 0.026), and the International Knee Documentation Committee and Lysholm scores improved significantly (p = 0.046 for both).Conclusion:The failure rate of meniscus repair in this study was 10.1% (7/69), all of which were medial meniscus tears. However, the surgical outcomes of ACL reconstruction were not affected, and there might be a role for graft protection. Therefore, meniscus retears can be successful treated by performing subsequent partial meniscectomy in patients with repair failure.

简介：AbstractArthroscopic superior capsular reconstruction is an innovative technique for the irreparable rotator cuff tears, but spontaneous pneumothorax after surgery is very rare. The present case was a 66-year-old female with irreparable rotator cuff tears of the right shoulder, treated with the arthroscopic shoulder superior capsular reconstruction. The general anesthesia and operation went smoothly, but the patient experienced stuffiness in the chest and shortness of breath after recovery from anesthesia. Thoracic CT scans showed spontaneous pneumothorax in the right side, which was successfully treated by the conservative treatments (oxygen therapy) according to multidisciplinary team. Prompt and accurate early-stage diagnosis is necessary in controlling postoperative complications and standardized treatment is the key to relieve the suffering. Spontaneous pneumothorax after arthroscopic shoulder surgery has been rarely reported in previous literatures.

简介：AbstractBipolar clavicular dislocation is rare, and therefore its management is contentious. With an increase of patient’s physical demand and a near-normal shoulder function, there has been a shift in the paradigm of its management from a conservative one to a stabilized one of anatomical open reduction. Proposed methods of fixation have also evolved with the advent of more biological fixation devices, which elude implant or fixation related complications. This case report highlights the salient features of this rare case and details the management options along with the benefits of biological anatomical repair and reconstruction.

简介：摘要：目的 探讨院前急救护理模式在脑卒中患者院前急救中的影响。方法 选取2021.3~2022.3期间我院急诊科接收的50例脑卒中患者，根据来院方式的不同进行分组，对照组由家属送至急诊科，应用常规护理，研究组为120接诊，应用院前急救护理模式，观察两组救治成功率和致残率。结果 救治成功率：研究组更高（P＜0.05）；致残率：研究组更低（P＜0.05）。结论 脑卒中患者应用院前急救护理模式效果显著，可促使救治成功率得到有效提升，并可降低致残率。

简介：【摘要】目的：研究脑卒中患者院前急救中应用院前急救护理路径的效果。方法：根据护理方式的不同将我院2020年1月-2022年6月收治的80例脑卒中患者分为两组，对照组（40例）行常规护理，研究组（40例）行院前急救护理路径干预，观察比较两组护理效果。结果：研究组院前急救各环节所用时间均短于对照组，患者残疾率低于对照组（P0.05）。结论：院前急救护理路径可缩短院前急救时间，降低患者残疾风险。

简介：摘要：近年来，随着全球生态环境问题逐渐加深，人们对保护环境的重视度也逐渐提升。垃圾分类对实现社会可持续发展，改善自然生态环境有重要意义，也是推动社会经济高质量发展、全面改善环境质量的必然要求。对此，本文对垃圾分类对自然生态环境、社会经济、居民生活环境的影响为切入点，对垃圾分类的意义进行了探析。

简介：摘要我国目前尚缺乏针对援潜救生伤病员的分类救治系统。北约针对援潜救生过程中的伤病员情况进行分类救治。该分类系统基于病情危重程度，将疾病分为4类（T1、T2、T3和T4）；根据是否需要加压治疗，将疾病分为2类（C1和C2）。另外，将救治场地分为5个区：分类区、一级治疗区、二级治疗区、三级治疗区和T4治疗区。笔者基于前期援潜救生的教学体会，对该分类救治系统存在的问题提出一些建议，为后期制定我国援潜救生分类救治系统提供借鉴。

