目的:基于文献计量学梳理惯性测量技术在步态分析领域的研究演进与热点结构,并从护理评估与干预转化角度分析其应用空白。方法:检索 Web of Science 核心合集2005年1月1日至2025年4月5日相关英文文献,纳入1,079篇记录;采用 CiteSpace 6.3.R1、VOSviewer 1.6.20 分析年度发文、国家/地区合作、期刊分布、关键词共现与突现,并在 Python 3.10 中以 PPMI/TF-IDF 表征、SVD降维、UMAP-HDBSCAN聚类开展关键词和摘要语义分析。结果:2006—2024年发文量由1篇增至140篇,年复合增长率为31.6%,2024年达到峰值;最高频关键词为 gait(404次)、gait analysis(268次)、walking(252次)、balance(183次)和 inertial sensors(156次)。关键词与摘要语义聚类的二维轮廓系数分别为0.579和0.642,热点集中于帕金森病/冻结步态、跌倒风险、平衡稳定性、可穿戴传感器、机器学习和康复干预。含 nursing/care 等护理相关词项的记录为142篇,但“护理”尚未形成独立主题簇。结论:惯性测量步态分析已形成医工交叉的成熟热点,但护理主导的连续评估、风险预警和干预闭环仍不足。未来应将步速、步态变异性、稳定性、对称性等参数转化为可执行的护理评估指标,推动精准护理场景中的临床验证与流程整合。
Objective: To map the research evolution and hotspot structure of inertial-measurement-based gait analysis and to examine its translational gap in nursing assessment and intervention. Methods: A total of 1,079 English records published from January 1, 2005 to April 5, 2025 were retrieved from the Web of Science Core Collection. CiteSpace 6.3.R1 and VOSviewer 1.6.20 were used for annual output, collaboration, journal distribution, keyword co-occurrence and burst analyses. Keyword and abstract semantic clusters were further examined in Python 3.10 using PPMI/TF-IDF representation, SVD, UMAP and HDBSCAN. Results: Publications increased from 1 in 2006 to 140 in 2024, with a compound annual growth rate of 31.6%. The most frequent terms were gait, gait analysis, walking, balance and inertial sensors. The two-dimensional silhouette coefficients of keyword and abstract semantic clusters were 0.579 and 0.642, respectively. Major hotspots involved Parkinson disease/freezing of gait, fall risk, balance and stability, wearable sensors, machine learning and rehabilitation. Records containing nursing/care-related terms accounted for 142 publications, but nursing did not form an independent topic cluster. Conclusion: Inertial-measurement-based gait analysis has become a mature medical-engineering research field, while nurse-led continuous assessment, risk warning and intervention feedback loops remain underdeveloped. Translating gait speed, variability, stability and symmetry into actionable nursing indicators should be prioritized in future clinical validation.
目的:基于文献计量学梳理惯性测量技术在步态分析领域的研究演进与热点结构,并从护理评估与干预转化角度分析其应用空白。方法:检索 Web of Science 核心合集2005年1月1日至2025年4月5日相关英文文献,纳入1,079篇记录;采用 CiteSpace 6.3.R1、VOSviewer 1.6.20 分析年度发文、国家/地区合作、期刊分布、关键词共现与突现,并在 Python 3.10 中以 PPMI/TF-IDF 表征、SVD降维、UMAP-HDBSCAN聚类开展关键词和摘要语义分析。结果:2006—2024年发文量由1篇增至140篇,年复合增长率为31.6%,2024年达到峰值;最高频关键词为 gait(404次)、gait analysis(268次)、walking(252次)、balance(183次)和 inertial sensors(156次)。关键词与摘要语义聚类的二维轮廓系数分别为0.579和0.642,热点集中于帕金森病/冻结步态、跌倒风险、平衡稳定性、可穿戴传感器、机器学习和康复干预。含 nursing/care 等护理相关词项的记录为142篇,但“护理”尚未形成独立主题簇。结论:惯性测量步态分析已形成医工交叉的成熟热点,但护理主导的连续评估、风险预警和干预闭环仍不足。未来应将步速、步态变异性、稳定性、对称性等参数转化为可执行的护理评估指标,推动精准护理场景中的临床验证与流程整合。
Objective: To map the research evolution and hotspot structure of inertial-measurement-based gait analysis and to examine its translational gap in nursing assessment and intervention. Methods: A total of 1,079 English records published from January 1, 2005 to April 5, 2025 were retrieved from the Web of Science Core Collection. CiteSpace 6.3.R1 and VOSviewer 1.6.20 were used for annual output, collaboration, journal distribution, keyword co-occurrence and burst analyses. Keyword and abstract semantic clusters were further examined in Python 3.10 using PPMI/TF-IDF representation, SVD, UMAP and HDBSCAN. Results: Publications increased from 1 in 2006 to 140 in 2024, with a compound annual growth