运用信息化技术监控合理用药——广州市“阳光用药”电子监察系统解析

广州市卫生局运用现代信息技术率先开发了"阳光用药"电子监察系统,并在信息化程度较高的广州市第一人民医院和市红十字会医院两所三甲医院试运行,并取得了初步成效。本文主要是从技术的角度与层面来分析"阳光用药"系统是如何得以实现的,包括其系统结构、网络组成、应用体系结构以及总体规划模式等内容。     

全程优质护理在产妇围产期的应用分析

目的：分析全程优质护理在产妇围产期的应用价值。方法：随机选取50例孕妇,按门诊单双号平均分为A、B两组。给予A组患者常规护理,给予B组患者全程优质护理,对比两组患者临床护理效果。结果：护理后,A组患者比之护理前差异无统计学意义（P＞0.05）,B组患者比之护理前则有明显改善,差异具有统计学意义（P＜0.05）。两组患者产后不良反应对比差异显著具有统计学意义（P＜0.05）。结论：全程优质护理可有效改善母婴结局,提高病人及其家属满意度,值得临床广泛推广。     

半坐卧位结合其它自由体位在分娩中的应用

目的：观察半坐卧位结合其它自由体位对促进产程及自然分娩的效果。方法：选择单活胎,枕先露,无严重并发症合并症孕妇800例,随机分为观察组和对照组,每组各400例,观察组在第一产程采取行走、蹲、坐、卧等自由体位,第二产程采取床头抬高,半坐卧位。对照组采取常规平卧,截石位分娩。观察两组患者三个产程、出血量、试产失败转剖宫产率、胎儿体重及Apgar评分。结果：观察组较对照组产程时间缩短,先露下降快,新生儿评分好,两组比较差异有统计学意义（P〈0．01）,转剖宫产率,观察组低于对照组,差异有统计学意义（P〈0．05）,出血量,胎儿体重两组无明显差异,无统计学意义（P〉0．05）。结论：自由体位分娩可缩短产程,减少母儿并发症,降低剖宫产率,提高产妇舒适度。     

Development and application of a real-time polymerase chain reaction method for Campylobacter jejuni detection

AIM:To develop a real-time polymerase chain reaction(PCR) method to detect and quantify Campylobacter jejuni(C.jejuni) from stool specimens.METHODS:Primers and a probe for real-time PCR were designed based on the specific DNA sequence of the hipO gene in C.jejuni.The specificity of the primers and probe were tested against a set of Campylobacter spp.and other enteric pathogens.The optimal PCR conditions were determined by testing a series of conditions with standard a C.jejuni template.The detection limits were obtained using purified DNA from bacterial culture and extracted DNA from the stool specimen.Two hundred and forty-two specimens were analyzed for the presence of C.jejuni by direct bacterial culture and real-time PCR.RESULTS:The optimal PCR system was determined using reference DNA templates,1 × uracil-DNA glycosylase,3.5 mmol/L MgCl 2,1.25 U platinum Taq polymerase,0.4 mmol/L PCR nucleotide mix,0.48 μmol/L of each primer,0.2 μmol/L of probe and 2 μL of DNA template in a final volume of 25 μL.The PCR reaction was carried as follows:95 ℃ for 4 min,followed by 45 cycles of 10 s at 95 ℃ and 30 s at 59 ℃.The detection limit was 4.3 CFU/mL using purified DNA from bacterial culture and 10 3 CFU/g using DNA from stool specimens.Twenty(8.3%,20/242) C.jejuni strains were isolated from bacterial culture,while 41(16.9%,41/242) samples were found to be positive by realtime PCR.DNA sequencing of the PCR product indicated the presence of C.jejuni in the specimen.One mixed infection of C.jejuni and Salmonella was detected in one specimen and the PCR test for this specimen was positive.CONCLUSION:The sensitivity of detection of C.jejuni from stool specimens was much higher using this PCR assay than using the direct culture method.     

