Evaluation of the child-growth-monitoring programme in a rural district in Zimbabwe

Growth monitoring (GM) is integral in child health programming. More than 73% of children under-five years in Mutasa district were missed during routine GM in 2015. We set out to evaluate the GM programme in 20 health facilities within Mutasa, Zimbabwe. A comparative process-outcome evaluation using the Logical Framework approach was used. A desk review of 20 health facility reports, 69 baby card records, 84 Village Health Worker (VHW) reports for the year 2015 and health facility GM statistics from 2014 to 2016 was done. VHW coverage was 86%. Height was being monitored in 51% of the villages. Only 7% of baby cards were completely filled for the height-for-age indicator, with the rest either partially or not filled. Discrepancies in recording GM trends present challenges in child health programming. There is need to ensure that data are captured well so as to inform appropriate health interventions.     

混合型生物人工肝治疗设备的研制

目的:结合临床应用需求,研制一种新式混合型生物人工肝治疗应用系统。方法:以2个可编程控制器(PLC)作为控制系统核心,辅以多种安全监测报警装置,具有密闭、洁净和恒温的生物反应治疗环境,为离线混合型生物人工肝治疗提供一体化集成解决方案。结果:该设备能实现对血液流量、流速、质量等参数的精确控制,并提供温度、气泡、漏血等参数的报警监测功能。控制系统操作简便,人机界面友好,并为封闭式生物反应离线治疗过程提供实时影像监控。结论:新型治疗设备实现了混合式生物反应人工肝的离线治疗,有效缩短了生物人工肝治疗时间,同时改善了生物治疗环境。     

Presence of Propionibacterium acnes in blood components

BACKGROUND: Sterility testing, as part of the QC of blood components at the Japanese Red Cross Aichi Blood Center between April 1998 and March 2000, showed that 10 of 5568 tested blood components (0.18%), all of which were RBC concentrates, were contaminated with bacteria. Nine isolates were Propionibacterium acnes and one was Staphylococcus capitis. STUDY DESIGN AND METHODS: To investigate the molecular relatedness of eight available P. acnes isolates, 16S rRNA gene analysis and random amplified polymorphic DNA (RAPD) analysis were performed. RESULTS: DNA sequencing analysis of the 16S rRNA gene showed that five isolates were identified as distinct strains and that three had identical sequences. RAPD analysis in the latter three isolates showed that two exhibited indistinguishable banding patterns that differed from that of the third isolate. CONCLUSION: P. acnes was the most frequent contaminant of blood components, and six of eight isolates were molecularly unrelated. Further studies are necessary to investigate the precise mechanisms of contamination.     

护理伦理至护理审美的逻辑趋向

从伦理学视野研究护理审美价值的意义,体现在护理美学和护理伦理学在对功利和社会效益的认识上是一致的;新护理模式的实施需要护士的人道伦理意识加以保证;引入审美情感机制,是实现护理道德与护理审美统一的有效途径;寻求护理伦理与护理审美的统一是护理美学发展的理论诉求。中外伦理学和美学研究都强调美与善的统一。护理伦理与护理审美是人之生命的两种精神性存在方式,在对人的终极关怀方面表现为一个逻辑的过程。即护理的关怀照顾通向审美超越,护理道德人格走向审美人格。     

Clinical thinking in psychiatry

I discuss the lack of precision in the term ‘clinical reasoning’ and its relationship to evidence‐based medicine and critical thinking. I examine critical thinking skills, their underemphasis in medical education and successful attempts to remediate them. Evidence‐based medicine (and evidence‐based psychiatry) offer much but are hampered by the ubiquity and flaws of meta‐analysis. I explore views of evidence‐based medicine among psychiatry residents, as well as capacity for critical thinking in residents before and after a course in philosophy. I discuss decision making by experienced doctors and suggest possible futures of this issue.     

