城市和农村婴儿身长,体重生长模式的差异

Mixed longitudinal data of length and weight growth from 595 rural and 337 urban infants were analysed. Count models were fitted to the means of length and weight in different ages, sexes and feedings separately. The curve fitting to the data was rather satisfactory. Comparison of model parameters between urban and rural infants suggested that rural infants had a higher length level at birth but lower accelerative growth afterwards than urban ones, which was even more obvious in breast-fed infants. The difference in birth weight between them was not significant; and the urban infants had a faster linear growth velocity than rural ones. These results might be caused by the fact that food supplementing in urban infants was significantly earlier and better than in rural ones.     

Impact of an electronic antibiotic advice and approval system on antibiotic prescribing in an Australian teaching hospital

The impact of a computer-based infectious diseases electronic antibiotic advice and approval system ("IDEA(3)S") was assessed as an alternative to a labour-intensive, phone-based approval system. IDEA(3)S-based approvals replaced 48% of all approvals for the most frequently requested antimicrobial agents (ceftriaxone/cefotaxime, vancomycin) and were associated with stable overall rates of antimicrobial use. Antibiotic prescribing for community-acquired pneumonia was 76% concordant with IDEA(3)S recommendations, and clinical acceptance of IDEA(3)S was excellent. Successful implementation required a coordinated, evidence-based approach between clinicians, pharmacists and hospital administration, together with ongoing staff education and feedback of results. IDEA(3)S is a useful new adjunct to routine clinician consultation to support appropriate antibiotic prescribing for a number of common indications in hospitals.     

2005～2008年某院抗菌药物应用情况调查

目的调查某医院2005～2008年抗菌药物的应用情况。方法收集2005～2008年抗菌药物使用资料,对用药金额、用药种类、用药频度等进行分析。结果4年来该院抗菌药物的品种数逐年增多,但抗菌药物的消耗占药品消耗总金额的比例逐年下降。临床使用抗菌药物主要以头孢菌素类和氟喹诺酮类为主。结论我院抗菌药物的使用基本合理,但仍有少数品种存在过量使用现象。     

2005年-2008年深圳市某医院抑郁障碍患者住院费用分析

目的:了解医疗服务价格政策调整对抑郁障碍患者住院费用及其构成的影响。方法:对深圳市某医院2005年至2008年四年间抑郁障碍单病种住院费用及其构成进行回顾性调查。结果:四年间,抑郁障碍单病种住院天数无明显变化,住院总费用在8000-9000元之间;与2005年相比,2008年床位费占住院总费用的比例下降44.3%、辅助检查费比例下降26.5%、护理费比例下降51.2%,而治疗费比例提高97.7%。结论:医疗服务价格调整正渐趋合理,未来调整应考虑护理成本。     

尼日利亚某城市医院急诊科死亡病例特点

目的：医院的急诊科通常能够反映当地公共卫生的服务质嚣。哈科特港大学教学医院是尼日利亚南部地区重要的卫生服务机构，以其为中心辐射的服务人门约5000000。本文研究死亡病例的人口统计学特点、死亡之前在急诊科的时间。方法：研究对象为2000年4月-2003年3月的3年中在哈科特港大学教学医院急诊科就诊的患者，回顾分析就诊记录、护理报告和死亡证明。找出其中的人口统计学特征、死亡原因，以及从到达急诊科到死亡的时间，建立复合频率表用于分析。     

Relative effectiveness and costs of antiulcer medications as a basis for rational prescribing

