血液净化中心机房的设计体会

整个血液净化中心机房设备包括血液透析机、整套完整的水处理及相关辅助设备.在机房设计时应根据整套系统的工作原理及使用条件,制定对机房设计、电源配置、管路布局结构等方面的具体要求,并正确实施安装调试.     

洁净手术室管理工作的探讨

洁净手术室的净化工作对于医院来说是非常重要的。它是防止手术室内发生交叉感染的1个重要环节。文章主要从以下几个方面对医院洁净手术室的净化工作进行了有关的探讨：（i）洁净手术室的净化管理工作。（2）洁净手术室净化的工作方式。（3）洁净手术室的净化程序和维护性管理。     

舒适护理在手术室护理中的临床效果

目的对比舒适护理在手术室护理中的临床效果。方法随机将480例手术患者分为观察组和对照组各240例。对照组常规护理。观察组有针对性制定舒适护理计划。同时采取问调查形式进行,对患者进行调查并统计数据。结果患者舒适度和满意度,观察组均明显高于对照组。结论整体护理观的内涵越来越丰富,人们越来越重视人性化的护理。     

Application of continuous positive airway pressure in the delivery room: a multicenter randomized clinical trial

This study evaluated whether the use of continuous positive airway pressure (CPAP) in the delivery room alters the need for mechanical ventilation and surfactant during the first 5 days of life and modifies the incidence of respiratory morbidity and mortality during the hospital stay. The study was a multicenter randomized clinical trial conducted in five public university hospitals in Brazil, from June 2008 to December 2009. Participants were 197 infants with birth weight of 1000-1500 g and without major birth defects. They were treated according to the guidelines of the American Academy of Pediatrics (APP). Infants not intubated or extubated less than 15 min after birth were randomized for two treatments, routine or CPAP, and were followed until hospital discharge. The routine (n=99) and CPAP (n=98) infants studied presented no statistically significant differences regarding birth characteristics, complications during the prenatal period, the need for mechanical ventilation during the first 5 days of life (19.2 vs 23.4%, P=0.50), use of surfactant (18.2 vs 17.3% P=0.92), or respiratory morbidity and mortality until discharge. The CPAP group required a greater number of doses of surfactant (1.5 vs 1.0, P=0.02). When CPAP was applied to the routine group, it was installed within a median time of 30 min. We found that CPAP applied less than 15 min after birth was not able to reduce the need for ventilator support and was associated with a higher number of doses of surfactant when compared to CPAP applied as clinically indicated within a median time of 30 min.     

21所医院微生物室感染控制支持能力现状调查

目的 了解德州市二级及二级以上医院微生物室对感染管理工作的专业支持能力.方法 对德州市11个县市区,21所二级及二级以上医院进行现场检查及问卷调查.结果 全市17所医院设立了微生物室,12所医院参加了省级室间质量控制,5所医院既未参加室内质控也未开展室间质控；近95.0％的医院未落实三级报告等检验规程.结论 微生物室基本专业水平较低下,感染控制支持能力较差,制约了感染控制工作的深入开展；微生物室人员知识理念陈旧,亟待提高微生物学及医院感染管理知识技能.     

加强护患沟通 推进“优质护理服务示范工程”活动

我院在实施卫生部"优质护理服务示范工程"活动(以下简称"示范工程"活动)中,通过对两组不同年龄病人交流沟通的经验总结,进一步掌握了更好的护患沟通技巧,构建了良好的护患关系,减少了护患矛盾与纠纷,保障医疗安全,全面提高了医院临床护理工作水平,推进了"示范工程"活动的深入开展。     

Role of viral RNA and lipid in the adverse events associated with the 2010 Southern Hemisphere trivalent influenza vaccine

In Australia, during the 2010 Southern Hemisphere (SH) influenza season, there was an unexpected increase in post-marketing adverse event reports of febrile seizures (FS) in children under 5 years of age shortly after vaccination with the CSL 2010 SH trivalent influenza vaccine (CSL 2010 SH TIV) compared to previous CSL TIVs and other licensed 2010 SH TIVs. In an accompanying study, we described the contribution to these adverse events of the 2010 SH influenza strains as expressed in the CSL 2010 SH TIV using in vitro cytokine/chemokine secretion from whole blood cells and induction of NF-κB activation in HEK293 reporter cells. The aim of the present study was to identify the root cause components that elicited the elevated cytokine/chemokine and NF-κB signature. Our studies demonstrated that the pyrogenic signal was associated with a heat-labile, viral-derived component(s) in the CSL 2010 SH TIV. Further, it was found that viral lipid-mediated delivery of short, fragmented viral RNA was the key trigger for the increased cytokine/chemokine secretion and NF-κB activation. It is likely that the FS reported in children <5 years were due to a combination of the new influenza strains included in the 2010 SH TIV and the CSL standard method of manufacture preserving strain-specific viral components of the new influenza strains (particularly B/Brisbane/60/2008 and to a lesser extent H1N1 A/California/07/2009). These combined to heighten immune activation of innate immune cells, which in a small proportion of children <5 years of age is associated with the occurrence of FS. The data also demonstrates that CSL TIVs formulated with increased levels of splitting agent (TDOC) for the B/Brisbane/60/2008 strain can attenuate the pro-inflammatory signals in vitro, identifying a potential path forward for generating a CSL TIV indicated for use in children <5 years.     

PDCA循环在输液室规范化管理中的应用

目的研究PDCA(计划—实施—检查—处理)循环管理模式在医院输液室规范化管理中的应用效果。方法分析影响输液室护理服务质量的原因,成立护理质量管理小组,提出切实可行的整改措施,并组织落实。每月科会讨论实施情况,每季小结一次,未解决的问题进入下一轮PDCA。结果比较输液室在实施PDCA循环前后,护患纠纷发生率及不良事件发生率比较,差异有高度统计学意义(P<0.01);满意度及护理部对输液室质量评分差异有统计学意义(P<0.05)。结论 PDCA循环是输液室规范化管理中的一项行之有效的管理模式。     

In vivo and in vitro effects of 42-hydroxy-palytoxin on mouse skeletal muscle: Structural and functional impairment

Palytoxins (PLTXs) are known seafood contaminants and their entrance into the food chain raises concern about possible effects on human health. The increasing number of analogs being identified in edible marine organisms complicates the estimation of the real hazard associated with the presence of PLTX-like compounds. So far, 42-OH-PLTX is one of the few congeners available, and the study of its toxicity represents an important step toward a better comprehension of the mechanism of action of this family of compounds. From this perspective, the aim of this work was to investigate the in vivo and in vitro effect of 42-OH-PLTX on skeletal muscle, one of the most sensitive targets for PLTXs. Our results demonstrate that 42-OH-PLTX causes damage at the skeletal muscle level with a cytotoxic potency similar to that of PLTX. 42-OH-PLTX induces cytotoxicity and cell swelling in a Na⁺-dependent manner similar to the parent compound. However, the limited Ca²⁺-dependence of the toxic insult induced by 42-OH-PLTX suggests a specific mechanism of action for this analog. Our results also suggest an impaired response to the physiological agonist acetylcholine and altered cell elasticity.