医院信息化平台住院陪护人员管理功能的开发与应用

目的 探讨医院信息系统中增加住院陪护管理功能的应用效果。方法 基于互联网医院、智慧医院等信息系统，开发信息化住院陪护管理功能，包括流行病学史调查、免费核酸申请、电子陪护证办理、体温监测登记及上报和统计查询。该功能与医院智慧护理链接后全院应用。比较功能应用前和应用后的遵医嘱一患一陪达标率、有效陪护证达标率、体温监测并登记日上报达标率和陪护证使用追溯率，评价护士和管理者疫情防控管理的人均耗时以及对该管理功能的满意度。结果 应用信息化陪护管理功能后，一患一陪达标率、有效陪护证达标率、体温监测并登记日上报达标率和陪护证使用追溯率显著高于应用前（均P＜0.05）；护士陪护管理人均耗时从（554.13±30.77）s降至（311.67±21.54）s（P＜0.05）；护士和管理者对该信息化陪护管理功能的满意度显著提高（均P＜0.05）。结论 信息化住院陪护管理功能的应用有效提升了疫情期间陪护的管理质量和管理效率，提高了一线护士和管理者的满意度。     

右美托咪定联合综合体温保护对腔镜手术治疗老年恶性肿瘤患者苏醒期质量及免疫功能的影响

目的 探讨右美托咪定联合综合体温保护对腔镜手术治疗老年恶性肿瘤患者苏醒期质量及免疫功能的影响。方法 选择择期行腔镜手术治疗的老年恶性肿瘤患者90例，随机均分为3组：对照组（C组）、体温保护组（T组）和体温保护联合右美托咪定组（T-D组），每组30例。C组常规体温保护，T组和T-D组综合体温保护；T-D组麻醉诱导前10 min泵注右美托咪定0.5 μg/kg。记录3组患者麻醉诱导开始时（T₀）、手术开始30 min（T₁）、60 min（T₂）、90 min（T₃）、120 min（T₄）以及手术结束时（T₅）的鼻咽温度；于T₀、术后2 h（T₆）、24 h（T₇）和48 h（T₈）时抽取静脉血标本，测定T淋巴细胞亚群（CD3⁺、CD4⁺和CD8⁺）和自然杀伤细胞（NK cell）水平；记录患者术中麻醉药物用量及苏醒期质量指标。结果 与T₀比较，C组T₂～T₅时点鼻咽温度均明显降低（P < 0.05）；与C组比较，T组和T-D组T₂～T₅时点鼻咽温度明显升高（P < 0.05）。与T₀时点比较，C组、T组和T-D组T₆、T₇和T₈时点CD3⁺和NK cell活性均明显降低（P < 0.05）；C组在T₆、T₇和T₈时点，T组和T-D组在T₆和T₇时点，CD4⁺活性均明显降低（P < 0.05）。与C组比较，T组和T-D组T₆和T₇时点CD3⁺细胞活性均明显升高（P < 0.05）；T组在T₇时点，T-D组在T₆和T₇时点，CD4⁺细胞活性均明显升高（P < 0.05）；T组在T₇时点，T-D组在T₆、T₇和T₈时点，NK cell活性均明显升高（P < 0.05）。结论 采用体温保护措施联合右美托咪定能够维持老年恶性肿瘤患者的体温稳定，减少围手术期意外低体温（IPH）的发生，并有效提高患者苏醒期质量，减轻免疫抑制程度，加速患者早期恢复。     

Buried Bumper Syndrome: A common complication of levodopa intestinal infusion for Parkinson disease

BackgroundPercutaneous endoscopic gastrostomy (PEG) is required for Levodopa/Carbidopa Intestinal Gel (LCIG) delivery in patients with advanced Parkinson's disease (PD) as well as for enteral feeding in a variety of neurological disorders. Buried Bumper Syndrome (BBS) is a serious complication of PEG. The frequency of BBS in patients receiving LCIG treatment has never been reported.ObjectivesTo compare the frequency of BBS in patients on LCIG treatment or on enteral feeding over the past 12 years and identify possible risk factors.MethodsWe reviewed prospectively recorded data from 2009 to 2020 on two case-series: LCIG-treated PD patients and non-PD patients on enteral nutrition. We identified all BBS incidences. Patients’ characteristics, clinical manifestations, BBS management, possible risk factors and outcomes were analyzed.ResultsDuring the 12 years, 35 PD patients underwent PEG insertion for LCIG infusion, and 123 non-PD patients for nutritional support. There were eight cases of BBS in six PD patients (17.1%). Six of them were effectively managed without treatment discontinuation. Of the enteral feeding patients, only one developed BBS (0.8%) (p < 0.001). We identified inappropriate PEG site aftercare, weight gain, early onset PD, longer survival, treatment duration, dementia and PEG system design as potential risk factors for BBS development.ConclusionsBBS occurs more frequently in LCIG patients than in patients receiving enteral feeding. If detected early, it can be successfully managed, and serious sequalae or treatment discontinuation can be avoided. Regular endoscopic follow-up visits of LCIG-treated patients and increased awareness in patients and clinicians are recommended.     

