医院全成本核算的应用研究

市场经济条件下,以科学、节约、合理的成本投入,去追求利润的最大化,不仅是企业单位的目标,业已成为医疗单位的目标之一.     

社区获得性呼吸道感染患儿肺炎链球菌耐药特征分析

肺炎链球菌（Streptococcus pneumonia,SPN）是儿童社区获得性呼吸道感染（Community Acquired Res-piratory Tract Infection,CARTI）最常见和最重要的病原菌,约30-50%社区获得性呼吸道感染与SPN有关[1],不同国家和地区SPN的耐药性差异很大,     

基于CT颅内动脉瘤支架的表面剪切应力分析

BACKGROUND: Numerical stimulation technology is a good method to analyze blood flow changes after intracranial aneurysm stenting that often result in restenosis.     

支架置入前脑动脉瘤血流场的特性分析

BACKGROUND: Cerebral aneurysm is a kind of mortal hemangioma, and its treatments such as endovascular embolization and clipping both cause high postoperative recurrence rate and mortality. So the stent implantation for cerebral aneurysm is coming into being. OBJECTTVE: To evaluate the hemodynamic parameters after stent implantation into cerebral aneurysm and to provide a novel feasible strategy for clinical treatment. METHODS: A retrospective analysis was preformed based on the CT image data of 11 patients with cerebral aneurysm from the Affiliated Hospital of Xinjiang Medical University. Firstly, the flexible and solid model of cerebral aneurysm was established by the MIMICS and reverse engineering. Secondly, the matching stent model was implanted into the cerebral aneurysm, and then the blood flow structure of cerebral aneurysm was analyzed by the fluid dynamics theory and the Fluent with the method of two-way flow solid coupling. Finally, comparative analysis of the kinetic parameters of cerebral aneurysm before and after implantation, including wall pressure, blood velocity, path line of the blood flow, wall shear stress, wall deformation was conducted, and blood flow characteristics after stent implantation were analyzed under different entrance velocity. RESULTS AND CONCLUSION: After implantation, the wall surface pressure was reduced about 61.1%; the blood flow velocity around the stent and the inside of the cerebral aneurysm was decelerated obviously; under setting 2 000 lines of blood flow, the number of path line of blood flow into the cerebral aneurysm reduced about 75.0%, the maximum wall shear stress decreased about 79.3%, and the maximum wall deformation reduced to a lower level. The entrance velocity was respectively v1=0.1 m/s, v2=0.2 m/s, v3=0.3 m/s and the wall pressure was in a gradient ascent; the wall shear stress increased with the velocity, meanwhile, τzou (left neck of aneurysm) <τzhong (aneurysm )< τyou (right neck of aneurysm). The path lines of blood flow mainly concentrated in the top of the aneurysm, and the blood velocity markedly affected the surface deformation. These results indicate that main hemodynamic parameters are obviously improved after stent implantation into cerebral aneurysm, and the blood velocity should never be neglectful in the treatment process.     

社区获得性MRSA所致哺乳期乳腺脓肿耐药性分析

目的：分析社区获得性MRSA所致哺乳期乳腺脓肿的病原菌分布和耐药状况。方法：收集153份乳腺脓肿脓汁标本进行细菌分离鉴定及药敏试验,用法国梅里埃公司生产的API鉴定系统进行细菌菌株鉴定,用K-B纸片扩散法作药敏试验。结果：金黄色葡萄球菌呈现多重耐药趋势,MRSA对青霉素的耐药率为100%,对苯唑青霉素、头孢西丁、红霉素的耐药率分别为94.3%、91.4%和80%,对左氧氟沙星和复方新诺明的敏感率均为100%。35例患者平均年龄26.8岁,一般出现在产后更早时期（P=0.0000）,脓肿直径更大（P=0.0083）。结论：社区获得性MRSA是哺乳期乳腺脓肿感染的主要细菌,左氧氟沙星可作为治疗的首选药物,抗菌药物的选择应以药敏结果为指导,避免乱用和滥用抗生素。     

