结肠癌腹腔镜切除与开腹切除短期疗效研究

1文献类型治疗。2证据水平1b。3文献来源The colon cancer laparoscopic or openresenction study group.Laparoscopic surgery versusopen surgery for colon cancer:short-term outcomesof a randomised trial[J].Lancet Oncol,2005,6(7):477-484.4背景腹腔镜胆囊切除术具有手术创伤小、术后恢复快、美容效果好等特点。但临床上结肠癌腹腔镜切除术的有效性和安全性存在一定争议。5目的评价结肠癌腹腔镜切除与开腹切除(COloncancer Laparoscopic or Open Resection,COLOR)的手术根治性、手术并发症和总体生存。同时比较两种手术时间…     

一例急性期布鲁氏菌病病例的个案调查分析

目的通过对一例布鲁氏菌病(简称布病)病例的调查与处理,为门诊诊疗病人提供参考。方法对一例布鲁氏菌病病例的个案流行病学调查资料、检验结果与调查处理情况进行描述性流行病学分析。结果本例病例确诊为急性期布鲁氏菌病。结论本例病例为一起与职业、个人行为相关的布鲁氏菌病病例,传染源为病羊,传染途径为饲养、无任何个人防护接触病羊等行为;应采取综合控制措施,加强重点人群健康教育和干预。     

基层医务人员对医学信息资源的需求分析

对我国现有医学信息资源进行简单归纳,列出可供基层医务人员获取的信息资源及其种类。根据调研结果,对基层卫生管理部门及农村三级医疗卫生机构医务人员医学信息资源需求进行详细分析,得出各类人员的实际需求。为基层医生继续学习和管理机构资源分配提供一定指导作用。     

Using Biometrics for Participant Identification in a Research Study: A Case Report

This paper illustrates the use of biometrics through the application of an iris-based biometrics system for identifying twins and their parents in a longitudinal research study. It explores the use of biometrics (science of measuring physical or anatomical characteristics of individuals) as a technology for correct identification of individuals during longitudinal studies to help ensure data fidelity. Examples of these circumstances include longitudinal epidemiological and genetic studies, clinical trials, and multicenter collaborative studies where accurate identification of subjects over time can be difficult when the subject may be young or an unreliable source of identification information. The use of technology can automate the process of subject identification thereby reducing the need to depend on subject recall during repeated visits thus helping to ensure data quality. This case report provides insights that may serve as useful hints for those responsible for planning system implementation that involves participants' authentication that would require a more secure form of identification.     

Medical Big Data Warehouse: Architecture and System Design,a Case Study: Improving Healthcare Resources Distribution

The huge increases in medical devices and clinical applications which generate enormous data have raised a big issue in managing, processing, and mining this massive amount of data. Indeed, traditional data warehousing frameworks can not be effective when managing the volume, variety, and velocity of current medical applications. As a result, several data warehouses face many issues over medical data and many challenges need to be addressed. New solutions have emerged and Hadoop is one of the best examples, it can be used to process these streams of medical data. However, without an efficient system design and architecture, these performances will not be significant and valuable for medical managers. In this paper, we provide a short review of the literature about research issues of traditional data warehouses and we present some important Hadoop-based data warehouses. In addition, a Hadoop-based architecture and a conceptual data model for designing medical Big Data warehouse are given. In our case study, we provide implementation detail of big data warehouse based on the proposed architecture and data model in the Apache Hadoop platform to ensure an optimal allocation of health resources.     

干部健康保健预警巡诊需求调查分析

目的 探索科学高效的干部健康保健预警巡诊模式.方法 2013年1-11月采用自制问卷对46名省干部保健委员会指定的干部保健人群进行无记名方式书面问卷调查.结果 在职干部和离退休干部对巡诊时间、地点、宣传单手册内容有不同的要求,差异均有统计学意义(P<0.05),对手机短信医学知识介绍的方式均接受.结论 干部保健对象的健康预警需要制定个性化的巡诊模式,并根据对象需求获得全面的健康资料,完善干部健康档案,提高巡诊效率.     

