改良qSOFA评分对儿童脓毒症的诊断效能及分诊价值

目的 探讨改良快速序贯器官衰竭(qSOFA)评分对儿童脓毒症的快速诊断效能,评价其对感染儿童急诊分诊的评估价值。方法 选取2021年5月至2022年4月于我院急诊儿科明确诊断为感染性疾病的1 197例患儿为研究对象,随机将其分为改良qSOFA组(n=601)和全身炎症反应综合征(SIRS)组(n=596),分别采用改良qSOFA及SIRS评分进行评估。采用受试者工作特征(ROC)曲线比较两种评分对儿童脓毒症的诊断效能。根据预后将明确诊断为脓毒症的102例患儿分为脏器支持组(n=18)和非脏器支持组(n=84),比较两组患儿改良qSOFA评分的差异。结果 改良qSOFA及SIRS评分预测儿童脓毒症患儿的ROC曲线下面积分别为0.778、0.951,敏感度分别为52.1%和94.4%,特异性为分别为88.6%和88.0%。脓毒症患儿中,脏器支持组与非脏器支持组的改良qSOFA评分分别为2(1.75,2)、1(1,1.75)分,差异有统计学意义(Z=-3.920,P<0.05)。结论 改良qSOFA评分在急诊儿科对感染患儿早期预测脓毒症的准确度欠佳;对于脓毒症患儿,改良qSOFA评分可...     

四种病情评分方法对急诊感染患者预后的预测价值比较

目的分析快速序贯器官衰竭估计(qSOFA)评分、序贯器官衰竭估计(SOFA)评分、早期预警(NEWS)评分及全身炎症反应综合征(SIRS)评分对急诊感染患者预后的预测价值。方法回顾性分析2016年10月-2019年10月南方医科大学南方医院收治的100例感染性疾病患者临床资料,依据28 d预后情况将其分为研究组(28 d内死亡)21例和对照组(28 d内存活)79例,分析两组患者一般资料、生命体征及入院24 h内qSOFA评分、SOFA评分、NEWS评分、SIRS评分情况,绘制受试者工作特征曲线(ROC)分析qSOFA评分、SOFA评分、NEWS评分及SIRS评分对急诊感染患者预后的预测价值。结果研究组患者年龄、心率、动脉血乳酸、脑钠肽前体、白细胞计数、血小板计数、血肌酐均高于对照组(P0.05),平均动脉压、格拉斯哥昏迷评分、动脉血氧分压、氧合指数均低于对照组(P0.05);研究组患者入院24 h内平均qSOFA评分、SOFA评分、NEWS评分及SIRS评分均高于对照组(P0.05); ROC曲线分析显示,qSOFA评分预测急诊感染患者死亡的曲线下面积为0.83,高于SOFA评分(0.73)、NEWS评分(0.75)及SIRS评分(0.73),且qSOFA评分的灵敏度、特异度、准确度也较其他3种评分高。结论 qSOFA评分、SOFA评分、NEWS评分及SIRS评分均对急诊感染患者预后有预测价值,其中qSOFA评分预测价值最佳,有望成为评估急诊感染患者病情与预后的快捷简便工具。     

儿童脓毒性休克年龄适应性快速序贯器官衰竭评分模型的建立及价值分析

目的 探讨儿童年龄适应性快速序贯器官衰竭评分(qSOFA)模型建立对脓毒性休克患儿的预警价值。方法 采取回顾分析温州医科大学附属第二医院PICU确诊为脓毒性休克168例患儿,按年龄分为3组：≥1月～1岁组,>1～6岁组,>6～14岁组。回顾统计各年龄组存活患者和死亡患者入科时的临床观察指标数据,建立儿童年龄适应性qSOFA模型并与pSOFA进行严重程度和预警价值对比。结果 儿童年龄适应性qSOFA与儿童序贯器官功能障碍(pSOFA)进行病情严重程度评分对比,死亡组和存活组儿童年龄适应性qSOFAZ值为-6.984, pSOFA的Z值为-7.921,差异均有统计学意义(均P<0.000)。绘制脓毒性休克患儿ROC曲线下面积比较,儿童年龄适应性qSOFA评分的AUC为0.855(P<0.000),约登指数为0.567,最佳截断点1.5,灵敏度(%)为0.817,特异度(%)为0.75。pSOFA评分的AUC为0.864(P<0.000),约登指数为0.619,最佳截断点7.5,灵敏度(%)为0.767,特异度(%)为0.852。当儿童年龄适应性qSOFA≥1分...     

