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。     

Throwing Away the Key: The Ethics of Risk Assessment for Preventive Detention Schemes

Preventive detention schemes that aim to protect the community from certain ‘dangerous’ individuals have long existed. While risk assessment is now pervasive in the management and treatment of many individuals, it raises particular issues when a person's liberty is at stake on the basis of what that person might do. This R.G. Myers Memorial Lecture addresses the ethical issues raised by mental health practitioners providing risk assessments for legislative schemes that involve the deprivation of liberty. It will focus in particular on Australian post-sentence preventive detention schemes for sex offenders that have been held by the United Nations Human Rights Committee to breach fundamental human rights. However, the ethical issues discussed also have repercussions for civil commitment laws that enable the detention of those with severe mental or intellectual impairments.     

Investigation of some Dental Filling Materials

Seppä L. Salmenkivi S, Hausen H. Salivary fluoride concentration in adults after different fluoride procedures.

Today, several alternatives for fluoride therapy are available. To give advice on the choice of method, the dentist should have information on how effective different fluoride treatments are in increasing salivary fluoride concentration. The aim of the present study was to measure the fluoride concentration of saliva after the use of four different fluoride methods commonly used in the Nordic countries: F mouthrinse (0.023% q, F toothpaste (1.1% F), F lozenge (0.25 mg F), and F chewing gum (0.25 mg Q. In addition, a new method using toothpaste-water mixture as a mouthrinse was included in the study. Fourteen adult volunteers used each of the five methods on separate days. Unstimulated saliva samples were collected;it base line and 0, 10, 20, 30, 45, and 60 min after the fluoride procedure. Fluoride was separated by the microdiffusion method and analyzed using a fluoride-specific electrode. Fluoride mouthrinse and fluoride toothpaste increased the fluoride concentration of saliva significantly more than fluoride lozenge and fluoride chewing gum. For both of the latter, salivary fluoride concentration was still increased after 1 h. Toothpaste–water rinse was more effective than brushing with toothpaste. Rinsing with toothpaste-water mixture appears a good alternative for adults who need extra fluoride therapy but are not motivated enough to brush their teeth several times a day.     

Caregiver acceptability and preferences for preventive dental treatments for young African-American children

Our prior research focused on parental treatment acceptability (TA) and treatment preferences (TPs) for preventive dental treatments for young Hispanic children. We adapted the interview for administration to parents of young African‐American children. Objective: In a sample of African‐American parents, determine parental TA and TP for five dental treatments to prevent early childhood caries. Methods: Interviewed 48 parents/caregivers of African‐American children attending Head Start, assessing TA and TP for three treatments for children: toothbrushing (TB) with fluoride toothpaste, fluoride varnish (FV), and xylitol in food (XF); and two treatments for mothers: xylitol gum (XG) and chlorhexidine (CHX) rinse. The interview included verbal information, illustrated treatment cards, photos/video clips, and samples. Parents provided TA of each treatment (one to five scale), TP between each of 10 pairs of the five treatments, and open‐ended reasons for their preferences. TPs were summed (zero to four) to create overall preference. Results: All treatments were acceptable (means 4.4‐4.9). TB was more acceptable than FV and XF (P < 0.05). Summed TP revealed a strong preference for TB (mean 3.1) above other treatments (all P < 0.01). Primary reasons for preferring TB were the following: promotes healthy habits; child focused; and effectiveness. Conclusions: All treatments were acceptable, however, parents/guardians strongly preferred TB. Parents' emphasis on healthy habits and child‐focused treatment supports efforts for oral health education programs in early childhood settings. Some parents expressed concerns about FV, XF, and CHX. Results may be useful in planning prevention programs for young children in African‐American communities.     

Validation of micro-CT against the section method regarding the assessment of marginal leakage of sealants

Background: The aim of this study was to validate the micro‐CT and related software against the section method using the stereomicroscope for marginal leakage assessment along the sealant‐enamel interface. Methods: Pits and fissures of the occlusal surface of 10 teeth were sealed with a resin‐fissure sealant material without acid etching, thermocycled for 5000 cycles, immersed in 50% silver nitrate for three hours and scanned using micro‐CT. Teeth were embedded in epoxy resin and cut in three sections. The middle section was subjected to micro‐CT and stereomicroscopy. Images were taken from the left and right sides of the sealant‐enamel interface at both the left and the right site of the section. Two experienced evaluators assessed marginal leakage. Results: Both assessment instruments observed no leakage in 37 out of the 40 images evaluated. Leakage at the sealant‐enamel interface was observed in three stereomicroscopy images only. A fracture line in the sealant was seen on eight stereomicroscopy images and observed in only two micro‐CT images. Conclusions: The quality of the micro‐CT and related software used in the present study does not qualify it to replace the section method as the gold standard for marginal leakage assessment at the sealant‐enamel interface of permanent teeth.     

Effect of silver and fluoride ions on enamel demineralization: a quantitative study using micro-computed tomography

Background: This study aimed to investigate the effect of silver and fluoride ions on demineralization of enamel. Methods: The coronal parts of 40 extracted sound premolars were prepared into tooth blocks. An unvarnished occlusal surface window (OW) and a flat buccal/lingual surface window (FW) were created for each tooth by covering all other surfaces with an acid‐resistant varnish. These blocks were randomly allocated into four groups of 10 blocks each and immersed in respective solutions for 5 minutes: Group 1 – 2.36 M silver fluoride; Group 2 – 2.36 M potassium fluoride; Group 3 – 2.36 M silver nitrate; and Group 4 – deionized water. After 7‐day immersion in a buffered demineralization solution at pH 4.4, micro‐CT scans were taken. Results: Mean lesion depth in the FW area for tooth blocks in AgF, KF, AgNO₃ and control groups were 0 μm, 3.3 ± 10.3 μm, 156.3 ± 30.8 μm, and 173.6 ± 48.6 μm, respectively (p < 0.001). The difference in mean lesion depth between the AgNO₃ and control groups was not statistically significant (p > 0.05). Similar OW and FW lesions were observed in tooth blocks in the AgNO₃ and control groups. Conclusions: Topical application of a 2.36 M fluoride solution can inhibit demineralization of enamel while topical application of silver ions has little effect.