The Effectiveness of Preventative Mass Vaccination Regimes Against the Incidence of Highly Pathogenic Avian Influenza on Java Island,Indonesia

We conducted an operational research study involving backyard and semicommercial farms on Java Island, Indonesia, between April 2008 and September 2009 to evaluate the effectiveness of two preventive mass vaccination strategies against highly pathogenic avian influenza (HPAI). One regimen used Legok 2003 H5N1 vaccine, while the other used both Legok 2003 H5N1 and HB1 Newcastle disease (ND) vaccine. A total of 16 districts were involved in the study. The sample size was estimated using a formal power calculation technique that assumed a detectable effect of treatment as a 50% reduction in the baseline number of HPAI‐compatible outbreaks. Within each district, candidate treatment blocks with village poultry populations ranging from 80 000 to 120 000 were created along subdistrict boundary lines. Subsequently, four of these blocks were randomly selected and assigned one treatment from a list that comprised control, vaccination against HPAI, vaccination against HPAI + ND. Four rounds of vaccination were administered at quarterly intervals beginning in July 2008. A vaccination campaign involved vaccinating 100 000 birds in a treatment block, followed by another 100 000 vaccinations 3 weeks later as a booster dose. Data on disease incidence and vaccination coverage were also collected at quarterly intervals using participatory epidemiological techniques. Compared with the unvaccinated (control) group, the incidence of HPAI‐compatible events declined by 32% (P = 0.24) in the HPAI‐vaccinated group and by 73% (P = 0.00) in the HPAI‐ and ND‐vaccinated group. The effect of treatment did not vary with time or district. Similarly, an analysis of secondary data from the participatory disease and response (PDSR) database revealed that the incidence of HPAI declined by 12% in the HPAI‐vaccinated group and by 24% in the HPAI + ND‐vaccinated group. The results suggest that the HPAI + ND vaccination significantly reduced the incidence of HPAI‐compatible events in mixed populations of semicommercial and backyard poultry.     

精准肝蒂解剖法肝段切除术的临床疗效研究

目的对比精准肝蒂解剖法肝段切除术和非规则性肝切除法治疗肝癌的疗效及安全性,分析精准肝蒂解剖法肝段切除术的临床应用价值。方法选取2009年3月至2013年3月期间在我院住院治疗的肝细胞性肝癌患者120例,对其临床资料进行回顾性分析,根据患者的病情特点及治疗需要分为实验组和对照组,实验组患者的治疗方法是精准肝蒂解剖法肝段切除术,对照组则为非规则性肝切除术。比较2种手术方法的疗效、并发症以及复发率情况。结果实验组患者的手术时间、术中出血量、住院时间及住院费用均小于对照组,2组比较差异具有统计学意义(P0.05)。实验组的并发症发生率为10.0%,复发率为13.3%;对照组的并发症发生率为33.3%,复发率为35.0%,2组比较差异具有统计学意义(P0.05)。实验组的谷草转氨酶和谷丙转氨酶水平明显低于对照组,2组比较差异具有统计学意义(P0.05)。结论精准肝蒂解剖法肝段切除术的疗效显著,并发症发生率低,不易复发,具有一定的临床应用价值。     

儿童早期肌功能训练与错（牙合）畸形预防矫治

现代儿童错(牙合)畸形的矫治更强调早期预防与阻断,矫正理念是“咬合发育管理”,治疗儿童从出生后到恒牙替换萌出结束整个过程的咬合发育不良。儿童早期肌功能训练及错(牙合)畸形预防矫治应用“Muscle?Win”理论,早期预防与阻断错(牙合)畸形的发生,以期最终降低儿童错(牙合)畸形的发生率与严重程度。早期肌功能训练及错(牙合)畸形预防矫治器是一种功能矫治器,其特点是：1）其重建了上下咬合关系,控制上下颌骨的位置及生长;2）矫治器功能结构能训练舌肌、唇颊肌及颏肌的功能和矫正口呼吸习惯;3）恒牙萌出诱导槽能引导排列新萌出的恒牙;4）矫治器能恢复上下牙弓的形态与宽度。临床佩戴矫治器,能训练儿童口腔功能,去除口腔不良习惯,引导恒牙萌出,并对Ⅱ/Ⅲ类错(牙合)畸形和轻中度牙弓发育不良有矫治效果。儿童早期肌功能训练及错(牙合)畸形预防矫治有局限性,正确选择临床适应证及使用时机是保证疗效、防止临床过度治疗的关键。作为儿童错(牙合)畸形早期功能矫治的有益探索,早期肌功能训练及错(牙合)畸形预防矫治器正成为“咬合发育管理”临床技术体系的有机组成,并得到儿童口腔医学及口腔正畸学医生越来越多的重视。     