山东地区图书馆微博应用情况调查与分析

通过对山东地区图书馆微博应用情况的调查与分析,总结了图书馆微博发展中的特点和存在的问题,对加强图书馆微博管理、提高图书馆服务质量提出了对策与建议。     

Detection of Risk Groups for Carcinogenic Liver Fluke Infection by Verbal Screening Questionnaire Using a Mobile Application

The carcinogenic liver fluke, Opisthorchis viverrini, is a serious health problem in Southeast Asia where infectionis associated with cholangiocarcinoma, a major cause of death in Thailand. This cross-sectional study aimed to screenfor O. viverrini infection among a Thai rural population of 560 individuals from Nakhon Ratchasima, Khonkaen, andChaiyaphum provinces with a verbal screening test with a mobile application (OvApp). Faecal samples were alsoprocessed with a mini-parasep sf parasite faecal concentrator. The infection rate of O. viverrini was found to be 2.86%.The majority of infections were detected in males aged 41–50, with primary school being their highest education level, andwho were engaged in agricultural occupations. In screening for O. viverrini infection, the OvApp had a high sensitivity(87.5%), specificity (94.6%), negative predictive value (98.9%), and accuracy (98.6%). The positive predictive valuewas 70.0% for the OvApp. The observed agreement was substantial for this application (k-value = 0.64) indicated thatit is a potentially useful tool for decreasing the cost of large-scale O. viverrini screening.     

变应原吸入激发试验应用概况

支气管哮喘(简称哮喘)是最常见的慢性气道疾病之一.近年来其患病率在全球范围内有逐年增加的趋势.变应性哮喘为哮喘的常见类型,通常于暴露变应原后诱发.环境中的吸入性变应原如尘螨、花粉等为变应性哮喘最主要的致敏物质.通过吸入特定类型及剂量的变应原,对敏感患者进行变应原吸入激发试验,可诱发其产生可控性的哮喘反应,对探讨变应性哮喘的发病机制及新治疗靶点有重要作用.本文就其发展史、原理和操作方法等方面进行阐述.     

口腔诊疗器械清洗质量检查记录表的设计及应用

目的探讨质量检查表的设计应用方法,以提高临床科室椅旁预清洁依从性和口腔诊疗器械的清洗质量。 方法根据中山大学附属口腔医院口腔诊疗器械污染物情况,自行设计专用于口腔器械的清洗质量检查记录表,并应用于器械回收分类及器械包装检查工作中,根据收集的数据,进行科学分析,采取针对性的措施控制影响因素,选取2012年11月与2013年11月改进前后数据进行比较,采用SPSS 13.0软件进行统计分析。 结果改进前后器械清洗不合格率明显降低,调拌刀分别为7.22%和2.30%（χ²= 237.50,P<0.001）,银汞充填器分别为8.29%和3.09%（χ²= 151.01,P<0.001）;改进前后椅旁预清洁不合格率明显降低,水门汀充填器分别为10.80%和3.19%（χ²= 247.70,P<0.001）,近远中雕刻刀分别为8.06%和2.89%（χ²= 212.31,P<0.001）。 结论口腔诊疗器械清洗质量检查记录表结合专科特色,可操作性强,为细化工作流程、修订质量标准以及人员培训提供依据,提高了椅旁预清洁依从性,提高口腔诊疗器械清洗的合格率,促进清洗质量的持续改进。     

CorelDRAW在期刊制图工作中的规范化设置及应用技巧

【目的】提高期刊制图的效果和工作效率,促进期刊制图规范化。【方法】在制图工作中,应结合期刊版面的特点,制定完善的制图规范,从而统一期刊的制图风格,在工作中应注意总结CorelDRAW的应用技巧、积累图例样本,也应掌握其他制图软件的使用方法,做到协同运用多种制图软件制图,通过对制图软件功能的深入研究,提高工作效率和质量。【结果】期刊制图规范得到统一,工作质量和效率得到提升。【结论】CorelDRAW在期刊制图工作中存在很多需要掌握的功能技巧,需要制图编辑不断发掘。     

托吡酯在儿童癫痫中的临床应用与分析

目的观察与分析托吡酯(妥泰)治疗不同类型儿童癫痫的临床疗效及安全性。方法选择符合1991年国际抗癫痫协会制订的分类标准且脑电图有明确的痫样放电波的儿童癫痫患儿120例,从加药剂量到目标剂量缓慢加药,从每日0.5mg/kg开始,每周加量0.5mg/kg,目标剂量每日(4-6)mg/kg。连续服药半年,以癫痫发作减少次数作为评定疗效。结果癫痫缓解的有效率为84%,副反应包括厌食、嗜睡、少汗、记忆力下降等,停药后均可自行消失。结论托吡酯治疗不同类型儿童癫痫疗效肯定,副作用轻微。