rate of 31.6%. The most frequent terms were gait, gait analysis, walking, balance and inertial sensors. The two-dimensional silhouette coefficients of keyword and abstract semantic clusters were 0.579 and 0.642, respectively. Major hotspots involved Parkinson disease/freezing of gait, fall risk, balance and stability, wearable sensors, machine learning and rehabilitation. Records containing nursing/care-related terms accounted for 142 publications, but nursing did not form an independent topic cluster. Conclusion: Inertial-measurement-based gait analysis has become a mature medical-engineering research field, while nurse-led continuous assessment, risk warning and intervention feedback loops remain underdeveloped. Translating gait speed, variability, stability and symmetry into actionable nursing indicators should be prioritized in future clinical validation.
摘要目的 探讨基于E-Coach健康管理模式的营养管理联合主动循环呼吸训练(ACBT)在非小细胞肺癌(NSCLC)化疗患者中的应用效果。方法 选取2023年6月至2025年8月我院收治的98例NSCLC化疗患者,采用随机数字表法将所有研究对象分为联合组和常规组,每组49例。常规组给予常规干预,联合组在常规组基础上予以E-Coach健康管理模式的营养管理联合ACBT干预。比较两组干预前后营养状况、肺功能、运动耐力、生活质量以及营养不良发生率。结果 干预12周后,两组BMI、ALB、PA、Hb均较干预前上升且联合组高于常规组(P<0.05);联合组FVC、FEV1、MVV及6MWT均显著高于常规组(P<0.05);干预前两组6MWT组间对比差异无统计学意义(P>0.05),干预4周、6周、8周、12周后,两组6MWT均较干预前增加,且联合组远于常规组(P<0.05);干预12周后,两组身体功能、社会或家庭功能、情感功能、功能性状况得分均较干预前上升,且联合组高于常规组(P<0.05)。结论基于E-Coach健康管理模式的营养管理联合ACBT能够有效改善NSCLC化疗患者的营养状况和肺功能,提高生活质量和运动耐力。
Abstract Objective To investigate the application effect of nutrition management based on the E-Coach health management model combined with active cycle of breathing technique (ACBT) in patients undergoing chemotherapy for non-small cell lung cancer (NSCLC). Methods A total of 98 NSCLC patients receiving chemotherapy in our hospital from June 2023 to August 2025 were selected and randomly divided into a combination group and a conventional group using a random number table method, with 49 cases in each group. The conventional group received routine intervention, while the combination group received nutrition management based on the E-Coach health management model combined with ACBT in addition to the routine intervention. The nutritional status, lung function, exercise endurance, quality of life, and incidence of malnutrition were compared between the two groups before and after the intervention. Results After 12 weeks of intervention, BMI, ALB, PA, and Hb in both groups increased compared with baseline, and the levels in the combination group were higher than those in the conventional group (P<0.05). The FVC, FEV1, MVV, and 6MWT in the combination group were significantly higher than those in the conventional group (P<0.05). There was no statistically significant difference in 6MWT between the two groups before intervention (P>0.05); after 4, 6, 8, and 12 weeks of intervention, the 6MWT in both groups increased compared with baseline, and the walking distance in the combination group was significantly longer than that in the conventional group (P<0.05). After 12 weeks of intervention, the scores of physical function, social/family function, emotional function, and functional well-being in both groups increased compared with baseline, and the scores in the combination group were higher than those in the conventional group (P<0.05). Conclusion Nutrition management based on the E-Coach health management model combined with ACBT can effectively improve the nutritional status and lung function of NSCLC patients undergoing chemotherapy, and enhance their quality of life and exercise endurance.
