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医疗服务操作分类与编码是医学信息标准化的重要组成部分,是临床数据提取、分析和应用的基础。世界卫生组织及世界多国一直致力于开发、更新和维护此分类与编码。我国此前一直沿袭美国准备在2014年停止使用的ICD-9-CM-3(卷3),中国需要结合国际主流设计思路,根据国情开发出适宜的多轴、一体化的医疗服务操作分类与编码体系。 相似文献
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主要就引起卵巢黄体功能不健的因素 ,分别从激素调节、细胞因子 (VEGF、TNF α、BFGF、IFN γ、IGF)、C myc、Fas、SGP 2基因调控以及细胞连接、细胞粘附分子、NO等对卵巢功能的调节及对黄体细胞的凋亡影响进行阐述 ,认为卵泡发育不良、颗粒细胞、黄体细胞的凋亡与黄体功能不足有密切的关系。且多种细胞因子、基因表达产物参与此过程的调控。深入的研究这一调控机制 ,对于进一步了解卵巢卵泡生长发育、卵泡闭锁及黄体细胞凋亡的内在机制有重要意义 相似文献
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环境中双酚A的污染及降解去除的研究进展 总被引:16,自引:0,他引:16
近10年来随着科学与社会的发展,环境雌激素污染日益引起人们的关注。双酚A是环境雌激素的一种,用途广泛,但具有多方面的毒性。对其毒理、污染及降解去除的研究已经成为国际上的研究热点。该文拟对上述几方面的研究进展情况作一简要介绍。 相似文献
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王声湧 《中华流行病学杂志》2010,31(10):1081-1082
2003年我国卫生部把伤害纳入疾病预防控制的内容,明确该项工作包括传染性疾病、慢性非传染性疾病和伤害三部分.那么,伤害的定义是什么?伤害到底包括哪些内容?其预防控制工作的对象又是什么?只有搞清楚这个问题,才能够知晓伤害预防与控制的目标和预防医学在伤害控制工作中的定位. 相似文献
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A group of 101 women, aged 40-65 years consisted of 48 premenopausal subjects and 53 postmenopausal ones living in Daegu and Gyeongbuk area in Korea were evaluated with their general characteristics, lifestyle factors, nutrient and phytoestrogen intakes, blood and urinary indices concerning antioxidant status and bone metabolism. Body mass index (BMI), waist hip ratio (WHR) and systolic blood pressure (SBP) of the postmenopausal women were significantly higher (23.8, 0.86, and 126.9 mmHg, respectively) than those of the premenopausal women (22.6, 0.82, and 115.9 mmHg; respectively). Nutrient intakes of the postmenopausal and premenopausal groups were not different except lower fat intake and higher dietary fiber and iron intakes in the postmenopausal group. Daily total phytoestrogen intake was significantly higher in the postmenopausal group (48.54 mg) than the premenopausal (31.41 mg) and was resulted mostly from higher intakes of daidzein and genistein from soy and soy products (45.42 mg vs 28.91 mg). Serum genistein level and excretion of enterolactone, major lignan metabolite, were not very different between the two groups. Serum retinal and α- tocopherol levels were higher in the postmenopausal group but TBARS levels were not different between the two groups. Serum osteocalcin (7.18 ng/mL) and urinary deoxypyridinoline (7.15 nmol/mmol creatinine), in the postmenopausal group were significantly higher than those in the premenopausal group (4.80 ng/mL, 5.95 nmol/mmol creatinine). Urinary excretion of enterolactone was positively correlated with serum osetocalcin in premenopausal women and serum genistein negatively correlated with the urinary DPD in postmenopausal women. Dietary phytoestrogen intake was negatively correlated with serum level of TBARS in all subjects. It is concluded that the effect of total phytoestrogen intake is beneficial on body antioxidant status in all middle-aged women regardless of menopause but the effect on bone metabolism appears different by the type of the phytoestrogen and the menopausal state. 相似文献
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D. Graa R. J. Elliott M. Magalo M. Muianga A. C. Mussagi M. Chongo B. Elias B. Simione W. C. Buck 《Public Health Action》2022,12(2):68
SETTING:Improved HIV monitoring and evaluation (M&E) is urgently needed to help close gaps in inpatient infant provider-initiated testing and counseling (PITC) and pediatric case identification. A revised reporting system was piloted on the Breastfeeding Ward at Hospital Central de Maputo in Maputo, Mozambique.OBJECTIVE:To demonstrate how a simplified reporting system designed for pediatric inpatient ward registers can be used to easily calculate key PITC indicators, including testing coverage, HIV status, linkage to antiretroviral therapy, maternal testing, and point-of-care nucleic acid testing.DESIGN:This was a retrospective review of PITC data documented in the ward discharge register for all inpatient infants with charts closed from January 1 to June 30, 2020.RESULTS:At chart closure, 97.7% of infants (477/488) had known serostatus: 76.3% were not exposed (364/477), 15.3% were exposed (73/477), 1.9% definitively non-infected (9/477), and 6.5% infected (31/477). There was a 26.9% positivity rate (14/52) for infant point-of-care nucleic acid testing. Of all HIV-infected infants, 80.6% (25/31) were linked to antiretroviral therapy by the time of discharge. Preferred maternal testing was done in 80.5% of eligible mothers (276/343), with 3.0% newly positive (8/276).CONCLUSION:This straightforward PITC reporting system enabled simple calculation of key indicators needed for standard M&E, contributed to quality improvement efforts to increase testing coverage, and could be easily adapted for use in other settings. 相似文献