Clustering of Unhealthy Lifestyle Behaviors is Associated with a Low Adherence to Recommended Preventive Practices Among COPD Patients in Spain

Aims: To analyze clustering of unhealthy lifestyle behavior and its relationship with non-adherence to recommended clinical preventive care services among Spanish COPD patients. Methods: Cross-sectional study including 2,575 COPD subjects from the 2006 Spanish National Health Survey (NHS) and 2009 European Health Survey for Spain (EHISS). Subjects were asked about the following recommended preventive practices: uptake of blood pressure (BP) measurement, lipid profile, influenza vaccination and dental examination. Lifestyle behaviors included: smoking status, physical activity, alcohol consumption and obesity. Logistic regression models were built to assess the association between clustering of unhealthy lifestyle and the uptake of preventive activities. Results: Blood pressure measurement in the previous 6 months and a blood lipid test in the last year had not been taken by 11.74% and 23.26% of the subjects, respectively, in 2006 NHS and by 11.16% and 16.33% of the subjects, respectively, in EHISS 2009. Then, 36.36% percent had not been vaccinated and 70.61% had not received dental examination in 2006 NHS and these percentages decreased to 27.33% and 66.22%, respectively, in 2009 EHISS. A higher number of unhealthy lifestyle behaviors increased the probability of not being vaccinated and not having a dental examination. Clustering of unhealthy lifestyle behaviors is linearly associated with a greater number of preventive measures unfulfilled. Conclusions: Compliance with healthy lifestyles and adherence to recommended clinical preventive services is under desirable levels among Spanish COPD patients. Patients with lifestyles considered as “worse” are those who also have lower uptake of recommended preventive activities.     

公立医院纪委加强疫情防控督导督查案例分析

在全国面临新型冠状病毒肺炎疫情的严峻形势下,为充分发挥医院纪检监察的监督作用,推动 全面从严治党向纵深发展,该文以中南大学湘雅医院为例全面探讨分析公立医院纪委在疫情防控期间督导督 查运行机制、形式内容及应对举措,在总结相关经验的基础上提出了公立医院纪委应对突发公共卫生紧急事 件督导督查工作的思考与建议,对广大医疗机构针对重大疫情的防控工作具有一定的参考价值和借鉴意义。     

基于风险分析的预防性维护对医疗设备管理质量的影响

目的探讨基于风险分析的预防性维护在医疗设备管理中的应用价值,以改善管理质量。方法选取2017年1月至2017年12月本院医疗设备作为常护组并给予常规医疗设备管理维护,选取2018年1月至2018年12月本院医疗设备作为风护组并在此基础上给予基于风险分析的预防性维护。分别统计管理人员的医疗设备管理知识评分、各个季度的医疗设备合格率、医疗设备使用人员满意度。结果风护组管理人员医疗设备管理知识评分明显高于常护组,差异有统计学意义(P<0.05);常护组与风护组医疗设备合格率在1季度分别为82.54%和89.03%,2季度分别为83.29%和90.02%,3季度分别为84.04%和91.77%,4季度分别为83.54%和92.77%,风护组医疗设备合格率明显高于常护组,差异有统计学意义(P<0.05);风护组医疗设备使用人员满意率为94.00%,明显高于常护组的80.00%,差异有统计学意义(P<0.05)。结论基于风险分析的预防性维护可有效提高医疗设备管理人员的管理能力,有利于改善医疗设备质量,并可提高医疗设备使用人员满意度,值得临床推广。     

儿童应用利福喷丁进行化学预防副反应观察

目的通过对儿童应用利福喷丁(L)和异烟肼(H)进行化学预防副反应的研究。方法在预防治疗前和治疗后1、2、3月末分别进行血常规和肝、肾功能检查,观察其副反应。结果月均副反应发生率7.5%,男女分别为7.8%和7.2%;副反应白细胞下降为4.0%,其次是肝功异常(2.8%)和胃肠反应(0.7%)。结论儿童用LH方案进行化学预防副反应发生率属正常反应水平,但在预防化疗期间须定期进行肝功和血常规检查,以免发生过重反应。     

COPD患者合并肺部真菌感染的高危因素分析及预防

目的探讨COPD患者合并肺部真菌感染的危险因素。方法随机选取2011年2月~2013年3月135例COPD患者为研究对象,对其中65例合并肺部真菌感染的病例进行危险因素分析。结果COPD患者合并肺部真菌感染的危险因素有低蛋白血症、住院时间、应用激素和抗生素时间长、机械通气、糖尿病、Ⅱ型呼吸衰竭等有关(P0.05),其中长期使用抗生素和激素、低蛋白血症、糖尿病、机械通气、住院时间长、Ⅱ型呼吸衰竭是独立危险因素(P0.05)。结论合理运用药物,加强营养支持,早期脱机和控制血糖,可减少COPD患者合并肺部真菌感染的发生。