加快医疗保险和医药卫生体制三项改革步伐——在国务院联合督查组西北片座谈会上的讲话(摘要)

总结了西北各省、区医疗保险和医药卫生体制三项改革的进展情况,分析了目前存在的问题:各地改革发展不平衡,有的尚存在观望等待思想和畏难情绪;有的缺乏符合本地实际的可操作性实施方案;有的有关管理机构和人员尚未完全到位;宣传教育广度、深度不够;改革进程与中央要求及上报计划完成目标尚有一定差距。对今后工作提出几点意见:进一步解放思想,提高认识,更新观念;加强对文件的学习、宣传和培训;深入调研,制定符合本地实际情况,具有操作性配套政策和实施方案;抓点带面,搞好试点,总结经验,积极推广;加强部门协调,团结协作,同步推进“三项”改革;加强领导,加快工作进度。     

Attitudes towards influenza and uptake of the flu vaccine: A survey of pharmacy staff working in English hospitals

ObjectivesPharmacy staff working in hospitals are at risk of contracting and disseminating influenza. Previous research focuses on community pharmacists’ attitudes towards influenza and vaccination. This survey investigates the beliefs and attitudes of pharmacists and other pharmacy staff working in English Hospitals regarding influenza and the vaccine and how this relates to vaccine uptake.MethodsA self-administered survey was provided to pharmacy staff at three hospitals in the East Midlands of England. Job role, age and vaccination status (vaccinated, intended to be vaccinated, and not vaccinated) were collected alongside ratings of agreement with 20 statements regarding influenza and vaccination using a Likert scale.Results170 pharmacy staff responded; 50.6% had been vaccinated, 17.1% intended to be vaccinated and 32.4% were not vaccinated. Increasing age showed a significant (p = 0.017) positive correlation with increased vaccine uptake as did the beliefs that vaccination protects the individual from influenza (p = 0.049) and that vaccination should be mandatory for NHS staff (p = 0.006). Fear of needles and believing their immune system is strong enough to protect against influenza were negatively correlated with vaccine uptake (p = 0.016 and p = 0.010, respectively). Job role was also strongly correlated with vaccine uptake (p = 0.001), with those holding a pharmacy degree more likely to report being vaccinated or intending to be vaccinated compared to all other pharmacy staff groups.ConclusionsThis is the first survey to focus on vaccine behaviours of all pharmacy staff groups working in hospitals. Current uptake of the influenza vaccine may be increased through engagement of senior pharmacy colleagues and providing education on influenza, vaccines, and vaccination. Similar studies should be undertaken on a larger scale to fully interrogate the differences between pharmacy staff groups.     

Who receives influenza vaccinations at the Pharmacy? An analysis of the Texas Behavioral Risk Factor Surveillance System

IntroductionVaccination helps to prevent influenza infection and reduce associated costs but the influenza vaccination rate in Texas for adults between the ages of 18 to 64 years old is the lowest in the US. Pharmacies and alternative locations have been shown to help increase vaccination rates but many adults still go unvaccinated.ObjectiveThis research aims to determine the factors associated with obtaining influenza vaccination at the pharmacy compared to non-pharmacy locations in Texas.MethodThis study used pooled Texas Behavior Risk Factor Surveillance System datasets (2014 to 2018) for this assessment. The main outcome variable was categorized into pharmacy and non-pharmacy vaccination locations and analyzed using a logistic regression analysis. Further statistical analysis was done using a multinomial logistic regression after re-categorizing the outcome variable into pharmacy, doctor office, and other locations.ResultBlacks were 63% (AOR 0.37, C.I. 0.26, 0.50) and Hispanics were 38% (AOR 0.62, C.I. 0.48, 0.80) less likely to receive influenza vaccinations at the pharmacy respectively when compared to Whites. Furthermore, those who did not live in a Metropolitan Statistical Area (MSA) were 33% (AOR 0.67, C.I 0.53, 0.84) less likely to receive influenza vaccinations at the pharmacy compared to those who lived in an MSA. While there was no observed difference in the likelihood of receiving influenza vaccination, the unemployed population were 40% (AOR 1.40, C.I 1.15, 1.71) more likely to be vaccinated in the pharmacy compared to the employed population.ConclusionThere is potential for increased utilization of pharmacies as a source of influenza vaccination in Texas. Racial differences exist both for receiving influenza vaccinations and being vaccinated in the pharmacy. Influenza vaccination advocacy and education efforts may be necessary to improve pharmacy-based vaccination in Texas, especially for minorities and rural-dwelling Texans.     

