Personal comorbidities and their subsequent risks for liver,gallbladder and bile duct cancers

Many environmental risk factors for hepatobiliary cancers are known but whether they are associated with specific cancer types is unclear. We present here a novel approach of assessing standardized incidence ratios (SIRs) of previously diagnosed comorbidities for hepatocellular carcinoma (HCC), gallbladder cancer (GBC), cholangiocarcinoma (CCA) and ampullary cancer. The 13 comorbidities included alcohol and nonalcohol related liver disease, chronic obstructive pulmonary disease, gallstone disease, viral and other kinds of hepatitis, infection of bile ducts, hepatic and other autoimmune diseases, obesity and diabetes. Patients were identified from the Swedish Inpatient Register from 1987 to 2018, and their cancers were followed from 1997 onwards. SIRs for HCC were 80 to 100 in men and women diagnosed with hepatitis C virus and they were also >10 in patients diagnosed with hepatitis B virus, other kind of hepatitis, hepatic autoimmune disease and nonalcohol related liver disease. Many of these risks, as well as alcohol related liver disease, were either specific to HCC or were shared with intrahepatic CCA. For GBC, CCA and ampullary cancer infection of bile ducts was the main risk factor. Gallstone disease, nonhepatic autoimmune diseases and diabetes were associated with all hepatobiliary cancers. The limitations of the study include inability to cover some rare risk factors and limited follow-up time. Many of the considered comorbidities are characterized by chronic inflammation and/or overt immune disturbance in autoimmune diseases. The results suggest that local chronic inflammation and a related immune disturbance is the carcinogenic trigger for all these cancers.     

早产儿消化道穿孔的病因及影响预后的危险因素分析

目的:探讨早产儿消化道穿孔的病因，分析影响早产儿消化道穿孔短期预后不良的危险因素。方法:回顾性分析山西省 儿童医院新生儿外科2015年1月—2021 年5月诊治的89 例早产儿消化道穿孔的临床资料。根据术后3 个月时结局分为生存 组和预后不良组。比较两组术前、术中及术后与早产儿消化道穿孔预后不良相关的因素，采用Logistic 回归分析筛选早产儿消 化道穿孔预后不良的危险因素。结果:早产儿消化道穿孔的病死率为25.84%，坏死性小肠结肠炎（NEC）和胃壁肌层缺损是早产 儿消化道穿孔常见的病因。单因素分析显示生存组患儿从发现气腹至手术时间在8 h 之内的比例显著高于预后不良组 （χ2=15.22，P＜0.01）。预后不良组合并脓毒性休克的比例显著高于生存组（χ2=33.19，P＜0.01）。预后不良组术后合并需非计划二次 手术的并发症比例显著高于生存组（χ2=7.24，P＜0.01）。Logistic 回归分析显示脓毒性休克（OR=0.06，95%CI:0.02~0.21，P＜0.01）和 气腹至手术时间大于8 h（OR=0.23，95%CI:0.07~0.81，P＜0.05）是早产儿消化道穿孔短期预后不良的危险因素。结论:NEC 和胃 壁肌层缺损是早产儿消化道穿孔的主要病因，脓毒性休克和从气腹发生至手术时间大于8 h 是早产儿消化道穿孔短期预后 不良的危险因素。     

基于虚拟教研室的公共卫生安全素养培育课程构建及实践

目的:探讨基于虚拟教研室的公共卫生安全素养培育课程构建及实践。方法:选取某医学院校专科护理专业学生(护生)为研究对象,将护理1班45人作为试验组,将护理2班43人作为对照组,对照组对公共卫生安全知识实施线上与线下的常规教学,试验组实施基于虚拟教研室的公共卫生安全素养培育课程。比较两组护生内容掌握情况及学习满意度。结果:试验组护生的学习成绩明显高于对照组(P<0.01),试验组护生对教学的满意度为95.6%(43/45),明显高于对照组(P<0.05)。结论:基于虚拟教研室的公共卫生安全素养培育课程构建既可以广泛促进不同专业教师进行教学研究交流,全面提高教师教书育人能力,又可以使护生在学习过程中接触不同专业、不同领域的知识与技能,注重护生主体作用,提高学习效果和学习满意度。     

