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目的 利用精益六西格玛（lean six sigma，LSS）管理中的界定、测量、分析、改进和控制（define，measure，analyze，improve，control；DMAIC）模型，优化妊娠合并脑血管病患者就医流程，提高患者就医效率，保障母婴安全。 方法 2021年12月，首都医科大学附属北京天坛医院根据DMAIC模型，对危重孕产妇的就诊流程进行优化：梳理就诊流程，明确到院—医嘱开立、采血—送检、医嘱开立—影像学检查为院内延误的关键环节，对上述环节进行流程跟踪及分析，找出延误原因，并采取改进措施，优化流程。本研究回顾性纳入流程优化前（2019年1月—2021年12月）的妊娠合并脑血管病患者为优化前组，流程优化后（2022年1月—2023年12月）的患者为优化后组。比较两组患者就诊流程中的到院—医嘱开立、采血—送检、医嘱开立—影像学检查、到院—办理住院的时间。 结果 急诊就诊流程优化后，妊娠合并脑血管病患者的总体就诊效率提高。到院—医嘱开立 [24.0（13.5～38.5）min vs. 39.0（17.5～98.0）min，P=0.027]、医嘱开立—影像学检查[48.0（10.0～73.0）min vs. 65.5（22.7～90.7）min，P=0.025]以及到院—办理入院总时间[120.0（93.0～149.0）min vs. 218.0（123.0～382.7）min，P＜0.001]均较优化前缩短，差异有统计学意义；采血—送检时间有缩短趋势，但优化前后差异无统计学意义。 结论 使用DMAIC模型能够明确流程优化的关键环节，优化妊娠合并脑血管病患者的急诊就诊流程。 文章导读： 妊娠合并脑血管病是严重危害孕产妇和胎儿健康的急重症，本研究基于DMAIC模型，通过科学的论证，对医院急诊接诊此类患者的流程进行了优化，结果显示，流程优化后可以显著缩短患者的院内延误时间，提高救治效率。 Abstract: Objective To optimize the medical treatment process of pregnant women with cerebrovascular diseases using the define, measure, analyze, improve, control (DMAIC) model in the lean six sigma (LSS) management, improve the efficiency of medical treatment, and ensure the safety of both mothers and infants. Methods In December 2021, Beijing Tiantan Hospital, Capital Medical University optimized the medical treatment process for critically ill pregnant women according to the DMAIC model with the measures listed below: sorting out the medical treatment process, identifying the key nodes of hospital delays, such as hospital arrival to medical order issuance, blood sampling to testing, and medical order issuance to imaging examination, tracking and analying the processes of the above nodes, finding out the reasons for the delay, and taking improvement measures to optimize the process. This study retrospectively included pregnant women with cerebrovascular diseases before process optimization (from January 2019 to December 2021) as the pre-optimization group, and patients after process optimization (from January 2022 to December 2023) as the post-optimization group. The time of hospital arrival to medical order issuance, blood sampling to testing, medical order issuance to imaging examination, and hospital arrival to hospitalization was compared between the two groups. Results After the optimization of the medical treatment process, the overall efficiency of emergency treatment for pregnant women with cerebrovascular diseases was improved. After optimization, the time of hospital arrival to medical order issuance [24.0 (13.5-38.5) min vs. 39.0 (17.5-98.0) min, P=0.027], medical order issuance to imaging examination [48.0 (10.0-73.0) min vs. 65.5 (22.7-90.7) min, P=0.025], and hospital arrival to hospitalization [120.0 (93.0-149.0) min vs. 218.0 (123.0-382.7) min, P