To be maximally effective, antiulcer medications should relieve ulcer symptoms rapidly and promote rapid healing of an ulcer crater; after the cessation of a course of treatment the ulcer should not recur. A wide variety of agents is available. These are of similar efficiency in the control of ulcer symptoms and in the acceleration of the healing of the ulcer crater. However, evidence exists of differences in the rate of the recurrence of duodenal ulcers on the cessation of these drugs. Surface-active agents (bismuth complexes, sucralfate, prostaglandins and carbenoxolone) are consistently superior to H2-histamine receptor antagonist drugs (cimetidine and ranitidine). A high relapse rate produces more patients with active disease at any one time, hence more patients will be exposed to the complications of the disease, and will require active investigation and therapy. Because of the increased rate of relapse, the use of H2-receptor antagonist drugs as first-line intermittent healing therapy can be shown to be associated with an eight-fold (800%) increase in cost of pharmaceutical agents as compared with first-line treatment with bismuth salts; a four-fold increase compared with the cost of using antacid drugs; and a two-fold increase compared with the cost of using sucralfate. When maintenance therapy with H2-receptor antagonist agents is given instead of intermittent therapy with bismuth complexes, a 14-fold increase in pharmaceutical costs is incurred, with inferior results that have already been demonstrated under the conditions of a controlled clinical trial. These considerations of efficacy and cost suggest that H2-receptor antagonist drugs ought not to be first-line therapy for duodenal ulcers; rather, surface-active agents such as colloidal bismuth or sucralfate should be prescribed initially.     

农村和基层医院推广肺功能检查技术教学模式的实践探索

肺功能检查对呼吸系统疾病的诊治有重要的指导价值,适合在农村和基层医院推广,但其临床应用和教学水平亟待改进.本文通过对肺功能检查技术向农村和基层医院推广教学中存在问题的剖析,探讨及构建了适合肺功能检查的综合性教学模式,主要包括编著教材、建立教学网站、开发多媒体课件及加强教学培训,在广大农村和基层医院中进行积极推广和实践,促进了肺功能检查教学的发展,加速了肺功能检查技术的临床应用,进一步提高了呼吸系统疾病的防治水平.     

新疆伊宁市城乡原发性高血压患者首次住院状况的差异性分析

目的:探讨新疆伊宁市城镇与农村原发性高血压患者首次住院状况的差异性。方法:回顾性分析2001年1￣2005年12月,我科共收治的1431例首次住院的原发性高血压病患者,依据患者住院时的临床症状、血压分级、高血压病知晓状况、服药规律性、以及血管并发症事件的发生状况,逐一列表统计分析。结果:城乡原发性高血压患者在知晓状况方面比值分别为:43.13%vs42.56%(P>0.05),两者服药规律性与坚持服药方面,农村患者显著低于城镇,两者之间的比值分别为:38.04%vs26.29%(P<0.0001),血管总的并发症方面,二者之间的比值分别为:36.75%vs77.49%(P<0.01),农村患者脑血管事件与心力衰竭发生率明显高于城镇。结论:与城镇原发性高血压患者住院状况相比较,农村患者在服药规律性、就诊意识方面显著低于城镇患者,从而导致农村原发性高血压病患者血管事件的发生率明显高于城镇患者,因此,应当正确引导农村原发性高血压患者对本病的重视,减少血管并发症的发生,改善农村原发性高血压患者的生存与生活质量。     

新疆伊宁市城乡原发性高血压患者首次住院状况的差异性分析

目的：探讨新疆伊宁市城镇与农村原发性高血压患者首次住院状况的差异性。方法：回顾性分析2001年1～2005年12月，我科共收治的1431例首次住院的原发性高血压病患者，依据患者住院时的临床症状、血压分级、高血压病知晓状况、服药规律性、以及血管并发症事件的发生状况，逐一列表统计分析。结果：城乡原发性高血压患者在知晓状况方面比值分别为：43．13％vs42．56％（P〉0．05），两者服药规律性与坚持服药方面，农村患者显著低于城镇。两者之间的比值分别为：38．04％vs26．29％（P〈0．0001），血管总的并发症方面，二者之间的比值分别为：36．75％vs77．49％（P〈0．01），农村患者脑血管事件与心力衰竭发生率明显高于城镇。结论：与城镇原发性高血压患者住院状况相比较，农村患者在服药规律性、就诊意识方面显著低于城镇患者，从而导致农村原发性高血压病患者血管事件的发生率明显高于城镇患者，因此，应当正确引导农村原发性高血压患者对本病的重视，减少血管并发症的发生．改善农村原发性高血压患者的生存与生活质量。     

医学高校城乡家庭经济困难学生心理健康状况调查

对比研究医学高校城乡家庭经济困难学生的心理健康状况.医学高校城乡家庭经济困难学生总体心理健康状况良好,且应对心理困扰的积极性高.相对而言,农村家庭经济困难学生心理状况及应对心理困扰的积极性低于城市学生.针对城乡学生特点,农村学生重点在于经济资助,并高度关注其心理状况,给予应对方式指导;城市学生关注其心理动态;加强学校作用.     

