Telerehabilitation is a new rehabilitation technology, using internet to provide rehabilitation services for patients in remote areas or unaccessible to rehabilitation. Longshi Ability of Daily Life scale is fomulated based on Chinese living customs. The assessment content of the scale can clearly reflect the needs of the service object, and the assessment result can directly reflect the ability level of the assessment object. The scale has been put into use online on the mobile internet and amassed a certain amount of big data, which is of great significance to the adjustment of rehabilitation treatment, the continuity of nursing guidance, and the assurance of adequate social support and disability benefits for the disabled. In this paper, the application of Longshi Ability of Daily Life scale in telerehabilitation is described.
ObjectiveTo investigate the medical quality of rehabilitation departments in medical institutions at all levels in Shenzhen and analyze the problems, so as to promote the continuous improvement of rehabilitation care quality in this city.MethodsFrom September to November 2019, a field investigation was carried out in 53 rehabilitation departments in Shenzhen. Five dimensions were scored by experts, including professional capacity, rules and regulations, knowledge and skills, supervision and feedback, and hospital infection control. Descriptive statistical analysis was used to characterize the data, and one-way analysis of variance was used to analyze the difference among different level hospitals.ResultsThe average score of rehabilitation medical care quality in Shenzhen was 83.98±8.28. The average score of tertiary, secondary, and primary hospitals were 85.61±7.02, 84.54±7.83, and 77.55±10.60, respectively, and the difference among different level hospitals was statistically significant (P<0.05). According to the standard score, the highest score was in the dimension of supervision feedback (95.75±6.50), and the lowest score was in the dimension of knowledge and skills (77.27±14.64).ConclusionThe overall quality of rehabilitation care in Shenzhen needs to be improved, and the management and professional training systems need to be established.
目的 探討腹腔鏡下膽道鏡聯合微爆破碎石術儀治療肝膽管結石的安全性及治療效果。 方法 回顧分析2008年7月－2012年6月183例膽道結石患者，行腹腔鏡下膽道鏡聯合微爆破碎石儀治療或單純經內鏡Oddi括約肌切開取石治療的臨床資料。87例患者在術中均應用微爆破碎石儀碎石（微爆破組），96例患者行單純經內鏡Oddi括約肌切開術或經內鏡乳頭切開術碎石（對照組）。 結果 微爆破組碎石成功率100%，結石取凈率85.06%（74/87），微爆破組的碎石時間、平均住院時間、平均住院總費用、并發癥發生率均明顯低于對照組（P＜0.05）。 結論 腹腔鏡下膽道鏡聯合微爆破碎石術在治療肝膽管結石病方面，具有微創、安全、經濟有效的優點，能降低結石殘留率及取石次數，值得臨床推廣。
ObjectiveTo compare the differences of curative effect, cosmetic effect, and shoulder-neck function protection effect between video-assisted lateral neck dissection (VALND) and traditional open thyroid surgery (OTS) in the treatment of papillary thyroid carcinoma (PTC) with lateral cervical lymph node metastasis. MethodsFifty patients with unilateral PTC accompanied by ipsilateral cervical lymph node metastasis who underwent sternal incision approach VALND at Fudan University Shanghai Cancer Center and Pudong Hospital Affiliated to Fudan University from January 2013 to December 2019 were collected. And 100 patients with unilateral PTC and ipsilateral cervical lymph node metastasis who underwent OTS during the same period were randomly selected at a ratio of 1∶2 using the random number method. All patients underwent unilateral thyroid lobectomy (or total thyroid lobectomy) + isthmus resection + central area (zone Ⅵ) and cervical lymph node dissection on the affected side (zones Ⅱ–Ⅴ). The therapeutic effects were compared between the two groups. ResultsCompare to OTS group, the operation time of VALND group was longer ［(218.3±86.6) min vs. (185.7±42.8) min, P=0.002］, but the hospital stay was shortened ［(6.1±2.2) d vs. (7.3±1.6) d, P<0.001］. In terms of surgical efficacy, there were no statistically significant differences between VALND group and OTS group in the number of lymph node dissections, the number of lymph node metastases, and the postoperative tumor recurrence rate (P>0.05). As for surgical safety, the two groups had similar rates of postoperative complications including recurrent laryngeal nerve injury, hypoparathyroidism, postoperative hematoma and infection(P>0.05). In terms of postoperative recovery, the scar color, vascular distribution, thickness, and softness, as well as in shoulder stiffness, tightness, pain, and numbness scores of VALND group were significantly lower than those in OTS group (P<0.05). ConclusionsFor PTC patients with lateral cervical lymph node metastasis, there is no significant difference in surgical efficacy and safety between VALND and OTS. However, VALND group shows obvious advantages in reducing the length of cervical incisions, improving cosmetic effects, and protecting cervical and shoulder functions. Therefore, VALND through the sternal notch approach has high promotion and application value in clinical practice.