呼吸机应急调用的气源通用转接头制作与应用

目的：解决呼吸机在医院各临床科室接入中央供气管路的统一制式问题,使呼吸机在科室间能正常借调使用.方法：自行设计制作呼吸机通用转接头,经气密性实验后接入呼吸机供气管路中,保证呼吸机气源接头的制式统一性和通用性.结果：研制的呼吸机气源通用转接头能通用于临床科室的呼吸机和各厂家医用条带或吊塔、设备柱,实现了全院呼吸机气源接头的制式统一,确保了呼吸机的正常借用和应急调用.     

医院呼吸机供应中心的作用与管理

医院的呼吸机供应中心,在大型医院能够提高呼吸机的利用率,调节医院各临床科室呼吸机的需求平衡,为医院节约呼吸机的添购资金。呼吸机供应中心的管理在实际工作中非常重要,严格有效的管理是呼吸机供应中心正常运作的有力保障。     

呼吸机维护与维修中的风险管理应用研究

医用呼吸机在抢救过程中有着重要作用,以其用途为依据,可以分为功能单一辅助治疗呼吸机、急救呼吸机等;呼吸机在重症监护病房中有着广泛应用;在日常工作中,必须做好机器的维护工作;本文主要探讨呼吸机的维护与风险管理方法,便于为医院呼吸机管理提供合理依据。     

两种呼吸机回路系统在儿科监护室中的使用效果比较

目的 比较RT系列一次性呼吸机回路系统与传统呼吸机回路(硅胶管)在儿科监护室中的工作强度.方法 收集本院儿科监护室多例使用传统“硅胶管”呼吸机回路和使用RT系列一次性呼吸机回路的新生儿患者的观察数据,并对两组患儿(传统“硅胶管”呼吸机回路和应用RT系列一次性呼吸机回路的患儿各35例)在呼吸机使用过程中回路的更换率、回路系统组装的耗时数等方面进行比较.结论 RT系列一次性呼吸机回路系统比传统呼吸机回路系统更具优势,适合新生儿监护室使用.     

呼吸机结构分析与检测

从呼吸机的动力系统、控制系统、通气源、呼吸机输出气路及气路部件等4个方面对其总体结构特点及原理进行了阐述，总结了呼吸机在结构上的共性，指出按照不同的动力系统、不同的控制方式可以组合出不同的通气模式，使呼吸机不断的改进，而这些进步都是由呼吸机结构上的共性发展而来的。同时对呼吸机在运行中常见故障根据呼吸机的结构进行了分析．在此基础上讨论了对于呼吸机故障的解决方法，说明任何问题都要依赖于了解呼吸机的结构和原理。     

呼吸机，为生命打气

呼吸机,在老百姓眼里,充满了神秘感,甚至恐惧感。似乎病人一旦使用了呼吸机,就等于宣判了死刑。呼吸机成了“准死刑”的代名词,谣言也随之而起：上呼吸机没有用,只是费钱;上呼吸机非常遭罪;上了呼吸机就再也不能醒过来……     

谊安VG70呼吸机常见故障因素与维修维护探析

随着呼吸机在现代医疗救护中的应用日益广泛,呼吸机的需求量也在不断增加。临床应用过程中会应用到各种类型的呼吸机,设备的类型、通气原理都不尽相同,这就要求呼吸机维修维护保养人员必须能够具备足够的专业知识和技能,并及时更新了解呼吸机治疗理论及呼吸机原理、结构、性能等,以确保呼吸机能够随时处于正常可用状态。对呼吸机不同故障进行分析并开展有针对性的维护保养已经成为当今医院工作中非常重要的一部分。文章主要对北京谊安公司VG70呼吸机常见故障以及维护保养方法进行了分析研究。     

关于呼吸机集中管理可行性探讨

随着各类呼吸机在临床科室的广泛应用,如何提高呼吸机使用效率,减少不必要的呼吸机重复购置成为大型三甲医院医疗设备迈向科学化管理一大课题,我院现有呼吸机有创、无创共计118台,实际呼吸机利用率不足60%,现就我院呼吸机集中管理的试行做简单探讨,以供交流。     

呼吸机临床使用全生命周期的管理及维护

目的：探讨临床上最常用的呼吸急救和生命支持设备—呼吸机的管理及维护方法,科学地对呼吸机全生命周期进行管理、维护、维修及质量控制,提高呼吸机使用效率及效果。方法：科学地建立呼吸机引进、管理、维护与维修、报废及质量控制的规章制度,以确保呼吸机服务于临床的全程监控。结果：通过科学地对呼吸机全生命周期管理,使其能够在急救呼吸危重患者上发挥最大的作用。结论：呼吸机全生命周期的管理方法及维护流程,能够改善并提高呼吸机在临床使用质量,延长呼吸机的使用寿命。     