简介：AbstractSurgical stabilization of the flail chest is challenging and has no established guidelines. Chest wall integrity and stability are the main factors that ensure the protection of intrathoracic organs and an adequate respiratory function. Here, we report a novel chest wall reconstruction technique in a 45-year-old man with a traumatic left flail chest and open pneumothorax diagnosed both clinically and radiographically. Rib approximation and chest wall reconstruction was done using intercostal figure-of-eight suture and polypropylene mesh with vascularized musculofascial flap. The patient improved gradually and was discharged after three weeks of total hospital stay. He returned to regular working after a month with no evidence of respiratory distress or paradoxical chest movement. Follow-up visit at one year revealed no lung hernia or paradoxical chest movement. This is a novel, feasible and cost-effective modification of chest wall reconstruction that can be adopted for thoracic wall repair in case of open flail chest, which needs emergency surgical interventions even in resource constraint settings.

简介：AbstractObjective:As exclusively endoscopic endonasal resection of benign orbital tumors has become more widespread, high-quality outcomes data are lacking regarding the decision of when and how to reconstruct the medial orbital wall following resection. The goal of this study was to systematically review pertinent literature to assess clinical outcomes relative to orbital reconstruction practices.Methods:Data Sources: PubMed, EMBASE, Web of Science. A systematic review of studies reporting exclusively endoscopic endonasal resections of benign orbital tumors was conducted. Articles not reporting orbital reconstruction details were excluded. Patient and tumor characteristics, operative details, and outcomes were recorded. Variables were compared using χ2, Fisher's exact, and independent t tests.Results:Of 60 patients included from 24 studies, 34 (56.7%) underwent orbital reconstruction following resection. The most common types of reconstruction were pedicled flaps (n = 15, 44.1%) and free mucosal grafts (n = 11, 32.4%). Rigid reconstruction was uncommon (n = 3, 8.8%). Performance of orbital reconstruction was associated with preoperative vision compromise (P < 0.01). The tendency to forego orbital reconstruction was associated with preoperative proptosis (P < 0.001), larger tumor size (P = 0.001), and operative exposure of orbital fat (P < 0.001) and extraocular muscle (P= 0.035). There were no statistically significant differences between the reconstruction and nonreconstruction groups in terms of short- or long-term outcomes when considering all patients. In patients with intraconal tumors, however, there was a higher rate of short-term postoperative diplopia when reconstruction was foregone (P = 0.041). This potential benefit of reconstruction did not persist: At an average of two years postoperatively, all patients for whom reconstruction was foregone either had improved or unchanged diplopia.Conclusion:Most outcomes assessed did not appear affected by orbital reconstruction status. This general equivalence may suggest that orbital reconstruction is not a necessity in these cases or that the decision to reconstruct was well-selected by surgeons in the reported cases included in this systematic review.

简介：摘要：微信公众号作为现代生产、生活活动中必不可少的信息化工具，其多种强大的传播功能，不但帮助人们提升了工作效率，也简化了信息传播的途径，进一步改善了传播的效果。健康科普传播中应用微信公众号，不但可以解决信息传播针对性的问题，同时也可以提升科普传播覆盖面，进一步满足不同人群对健康科普的需求。本文首先介绍了微信公众号应用于健康科普的功能，其次分析了应用中的现状与问题，最后则进一步提出了未来微信公众号应用中的展望，希望可以进一步改善健康科普传播效果，为提升社会公共医疗卫生服务水平创造良好的条件。

简介：摘要：目的：分析研究项目管理在规范院前急救中的应用效果。方法:成立项目管理小组，由医疗办，急诊科医生，护士，物管，车队共同组成。通过现状把握，拟定对策、原因分析、目标设定、对策实施及效果评价等程序，开展项目管理活动，研究中选取2021年01月至04月院前急救质量作为对照组，2021年05月至08月院前急救质量作为观察组，对两组数据中的重点优化项目进行比较。结果:观察组院前急救超4min出车、车载设备不齐全及超20min未到达现场未上报发生率同对照组相比均明显下降。结论:在院前急救当中实施项目管理的效果可观，其有利于提升院前急救响应率，为救治患者争取到更多的时间，同时提供展示自我才能的平台，极大地体现了个人价值，加强团队的凝聚力，提升科室的工作效率。

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