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  • 简介:AbstractThroughout the past 2020, the pandemic COVID-19 has caused a big global shock, meanwhile it brought a great impact on the public health network. Trauma emergency system faced a giant challenge and how to manage trauma under the pandemic of COVID-19 was widely discussed. However, the trauma treatment of special population (geriatric patients and patients taking anticoagulant drugs) has received inadequate attention. Due to the high mortality following severe traumatic hemorrhage, hemostasis and trauma-induced coagulopathy are the important concerns in trauma treatment. Sepsis is another topic should not be ignored when we talking about trauma. COVID-19 itself is a special kind of sepsis, and it may even be called as serious systemic infection syndrome. Sepsis has been become a serious problem waiting to be solved urgently no matter in the fields of trauma, or in intensive care and infection, etc. This article reviewed the research progress in areas including trauma emergency care, trauma bleeding and coagulation, geriatric trauma and basic research of trauma within 2020.

  • 标签: Trauma COIVD-19 Trauma-induced coagulopathy Sepsis Geriatric trauma
  • 简介:摘要: 零信任安全防护架构作为成熟及领先的安全解决方案,可以对C/S和B/S业务系统进行有效防护。在业务访问过程中,借助单包认证、动态授权、身份权限最小化等手段,面向C/S和B/S业务系统提供针对性的解决方案。本文对基于零信任安全架构下的C/S和B/S业务系统防护方式进行分析,并研究不同方式的优劣。

  • 标签: 零信任 SDP 安全边界 网络隐身 单包认证
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  • 简介:AbstractObjectives:Describe the h index as a bibliometric that can be utilized to objectively evaluate scholarly impact. Identify which otolaryngology subspecialties are the most scholarly. Describe if NIH funding to one’s choice of medical school, residency, or fellowship has any impact on one’s scholarly output. Determine other factors predictive of an academic otolaryngologist’s productivity.Study design:Analysis of bibliometric data of academic otolaryngologists.Methods:Active grants from the National Institutes of Health (NIH) to otolaryngology departments were ascertained via the NIH Research Portfolio Online Reporting Tools Expenditures and Reports database. Faculty listings from these departments were gleaned from departmental websites. H index was calculated using the Scopus database.Results:Forty-seven otolaryngology programs were actively receiving NIH funding. There were 838 faculty members from those departments who had a mean h index of 9.61. Otology (h index 12.50) and head and neck (h index 11.96) were significantly (P < 0.0001) more scholarly than the rest of subspecialists. H index was significantly correlative (P < 0.0001) with degree of NIH funding at a given institution. H index was not significantly higher for those that attended medical school (P < 0.18), residency (P < 0.16), and fellowship (P < 0.16) at institutions with NIH funding to otolaryngology departments.Conclusions:H index is a bibliometric that can be used to assess scholarly impact. Otology and head and neck are the most scholarly subspecialists within otolaryngology. NIH funding to an individual’s medical school, residency, or fellowship of origin is not correlative with one’s scholarly impact, but current institutional affiliation and choice of subspecialty are.

  • 标签: Bibliometric Impact h-index Citation
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  • 简介:AbstractObjective:Scoping review of published literature to establish clinical characteristics and audiologic outcomes in patients diagnosed with Susac’s Syndrome(SS) who have undergone cochlear implantation (CI).Data sources:All published studies of CI in SS and contribution of two of our own patients who have not been reported previously.Methods:A comprehensive search of MEDLINE (via PubMed) was carried out in March 2020 using the following keywords and related entry terms: Susac’s Syndrome, Cochlear Implantation. Results: Our search identified a total of five case reports of CI in SS. With the addition of our two patients reported here, we analyzed characteristics and outcomes in seven patients. Mean age at implantation was 30 years old (range 19-46), with six women and one man implanted. Mean time from onset of hearing loss to implantation was 17 months (range three months to four years). Best reported postoperative speech understanding was reported via different metrics, with six of seven patients achieving open set speech scores of 90% or better, and one subject performing at 68%. Vestibular symptoms were present preoperatively in four of seven patients (57%), with vestibular testing reported in two patients, and showing vestibulopathy in one patient. No complications were reported following cochlear implantation.Conclusion:Cochlear implantation is a viable option for hearing rehabilitation in patients with SS, with levels of attainment of open set speech comparable to other populations of CI candidates.