目的 在立德树人视域下，根据“价值塑造、能力培养、知识传授”三位一体学生培养目标和职业核心能力要求，编制以脑血管病情景模拟案例为载体的教学效果评价问卷，并评价其信效度。 方法 采用访谈、专家函询等方法构建脑血管病情景模拟案例教学效果评价问卷。在山东第二医科大学2021级护理专业学生中随机抽取50名进行问卷填写和意见收集，进一步完善问卷。另外随机抽取130名学生进行正式问卷填写，并对问卷进行条目分析、效度和信度评价。 结果 本研究形成了脑血管病情景模拟案例教学效果评价问卷，该问卷包括能力培养、价值引领、案例编制3个维度，共25个条目。130份正式调查问卷中有125份为合格问卷，信效度检验显示：探索性因子分析提取3个公因子，累计方差贡献率为65.68%。问卷整体的Cronbach’α系数为0.914，能力培养、价值引领和案例编制维度的Cronbach’α系数分别为0.917、0.941和0.937。问卷具有良好的可靠性、稳定性。各维度得分与总分的相关系数r值在0.607～0.799之间。 结论 本研究形成的问卷具有良好的信效度，可以作为情景模拟案例教学效果的评价工具。 Abstract: Objective To compile a questionnaire for evaluating the teaching effects of cerebrovascular disease scenario simulation cases in accordance with the training objectives and occupational core competence requirements of students in the trinity of “value shaping, ability training and knowledge imparting” from the perspective of morality education. Methods Interviews and expert consultations were used to construct the evaluation questionnaire for cerebrovascular disease scenario simulation case teaching. Fifty nursing students in grade 2021 at Shandong Second Medical University were randomly selected to fill in the questionnaire, and their opinions were collected to the questionnaire. In addition, 130 students were randomly selected to complete a formal questionnaire. Then the questionnaire items were analyzed, and the validity and reliability were evaluated. Results In this study, a questionnaire was developed to evaluate the teaching effects of cerebrovascular disease scenario simulation cases, which included 25 items across three dimensions: ability cultivation, value guidance, and case compilation. A total of 125 out of the 130 formal questionnaires were qualified. The reliability and validity tests showed that three common factors were extracted by exploratory factor analysis, and the cumulative variance contribution rate was 65.68%. The Cronbach’α coefficient of the whole questionnaire was 0.914, and the Cronbach’α coefficients of the ability cultivation, value guidance and case compilation dimensions were respectively 0.917, 0.941 and 0.937, indicating good reliability and stability of the questionnaire. The correlation coefficient between each dimension score and the total score were 0.607-0.799. Conclusions The questionnaire developed in this study has good reliability and validity, and can be used as an evaluation tool for the teaching effects of scenario simulation cases.

目的 探索脑血管病患者主观性失眠与慢性期功能预后的关系。 方法 本研究是对多中心、大型前瞻性研究——中国卒中后抑郁发生及其结局的前瞻性队列研究（prospective cohort study on the incidence and outcome of patients with post-stroke depression in China，PRIOD）的事后分析。选取PRIOD中入组患者人数较多的15个中心，对入组的脑血管病患者进行发病5年后的电话随访。收集患者的一般资料、临床特点。根据《精神障碍诊断与统计手册》（第五版）中失眠的诊断标准编制调查问卷，收集失眠及相关睡眠问题，评估患者是否存在主观性失眠以及睡眠时间。采用mRS评估患者的功能预后。采用多因素logistic回归分析脑血管病患者主观性失眠与功能预后的关系。 结果 本研究共纳入698例患者，其中319例（45.70%）为主观性失眠患者，仅17.55%（56/319）服用助眠药物。logistic回归分析显示，主观性失眠与脑血管病患者功能预后存在显著关联：校正协变量后，与无失眠患者相比，主观性失眠患者功能残疾风险较高（OR 1.64，95%CI 1.11～2.42，P=0.013）；亚组分析显示，在基线为首次脑血管病发作患者中，与无失眠患者相比，主观性失眠患者功能残疾的风险较高（OR 1.74，95%CI 1.13～2.68，P=0.013）。 结论 主观性失眠是导致脑血管病慢性期功能残疾的危险因素。 Abstract: Objective To explore the relationship between subjective insomnia and functional prognosis in the chronic phase of patients with cerebrovascular disease. Methods This study is a post-hoc analysis of the multicenter, large-scale prospective study— prospective cohort study on the incidence and outcome of patients with post-stroke depression in China (PRIOD). Fifteen centers with a high number of patients enrolled in the PRIOD were selected, and the patients were followed up by telephone 5 years after the onset of cerebrovascular disease. General information and clinical characteristics were collected. According to the diagnostic criteria of insomnia in the Diagnostic & Statistical Manual of Mental Disorders (Fifth Edition), a questionnaire was compiled to collect data on insomnia and related sleep issues, and to assess the presence of subjective insomnia and sleep duration. The functional prognosis was evaluated by mRS. Multivariate logistic regression was used to analyze the relationship between subjective insomnia and functional prognosis in cerebrovascular disease patients. Results A total of 698 patients were included, of which 319 (45.70%) had subjective insomnia. Only 17.55%(56/319) were taking sleep aids. Logistic regression analysis revealed a significant association between subjective insomnia and functional prognosis in cerebrovascular disease patients: after adjusting for covariates, subjective insomnia patients had a higher risk of functional disability compared to those without insomnia (OR 1.64, 95%CI 1.11-2.42, P=0.013). Subgroup analysis showed that among patients experiencing their first cerebrovascular event at baseline, those with subjective insomnia had a higher risk of functional disability compared to those without insomnia (OR 1.74, 95%CI 1.13-2.68, P=0.013). Conclusions Subjective insomnia is a risk factor for functional disability in the chronic phase of patients with cerebrovascular disease.

