兰索拉唑治疗慢性胃溃疡的效果及用药不良反应评价

目的评价兰索拉唑治疗慢性胃溃疡的效果及用药不良反应。方法100例慢性胃溃疡患者,通过随机数字编号分为对照组与研究组,每组50例。对照组给予奥美拉唑肠溶片治疗,研究组采用兰索拉唑肠溶胶囊治疗,比较两组生活质量评分、治疗效果、不良反应(腹泻、头痛)发生情况。结果治疗后,研究组生活质量评分(80.32±2.33)分高于对照组的(73.31±3.21)分,差异具有统计学意义(P<0.05)。研究组治疗总有效率96.00%高于对照组的84.00%,差异具有统计学意义(P<0.05)。研究组不良反应发生率4.00%低于对照组的16.00%,差异具有统计学意义(P<0.05)。结论兰索拉唑治疗慢性胃溃疡的临床效果显著,可以有效降低患者的用药后不良反应发生率,能够改善患者的生活质量水平。     

静脉用药调配中心优化院内感染控制管理对患者静脉输液质量及降低医院感染率的影响

目的:探究静脉用药调配中心(PIVAS)优化院内感染控制管理对患者静脉输液质量及降低医院感染率的影响。方法:抽取2015年1月—2016年12月间PIVAS 1586例患者资料(优化管理前);另抽取2017年1月—2019年1月实施优化管理后的1865例患者资料(优化管理后);优化管理前后PIVAS工作人员均为25名;比较优化管理前后静脉输液质量及医院感染率的差异。结果:与优化管理前相比,优化管理后化疗药物的包装、输液配制质量及操作台环境的满意度均较高(P<0.05),院内感染发生率低于优化管理前(P<0.05)。结论:PIVAS实施优化院内感染控制管理,有效提高了静脉输液质量,遏制了院内感染的发生,保证了患者用药的安全性。     

基于一测多评法对丁蔻理中丸中6种成分的质量控制研究

目的:建立一测多评法同时测定丁蔻理中丸中白术内酯Ⅲ、白术内酯Ⅰ、丁香酚、6-姜辣素、8-姜酚、10-姜酚6种成分的含量。方法:以白术内酯Ⅰ为内标物,建立白术内酯Ⅰ与白术内酯Ⅲ、丁香酚、6-姜辣素、8-姜酚、10-姜酚之间的校正因子,计算待测成分含量,并将外标法测定值与一测多评法计算值进行对比,验证所建立一测多评法的准确性。结果:白术内酯Ⅲ、白术内酯Ⅰ、丁香酚、6-姜辣素、8-姜酚和10-姜酚分别在1.09~21.80μg·mL-1、0.71~14.20μg·mL-1、13.67~273.40μg·mL-1、6.04~120.80μg·mL-1、1.46~29.20μg·mL-1、1.78~35.60μg·mL-1范围内线性关系良好;各成分一测多评法计算值与外标法实测值无显著性差异。结论:利用校正因子对丁蔻理中丸中6种成分的含量测定是可行的,一测多评法可以用于丁蔻理中丸的质量评价研究。     

Cardiopulmonary Resuscitation Feedback: A Comparison of Device-Measured and Self-Assessed Chest Compression Quality

BackgroundHigh-quality cardiopulmonary resuscitation is the foundation of cardiac arrest care. Guidelines specify chest compression depth, recoil, and rate, but providers often fail to achieve these targets. Furthermore, providers are largely unable assess the quality of their own or other peoples’ chest compressions. Chest compression feedback devices can improve chest compression quality; their use is endorsed internationally, but they remain largely absent in clinical care.This article analyzes preclinical data collected during a quality improvement project. It describes provider demographics and perceptions about their chest compression quality and correlates them to measured chest compression quality, compares clinician perception of chest compressions to objective measures, and describes the effect of feedback on compression quality.MethodsClinicians were recruited from 2 metropolitan emergency departments. A questionnaire was used to assess participants’ levels of training and experience. A before-and-after assessment of chest compression quality was performed using a Laerdal CPRmeter 2 and a CPR mannequin. Pretest measures of chest compression quality were made by covering the device screen thereby blinding providers to feedback; repeat measures were then collected from the same participants but unblinded to feedback. Provider charecteristic were collected by survey. Correlations between blinded chest compression quality and provider charecteristics; the reliability of providers estimated compared to measured quality; and the effects of feedback on chest compression quality were assessed using Pearsons correlations, Cohens κ, and paired t testing.Results84 participants were assessed. The mean years of certification were 11.74. Ninty-five percent of the providers self-assessed as more experienced than novice and 81% reported performing cardiopulmonary resuscitation at least occasionally. The frequency of performing chest compressions was correlated with self-assessed skill (r = 0.58, P < .001). However, self-assessed skill was only weakly correlated with chest compression quality (r = 0.29, P = .01) and not at all with the frequency of performing chest compressions or years of certification. There was no agreement between self-assessed and device-measured chest compression depth (κ = ?0.10, P = 0.11), recoil (κ = ?0.14, P = .03), or rate (κ = 0.06, P =.30). The overall quality of compressions improved by 16.9%; the percentage of chest compressions achieving target depth by 3.58%; recoil by 22.82%; and rate by 23.66% with feedback. A total of 97.6% of the staff rated chest compression feedback helpful.ConclusionsOur findings suggest that participants’ demographics were not correlated with chest compression quality and that providers cannot reliably assess chest compression quality. The data also demonstrate that with minimal training, feedback can significantly improve chest compression quality.     