不同术式治疗良性前列腺增生症术后性功能比较

[目的]比较开放与腔内不同术式治疗良性前列腺增生症(BPH)术后对性功能的影响.[方法]对120例腔内经尿道前列腺电切术(TURP)与经尿道前列腺汽化电切术(TVP)和80例包括膀胱耻骨上前列腺摘除术(SPPC)与保留尿道前列腺切除术(MPC)开放手术的BPH病人进行9个月的追踪观察,总结其术后阳萎及逆行射精发生率.[结果]TURP与TVP术后阳萎发生率分别是10%(4/41)和5%(2/42),逆行射精发生率分别是55%和51%.SPPC与MPC术后阳萎发生率分别是10%(3/31)和3%(1/29),逆行射精发生率分别是48%和14%.[结论]治疗BPH的4种术式术后性功能损害TVP和MPC优于TURP和SPPC,逆行射精发生率MPC术式明显优于其他术式.     

卵巢子宫内膜异位囊肿腹腔镜与开腹手术剥除的疗效比较

目的 比较腹腔镜下与开腹行卵巢子宫内膜异位囊肿剥除术的临床疗效.方法 将276例卵巢子宫内膜异位囊肿患者根据自愿选择手术方式的原则分成2组,腹腔镜组107例,开腹组169例,比较2组临床疗效、复发率以及对卵巢功能的影响.结果 腹腔镜组痛经改善率为83.9%(52/62),开腹组痛经改善率为82.7%(67/81),2组比较差异无统计学意义(P>0.05);术后1、2、5年腹腔镜组囊肿复发率分别为9.3%(8/86)、20.5%(16/78)、34.3%(23/67);开腹组复发率分别为8.5%(11/130)、24.8%(29/117)、44.4%(34/81),2组比较差异无统计学意义(P>0.05).E2水平的比较:腹腔镜组中单纯电凝组术后1个月血清E2水平与术前比较差异无统计学意义(P>0.05);反复电凝+缝合组与开腹组术后E2水平明显低于术前(P<0.05).结论 腹腔镜卵巢子宫内膜异位囊肿剥除术与开腹手术临床疗效相似,但腹腔镜对患者损伤小,而术中过多电凝烧灼仍可能导致卵巢功能的损伤.     

中医药院校运动医学硕士研究生教育的保障体系构建——以广州中医药大学为例

以广州中医药大学为例,从培养目标与研究方向、招收筛选机制和培养机制三个方面,分析中医药院校运动医学硕士研究生教育的发展现状,从优化课程设置、加强导师队伍和联合培养基地建设、创新管理机制等角度,对运动医学硕士研究生教育的保障体系构建进行探讨,提出中医药院校运动医学硕士研究生教育改革发展的新思路。     

阿兹夫定对新型冠状病毒感染患者肝肾功能影响的研究

背景 阿兹夫定是中国新型冠状病毒感染常用抗病毒药物,但其对肝肾功能影响的研究极为匮乏。目的 探讨新型冠状病毒感染患者使用阿兹夫定后肝肾功能的变化,为肾功能不全患者安全使用阿兹夫定提供用药参考。方法 回顾性连续纳入某三甲综合医院2022-12-26—31使用阿兹夫定治疗新型冠状病毒感染的住院患者,按估算肾小球滤过率(eGFR)水平将其分为正常组、轻度损伤组、中度损伤组、重度损伤组、终末期组,观察各组患者使用阿兹夫定后肝肾生化指标[丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)、白蛋白、总胆红素(TB),血肌酐(Scr)、eGFR]变化;对eGFR<60 mL·min^-1·(1.73 m²)^-1的患者应用D＿FR=D＿NL×[1-F＿k(1-K＿f)]公式校正阿兹夫定维持剂量,按是否遵循此公式给药将其分为校正组和未校正组,比较两组患者肝肾功能生化指标变化。结果 336例使用阿兹夫定的患者中190例符合纳入、排除标准,按eGFR水平分组后各组年龄、新型冠状病毒感染严重程度、降钙素原峰值、降...     

Overcoming Barriers to the Implementation of a Pharmacy Bar Code Scanning System for Medication Dispensing: A Case Study

Technology has great potential to reduce medication errors in hospitals. This case report describes barriers to, and facilitators of, the implementation of a pharmacy bar code scanning system to reduce medication dispensing errors at a large academic medical center. Ten pharmacy staff were interviewed about their experiences during the implementation. Interview notes were iteratively reviewed to identify common themes. The authors identified three main barriers to pharmacy bar code scanning system implementation: process (training requirements and process flow issues), technology (hardware, software, and the role of vendors), and resistance (communication issues, changing roles, and negative perceptions about technology). The authors also identified strategies to overcome these barriers. Adequate training, continuous improvement, and adaptation of workflow to address one's own needs mitigated process barriers. Ongoing vendor involvement, acknowledgment of technology limitations, and attempts to address them were crucial in overcoming technology barriers. Staff resistance was addressed through clear communication, identifying champions, emphasizing new information provided by the system, and facilitating collaboration.     

