环境水样中痕量铜的浊点萃取-火焰原子吸收光谱测定法

目的建立环境水样中痕量铜的浊点萃取(cloud point extraction,CPE)-火焰原子吸收光谱(flame atomic absorption spectrometry,FAAS)测定法。方法样品在p H 9.5的条件下,加入0.4 ml的1 mmol/L 2-(5-溴-2-吡啶偶氮)-5-二乙氨基酚(5-Br-PADAP)溶液,0.1%氯化钙溶液0.1 ml,5%(W/V)Triton X-114溶液0.8 ml,40℃加热15 min后离心,采用火焰原子吸收光谱法进行检测。结果在2~240μg/L的线性范围内,所得回归方程为A=0.002 7c+0.024 6,r=0.995 8。以3倍信噪比计算,方法的检出限为0.62μg/L,富集倍数为36.58倍,平均加标回收率为96.28%~98.08%,RSD为1.67%~3.13%。结论该方法简单、灵敏,具有良好的重现性,适用于环境水样中痕量铜的测定。     

“一院两区”医疗质量管理信息平台的研制与应用

医疗质量同质化是“一院多区”医院管理工作中的难点。同济大学附属东方医院通过搭建“一院两区”医疗质量管理信息平台,充分借助信息化手段,实现医疗质量管理委员会、医疗质量管理部门、临床科室三级联动的闭环管理模式,助力提升院区间医疗质量同质化水平。     

单病种质量管理信息化平台建设与应用

信息化建设是医院实现单病种质量管理要求的必要手段。浙江大学医学院附属第二医院结合单病种质量管理实践,运用信息化手段,构建了单病种质量管理信息化平台。依托平台,可自动采集单病种质量管理数据并实现网络直报,便于开展单病种质量控制与过程管理,使单病种质量管理流程高效、便捷的同时,进一步提升了医疗质量管理水平。     

两种DRGs指标体系的绩效评价效果比较研究

目的应用传统与新型DRGs指标体系进行绩效评价效果比较研究,探讨新型DRGs指标体系应用价值。方法基于某省大数据平台的31家三级综合公立医院DRGs资料,分别采用传统与新型DRGs指标体系对之进行综合绩效评价,采用Pearson检验对医院排名进行相关性分析,通过专家咨询法论证两种指标体系。结果31家医院排名均发生了变化,超过一半的医院排名变化幅度超过10名。两种DRGs指标体系的医院排名不存在显著相关性（相关系数为-0.348,P=0.057）,即在实际评价效果上存在较大差异。新型DRGs评价指标体系的应用价值优于传统型。结论相较于传统DRGs指标体系,新型DRGs指标体系严格把控区域医疗质量指标,通过强化学科评价与费用控制,重视患者医疗质量,使评价更为科学、全面。     

应用移动管理平台提高危急值管理水平

基于移动管理平台,对传统危急值管理进行改进,使手机移动端具备危急值管理功能,实现在手机移动端查看、提醒和监控危急值。平台应用后,临床科室在5 min内、10 min内、20 min内、30 min内危急值平均处置效率分别为31.43%、58.32%、70.05%、80.76%。运用移动管理平台,可提高对危急值处置和监管的及时性,提升危急值闭环管理能力,进一步保障患者安全。     

某院三级查房考核质量分析

目的了解三级查房中各级医师存在问题,提出改进策略。方法由7名具有高级职称的临床专家,按照统一评分标准进行观摩并打分,利用词云图分析存在问题。结果一级医师存在辅助检查解读不全面、疑难点报告不清晰、病历陈述缺项、查体手法不规范及查体前后未执行手卫生等问题;二级医师存在解答疑难问题不全面、临床思维讲解不透彻及查体纠正不到位等问题;三级医师存在对国内外最新知识进展讲解不全面及对查房内容点评不到位等问题。结论各级医师查房中都存在一定问题。医院管理者应针对不同级别医师提供个性化培训,促其努力提升医疗服务能力。同时,树立优秀科室榜样,充分发挥榜样带动作用。此外,还应充分利用人工智能技术辅助。     

城市一体化输血管理智慧云平台构建

结合智慧城市建设规划,依托射频识别技术,建立血液物联及冷链监管系统,整合并优化血站、医院输血管理信息系统,建立城市一体化输血管理智慧云平台,实现了血液从“血管到血管”全流程的信息追溯,为城市智慧应急用血提供了决策依据。     

Applications of platform technologies in veterinary vaccinology and the benefits for one health

The animal-human interface has played a central role in advances made in vaccinology for the past two centuries. Many traditional veterinary vaccines were developed by growing, attenuating, inactivating and fractioning the pathogen of interest. While such approaches have been very successful, we have reached a point where they have largely been exhausted and alternative approaches are required. Furthermore, although subunit vaccines have enhanced safety profiles and created opportunities for combined discrimination between vaccinated and infected animal (DIVA) approaches, their functionality has largely been limited to diseases that can be controlled by humoral immunity until very recently. We now have a new generation of adjuvants and delivery systems that can elicit CD4 + T cells and/or CD8 +  T cell responses in addition to high-titre antibody responses. We review the current vaccine platform technologies, describe their roles in veterinary vaccinology and discuss how knowledge of their mode of action allows informed decisions on their deployment with wider benefits for One Health.     

An improved technique for the extraction of stochastic parameters from stabilograms

An improved characterization of the dynamics of postural sway can provide a better understanding about the functional organization of the postural control system as well as a more robust tool for postural pattern recognition. To this aim, a novel parameterization was applied to the stabilogram diffusion analysis formerly proposed by Collins and De Luca [Collins JJ, De Luca CJ. Open-loop and closed-loop control of posture: a random-walk analysis of center-of-pressure trajectories. Exp Brain Res 1993;95:308–18] that considered the act of maintaining posture as a stochastic process. The main purpose of the present technique was to overcome some drawbacks of the model presented by Collins and De Luca that may restrain its potential application in clinical practice. The approach uses a unique non-linear model to describe the center of pressure (COP) dynamics that reduces the number of parameters and decreases their intra-subject variability; consequently, fewer trials are required to perform reliable estimates of stochastic parameters and this is of particular importance for subjects that cannot afford many repeated measurements because of age or pathology. Four new statistical mechanics parameters (NSMP) were computed on the log–log stabilogram diffusion plots and their estimates were compared in terms of reliability and sensitivity to the visual conditions with: (1) a minimal set of four summary statistic scores (SSS); and (2) the six statistical mechanics parameters (SMP) proposed by Collins and De Luca. All four NSMP showed at least a fair-to-good reliability (intraclass correlation coefficient, ICC>0.49) while SMP (ICC>0.20) showed some poor reliability. A better overall reliability was also observed with respect to SSS. Moreover, only NSMP had a similar score for eyes open and eyes closed conditions. Three out of four NSMP were also significantly sensitive to eyes open or closed conditions (P<0.001) while only three out of six SMP were sensitive to operating conditions (P<0.01).