BACKGROUND Type 1 diabetes is one of the most common chronic diseases in childhood.The number of type 1 diabetes patients in China still ranks fourth in the world.Therefore,children with type 1 diabetes in China are a...BACKGROUND Type 1 diabetes is one of the most common chronic diseases in childhood.The number of type 1 diabetes patients in China still ranks fourth in the world.Therefore,children with type 1 diabetes in China are a group that needs attention.The management of type 1 diabetes mellitus(T1DM)involves many aspects of daily life.It is extremely challenging for children and their families.T1DM children have complex medical care needs.Despite the continuous development of therapeutic medicine and treatment technologies,blood glucose control in children with T1DM is still not ideal.They and their parents need to acquire more knowledge and skills before being discharged.AIM To explore the influence of hospital discharge plan based on parental care needs of children with T1DM on discharge readiness,quality of discharge education and blood glucose control level.METHODS In total,102 parents of children with type 1 diabetes were divided into control group and intervention group according to admission time.Fifty cases from February to June 2019 were selected as the control group,and 52 cases from July to October 2019 were selected as the intervention group to implement the discharge plan.The Readiness for Hospital Discharge Scale,Hospital Discharged Education Quality Scale and children's blood glucose metabolism indicators were used to compare the differences in discharge preparation,discharge education quality and blood glucose control between the two groups of children and their parents.RESULTS On the day of discharge,the two groups of children had the following scores of readiness for discharge:The intervention group score was 225.34±32.47,and the control group score was 208.68±29.31.The P value was 0.007,and the difference was statistically significant.The discharge education quality scores were as follows:The intervention group score was 135.11±19.86,the control group score was 124.13±15.56,the P value was 0.002 and the difference was statistically significant.Three months after discharge,the blood glucose metaboli展开更多
<div style="text-align:justify;"> <strong>Objective</strong>: The work aimed to describe the etiological and evolutionary aspects of cardiogenic shock in the intensive care unit of the card...<div style="text-align:justify;"> <strong>Objective</strong>: The work aimed to describe the etiological and evolutionary aspects of cardiogenic shock in the intensive care unit of the cardiology department (USIC) of the G-spot hospital in Bamako,<span "=""> Mali. <b>Materials and Methods</b></span><span "="">: This was a descriptive cross-sectional study from January 1, 2018 to April 30, 2019 that included all patients admitted to the USIC during this period. Each patient benefited from individual data support with systematic recording of socio-demographic, clinical, complementary and therapeutic data and analyzed with the SOFTWARE SPSS 20.0 French version. <b>Results</b>: The study involved 40 patients out of 311 patients hospitalized in USIC, representing a hospital frequency of 12.86%. Males were the most affected (60%) with a sex ratio of 1.50. The modal class was 41</span> - 60 years with extremes at 18 years and 89 years. Cardiovascular risk factors were dominated by HTA (27.50%), diabetes and tobacco, each with 22.50%. The general signs were tachycardia (90%), oxygen desaturation (77.50%), impregnable blood pressure (62.50%), agitation (52.50%) and an oliguria (70%). At the electrocardiogram the rhythm was sinus (80%), it was an atrial fibrillation (15%), a ventricular tachycardia (10%) and signs of coronary ischemia (necrosis in 35% and ST over shifted in 20% of cases). At cardiac doppler ultrasound,the left ventricle was dilated (50%), the right cavities dilated (30%), segmental kinetic disorder (40%), the left ventricular systolic function (FEVG) impaired (75%) and valve disease (10%). Biology noted hyper-creatinemia (65%), hyper-glycemia (12.50%), anemia and hyponatremia with 20% frequency each. Among etiology,<span "=""> ischemic heart disease accounted for 57.50% followed by pulmonary embolism 20%, dilated valve cardiomyopathy 7.50% and chronic pulmonary heart 2.50%. The trend in the majority of cases was unfavorable with 60% of deaths. Chronic pulmonary heart and pulmonary embolism were the deadliest with a frequency of 100% and 87.50% respectively. <b>Conclusion</b>: Cardiogenic shock is an infrequent condition with a high mortality of a prognosis. Ischemic heart disease is the most common etiology of the disease</span>. </div>展开更多
BACKGROUND Spinal metastases are common in patients with malignancies,but studies on those metastasized from unknown primaries are scarce due to the difficulty in treatment and the relatively poor prognosis.Knowledge ...BACKGROUND Spinal metastases are common in patients with malignancies,but studies on those metastasized from unknown primaries are scarce due to the difficulty in treatment and the relatively poor prognosis.Knowledge of surgical complications,particularly perioperative mortality,in patients with spinal metastases from unidentified sources is still insufficient.CASE SUMMARY A 54-year-old man with chest-back pain was diagnosed with spinal metastasis in the seventh thoracic vertebra(T7).Radiographic examinations,as well as needle biopsy and immunohistochemical tests were performed to verify the characteristics of the lesion,resulting in an inconclusive diagnosis of poorly differentiated cancer from an unknown primary lesion.Therefore,spinal surgery was performed using the posterior approach to relieve symptoms and verify the diagnosis.Postoperative histologic examination indicated that this poorly differentiated metastatic cancer was possibly sarcomatoid carcinoma.As the patient experienced unexpectedly fast progression of the disease and died 16 d after surgery,the origin of this metastasis was undetermined.We discuss this case with respect to reported perioperative mortality in similar cases.CONCLUSION A comprehensive assessment prior to surgical decision-making is essential to reduce perioperative mortality risk in patients with spinal metastases from an unknown origin.展开更多