公共卫生服务系统绩效的影响因素分析及模型构建

研究初步分析了公共卫生服务系统结构不完善、筹资结构不舍理、系统内部激励不足和监管机制不完善等影响我国公共卫生服务系统绩效的因素。构建公共卫生服务系统概念模型和逻辑模型,用于明确公共卫生服务系统的组成、范畴与边界．以及系统的行为特征和焦点问题的形成原因与机制。     

制药4.0背景下关于智慧文件管理系统的探讨

本文以药品生产企业为例,探讨智慧文件管理系统的定义、需求,再结合国内外制药行业药品生产质量管理规范(GMP)检查缺陷项目现状和数据完整性的要求,以数据的4W(who,when,where,what)属性为基础,探讨智慧化文件系统的构建思路,通过3个设计的运用举例来展现该系统具备搜索和逻辑运算功能的显著特点,并预见该系统的优点和实施难点。该系统将有利于制药4.0背景下的工厂实现高效、便捷地利用各类文件进行信息检索和逻辑运算,使得药品研发和注册工作更加科学、系统、有序,同时也利于国际标准化录入和建立绿色低碳、信息化、智能化、国际化的制药核心技术平台。     

血清前列腺特异性抗原联合Gleason评分对初诊前列腺癌转移风险的预测价值

目的 探讨血清前列腺特异性抗原(PSA)联合活体组织穿刺的Gleason评分对初诊前列腺癌患者转移风险的预测价值.方法 回顾性分析2019年1月至12月经前列腺活体组织穿刺病理学初次确诊、于海军军医大学(第二军医大学)长海医院行以68镓(68Ga)标记的靶向前列腺特异性膜抗原(PSMA)分子探针PSMA-11为示踪剂的PET-CT(68Ga-PSMA-11 PET-CT)检查的85例未经治疗的初诊前列腺癌患者的影像学及临床资料.85例患者中未发生肿瘤转移的有46例(无转移组)、发生肿瘤转移的有39例(转移组).以68Ga-PSMA-11 PET-CT是否发现转移病灶为二分类因变量,以PSAX(Gleason评分-5)为连续自变量,建立转移风险的logistic回归预测模型,并通过ROC曲线分析其诊断效能;用外部验证数据(n=20)对该模型进行检验,评估回归方程预测肿瘤转移的准确性.结果 转移组患者PSA水平、Gleason评分均高于无转移组[75.0(17.7～533.9)ng/mL vs 13.8(3.8～62.0)ng/mL,P＜0.01;8(6～10)分vs 8(6～10)分,P=0.042].以PSAX(Gleason评分-5)作为连续自变量时,预测转移风险的 ROC AUC 为0.857(95％CI 0.772～0.942,P＜0.01);PSA×(Gleason 评分-5)最佳界值为 130.62,对应的灵敏度为71.8％,特异度为95.7％,约登指数为0.675.回归方程logit(P)=0.019×PSA×(Gleason评分-5)-2.3对转移风险的预测准确度达81.2％(69/85).外部验证预测的PSA水平(Z=-1.616,P=0.106)和Gleason 评分(Z=-1.391,P=0.164)与构建模型数据相比差异无统计学意义,说明外部验证数据符合检验条件,其检验回归方程的准确度为85.0％(17/20).结论 PSA联合Gleason评分对初诊前列腺癌患者转移风险有较好的预测价值.     

问题·直觉·逻辑

作为科学思维的三大基本类型之一的直觉思维，常被人们用逻辑思维这个词所代替。本文将从数学直觉思维和逻辑思维的区别与联系；数学直觉思维与解决问题；数学直觉思维在解决问题中的作用和意义等方面诠释直觉思维在数学创造活动中的重要性，从而引起我们对加强学生数学直觉思维能力培养的高度重视。     

洁净手术部中央监控系统的实际应用

介绍了中央监控系统在洁净手术部自动控制系统中的应用，其通过工业组态软件开发出方便洁净手术部日常操作管理的人机交互界面，利用现场工业级可编程控制器为核心的控制柜，控制净化机组及其辅助设备与手术部人机操作界面进行数据交换．实时监控。中央监控系统是未来洁净手术部向高度自动化、集中化、数字化方向发展过程中不可或缺的重要环节。