Assessment of spermicidal activity of the antimicrobial peptide sarcotoxin Pd: A potent contraceptive agent

Objectives In searching for new spermicidal microbicides for use in the prevention of unplanned pregnancy and sexually transmitted infections (STIs) we investigated the spermicidal and cytotoxicity activities of the antimicrobial peptide sarcotoxin Pd.

Methods Washed sperm from 10 healthy, normal volunteers was treated with different concentrations of sarcotoxin Pd. Sperm motility and morphology were assessed at 0, 0.3, 5, 10 and 15 min. The cytotoxicity of sarcotoxin Pd in normal human cervical HeLa cells was measured. Percentage cell survival was expressed as the number of live cells in the test group.

Results The cytotoxic effect of sarcotoxin Pd was concentration-dependent. Significant cytotoxicity was observed at concentrations above 24 μg/ml. Sarcotoxin Pd immobilised 100% of spermatozoa at a dose of 90 and 80 μg/ml after 0.3 and 5 min, respectively, and immobilised 50% of spermatozoa after 15 min at lower doses. Sarcotoxin Pd inhibited sperm motility in a dose-dependent manner. The peptide immobilised sperm within 20 s at its maximal effective concentration of 90 μg/ml.

Conclusions Sarcotoxin Pd appears to be a good candidate for a contraceptive agent in the prevention of unplanned pregnancy and STIs.     

安全型无指硬底约束手套在防止患者术后拔管中的应用

目的：探讨安全型无指硬底约束手套对术后患者的约束效果。方法采用随机抽样的方法，将100例术后患者随机分为观察组（50例）和对照组（50例），分别应用安全型无指硬底约束手套及常用约束带对患者进行防护性约束。结果观察组患者拔管及并发症的发生率显著低于对照组（ P＜0．05、P＜0．01）。结论安全型无指硬底约束手套的防护性约束效果明显优于目前常用的约束带。     

ICU气管插管患者改良约束护理方案的临床应用效果分析

目的探讨ICU气管插管患者约束方案的改良及效果。方法选取2017年6月～2018年6月34例干预组实施呼吸机辅助通气的ICU,给予约束方案的改良护理干预,缩减约束,另外,选取2016年6～7月31例患者采用常规约束护理流程,作为对照组,对比分析两组患者的非计划性拔管率、身体约束率、约束时间、患者或家属的满意度。结果两组患者的拔管前指标比较差异无统计学意义(P0.05),干预组非计划性拔管发生率、身体约束率降低,约束时间缩短;患者或家属的满意度提升,与对照组比较,差异均有统计学意义(P0.05)。结论约束方案的改良护理干预可降低患者的身体约束率,减少ICU气管插管非计划性拔管的发生率,提高护理满意度。     

高频重复经颅磁刺激对脑卒中后吞咽障碍患者摄食功能的影响

目的 探讨高频重复经颅磁刺激（rTMS）对脑卒中后吞咽障碍患者摄食功能和进食途径的影响。方法 选取2019 年5 月至2020 年5 月绍兴市人民医院康复医学科收治的脑卒中后留置鼻饲管的吞咽障碍患者60 例,按随机数字表法分为对照组30 例和观察组30 例。对照组给予常规摄食训练,观察组rTMS 后行摄食训练。治疗前后,两组行改良曼恩吞咽能力评估（MMASA）和功能性经口摄食评估（FOIS）,并比较治疗后拔管人数。结果 治疗前,两组患者MMASA 评分、FOIS 评分比较,差异无统计学意义（P>0.05）。治疗后,观察组MMASA 评分、FOIS评分分别为（85.03±9.01）分、（5.64±1.42）分,均高于对照组的（77.27±18.66）分、（4.62±1.80）分,差异有统计学意义（P<0.05）;观察组拔管例数（27 例）多于对照组（19 例）,差异有统计学意义（P<0.05）。结论 高频重复经颅磁刺激能改善患者吞咽摄食功能水平,帮助患者尽快拔除鼻饲管,恢复正常经口进食。     

PDCA循环法在重症烧伤患者胃管非计划性拔管的应用

目的 探讨PDCA循环法在留置胃管的重症烧伤患者非计划性拔管中的应用效果,以提高烧伤重症监护室的护理质量,降低胃管非计划性拔管的发生率.方法 将PDCA循环法应用于重症烧伤患者胃管非计划性拔管管理中,比较PDCA循环法实施前后胃管非计划性拔管的发生率.结果 PDCA循环法实施后胃管非计划性拔管发生率为5.1％,低于实施前的14.9％,差异有统计学意义(P＜0.05).结论 PDCA循环法在重症烧伤患者胃管非计划性拔管中发挥了积极作用,降低了胃管非计划性拔管的发生率,值得进一步在临床上推广使用,以提高患者安全.     