呼吸机质量安全风险管理及质控检测结果分析

目的：通过对呼吸机进行周期的质量控制以及加强呼吸机在临床应用中的安全风险管理,提高呼吸机的使用合格率。方法：采用专业的质量控制设备对近3 a来不同品牌同数量、同型号、不同条件下呼吸机的各项指标进行检测对比。结果：呼吸机的合格率呈现逐年上升的趋势,不合格的指标主要是呼吸机潮气量和氧气体积分数。结论：通过呼吸机的质量控制和安全风险管理,保证了呼吸机在临床使用中的安全性和可靠性。     

中山市儿童期超重对青少年肥胖影响的队列研究

目的 了解广东省中山市7~18岁儿童青少年肥胖的发病率,探讨儿童期超重对青少年肥胖的影响。方法 于2005年对中山市一年级小学生体检测量身高、体重,连续随访10年(1次/年),共有2 188名中山市小学一年级到高中一年级学生作为回顾性队列研究对象。使用2018年颁布的《学龄儿童青少年超重与肥胖筛查》 (WS/T 586-2018) 评价超重及肥胖,并计算肥胖的检出率及发病率,采用χ²检验和log-binomial模型分析儿童期超重对青少年肥胖的影响。结果 小学一年级学生肥胖的检出率为4.89%,小学四年级时达到最高为6.99%,高中一年级时为4.43%。肥胖的发病率在小学二年级时最高为1.83%,高中一年级时降低到0.74%。小学一年级时超重的学生在高中一年级时肥胖累积发病率是小学一年级时正常体重学生的8.85倍(9年的累积发病率41.33% vs.4.67%,RR=8.85,95%CI:6.12~12.78)。结论 从小学一年级到高中一年级期间,儿童期肥胖发病率较高。儿童期超重明显增加青少年肥胖的风险。肥胖干预应该从儿童期开展,尤其应该重点关注超重的儿童。     

Gamma-hydroxybutyric acid Efficacy, potential abuse, and dependence in the treatment of alcohol addiction

The main objective in alcoholism therapy is to achieve and maintain abstinence and to prevent relapse. Pharmacotherapy may be necessary in treating persons who are not helped by group or psychosocial support alone. Among the substances experimented with in the past few years, gamma-hydroxybutyric acid has been effective in preventing alcohol withdrawal syndrome and in inducing a reduction in craving and an increase in the abstinence rate in treated alcoholics, in view of the alcohol-mimicking effects of the drug on the central nervous system. However, a possible development of craving for the drug and the risk of abuse and physical dependence have been reported in subjects who used gamma-hydroxybutyric acid for different reasons, including alcoholism therapy. The present review updates the existing differences in drug abuse behavior, side effects, and poisoning in the use of gamma-hydroxybutyric acid in a treatment alcoholism program and in self nonclinical illicit use.     

中国东中西部地区乙型病毒性肝炎流行现状

目的了解中国东、中、西部地区乙型病毒性肝炎(乙肝)流行现状。方法利用2002年中国居民营养与健康状况调查保留的血清开展乙肝病毒感染血清学检测。结果①中国东、中、西部地区全人群乙肝病毒表面抗原(HBsAg)标化阳性率分别9.20%、7.24%、8.24%。东部地区城市、农村全人群HBsAg阳性率分别为4.29%、11.79%;中部地区城市、农村全人群HBsAg阳性率分别为4.41%、7.84%;西部地区城市、农村全人群HBsAg阳性率分别为4.53%、9.05%。②东、中、西部地区<15岁儿童HBsAg阳性率分别为6.46%、4.47%、5.48%。东部地区城市、农村<15岁儿童HBsAg阳性率分别为2.29%、12.39%;中部地区城市、农村<15岁儿童HBsAg阳性率分别为1.61%、6.82%;西部地区城市、农村<15岁儿童HBsAg阳性率分别为2.57%、7.35%。结论中国东、中、西部地区全人群HBsAg阳性率均有不同程度下降,<15岁儿童下降最明显。表明中国自1992年将乙肝疫苗纳入儿童计划免疫管理效果显著。     

西安市主城区健康乳母产后不同时期乳汁成分分析

目的研究人乳成分在不同时期的动态变化规律,以指导婴儿合理喂养。方法选取121名健康乳母,分别在其产后1~6、8、10、12月采集前乳和后乳,采用MIRIS HMA型人乳分析仪检测其中的蛋白质、脂肪、糖类、干物质含量以及能量。结果前乳和后乳中蛋白质含量在产后前3个月明显高于其它月份。乳汁中脂肪和能量的变化是一致的,前乳中脂肪、能量在产后12月内无差异,后乳中脂肪及能量10、12月组高于其它各组。产后1月前、后乳蛋白质含量差异无统计学意义,之后各组前乳均高于后乳。各个时期脂肪含量、能量、干物质后乳均明显高于前乳,而糖类含量前乳均高于后乳。结论人乳在产后不同时期有其自身的变化规律。     

