非定点收治中医院脑病科应对新型冠状病毒肺炎防控策略

本文分析非定点收治中医院脑病科患者特点及防控重点,总结应对2019新型冠状病毒防控措施主要以艾灸、耳穴压豆、佩戴中药香囊包、口服防流感汤、艾熏等中医特色疗法。为中医特色疗法防治冠状病毒提供新思路。     

经皮冠状动脉介入术后发生不良心脏事件的危险因素及防范措施研究现状

经皮冠脉介入术后不良心脏事件的发生率较高,严重影响患者的健康结局。临床研究发现,不良心脏事件的发生是由多种危险因素导致的,提高医护人员对危险因素的识别,加强对危险因素的管理对患者的预后具有重要意义。因此本研究旨在对经皮冠脉介入后不良心脏事件的发生率,危险因素和防范措施进行综述,以期对预防经皮冠脉介入后不良心脏事件的发生提供理论基础和方法借鉴。     

产后出血的相关因素及预防

目的 探讨产后出血的相关因素及预防措施,以降低孕产妇的死亡率。方法 回顾性分析2007年3．6月在我科收治的89例产后出血患者的临床资料。结果67例产后出血发生在2h以内,占75．28％（67／89）。孕周在37—40周,胎儿体质量在2500～4000g者,产后出血的发病率较低,发病率分别为6．46％（40／619）、6．38％（54／847）。有多次分娩史、双胎、胎盘因素者出血发病率明显增高,分别为31．25％（5／16）、44．44％（4／9）、74．19％（23／31）。结论 产后出血的发生与孕周、胎儿体质量、分娩方式、流产史、精神因素等密切相关。     

上海市松江区1953—2008年传染病疫情分析

目的探讨上海市松江区1953—2008年甲、乙类传染病流行趋势,为制定传染病防治对策提供依据。方法采用描述流行病学方法,对松江区1953—2008年甲、乙类传染病疫情资料进行分析。结果50多年来,松江区甲、乙类传染病平均发病率和死亡率总体呈递减趋势;疾病谱从20世纪50、60年代以呼吸道传染病、虫媒及自然疫源性传染病为主转变为70年代后以肠道传染病为主。90年代后性传播疾病和肺结核呈明显上升态势;甲类传染病、免疫规划相关传染病、虫媒及自然疫源性传染病得到有效控制或消除,一些多发传染病得到基本控制。结论松江区传染病防治工作取得显著成效,但传染病疫情出现了新的特点,防制形势仍然严峻。应制定和完善传染病防制对策,加强防病工作基础建设,提高疾病预防和监测水平。     

出入境人员艾滋病干预措施的进展

目前,艾滋病在没有特效治疗方法和疫苗预防的情况下,健康教育和行为干预措施是预防的有效手段。本文针对出入境人员艾滋病行为干预的方法、效果评价的进展及存在的问题进行综述。     

腹部手术后急性肾功能衰竭防治

目的：总结腹部手术后病人急性,肾功能衰竭的预防和治疗。方法：回顾分析280例病人在腹部手术后。肾功能衰竭预防和治疗经验。结果：175例病人在术后痊愈出院,3例病危出院,2例死亡。结论：腹部手术后病人早期补充足够血容量及应用利尿剂、加强抗感染、预防性血液透析能达到早期预防急性。肾功能衰竭和治疗目的。     

Good mid-term outcome of the rotating hinge knee in primary total knee arthroplasty – Results of a single center cohort of 106 knees with a median follow-up of 6.3 years

BackgroundThe prognosis of complex primary total knee arthroplasty (TKA) with severe deformity and ligament deficiency is not clear. There is a paucity of evidence in the current literature on treatment outcomes of the rotating hinge knee implants in primary TKA. The aim of this study was to determine the mid-term clinical, radiographic, and health-related quality of life (HRQoL) outcomes in patients who had undergone complex primary TKA using single hinged knee replacement.MethodsIn total, 106 complex primary TKAs (101 patients) were performed using the single rotating hinged knee (RHK) implant design at our institution between January 2004 and December 2013. We conducted a retrospective analysis of prospectively collected outcome data of these patients, obtaining also information on all possible revision surgeries from the Finnish Arthroplasty Register, and conducted a prospective follow-up study of all living patients.ResultsThe 10-year Kaplan-Meier survival rate of the RHK knees was 91.6% (95% CI 86.0% to 97.2%) with revision for any reason as the endpoint. Overall, eight knees (7.5 %) underwent revision surgery during the follow-up. None of the unrevised RHK knees were radiographically loose. The majority of patients evinced good clinical outcome and quality of life as measured with patient reported outcome measures.ConclusionThe hinge knee replacement which was assessed current study can be regarded as a suitable option in complex primary TKA, provided adequate attention is paid to the correct indications and patient selection.     

Diagnosis,classification, and assessment in psoriatic arthritis

There have been considerable advances in the classification and assessment of psoriatic arthritis (PsA). In this report, we give an overview of historic and current classification criteria and discuss its role and limitations in research and clinical practice. We discuss the most commonly used assessment instruments for arthritis, psoriasis, onychodystrophy, enthesitis, dactylitis and axial PsA with a focus on clinical practice. We pay particular attention to the current evidence for the use of composite outcome measures, and their use in randomised controlled trials and routine care.     

COVID-19 in the endoscopy unit: How likely is transmission of infection? Results from an international,multicenter study

BACKGROUND Coronavirus disease 2019(COVID-19) significantly affected endoscopy practice,as gastrointestinal endoscopy is considered a risky procedure for transmission of infection to patients and personnel of endoscopy units(PEU).AIM To assess the impact of COVID-19 on endoscopy during the first European lockdown(March-May 2020).METHODS Patients undergoing endoscopy in nine endoscopy units across six European countries during the period of the first European lockdown for COVID-19(MarchMay 2020) were included. Prior to the endoscopy procedure, participants were stratified as low-or high-risk for potential COVID-19 infection according to the European Society of Gastrointestinal Endoscopy(ESGE) and the European Society of Gastroenterology and Endoscopy Nurses and Associates(ESGENA) joint statement, and contacted 7-14 d later to assess COVID-19 infection status. PEU were questioned regarding COVID-19 symptoms and/or infection via questionnaire, while information regarding hospitalizations, intensive care unitadmissions and COVID-19-related deaths were collected. The number of weekly endoscopies at each center during the lockdown period was also recorded.RESULTS A total of 1267 endoscopies were performed in 1222 individuals across nine European endoscopy departments in six countries. Eighty-seven(7%) were excluded because of initial positive testing. Of the 1135 pre-endoscopy low risk or polymerase chain reaction negative for COVID-19, 254(22.4%) were tested post endoscopy and 8 were eventually found positive, resulting in an infection rate of 0.7% [(95%CI: 0.2-0.12]. The majority(6 of the 8 patients, 75%) had undergone esophagogastroduodenoscopy. Of the 163 PEU, 5 [3%;(95%CI: 0.4-5.7)] tested positive during the study period. A decrease of 68.7%(95%CI: 64.8-72.7) in the number of weekly endoscopies was recorded in all centers after March 2020. All centers implemented appropriate personal protective measures(PPM) from the initial phases of the lockdown.CONCLUSION COVID-19 transmission in endoscopy units is highly unlikely in a lockdown setting, provided endoscopies are restricted to emergency cases and PPM are implemented.