某三甲医院城乡居民2013年住院患者疾病构成及费用分析

目的 比较某三甲医院参加城镇居民医保(简称居民医保)和参加新型农村合作医疗(简称新农合)住院患者疾病构成及住院医疗费用,分析其现状和影响因素。方法 选择该医院2013年所有住院的城乡居民患者的病例资料,比较居民医保和新农合住院患者的疾病构成、科室分布、住院费用构成、医疗费用。结果 居民医保和新农合住院患者的疾病类型和科室分布各有特点;新农合患者平均住院总医疗费13855.25元、平均统筹支付费用6086.17元及平均个人支付费用7769.08元均较居民医保的11676.42元、5394.95元及6216.06元要高,差异均有统计学意义(P<0.05);药费、材料及其他费用均占两类患者总住院费用的70%。结论 居民医保患者住院费用较新农合患者低。降低住院费用要控制药费、材料和其他费用尤其高值耗材使用,完善城乡统一医疗保障、实施分级诊疗等综合措施。     

福建省边远海岛和城市地区幽门螺杆菌耐药菌株比较

目的 研究福建省边远海岛和城市地区幽门螺杆菌（却）的耐药状况，并比较城市地区2001—2006年Hp耐药状况的变化。方法 取Hp阳性者胃窦黏膜进行上Hp培养，对分离的幽门螺杆菌菌株进行药敏试验。用琼脂稀释法和临界点浓度法测定Hp对甲硝唑、克拉霉素和阿莫西林的敏感性。判定为耐药的标准：甲硝唑的最小抑菌浓度（MIC）〉18mg／L，克拉霉素的MIC值〉12mg／L，阿莫西林的MIC值〉10．5mg／L。结果 边远海岛地区Hp对甲硝唑的耐药率为11．4％，显著低于城市居民的55．6％（P〈0．01）；对克拉霉素的耐药率为5．7％，也显著低于城市居民的26．0％（P〈0．01）。城市居民Hp对甲硝唑的耐药率自2001年后明显升高，由34．0％上升至47．1％（p〈0．05）；Hp对克拉霉素的原发耐药率自2001年后也明显升高，由10．6％上升至29．4％（P〈0．01）。却对阿莫西林的耐药极少。2004年以前未发现Hp对阿莫西林的耐药菌株，但2006年发现有2株Hp对阿莫西林耐药，占2％（2／102）。结论 边远海岛地区Hp对甲硝唑和克拉霉素的耐药率显著低于城市地区，城市地区Hp对甲硝唑、克拉霉素和阿英西林的耐药2006年比2001年明显上升。     

The benefit of myomectomy in women aged 40 years and above: Experience in an urban teaching hospital in Nigeria

Background:

Abdominal myomectomy remains the mainstay of surgical management of uterine fibroids in our environment. However, its benefit in women aged 40 years and above remains debatable.

Materials and Methods:

An 11-year prospective study was conducted involving 98 women, aged 40 years and above, who had abdominal myomectomy for the treatment of uterine fibroid at the University of Maiduguri Teaching Hospital, Maiduguri. They were followed up regularly for 1–6 years to detect conception, resolution of symptoms and obstetrics performance. Data were analyzed using SPSS version 13.

Results:

The mean age of the patients was 42.6±2.9 years and 77 (78.6%) of them were nulliparous. Lower abdominal swelling was the commonest clinical presentation and the mean uterine size was 18.6±8.5 weeks. Infertility with uterine fibroids was the indication for myomectomy in majority of the cases [48 (48.9%)], while pregnancy complications accounted for 11.2% (11) of the cases Fertility restoration was 10.4% among the infertile patients. There was complete resolution of symptoms in 35.9% of those who required symptomatic relief, and term pregnancies were recorded in 72.7% of patients with pregnancy complications.

