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Objective:To explore the integration path of medical resources in regional medical consortium, find out the problems affecting the process of integration, and put forward relevant suggestions.Methods:Methods According to the purposive sampling and combined with grounded theoretical research methods, semi-structured interviews were conducted with 73 government officials, heads and backbones of medical institutions in different regions of a city from August to November 2019. The data obtained from semi-structured interviews were analyzed by using grounded theory, and the path framework of medical resource integration in regional medical consortium was constructed through open coding, spindle coding and selective coding.Results:Four key links of medical resource integration in the regional medical alliance were sorted out, namely, integration prerequisites, integration strategies, support conditions, and integration methods, which together constituted the main axis of the theoretical framework. In addition, integration methods were affected by integration prerequisites, integration strategies and support conditions. The four factors and integration willingness served as influencing factors to exert impact on the integration tendency.Conclusions:The integration of medical resources in the medical alliance is a systematic project, which emphasizes the organic and overall governance of each key link, and the interaction between various elements will affect the final effect of medical resource integration.
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@#Objective To study the feasibility, safety, tolerance and the effectiveness of constraint-induced movement therapy (CIMT) in early cerebral infarction, and the long-term outcome.Methods 2 weeks after cerebral infarction, 22 patients with upper extremity weakness were divided into treatment group (11 cases, accepted CIMT) and control group (11 cases, accepted routine rehabilitation). They were assessed with Fugl-Meyer Assessment (FMA), Wolf Motor Function Test (WMFT), Motor Activity Log (MAL) and Barthel Index (BI) before and 2 weeks, 3 months after treatment. Results The scores of FMA, WMFT, MAL and BI improved in both group (P<0.05), but more in the treatment group (P<0.05). 3 months after treatment, the score of MAL quality was no different between two group.Conclusion CIMT is safe and effective for early cerebral infarction, and more effective than routine immediately, but it is similar 3 months later.
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Objective To evaluate the outcome of unconstrained shoulder arthroplasty in treatment of se- vere damages of shoulder and proximal humerus.Methods Eleven cases of unconstrained shoulder arthroplasty were carried out in our department from 1999 to 2004.The average age of the 11 patients was 65 years.Nine cases underwent hemi-arthroplasty for their complex fractures of proximal humerus with unstrained protheses and two cases received total shoulder arthroplasty for their shoulder osteoarthritis.Cemented prostheses were used in all the cases. Results Follow-ups averaged 2.3 years.Two cases of four-part fractures reported slight pain and limited external rotation of the shoulder after operation,while there was no pain or loosening of prosthesis in all the other cases who recovered full range of motion.Conclusion Unconstrained shoulder arthroplasty is a satisfactory and safe tech- nique for severe damages of proximal humerus.
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Objective To observe the effect of Guxi Recipe 2 combined with joint loosening training for the treatment of postoperative ankylosis in tibial plateau fracture patients.Methods Thirty-two patients with postoperative ankylosis had active exercise combined with small-range continuous passive motion(CPM) 2 weeks after operation,and received steaming and washing with Guxi Recipe 2(mainly composed of Herba Menthae,Radix Saposhnikoviae,fermented soybean,Rhizoma et Radix Notopterygii,Ramulus Cinnamomi,Radix Clematidis,Radix Pterospermi Heterophylli,Radix Angelicae Pubescentis,Olibanum,Cortex Acanthopanacis,and Myrrha) combined with CPM and manipulation for loosening joint 3 weeks after operation.The function of knee joint was assayed with the criteria of knee joint function evaluation issued by the Hospital for Special Surgery(HSS) 6 and 12 months after operation.Results The results of knee joint function scoring showed that the therapeutic effect was excellent in 21 patients,good in 8,average in 3,and the excellent and good rate was 90.6%.Conclusion Guxi Recipe 2 combined with joint loosening training is effective on the recovery of knee joint function of tibial plateau fracture patients with postoperative ankylosis.