关于华西医院肿瘤中心住院患者癌痛情况的调查分析

目的:了解四川大学华西医院肿瘤中心住院的癌症患者疼痛的发生率,癌性疼痛(以下简称癌痛)患者的疼痛情况、镇痛药物的使用情况,并分析癌痛患者镇痛治疗不足的相关因素。方法:采用问卷的方式调查癌症患者的疼痛发生率,癌痛患者的疼痛情况、镇痛药物的使用情况,以及癌痛患者所用镇痛药物的花费情况。结果:四川大学华西医院肿瘤中心住院的癌症患者中疼痛的发生率为46.4%,最痛时视觉模拟评分(Visual analogue scale,VAS)为66.01±23.07。癌症患者中发生疼痛的患者与非疼痛患者相比,其情绪、正常工作、睡眠、生活乐趣等均受到不良影响(P<0.05),且疼痛患者有更高的自杀倾向的发生率(P<0.05)。发生癌痛时仅有49.7%的患者使用镇痛药物。92.9%的癌痛患者镇痛药物花费占所有治疗总费用的比例≤1%。结论:在华西医院肿瘤中心住院的癌症患者中,癌痛是较为普遍存在的临床症状,癌痛的发生会显著影响患者的生活质量,目前尚存在癌痛患者镇痛不足的情况,应从医患两方面进行癌痛相关知识的宣教,推进癌痛的规范化诊疗。     

MUSIC INTERVENTIONS IN PEDIATRIC ONCOLOGY: Systematic review and meta-analysis

BackgroundPain is a disagreeable and distressing feeling that affects human beings in multi-dimensional ways. A number of non-pharmacological interventions have had varying degrees of success in treating cancer-related pain, such as breathing and relaxation techniques, and music therapy, which have been identified as beneficial therapies for alleviating pain and anxiety.ObjectiveIdentify the therapeutic effects of music interventions in psychological and physiological terms and on the quality of life of children undergoing cancer treatment.MethodSystematic review of effectiveness based on the methodology of the Joanna Briggs Institute.ResultsEleven articles were included with a total of 429 children, whose ages ranged from 0 to 18 years. The mean duration of the music intervention was 30.6 (±SD 9.8) min. In a combined estimate of five studies for pain and anxiety outcomes, there were benefits to using music when compared with the control group (SMD −1.05; CI 95 % −1.70 – 0.40 N = 453 I² = 90 %). A combined analysis of five studies to assess quality of life showed that the use of music was favorable when compared with the control (SMD -0.80; CI 95 % −1.17−0.43 N = 457= I² = 71 %).ConclusionAfter completing this review, it was determined that there is evidence to support the use of music to reduce pain and anxiety and improve the quality of life of children undergoing cancer treatment.     

医院肿瘤病房医务人员手卫生现状调查

目的了解医院肿瘤病房医务人员手卫生现状,为改进和提高手卫生质量提供参考。方法通过现场查看和问卷调查方式,对黄石市部分综合医院肿瘤病房医务人员手危险现状进行了调查。结果医院肿瘤科医务人员洗手用固体肥皂占86.6%,只有少数使用洗手液;有19%医务人员手消毒用消毒液浸泡,另有20.7%的人员使用消毒巾擦拭。医院肿瘤科医务人员中有98%以上人了解接触病人血液、分泌物等污染后要洗手,但洗手执行率较低,多数人认为没有时间或洗手设施不方便。结论该地区医院肿瘤科医务人员对手卫生知识了解不够,执行率低,手消毒剂和手卫生设施不足。     

住院肿瘤患者医院感染现患率调查

目的了解住院肿瘤患者医院感染现患率情况及危险因素,为制定干预措施提供依据。方法采用横断面调查的方法,对本医院住院肿瘤患者医院感染现患率及危险因素进行调查。结果在调查的时间点该医院住院肿瘤患者共237例,发生27例合并感染(含医院获得性感染和社区获得性感染),总感染率为11.39%;其中医院获得性感染8例,医院感染现患率为3.38%;社区获得性感染19例,社区感染率为8.02%。肿瘤病人并发感染以呼吸道感染为主,占总感染人数的77.78%。放化疗的肿瘤病人预防性使用抗菌药物约占40%,手术治疗的肿瘤病人预防性用药比例达到70%以上。结论肿瘤病人合并感染的比例较高,但医院内获得感染远低于社区获得感染,应积极开展社区干预,提高肿瘤放化疗患者的生存质量。     

TIMBER IN AUSTRALIA IN WARTIME

Fire history since 1850 was reconstructed by analysing tall wet eucalypt forest stands in the Warra long-term ecological research (LTER) site in southern Tasmania. Major fires occurred in 1898, 1906, 1914 and 1934. Fifty-seven percent of the forest has remained unburnt since 1850. Sixty percent of the forest burnt since 1850 occurs as mixed age stands, while 40 percent is pure regrowth. Ring counts of stumps of three veteran eucalypt trees indicated that the mature and oldgrowth forests of the Warra site represent a number of pre-1850 fires. One extant oldgrowth eucalypt stand was estimated to be over 450 years old. The common occurrence of multi-aged wet eucalypt stands has silvicultural implications where a management objective is to emulate pre-existing stand structures. While the fire history reported here is limited mainly to the period since 1850, it provides a good basis for understanding the current stand structures of the tall wet eucalypt forests of the Warra site. Such an understanding is essential to interpret results from current and planned ecological studies associated with the LTER program at Warra.     

STAGGERS IN SHEEP IN PATAGONIA

After observations and experimental work both in the field and laboratory, the following conclusions seem justified. 1. Staggers is a non-infectious disorder affecting horses, cattle, and sheep. 2. The disease is characterized by weakness, muscular twitching, irregular movements of the head, stiffness of the limbs, and transient motor paralysis, accompanied with spastic spasms on excitement. There is also a derangement of vision and conjunctivitis. 3. The postmortem lesions are not characteristic. 4. We readily produced the disease by feeding susceptible sheep on a coarse tuft grass commonly known as coiron or pampa grass (Poa argentina). 5. The time required to produce definite symptoms by feeding the grass varied. Two animals developed typical staggers after two feedings; in another instance a period of 21 days of feeding was required. The average time for the production of unmistakable symptoms in our experiments was 10 days. 6. Many sheep recover from staggers spontaneously. A complete change of diet will usually effect a cure within 2 weeks. 7. Older .animals that have pastured for long periods on lands where the grass grows become tolerant and are rarely affected with staggers. 8. The grass is toxic to sheep at all seasons of the year. We fed late winter and early spring grass and grass in flower, and produced staggers in every instance. The young green grass is as toxic as any edible portion of the plant.     

BACTERIUM PNEUMOSINTES IN CLINICAL INFLUENZA IN NEW YORK CITY IN 1926

The presence of Bacterium pneumosintes has been demonstrated in nasopharyngeal washings from 2 patients in a sporadic outbreak of clinical influenza in New York City in March, 1926. 2 strains of bacteria morphologically similar to Bact. pneumosintes, but differing in certain cultural characters, and 2 other anaerobic filter-passing organisms were also isolated from the 9 patients examined. The blood serum of 16 among 17 persons convalescent from clinical influenza, and of 6 among 10 supposedly normal persons, agglutinated 1 or more strains of Bact. pneumosintes.