With the increasing demands of health care,the design of hospital buildings has become increasingly demanding and complicated.However,the traditional layout design method for hospital is labor intensive,time consuming...With the increasing demands of health care,the design of hospital buildings has become increasingly demanding and complicated.However,the traditional layout design method for hospital is labor intensive,time consuming and prone to errors.With the development of artificial intelligence(AI),the intelligent design method has become possible and is considered to be suitable for the layout design of hospital buildings.Two intelli-gent design processes based on healthcare systematic layout planning(HSLP)and generative adversarial network(GAN)are proposed in this paper,which aim to solve the generation problem of the plane functional layout of the operating departments(ODs)of general hospitals.The first design method that is more like a mathemati-cal model with traditional optimization algorithm concerns the following two steps:developing the HSLP model based on the conventional systematic layout planning(SLP)theory,identifying the relationship and flows amongst various departments/units,and arriving at the preliminary plane layout design;establishing mathematical model to optimize the building layout by using the genetic algorithm(GA)to obtain the optimized scheme.The specific process of the second intelligent design based on more than 100 sets of collected OD drawings includes:labelling the corresponding functional layouts of each OD plan;building image-to-image translation with conditional ad-versarial network(pix2pix)for training OD plane layouts,which is one of the most representative GAN models.Finally,the functions and features of the results generated by the two methods are analyzed and compared from an architectural and algorithmic perspective.Comparison of the two design methods shows that the HSLP and GAN models can autonomously generate new OD plane functional layouts.The HSLP layouts have clear functional area adjacencies and optimization goals,but the layouts are relatively rigid and not specific enough.The GAN outputs are the most innovative layouts with strong applicability,but the dataset has strict con展开更多
文摘BACKGROUND Type 1 diabetes is one of the most common chronic diseases in childhood.The number of type 1 diabetes patients in China still ranks fourth in the world.Therefore,children with type 1 diabetes in China are a group that needs attention.The management of type 1 diabetes mellitus(T1DM)involves many aspects of daily life.It is extremely challenging for children and their families.T1DM children have complex medical care needs.Despite the continuous development of therapeutic medicine and treatment technologies,blood glucose control in children with T1DM is still not ideal.They and their parents need to acquire more knowledge and skills before being discharged.AIM To explore the influence of hospital discharge plan based on parental care needs of children with T1DM on discharge readiness,quality of discharge education and blood glucose control level.METHODS In total,102 parents of children with type 1 diabetes were divided into control group and intervention group according to admission time.Fifty cases from February to June 2019 were selected as the control group,and 52 cases from July to October 2019 were selected as the intervention group to implement the discharge plan.The Readiness for Hospital Discharge Scale,Hospital Discharged Education Quality Scale and children's blood glucose metabolism indicators were used to compare the differences in discharge preparation,discharge education quality and blood glucose control between the two groups of children and their parents.RESULTS On the day of discharge,the two groups of children had the following scores of readiness for discharge:The intervention group score was 225.34±32.47,and the control group score was 208.68±29.31.The P value was 0.007,and the difference was statistically significant.The discharge education quality scores were as follows:The intervention group score was 135.11±19.86,the control group score was 124.13±15.56,the P value was 0.002 and the difference was statistically significant.Three months after discharge,the blood glucose metaboli