Post-cardiac arrest intensive care in Sweden: A survey of current clinical practice

Background

European guidelines recommend targeted temperature management (TTM) in post-cardiac arrest care. A large multicentre clinical trial, however, showed no difference in mortality and neurological outcome when comparing hypothermia to normothermia with early treatment of fever. The study results were valid given a strict protocol for the assessment of prognosis using defined neurological examinations. With the current range of recommended TTM temperatures, and applicable neurological examinations, procedures may differ between hospitals and the variation of clinical practice in Sweden is not known.

Aim

The aim of this study was to investigate current practice in post-resuscitation care after cardiac arrest as to temperature targets and assessment of neurological prognosis in Swedish intensive care units (ICUs).

Methods

A structured survey was conducted by telephone or e-mail in all Levels 2 and 3 (= 53) Swedish ICUs during the spring of 2022 with a secondary survey in April 2023.

Results

Five units were not providing post-cardiac arrest care and were excluded. The response rate was 43/48 (90%) of the eligible units. Among the responding ICUs, normothermia (36–37.7°C) was applied in all centres (2023). There was a detailed routine for the assessment of neurological prognosis in 38/43 (88%) ICUs. Neurological assessment was applied 72–96 h after return of spontaneous circulation in 32/38 (84%) units. Electroencephalogram and computed tomography and/or magnetic resonance imaging were the most common technical methods available.

Conclusion

Swedish ICUs use normothermia including early treatment of fever in post-resuscitation care after cardiac arrest and almost all apply a detailed routine for the assessment of neurological prognosis. However, available methods for prognostic evaluation varies between hospitals.     

新疆低温奶消费情况调研报告

本文旨在探讨影响新疆低温乳消费市场的限制性因素及相应的对策。调研通过网络调查问卷和实地调研走访相结合的方式,从乳制品消费结构、消费能力,低温奶认知、低温奶购买意愿、购买便利性、购买偏好及健康饮奶习惯等方面分析影响新疆低温乳消费市场的因素。结果显示:32.93%的消费者不了解乳中生物活性物质(如乳铁蛋白)的热敏性,39.97%的消费者不能区分各类液态乳产品,47.64%的消费者有煮沸巴氏杀菌乳后饮用的习惯;43.21%的消费者"担心未消毒彻底,存在细菌",36.30%的消费者认为"加热后可增加营养价值和香味";72.64%的消费者曾感到"购买巴氏杀菌乳不方便";54.85%的消费者认为本地品牌"更新鲜、更健康"。结果启示:本地乳企应该充分利用在当地的良好品牌信誉度和牧场资源,尽早布局低温奶市场,通过研发高品质低温乳制品、普及科学饮奶理念、改善冷链物流能力、完善购物体验和精细化服务能力等手段,提高生产竞争力,抵御进口乳制品和常温乳对当地乳品市场的冲击,占领区域低温奶消费市场。     

深圳市龙岗区大气污染物与医院呼吸系统疾病门诊量的广义相加模型分析

目的 探讨深圳市龙岗区主要大气污染物(SO₂、NO₂、PM₁₀与PM_2.5)与医院呼吸系统疾病门诊量的关系。 方法 收集2013年1月1日－2015年12月31日深圳市龙岗区2家公立医院呼吸系统疾病逐日门诊量资料,深圳市龙岗区逐日大气污染物浓度及逐日气象资料分别来自深圳市环境监测站及气象局,运用时间序列分析广义相加模型对大气污染物日均浓度与呼吸系统疾病门诊量的关系及滞后效应进行分析。 结果 深圳市龙岗区2013－2015年SO₂ 、NO₂ 、PM₁₀ 与PM_2.5浓度中位数分别为8.08、38.08、46.05 μg/m³及31.04 μg/m³。2家医院三年呼吸系统门诊总量为549 169人次,日门诊量中位数为499人次/d。广义相加模型分析结果表明,除NO₂对呼吸系统疾病门诊量影响差异无统计学意义外,其余三种污染物对呼吸系统疾病门诊量影响均存在滞后效应,污染物每升高10 μg/m³,滞后2 d时SO₂对门诊量影响最强(相对危险度RR为1.030 7,95%CI:1.015 7~1.045 9),滞后3 d时PM₁₀与PM_2.5浓度对呼吸系统疾病门诊量影响最强(PM₁₀:RR=1.005 4,95%CI:1.002 8~1.008 0,PM_2.5:RR=1.006 0, 95%CI:1.002 7~1.009 4)。 结论 深圳市龙岗区大气SO₂、PM₁₀与PM_2.5浓度对医院呼吸系统疾病门诊量影响存在滞后效应。     

Effect of Tepid Sponge on changes in body temperature in children under five who have fever in Dr. Achmad Mochtar Bukittinggi Hospital

Objective

The purpose of the study was to determine the effect of Tepid Sponge on changes in body temperature in children aged under five who had a fever in Dr. Achmad Mochtar Bukittinggi Hospital.

