新乡市县级医院糖尿病患者的用药情况调查

目的：对市县级医院糖尿病患者的用药情况进行调查,了解市县级医院内分泌科的患者在住院期间血糖管理上的总体用药观念,为医院管理糖尿病患者的血糖提供参考。方法：采用问卷调查的方式,选取新乡市县级和市级12所医院的内分泌科医生与患者为调查对象。结果与结论：市级医院医生在药物选择上,选择胰岛素的占85%,在胰岛素品牌上,外企占66%;在胰岛素类别上,胰岛素类似物占63%;县级医院医生分别占83%,52%,35%;市级与县级医院病人在药物选择上,胰岛素分别占88%和57%。市级医院医生使用外企生产的胰岛素为66%,国内生产的胰岛素为34%;县级医院医生使用外企生产的胰岛素为52%,国内生产的胰岛素为48%;市级医院的用药条件要优于县级医院。     

Ovarian cancer care for the underserved: Are surgical patterns of care different in a public hospital setting?

BACKGROUND:

The New York City (NYC) public hospital system includes subspecialty care for gynecologic cancers, providing care to patients regardless of insurance status. The authors sought to determine the surgical patterns of care for ovarian cancer patients in the NYC public hospital system.

METHODS:

Ovarian cancer cases were identified in the New York State Department of Health Statewide Planning and Research Cooperative System database for years 2001 to 2006. Cases from NYC hospitals were separated into 2 cohorts: public and other NYC hospitals. Surgeons associated with each case were identified using the database and were stratified by volume of cases and presence of subspecialty training.

RESULTS:

A total of 12,202 admissions for ovarian cancer were identified. Of these, 3639 involved major surgery, and 187 were performed at public hospitals. There were more African American and Asian patients in the public cohort (P < .001). The primary insurer was more likely to be Medicaid or a self‐payer in the public cohort (P < 0.001). Urgent or emergent admissions comprised 55% of all admissions in public hospitals, compared with 29% of admissions in other NYC hospitals (P < .001). Patients in public hospitals were less likely to have their surgery performed by a gynecologic oncologist (57% vs 74%, P < .001) and less likely to have their surgery performed by a high‐volume surgeon (21% vs 47%; P < .001) compared with patients in other NYC hospitals.

CONCLUSIONS:

Ovarian cancer patients treated in public hospitals are less likely to have gynecologic oncologists and high‐volume surgeons involved in their care. This is a preliminary finding that warrants further investigation. Cancer 2011. © 2010 American Cancer Society.     

城市生活垃圾分类收集现状及对策研究

在城市生活垃圾收集现状的基础上,分析了城市生活垃圾分类收集存在的问题,并提出了分类收集工作改进措施.     

简析我国城市生活垃圾处理技术特点及发展趋势

简述了我国垃圾量变化趋势和特点,以及生活垃圾处理各阶段及其特点;并对我国城市生活垃圾处理方式的发展前景和趋势进行了预测.     

城市生活垃圾推流式厌氧干发酵技术

以北京沼气工程为例介绍了经过高压挤压分离后的城市生活垃圾推流式厌氧干发酵工艺技术,该工程处理规模50 t/d,厌氧发酵温度55℃,单位有机质产气量433.6 m3/t,每年可产沼气92万m3,可发电147万kWh.     

郑州市城市生活垃圾处理问题及对策

针对郑州市垃圾分类条件不完善,垃圾减量、资源化低,垃圾中转站复建滞后,作用单一,垃圾末端治理污染问题敏感等问题,提出建议与对策：完善源头收集分类条件,强化中途转运功能,保证末端治理无害化.在各环节管理中,须健全法律法规,创新管理体制,谨慎推行市场化运营,建立垃圾收费体系,提高垃圾分类意识.     

地市级药检所执行《实验室资质认定评审准则》应重视的几个问题

目的探讨地市级药检所执行《实验室资质认定评审准则》应重视的几个问题。方法分析地市级药检所实验室资质认定过程中,在人员培训、仪器设备、记录、文件控制、质量监督五个方面如何加强实验室管理体系建设。结果与结论通过实施实验室资质认定,基层药检所要强化软件管理。     

2010年某儿童医院耐甲氧西林金黄色葡萄球菌感染临床分析

目的了解2010年某儿童医院耐甲氧西林金黄色葡萄球菌(MRSA)感染、预后情况及特殊群体儿童与普通儿童MRSA感染的临床特点。方法按常规方法进行细菌的分离与鉴定,细菌药物敏感试验采用纸片扩散(Kirby-Baner)法。患儿分组根据其来源及卫生部颁布的《医院感染诊断标准(试行)》进行。结果该儿童医院2010年收治病史完整的MRSA感染病例66例,其中30例为来自上海市儿童福利院(护理院)的救治弃婴。社区感染组以新生儿及接触感染者为主;护理院感染组相关因素包括重度营养不良、术后切口感染、先前住院史、长期卧床/局部压迫等;医院感染组与恶性肿瘤术后化疗、长期经鼻留置胃管、近期手术、气管插管/机械通气有关。平均住院天数为40 d。预后:社区感染组全部好转,治愈出院;护理院感染组有2例死亡,病死率6.67%;医院感染组6例中有3例死亡,占50%。结论来自护理院的患儿与来自社区的普通患儿MRSA感染情况有显著差异,在综合性儿童医院中对此类特殊患者设立独立病房进行隔离治疗,是有效减少社区获得性MRSA与医院获得性MR-SA的交叉感染,降低综合性医院医院感染的有效措施。     

城市生活垃圾填埋密度及其随深度分布规律

介绍了生活垃圾填埋密度的测定方法,基于苏州七子山垃圾填埋场现场测试数据及国外相关数据,探讨了垃圾填埋密度的主要影响因素,获得了该场垃圾填埋密度变化范围(510～1 730 kg/m3)及其随填埋深度增加而增大的规律,推荐了适合于我国南方城市生活垃圾场工程的密度-深度分布曲线。