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Background/aim: Grip strength is useful in clinical practice for the assessment of disease and/or rehabilitation progression. Brief maximal gripping is seldom required in everyday occupations, with repeated or sustained gripping at sub‐maximal power more commonly involved. It has been proposed that assessment of both maximal hand‐grip force and endurance is utilised. While the suitability of maximal contraction measures has been clearly established, the reliability and validity of other hand‐grip indices have not been investigated. This study examined the reliability of various hand‐grip indices and their validity in relation to distance walked during the six‐minute walk test, a standardised exercise capacity test. Methods: Subjects undertook static sub‐maximal (50%) and maximal force contraction hand‐grip testing from which various indices were derived, and six‐minute walk testing from which distance walked was determined. Testing was repeated on three separate occasions for determination of test–retest reliability. Results: Pre‐ and post‐fatigue maximal contraction measurements demonstrated excellent test–retest reliability and validity. Conversely, other hand‐grip indices were shown to be unreliable and exhibited no relationship with distance walked and hence concurrent validity could not be established. Conclusions: Based on the results of this study, it is recommended that pre‐ and post‐fatigue maximal contraction may be utilised for the assessment of client ability and progression due to their established validity and test–retest reliability. However, previously proposed measures of fatigue such as endurance (duration of sustained contraction), Strength Decrement Index and work performed (function of endurance and force of contraction) are unreliable and invalid and may have limited use in clinical practice. 相似文献
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叙述了招标采购的优势,在分析现有问题的基础上,提出了相应的对策,指出医疗装备及耗材这一特殊商品的招标采购必须本着“三公”原则,注重严谨性和科学性,以服务患者、服务医院为宗旨,努力维护供求双方的利益,才能杜绝违规、违法现象的发生,使招标采购工作圆满完成。 相似文献
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非霍奇金淋巴瘤(non⁃Hodgkin lymphoma,NHL)是免疫细胞的恶性肿瘤,包括B淋巴细胞、T淋巴细胞和NK细胞。病毒感染在NHL发生发展中具有重要作用,例如EB病毒(Epstein⁃Barr virus,EBV)和肝炎病毒等。乙型肝炎病毒(hepatitis B virus,HBV)感染通过基因整合、变异和病毒复制在肝细胞癌发生发展中的作用和机制已经得到比较深入的研究。载脂蛋白B mRNA编辑酶催化多肽(apolioprotein B mRNA⁃editing enzyme catalytic polypeptide,APOBEC)诱导的突变是HBV及宿主基因变异的来源之一,APOBEC家族成员在HBV相关慢性炎症和HBV及宿主基因组突变中起着桥梁作用。由此推测HBV感染在HBV相关NHL发生过程中发挥重要作用。本文从HBV整合、慢性炎症与免疫、病毒变异、信号通路、高频突变基因和表观遗传修饰等方面总结了HBV在NHL发生发展中的作用及机制,为HBV相关NHL研究提供理论依据。
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Adenocarcinoma of the stomach and esophagus and drinking water and dietary sources of nitrate and nitrite 总被引:1,自引:0,他引:1
Ward MH Heineman EF Markin RS Weisenburger DD 《International journal of occupational and environmental health》2008,14(3):193-197
We conducted a population-based case-control study of adenocarcinoma of the stomach and esophagus in Nebraska, U.S.A. Nitrate concentrations in public drinking water supplies were linked to residential water source histories. Among those using private wells at the time of the interview, we measured nitrate levels in water samples from wells. Dietary nitrate and nitrite were estimated from a food-frequency questionnaire. Among those who primarily used public water supplies (79 distal stomach, 84 esophagus, 321 controls), average nitrate levels were not associated with risk (highest versus lowest quartile: stomach OR=1.2, 95% CI [0.5-2.7]; esophagus OR=1.3, 95% CI [0.6-3.1]). We observed the highest ORs for distal stomach cancer among those with higher water nitrate ingestion and higher intake of processed meat compared with low intakes of both; however, the test for positive interaction was not significant (p=0.213). We did not observe this pattern for esophagus cancer. Increasing intake of nitrate and nitrite from animal sources was associated with elevated ORs for stomach cancer and with a significant positive trend in risk of esophagus cancer (P-trend=0.325 and 0.015, respectively). Larger studies with higher exposures to drinking water sources of nitrate are warranted to further evaluate N-nitroso compound precursors as risk factors for these cancers. 相似文献
