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目的 根据新冠肺炎应急和防护要求,因地制宜建立优化的营养诊疗流程。方法 根据新冠肺炎疫情爆发和防护要求,在四川和湖北参与新冠肺炎临床营养救治工作中,组建多学科团队,对传统临床营养诊疗流程的步骤进行优化改进,建立适合当时实际情况的临床营养诊疗方案。结果 在新冠肺炎流行期间,完成了对509余名患者营养风险筛查,180名患者的营养状况评价,73名患者的个体化肠内或/和肠外营养支持,以及94名患者接受治疗饮食,顺利完成救治任务。结论 在新冠肺炎临床营养救治过程中,改进优化的临床营养诊疗流程能有效保障新冠肺炎的临床营养救治。 相似文献
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《现代医院》2022,(1):134-136
目的 通过分析我院入境新冠肺炎可疑症状人员的临床特点,探讨定点医院防控管理经验,为应对入境新冠肺炎疫情等公共卫生事件方面提供参考。方法 选取我院2 361例入境新冠肺炎可疑症状人员为研究对象,回顾性调查分析其一般情况,筛查结果及留观时间。结合特点从医疗队管理、应急物资管理、入境管理、筛查方案、救治分区管理五方面探讨其防控管理经验。结果 ①入境新冠肺炎可疑症状人员平均年龄31. 44±13. 84岁,中青年为主;学生占比41. 04%,职员占比22. 53%;中国籍占比95. 48%。②筛查后确诊病例占比5. 25%,无症状感染者占比4. 62%,未发生漏筛问题;新冠肺炎排除患者留观时间集中在2至5天,占新冠肺炎排除患者留观时间的65. 93%。结论 入境新冠肺炎可疑症状人员有其临床特点,我院采取的防控管理策略有效防止新冠肺炎境外输入。 相似文献
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目的:探索新冠疫情下,对作为某三级甲等综合医院临时分院,收治新冠肺炎疑似病例的乡镇卫生院的改建与管理。方法:由指定某三级甲等综合医院派出的医疗、护理及院感组成的管理团队对其进行直接管理,通过改造布局流程、规范运行模式、健全制度建设、合理人员配置、严格质量控制,有效落实新冠肺炎的防控措施,防止疫情扩散。结果:新冠肺炎疑似病例集中收治医院共收治新冠疑似患者91例,其中住院患者71例,留观患者20例,6例核酸检测阳性患者安全转运至定点收治医院治疗,所有患者(包含转出的6名)均康复出院居家隔离观察。结论:规范改建后的新冠肺炎疑似病例集中收治医院,成功收治甄别了近百名疑似患者,有效地落实疫情防控措施,提高了突发公共卫生事件的应对能力;同时还培养了一批专业管理及医护人员。 相似文献
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目的:研究新型冠状病毒肺炎(以下简称“新冠肺炎”)的多层螺旋CT影像学特点及诊断价值。方法:选取2020年2-3月武汉火神山医院接收的600例经核酸检测确诊的新冠肺炎患者为研究对象,其中普通型483例、重型98例、危重型19例。对所有患者均行多层螺旋CT检查。比较多层螺旋CT和核酸检测的新冠肺炎检出率,分析多层螺旋CT检查下新冠肺炎患者累及肺叶情况与病灶特点,并根据临床分型及影像学特点重新分型。采用SPSS 18.0软件进行数据分析。结果:新冠肺炎的多层螺旋CT检出率为99.50%(597/600),与核酸检测相当,差异无统计学意义(P>0.05)。经多层螺旋CT检查,597例患者中普通型480例、重型98例、危重型19例,而且相较于轻型患者,重型与危重型患者的肺部感染面积更大。新冠肺炎患者的病灶特点主要为单纯磨玻璃密度影(61.47%)。结论:对于新冠肺炎患者,可积极应用多层螺旋CT检查,明确患者的肺部感染情况,从而为临床治疗提供可靠的依据。 相似文献
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文章总结了同济大学附属第十人民医院支援新冠肺炎患者定点收治医院的救治工作经验。即根据所支援的病区新冠肺炎患者状况,合理分配医师、护士、药师三方人力资源,明确各自岗位责任,在分工合作基础上,不断优化工作流程,并始终贯彻院感理念。文章认为对新冠肺炎重症患者治疗是支援救治工作的重点与难点,需同时采取多学科协作和心理干预方式,而持续强化重症医学学科的发展是今后应对重大公共卫生事件的重要策略。 相似文献
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目的:调查分析新冠肺炎流行期间孕妇心理状态,为采取心理干预提供依据。方法:选取2020年1月31日-2020年2月25日在镇江市妇幼保健就诊的孕妇122人为研究对象。使用一般情况调查表、自编新冠肺炎期间孕妇行为调查表、抑郁和焦虑和自评量表,对孕妇进行问卷调查,运用单因素分析、Logistic回归模型进行统计分析。结果:孕妇焦虑筛查总阳性率为9.83%,抑郁筛查总阳性率为40.16%。单因素分析新冠肺炎疫情与孕妇抑郁相关(P<0.05)。以抑郁筛查阳性为因变量进行Logistic回归分析,与体温测量的频率及新冠知识的知晓度相关(P<0.05)。结论:新冠肺炎疫情期间,孕妇出现不同程度的抑郁及焦虑心理,与孕妇关注疫情程度相关,且不同程度焦虑和抑郁情绪的影响因素不完全相同,应针对性地对孕妇进行心理干预,减少孕妇不良心理。 相似文献
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医疗服务操作分类与编码是医学信息标准化的重要组成部分,是临床数据提取、分析和应用的基础。世界卫生组织及世界多国一直致力于开发、更新和维护此分类与编码。我国此前一直沿袭美国准备在2014年停止使用的ICD-9-CM-3(卷3),中国需要结合国际主流设计思路,根据国情开发出适宜的多轴、一体化的医疗服务操作分类与编码体系。 相似文献
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环境中双酚A的污染及降解去除的研究进展 总被引:16,自引:0,他引:16
近10年来随着科学与社会的发展,环境雌激素污染日益引起人们的关注。双酚A是环境雌激素的一种,用途广泛,但具有多方面的毒性。对其毒理、污染及降解去除的研究已经成为国际上的研究热点。该文拟对上述几方面的研究进展情况作一简要介绍。 相似文献
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主要就引起卵巢黄体功能不健的因素 ,分别从激素调节、细胞因子 (VEGF、TNF α、BFGF、IFN γ、IGF)、C myc、Fas、SGP 2基因调控以及细胞连接、细胞粘附分子、NO等对卵巢功能的调节及对黄体细胞的凋亡影响进行阐述 ,认为卵泡发育不良、颗粒细胞、黄体细胞的凋亡与黄体功能不足有密切的关系。且多种细胞因子、基因表达产物参与此过程的调控。深入的研究这一调控机制 ,对于进一步了解卵巢卵泡生长发育、卵泡闭锁及黄体细胞凋亡的内在机制有重要意义 相似文献
