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Background Work-related musculoskeletal disorders (WMSDs) seriously affect work efficiency and quality of life of nurses. Currently, there are significant differences in the published studies on WMSDs in nurses. Objective To systematically evaluate the prevalence of WMSDs among nurses in the mainland of China and analyze its main influencing factors. Methods Eight databases (CNKI, Wanfang data, VIP, SinoMed, PubMed, Cochrane Library, Web of Science, and Embase) were selected for searching literature reporting prevalence and influencing factors of WMSDs among clinical nurses in China from inception to December 31, 2022. The literature was included according to a pre-set criteria of inclusion and exclusion. The quality of cross-sectional studies was assessed using the criteria recommended by the Agency for Healthcare Research and Quality (AHRQ), and the extracted data were analyzed by Stata 15.0 software. A random effect model or a fixed effect model was selected to calculate combined effects based on heterogeneity of included studies. Results A total of 19 studies were included in this meta-analysis, including 14 studies published in Chinese and 5 in English, involving 17852 nurses in total. The estimated prevalence rate of WMSDs since work among clinical nurses in China was 85.5% (95%CI: 79.8%, 91.1%), the estimated annual prevalence rate was 81.0% (95%CI: 75.2%, 86.8%), and the estimated weekly prevalence rate was 65.0% (95%CI: 48.5%, 81.5%). The results of subgroup analysis showed that the prevalence rate of WMSDs among nurses in specific departments of emergency, ICU, and midwifery was 88.6% (95%CI: 82.6%, 94.6%), higher than that among nurses in general departments [79.0% (95%CI: 72.5%, 85.5%)]. The reported prevalence of WMSDs from 2018 to 2022 was 82.2% (95%CI: 75.0%, 89.4%), which was higher than that from 2004 to 2017 [76.8% (95%CI: 67.2%, 86.4%)]. Age >40 years (OR=2.34, 95%CI: 1.69, 3.24), length of service >10 years (OR=2.12, 95%CI: 1.43, 3.15), obesity (OR=2.73, 95%CI: 1.56, 4.77), night shift (OR=2.03, 95%CI: 1.81, 2.28), lifting heavy objects (OR=3.80, 95%CI: 1.79, 8.07), rest during work (OR=0.49, 95%CI: 0.30, 0.83), and bending (OR=3.47, 95%CI: 2.37, 5.08) were influencing factors of WMSDs in nurses. Conclusion The prevalence rate of WMSDs among Chinese nurses is high, and it is increasing year by year. Nurses in specific departments such as emergency, ICU, and midwifery show higher prevalence rates than those in general departments. Age > 40 years, length of service >10 years, obesity, night shifts, lifting heavy objects, and bending are risk factors for WMSDs among nurses, while rest during work is a protective factor. Therefore, early prevention actions should be taken targeting the above factors, such as increasing auxiliary assistance facilities and improving work patterns, so as to reduce the risk of WMSDs.
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Microphone array based methods are gradually applied in the front-end speech enhancement and speech recognition improvement for cochlear implant in recent years. By placing several microphones in different locations in space, this method can collect multi-channel signals containing a lot of spatial position and orientation information. Microphone array can also yield specific beamforming mode to enhance desired signal and suppress ambient noise, which is particularly suitable to be applied in face-to-face conversation for cochlear implant users. And its application value has attracted more and more attention from researchers. In this paper, we describe the principle of microphone array method, analyze the microphone array based speech enhancement technologies in present literature, and further present the technical difficulties and development trend.
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Humans , Cochlear Implantation , Cochlear Implants , Speech , Speech PerceptionABSTRACT
Objective To analyze the clinical features of the uterine sarcoma with different histological types and improve the capability of diagnosis and therapy. Methods Thirty-four cases with uterine sarcoma treatment were analyzed respectively , among which there were 19 cases with malignant endometrial interstitial sarcomas (55.8%), 6 cases with leiomyosarcoma (18%), 9 with malignant mixed tumor (26%). Results (1) The average age of patients were about 46 , patients with endometrial interstitial sarcomas aged 28 ~ 60 were more common in relatively younger , and patients with malignant mixed tumor aged about 56 were more common in postmenopausal women. Incidence rate of patients with endometrial interstitial sarcomas were more common (55.8%). (2) The patients usually manifested with abnormal vaginal bleeding (76%). Diagnosis curettage were the most commonly used before operation, which the positive rate was 65.3% and postoperative pathological di-agnosis was 35%. (3) 26 patients underwent one stage surgical treatment.7 patients underwent two stage surgical treatment. Surgical methods were the removal of the uterine double accessories and pelvic lymph node dissection. The five year survival rate was 77.7% (14/18). Conclusions The age range of uterine sarcoma is more exten-sive. Preoperative diagnosis can be diagnosed by curettage, and may also be missed. It should be paid attention to the operation of the examination examination , timely delivery of frozen examination to improve the diagnostic rate. and the appropriate surgical choice are meaningful methods to improve the prognosis.
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Objective To explore the effects of combined with treating winter disease in summer and acupoint application in obstructive lung disease patients with chronic obstructive pulmonary disease.Methods Based on normal treatment and community nursing, 184 patients with obstructive lung disease were treated with the therapy of combined with treating winter disease in summer and acupoint application. The associated symptoms and lung function index of patients were compared before and after 3 years.Result After 3 years' intervention,the patients' incidence of associated symptoms was less than before and lung function index was better than before with differences is statistical significance(P<0.05).Conclusion Treating winter disease in summer and acupoint application therapy for obstructive lung disease patients reducs the incidence of adverse reactiones of the therapy and improve lung fuction and quality of life.
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Objective To evaluate long term effect and related factors in patients with menorrhagia treated by microwave endometrial ablation(MEA).Methods Total of 334 women with menorrhagla were treated hy MEA,the range of age was from 29 to 59 years old.Among them,59 cases were complicated by adenomyosis.All the patients were followed up on the change of menstrual cycle.the amount of flow,improvement of anaemia and complication.Fifty-three women underwent outpatient diagnostic hysteroscopy,the biopsy tissue was taken from the endometrium for histopathological examination.The mean duration of follow-up was 64.7 months (3-96 months).Results The overall curative rate wag 91.3%(305/334),of which amenorrhea rate was 49.7%(166/334),menstruation reduction rate was 41.6%(139/334):71.1%(140/197) of the cases who previously had dysmenorrhea had relieved their pelvic pain and the satisfactory rate was 91.9%(307/334).Among patients＞40 years,92.9%(196/211) of operation effective rate,93.8% (198/211) of satisfactory rate and 64.9% (137/211) of amenorrhea rate were obtained.while patients≤40 years,88.6%(109/123) of operation effective rate,88.6%(109/123) of satisfactory rate and 23.6%(29/123) of amenorrhea rate were obtained.There was significant difierence in rate of operation effectiveness,satisfaction and amenorrhea (P＜0.05).Forty-two cases required subsequent treatment due to recurrence,of which 9 cases were given by secondary MEA and 33 cases (9.9%、33/334) underwent hysterectomy indicated by frequent menorrhagla,adenomyosis or leiomyoma.A completely destroyed endometrium was observed by hysteroscopy after MEA,pathologic characteristics of MEA showed two zones of necrotic tissue:the inner zone was coagulation necrosis and the outer zone of necrosis was hypocellular hyalinized myometrium.Conclusions MEA is the safe and efficacious management to treat menorrhagia.Incomplete removal of endometrium was the major reason resulting in postoperative recurrence.Young age and complicated with adenomysis were the main factors influencing long term clinical effect of MEA.