Fractal analysis of gait in people with Parkinson’s disease: three minutes is not enough

BackgroundThe fractal dynamics of gait variability in people with Parkinson’s disease has been studied by applying the detrended fluctuation analysis (DFA) to short time series (<200 strides). However, DFA is sensitive to time series length, and it is unclear if DFA results from short time series are reliable and if they reflect the fractal dynamics of longer time series.Research questionIs DFA reliable when applied to short time series?MethodsWe applied DFA to stride time series from five 3-min trials and one 15-min trial in 12 people with Parkinson’s disease, 14 healthy older adults and 14 healthy young adults walking overground. Within each group, intraclass correlations (ICC 3,1) were performed to assess the reliability of i) the five 3-min trials together, ii) each 3-min trials to the 15-min trial, and iii) the first 150 strides from the 15-min trial to the full 15-min trial.ResultsOur three main findings are that 1) stride time α-DFA values are not consistent from trial-to-trial for short stride time series, 2) stride time α-DFA values from each 3-min trials are not consistent when compared to stride time α-DFA values from a 15-min trial, and 3) stride time α-DFA values from the first 150 strides of the 15-min trial are not consistent when compared to α-DFA values from the full 15-min trial.SignificanceOur results confirm that α-DFA values from 3-min walking trials are not reliable, and that they do not reflect the scale invariant properties of longer time series. This suggests that previous studies assessing the fractal dynamics of gait variability from about 3-min walking must be interpreted with caution. A major clinical implication is that DFA cannot be used to study gait in people unable to perform 500 strides continuously.     

Composites with AIEgens for Temperature Sensing and Strain Measurement

Traditional fluorescent molecules are easily quenched in most solid applications. Materials with aggregation‐induced emission (AIE) characteristics offer a new way to solve this problem. In this paper, polymer composites consisting of tetraphenylethene (TPE) with AIE properties and polydimethylsiloxane (PDMS) are developed by a simple blending method. The prepared material shows a variable fluorescent emission with different TPE concentrations in the polymer matrix. Such a unique phenomenon arises mainly from the transition of the AIEgen from the crystal to the amorphous state. Interestingly, the fluorescent emission of composites is strongly affected by external factors, such as temperature and mechanical conditions, thus giving the material a stimuli‐sensitive fluorescence property. Specifically, the fluorescence intensity of composites decreases with an increasing temperature, and the same response exhibits when the mechanical force is applied to the material. The excellent response of composites to the temperature and mechanical deformation guarantees the sensory applications of the developed material.     

Effect of carbon-rich biochar on mechanical properties of PLA-biochar composites

Agricultural biomass residues are emerged from harvesting and processing of agricultural crops. When the crop production increases, a large amount of biomass residues is produced and remained after cutting of peel, bunch, straw and stalk of crops. In this work, agricultural biomass residues (cassava rhizome, durian peel, pineapple peel and corncob) were selected as feedstock for carbon-rich biochar (CRB) production using a facile pyrolysis method. Proximate analysis and thermogravimetric analysis (TGA) were used to characterize biomass feedstock. The results showed that the percentage of fixed carbon in biomass feedstock ranged between 11.91% and 17.51%. Characteristic differences of the CRB were investigated using scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDS), Fourier transform infrared spectroscopy (FTIR) and Raman spectroscopy. The carbon content in the CRB was found to significantly depend on biomass origin. Interestingly, cassava rhizome, which has a higher percentage of fixed carbon, is a superior precursor for CRB production. The study of different pyrolysis temperature indicated that the carbon content of cassava rhizome derived CRB is increased with pyrolysis temperature. The tensile properties of composite between poly(lactic acid) PLA and different types of biomass-derived CRB were investigated. PLA composite incorporated with a higher carbon content-CRB tended to exhibit improved mechanical properties. Specifically, the elastic modulus and impact energy of PLA/CRB composite specimens increased remarkably with the incorporation of CRB powder. The current research indicates that CRB prepared from agricultural biomass residues could be a sustainable material for utilization in PLA biocomposites.