四种评分系统对呼吸机相关性肺炎的预后评估研究

目的 探讨急性生理学和慢性健康评分(APACHEⅡ)、序贯器官衰竭评估(SOFA)评分、临床肺部感染评分(CPIS)及多器官功能障碍综合征(MODS)评分对呼吸机相关性肺炎(VAP)患者的预后评估价值.方法 68例诊断为VAP患者,分别在入院第一个24 h进行APACHEⅡ、SOFA评分、MODS评分及发生VAP第一个24 h进行APACHEⅡ、SOFA评分、CPIS及MODS评分.根据实际预后分为存活组38例和死亡组30例,并根据受试者工作特征曲线下面积(AUROC)与Logistic回归分析评估四种评分系统对VAP患者预后的预测价值.结果 死亡组发生VAP第一个24 h的APACHEⅡ、CPIS、MODS评分及SOFA评分均明显高于存活组.发生VAP第一个24 h的APACHEⅡ、SOFA评分、MODS评分及CPIS AUROC分别为0.80、0.75、0.73、0.71.Logistic回归分析提示发生VAP第一个24 h的APACHEⅡ＞18分是预测VAP患者的独立相关因素(OR值为5.7,95%CI为1.9～20.0,P值为0.013).结论 发生VAP第一个24 h的APACHEⅡ评分可作为预测VAP患者预后的指标.     

序贯器官衰竭估计评分预测急诊严重感染患者预后的临床分析

目的探讨序贯器官衰竭估计(SOFA)评分对急诊严重感染性患者预后进行预测的关系。方法选取2013年5月-2014年5月92例急诊严重感染性患者为研究对象,按患者结局将其分为生存组71例和死亡组21例,计算T0SOFA和T48SOFA,得出SOFA,分别观察入院T0SOFA评分、T48h的△SOFA评分与患者病死率的关系,分析SOFA评分在预测急诊严重性感染性患者预后中的作用。结果两组患者入住急诊当日对T0SOFA评分进行比较,死亡组评分(11.9±3.5)分,高于生存组(7.6±2.3)分,治疗48h后的T48SOFA及SOFA分别进行比较,死亡组评分仍然高于生存组,差异均有统计学意义(P<0.05);随着SOFA评分分值的增高,病死率呈上升趋势,且在SOFA评分为0~3分时病死率为0,在>15分时病死率为100.0%,差异有统计学意义(P<0.05);两组患者平均器官损伤数比较,生存组为(3.1±1.3)个、死亡组为(4.5±1.7)个,死亡组多于生存组,差异有统计学意义(P<0.05),两组在心血管循环系统、呼吸系统及肾脏系统器官中最大SOFA评分比较,死亡组评分得分高于对照组,差异均有统计学意义(P<0.05),在其他系统评分中比较,差异无统计学意义。结论 SOFA评分能较好的预测急诊严重感染性患者预后,可在临床推广应用。     

三种评分法对重症急性胰腺炎病人并发胰腺感染预测价值的比较研究

目的:探讨序贯器官衰竭评估(SOFA)评分、急性生理与慢性健康评估Ⅱ(APACHEⅡ)评分和腹部CT胰腺外炎症(EPIC)评分对预测重症急性胰腺炎(SAP)并发胰腺感染的意义. 方法:选取127例SAP病人进行研究,入院24h内对病人进行SOFA、APACHEⅡ和EPIC评分,分析三种评分方法对预测病人病情的价值. 结果:感染组病人三种评分均高于非感染组,且差异均有显著性统计学意义(P＜0.05).在已并发胰腺感染的SAP病人中,发现APACHEⅡ评分、SOFA评分和EPIC评分的AUC数值依次为0.787、0.786、0.765,说明三种评分在感染预后的评估中具有一定的价值.EPIC评分和APACHEⅡ评分的灵敏度相等,均高于SOFA评分;APACHEⅡ评分和SOFA评分的特异性均高于EPIC评分.将三种评分做Logstic回归分析显示,EPIC评分对SAP并发胰腺感染有预测价值(P＜0.05). 结论:三种评分法对SAP病人的感染预后评估有一定的价值.EPIC评分为SAP并发胰腺感染的危险因素,具有预测作用,可帮助临床早期采取必要的临床干预.     