芳香化酶抑制剂治疗期间乳腺癌患者症状群对生活质量的影响

目的 探讨乳腺癌患者在接受芳香化酶抑制剂（aromatase inhibitor,AI）治疗期间所出现的症状群及生活质量,并分析症状群与生活质量的相关性。方法 采取横断面调查,选取2020年4月—2021年1月就诊于北京市某肿瘤专科医院乳腺中心门诊患者260例。采用一般情况调查表、安德森症状量表、简明健康调查量表进行调查。 结果 回收有效问卷254份。通过主成分分析,提炼出3组症状群：病感症状群、治疗相关-心理症状群、消化系统症状群。患者简明健康调查量表生理健康、心理健康得分分别为（38.51±12.03）分、（43.06±14.29）分。多元线性回归分析显示,病感症状群越重、治疗相关-心理症状群越重、体重指数越高、文化程度越低,患者的生理健康越差;随着口服AI时间的延长,生理健康会有所改善。治疗相关-心理症状群越重,则患者的心理健康越差。 结论 乳腺癌患者在接受AI治疗期间存在多组症状群,症状群与生活质量呈负相关。医护人员应关注接受AI治疗患者,有必要制订针对性的干预措施,以缓解症状群并改善患者的生活质量。     

居家安宁疗护对晚期癌症患者生活质量和情绪影响的Meta分析

目的 系统评价居家安宁疗护对晚期癌症患者生活质量和情绪的影响,为相关研究提供循证依据。 方法 计算机检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、CINAHL、CENTRAL、PubMed、Web of Science、Embase中关于居家安宁疗护对晚期癌症患者的随机对照试验,并追踪参考文献,检索时限为建库至2020年11月13日。由2名研究者独立筛选文献并交叉核对纳入文献质量,按照Cochrane评价手册5.1.0的质量评价方法评价纳入文献质量。采用RevMan 5.3软件进行Meta分析。 结果 共纳入10篇文献,包括1 720例晚期癌症患者。Meta分析结果显示,居家安宁疗护可以改善晚期癌症患者的生活质量[SMD=0.41,95%CI（0.30,0.51）,Z=7.44,P<0.001],减轻抑郁情绪[SMD=-0.29,95%CI（-0.45,-0.14）,Z=3.68,P<0.001],尚不能认为居家安宁疗护能够减轻晚期癌症患者的焦虑情绪[SMD=-0.15,95%CI（-2.12,1.82）,Z=0.15,P=0.880]。 结论 居家安宁疗护能够提高晚期癌症患者的生活质量,减轻患者的抑郁情绪,暂未发现能够减轻患者的焦虑情绪,需高质量、大样本研究进一步探讨居家安宁疗护对患者的影响。     

不锈钢麻花牵引圈的制作及在管腔器械清洗质量检查中的应用

目的 制作不锈钢麻花牵引圈并探讨其在管腔器械清洗质量检查中的应用效果。方法 将制作的不锈钢麻花牵引圈用于管腔器械清洗质量的检查,通过与目测+光源放大镜法、探条纱布法、ATP生物荧光法做比较,评价其在管腔器械清洗质量检查中的效果。结果 A类空腔器械清洗质量检查中,麻花牵引圈法、目测+放大镜法和ATP生物荧光法的清洗质量检查合格率差别有统计学意义（P<0.010）,两两比较,目测+放大镜法合格率最高,与其他2组的检查合格率差异具有统计学意义（P<0.017）,麻花牵引圈法与ATP生物荧光法的检查合格率差异无统计学意义（P>0.017）。B类空腔器械清洗质量检查中,4种清洗质量检查方法合格率差异具有统计学意义（P<0.010）,两两比较,目测+放大镜法合格率最高,与其他3组的检查合格率差异具有统计学意义（P<0.008）。麻花牵引圈法、探条纱布法和ATP生物荧光法的检查合格率差异无统计学意义（P>0.008）。结论 不锈钢麻花牵引圈在管腔器械清洗质量检查中,能发现目测+放大镜法无法检出的不合格器械,其检测效果与探条纱布法、ATP生物荧光法相当,比ATP生物荧光法节省费用,但操作较金属探条法便捷,适用范围更广。     