数字健康广义上是指发展和利用数字技术提高健康的知识和实践领域，包括智能设备、数字消费者、物联网等相关的健康服务等。近年来，数字健康技术在脑血管病领域发展迅速，在脑血管病的一级预防、二级预防及急性期和康复阶段的诊疗中均有应用。相关研究结果提示，开发良好的数字健康产品可预测脑血管病的发生风险，助力脑血管病急性期远程医疗，提高患者二级预防的依从性，辅助患者出院后的功能康复训练。数字健康可使更多临床数据得到即时共享，让患者得到更及时的救治，同时也在一定程度上降低医疗成本。本文讨论数字健康在脑血管病领域的应用现状，展望其未来的发展趋势。 Abstract: Digital health broadly refers to the development and use of digital technology to improve health knowledge and practice areas, including smart devices, digital consumers, the internet of things and other related health services. In recent years, digital health has developed rapidly in the field of cerebrovascular diseases. It has been applied in primary prevention and secondary prevention, as well as in the diagnosis and treatment of cerebrovascular diseases in the acute phase and rehabilitation. The related studies show that well-developed digital health products can predict the risk of cerebrovascular disease, help patients in the acute phase through telemedicine, enhance the compliance of patients with secondary prevention, and assist rehabilitation training after discharge. Digital health allows more clinical data to be shared instantly, patients to be treated more timely, and can reduce medical costs to some extent. This paper discussed the application of digital health in cerebrovascular disease and its possible development trend in the future.

心脑血管疾病是全球主要的致死和致残病因之一。尽管医疗技术不断进步，心脑血管疾病的诊治仍存在许多亟待解决的问题，人工智能与机器学习的出现为应对这些问题提供了新途径。美国心脏学会2024年发布的科学声明从影像分析、心电图判读、床旁监护、可穿戴设备、基因组学及电子健康记录等方面介绍了人工智能与机器学习在临床中的应用及面临的挑战。本文对该指南进行介绍，并分析人工智能与机器学习在脑血管病领域中应用的优势，为我国未来在这一领域的研究提供参考。 Abstract: Cardiovascular and cerebrovascular diseases are among the leading causes of death and disability worldwide. Despite continuous advancements in medical technology, the diagnosis and treatment of these diseases still face many unresolved challenges. The emergence of artificial intelligence and machine learning provides new approaches to addressing these issues. The American Heart Association’s 2024 scientific statement highlights the applications and challenges of artificial intelligence and machine learning in clinical scenarios, including imaging analysis, electrocardiogram interpretation, bedside monitoring, wearable devices, genomics, and electronic health records. This paper aims to introduce these aspects and analyze the advantages of artificial intelligence and machine learning in the field of cerebrovascular diseases, providing a reference for the future development of artificial intelligence and machine learning in this area in China.

Copyright of Chinese Journal of Stroke is the property of Chinese Journal of Stroke Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Journal of Stroke is the property of Chinese Journal of Stroke Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Journal of Stroke is the property of Chinese Journal of Stroke Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Journal of Stroke is the property of Chinese Journal of Stroke Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Journal of Stroke is the property of Chinese Journal of Stroke Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

摘要： 预测模型是用来预测个体发生目标事件概率或预测结局值的统计模型。预测模型结果可视化展现是开发预测模型全流程中必不可少的一部分。良好的预测模型展现形式不仅可以使预测结果具有更好的可读性、可解释性，也在很大程度上决定了其使用方式和便利性。本文将详细介绍各种预测模型的展现形式，并阐述各自的优缺点。随后结合脑血管病临床预测模型研究，通过研究示例逐一介绍不同展现形式在脑血管病研究中的应用。 Abstract: A prediction model is a statistical model used to predict the probability of an individual with a target event or to predict the outcome value. Visualization of prediction model results is an essential part of the whole process of developing a prediction model. A good presentation of a prediction model can not only make the prediction results more readable and interpretable, but also determine its use and convenience to a large extent. This paper provided a detailed introduction to various forms of prediction model presentation and reported their advantages and disadvantages. Combining clinical prediction model research on cerebrovascular disease, this paper introduced the application of each presentation in cerebrovascular disease research through research examples.

