神经内科院内感染病原菌分布及耐药性分析

目的 分析神经内科患者医院感染病原菌分布及耐药性,为合理选择临床抗菌药物提供依据。方法 选取 2016 年5 月—2019年5 月滕州市中心人民医院神经内科院内感染患者202例,按照《全国临床检验操作规程》标准分离、鉴定细菌,用K-B纸片法进行药敏试验,统计医院感染情况,并对分离病原菌的分布及耐药情况进行回顾性分析。结果 神经内科院内感染以下呼吸道感染为主,占33.17%,其次为泌尿道和消化系统感染,占比为21.29%和13.86%;共分离病原菌268株,其中革兰阴性菌112株,占41.79%;真菌103株,占38.43%;革兰阳性菌53株,占19.78%。革兰阴性杆菌中大肠埃希菌对亚胺培南、头孢哌酮舒巴坦耐药率低于<15%,对哌拉西林和头孢噻肟耐药率>65%;产ESBLs肺炎克雷伯菌、铜绿假单胞菌和大肠埃希菌检出率为分别为37.50% 、34.62%、38.10%;金黄色葡萄球菌对阿莫西林耐药率为91.30%,革兰阳性球菌对利奈唑胺、万古霉素敏感。结论 神经内科院内感染分离病原菌以革兰阴性菌为主,对常用的抗菌药物耐药率高,应合理选用抗菌药物。     

Summary of the special symposium ‘Towards Elimination of Rubella’

A special symposium titled ‘Towards Elimination of Rubella’ was held at the 23rd Annual Meeting of the Japanese Society for Vaccinology in Tokyo, Japan on November 30, 2019. Representatives from the Japanese national government, a local government, and a private company presented their efforts to control rubella, and the group discussed the challenges of eliminating rubella in Japan.     

正交试验优选益母阿胶膏的最佳工艺研究

目的优选益母阿胶膏生产的最佳提取工艺。方法以出膏率为指标,采用正交试验考察A加水量(倍)、B提取时间(h)、C提取次数(次)三个因素的影响,确定益母阿胶膏的最佳提取工艺。结果提取因素按影响大小依次是C提取次数>B提取时间>A加水量,最佳提取条件为:加12倍量水,提取1.5 h,提取2次。结论该制备工艺合理可行,可作为益母阿胶膏的最佳提取工艺。     

多媒体联合情景教学在急诊医师培训中的应用

目的探讨多媒体联合情景教学在急诊医师培训的应用效果。方法将本院2018年1月-2018年12月的34名急诊医师纳入观察组,应用多媒体联合情景教学法对其进行院内培训,另将本院2017年1月-2017年12月的34名急诊医师纳入对照组,应用传统教学法对其进行培训,对比两组医师的考试成绩、岗位胜任能力以及应急能力。结果观察组理论知识与技术操作的考试成绩均高于对照组,观察组自学、交流、表达、理解、解决问题的能力以及综合能力的评分均高于对照组,观察组急救意识、急救效率、病情评估、团队合作、职业防护的评分均高于对照组(P<0.05)。结论多媒体联合情景教学在急诊医师培训的应用效果显著,可明显提高医师的考试成绩、岗位胜任能力以及应急能力。     

精神分裂症患者与正常人的罗夏测验自我损伤指数

目的:了解精神分裂症患者与正常人的罗夏测验自我损伤指数(EII)差异。方法:选取符合美国精神障碍诊断与统计手册第4版(DSM-IV)精神分裂症诊断标准的患者60例(年龄17~53岁)及性别、年龄与之匹配的正常对照组60例,分别对两组被试实施罗夏测验。对被试罗夏测验的反应进行编码与记分,计算出两组被试的EII值,比较两组被试EII及其各分变量(歪曲形状质量、认知加工错误加权和、歪曲感知人类运动、批判性内容、好的人物表征和坏的人物表征)的差异,分析EII对此两组被试的区分程度。结果:精神分裂症组的EII[(0.7±1.7)vs.(-0.9±0.9)]、歪曲形状质量[(6.2±2.3)vs.(3.4±2.6)]、认知加工错误加权和[(14.0±6.5)vs.(7.2±4.2)]、歪曲感知人类运动[(0.7±1.2)vs.(0.3±0.7)]、坏的人物表征[(3.1±2.7)vs.(1.8±1.8)]得分高于正常对照组(均P0.05),但两组"好的人物表征"和"批判性内容"得分差异均无统计学意义(均P0.05)。诊断试验结果显示当EII值为-0.5时,对精神分裂症和正常人区分的灵敏度为0.91,特异度为0.75,Youden指数为0.66。结论:与正常人相比,精神分裂症患者的自我功能存在较严重的损伤,罗夏测验自我损伤指数区分精神分裂症患者的敏感性较高,但特异性较低,尚须进一步完善。     

Évaluation de l’utilisabilité des poches industrielles de nutrition parentérale

ObjectivesTo assess the compliance of parenteral nutrition bags to standards and to evaluate the ease of use and the time required to mix the different compartments of bags sold on the French market in 2014.Materials and methodsThree in vitro tests have been carried out: volume measurement, tests of penetration and adhesion of the infusion needle. Users evaluated the various stages of bags preparation using the Likert scale. The reading time of the instruction guide and the preparation time of the bags were recorded.ResultsAccording to in vitro tests, all bags were in conformity with the standards. The assessment of ease of use revealed variations between the different bags. Bags with two compartments displayed similar general appreciation but a different handling time. Two ranges of bags with three compartments for central line (Olimel^® and Kabiven^®) obtained different results in terms of general appreciation and handling time. One of three ranges of bags with three compartments for administration via peripheral route got better appreciations and a lower handling time than the two others.ConclusionAll bags were in conformity with standards in terms of volume and connection between the bag and the infusion set. The handling test showed variations of the preparation time and the ease of use.     

Elastic properties of Thiel‐embalmed human ankle tendon and ligament

Thiel embalming is recommended as an alternative to formalin‐based embalming because it preserves tissue elasticity, color, and flexibility in the long term, with low infection and toxicity risk. The degree to which Thiel embalming preserves elasticity has so far been assessed mainly by subjective scoring, with little quantitative verification. The aim of this study is to quantify the effect of Thiel embalming on the elastic properties of human ankle tendons and ligament. Biomechanical tensile tests were carried out on six Thiel‐embalmed samples each of the peroneus longus, peroneus brevis, and calcaneal tendons, and the calcaneofibular ligament, with strain rates of 0.25%s^?1, 2%s^?1, and 8%s^?1. The stress?strain relationship was calculated from the force‐extension response with cross‐sectional area and gauge length. Young's modulus was determined from the stress?strain curve. The results showed that the tendon and ligament elasticity were lower after Thiel embalming than the literature values for fresh nonembalmed tendons and ligament. The biomechanical tensile test showed that the measured elasticity of Thiel‐embalmed tendons and ligaments increased with the strain rate. The Thiel embalming method is useful for preserving human ankle tendons and ligaments for anatomy and surgery teaching and research, but users need to be aware of its softening effects. The method retains the mechanical strain rate effect on tendons and ligament. Clin. Anat. 28:917–924, 2015. © 2015 Wiley Periodicals, Inc.