基于CT的脑动脉瘤双向流固耦合数值模拟研究

目的：探讨基于动脉瘤壁与动脉血管壁厚度不一的脑动脉瘤双向流固耦合数值模型的建模方法。方法：用MIMICS16.0软件提取1例患者颅内动脉瘤CT影像DICOM数据,获得动脉瘤体的初步模型。将该模型导入逆向工程软件Geomagic Studio 12,以及UGS NX 8.5进一步处理后,得到厚度不一的脑动脉瘤三维几何模型。运用ANSYS Workbench 15.0软件进行双向流固耦合计算,并分析瘤体内血流特性及动脉瘤壁所受应力应变情况。结果：快速准确地建立了厚度不一的动脉瘤双向流固耦合模型,清晰地模拟出1个心动周期内动脉瘤表面剪切应力、表面变形及速度流线的变化情况。结论：应用上述方法能够快速准确地建立动脉瘤的双向流固耦合模型,且相较于刚性模型和厚度一致的动脉瘤体模型更准确和实用。可以为动脉瘤介入治疗模拟研究提供优良的模型参数。     

参芪扶正汤对盆腔炎性疾病后遗症小鼠上生殖道细胞自噬水平的影响

目的:研究参芪扶正汤不同途径给药对盆腔炎性疾病后遗症(SPID)小鼠模型的治疗作用,并探究参芪扶正汤对SPID小鼠模型上生殖道组织中肿瘤坏死因子α(TNF-α)及自噬相关蛋白[Beclin-1、微管相关轻链蛋白3(LC3)]的影响,探讨潜在治疗机制.方法:选取60只SPF级雌性BALB/c小鼠,7～8周龄,随机分为空白...     

儿童侵袭性肺炎链球菌病临床特征及重症早期预警指标分析

目的 探讨儿童侵袭性肺炎链球菌病(IPD)临床特征及重症早期预警指标。方法 回顾性收集2007年1月至2021年12月该院至少1次血培养分离出肺炎链球菌(Sp)的101例IPD住院患儿病例资料,根据患儿住院期间是否入住儿童重症监护病房(PICU),将其分为PICU组(35例)和普通病房组(66例),对比分析两组一般临床资料、感染类型、药敏试验、菌株血清型鉴定结果。结果 与普通病房组比较,PICU组男性、合并神经系统疾病和缺铁性贫血占比、冬季发病率,意识障碍、惊厥、呼吸困难、心率增快、呕吐和腹泻发生率,外周血中性粒细胞百分比、C反应蛋白(CRP)、乳酸脱氢酶(LDH)水平,Hb<90 g/L、LDH>700 U/L、肌酸激酶同工酶-MB(CK-MB)异常、细菌性脑膜炎、脓毒症及重症肺炎占比更高,体重第3～97百分位、支气管肺炎、无病灶血流感染占比及WBC、Hb、白蛋白水平更低,差异有统计学意义(P<0.05)。该研究鉴定出11种IPD血清型,排名前5依次为6B、14、19F、23F和19A。十三价肺炎链球菌结合疫苗(PCV13)可覆盖96.9%IPD血清型。多因素log...     

TaqMan荧光探针技术检测不同血清型B群链球菌的方法建立及评价

目的建立基于TaqMan荧光探针技术,对不同血清型B群链球菌(GBS)鉴定的分子方法,为后续研究多重荧光探针技术检测不同血清型GBS奠定基础。方法根据不同血清型荚膜多糖(CPS)序列的差异设计引物和探针,用实时荧光定量PCR扩增CPS序列,建立不同血清型的GBS分型方法,从灵敏度、特异度及临床分离株检测等方面对该方法进行评价,并与胶乳凝集试验结果比较。结果同一血清型GBS的DNA的对数浓度与循环阈值(Ct)呈良好的线性相关,该方法的检测下限均为1pg/μL,一种探针只能检测对应血清型的GBS。10株标准菌株的TaqMan荧光探针技术检测结果与胶乳凝集试验结果一致。结论 TaqMan荧光探针技术是一种简单、快速、具有较高灵敏度和特异度的检测GBS血清型的方法,对临床分离株的分型优于乳胶凝集试验。