Conclusion:

Myomectomy is the recommended treatment of uterine fibroids in women aged 40 years and above with infertility and who wish to become pregnant. If there is no need for further fertility preservation, hysterectomy should be offered.     

A survey of the prevalence of smoking and smoking cessation advice received by inpatients in a large teaching hospital in Ireland

Background

The adverse effects of smoking are well documented and it is crucial that this modifiable risk factor is addressed routinely. Professional advice can be effective at reducing smoking amongst patients, yet it is not clear if all hospital in-patient smokers receive advice to quit.

Aims

To explore smoking prevalence amongst hospital in-patients and smoking cessation advice given by health professionals in a large university teaching hospital.

Methods

Interviews were carried out over 2 weeks in February 2011 with all eligible in-patients in Beaumont Hospital.

Results

Of the 205 patients who completed the survey, 61% stated they had been asked about smoking by a healthcare professional in the past year. Only 44% of current/recent smokers stated they had received smoking cessation advice from a health professional within the same timeframe.

Conclusions

Interventions to increase rates of healthcare professional-provided smoking cessation advice are urgently needed.     

切断与不切断肱三头肌内固定术式治疗小儿Ⅲ型肱骨髁上骨折

目的比较切断与不切断肱三头肌腱内固定术式治疗小儿Ⅲ型肱骨髁上骨折的疗效。方法对1997-2003年在我院治疗的3～12岁Ⅲ型肱骨髁上骨折患者56例，33例采用切断肱三头肌术式（A组）。23例采用不切断肱三头肌术式（B组），均交叉克氏针内固定。结果随访6-13个月，平均9．1个月。按Flynm评分标准评定。A组优良率为85％．B组优良率达79％，两组之间结果不存在明显的差别，但B组中前倾角明显减少，已发生的肘内翻畸形严重，3例需要及时手术治疗。结论切断肱三头肌腱术式仍是治疗小儿Ⅲ型肱骨髁上骨折的有效方法。     

南京市雨花区城乡居民健康素养水平干预效果的比较

文章对南京市雨花区城乡居民健康素养水平进行调查,分别抽取铁心桥社区(城区代表)和西善桥社区(乡镇代表)15~69岁的居民各300人,采用《2009中国公民健康素养调查问卷》获取数据?结果发现,健康干预对城区居民的作用显著优于乡镇,干预后乡镇具备基本知识和理念的人口比例相对较低,且干预对乡镇65~69岁居民效果不显著?据此提出,构建乡镇“双轮驱动”机制?缩小城乡健康素养水平差异的相关策略和措施?     

An audit of the impact of a stroke unit in an acute teaching hospital

Background  

Previous audits of stroke care in 2002 and 2005 in our institution recommended organised and specialised care of stroke patients. A stroke unit was therefore established in June 2008.     

某三级教学医院呼吸重症病房抗菌药物管理核查表的临床应用及评价

目的 分析抗菌药物管理核查表实施前后呼吸监护室(RICU)抗菌药物的使用情况,探讨其临床价值。方法 使用具有RICU特点的抗菌药物管理核查表,并回顾性分析蚌埠医学院第一附属医院2013年1月—2019年12月RICU所有患者的抗菌药物使用情况,将2013年1月—2015年12月实施核查表前的住院患者设为对照组,2017年1月—2019年12月实施核查表后的住院患者设为干预组,计算分析2组患者抗菌药物使用强度(AUD)、病原学送检、住院时间、好转率等信息。结果 抗菌药物管理核查表实施后,对照组(329例)与干预组(550例)AUD值分别为207.51 DDD/(100人·d)和146.21 DDD/(100人·d),特殊级抗菌药物使用率分别为67.99%(223/328)和25.83%(124/480,χ²=141.313,P<0.001),联合用药比例分别为94.82%(311/328)和65.21%(313/480,χ²=97.132,P<0.001),抗菌药物使用前微生物送检率分别为92.68%(304/328)和97.50%...