新型有益菌纤维素敷料抑菌作用的实验研究

目的通过对三种创面敷料在体抑菌作用的比较,为临床针对外科创面选择并应用合适创面敷料提供理论依据。方法选用新型有益菌纤维素敷料、凡士林纱布和浸有新霉素黄连素溶液的敷料三种敷料,分别对金黄色葡萄球菌和大肠杆菌进行在体创面抑菌实验的比较。结果新型有益菌纤维素敷料具有较好的广谱抑菌作用。结论新型有益菌纤维素敷料是目前临床上较为理想的创面敷料。     

亚健康证候测试量表的编制和信效度分析

目的:研制能够测量亚健康人群,并可以体现中医基本证候特点的调查量表,分析其信效度。方法:根据问卷设计的原理,结合文献研究设计条目,专家咨询确定常见证候,重点参考SCL-90表,并在中医基础理论指导下编制量表。作信度、效度检验以及修订。结果:确定了64个条目,量表的内部信度与分半信度都较好,结构效度分析提取了14个公因子,累计贡献率达57.89%。结论:该量表能够在一定程度上对人群的健康状态做出判断,揭示了人群中医证候的分布规律,为亚健康状态中医证候的辨证研究提供了方法和应用工具。     

多参数监护仪维修及维护探讨

多参数监护仪在医疗服务工作中承担着重要的作用,因此对该类设备的维修、维护工作也提出了较高的要求。本文简要介绍了多参数监护仪的工作原理,并对使用中常见故障进行了分析,总结了日常维护保养方法及心得体会。     

Development of the Korean Standardized Antimicrobial Administration Ratio as a Tool for Benchmarking Antimicrobial Use in Each Hospital

BackgroundThe Korea National Antimicrobial Use Analysis System (KONAS), a benchmarking system for antimicrobial use in hospitals, provides Korean Standardized Antimicrobial Administration Ratio (K-SAAR) for benchmarking. This article describes K-SAAR predictive models to enhance the understanding of K-SAAR, an important benchmarking strategy for antimicrobial usage in KONAS.MethodsWe obtained medical insurance claims data for all hospitalized patients aged ≥ 28 days in all secondary and tertiary care hospitals in South Korea (n = 347) from January 2019 to December 2019 from the Health Insurance Review & Assessment Service. Modeling was performed to derive a prediction value for antimicrobial use in each institution, which corresponded to the denominator value for calculating K-SAAR. The prediction values of antimicrobial use were modeled separately for each category, for all inpatients and adult patients (aged ≥ 15 years), using stepwise negative binomial regression.ResultsThe final models for each antimicrobial category were adjusted for different significant risk factors. In the K-SAAR models of all aged patients as well as adult patients, most antimicrobial categories included the number of hospital beds and the number of operations as significant factors, while some antimicrobial categories included mean age for inpatients, hospital type, and the number of patients transferred from other hospitals as significant factors.ConclusionWe developed a model to predict antimicrobial use rates in Korean hospitals, and the model was used as the denominator of the K-SAAR.     

Impact of COVID-19 on Clinicopathological Spectrum of Pityriasis Rosea in Korea

BackgroundPityriasis rosea (PR) is a papulosquamous eruption with generally unknown origin but suspected to be related to viral etiologies. The clinicopathological spectrum of several disorders with viral etiologies has been altered after the coronavirus disease 2019 (COVID-19) pandemic. The author group could experience coherent histological alterations in PR after the COVID-19 pandemic. This study aimed to investigate how the clinicopathological findings of PR were changed after the COVID-19 pandemic.MethodsPatients (n = 11) diagnosed with PR based on the clinical manifestations and skin biopsies between February 2018 and October 2019 and 11 patients in February 2020 and October 2021 were retrospectively analyzed by investigating the medical records.ResultsThe patients with PR during the COVID-19 pandemic demonstrated statistically significant histopathological alterations from classic brisk and dense infiltration pattern to dormant and sparse infiltration and psoriasiform-dominant patterns (P = 0.019). PR was associated with more frequent pruritus during the pandemic period (P = 0.027).ConclusionIn conclusion, PR demonstrated a significant histopathological alteration with more frequent pruritus during the COVID-19 pandemic. The comparative results about clinicopathological findings of PR will provide a useful reference for dermatologists in the diagnostic process of PR in the COVID-19 pandemic.     