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A group of 101 women, aged 40-65 years consisted of 48 premenopausal subjects and 53 postmenopausal ones living in Daegu and Gyeongbuk area in Korea were evaluated with their general characteristics, lifestyle factors, nutrient and phytoestrogen intakes, blood and urinary indices concerning antioxidant status and bone metabolism. Body mass index (BMI), waist hip ratio (WHR) and systolic blood pressure (SBP) of the postmenopausal women were significantly higher (23.8, 0.86, and 126.9 mmHg, respectively) than those of the premenopausal women (22.6, 0.82, and 115.9 mmHg; respectively). Nutrient intakes of the postmenopausal and premenopausal groups were not different except lower fat intake and higher dietary fiber and iron intakes in the postmenopausal group. Daily total phytoestrogen intake was significantly higher in the postmenopausal group (48.54 mg) than the premenopausal (31.41 mg) and was resulted mostly from higher intakes of daidzein and genistein from soy and soy products (45.42 mg vs 28.91 mg). Serum genistein level and excretion of enterolactone, major lignan metabolite, were not very different between the two groups. Serum retinal and α- tocopherol levels were higher in the postmenopausal group but TBARS levels were not different between the two groups. Serum osteocalcin (7.18 ng/mL) and urinary deoxypyridinoline (7.15 nmol/mmol creatinine), in the postmenopausal group were significantly higher than those in the premenopausal group (4.80 ng/mL, 5.95 nmol/mmol creatinine). Urinary excretion of enterolactone was positively correlated with serum osetocalcin in premenopausal women and serum genistein negatively correlated with the urinary DPD in postmenopausal women. Dietary phytoestrogen intake was negatively correlated with serum level of TBARS in all subjects. It is concluded that the effect of total phytoestrogen intake is beneficial on body antioxidant status in all middle-aged women regardless of menopause but the effect on bone metabolism appears different by the type of the phytoestrogen and the menopausal state. 相似文献
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Background/aim: Grip strength is useful in clinical practice for the assessment of disease and/or rehabilitation progression. Brief maximal gripping is seldom required in everyday occupations, with repeated or sustained gripping at sub‐maximal power more commonly involved. It has been proposed that assessment of both maximal hand‐grip force and endurance is utilised. While the suitability of maximal contraction measures has been clearly established, the reliability and validity of other hand‐grip indices have not been investigated. This study examined the reliability of various hand‐grip indices and their validity in relation to distance walked during the