Engaging Radiology Nurses in Quality Improvement Projects in a Women's Specialty Hospital

Measuring outcomes in health care have become mandatory as regulatory agencies, institutional guidelines, employers, and consumer groups advocate for quality health care focusing on improving patient outcomes. System-level quality departments often provide a framework for performance improvement (PI) that supports the organizational PI plan. However, nurses must learn to lead and be actively involved in projects in the radiology department to ensure key performance indicators are developed with on-the-ground quality management to improve patient outcomes, system performance, and professional development. This article explores such efforts at a large women’s specialty hospital in the Southern United States.     

运用六经辨证治疗子嗽探析

妊娠期间,咳嗽不已,称"妊娠咳嗽",亦称"子嗽",孕妇咳嗽日久未见好转,咳嗽胸痛甚则咳而呕吐,或咳嗽剧烈或久咳不愈,可损伤胎气,导致堕胎、小产。笔者运用六经辨证治疗外感型中表寒里热证子嗽,认为此类患者病在太阳阳明,属于寒热错杂之表寒里热,采用《伤寒论》中方证麻杏甘石汤合止嗽散,使热从外泄,宣发卫气,散寒不助热、解表不伤正,故辨证论治取得了显著的疗效。同时子嗽治疗还需注意健脾固肾安胎,应将顾护胎元贯穿治疗妊娠咳嗽的始终。     

Non alcoholic fatty liver disease and risk of incident diabetes in subjects who are not obese

Background and aims

It is not known whether non alcoholic fatty liver disease (NAFLD) is a risk factor for diabetes in non obese, non centrally-obese subjects. Our aim was to investigate relationships between fatty liver, insulin resistance and a biomarker score for liver fibrosis with incident diabetes at follow up, in subjects who were neither obese nor centrally-obese.

六经气津互化论

气与津皆生于水谷,气生于水,水化于气,津即为水。由于气津互化的密切关系,故任何一方的改变,都会影响到另一方,即所谓水化于气,亦能病气;气生于水,亦能病水。因此,太阳经气可概括为两大功能,即卫外和气化,是由气津互化而体现的;阳明气津之间,表现为相互制约;少阳经的气津互化,关系到少阳气机的条达舒畅及三焦水道的通调运使;太阴脾气的健旺,可使津液化生有源;少阴心肾精血充沛,滋养有时,才可使心肾之气化生有源;而厥阴之气的条达顺畅,又可维持津液代谢的平衡状态。     

《素问玄机原病式》学术思想探讨

《素问玄机原病式》一书，发挥《内经》病机学说，弥补了原“病机十九条”过于简略之不足，创造性地继承和发展了《内经》理论，特别是首倡“六气皆从火化”之说；关于“相火”的论述，则为后世相火理论的形成奠定了基础；它还总结了温热病的治疗原则，对后世温病学派的形成产生了重要影响。     

中国围绝经期妇女体脂含量与骨密度关系的初步研究

目的探讨肌肉、脂肪含量与围绝经期骨质疏松妇女骨密度之间的关系。方法利用双能X线骨密度测量仪(美国,Hologic DiscoveryA型)测量门诊围绝经期妇女(90例,年龄:45~52岁(47.3±8.2))骨密度与体脂含量;同时测量登记受试者的年龄、身高、体重。结果结果显示,21%受试者腰椎和股骨骨量降低,全身脂肪含量(20675.129±5080.44)g与腰椎骨密度(0.91±0.177)g/cm2(P>0.05,r=-0.17)和髋部骨密度(0.99±0.102)g/cm2(P>0.05,r=0.158)没有相关性,肌肉含量(39790.80±6551.54)g与腰椎骨密度没有相关性(P>0.05,r=0.078),但是与髋部骨密度高度正相关(P<0.05,r=0.216)。体重(63.01±9.39)kg和腰椎(P<0.05,r=0.217)和髋部(P<0.05,r=0.305)骨密度高度正相关;BMI指数(24.6751±3.45637)与腰椎(P<0.05,r=0.244)和髋部(P<0.01,r=0.339)骨密度高度正相关。结论研究结果表明BMI指数和肌肉含量与围绝经期妇女髋部骨密度高度相关。     

Immunohistochemical analysis of 14-3-3 sigma and related proteins in hyperplastic and neoplastic breast lesions, with particular reference to early carcinogenesis

In order to confirm the role of 14-3-3 sigma (sigma) as a tumor suppressor in breast carcinogenesis, we have studied the expression of 14-3-3sigma immunohistochemically in usual ductal hyperplasia (UDH), ductal carcinoma in situ (DCIS) and invasive ductal carcinoma (IDC) breast lesions. Immunostaining for estrogen receptor alpha (ERalpha), p53 and estrogen-responsive RING finger protein (Efp) was also carried out. Immunohistochemically, expression of 14-3-3sigma was seen in 92% UDH lesions and gradually decreased from 65% in DCIS to 23% in IDC. The expression of ERalpha decreased gradually from UDH to DCIS to IDC, while p53 showed an inverse staining pattern to that of ERalpha. The expression of Efp showed no significant difference among the three breast lesions. Hence, the present immunohistochemical study confirmed 14-3-3sigma as a tumor suppressor in breast carcinogenesis. A similar immunohistochemical analysis was then carried out on columnar cell hyperplasia with atypia (CCHA), in which the expression pattern of tumor suppressor 14-3-3sigma, ERalpha and p53 suggested that it might be possible that CCHA is a precancerous lesion.     

Gender difference in the relationship of performance in the handgrip and standing long jump tests to lean limb volume in young adults

Summary Groups of young, adult males and females performed the handgrip and standing long jump tests. Their total forearm and leg volumes were calculated from a series of circumference and length measurements, and the lean volumes (bone + muscle) calculated by taking the skinfold thickness into consideration. In the handgrip, the mean female performance was 298 N compared with 496 N for the males. In the standing long jump, mean performance expressed as distance x body mass was 87.3 kg · m for females compared with 137.7 kg · m for males. These superior performances of males could simply reflect their greater muscle mass, as the mean lean volumes of female and male limbs respectively were 0.54 l and 0.89 l for forearms, and 11.82 l and 14.82 l for the two legs. However, when the performances of males and females were grouped by lean limb volume, it was found that while in both tests there were linear relationships, males and females did not share a common line. In both tests the male relationship was at a higher level than the female; therefore, for a given lean volume, the male performance was significantly superior to that of the female. The gender difference found in this study has not been seen in other studies in which the performance of skeletal muscle has been related to the cross-sectional area of the active muscles and the possible reasons for the differences are considered.     

价值流应用于我国公立医院流程优化的文献分析

目的分析价值流在我国公立医院流程优化方面的应用情况,为医院管理者提供参考。方法以“价值流”“Value Stream Mapping”为检索词,搜索中国知网、万方数据库、维普中文期刊全文数据库以及PubMed数据库,收集2010年1月-2021年3月价值流应用于我国公立医院流程优化的相关文献,按照纳入排除标准确定文献后进行文献计量学分析。结果共纳入13篇文献。纳入文献发表时间主要为2015年-2020年,主要地区为广东省。涉及科室有儿科、放射科、手术室、妇科、出入院办理中心、神经科、门诊和检验科,涉及优化绩效指标共6项,涉及辅助工具使用的研究共10项,涉及政策策略可归纳为9种。结论通过价值流能实现流程优化。高层管理者参与对价值流优化有着关键作用。多工具配合使用能够提高价值流改善效率。未来应更多关注医务人员满意度与成本控制。