  • 标签: Susac’s syndrome Cochlear implantation Scoping review
  • 简介:摘 要: 概略总结S公司项目研制过程风险特点,针对当前S公司在项目研制过程中存在的风险问题,开展风险管理探索工作,制定项目风险管理流程和措施,可供相关项目风险管理借鉴。

  • 标签: 项目管理 风险分析 风险流程
  • 简介:摘要: S企业集团作为中国最大的肉类加工基地,具有代表典型性,选取其作为分析对象,通过部分财务数据资料,从以下几个角度对其展开简明扼要的分析,评估竞争力,预测其未来的发展趋势。

  • 标签: 企业发展 财务分析 发展前景
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  • 简介:摘要目的探讨完全后腹腔镜经膀胱外途径规范化直视下(P.R.E.S.S.)膀胱袖套状切除术的操作要点和疗效。方法回顾性分析2017年8月至2020年12月收治的95例上尿路尿路上皮癌(UTUC)患者的病例资料,分别为海军军医大学长征医院30例,北京大学第一医院21例,烟台毓璜顶医院20例,大连医科大学附属第二医院21例,东部战区总医院3例。男57例,女38例。平均年龄(67.7±10.0)岁。中位肿瘤最大径3.0 cm。95例均行单次体位全程后腹腔镜肾输尿管全长切除联合P.R.E.S.S.技术膀胱袖套状切除术,根据术者手术习惯和经验分别采用四孔法(36例)和五孔法(59例)套管布局完成手术。四孔法组和五孔法组的年龄[(66.3±11.2)岁与(68.6±9.1)岁]、性别(男/女:25/11例与32/27例)、体质指数[(25.0±3.0)kg/m2与(24.8±3.4)kg/m2]、肿瘤最大径[2.8(1.6,3.5)cm与3.0(2.0,4.0)cm]、肿瘤侧别(左/右:19/17例与34/25例)、临床分期(T1~2/T3~4/Tis期:25/10/4例与49/10/0例)、多灶性肿瘤(3例与2例)比较差异均无统计学意义(P>0.05);术侧合并肾积水(13例与39例,P=0.004)、肿瘤位置(肾盂肾盏及上段输尿管/中段输尿管/下段输尿管:23/9/4例与35/4/20例,P=0.005)的差异均有统计学意义。术中行P.R.E.S.S.技术膀胱袖套状切除时,以脐动脉索为解剖标志,扩大输尿管周围的盆底侧方腹膜外间隙,切开膀胱壁后形成气膀胱效应,进行充分的膀胱袖套状切除和确切的膀胱袖口关闭。记录围手术期临床指标及随访结果。比较四孔法组和五孔法组的相关临床指标,分析套管布局方式对手术操作的影响。结果本研究95例中,91例(95.8%)采用P.R.E.S.S.技术完成膀胱袖套状切除;1例(1.1%)因出血中转开放手术;3例(3.1%)因局部空间显露困难,仅以Hem-o-lok夹闭输尿管远端完成手术。手术时间中位值180(125,230)min。术中估计出血量中位值100(50,100)ml。总体并发症发生率10.5%(10/95),其中术中并发症2例(2.1%)均为出血,1例术中输血400 ml,1例中转开放手术,未输血;术后并发症8例(8.4%),其中Clavien-DindoⅡ级7例[继发出血3例,药物过敏、急性肾功能减退(血肌酐490 μmol/L)、肺部感染及淋巴漏各1例],Ⅲa级1例(肠梗阻,局麻下置入肠梗阻导管),患者经对症治疗后均顺利出院。四孔法组和五孔法组在手术中转率[8.3%(3/36)与1.7%(1/59)]、术中估计出血量(100 ml与60 ml)、术中淋巴结清扫率[25.0%(9/36)与20.3%(12/59)]、P.R.E.S.S.技术膀胱袖套状切除成功率[91.7%(33/36)与98.3%(58/59)]、并发症发生率[13.8%(5/36)与8.5%(5/59)]、肿瘤病理分期(pT1~2/pT3~4/pTis期:22/11/3例与37/19/3例)以及复发转移比例[8.3%(3/36)与3.4%(2/59)]方面差异均无统计学意义(P>0.05);在手术时间(190 min与170 min,P=0.011)和术后住院时间(5 d与6 d,P=0.005)方面差异均有统计学意义。结论P.R.E.S.S.技术通过建立扩大的盆底侧方腹膜外间隙和气膀胱效应,以脐动脉索为解剖标志,可直视下确切地行膀胱袖套状切除术,用于单次体位完全后腹腔镜肾输尿管全长切除术安全、可行。五孔法布局较四孔法布局更适用于下段输尿管肿瘤患者,但可能延长术后住院时间。