序贯器官衰竭评估与急性生理及慢性健康状况Ⅱ评分在百草枯中毒中的应用

目的 比较序贯器官衰竭评估(SOFA)与急性生理及慢性健康状况(APACHE)Ⅱ评分在百草枯中毒评估中的价值.方法 回顾性分析54例百草枯中毒患者的临床资料,比较sOFA评分与APACHEⅡ评分两种评估方法 结果 的一致性及与病死率、并发症间的关系.结果 SOFA评分与APACHEⅡ评分在百草枯中毒预后评估中具有一致性(P<0.05);SOFA评分≥5分或APACHEⅡ评分≥5分时病死率均为100%;不同SOFA评分、APACHEⅡ评分的并发症发生率的差异均有统计学意义(SOFA评分,x~2=18.408,P<0.05;APACHEⅡ评分,x~2=22.934,P<0.05).结论 SOFA评分与APACHEⅡ评分在百草枯中毒评估中价值一致,均能比较准确地评估百草枯中毒严重程度及预后.     

老年脓毒症患者中性粒细胞与淋巴细胞比值的临床意义

目的 探讨中性粒细胞与淋巴细胞比值(neutrophil-lymphocyte ratio, NLR)与脓毒症严重程度及预后的相关性。方法 选取北京丰台医院2022年1-11月进入急诊科抢救室就诊的126例老年脓毒症患者作为病例组,选取36例健康者为对照组,比较NLR,将病例组按照确诊分为：脓毒症组(77例)与脓毒症休克组(49例),比较两组间的NLR以及血清降钙素原(PCT)、急性生理学与慢性健康状况Ⅱ评分（APACHEⅡ）、序贯器官功能衰竭评分(SOFA)的差异。随访28d,分析死亡组(95例)和存活组(31例)NLR以及PCT、APACHEⅡ评分、SOFA评分的差异。分析NLR的水平与PCT,APACHEⅡ评分、SOFA评分的相关性。结果 病例组的NLR高于健康组,差异有统计学意义（P<0.05）。脓毒症休克组的NLR以及PCT、APACHEⅡ评分、SOFA评分高于脓毒症组,差异有统计学意义（P<0.05）。老年脓毒症患者中死亡组的NLR以及PCT、APACHEⅡ评分、SOFA评分高于存活组,差异有统计学意义（P<0.05）。病例组患者中NLR与PCT,APAC...     

序贯器官衰竭评分在急性有机磷中毒病情评估中的应用

采用序贯器官衰竭评分(SOFA)系统对116例急性有机磷中毒(AOPP)患者病情进行评价。结果显示,轻、中、重度中毒患者SOFA评分差异有统计学意义(P0.05),高SOFA(评分2)组与低SOFA组呼吸衰竭、反跳、中间型综合征(IMS)、代谢性酸中毒等严重并发症发生率差异有统计学意义(P0.05)。提示SOFA对判定急性重度有机磷中毒的病情具有参考价值。     

序贯器官衰竭评分与ICU非脓毒症及脓毒症患者死亡率的关系研究

目的 探讨序贯器官衰竭评分(SOFA评分)与重症监护室(ICU)非脓毒症及脓毒症患者死亡率的相关性及其对患者生存时间的预测价值.方法 收集本院2018年1月1日-2019年12月31日的ICU患者共348例,根据是否合并脓毒症分为非脓毒症组及脓毒症组,其中非脓毒症组共251例,男性144例,女性107例;脓毒症组共97...     

Trends in meningococcal disease in Italy in 1988

Meningococcal disease in Italy decreased 15% in 1988 from the previous year (290 vs. 342 cases). The decline was particularly evident in military cases (1.7/100,000 in 1988 vs. 5/100,000 in 1987) reflecting the full coverage of bivalent serogroup (A + C) meningococcal polysaccaride vaccine in army recruits, achieved since January 1988. The highest proportion of cases was seen in people older than 25 years of age (25%). Serogroup C constituted 60% of the isolates, while 19% belonged to serogroup B. The proportion of strains resistant to sulphonamides was 45%, while 15% were resistant to Minocycline and none to Rifampin. Out of the five military cases, only one (due to serogroup C) was attributable to the vaccine failure. A single coprimary case, but no secondary cases occurred among civilians. These findings are consistent with the trends reported in Italy in the previous years.     

Benzene in blood and phenol in urine in monitoring benzene exposure in industry

Determinations of benzene concentration in blood and of phenol in urine were made by head-space gas chromatography techniques on samples taken near the end of the work day from two groups of workers potentially exposed to low levels of benzene in the work-place atmosphere. Preliminary results suggest that benzene in blood is more reliable than phenol tests for assessing both exposure and uptake of benzene. Normal values of phenol in urine (10 mg/liter or less) were found in nearly all those cases in which benzene was detected in the blood.     