目的:描述发病48 h内急性缺血性卒中(acute ischemic stroke,AIS)患者依达拉奉右莰醇真实世界用药特征,探讨48 h内不同启动时间与住院期间神经功能改善及短期预后的关系。方法:回顾性连续筛选2023年12月1日至2026年4月30日本院诊断为AIS并使用依达拉奉右莰醇的住院患者,药学部基于药学信息系统、住院医嘱及病历记录提取资料。初筛147例,排除35例,纳入112例发病至首次用药时间(onset-to-treatment time,OTT)≤48 h者;按预设24 h界值分为24 h内用药组(n=67)和24~48 h用药组(n=45)。主要结局为住院期间美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)变化值(ΔNIHSS=入院NIHSS评分-出院前NIHSS评分);次要结局包括出院前NIHSS评分、出院改良Rankin量表(modified Rankin Scale,mRS)评分、显著神经功能改善、住院时间、出院去向及安全性事件。采用多因素线性回归分析24 h内用药与ΔNIHSS的相关性,并行简化模型、排除再灌注治疗患者、完整疗程人群、进一步调整大血管闭塞及OTT连续变量模型等敏感性分析。结果:总体OTT为19.65(14.97,34.68)h,疗程12.00(11.00,13.00)d,完成相对完整疗程比例89.3%。两组入院NIHSS评分差异无统计学意义[8.00(6.00,9.00)分 vs 8.00(6.00,10.00)分,P=0.447];24 h内用药组出院前NIHSS评分更低[5.00(4.00,6.50)分 vs 6.00(5.00,8.00)分,P=0.025],ΔNIHSS更高[3.00(2.00,3.00)分 vs 2.00(1.00,2.00)分,P<0.001],显著神经功能改善率更高(77.6% vs 60.0%,P=0.045)。多因素校正后,24 h内用药仍与更大的ΔNIHSS相关(β=0.768,95%CI:0.377~1.159,P<0.001);Logistic探索性分析显示其与显著神经功能改善发生可能性较高相关(OR=2.475,95%CI:1.047~5.853,P=0.039)。两组出血转化、症状性颅内出血、药物相关不良反应及院内死亡差异均无统计学意义。结论:本单中心真实世界队列中,发病48 h内依达拉奉右莰醇治疗疗程完成比例较高、短期安全性事件发生率低;24 h内启动治疗与住院期间NIHSS改善幅度较大及显著神经功能改善率较高相关。由于为回顾性观察性研究,结果应解释为关联性证据,需前瞻性、多中心研究及长期功能结局验证。
Objective: To describe real-world treatment characteristics of edaravone dexborneol in acute ischemic stroke (AIS) patients treated within 48 hours of onset and to explore the association between initiation time and short-term in-hospital outcomes. Methods: This single-center retrospective real-world study screened hospitalized AIS patients with edaravone dexborneol records from December 1, 2023 to April 30, 2026. Medication data were extracted from the pharmacy information system, inpatient orders, and medical records. After 35 exclusions, 112 of 147 patients with onset-to-treatment time (OTT) ≤48 h were included and classified by a prespecified 24-hour cutoff into a within-24-hour group (n=67) and a 24-48-hour group (n=45). The primary outcome was in-hospital National Institutes of Health Stroke Scale (NIHSS) change (ΔNIHSS=admission NIHSS minus pre-discharge NIHSS); secondary outcomes included pre-discharge NIHSS, discharge modified Rankin Scale (mRS), marked neurological improvement, length of stay, discharge destination, and safety events. Multivariable linear regression assessed the association between within-24-hour treatment and ΔNIHSS, with sensitivity analyses using