不同垂直骨面型错(牙合)矫治后牙(牙合)的补偿

目的:研究不同垂直骨面型错矫治后牙的补偿。方法:选择矫治后满意病例157例,对治疗后头颅定位侧位片进行计算机化的头影测量,以获得垂直骨面型的信息和相应牙各指标的数据,与从治疗后模型上测得的切牙转矩角数据综合后进行相关分析。结果:矫治后仅上中切牙转矩与MP-SN角呈负相关关系(P<0.05),但不同垂直骨面型间切牙转矩的差异无统计学意义。MP-SN角与1-SN、1-PP及1-MP极显著负相关(P<0.001),与OP-SN、OP-MP、OP-PP极显著正相关(P<0.001)。结论:不同的垂直骨面型矫治后上下切牙相对于上下颌基骨的倾斜度和平面的倾斜角度都有补偿性改变,但切牙的转矩未受明显影响。     

腭裂术后构音障碍患者音韵历程的初步分析

目的：分析腭裂术后构音障碍患者音韵历程,为语音治疗提供依据。方法：对46例腭裂术后构音障碍患者的语音资料进行回顾性分析,从腭咽闭合功能、腭瘘、辅音正确构音率（ percentage of consonant correct,PCC）与音韵障碍的相关性方面进行统计研究。结果：46例构音障碍患者中37例出现结构历程,均为声母省略;34例出现位置替代历程,均为后置化;40例出现方法替代历程。患者音韵的结构历程、位置替代历程与PCC分级有相关性。结论：PCC分级高的患者与声母省略的结构历程和后置化的位置替代历程相关。     

健康促进对医护人员手卫生依从性的影响研 究简

目的 对包头某医院医护人员进行健康促进,以评价其对医护人员手卫生的影响.方法 2012年11月～2013年10月对某院临床各科室医护人员进行手卫生知识调查,并进行健康促进,评价项目实施前、实施中和实施后医护人员手卫生知识知晓率、卫生洗手正确率和手卫生依从性,并对卫生用品领取量进行分析.结果 项目实施前医护人员手卫生知识知晓率均较低,项目实施中和实施后,医护人员手卫生知识知晓率均明显上升（P＜0.05）;项目实施前医护人员手卫生洗手正确率均较低,项目实施中和实施后,医护人员洗手正确率均明显上升（P＜0.05）;项目实施前医师、护士手卫生依从率差异有统计学意义（P＜0.05）,项目实施中、实施后两组依从性均明显提高,与实施前比较差异有统计学意义（P＜0.05）,但医护之间差异仍有统计学意义（P＜0.05）;项目实施中及实施后,肥皂、洗手液和手消液领取量与实施前相比均明显增加,差异有统计学意义（P＜0.05）.结论 健康促进项目能够培养医护人员手卫生意识,提高医护人员手卫生知识知晓率、卫生洗手正确率和手卫生依从性.     

提高护士对四肢骨折患者疼痛评分的正确率

目的应用品管圈手法提高护士对四肢骨折患者疼痛评分的正确率。方法依据"问题解决型"的品管圈十大步骤,于2017年4月-2017年9月,对我院骨科骨折患者进行疼痛评分,调查所有下肢骨折患者共150例,以原始调查数据统计四肢骨折患者正确评估疼痛的例数。结果骨科骨折患者由疼痛评分的34.67%提高到67.30%。结论本次品管圈活动使我们成立了无痛病房,建立了完善的疼痛评估体系,为患者提供了多模式镇痛和个性化镇痛等新方法,改善了患者的就医体验,同时还提高圈员们解决问题的能力,发明专利两项,收获巨大的经济效益和社会效益,提升了医疗单位的社会形象,提高了患者满意度。     

Comparative assessment of prophylactic transfusions of platelet concentrates obtained by the PRP or buffy-coat methods,in patients undergoing allogeneic hematopoietic stem cell transplantation

ABSTRACT

Objectives: Whole blood-derived platelet concentrates can be obtained by the platelet-rich plasma (PRP-PCs) or the buffy-coat (BC-PCs) method. Few studies have shown that BC-PCs display lower in vitro platelet activation, but scarce information exists regarding transfusion efficacy. We have performed a retrospective study assessing platelet transfusion in patients undergoing allogeneic hematopoietic cell transplantation (AHCT) in our clinic, before and after the implementation of BC-PCs.

