床旁临时起搏器作为AMI的常备急救设备及其在基层医院推广应用研究

目的 床旁临时起搏器作为急性心肌梗死（AMI）的常备急救设备的价值及其在基层医院推广应用的可行性研究。方法 回顾性研究分析2001-2003年间不能床旁植入临时起搏器与2004-2005年能床旁植入临床起搏器抢救AMI的住院病死率、心衰、心源性休克、2mo后再次住院发生率。临时起搏器植入术安全性的指标比较。结果 不能床旁植入临时起搏器组的住院病死率为14．58％，心衰发生率为27．08％，心源性休克发生率为12．5％，2mo后再次住院发生率为16．67％。床旁植入临时起搏器组的住院病死率为3．57％，心衰发生率为7．14％，心源性休克发生率为3．57％，2mo后再次住院发生率为3．57％，两组相比p〈0．01有显著性差异。而起搏器植入的安全性指标：起搏器植入成功率为100％，脱位率为10．7％，并发症发生率为14.3％，住院病死率3．57％。结论 床旁临时起搏器抢救AMI住院病死率低，心衰发生率、心源性休克发生率及2mo后再次住院发生率低，应作为AMI抢救的常备急救设备，另外床旁临时起搏器植入是安全的、有效的，成功率高，操作不难，在基层医院（二甲医院）可推广应用。     

我院2000-2004年医院感染革兰阴性杆菌耐药性趋势的研究

[目的]了解2000年～2004年院内感染革兰阴性杆菌分布及其耐药性。[方法]主要使用MicroScan-4微生物鉴定及药敏仪对2000年1月～2004年12月引起院内感染革兰阴性杆菌进行鉴定及药物敏感试验，结果录入Whonet5．3软件进行分析、统计。[结果]5年间，革兰阴性杆菌所致医院感染中，大肠埃希菌比例最高，在32．8％～38．1％之间，阴沟肠杆菌、不动杆菌比例呈上升趋势。细菌的耐药率在逐年上升，其中阴沟肠杆菌和鲍曼不动杆菌，耐药性高于其它革兰阴性杆菌（P〈0．05），对第三代头孢菌素耐药率分别达到60％～80％、40％～70％。对亚胺培南耐药的菌株日益增多。[结论]细菌的耐药性逐渐增强，阴沟肠杆菌、鲍曼不动杆菌成为非常重要的医院感染病原菌，医务工作者要重视医院感染，加强耐药性监测，合理使用抗生素。     

Hospital visiting in obstetrics and gynecology: a tool for the advancement of training.

OBJECTIVE: To assess the improvement of obstetric and gynecologic training brought about by peer influence in Europe. METHODS: In 1996, the European Board and College of Obstetrics and Gynecology (EBCOG) initiated a visiting process by international and local peers to improve training and decrease differences in health care standards. RESULTS: A large number of visits of obstetrics and gynecology departments have been conducted across Europe at teaching hospitals by the Hospital Visiting Committee. Compliance with the structured approach of the visiting policy and problems met during these visits are reported. CONCLUSION: The program focuses on the continuous improvement of the competencies of all persons trained in the obstetrics and gynecology departments of teaching hospitals throughout Europe. It also increases the understanding of diversity in training methods and can gradually lead to the convergence of training and health care standards in Europe.     

新生儿医院感染原因探讨及干预对策

目的：分析新生儿医院感染相关危险因素及干预对策.方法：通过对榆林市第一医院2006年5月至2010年5月收治的1428例住院新生儿医院感染发生情况.结果：新生儿患者医院感染率从2006年5月至2008年5月的3.20%,下降到2008年5月至2010年5月的1.99%.结论：对新生儿室医疗护理工作中各种医院感染相关危险因素采取相应的干预对策后,新生儿患者的医院感染率明显降低,提高了医疗护理质量.     

No difference in symptoms of irritable bowel syndrome between healthy subjects and patients with recurrent depression in remission

There is bidirectional comorbidity between anxiety/depression and irritable bowel syndrome (IBS). To investigate the prevalence of IBS symptoms, and factors associated with gastrointestinal symptoms in patients with recurrent depressive disorder. Patients (n = 95) with recurrent type of major depression according to DSM-IV criteria and sex- and age-matched controls (n = 190) were sent questionnaires investigating symptoms of IBS [Gastrointestinal Symptom Rating Scale (GSRS)-IBS] and symptoms of anxiety and depression [Hospital Anxiety and Depression Scale (HADS)]. Medical records were checked over a 10-year period for chronic somatic symptoms or diseases. Seventy-three patients with unipolar disorder (mean age 63.6 years SD 13.8; range 23-86 years) and 156 controls (mean age 59.2 years SD 11.6, range 21-85 years) responded. Patients with recurrent depression had higher GSRS-IBS scores and showed a strong correlation between symptoms of IBS and anxiety-depression (r(s) = 0.54; P < 0.001). IBS symptoms were also associated with multiple pain symptoms, higher health-seeking behaviour and selective-serotonin-reuptake inhibitor intake. However, patients with recurrent depression (n = 46) in remission (HADS-Depression score <8) did not have more symptoms of IBS than controls (GSRS-IBS median score 6.0 vs 6.5; P = 0.46). There is a strong association between symptoms of IBS and symptoms of anxiety and depression, whereas depressive patients in remission do not have more IBS symptoms than controls.     

构筑健康教育工程实现社会医院双赢

介绍了四川大学华西医院10年来构筑普及医疗卫生保健知识系统工程的认识体会、经验和取得的成效,指出医院在普及卫生保健知识中的职责和优势。     

人力资源战略在医院管理中的运用及价值探讨

人力资源是医院最重要的资源,随着国内医疗市场的逐步开放和"三医"联动医药卫生体制改革的实施,医院之间的竞争愈加表现为人才的竞争,作为医院的高层管理者在战略决策管理中如何通过合理的人才战略和管理机制,吸引、培养、留下更多的人才并最大程度地调动他们的积极性和创造性显得十分重要.本文重点阐述了医院实施人力资源战略管理的方法,认为个人目标与组织目标保持高度一致,设计合理、灵活、富有激励的绩效考核办法是医院人力资源战略管理的关键所在.     

基层医院腹腔镜胆囊切除术1 696例的治疗体会

目的:探讨腹腔镜在基层医院普及开展的可行性和主要并发症的预防.方法:回顾分析1999年6月至2006年5月我院1 696例腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)的临床资料.结果:1 696例LC成功 1 635例,中转开腹61例,中转率3.6%,发生并发症17例,其中胆管损伤1例,腹腔内出血2例,胆漏2例,腹腔感染1例,胆管残石3例,遗漏腹腔内病变6例,上消化道出血2例.结论:LC在基层医院的开展日益成熟,成为治疗胆囊良性疾患的"金标准".术前注意鉴别诊断,术中操作轻柔,辨明胆囊三角结构,能避免严重并发症的发生.     

Abnormal behavior of elderly people residing in institutions of medical and social welfare systems

Abstract We investigated factors correlated with abnormal behavior in the elderly residing in a special nursing home (group A) and a psychiatric hospital (group B) using the dementia behavior disturbance scale, the mini mental state examination, the Japanese version of the Philadelphia Geriatric Center morale scale, and the ADL assessment scale. The cognitive function of group B was decreased compared with that of group A, but most activities of daily living (ADL) in the latter group were disrupted compared with those in the former. Only a few categories of ADL correlated with abnormal behavior in group A, whereas cognitive function, quality of life, and most categories of ADL correlated with abnormal behavior in group B. These results suggest that factors correlated with abnormal behavior in the elderly differ within institutions of medical and social welfare systems.