HPV联合TCT检查应用于宫颈癌筛查的临床效果

目的观察HPV联合TCT检查应用于宫颈癌筛查的临床效果。方法选择2018年1-10月于北京市昌平区医院妇科门诊实施宫颈癌筛查的妇女400例为研究对象,均接受病理检查和HPV、TCT检查,比较联合检查与单独检查的应用价值。结果HPV联合TCT检查的阳性率高于单独检查,但差异无统计学意义(P>0.05);HPV联合TCT检查的灵敏度、阴性预测值、诊断准确率均高于单独检查(P<0.05)。结论HPV联合TCT检查用于宫颈癌筛查的价值较高,值得临床推广应用。     

胸部X线透视检查在精神科体检中的应用价值

目的 探讨胸部X线透视检查(胸透)在精神科体检中阳性检出率及应用价值.方法 搜集22 683例住院精神病患者的胸透资料,按照年龄进行分组,计算阳性检出率,采用x2检验进行统计学处理.结果 精神病患者胸透阳性检出率为0.71％,40岁以上各年龄组各种疾病阳性检出率增加明显;40 ～49岁组与30～39岁组[0.50％( 21/4174)比0.22％(9/4081),P＜0.05],50～59岁组与40～49岁组[1.01％( 35/3473)比0.50％ (21/4174),P＜0.05],≤39岁与≥40岁组的阳性检出率差异具有统计学意义(P＜0.01).结论 胸透在精神科体检中阳性检出率低,且受X线照射剂量大,不应作为入院常规体检项目,应根据受检者的年龄、症状、既往病史等有选择地进行胸部X线摄影.     

HBeAg定量阳性和乙肝DNA的相关性研究及临床价值

目的:探讨乙肝病毒基因组(HBV-DNA)病毒载量与乙型肝炎血清标志物乙肝病毒e抗原(HBeAg)之间的关系.方法:对2007年1月～2010年1月同时采用时间分辨荧光分析仪和荧光定量聚合酶链反应(PCR)技术对440例各型乙型肝炎患者进行HBV-DNA含量及HBeAg定量结果进行回顾性分析.结果:血清学检测乙肝表面抗原(HBsAg)+HBeAg患者HBeAg定量结果显著大于HB-sAg+HBeAg+乙肝病毒核心抗体(抗HBc)阳性(大三阳)患者(P＜0.05).HBsAg+HBeAg患者HBV-DNA定量结果波动范围也大于HB-sAg+HBeAg+抗HBc阳性患者.结论:HBeAg定量结果对病情的进展和诊治有一定的应用价值,HBeAg定量检查能较好地反映乙肝患者体内HBV-DNA的含量,揭示患者传染性强弱.     

子宫内膜癌腔内放射治疗的护理分析及研究

目的:探讨子宫内膜癌腔内放射治疗的护理价值。方法:选择我院2018年6月-2019年6月收治的100例子宫内膜癌患者作为本次研究入组对象,根据随机数字表随机分为研究组和对照组,对照组采用传统的基本护理措施,对照组在传统护理的基础上进一步加强细致的护理措施,对比两组护理效果。结果:研究组治疗后并发症和护理满意度优于对照,差异有统计学意义(P<0.05)。结论:子宫内膜癌腔内放射治疗的护理需要细致加强饮食护理、心理护理、腔内装置护理、皮肤护理、健康教育等方面,从而减少子宫内膜癌腔内放射治疗后并发症和护理满意度,值得临床广泛应用。     

结肠镜检查等待时间对患者肠道准备质量的影响研究

目的 了解结肠镜检查患者肠道准备现状并分析其影响因素,评价肠道准备完成至结肠镜检查开始的间隔时间对肠道准备质量的影响。 方法 收集2019年4月—9月在福州市3所三级甲等医院消化内镜中心行结肠镜检查门诊患者的人口统计学与临床资料。采用卡方检验筛选对肠道准备质量影响显著的因素（P<0.10）,应用倾向值匹配分析法消除混杂因素后,对比间隔时间（2,3] h、（3,4] h、（4,5] h、（5,6] h、（6,7] h、（7,8] h、（8,∞） h组的肠道准备质量差异。 结果 共有401例患者纳入研究,经匹配新生成316组样本数据,并检验证实已排除混杂因素影响。方差分析得出：不同间隔时间组之间的肠道准备质量存在差异,间隔（2,3] h肠道准备质量显著优于（4,5] h、（6,7] h,间隔（3,4] h肠道准备质量显著优于（6,7] h,（2,3] h与（3,4] h两组之间无显著差异,（4,5] h、（6,7] h、（7,8] h、（8,∞） h任意两组之间无显著差异。 结论 肠道准备完成至开始结肠镜检查间隔时间在2~4 h内,肠道准备质量可以保持在最佳清洁状态。     