聚集性新冠肺炎疫情期间某综合医院隔离留观病房运行分析与思考

2020年6月中旬,北京市新发地聚集性新型冠状病毒肺炎(以下简称新冠肺炎)疫情发生,首都医科大学大兴教学医院共确诊新冠肺炎患者65例。通过临时改建隔离留观病房,建立隔离留观病房工作机制与工作流程,探索适宜的会诊方法等措施,保障了隔离留观病房的平稳运行。通过总结、分析疫情期间患者就诊情况及诊治效果,认为聚集性疫情发生后患者的就诊行为有一定特点与规律性,隔离留观病房在新冠肺炎排查、诊治过程中发挥了重要作用。一旦发生新冠肺炎疫情,可根据具体情况设置、运行隔离留观病房。     

Examining community pharmacists’ intention to provide pharmacist-driven vaccination services: A structural equation modelling

BackgroundThe evidence of pharmacists' current involvement in vaccination services in low- and middle-income countries (LMICs) is uncertain. This study would be a first step to develop vaccination services by investigating community pharmacists’ intention to be involved in PDV services not just during COVID-19 pandemic but also during standard service provision in Turkey which can be taken as an example across LMICs.ObjectiveConsidering the efforts to empower community pharmacists in service provision, the goal of the present study was to develop a structural equation model to explain the “Pharmacist-Driven Vaccination Service Intention Model (PDV-SIM)” by using the theory of planned behavior (TPB).MethodsBased on the constructs of TPB, a measurement tool was developed. Sub-factors of PDV service intention was determined by conducting exploratory factor analysis (EFA). In the second step, confirmatory factor analysis (CFA) was conducted to prove the theoretical structure of the tool. Finally, a model explaining the relationship between observed variables, latent constructs from TPB was developed by SEM analysis.ResultsIn the proposed PDV-SIM, patient related attitude toward PDV services, attitude toward negative consequences of PDV services, and subjective norm about PDV services had an impact on the behavioral intention of community pharmacists. Nevertheless, professional development attitude toward PDV services and perceived behavioral control were not evaluated as determinants of the behavioral intention.ConclusionResults of this study revealed that TPB is appropriate for modelling PDV service intention of community pharmacists. This model can be utilized as a guide to potential pharmacy regulatory bodies and policy makers in their efforts to enable community pharmacists as vaccinators across LMICs.     

常见病原菌的感染分布特点与抗生素敏感性变化的调查

目的：为了了解临床常见菌感染的分布特点和掌握抗生素的敏感性变化,为临床提高感染性疾病的治愈率提供依据。方法：细胞的分离采用常规方法;细菌的鉴定和药敏采用进口仪器法。结果：5794份标本共检出1935株细菌,检出率为33％。大肠艾希氏菌,铜绿色假单胞菌,金黄色葡萄球菌,表皮葡萄球菌,肺炎克雷伯氏菌是近年来临床感染的主要病原菌,细菌对抗生素的敏感性：阴性杆菌中磺胺类（复方新诺明）为33％,青霉素类平均为42％;头孢菌素类平均为46％,氨基糖苷类平均为53％,喹诺酮类平均为61％,其它内酰胺类为69％,葡萄球菌中大环内酯类为28％,头孢菌素类平均为42％,其它内酰胺类为48％,喹诺酮类平均为50％,青霉素类平均为51％;氨基糖苷类平均为53％,其它类为57％,结论：细菌分布广,检出种类多（104种）,耐药性严重。     

宫颈湿疣的临床病理与HPV亚型分析

目的 探讨宫颈温疣的临床类型及组织病理学特征与人乳头瘤病毒（ＨＰＶ）亚型的关系。方法 对１３０例宫颈湿疣进行病理形态学观察,同时采用ＰＣＲ技术进行ＨＰＶ６／１１、ＨＰＶ１６／１８检测。结果 扁平型宫颈湿疣与ＨＰＶ６／１１感染密切相关（Ｐ〈０．０１）,凹空细胞呈轻度异型性。乳头型宫颈湿疣与ＨＰＶ１６／１８密切相关（Ｐ〈０．０１）,凹空细胞呈重度异型性。结论 宫颈湿疣的临床类型及组织病理学特征与ＨＰＶ     

The anaesthetist as determinant factor of quality of surgical antimicrobial prophylaxis. A survey in a university hospital.

In actual surgical antimicrobial prophylaxis, the anaesthetist administers the drugs at induction of anaesthesia. In the first phase of our qualityofuse intervention study on antimicrobial drugs in a large university hospital, information on the practice of antimicrobial prophylaxis was needed. The staff of 44 anaesthetists was interviewed by means of a questionnaire. Response rate was 36/44 (82%). The anaesthetists' method of administering surgical prophylaxis was rather uniform and inexpensive: cephalosporins were almost exclusively administered by bolus method. The main reason was that infusion was more cumbersome (range 7785%). Communication between surgeon and anaesthetist was reported to be poor, and in two out of three operating departments, orders of prophylaxis transmitted at or after induction accounted for more than 80%. Seventyseven percent of the responders asked the surgeon if prophylaxis was necessary if they were in doubt; 20% responded that they checked it systematically. The data collected by the inquiry proved useful in the process of optimizing surgical prophylaxis in our hospital.