Early Clinical Efficacy of Laparoscopic Sleeve Gastrectomy as a Bariatric Surgery for Obese Patients: A Uni-center Report in China

ObjectiveTo report the experience with laparoscopic sleeve gastrectomy as a bariatric surgery in our center.MethodsTwenty obese patients were followed up for 1 year after receiving laparoscopic sleeve gastrectomy as a bariatric surgery in our center from January 2009 to October 2010, during which their general conditions, complications, and improvement of obesity-related diseases were assessed.ResultsOf the 20 patients, 19 underwent laparoscopic sleeve gastrectomy and 1 underwent open sleeve gastrectomy with no death occurred. The average weight loss was 36.4±10.0 kg, the average BMI decreased from 46.1±11.5 to 33.6±5.6 kg/m², and the excess weight loss was 55.9%±14.2% one year after the operation. The majority of obesity-related diseases were improved. In one year after the operation, excellent, good, fairly good and poor scores were achieved in 2 (10.0%), 8 (40.0%), 7 (35.0%), and 3 patients (15.0%), respectively.ConclusionLaparoscopic sleeve gastrectomy as a bariatric surgery is a safe and feasible procedure for obesity with excellent short-term effects. More studies with a long-term follow-up are needed to validate its benefits.     

Designing a Personal Health Application for Older Adults to Manage Medications: A Comprehensive Case Study

Older adults with multiple chronic conditions often go through care transitions where they move between care facilities or providers during their treatment. These transitions are often uncoordinated and can imperil patients by omitted, duplicative, or contradictory care plans. Older adults sometimes feel overwhelmed with the new responsibility of coordinating the care plan with providers and changing their medication regimes. In response, we developed a Lesser General Public License (LGPL) open source, web-based Personal Health Application (PHA) using an iterative participatory design process that provided older adults and their caregivers the ability to manage their personal health information. In this paper, we document the PHA design process from low-fidelity prototypes to high-fidelity prototypes over the course of six user studies. Our findings establish the imperative need for interdisciplinary research and collaboration among all stakeholders to create effective PHAs. We conclude with design guidelines that encourage researchers to gradually increase functionality as users become more proficient.     

腹腔镜下结直肠全系膜切除术与传统开腹手术对结直肠癌患者的免疫功能及预后比较

目的比较腹腔镜下结直肠全系膜切除术与传统开腹手术对结直肠癌患者的免疫功能及预后的影响。方法将2012年6月至2014年6月重庆市万盛经济技术开发区人民医院采取腹腔镜结直肠全系膜切除的80例结直肠癌患者作为观察组。另选取同期进行开腹结直肠全系膜切除术的80例患者作为对照组。比较两组患者手术时间、术中出血量、胃功能恢复时间、住院时间等手术一般情况,并对患者免疫功能和术后并发症发生情况进行分析。结果两组患者手术时间、术中出血量、胃功能恢复时间、住院时间等手术情况差异均无统计学意义(P>0.05);两组患者的Ig A、Ig M、Ig G组间差异无统计学意义(P>0.05)。而两组患者的C反应蛋白、IL-6术后1 d明显升高,术后7 d相较于术后1 d明显下降,但相较于术前明显升高;差异有统计学意义(P<0.05)。两组癌胚抗原(CEA)较治疗前均呈下降趋势,两组在不同时点间比较差异有统计学意义(P<0.05),而在组间及组间·时点间比较上差异无统计学意义(P>0.05);两组患者的白细胞、血小板也均无统计学意义(P>0.05)。观察组术后总并发症发生率显著低于对照组[31.3%(25/80)比87.5%(70/80),P<0.05];患者术后5年的病死率比较差异无统计学意义(P>0.05)。结论结直肠全系膜切除术较传统开腹手术术后并发症发生率低,对免疫功能的影响小于传统开腹手术,是临床结直肠癌的有效方法,值得在临床上广泛应用。