医院工作质量统计分析方法探讨

<正> 运用统计指标分析医院工作,可以为改变医院管理,提高医疗质量及时提供科学依据。 一、医院统计分析的基本方法和形式 1、用相对数:即率和比两个指标分析一个总体,如各种疾病的病死率、治愈率及病死人数中各种疾病所占的比重等,可用于比较各种疾病的严重度及医疗质量,并可用于疾病分类。 2、用平均数:由这一指标表明事物特征时,要注意     

医学技术评估

一、医学技术与医学技术评估医学技术主要指用于医疗保健的药物、仪器设备、医疗程序及相关的组织管理系统 ,即为健康目的而对医学知识体系的有组织的运用。具体地说 ,医学技术包括 :用于疾病预防和诊治的化学或生物制剂 ;用于疾病诊治和康复的仪器设备 (如医疗仪器设备、医疗器械、医疗器具、康复设施等 ) ;卫技人员运用自身的专业知识和技能对物化技术 (药物、仪器设备等 )的综合运用 (如医疗程序、手术方案、免疫措施等 ) ;以及为保证业务活动的高效率而采取的医学组织管理技术。医学技术的广泛应用 ,特别是医学新技术的推广应用是医学…     

肺笛在呼吸系统疾病的应用及研究进展

肺笛是一种新型的振荡呼气末正压装置,其能产生一个低频率声波和强有力的呼气,增加痰液的清除,并可导致诱导痰咳出。对慢性基础疾病如慢性阻塞性肺病(COPD)合并有黏液分泌物增多的患者有治疗作用;肺笛还可用于获取痰液标本,用于快速诊断肺结核、肺癌等呼吸系统疾病;此外,肺笛还可用于如肺囊性纤维化等疾病痰液的获取,以利于疾病的诊断和鉴别诊断。肺笛因操作简单、安全有效,对于呼吸系统疾病的诊断、治疗有非常重要的作用。     

中药注射剂川芎嗪与多种药物存在配伍禁忌

生理盐水配川芎嗪注射液，具有扩张小动脉、抗血小板凝集、改善微循环，用于治疗周围神经病变及抗血栓和溶血栓的作用，用于闭塞性脑血管疾病如：脑血栓形成、脑栓塞等。还可用于其他缺血性血管疾病如：冠心病、脉管炎等。     

医学英语中treat、cure、heal、save、recover、restore、remedy等词的用法

1.treat 表示治疗的意思时,只指予以医治,可用于治疗各种疾病,为及物动词。如: Which doctor is treating you for your illness? 哪位医生在给你治病? 2.cure 用作动词表示治疗、医治的意思时,多指治愈疾病,祛除病苦,使人恢复健康,多用于治疗(愈)内科疾病。用于此意时为及物动词。如: The physician cured me of the disease. 医生治好了我的病。 3.heal 的意思是医治、愈合,多指治愈伤口。该词既可用作及物动词,又可用作不及物动词。如:     

止痛如神汤加减治疗生殖器疱疹伴骶神经根病1例

<正>止痛如神汤出自明代申斗垣的《外科启玄》,具有祛风清热、行气利湿、润肠通便之功效,主要用于诸痔发作时肿胀痒痛者。我科在临床上常在原方基础上加减,用于湿热内盛所致各种肿胀疼痛皮肤疾病,如带状疱疹、带状疱疹后神经痛、肋间神经痛、脂肪瘤等。1病例介绍患者胡某,女性,71岁,初诊主诉:反复会阴部灼热麻痛3 a,加重1月。3 a前无明显诱因出现会阴部、大腿上段内侧、肛周等处灼热、疼痛,触碰、穿     

细胞凋亡与生物碱

细胞凋亡(AP)是一种不同于坏死的由基因调控的细胞主动性、程序性死亡的过程.可见于胚胎发育、组织发生、组织分化、组织缺如、细胞癌变等过程.AP异常可导致某些疾病的发生发展,如AP功能受抑可见于肿瘤、自身免疫病、病毒感染等;功能增强可见于IDS、骨质疏松、神经蜕变性疾病等.目前,对凋亡与某些疾病的关系许多学者已进行了相关报道,明确提出AP与下列疾病相关:肿瘤方面:如前列腺癌、囊泡淋巴瘤、乳腺癌、卵巢癌等;自身免疫病方面:SLE、糖尿病、银屑病等;病毒感染方面:如疱疹病毒、腺病毒、痘病毒、乙肝病毒等;神经蜕变性疾病方面:如与帕金森氏病、阿尔海默氏病、肌萎缩性侧索硬化症、视网膜色素沉着症等;缺血性损伤方面:如心肌梗死、中风、再灌注损伤等;另外,再生障碍性贫血、AIDS、急性爆发性肝炎等疾病皆与AP相关.     

治疗呼吸道疾病的穿心莲提取物和姜黄提取物制剂

US 20070160696 A1本品由穿心莲提取物和姜黄提取物或它们的活性成分组成,具有抗呼吸系统疾病、调节免疫、杀病毒、抗过敏、止痛、退热等活性。用于治疗哺乳动物呼吸系统疾病,如流鼻涕、咳嗽、全身疼痛、发热、疲劳、寒战、打喷嚏、鼻充血;还用于治疗感冒、流感和过敏症状。     

通督灸临床应用研究进展

随着人们对疾病认识以及保健意识的提高,艾灸作为中医的一种特色疗法,被广泛用于各种疾病的预防和治疗。而艾灸亦有各种灸法,在隔物灸的基础上又演变出通督灸,现在临床上通督灸涉及疾病广泛,内科如疾病如慢性阻塞性疾病、哮喘、失眠、类风湿性关节炎,强直性脊柱炎等,外科疾病如颈、肩、腰腿痛等,妇科疾病如不孕、经行腹痛、盆腔炎、子宫肌瘤等,儿科疾病如泄泻、遗尿等,疗效好,因此推广通督灸的临床应用,发挥其独特的治病功效势在必行。     

消灭苍蝇问答

苍蝇能传播什么疾病?苍蝇虽小,危害却大。在人类已知的100多种传染病中,有60多种与苍蝇传播的细菌、病毒有关。这60多种疾病可归纳为五炎:①胃肠道传染病:如霍乱、痢疾、伤寒等;②呼吸道传染病:如肺结核等;③眼的     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.