2015年郑州市饮用水放射性水平状况调查

目的了解郑州市不同地区、不同季节、不同水源类型的放射性水平。方法分别于丰水期和枯水期采集郑州市区黄河水源水、井水源水、丹江口水源水、出厂水和末梢水各一份;以县为单位,每单位采集出厂水、末梢水、水库水、河水、井水各1份,按《生活饮用水生活标准检验方法》(GB/T 5750.13-2006)检测饮用水中总α和总β放射性水平,依据《生活饮用水卫生标准》(GB 5749-2006)进行判定。结果丰水期、枯水期水体总α、总β放射性水平均低于国家标准限值。结论郑州市不同水源类型均处于正常的天然放射性本底水平。     

Occupational stress in nurses in psychiatric institutions in Taiwan

Nurses are known to be exposed to occupational stress. However, occupational stress is not well documented for nurses in psychiatric institutions in Taiwan. A cross-sectional study was conducted to explore the work-related stress and risk factors of nurses in psychiatric institutions in Taiwan. A structured questionnaire was distributed to nurses at five state-owned psychiatric hospitals in Taiwan in 2001. Demographic information, working environment, and personal health status were inquired. Occupational stress was assessed based on the Chinese version of Job Content Questionnaire (JCQ). General health status and mental health were evaluated by the International Quality of Life Assessment Short Form-36 (IQOLA SF-36). A total of 573 questionnaires were disseminated to nurses and 518 (90.4%) were satisfactorily completed by nurses, including 408 female full-time nurses who had been in their current work for more than 6 months. In the past one month, 17.2% of nurses reported being under significant stress often or always. Assault episodes were reported by 45.1% of nurses in the past 6 months. Among the nurses, 16.9%, 25.2%, 50.0%, and 7.8% belong to the "High strain", "Low strain", "Active", and "Passive" groups, respectively. Perceived occupational stress was associated with young age, widowed/divorced/separated marital status, high psychological demand, low workplace support, and threat of assault at work. Lower general health score was associated with low job control, high psychological demand, and perceived occupational stress. A lower mental health score was associated with low job control, high psychological demand, low workplace support, and perceived occupational stress. We concluded that nurses in psychiatric institutions are under significant stress related to work factors.     

Changes in nursing administration in supporting transplantation in Brazil

This historical and bibliographic study aimed to understand how Nursing was organized to support care in transplantation. The HISA, LILACS, BDENF, PERIENF and DEDALUS databases were consulted, and thirteen references were found, ten of which were scientific articles, two were master's dissertations and one was a doctoral thesis. The span of time chosen for study ranges from the date of the first kidney transplant in Brazil (1965), to the date of publication of the last scientific article found in the databases mentioned above (2003). After reading these articles, the ones that were similar in topic were grouped together, thus creating the thematic axis for the presentation of the results. The results showed that the Nursing profession has played an important and active role in transplants ever since the first procedure in 1965.     

2019年中国肿瘤流行病学研究进展

恶性肿瘤已成为中国居民的主要死因之一。近些年来,中国政府积极推进肿瘤预防和控制领域的研究工作,取得了很大的进步。本文简要汇总中国在肿瘤流行病学领域的研究进展,具体包括2019年的肿瘤负担、癌症危险因素及其干预、筛查和早期发现、癌症防治专项行动(2019-2022年)方案等方面,以期为我国肿瘤防治工作的有效开展提供技术支撑和理论依据。     

2012年绵阳市蔬菜中农药残留状况

目的 了解绵阳市2012年市售蔬菜中农药残留情况,为食用蔬菜监管提供依据.方法 全部样品均按照GB/T 5009-2003的方法进行农药的残留检测.依据GB 2763-2005《食品中农药最大残留限量》进行判定.结果 2012年共检测蔬菜165份,农药检出率和超标率分别为72.12％和23.64％.豆类、根茎类、叶菜类、瓜果菜类和食用菌类蔬菜检测农药残留超标率分别为8.00％、23.53％、36.00％、5.26％和27.03％,差异有统计学意义(x2=11.41,P＜0.01).不同种类农药超标率差异有统计学意义(x2 =62.42,P＜0.01).夏季和冬季蔬菜农药超标率差异无统计学意义(x2=3.44,P＞0.05).结论 绵阳市叶菜类蔬菜中农药残留情况较为严重,应采取有效措施,加强蔬菜的监督管理,从源头禁止高毒农药的使用,加大蔬菜种植、销售环节的监测,确保市民食用蔬菜的安全.