四川省互联网医疗服务监管平台建设及思考

随着“互联网+”战略的不断推进,医疗卫生领域的互联网技术运用日益成熟。以四川省互联网医疗服务监管平台为研究对象,结合传统医疗监管模式存在的针对性不强、监管局限以及监管滞后等问题,从设计监管理念、监管模式、平台服务以及监管要点等方面对政府监管方式进行了阐述。同时,对未来监管平台建设提出完善医师多点执业、强化医疗平台责任、构建多元共治体系、打造统一的卫生行政执法平台等建议。     

基于校医院视角的医院感染管理方法

该文立足于校医院,探讨控制医院感染的管理方法。管理方法包括建立健全的医院感染管理体系,制定并完善医院感染管理制度,严格规范医院感染监测,加强细节管理力度,保障医疗安全。严格执行以上管理方法可以提高校医院医务人员对医院感染管理的认识,实施各项医院感染管理制度,控制医院感染的发生。要做好校医院的医院感染的管理工作,必须加强组织领导,加强监测,各部门明确职责,共同协作,严格遵守管理制度。     

Impact of new technologies on diabetes care

Technologies for diabetes management, such as continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM) systems, have improved remarkably over the last decades. These developments are impacting the capacity to achieve recommended hemoglobin A1c levels and assisting in preventing the development and progression of micro- and macro vascular complications. While improvements in metabolic control and decreases in risk of severe and moderate hypoglycemia have been described with use of these technologies, large epidemiological international studies show that many patients are still unable to meet their glycemic goals, even when these technologies are used. This editorial will review the impact of technology on glycemic control, hypoglycemia and quality of life in children and youth with type 1 diabetes. Technologies reviewed include CSII, CGM systems and sensor-augmented insulin pumps. In addition, the usefulness of advanced functions such as bolus profiles, bolus calculators and threshold-suspend features will be also discussed. Moreover, the current editorial will explore the challenges of using these technologies. Indeed, despite the evidence currently available of the potential benefits of using advanced technologies in diabetes management, many patients still report barriers to using them. Finally this article will highlight the importance of future studies tailored toward overcome these barriers to optimizing glycemic control and avoiding severe hypoglycemia.     

内镜下鼓室成形术治疗慢性中耳炎的效果观察

目的探讨内镜下鼓室成形术治疗慢性中耳炎的效果。方法选取于我院接受治疗的86例慢性中耳炎患者为研究对象,随机分为对照组与观察组。对照组采用常规治疗方法,观察组接受内镜下鼓室成形手术。对比两组患者的治愈效果。结果观察组治疗总有效率为97.92%,对照组的治疗总有效率为52.63%,观察组治疗有效率高于对照组,P0.05,差异具有统计学意义。结论内镜下鼓室成形术可提高中耳炎患者的治疗有效率、干耳率,可以改善患者听力,并降低中耳炎的复发率。     

A robust method for assessing chemically induced mutagenic effects in the oral cavity of transgenic Big Blue® rats

The Big Blue® (BB) in vivo mutation assay uses transgenic rodents to measure treatment‐induced mutations in virtually any tissue. The BB assay can be conducted in rats or mice and is ideal for investigating tissue‐specific mutagenic mode of action of tumor induction. Some tissues such as oral mucosa have not been thoroughly studied. Due to the small quantity and cartilaginous nature of oral cavity tissues, development of special prosection and DNA isolation methods was required to permit robust analysis of mutations in these tissues. Improved surgical methods permitted collection of adequate and reproducible quantities of tissue (～45 mg gingiva/buccal and ～30 mg gingiva/palate). Optimized DNA isolation methods included use of liquid nitrogen pulverization, homogenization, nuclei pelleting, digestion, and phenol/chloroform extraction, to yield sufficient quantities of DNA from these tissues. In preliminary optimization work, mutant frequency (MF) in tongue and gingiva was increased in rats exposed to the promutagen, benzo[a]pyrene, and the direct mutagen, N‐ethyl‐N‐nitrosourea. The oral cavity carcinogen, 4‐nitroquinoline‐1‐oxide (4‐NQO; 10 ppm in drinking water; 28 days), was qualified as a positive control for mutagenesis in oral tissues since it caused significant increases in cII MFs in gingiva/palate (50.2‐fold) and gingiva/buccal tissues (21.3‐fold), but not in liver or bone marrow (0.9‐ and 1.4‐fold, respectively). These results are consistent with the observation that 4‐NQO primarily induces tumors in oral cavity. Results also demonstrate the utility of the BB rat mutation assay and optimized methods for investigation of oral cavity mutagenicity, and by extension, analysis of other small and cartilaginous tissues. Environ. Mol. Mutagen. 56:629–636, 2015. © 2015 Wiley Periodicals, Inc.     

加强医院实习生实习档案管理的分析

医学院的学生实习阶段是学生在教育中将理论与实践、基础知识与临床应用联系到一起的重要环节，是训练如何掌握专业的临床诊疗与各种医疗器械的操作技能不可缺少的阶段，是临床教育中重要的组成部分，同时也是医院选拔人才的一种重要的手段。因此许多医院在实习生参加实习的过程中都会建立实习档案对实习生进行系统的评价，档案不仅能反应一个学生的学习情况，增加考核临床带教的功能，还能够为用人单位提供一定参考价值的依据。     

Treatment of Chronic Migraine with OnabotulinumtoxinA: Mode of Action,Efficacy and Safety

Background: Chronic migraine is a common, highly disabling, underdiagnosed and undertreated entity of migraine. It affects 0.9%–2.2% of the general adult population. The present paper overviews the preclinical and clinical data regarding the therapeutic effect of onabotulinumtoxinA in chronic migraineurs. Methods: A literature search was conducted in the database of PubMed up to 20 May 2015 for articles related to the pathomechanism of chronic migraine, the mode of action, and the efficacy, safety and tolerability of onabotulinumtoxinA for the preventive treatment of chronic migraine. Results: The pathomechanism of chronic migraine has not been fully elucidated. The mode of action of onabotulinumtoxinA in the treatment of chronic migraine is suggested to be related to the inhibition of the release of calcitonin gene-related peptide and substance P in the trigeminovascular system. Randomized clinical trials demonstrated that long-term onabotulinumtoxinA fixed-site and fixed-dose (155–195 U) intramuscular injection therapy was effective and well tolerated for the prophylactic treatment of chronic migraine. Conclusions: Chronic migraine is a highly devastating entity of migraine. Its exact pathomechanism is unrevealed. Two-third of chronic migraineurs do not receive proper preventive medication. Recent clinical studies revealed that onabotulinumtoxinA was an efficacious and safe treatment for chronic migraine.