  • 标签: 泌尿系肿瘤 膀胱袖套状切除 肾输尿管全长切除术 后腹腔镜
  • 简介:AbstractBackground:Meniere’s disease (MD) is an idiopathic disorder of the inner ear, which manifests as cochleo-vestibular dysfunction. Hearing loss will progress to a profound levelin a subset of patients with MD, and vestibular interventions can independently cause loss of hearing. The aim of this study was to systematically review the published literature describing the safety and efficacy of CI in patients with MD.Materials and methods:A systematic literature review was conducted in accordance PRISMA guidelines to identify articles that assessed at least one functional outcome in patients with MD who underwent CI. Demographic information, disease history, MD symptoms, outcomes measures, and complications related to CI were extracted from included studies.Results:In total, 17 studies were included, and 182 patients with MD underwent CI. The weighted-mean age was 61.9 years (range 27-85). Study objective and methodology varied, and there was significant heterogeneity in CI outcome measures reported. In total, 179 (98.3%) of 182 patients reported objective improvements in at least one hearing metric after CI. A total of 69 patients (37.9%) reported vertigo or severe dizziness prior to CI, compared to 22 patients (15.4%) postoperatively. Two studies reported significant reductions in postoperative Tinnitus Handicap Inventory score (THI). Quality of life assessments varied between studies. Complications rates were low with only nine patients (4.9%) reporting a serious CI-related complication.Conclusions:This systematic review evaluated 17 studies describing the safety and efficacy of CI in patients with MD and encountered many challenges due to small sample sizes, and heterogeneity in study design and outcomes measured. Despite these limitations, this study of 182 patients is to the best of our knowledge the largest systematic review evaluating the safety and efficacy of CI in MD. The results of this study support the need for a standardized approach to evaluating outcomes of CI in patients with MD in future studies.

  • 标签: Cochlear implantation Meniere’s disease
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  • 简介:摘要:随着中国国民经济近些年持续、快速的发展,民航业服务已全面普及。预计“十三五”期间,中国经济总量将继续保持中高速增长,居民收入将继续增加;消费潜力将会进一步释放;带薪休假政策将不断完善,旅游业将高速发展;全方位对外开放,“丝绸之路经济带和21世纪海上丝绸之路”建设;综合运输体系融合发展,这些综合因素形成了民航发展的重大机遇。民用航空企业仍然将面临安全、正点、服务、效益等四大主题,消费者则将从简单的位移服务需求转化成更加复杂、更加多重的服务需求。本文提出建设以科技型、服务型和具有软实力为目标的运行控制体系,从组织机构、关键绩效管理和企业文化建设等六个方面制定实施方案,以期能够解决S航空运行控制体系遇到的七个突出问题。通过运行控制体系的建设,使得运行控制体系能够更好的支撑公司的发展战略。

  • 标签: 航空公司 运行控制 体系
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  • 简介:摘要:随着信息化的推进过渡到了社会化网络时代,社会化网络以互联网为介质,利用其所具备的实时性,互动性和分享性等特点使得人们能够在互联网中组建稳定的关系网络,移动化成为了社会化交往的亮点,弥补了社会化网络在时间和空间上的限制。本文为适应这种应用需求,拟解决在繁多的社会化网络中无法集中化管理的问题,构想并实现出一种新的模式将社会化网络与移动终端相结合对人脉资源进行一站管理的系统。

  • 标签: 人脉分析 模块化设计 管理
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