甲泼尼龙冲击递减疗法治疗小儿重症过敏性紫癜的临床效果

目的 探讨小儿重症过敏性紫癜治疗中甲泼尼龙冲击递减疗法的临床效果。方法 选取2018年4月至2020年4月榆林市靖边县人民医院收治的80例重症过敏性紫癜患儿,随机分为对照组与观察组,各40例,对照组采用甲泼尼龙常规治疗,观察组采用甲泼尼龙冲击递减疗法,观察两组患儿疗效、病情改善时间、治疗前后的炎性因子水平以及不良反应。结果 治疗后,观察组患儿疗效优于对照组,且病情改善时间明显较对照组短;观察组炎性因子水平与不良反应低于对照组,差异均有统计学意义（P<0.05）。结论 甲泼尼龙冲击递减疗法治疗小儿重症过敏性紫癜临床效果显著,且不良反应小。     

基于项目反应理论的中国职业人群职业紧张测量核心量表条目分析

目的 利用项目反应理论（item response theory,IRT）对《中国版职业紧张核心量表》质量进行分析与评价,为后期量表使用和修订提供参考依据。方法 采用方便抽样方法,抽取湖北省两家三甲医院和多家一、二级医院共1261名医务人员作为研究对象,应用《中国版职业紧张核心量表》调查其职业紧张情况。采用主成分分析验证量表4个维度的单维性。采用IRT中的Same Jima等级反应模型计算每个条目的区分度、难度系数和信息量,从微观角度评价量表的测量特性。结果 量表4个维度均满足单维性假设。IRT结果显示所有条目的区分度较好,取值范围在0.67~3.10;17个条目中有13个条目的难度系数在-2.78~2.30之间,且不存在难度逆反现象,条目9和11难度过高且难度逆反,条目15和16难度过低过高并存且有难度逆反现象,提示待改进;除了条目9、11和15提供的信息量中等,条目16和17提供的信息量较差以外,其余条目的信息量均较好。结论 《中国版职业紧张核心量表》所有条目的区分度较好。从难度系数和信息量两个角度,条目9、11、15、16、17的测验质量均是有待改进的,其余条目性能良好,建议针对上述分析结果结合专家意见对问题条目进行修订。     

Heterotopic lung transplant: a feasible approach to compensate for organ shortages

Lung transplants are still limited by the shortage of suitable donor lungs, especially during the coronavirus disease 2019 pandemic. A heterotopic lung transplant (HLTx), as a flexible surgical procedure, can maximize the potential of donor lungs in an emergency, but its widespread use is hindered by difficulties in anastomosis and paucity of outcome data. We performed a retrospective review of 4 patients, each of whom received an HLTxs over 1 year, including 1 left-to-right single HLTx, 2 right-to-left single HLTxs and 1 lobar HLTx (right upper lobe-to-left). The median recipient age was 58.5 years (46–68); 3 patients were male. The postoperative hospital stay was 33 days (30–42). One recipient lived for 10 years and died of bronchiolitis obliterans syndrome; the others were alive with no major morbidity at 12 to 31 months after the operation with a 1-year survival of 100%. The follow-up chest images showed that transplanted lungs could be inflated well and adapted morphologically to fill the thoracic cavity in the short and long term. This study demonstrates that an HLTx is a feasible alternative to a conventional lung transplant in emergency cases and could be considered in selected patients at advanced medical centres.     

突发公共卫生事件下医院外派医疗队伍应急物资保障体系研究

目的 外派医疗队伍承担着突发公共卫生事件下高发区救治患者的重要使命,对外派医疗队伍应急物资供应保障机制提出了更高要求,本文旨在为应对突发公共卫生事件时外派医疗队伍物资供应保障工作提出对策建议。方法 针对外派医疗队应急物资需求量大及储备不足、采购和运输难度较大、应急物资管理信息化程度低等现状,基于医院内部与外派医疗队伍应急物资平衡调配的目标,合理构建医院外派医疗队应急物资保障体系。结果 从外派医疗队伍的应急物资需求清单、应急物资储备策略、应急物资采购策略、应急物流配送策略以及应急物资管理的信息化建设等方面进行探索与思考,构建完善可控的医院外派医疗队伍应急物资保障体系。结论 基于本院与外派医疗队伍应急物资平衡调配目标的应急物资保障体系的合理构建和运作,为完善我国应急管理机制、提高突发公共卫生事件应急水平提供有益参考和借鉴。