慢性阻塞性肺疾病患者住院日适当性评价与分析

目的分析某院慢性阻塞性肺疾病（COPD）患者住院日的适当性及其影响因素,为进一步研究提供依据。方法利用国际上广泛应用的入院及住院日适当性评价方案评价标准,采用回顾性调查的方法对某院2011年入院的COPD患者的350个住院日进行适当性评价。结果 15.4%的住院日被判定为不适当住院日,影响患者住院日适当性的主要因素是费用支付方式和住院天数。结论本研究不适当住院日所占比例较低,但是需进一步研究,并制定本土化适当性评价标准。     

老年慢性阻塞性肺疾病合并陈旧性肺结核患者抑郁相关因素调查

目的 研究老年慢性阻塞性肺疾病合并陈旧性肺结核患者抑郁的相关因素.方法 按照入院登记序号选取某科室2009年1月～2011年12月入院诊治慢性阻塞性肺疾病合并陈旧性肺结核患者90例,其中男56例,女38例,病程1.5～30年.用汉密顿抑郁量表(Hamilton Depression Scale,HAMD)进行评定.结果 老年慢性阻塞性肺疾病合并陈旧性肺结核患者抑郁的发病情况与患者的年龄、家庭经济收入、病程长短等因素有关,而与患者的文化程度等因素无关.结论 老年性老年慢性阻塞性肺疾病合并陈旧性肺结核患者在患病及入院诊治的过程中常伴有抑郁的发生,医者应根据其抑郁的相关因素进行正确的心理疏导,以帮助患者康复及减少抑郁的发生.     

慢性阻塞性肺疾病合并肺癌252例临床分析

[目的]探讨慢性阻塞性肺疾病(COPD)合并愿发性支气管肺癌(简称肺癌)的临床特点及诊断.[方法]通过临床表现、影像学、病理学对COPD合并肺癌252例患者进行临床分析.[结果]慢性阻塞性肺疾病合并肺癌多系老年人,吸烟者及肺内有慢性炎性疾病和癜痕病变者.[结论]慢性阻塞性肺疾病患者应定期体格检查,及早发现亚临床症状的早期肺癌.     

慢性阻塞性肺疾病急性加重危险因素临床观察与研究

目的探讨慢性阻塞性肺疾病(COPD)患者出院后再入院的风险及危险因素。方法分析2013~2014年诊断为COPD急性加重的住院患者及出院后再入院原因,同时根据其是否1年内再住院分为未再住院组及再入院组,分析两组间年龄、性别、体质量指数、吸烟、使用药物、肺功能、血气、降钙素原(PCT)、C反应蛋白(CRP)等方面的差异。结果两组患者的性别、年龄、吸烟指数等无统计学差异(P0.05),既往住院史、低BMI、差FEV1%pred、增高的CRP及PCT,差异有统计学意义(P0.05)。结论影响慢性阻塞性肺疾病患者再住院的因素主要为既往住院史、炎性生物标讠志物水平及肺功能损害程度,同时积极改善患者的营养状态,对减少患者再住院有重要的意义。     

慢性阻塞性肺疾病的诊治

目的总结慢性阻塞性肺疾病的诊疗方法,使其临床系统化。方法分析2007年我科的100例典型慢性阻塞性肺疾病的患者的临床特点,将其诊断治疗方法进行归类总结。结果临床100例慢阻肺患者经我院治疗的有效率为84%(包括痊愈+显效+有效的患者)。结论存在不完全可逆性气流受限是诊断慢性阻塞性肺疾病(COPD)的必备条件。肺功能检查是诊断慢性阻塞性肺疾病(COPD)的金标准。治疗慢性阻塞性肺病应按临床分型而采取不同的治疗策略。     

老年慢性阻塞性肺疾病患者抑郁发病情况及影响因素分析

目的：探讨老年慢性阻塞性肺疾病（COPD）患者抑郁发病情况及影响因素,为老年慢性阻塞性肺病患者抑郁症的预防和治疗提供理论依据。方法：选取本院2012年1月-2013年6月收治的135例老年慢性阻塞性肺疾病患者作为研究对象,采用CES-D抑郁量表进行调查,分析抑郁发病情况及其影响因素。结果：135例COPD患者中共55例发生抑郁,发病率40.74%。年龄、吸烟情况、病情严重程度以及COPD病程是影响COPD患者抑郁发病情况的独立危险因素（P〈0.05）。病情严重程度是最强因素。结论：老年慢性阻塞性肺病患者抑郁发病率较高,年龄、吸烟情况、病情严重程度以及COPD病程是影响COPD患者抑郁发病情况的独立危险因素,应针对性给予情感支持和心理干预。     

COPD住院患者CD-RISC量表评分现况调查及影响因素

目的 分析慢性阻塞性肺疾病(COPD)住院患者心理弹性量表(CD-RISC)评分现况及影响因素.方法 选取2018年2月至2020年2月本院收治的110例COPD住院患者为研究对象,均采用一般资料调查表、CD-RISC、领悟社会支持量表(PSSS)进行调查,统计调查结果,分析CD-RISC评分的影响因素.结果 问卷调查...     

慢性阻塞性肺疾病合并呼吸衰竭患者无创机械通气的护理体会

目的:探讨对慢性阻塞性肺疾病(COPD)合并呼吸衰竭(ARF)患者使用无创机械通气治疗后的护理方法和体会.为慢性阻塞性肺疾病(COPD)合并呼吸衰竭(ARF)患者使用无创机械通气治疗后的护理提供科学的指导.方法:回顾性分析100例慢性阻塞性肺疾病(COPD)合并呼吸衰竭(ARF)患者的相关临床资料,使用无创机械通气治疗后进行综合性护理,观察患者的治疗效果.结果:在100例慢性阻塞性肺疾病(COPD)合并呼吸衰竭(ARF)患者中,经过治疗和护理有92例患者的临床症状和血常规检查得到明显改善,治疗结束后患者的PaO2含量(84.23±7.31)mmHg显著高于治疗前的(47.29±6.78)mmHg,治疗后的PaCO2含量(41.23±9.22)mmHg显著低于治疗前的(75.23±9.11)mmHg.结论:无创机械通气在治疗慢性阻塞性肺疾病合并呼吸衰竭的患者时有利于改善其呼吸状况,加之以正确的护理干预措施可以明显提高机械通气治疗的成功率,减少术后不良反应和并发症的发生.     

药物预防慢性阻塞性肺疾病患者真菌感染的探讨

慢性阻塞性肺疾病((COPD)是呼吸内科的主要疾病,呼吸道感染是造成COPD患者急性加重的重要因素,在COPD急性加重期(AECOPD)的治疗中,抗生素是不可缺少的,同时根据病情可能还要使用激素,这样就容易引起侵袭性真菌感染(IFI),加重病情,增加了治疗的难度,甚至导致患者死亡.目前报道最多的是侵入性肺曲霉菌病(IPA).     

90例慢性阻塞性肺疾病并发低钠血症医源性因素分析

<正>慢性阻塞性肺疾病(Chronic obstructive pulmonary disease,COPD)是一种严重危害公众健康的慢性呼吸系统疾病,急性加重期COPD(AECOPD)常常并发低钠血症,对原发病的转归与预后产生重要影响。本文采用回顾性研究,分析COPD急性加重期合并低钠血症患者的临床资料和实验室检测资料,深入了解医源性因素对患者并发低钠血症及严重程度的影响作用。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.