Nationwide survey of home transfusion practices

BACKGROUND: Limited information exists on home transfusion practices. STUDY DESIGN AND METHODS: In 1995, a survey requesting data for 1994 was sent to 1273 American Association of Blood Banks (AABB) institutional members and 113 non-AABB home health care agencies that provide out-of-hospital transfusions. RESULTS: Of 943 respondents, 102 provide blood to a home transfusion program, 37 provide blood and run a home transfusion program, and 13 run a home transfusion program only, for a total of 152 (16%) with some involvement in home blood transfusions. Most of the 50 respondents with a home transfusion program are licensed by their state and accredited by the Joint Commission on Accreditation of Healthcare Organizations. All respondents have written policies for home transfusion, and 90 percent require a signed informed-consent document before initiating transfusions in the home. Most have policies requiring that there be a second adult and a telephone in the home, that the home be deemed safe for transfusion, that the patient's physician be readily available, and that the patient have had prior transfusions. The most common component issued by the blood providers was red cells, followed by platelets. White cell-reduced components were always provided by 36 percent of respondents. The most common patient diagnosis was cancer. Home transfusions were provided primarily by registered nurses. Only 14 percent of respondents indicated that the medical director of the blood bank is responsible for approving a patient for home transfusion. A posttransfusion visit is performed by 46 percent of respondents. CONCLUSION: Although most facilities have policies for the administration of home transfusions, there remains marked heterogeneity among blood providers and transfusionists regarding home transfusion practices.     

3种正畸粘接剂临床粘接效果对比分析

目的:比较3种临床常用的不同类型的正畸粘接剂托槽脱落率.方法:将新诊正畸患者75例分成3组,分别用3种粘接剂(A-Transband XT光固化粘接剂,B-京津釉质粘接剂,C-TF非调和型粘接剂)粘接后比较即刻加载后、加力1个月、3个月复诊后的托槽累计脱落率.结果:3种粘接剂即刻粘接后脱落率差异有统计学意义.结论:3种粘接剂远期粘接效果相同,即刻粘接效果TF非调和型粘接剂在3者中为最好.     

中医大学生传统医德教育创新对策思考

文章通过阐述中国传统医德的基本原则——＂医乃仁术＂,指出：面对市场经济和医学技术飞速发展的挑战,人们呼唤＂医乃仁术＂传统的复归,中国传统医德仍然具有现代价值。在此基础上,通过分析我国医疗服务工作和高等中医教育面临的新形势和新任务,阐明中国传统医德教育在中医大学生人才培养中的现实意义,提出加强中国传统医德教育的创新对策。     

封闭治疗在颈椎病中的应用

随着生活节奏的加快,颈椎病的发病率逐年升高,并趋向年轻化。治疗分为手术治疗和非手术治疗,手术治疗虽逐年改进,近年来有长足发展,但因其是有创操作,风险大,而且费用高,手术治疗者仅为少数,非手术治疗有独特的优点,多数不需住院,患者痛苦少,花费少,不破坏正常解剖结构。封闭治疗是非手术治疗方法的一种,症状缓解,疗效最佳。本文从交感型颈椎病及神经根型颈椎病发病机制上阐明封闭疗法的理论基础,并概述了各种封闭疗法。     

应用E-tracking技术评价妊娠期高血压疾病患者颈动脉弹性功能

目的：探讨E-Tracking技术在评价妊娠期高血压疾病患者颈动脉弹性功能中的应用价值。方法：对29例妊娠晚期妊娠期高血压疾病患者（疾病组）和32例正常妊娠晚期妇女（对照组）进行双侧颈总动脉血管弹性指标（弹性模量Ep、僵硬度β、顺应性AC、脉搏波传导速度PWVβ及膨大指数AI）及内中膜厚度（IMT）的测量,并进行统计学分析。结果：疾病组双侧颈总动脉Ep、β、PWVβ及AI较对照组升高,疾病组AC较对照组减低,具有极显著性差异（P〈0.01）;两组间颈总动脉内中膜厚度无显著性差异（P〉0.05）。结论：血管回声跟踪技术在评价妊娠期高血压疾病血管弹性方面具有一定价值。     

GC法同时测定伊痛舒注射液中4种成分的含量

目的建立伊痛舒注射液中α-蒎烯、莰烯、柠檬烯和甲基丁香酚4种成分含量测定的方法。方法采用挥发油提取器,利用GC法进行测定。采用DB-1石英毛细管柱(30 m×0.25 mm,0.25μm),氢火焰离子化检测器,程序升温,流速为1.0 mL.min-1,进样量为1μL,分流比为10∶1,内标物为丁香酚。结果α-蒎烯、莰烯、柠檬烯和甲基丁香酚质量浓度分别在22.77～728.6 mg·L-1、5.069～162.2 mg·L-1、4.844～155.0 mg·L-1和65.58～2 099 mg·L-1内线性关系良好,平均回收率分别为(94.0±1.2)%、(93.3±1.6)%、(93.1±2.2)%和(92.4±1.6)%。结论该方法准确,重复性好,可为伊痛舒注射液的质量控制提供依据。     

双向干预对骨科Ⅰ类切口手术预防性应用抗菌药物的影响

目的:评价双向干预对骨科Ⅰ类切口手术预防性应用抗菌药物的实施效果.方法:抽取某院双向干预前骨科Ⅰ类切口手术病例298份,双向干预后病例289份,考察围手术期预防性使用抗菌药物的合理性.结果:双向干预后,Ⅰ类切口手术预防用药的合理性在药物选择、用法用量、超权限应用抗菌药物、溶媒选择、给药途径、联合用药、给药时机等方面均明显改善(P＜ 0.05);人均抗菌药物费用和人均预防用药时间都有明显的下降.结论:双向干预是有效和可行的,但仍需进一步加强监管力度,促进围手术期抗菌药物的合理使用.     

MR运动成像对CSM诊断的临床研究

目的探讨MR运动成像对脊髓型颈椎病（cervical spordylogic myelopathy,CSM）的诊断价值。方法比较52例患者常规（静态）MR成像和MR运动成像检查结果,观察分析CSM患者脊髓受压的因素和特征,并与正常组MR表现进行对照分析。常规MR成像采用SE、FSE矢状位及横断位T1WI、T2WI或STIR等序列。MR运动成像采用FSE矢状位T2WI序列观察分析颈椎过屈、自然和过伸位MR征象特点。结果52例患者中,常规MR成像发现脊髓压迫46例,其中1级9例,2级26例,3级11例。MR运动成像全组病例均见脊髓压迫,其中1级10例,2级29例,3级13例。结论MR运动成像可动态观察CSM患者脊髓受压的因素及特征,并且能早期发现椎体不稳,为临床制定合适治疗方案及早期干预提供较可靠依据。     

肠道胃肠间质瘤的临床病理改变

目的：了解肠道胃肠间质瘤（gastrintestinal stromal tumors GIST）的特殊临床病理改变。方法：收集31例肠道胃肠间质瘤的临床病理资料,每例常规光镜切片观察,作免疫组化CD34、CD117、SMA、S100、CKp标记。结果：肠道胃肠间质瘤临床症状以腹痛、肿块、便血为主。分布在十二指肠、小肠和直肠。以高危险度胃肠间质瘤为主。免疫组化标记：肿瘤细胞以CD34和CD117阳性为主。结论：肠道胃肠间质瘤临床症状与肠恶性肿瘤相似,诊断依据组织学改变和免疫组化标记,并以此判断肿瘤的危险度。