应用DWI早期评价脑肿瘤伽玛刀治疗效果

目的比较伽玛刀治疗前与治疗后1个月脑肿瘤实质标准化表观扩散系数(nADC)值的变化,研究扩散加权成像(DW I)早期评价脑肿瘤伽玛刀治疗效果的价值,为临床诊断治疗提供更可靠的方法和依据。资料与方法选择27例患者31个病灶作为研究对象,详细了解患者一般情况。在伽玛刀治疗前1天及治疗后1个月分别行常规MR I及DW I检查。在肿瘤实质区及对侧相应或邻近部位正常白质选取3~5个兴趣区,计算肿瘤实质的nADC值,比较伽玛刀治疗前后脑肿瘤实质nADC值的变化,并与肿瘤最大直径的变化比较。结果脑转移瘤、垂体瘤伽玛刀治疗后1个月肿瘤实质的nADC值较治疗前明显升高(P<0.05),脑转移瘤最大直径缩小,垂体瘤直径未见明显变化;胶质瘤、脑膜瘤、血管母细胞瘤、神经纤维瘤的nADC值伽玛刀治疗后未见明显升高(P>0.05),肿瘤直径亦未见明显缩小。结论肿瘤实质的nADC值能够早期较好地评价脑肿瘤的伽玛刀治疗效果,同时,nADC值能够较好地鉴别脑肿瘤的良恶性。但是应用nADC鉴别肿瘤类型仍需进一步研究。     

Global burden attributable to high sodium intake from 1990 to 2019

Background and aimsHigh sodium intake is associated with a higher risk of a wide range of diseases. We aimed to estimate the pattern and trend of the global disease burden associated with high sodium intake from 1990 to 2019.Methods and resultsWe obtained numbers and rates of death and disability-adjusted life year (DALY) attributable to high sodium intake by sex, socio-demographic index, and country from the Global Burden of Disease Study 2019. We calculated the estimated annual percentage change to evaluate the age-standardized rate (ASR) of the burden attributable to high sodium intake between 1990 and 2019. We further calculated the contribution of population growth, population aging, and age-specific rates of death and DALY to the net change in the total number of deaths and DALYs attributable to high sodium intake. From 1990 to 2019, global age-standardized rates of death and DALY attributable to high sodium intake substantially decreased for both sexes. However, there were significant increases in the total numbers of deaths and DALYs attributable to high sodium intake, which were driven by population growth and population aging. The attribution of population growth and population aging varied widely across countries, with a higher contribution of population growth in most developing countries and a higher contribution of population aging in countries with slow population growth.ConclusionsAlthough the global burden attributable to high sodium intake in terms of age-standardized rate declined from 1990 to 2019, the absolute burden increased significantly, which was driven by population growth and population aging.     

Moderate sedation for chest physicians

Specialists in pulmonary and critical care medicine frequently perform invasive procedures that may require sedation or anesthesia for patient comfort. The number and complexities of interventional pulmonary procedures that can be performed in the bronchoscopy suite or critical care unit continues to expand. Procedures that formerly were done only in the operating room on inpatients are now done routinely in the office, ambulatory surgery center, or hospital outpatient department. No matter the setting, the key to successfully performing these procedures is a safe, pain-free environment for the patient. Anesthesia care and procedural sedation services share the goals of providing the patient comfort during a painful procedure and the operating physician an acceptable working environment. Historically, anesthesiologists have applied the expertise gained in managing anesthesia for major surgeries to sedation care for minor procedures. While the supply of anesthesiologists and anesthetists has shown only a modest increase, the growth in minimally invasive procedures has been explosive in recent years. To meet demand, a service, originally known as conscious sedation and now referred to as moderate sedation, has become common, in which the operating physician supervises a specially trained sedation nurse. This article will provide a clinical definition of moderate sedation and then focus on ways to properly code and bill for pulmonary procedures performed with moderate sedation.     

护理本科生就业价值取向现况调查与分析

目的:调查护理专业本科生择业观念与就业价值取向,采取有效措施提高本科生就业率,为高等护理教育改革提供参考依据。方法:采用自设问卷对某护理学院4个年级600名学生进行现况调查。结果:79.17%护理专业本科生表示就业单位意向为三级医院临床护理工作,61.50%护理专业本科生在择业首选因素中选择经济收入与福利待遇,39.67%护理专业本科生愿意到经济发达地区或沿海地区医院,69.67%护理专业本科生迫切需要了解单位用人标准和聘用条件,87.73%护理专业本科生希望学校提供就业政策、形势分析及就业相关信息;2009级护理本科生就业价值观和就业态度与2012级比较差异有统计学意义(P0.05)。结论:护理本科生就业观和就业价值取向不断变化,其选择单位的局限性和功利性应引起学校的高度重视。加强对本科生正确引导,为学生提供相关就业信息,全面了解用人单位需求,为提高护理本科生的就业率和就业质量提供参考。     

结核感染T细胞斑点试验在血液病合并结核中的诊断价值

目的评价结核感染T细胞斑点试验（T-SPOT．TB）在血液病合并结核感染患者中的诊断价值。方法应用T-SPOT．TB对2012年3月-2013年4月间收治的82例结核感染待排的血液病患者外周血标本进行检测。结果T．SPOT．TB检测对于血液病患者合并结核感染的阳性检出率为59．09％（13／22）,明显高于结核抗体检测的13．64％（3／22）,P〈0．05。T-SPOT．TB检测血液病患者合并结核感染的灵敏度和特异度分别为59．09％（13／22）、68．33％（41／60）,灵敏度优于结核抗体检测（P〈0．05）。结论T-SPOT．TB检测对于血液病患者合并结核感染具有较大的辅助诊断价值,对于确诊结核感染阳性患者的诊断价值大于确诊结核感染阴性患者的诊断价值,临床上可作为血液病患者合并菌阴结核感染的辅助诊断。