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Kjeldsen SE Lyle PA Kizer JR Oparil S Høieggen A Os I 《Vascular health and risk management》2007,3(3):299-305
A fixed-dose combination of losartan/hydrochlorothiazide (HCTZ) therapy may be a logical choice for antihypertensive treatment, including for initial therapy in patients with blood pressure elevation >20/10 mmHg above treatment target. The renin-angiotensin-aldosterone-system-activating effect of hydrochlorothiazide augments the efficacy of blocking the angiotensin II type 1 (AT1) receptor with losartan. Some adverse effects associated with hydrochlorothiazide, including increased risk for new-onset diabetes mellitus, may be offset by losartan. Losartan was frequently administered with hydrochlorothiazide in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study, in which there was a 25% risk reduction for stroke in the losartan-based compared with the atenolol-based treatment group. The efficacy, tolerability, and convenience of losartan/HCTZ combination therapy may increase patient compliance and lower risk for stroke, a devastating outcome in patients with hypertension. 相似文献
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目的 了解新疆柯尔克孜族中小学生2010年和2014年的身体形态状况、变化及原因,为提高柯尔克孜族学生体质健康水平提供依据。方法 利用参加2010年和2014年全国学生体质与健康调研的新疆柯尔克孜族中小学生形态指标数据,对7~18岁柯尔克孜族学生的身高、体重、胸围等指标进行比较及统计分析。结果 与2010年比较,2014年柯尔克孜族男女生各年龄组3项指标均不同程度的增长。柯尔克孜族男生身高、体重、胸围等三项指标的平均增长值分别为1.7 cm,2.5 kg和0.3 cm;女生分别为 1.4 cm,1.9 kg和1.9 cm。男生身高和体重增长的幅度总体高于女生,女生胸围增长幅度明显快于男生。不同年度7~18岁同年龄组比较,多数年龄组差异均有统计学意义(P<0.05或<0.01 )。结论 2014年新疆7~18岁柯尔克孜族学生的身体形态均保持增长,但与全国平均水平比较依然存在较大的差距,应加强重视,采取有效措施,提高柯尔克孜族学生生长发育水平。 相似文献
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目的 对医院感染发生率、抗菌药物使用及病原菌的送检情况进行比较,为提高和改进医院感染管理水平提供科学依据.方法 调查前1周对各科室感染管理联络员进行培训,完善病历及病原学检查,以床旁调查与病例调查相结合的方法,填写统一调查表.结果 应调查住院患者974例,实查973例,实查率为99.9%;发生医院感染74例,感染现患率为7.6%,社区感染88例,感染率为9.0%;接受抗菌药物治疗的患者微生物检验送检率为30.7%,住院患者抗菌药物使用率为54.9%,Ⅰ类切口手术患者预防使用抗菌药物比例47.2%.结论 通过医院感染现患率调查,加强对重点科室医院感染的监督和管理,提高患者微生物标本的送检率,促进抗菌约物临床合理应用能力和管理水平. 相似文献
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Nitya Sharma Sarmad Hanif Rakesh Rana Dilip Upadhyay Manoj Kumar Chhikara 《Vaccine》2019,37(7):965-972
The changes in the recommended storage conditions of the glycoconjugate vaccines against Neisseria meningitidis (Men) serogroup A and serogroup X can affect its activity or potency. Elevated temperature and the change in pH may result in the physical instability leading to the size degradation of the polysaccharide (PS) and subsequent loss of PS epitopes. Moreover, high temperature may also result in protein aggregation and altered tertiary structure of the protein in the conjugate. Consequently, the construction of a potent glycoconjugate is dependent on optimal temperature and pH. The changes in both these conditions can also affect the production of a capsular polysaccharide (PS) and its conjugation to a protein carrier and may also affect the integrity of the vaccine molecule including the maintenance of the protective epitopes. In our study we have used inhibition ELISA as a tool to assess the impact of temperature and pH alterations on the antigenicity of N. meningitidis serogroup A and X, PS and conjugates and their correlation with the size distribution analysis using high pressure size exclusion chromatography. The studies on pH alterations from 5 to 9 led to minimal impact on size and antigenicity of all antigens, however, an elevated temperature adversely impacted the antigen size as well as antigenicity to varying extent. Results indicate the higher stability of MenX PS and conjugate as compared to that for MenA counterparts at elevated temperatures. Furthermore, both the MenA and MenX conjugates appears to be more stable as compared to the corresponding PSs. 相似文献