six‐minute walk test, a standardised exercise capacity test. Methods: Subjects undertook static sub‐maximal (50%) and maximal force contraction hand‐grip testing from which various indices were derived, and six‐minute walk testing from which distance walked was determined. Testing was repeated on three separate occasions for determination of test–retest reliability. Results: Pre‐ and post‐fatigue maximal contraction measurements demonstrated excellent test–retest reliability and validity. Conversely, other hand‐grip indices were shown to be unreliable and exhibited no relationship with distance walked and hence concurrent validity could not be established. Conclusions: Based on the results of this study, it is recommended that pre‐ and post‐fatigue maximal contraction may be utilised for the assessment of client ability and progression due to their established validity and test–retest reliability. However, previously proposed measures of fatigue such as endurance (duration of sustained contraction), Strength Decrement Index and work performed (function of endurance and force of contraction) are unreliable and invalid and may have limited use in clinical practice. 相似文献
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Nitya Sharma Sarmad Hanif Rakesh Rana Dilip Upadhyay Manoj Kumar Chhikara 《Vaccine》2019,37(7):965-972
The changes in the recommended storage conditions of the glycoconjugate vaccines against Neisseria meningitidis (Men) serogroup A and serogroup X can affect its activity or potency. Elevated temperature and the change in pH may result in the physical instability leading to the size degradation of the polysaccharide (PS) and subsequent loss of PS epitopes. Moreover, high temperature may also result in protein aggregation and altered tertiary structure of the protein in the conjugate. Consequently, the construction of a potent glycoconjugate is dependent on optimal temperature and pH. The changes in both these conditions can also affect the production of a capsular polysaccharide (PS) and its conjugation to a protein carrier and may also affect the integrity of the vaccine molecule including the maintenance of the protective epitopes. In our study we have used inhibition ELISA as a tool to assess the impact of temperature and pH alterations on the antigenicity of N. meningitidis serogroup A and X, PS and conjugates and their correlation with the size distribution analysis using high pressure size exclusion chromatography. The studies on pH alterations from 5 to 9 led to minimal impact on size and antigenicity of all antigens, however, an elevated temperature adversely impacted the antigen size as well as antigenicity to varying extent. Results indicate the higher stability of MenX PS and conjugate as compared to that for MenA counterparts at elevated temperatures. Furthermore, both the MenA and MenX conjugates appears to be more stable as compared to the corresponding PSs. 相似文献