Methods: We reviewed clinical records corresponding to 70 PRP-PCs and 86 BC-PCs prophylactic transfusions, which were performed to 55 AHCT patients. Transfusion efficacy was assessed by the 24-h post-transfusion corrected count increment (24-h CCI) and bleeding events. Clinical factors affecting transfusion outcome were also investigated.

Results: Clinical characteristics and the total number of platelet transfusions were similar among groups. Mean donor exposure was 5.8 and 5.0 in each single PRP-PCs and BC-PCs transfusion, respectively (p?<?0.01). The 24-h CCI was significantly higher in patients transfused with BC-PCs than in those receiving PRP-PCs (8.3[2.7–13.4] vs. 4.7[1.3–8.1]; p?<?0.01). Independent predictors of poor platelet transfusion response included diagnosis other than acute leukemia (HR 8.30; 95% CI 1.96–35.22; p?=?0.004), splenomegaly (HR 8.75; 95% CI 2.77–27.60; p?<?0.001), graft versus host disease prophylaxis different from cyclosporine A and methotrexate (HR 3.96; 95% CI 1.55–10.14; p?=?0.004) and PRP-PCs transfusion (HR 4.54; 95% CI 1.72–12.01; p?=?0.002). There were no differences between both groups regarding the bleeding events.

Conclusion: In the AHCT setting, we hypothesize that BC-PCs transfusion, when compared to PRP-PCs, results in higher CCI and reduced donor exposure, but provides no significant benefit regarding bleeding outcome.     

根本死因自动编码工具的应用研究

为提高常规死因监测中根本死因编码的准确性，按照WHO的ICD-10根本死因编码规则及国际上同类软件开发设计原理，并参照美国编码策略表，通过计算机语言实现根本死因编码的自动化，研制基于全国死因登记报告信息系统的根本死因自动编码工具，其根本死因编码正确率达到85 %，实现了对死亡个案数据的自动编码，且编码正确率达到国际同类软件水平。     

Phénomènes psychogéniques collectifs et lieux de travail: Le cas particulier de l’hôpital

Mass psychogenic phenomena can affect adults within their working community in a primitive way. It appears that people working in hospitals are exceptionally affected by these phenomena even if they are daily exposed to contagious risks. On the other hand, two French examples show that a hospital is a fertile breeding ground for the development of the sick building syndrome. This syndrome, in its epidemic form and beyond the environmental factors triggering it, appears as a variant of the same collective psychogenetic phenomenon and sick building syndrome is a politically correct way to designate it. The authors present social reasons playing a role in the diffusion of these phenomena.     

Y型切口矫治内眦赘皮50例

目的探索一种简便有效矫治先天性倒向型内眦赘皮伴下睑倒睫和单上睑手术方法。方法采用Y型切口V型缝合术鼻侧腱膜固定联合下睑去皮缝合矫治内眦赘皮及下睑内翻倒睫并联合重睑术。结果术后随访3~24个月所有术后患者内眦赘皮及下睑内翻倒睫矫正满意,上重睑形成,取得了良好的美容效果。结论术式简便,创伤面积小,术后无明显瘢痕,不易复发,睑裂睁大,是矫治内眦赘皮,单上睑,下睑内翻倒睫的有效方法。     

PDCA在提高患者对重组人促卵泡激素注射笔正确使用率中的应用

目的总结开展PDCA循环在提高助孕患者对重组人促卵泡激素注射笔正确使用率的效果分析。方法2019年3-11月成立PDCA持续质量改进小组,选定提高助孕患者对重组人促卵泡激素注射笔正确使用率为活动主题,应用PDCA循环模式中的计划、实施、检查、处理四个步骤对患者使用重组人促卵泡激素注射笔发生的不正确使用事件进行原因分析,找出要因,并根据要因,制定改进措施,组织实施,检查评价实施结果。结果通过PDCA循环工具的使用,患者自行使用重组人促卵泡激素注射笔发生的不正确事件:注射手法不当、针头处理不当、针头溢液、调节计量不当、皮肤消毒不当,改善前后的差异有统计学意义(P<0.05)。结论开展PDCA循环活动提高了助孕患者自行使用重组人促卵泡激素注射笔的正确使用率。