文摘<div style="text-align:justify;"> <strong>Objective</strong>: The work aimed to describe the etiological and evolutionary aspects of cardiogenic shock in the intensive care unit of the cardiology department (USIC) of the G-spot hospital in Bamako,<span "=""> Mali. <b>Materials and Methods</b></span><span "="">: This was a descriptive cross-sectional study from January 1, 2018 to April 30, 2019 that included all patients admitted to the USIC during this period. Each patient benefited from individual data support with systematic recording of socio-demographic, clinical, complementary and therapeutic data and analyzed with the SOFTWARE SPSS 20.0 French version. <b>Results</b>: The study involved 40 patients out of 311 patients hospitalized in USIC, representing a hospital frequency of 12.86%. Males were the most affected (60%) with a sex ratio of 1.50. The modal class was 41</span> - 60 years with extremes at 18 years and 89 years. Cardiovascular risk factors were dominated by HTA (27.50%), diabetes and tobacco, each with 22.50%. The general signs were tachycardia (90%), oxygen desaturation (77.50%), impregnable blood pressure (62.50%), agitation (52.50%) and an oliguria (70%). At the electrocardiogram the rhythm was sinus (80%), it was an atrial fibrillation (15%), a ventricular tachycardia (10%) and signs of coronary ischemia (necrosis in 35% and ST over shifted in 20% of cases). At cardiac doppler ultrasound,the left ventricle was dilated (50%), the right cavities dilated (30%), segmental kinetic disorder (40%), the left ventricular systolic function (FEVG) impaired (75%) and valve disease (10%). Biology noted hyper-creatinemia (65%), hyper-glycemia (12.50%), anemia and hyponatremia with 20% frequency each. Among etiology,<span "=""> ischemic heart disease accounted for 57.50% followed by pulmonary embolism 20%, dilated valve cardiomyopathy 7.50% and chronic pulmonary heart 2.50%. The trend in the majority of cases was unfavorable with 60% of deaths. Chronic pulmonary heart and pulmonary embolism were the deadliest with a frequency of 100% and 87.50% respectively. <b>Conclusion</b>: Cardiogenic shock is an infrequent condition with a high mortality of a prognosis. Ischemic heart disease is the most common etiology of the disease</span>. </div>
基金National Natural Science Foundation of China,No.81702662.
文摘BACKGROUND Spinal metastases are common in patients with malignancies,but studies on those metastasized from unknown primaries are scarce due to the difficulty in treatment and the relatively poor prognosis.Knowledge of surgical complications,particularly perioperative mortality,in patients with spinal metastases from unidentified sources is still insufficient.CASE SUMMARY A 54-year-old man with chest-back pain was diagnosed with spinal metastasis in the seventh thoracic vertebra(T7).Radiographic examinations,as well as needle biopsy and immunohistochemical tests were performed to verify the characteristics of the lesion,resulting in an inconclusive diagnosis of poorly differentiated cancer from an unknown primary lesion.Therefore,spinal surgery was performed using the posterior approach to relieve symptoms and verify the diagnosis.Postoperative histologic examination indicated that this poorly differentiated metastatic cancer was possibly sarcomatoid carcinoma.As the patient experienced unexpectedly fast progression of the disease and died 16 d after surgery,the origin of this metastasis was undetermined.We discuss this case with respect to reported perioperative mortality in similar cases.CONCLUSION A comprehensive assessment prior to surgical decision-making is essential to reduce perioperative mortality risk in patients with spinal metastases from an unknown origin.
基金the Scientific Research Project of Shanghai Science and Technology Commission(No.18DZ1205603)the Science Research Plan of Shanghai Municipal Science and Technology Committee(No.20DZ1201300)the National Key Research and Development Program of China(No.2017YFC0806100)。
文摘With the increasing demands of health care,the design of hospital buildings has become increasingly demanding and complicated.However,the traditional layout design method for hospital is labor intensive,time consuming and prone to errors.With the development of artificial intelligence(AI),the intelligent design method has become possible and is considered to be suitable for the layout design of hospital buildings.Two intelli-gent design processes based on healthcare systematic layout planning(HSLP)and generative adversarial network(GAN)are proposed in this paper,which aim to solve the generation problem of the plane functional layout of the operating departments(ODs)of general hospitals.The first design method that is more like a mathemati-cal model with traditional optimization algorithm concerns the following two steps:developing the HSLP model based on the conventional systematic layout planning(SLP)theory,identifying the relationship and flows amongst various departments/units,and arriving at the preliminary plane layout design;establishing mathematical model to optimize the building layout by using the genetic algorithm(GA)to obtain the optimized scheme.The specific process of the second intelligent design based on more than 100 sets of collected OD drawings includes:labelling the corresponding functional layouts of each OD plan;building image-to-image translation with conditional ad-versarial network(pix2pix)for training OD plane layouts,which is one of the most representative GAN models.Finally,the functions and features of the results generated by the two methods are analyzed and compared from an architectural and algorithmic perspective.Comparison of the two design methods shows that the HSLP and GAN models can autonomously generate new OD plane functional layouts.The HSLP layouts have clear functional area adjacencies and optimization goals,but the layouts are relatively rigid and not specific enough.The GAN outputs are the most innovative layouts with strong applicability,but the dataset has strict con