simplified adjustment, exclusion of reperfusion-treated patients, the complete-course population, additional adjustment for large-vessel occlusion, and continuous OTT modeling. Results: Median OTT was 19.65 (14.97, 34.68) h, treatment duration was 12.00 (11.00, 13.00) days, and 89.3% completed a relatively complete course. Baseline NIHSS was comparable [8.00 (6.00, 9.00) vs 8.00 (6.00, 10.00), P=0.447]. The within-24-hour group had lower pre-discharge NIHSS [5.00 (4.00, 6.50) vs 6.00 (5.00, 8.00), P=0.025], greater ΔNIHSS [3.00 (2.00, 3.00) vs 2.00 (1.00, 2.00), P<0.001], and a higher marked improvement rate (77.6% vs 60.0%, P=0.045). After adjustment for age, admission NIHSS, reperfusion therapy, and atrial fibrillation, within-24-hour treatment remained associated with greater ΔNIHSS (β=0.768, 95% CI: 0.377-1.159, P<0.001). Exploratory logistic regression showed a higher likelihood of marked improvement (OR=2.475, 95% CI: 1.047-5.853, P=0.039). Hemorrhagic transformation, symptomatic intracranial hemorrhage, drug-related adverse reactions, and in-hospital death did not differ significantly. Conclusion: In this real-world cohort, edaravone dexborneol within 48 h of AIS onset showed a high complete-course proportion and low short-term safety event incidence. Initiation within 24 h was associated with greater in-hospital NIHSS improvement and a higher marked improvement rate than initiation at 24-48 h. These findings are associative and need prospective multicenter validation with long-term functional outcomes.
目的 分析2024年2月至2026年2月郑州人民医院收治的急性下呼吸道感染(ALRTI)患儿的病原体分布情况及其流行病学特征。方法 选取2024年2月—2026年2月于郑州人民医院就诊的193例ALRTI患儿为研究对象,采集患儿咽拭子样本,统计患儿病原体检测结果,比较不同性别、不同年龄段、不同发病季节患儿病原体分布情况。结果 193例患儿中,经病原体检测出阳性患儿165例,总阳性检出率85.49%,检出率最高的前三位为RSV(20.73%)、MP(19.69%)、HRV(15.54%);婴儿期患儿RSV感染占比(44.83%)最高,其次为HRV感染(20.69%),幼儿期患儿RSV、HRV、MP感染占比(17.31%、17.31%、19.23%)均较高,学龄前、学龄期患儿MP感染占比(33.33%、26.32%)最高,婴儿期患儿混合感染占比(6.90%)较低,学龄前患儿混合感染占比(20.00%)较高;春季时,各病原体分布较均衡,HRV、MP、SP感染占比(14.58%、12.50%、14.58%)均较高,夏季、秋季时,MP感染率(31.82%、28.85%)较高,冬季时,RSV感染率(55.10%)较高,四个季节中混合感染患儿占比较接近,其中秋季感染率(17.31%)相对较高。结论 2024年至2026年郑州人民医院收治的急性下呼吸道感染患儿病原体中,RSV、MP为主要病原体,各呼吸道病原体随患儿年龄段、季节变化存在不同发病高峰,临床应结合实际情况早期鉴别病原体,以指导临床制定针对性治疗方案,改善患儿预后。