目的 通过对比网络远程招生与非网络远程招生方式下脑血管病方向统招硕士研究生的一般情况和成绩等信息，探讨网络远程招生方式对生源质量的影响。 方法 以首都医科大学附属北京天坛医院2017—2022年脑血管病方向的统招硕士研究生为研究对象，根据招生方式将其分为两组，2017—2019年招收的统招硕士研究生为非网络远程招生组，2020—2022年招收的为网络远程招生组。本研究主要通过历年的研究生复试名单来获取研究数据，收集的信息包括考生的性别、年龄、民族、毕业院校、是否是应届生等基本信息以及其初试成绩和复试成绩，并对两组考生的上述指标进行差异化分析。 结果 2017—2022年，首都医科大学附属北京天坛医院脑血管病方向的统招硕士研究生生源数量总体呈增长趋势。在所招收的统招硕士研究生中，女性88名（33.98%），比例低于男性，民族以汉族（246名，94.98%）为主，来源以应届毕业生（203名，78.38%）为主，网络远程招生组与非网络远程招生组相比，上述指标的差异均不具有统计学意义。网络远程招生组生源的平均年龄显著小于非网络远程招生组[（23.1±1.1）岁 vs.（23.5±1.3）岁，P=0.014]。网络远程招生组神经病学和外科学（神经外科）专业的统招硕士研究生复试成绩均显著高于非网络远程招生组[神经病学，（255.5±12.3）分 vs.（241.0±13.8）分，P

在全球脑血管病医疗工作者的共同努力下，近年来脑血管病的诊疗取得了长足的进步。众多高质量的临床研究涵盖了脑血管病多个领域和热点，例如：缺血性卒中急性期取栓/溶栓，针对心房颤动的干预，血压管理等其他卒中急性期干预措施，为脑血管病的临床诊疗提供了扎实可靠的循证医学证据，并促进了脑血管病疾病负担的降低。本文对2023年脑血管病领域重要的临床研究进展进行回顾，帮助读者更好地了解这些临床研究的精华，并期待未来涌现出更多、更好的脑血管病临床研究。 Abstract: Cerebrovascular clinicians from different countries all over the world made great progress in the diagnosis and treatment of cerebral vascular diseases in recent years. Numerous high-quality clinical studies cover multiple fields and hotspots of cerebral vascular disease, such as thrombectomy/thrombolysis in the acute phase of ischemic stroke, intervention for atrial fibrillation, blood pressure management and other acute phase intervention measures, providing solid and reliable evidence-based medical evidence for clinical diagnosis and treatment in cerebral vascular disease, and promoting the reduction of cerebral vascular disease burden. This paper reviews the important clinical research progress in the field of cerebral vascular disease in 2023, helping readers better understand the advantages and great significance of these clinical studies, and looking forward to more and better cerebral vascular disease clinical studies in the future.

目的: 分析神经内科开展脑血管病介入治疗的效果。方法: 选取 2023 年 4 月-2024 年 4 月本院 76 例脑血管 病患者开展研究, 用随机数字表法平均分为对照组 38 例, 行常规治疗, 观察组 38 例, 行介入治疗, 比较两组临床疗 效。结果: 观察组的动态阻抗、最小血流量和最小血流速度均明显高于对照组, NIHSS、VAS 评分、病变最小直径、病变长度、血管狭窄程度和脑血管外周阻力均明显低于对照组 (P < 0.05)。结论: 给予脑血管病患者介入治疗能改 善神经功能, 调节脑血流动力学, 减轻病变, 具有推广价值。 [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Stroke is the property of Chinese Journal of Stroke Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Cerebrovascular clinicians from different countries all over the world made great progress in the diagnosis and treatment of cerebral vascular diseases in recent years. Numerous high-quality clinical studies cover multiple fields and hotspots of cerebral vascular disease, such as thrombectomy/thrombolysis in the acute phase of ischemic stroke, intervention for atrial fibrillation, blood pressure management and other acute phase intervention measures, providing solid and reliable evidence-based medical evidence for clinical diagnosis and treatment in cerebral vascular disease, and promoting the reduction of cerebral vascular disease burden. This paper reviews the important clinical research progress in the field of cerebral vascular disease in 2023, helping readers better understand the advantages and great significance of these clinical studies, and looking forward to more and better cerebral vascular disease clinical studies in the future. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Modern Laboratory Medicine is the property of Journal of Modern Laboratory Medicine Editorial Department and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)