输血管理信息系统的应用与实现

介绍了医院输血管理存在的问题,设计了输血管理信息系统的业务模型和输血管理的各项功能,并介绍了应用效果和体会.     

基层医院输血科医院感染因素和预防措施分析

目的分析影响基层医院输血科医院感染的多种因素,并探讨预防对策。方法调查我县各家医院输血科院感现状,探讨感染隐患,制定预防措施。结果多因素回归分析发现,消毒隔离意识差、医院感染预防操作不规范、标本操作环节不规范、输血观念落后、输血申请单受污染及科室消毒不严格均为影响基层医院输血科医院感染的独立危险因素。结论上述因素增加了基层医院输血科患者及工作人员的感染风险,应要求医务人员严格遵守操作规范,保障输血人员和受血患者的安全,以降低输血科医院感染发生率,提高诊疗质量。     

医院输血信息管理系统的开发与应用

医院输血工作中，离不开血液的来源、生产、管理、检测及应用。血液制品的质量至关重要，它直接关系到病人的生命安危，关系到医院的声誉。为建立健全血液生产过程中的监测手段，提高自我保护意识，减少或避免不必要的医疗纠纷，我院应用微机对输血科信息进行全方位管理，确保了血液质量，取得了良好的社会效益和经济效益。     

临床输血病历质量调查分析

调查医院输血病历存在的问题,分析不合理原因,提高临床输血质量。方法 以《病历书写基本规范》《医疗机构临床输血管理办法》《临床输血技术规范》《医院输血管理检查评分表》为依据,随机抽查我院2017年1月~12月临床用血科室的466份输血病历,对输血有关记录的完整性、输血适应证、输血不良反应进行分析。结果 共抽取病历466份,其中手术科室224份,非手术科室242份;手术科室与非手术科室输血相关记录不合格率相比较,差异有统计学意义（P＜0.05）,以输血治疗同意书记录缺陷为主;非手术科室输血合理率（93.80%）高于手术科室（89.73%）,但差异无统计学意义（P＞0.05）。结论 部分临床医生对输血病历质量的重要性认识不足,医院应加强对临床输血病历质量的检查、分析和改进,加强医务人员输血知识的培训,不断提高临床输血的科学性和规范性。     

确保安全输血预防医院感染

血液是医疗、抢救工作中不可缺少的临床治疗手段，它在人的生命体征中的重要作用是其它任何药品、疗法所不能替代的。但是我们必须清楚的认识到血液本身可以成为致病物质的载体，成为最严重的医院感染的原因之一。为了预防因输血引起的医院感染，确保安全输血，我血站以WHO输血合作中心提出的从低危险度的献血者采血、严格筛选检测血液、临床合理用血这三大关键环节为目标，通过“四严”措施，实现了输血2755例次零感染的良好效果。     

对于手术输血病案质量缺陷与对策分析

目的：探讨手术输血病案质量存在的问题,促进输血病案相关管理工作的规范化,提高医院输血病案的整体质量,保障医疗安全。方法针对医院输血病案制定专门的检查标准,随机抽取本院收集的357份手术输血病案,对其开展质量分析。结果质量控制手术输血病案主要由手术护理记录、麻醉记录、手术记录以及术后首次病程记录这4个方面构成。本次研究的357分手术输血病案中,四项内容均记录完整的占58.8%,存在缺陷的有42.2%,其中术后首次病程记录的缺陷缺最高,高达68.3%。结论医院输血病案的质量直接影响着病案内涵的正确表达,并与医院医疗质量的好坏以及医疗安全性存在密切的关系,医院必须要高度重视输血案例质量管理工作,促进医疗有效性及安全性的提高,尽可能减少医疗纠纷的发生。     

自体引流血回输的临床应用

输血可分为异体输血和自体输血两种.异体输血越来越多的副作用引起了人们的恐慌,特别是经血液传播的各种病毒性肝炎、梅毒、艾滋病等等.因而人们在输异体血的同时,寻找并发现了一种更安全的输血方式-自体输血.     

储存式自体输血在体外循环心脏瓣膜置换术患者中的应用效果

目的:探究储存式自体输血对体外循环心脏瓣膜置换术患者凝血功能、氧合状况及细胞免疫功能的影响.方法:选取2017年1月至2020年6月在航天中心医院进行体外循环心脏瓣膜置换术患者130例,按输血方式不同分为对照组(n=65)与观察组(n=65).对照组进行异体输血,观察组进行储存式自体血回输.对比两组手术一般情况,术前1...     

河北省输血后艾滋病病毒感染暴发的追踪监测

目的 研究河北省输血后艾滋病暴发流行特征及家庭传播情况.方法 在全省范围内,通过艾滋病监测网络和输血感染重点区域的疫情普查,对在河北省某市发现的输血感染艾滋病及其导致的家庭传播进行分析,用ELISA法初筛HIV抗体,用Western-blot进行确认试验,用套式PCR进行HIV env基因扩增.对扩增产物进行亚型分析.结果 发现在河北省某市医疗机构输血后HIV感染173例,占全省输血感染的68.7%(173/252),其中医院发现89例,疾病预防控制中心发现84例.家庭传播率为32.0%(49/153),夫妻家庭传播率为17.0%(26/153),母婴家庭传播率为32.7%(32/98).输血感染者以青壮年为主,女性多于男性,输血原因以怀孕分娩及妇女病为主,其次是外伤手术.输血时间为1990年至1999年,高峰为1995年;发现时间为1999年至2009年,高峰为2003年,输血后感染者主要分布于该市境内的某康泰医院和某煤矿医院,分别占45.1%(78/173)和42.2%(73/173).病原型别为HIV-1 B'亚型.结论 该市基层医疗机构由于不对有偿供血者筛查HIV抗体,导致了输血者HIV感染的暴发.     

输血前血液传播性疾病检测的临床分析

目的 探讨受血者在输血前进行血液传播性疾病相关检测的临床意义.方法 对2560例受血者在输血前进行乙型肝炎病毒表面抗原(HBsAg)、丙型肝炎病毒抗体(抗-HCV)、人类免疫缺陷病毒抗体(抗-HIV)、梅毒试验(TRUST)及谷丙转氨酶(ALT)检测分析.结果 HBsAg阳性率10.10%、抗-HCV阳性率1.53%、抗-HIV阳性率0.19%、TRUST阳性率2.06%、ALT>40u/L者18,90%.结论 对受血者进行输血前五项指标检测对于预防和减少因输血引起的医疗纠纷具有重要的临床意义.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.