Objective To analyze the distribution of pathogens and the epidemiological characteristics of children with acute lower respiratory tract infections (ALRTI) admitted to Zhengzhou People’s Hospital from February 2024 to February 2026. Methods: A total of 193 pediatric patients with ALRTI who visited Zhengzhou People’s Hospital between February 2024 and February 2026 were selected as study subjects. Throat swab samples were collected from the patients, and pathogen testing results were compiled to compare the distribution of pathogens across different genders, age groups, and seasons of onset. Results: Among the 193 children, 165 tested positive for pathogens, resulting in an overall positive detection rate of 85.49%. The top three most frequently detected pathogens were RSV (20.73%), MP (19.69%), and HRV (15.54%); RSV infection had the highest prevalence (44.83%) among infants, followed by HRV infection (20.69%). Among preschoolers, the prevalence of RSV, HRV, and MP infections (17.31%, 17.31%, and 19.23%, respectively) was relatively high. MP infections were most common among preschool and school-age children (33.33% and 26.32%, respectively); the proportion of mixed infections was lower among infants (6.90%) but higher among preschoolers (20.00%); In spring, the distribution of pathogens was relatively balanced, with high proportions of HRV, MP, and SP infections (14.58%, 12.50%, and 14.58%, respectively). In summer and fall, the MP infection rate was high (31.82% and 28.85%, respectively). In winter, the RSV infection rate (55.10%) was high. The proportion of children with mixed infections was relatively similar across the four seasons, with a relatively higher infection rate (17.31%) in autumn. Conclusion: Among the pathogens identified in children with acute lower respiratory tract infections admitted to Zhengzhou People’s Hospital from 2024 to 2026, RSV and MP were the primary pathogens. The incidence peaks of various respiratory pathogens varied according to the children’s age groups and seasons. Clinicians should conduct early pathogen identification based on actual conditions to guide the development of targeted treatment plans and improve patient outcomes.
目的:本研究旨在调查广州市重点专科建设背景下护理管理者核心能力的现状,分析其主要影响因素,为护理管理者核心能力提升策略的制定提供参考。方法:采用便利抽样法,选取广州市某区联合申报市级重点专科单位的159名护理管理者作为研究对象。采用一般资料调查表和护士长岗位胜任力问卷进行调查。将搜集的数据使用 SPSS 27.0 软件进行描述性统计、独立样本 t 检验和单因素方差分析以及多元线性回归分析。结果:广州市区联合申报市级重点专科单位护理管理者综合素质总均分为(148.81±26.54)分,各维度得分从高到低依次为:个人性格特质(6.22±1.11)分、临床管理能力(6.20±1.12)分、团队影响能力(6.17±1.14)分。单因素分析显示,职称和工作职务对综合素质得分有显著影响(P<0.05)。多元线性回归分析进一步表明,在控制其他变量后,年龄30-40岁组对核心能力有显著影响(P<0.05)。结论:广州市区联合申报市级重点专科单位护理管理者岗位胜任力总体处于中等偏上水平,各维度表现均衡。建议重点专科建设单位重点关注不同职务层次护理管理者的能力发展需求,进一步优化管理体系,促进区域护理管理水平的整体提升。