项目管理在降低呼吸重症监护室环境物品表面多重耐药菌检出率中的应用

目的:探讨项目管理在降低呼吸重症监护室(RICU)环境物品表面多重耐药菌检出率中的应用效果。方法:采用目的抽样方法,选取医院呼吸与危重症医学科RICU 17张编制床位、32处高频接触环境物品表面及42名工作人员为观察对象。2019年1月—2019年3月实施RICU常规管理,2019年4月—2019年6月实施项目管理。比较项目管理前后RICU各类别工作人员手卫生依从率、RICU环境物品表面清洁合格率及多重耐药菌检出率。结果:在项目管理后RICU各类别工作人员手卫生依从率均高于项目管理前(P<0.05);项目管理后RICU环境物品表面清洁合格率较项目管理前升高(P<0.05);项目管理后多重耐药菌(MDRO)病人床单位及病区办公区域环境物体表面的耐甲氧西林金黄色葡萄球菌(MRSA)和耐碳青霉烯鲍曼不动杆菌(CRAB)检出率均较项目管理前降低(P<0.05)。结论:项目管理可有效提高RICU各类别工作人员手卫生依从性及环境物品表面清洁合格率,降低RICU环境物品表面多重耐药菌检出率。     

智力和发展性残疾儿童青少年身体活动效益：基于ICF的系统综述

目的 基于《国际功能、残疾和健康分类》(ICF)构建智力和发展性残疾儿童青少年身体活动效益系统综述的范畴和PICO架构，探讨智力和发展性残疾儿童和青少年参加身体活动的健康效益。     

Clinical characteristics of pediatric patients with COVID-19 between Omicron era vs. pre-Omicron era

IntroductionDetailed data on clinical characteristics in children with the omicron strain of SARS-COV-2 are limited.MethodsWe conducted a retrospective observational study of children with COVID-19 at the National Center for Child Health and Development to evaluate the clinical manifestations during and before the emergence of the omicron variant. Only symptomatic patients without underlying diseases were included. Participants were divided into two temporal groups: the “omicron era” (1/2022–2/2022) and the “pre-omicron era,” where the delta variant predominated (7/2021–11/2021). The patients were subclassified into an older vaccine-eligible group (aged 12–17 years), a younger vaccine-eligible group (aged 5–11 years), and a vaccine-ineligible group (aged 0–4 years).ResultsWe compared 113 patients in the omicron era with 106 in the pre-omicron era. Most patients in both eras had non-severe disease, and no patients required mechanical ventilation or died. Among patients aged 0–4 years, sore throat and hoarseness were more common during the omicron era than the pre-omicron era (11.1% vs. 0.0% and 11.1% vs. 1.5%, respectively). Croup syndrome was diagnosed in all patients with hoarseness. Among patients aged 5–11 years, vomiting was more frequent during the omicron era (47.2%) than during the pre-omicron era (21.7%). Cough and rhinorrhea were less common during the omicron era in patients aged 0–4 and 5–11 years, respectively, than during the pre-omicron era.ConclusionsIn children with COVID-19, clinical manifestations differed between the omicron and pre-omicron eras. In the Omicron era, croup syndrome was more frequent in vaccine-ineligible children.     

Practice developments supporting change implementation in Wellington,New Zealand (NZ) for ‘continuity of care when transitioning complex preterm infants from NICU to home’

The discussion paper will focus on continuity of care relating to previous NZ research, specifically to transitioning complex preterm infants from NICU to home based on parent experiences, and on the practice developments that have occurred, to ensure optimal health outcomes. Previous NZ research discovered parent desire a consistent service delivery for the entire transition journey from NICU and at home.An informative and comprehensive opportunity has occurred for reflective professional practice, evaluation, development and implementation which have transpired in positive change through innovative practice developments and support change implementation in Wellington, NZ. This has resulted in the articulation of a model of care that has both embraced and integrated parental desires for a continuity of care process for complex preterm infants. This has been achieved by having the same Discharge Facilitator/Key Case Manager present within the NICU and external to the NICU for Home-based infants for the entire transition journey.The paper will focus and emphasis additional practice development changes and furthermore, will present a real purpose, for other countries to learn of such practice developments that have exemplified a celebratory success for families of Wellington, NZ.     

中文科技期刊术语规范化现状:调查与分析

【目的】 对术语使用情况进行调研,找出术语使用不规范的问题,为提升我国科技期刊术语规范化水平、推进科技期刊高质量发展提供依据。【方法】 采用回顾性调查方法,选择18种科技期刊2020年全年刊出的所有文章,调查其中术语使用差错情况。【结果】 术语相关差错主要涉及术语使用规范问题、术语编校规范问题及专有名词术语规范问题,具体差错类型比较多样化,不利于期刊质量及影响力的提升,应引起论文作者及期刊工作者的高度重视。术语相关差错中,术语使用规范问题最为突出;术语使用规范问题的各种类型中,术语形音义相近而误的现象最为突出。【结论】 我国科技期刊术语规范化水平有待提升,需要引起重视。