The impact of the COVID-19 pandemic on hepatitis B virus vaccination and transmission among men who have sex with men: A mathematical modelling study

BackgroundDuring the COVID-19 pandemic, the number of hepatitis B virus (HBV) vaccinations among men who have sex with men (MSM) has been considerably lower than before the pandemic. Moreover, less frequent HBV testing and a reduction in numbers of sex partners have been reported. We assessed the impact of these COVID-19-related changes on HBV transmission among MSM in the Netherlands.MethodsWe estimated the changes in sexual activity, HBV testing, and HBV vaccination among MSM during the pandemic from Dutch data. We used a deterministic compartmental model and investigated scenarios with small or large declines in sexual activity, testing, and vaccination for the current phase of the pandemic (without available data). We examined the increase in HBV vaccinations needed to prevent further increase in HBV incidence.ResultsWith a decrease in numbers of sex partners of 15–25% during the first lockdown and 5% during the second lockdown, we found a decline of 6.6% in HBV incidence in 2020, despite a >70% reduction in HBV testing and vaccination during the first lockdown. With numbers of sex partners rebounding close to pre-pandemic level in 2021, and a reduction of 15% in testing and 30% in vaccination in 2021, we found an increase of 1.4% in incidence in 2021 and 3.1% in 2026. With these changes, an increase of ≥60% in HBV vaccinations in 2022 would be needed to bring the HBV incidence in 2023 back to the level that it would have had if the COVID-19-related changes had not occurred.ConclusionsDespite reductions in sexual activity during the COVID-19 pandemic, the decrease in HBV vaccinations may result in a small increase in HBV incidence after 2021, which may persist for years. It is important to restore the vaccination level and limit further increase in HBV transmission among MSM.     

Morphologie et alimentation de l’enfant : Évolution au cours des dernières décennies

Growth is a favourable period to study the association between environmental factors and body composition, as many body parameters can be investigated. The analysis of secular trends in nutrition and growth could suggest hypotheses about the factors responsible for the body parameter changes over time.We have conducted several studies at different periods to assess secular trends. We also have developed growth indicators such as the BMI growth curves, the adiposity rebound and the arm muscle and arm fat areas.Since many years, increased stature has been recorded in various countries. The same trend was recorded in our studies. Mean stature in 2000 was 1.31m and 1.30m in 8-year-old boys and girls respectively. In 1960, in the French reference study, these figures were 1.27 and 1.26m, corresponding to a 4cm increase over the last 40 years. A comparison between two longitudinal studies conducted 30 years apart, indicates that the higher stature recorded at adult age in the more recent study, mainly results from an increase stature in early life. This increase mainly results from increased leg length. Birth weight recorded in studies conducted at different periods did not reveal any changes. By contrast, in school children, an increase in weight has been recorded in the last decades. Studies conducted in 10-year-old children at different time periods revealed that the prevalence of overweight defined by the 97^th centile of the French reference values was about 3% in 1965, 6% in 1980, 12% in 1995 and 16% in 2000. The age at adiposity rebound was 6.2 years in children born in 1965 and 5.6 in those born 30 years later. The earlier rebound recorded in the more recent study reflects an acceleration of growth.While children are taller, fatter, and grow faster, mean energy intake decreases over time, particularly due to a decrease in fat intake. The infant diet in many countries (by the age of 6-12 months) is characterised by high levels of proteins and low levels of fat. The high protein diet in infancy could explain the rapid growth process observed nowadays. Various studies have suggested that an accelerated growth in early life is associated with risk factors. Like in adults, obesity in children, is associated with metabolic diseases.In conclusion, growth is the period when environmental factors can have long lasting influence on body composition. The secular trends reported in many countries, such as increased stature, accelerated growth or the increasing prevalence of obesity, could result from influences taking place early in life. It is then important to develop research focussing on the identification of the early environmental factors which influence adult health.     