目的 探讨急性心肌梗死(AMI)患者经皮冠状动脉介入(PCI)术后6个月内预后不良的影响因素及术前血清髓过氧化物酶(MPO)、淀粉样蛋白A(SAA)、肌酸激酶同工酶(CK-MB)水平联合检测对预后不良的预测效能。方法 前瞻性选取2023年1月~2025年1月许昌市人民医院诊治的204例AMI患者作为AMI组,另选取同期102例健康志愿者作为对照组。比较两组血清MPO、SAA、CK-MB水平。AMI组患者予以PCI术治疗,依据PCI术后6个月内(失访8例)预后情况将分为预后不良亚组(42例)和预后良好亚组(154例),比较不同预后AMI患者临床资料及术前血清MPO、SAA、CK-MB水平。分析AMI患者PCI术后6个月内预后不良的影响因素;分析术前血清MPO、SAA、CK-MB水平联合检测对预后不良的预测效能。结果 AMI组血清MPO、SAA、CK-MB水平高于对照组(P<0.05);预后不良亚组多支病变占比、Killip分级Ⅲ级占比、支架置入数、术前血清MPO、SAA、CK-MB水平高于预后良好亚组(P<0.05);校正病变支数、Killip分级、支架置入数后,术前血清MPO、SAA、CK-MB水平是AMI患者PCI术后6个月内预后不良的独立影响因素(P<0.05);术前血清MPO、SAA、CK-MB联合预测预后不良的AUC值明显高于各血清指标单度指标预测(P<0.05)。结论 AMI患者血清MPO、SAA、CK-MB水平明显升高,且是AMI患者PCI术后预后不良的独立影响因素,联合检测其水平对预后不良具有较高的预测效能。
目的 比较横断疝囊与完全剥离疝囊在经腹腹膜前疝修补术(TAPP)在中老年单侧腹股沟疝中的临床价值。方法 回顾性选取2021年3月至2025年3月我院95例中老年单侧腹股沟疝,均采用TAPP治疗,根据疝囊具体处理策略分为横断组(横断疝囊,n=65)和剥离组(完全剥离疝囊,n=30)。比较两组手术指标、手术前后疼痛程度[疼痛数字评价量表(NRS)评分]、生活质量[生活质量综合评定问卷-74(GQOLI-74)]、并发症及术后12个月复发情况。结果 较剥离组,横断组手术、疝囊处理、卧床及住院时间缩短,腹股沟区积液及术中失血量减少(P<0.05);术后6 h、24 h、72 h横断组NRS评分较剥离组降低(P<0.05);术后3个月横断组GQOLI-74总分高于剥离组(P<0.05);两组并发症及复发率无显著差异(P>0.05)。结论 在中老年单侧腹股沟疝TAPP中应用横断疝囊能优化手术流程,减轻疼痛程度,改善生活质量,且安全性、复发效果与完全剥离疝囊相当。
目的 探讨老年髋部骨折术后患者跌倒恐惧的影响因素,构建个体化风险预测列线图模型并进行临床效能验。方法 采用便利抽样法,选取2025年4月-2025年10月在我院骨科住院并接受手术治疗的老年髋部骨折患者227例作为研究对象。采用一般资料调查表、国际版跌倒效能量表、医院综合焦虑抑郁量表、社会支持评定量表、简易体能状况量表、康复自我效能量表、临床衰弱量表及肌少症筛查问卷等进行横断面调查。采用卡方检验筛选预测变量,多因素Logistic回归分析确定跌倒恐惧的独立影响因素,并基于R语言构建列线图预测模型。通过Bootstrap法进行内部验证,采用校准曲线和受试者工作特征曲线评估模型的区分度与校准度。结果 227例患者中,150例存在跌倒恐惧。多因素Logistic回归分析显示:年龄≥75岁(OR=3.28)、视力不良(OR=6.017)、焦虑抑郁(OR=3.738),衰弱(OR=3.821),肌少症(OR=2.704),康复自我效能低(OR=0.275),为患者发生跌倒恐惧的风险因素。基于上述6个预测因子构建的列线图模型,其ROC曲线下面积为0.839(95%CI:0.832-0.916),。校准曲线显示预测概率与实际发生率一致性良好(Bootstrap验证,P=0.028),DCA结果显示,当阈值概率在0.1-0.9时,该模型净收益优于假设所有患者均接受或均不接受治疗的策略。结论 本研究构建的列线图模型能有效预测老年髋部骨折术后患者发生跌倒恐惧的风险,有助于临床医护人员早期识别高危人群并进行多维度靶向干预。
目的 评估中医穴位疗法结合康复护理对脑瘫患儿的积极价值。方法 选取某社会福利院康复医院2024年12月至2025年12月间儿科收治的40例脑瘫患儿,通过随机数字表分为两组,对照组(20例)接受常规康复护理,观察组(20例)则联合应用中医穴位疗法,对比两种方案的康复效果。结果 观察组患儿的临床痉挛指数(包括肢体腱反射、肌张力及阵挛等维度)评分低于对照组,差异具统计学意义(P<0.05);观察组血清CD4+和CD4+/CD8+免疫功能指标均高于对照组(P<0.05);观察组在躯干控制测量量表(TCMS)、儿童睡眠习惯问卷(CSHQ)评估中的分数改善较对照组更优(P<0.05)。结论 将中医穴位疗法融入康复护理,对脑瘫患儿实施综合干预,有助于优化其睡眠质量,减轻肌张力异常,提升免疫力和平衡功能,为其康复提供有效支持。