管道护理在IABP患者非计划性脱管和拔管中的价值

目的：探讨管道护理在主动脉内球囊反搏患者非计划性脱管和拔管中的价值。方法方便选择2013年6月—2015年9月该院收治的冠心病需要行IABP治疗患者80例,按照随机数字法分为两组,各40例,观察组实施该研究护理干预方法,对照组实施常规护理,比较两组非计划性脱管及拔管比例及两组IABP治疗时间及因导管问题引起死亡情况。结果观察组发生非计划性脱管﹑拔管的比例分别为2.5%和2.5%,均显著低于对照组的22.5%和25.0%差异有统计学意义(P<0.05),观察组IABP治疗时间为(128.6±25.1)h,长于对照组的(103.5±23.3)h,差异有统计学意义(P<0.05),治疗后因导管问题引起死亡例数为1例,比例为2.5%,显著低于对照组的9例,22.5%,差异有统计学意义(P<0.05)。结论有效的护理干预能提高主动脉球囊反博治疗患者临床治疗效果,减少非计划性脱管﹑拔管比例。     

Soft tissue sarcoma of the hand: Is unplanned excision a problem?

BackgroundSoft tissue sarcoma (STS) of the hand are prone to unplanned excisions, altering oncologic outcomes. The aim of this study is to compare STS of the hand with initial treatment at an oncology center versus those initially treated at a non-oncology center. Additionally, we evaluated what factors were associated with oncologic outcomes.MethodsWe retrospectively identified patients with a STS of the hand using ICD-9 codes along with an institutional oncologic database. We included all adult patients with a non-metastatic STS of the hand (n = 64) with a median follow up of 4.0 years (IQR:1.7–10.0).ResultsEight-three percent (n = 53) of tumors had an unplanned excision, of which one was treated at the oncology center. Patients treated primarily at an oncology center were older (57.6 vs. 43.6 years), had fewer operations and tended to have a larger tumors (median 4.7 cm vs. 3.0 cm) compared to those initially treated at a non-oncology center. The 5-year survival for patients treated at an oncology center was 60% compared to 89% in those initially treated at a non-oncology center. Worse disease-free survival was associated with positive final margins and subfascial tumors.ConclusionTumors with primary treatment at an oncology center were larger and presented in older patients, having worse overall survival compared to those initially treated at a non-oncology center. Initial treatment at a non-oncology center did not influence the oncologic outcomes, but lead to more re-excisions and amputations. Final tumor margins and tumor depth determined oncologic outcomes.     

多学科协作降低非计划拔管发生率

跨部门多学科协作,运用PDCA循环,对非计划拔管存在问题进行分析,针对主要原因,在循证基础上建立10大类管道维护指引,革新改良固定方法与材料,加大医护人员培训力度,加强风险评估管理。使非计划拔管发生率从0.109%降低至0.021%,提升了医护人员的质量管理能力。     

某院2011年-2015年“重返类”指标质量评价分析

目的应用中国医疗质量指标体系对北京市某院2011年-2015年“重返类”指标进行评价分析,旨在了解医院医疗质量现状,发现医疗服务薄弱环节,提出改进建议。方法采用“基准比较”方法,包括以年度为基准的医院自身纵向比较和以全国标杆为基准的医院间横向比较。结果医院2天~31天出院患者重返住院率呈波动状态,手术患者术后重返手术室率下降。肺炎（肺部感染）、肾功能衰竭患者出院2天~31天再住院率、手术患者术后重返手术室率均明显高于基准值。结论医院2011年-2015年“重返类”指标有升有降,与国内先进水平存在差距,需持续改进。