Social inequalities in ischaemic heart and cerebrovascular disease mortality in men: Spain and France, 1980–1982 and 1988–1990

In this study we analyse the trend in socio-economic differences in mortality from ischaemic heart and cerebrovascular diseases in the economically active male population aged 25–64 years in Spain and France. The data used were taken from deaths from these two causes in 1980–1982 and 1988–1990; in the case of Spain the data came from the Eight Provinces Study. Individuals were grouped into four categories — professional/managerial, clerical/sales/service workers, farmers, and manual workers — and the mortality rate ratio was estimated with reference to the professional/managerial group. For ischaemic heart disease in 1980–1982, professionals and managers aged 25–44 years had the lowest risk of mortality in Spain, and the highest risk of mortality in France; in 1988–1990 the socio-economic differences in mortality in Spain increased, whereas the relation was inverted in France. In 1980–1982, professionals and managers aged 45–64 years had higher mortality from ischaemic heart disease than the other occupational groups in both countries; in 1988–1990 this relation was inverted, except in the case of clerical/sales/service workers in Spain. For cerebrovascular disease, manual workers experienced the highest mortality in the 25–44 year age group in 1980–1982, and the differences increased in 1988–1990 in all groups with respect to professionals and managers in both places. Professionals and managers in France and manual workers in Spain had the highest mortality between 45 and 64 years in 1980–1982; in contrast, in 1988–1990 professionals and managers had the lowest risk of mortality from this disease in both Spain and France, although in Spain the magnitude was similar to that of clerical/sales/service workers. In general terms, mortality from each disease was different in professionals and managers than in clerical/sales/service workers. Thus, the pattern of mortality and its evolution in different socio-economic groups cannot be analysed accurately when the two occupational groups are combined in a single large group of non-manual workers.     

安徽省男男性行为人群艾滋病防治服务利用情况分析

目的了解安徽省男男性行为(MSM)人群对艾滋病防治服务的利用情况,为制定防治策略提供依据。方法利用中国疾病预防控制中心性病艾滋病预防控制中心2008～2009年组织的全国MSM人群调查安徽省的资料,对有关艾滋病防治服务的利用情况进行分析。全国MSM人群调查在61个城市开展,于2008～2009年每隔6个月开展1次共3次调查,安徽省有合肥和芜湖2个市参加了这个调查。结果安徽省3轮调查的人数分别是490、443和708人。大多数人参加调查的目的是为了作艾滋病检测,了解自身感染状况,3轮分别占72.4%、71.8%和74.7%。调查对象获得艾滋病防治知识信息的主要来源前3位是互联网、电视、免费宣传材料,均超过40%。而学校教育、广播和宣传栏广告栏是MSM人群获得信息的倒数前3位,均在20%左右或以下。调查对象获得较多的预防艾滋病服务是安全套、宣传材料和润滑剂的发放,均超过50%。获得较少的服务是性病检查或治疗,只有26.8%。自报在最近一年作过艾滋病病毒抗体检测的人数和比例分别是149(30.4%)、195(44.1%)、383(54.1%)(2χ=68.57,P<0.001)。在接受检测的人中,知道检测结果的人数和比例分别为133(86.4%)、169(84.9%)、353(91.2%)(2χ=6.00,P=0.050)。结论安徽省MSM人群艾滋病知识和信息来源的渠道多,主要集中在互联网、电视和免费宣传材料发放;预防艾滋病服务和艾滋病检测服务利用不足。     

2005年和2015年曲靖市2所学校学生体质量超标和肥胖状况比较

目的 比较2005年和2015年2所中小学校学生体质量超标肥胖状况及变化趋势,为采取有效的干预措施提供参考。方法 选择曲靖市重点中学及小学各1所,共11 516名学生,按《中国卫生监督统计报表学校卫生年报表技术规范》和《全国学生体质健康调研检测细则》的要求进行健康检查测量。结果 曲靖市2所学校2005年至2015年中小学生体质量超标检出率中学生由7.63%升至10.85%(χ2=18.801,P<0.05);小学生由8.36%上升至10.61%(χ2=7.657,P<0.05);肥胖检出率中学生由5.56%升至8.37%(χ2=18.487,P<0.05);小学生由6.96%上升至15.23%(χ2=86.943,P<0.05);体质量超标检出率男生由8.80%升至11.97%(χ2=16.456,P<0.05);女生检出率由6.86%上升至9.46%(χ2=11.601,P<0.05);肥胖检出率男生由7.87%升至14.45%(χ2=66.099,P<0.05);女生检出率由3.98%上升至8.85%(χ2=49.030,P<0.05)。结论 曲靖市中小学生体质量超标、肥胖处于增长趋势,小学生肥胖明显高于中学生,男生体质量超标和肥胖明显高于女生。需要采取相应的干预措施。     

2007年宁南县麻风病疫点与家庭发病情况调查

[目的]为制定麻风病防制策略提供科学参考。[方法]2007年,对宁南县全部现存麻风病患者及历年治愈者(现存者)进行疫点与家庭发病情况调查。[结果]调查全部现存者218例,占全县人口的0.12%,占调查疫点人口的2.08%,占调查家庭人口的17.94%。MB病例所占比例,全县为58.26%(127/218),调查疫点为63.77%(44/69),调查家庭为62.92%(56/89);调查疫点继发率为146.43%,调查家庭继发率为117.07%,MB率分别为63.41%和41.67%。[结论]疫点人群和家庭人群是麻风病防制的监视人群。