| 2 | WONCA研究论文摘要汇编——初级医疗连续性服务及其与老年人生存的关系:一项17年的前瞻性队列研究显示文摘背景尽管连续性服务在基层医疗中是被广泛接受的核心原则,但是关于其优势的证据仍然不足。目的探讨全科医学中连续性服务是否与老年人长寿相关。设计与场所数据来源于阿姆斯特丹纵向衰老研究,对荷兰老年人进行不间断队列研究。研究样本包括1 712例年龄≥60岁的老年人,进行3年随访,周期长达17年,随访其死亡率直至2013年。方法连续性服务被定义为患者和全科医生之间不间断的治疗关系的持续过程。采用赫芬达尔-赫希曼指数计算服务的连续性(COC)。COC指数为1代表最大连续性。将COC指数〈1的患者分为3组,COC最大值的参与者为第4组。采用Cox回归分析探讨COC和存活时间之间的关联。结果 742例参与者(43.3%)COC取得最大值。在生存17年的759例参与者中,251例(33.1%)仍有相同的全科医生服务。COC最小值组(指数〉0~0.500)死亡率高于COC最大值组,差异有统计学意义〔HR=1.20,95%CI(1.01,1.42)〕。目前无混杂因素影响该HR。结论该研究表明全科医学中低连续性服务与高死亡风险相关,应强化该案例以鼓励连续性服务。 | MAARSINGH O R HENRY Y VAN DE VEN P M 本刊编辑部 | 2016 | 中国全科医学2016，19，27： | 4 |
| 7 | 颅脑损伤周围区域脑血流变化与感觉运动障碍有关(英文)显示文摘In the traumatic brain injury(TBI) the initial impact causes both primary injury,and launches secondary injury cascades.One consequence,and a factor that may contribute to these secondary changes and functional outcome,is altered hemodynamics.The relative cerebral blood volume(CBV) changes in rat brain after severe controlled cortical impact injury were characterized to assess their interrelations with motor function impairment.Magnetic resonance imaging(MRI) was performed 1,2,4 h,and 1,2,3,4,7,and 14 days after TBI to quantify CBV and water diffusion.Neuroscore test was conducted before,and 2,7,and 14 days after the TBI.We found distinct temporal profile of CBV in the perilesional area,hippocampus,and in the primary lesion.In all regions,the first response was drop of CBV.Perifocal CBV was reduced for over 4 days thereafter gradually recovering.After the initial drop,the hippocampal CBV was increased for 2 weeks.Neuroscore demonstrated severely impaired motor functions 2 days after injury(33% decrease),which then slowly recovered in 2 weeks.This recovery parallelled the recovery of perifocal CBV.CBV MRI can detect cerebrovascular pathophysiology after TBI in the vulnerable perilesional area,which seems to potentially associate with time course of sensory-motor deficit. | Immonen R Heikkinen T Thtivaara L Nurmi A Stenius TK Puolivli J Tuinstra T Phinney AL Van Vliet B Yrjnheikki J Grhn O | 2010 | 中华神经外科疾病研究杂志2010，9，2： | 1 |
您所在的机构暂未开通此部分的功能，请联系管理员