The relationship between interpersonal problems,negative cognitions,and outcomes from cognitive behavioral group therapy for depression

Background

Interpersonal functioning is a key determinant of psychological well-being, and interpersonal problems (IPs) are common among individuals with psychiatric disorders. However, IPs are rarely formally assessed in clinical practice or within cognitive behavior therapy research trials as predictors of treatment attrition and outcome. The main aim of this study was to investigate the relationship between IPs, depressogenic cognitions, and treatment outcome in a large clinical sample receiving cognitive behavioral group therapy (CBGT) for depression in a community clinic.

Methods

Patients (N=144) referred for treatment completed measures of IPs, negative cognitions, depression symptoms, and quality of life (QoL) before and at the completion of a 12-week manualized CBGT protocol.

Results

Two IPs at pre-treatment, ‘finding it hard to be supportive of others’ and ‘not being open about problems,’ were associated with higher attrition. Pre-treatment IPs also predicted higher post-treatment depression symptoms (but not QoL) after controlling for pre-treatment symptoms, negative cognitions, demographics, and comorbidity. In particular, ‘difficulty being assertive’ and a ‘tendency to subjugate one's needs' were associated with higher post-treatment depression symptoms. Changes in IPs did not predict post-treatment depression symptoms or QoL when controlling for changes in negative cognitions, pre-treatment symptoms, demographics, and comorbidity. In contrast, changes in negative cognitions predicted both post-treatment depression and QoL, even after controlling for changes in IPs and the other covariates.

Limitations

Correlational design, potential attrition bias, generalizability to other disorders and treatments needs to be evaluated.

Conclusions

Pre-treatment IPs may increase risk of dropout and predict poorer outcomes, but changes in negative cognitions during treatment were most strongly associated with improvement in symptoms and QoL during CBGT.     

Maurice Tréand et les autobiographies du Parti communiste français

The system of biographies in the French Communist Party was a system for evaluating and selecting militants. It was really put in place only thanks to the action of one man, the prototype of the Bolshevik, “à la française”. Born in 1900, son of a customs officer who died of alcohol and a farmer. Tuberculous, he becomes a waiter and adheres to communism. With a brawling temperament, he is also noted by the local PCF leadership for his organizational skills. Regularly imprisoned, he was called by the national leadership of the PCF to reorganize the PCF in the regions and then in Paris. Sent to the best training place for a communist, the International Leninist School, he learned the techniques of going underground and the workings of the Soviet model party. On his return to France, he applied his methods to the functioning of the PCF and imported the new biographical questionnaire. Analysis of the questionnaires shows that in the name of fear of police infiltration and heterodoxy, an extremely thorough control system of militant personnel has been developed. Tréand's entire character led him to misinterpret the new line of the Communist International, which led to his political downfall and death in 1949.     

Oncoplastic Surgery in Breast-Conserving Treatment: Patient Profile and Impact on Quality of Life

BackgroundBreast-conserving treatment (BCT) provides better quality of life (QL) than mastectomy without reconstruction. Oncoplastic surgery (OS) encompasses a series of surgical techniques, increasing the indications for BCT, but few studies have evaluated the impact on QL in patients who undergo BCT with OS.Materials and MethodsA prospective, cross-sectional study was conducted in women who underwent BCT. We evaluated the characteristics of patients who underwent BCT with and without OS and the associated QL. QL was assessed through the EORTC QLQ-30, EORTC QLQ-BR23, and Breast Cancer Treatment Outcome Scale (BCTOS) questionnaires.ResultsA total of 300 patients underwent BCT, 72 underwent breast OS, and 37 underwent bilateral surgery. Patients who underwent OS were younger (p = 0.004), had a higher level of education (p = 0.01), had a smaller time interval since the end of treatment (p = 0.02), had tumours with greater dimensions (p = 0.003), and were more likely to receive neoadjuvant chemotherapy (p = 0.05). Based on the QL questionnaires, no difference was observed between the groups. Breast symmetry was not associated with high patient satisfaction (p = 0.55).ConclusionDespite the fact that OS was performed in patients with worse tumour conditions and in more demanding patients, OS allowed similar cosmetic results to classical BCT.