我院医院感染现患率调查分析

目的了解某院医院感染现患率,发现医院感染管理中存在的问题和医院感染发生的特点,以改进预防控制措施.方法统一培训调查人员,床旁询问病史、体格检查与在架病历调查相结合,填写统一的个案调查表.对调查日处于医院感染状态的病例进行统计分析.结果应查病例512人,实查495人,实查率96.68%.发生医院感染40例,41例次,医院感染现患率为8.08%、例次现患率为8.28%,高于日常连续性调查结果.医院感染部位以下呼吸道居首位.结论医院感染现患率调查有利于发现医院感染管理工作中存在的问题,为制定医院感染监控措施提供可靠依据.     

荧光分光光度法测定饮用水中挥发酚类的研究

〔目的〕分析 4-氨基安替比林氯仿萃取分光光度法、直接荧光分光光度法、正丁醇萃取荧光分光光度法三种方法测定水中挥发酚的优缺点及适用范围 ,旨在找出一个更好的检测方法测定饮用水中挥发酚。〔方法〕使用此三种方法分别测定样品及标准中的挥发酚的含量 ,比较其相关系数、线性范围、灵敏度、回收率与检出限。〔结果〕以上三种方法的相关系数分别为 0 .9988、0 .9998、0 .9994,线性范围分别为 0 -0 .0 40mg L、0 -0 .0 40mg L、0 -0 .0 2 0mg L ,平均回收率分别为 95 .9%、10 0 .2 %、96.9% ,检出限分别为 0 .0 0 2mg L、0 .0 0 10 7mg L、0 .0 0 0 3 3mg L ,灵敏度分别为 11.177、3 2 61.9、3 745 6。〔结论〕正丁醇萃取荧光分光光度法有很好的灵敏度、回收率、检出限和相关系数 ,方法较简单且试剂毒性小 ,适合饮用水中挥发酚测定的国家标准要求 ,可以取代 4-氨基安替比林氯仿萃取分光光度法成为国家标准方法。     

关于血液透析机维护和管理中需要注重的问题

随着医疗卫生事业的飞速发展，大量高科技电子设备不断涌现，是技术密集．知识密集、资金密集的产品，而血液透析机无论是国产还是进口的设备，（进口占比侧大），均属高科技机电一体化医电产品，并且采用微机技术．自检报警功能多，操作相对复杂，而不同产地（不同型号其操作方法和日常维护方法也不同着重阐述了透析机供电和透析掖的配制和血液透析机的维护与保养和维修。     

4799例妇女病普查结果分析

目的:掌握和了解十堰市妇女常见病、多发病患病率,制定干预措施。方法:于2004年1~12月对十堰市4 799名妇女进行了妇科病、乳腺病普查。结果:4 799人中患各种妇科病1 885人,患病率为39.28%。妇科疾病前3位是阴道炎、宫颈糜烂、附件炎或附件包块,4 799例中患乳腺疾病者570人,患病率为11.88%,乳腺疾病以乳腺增生为主,其次是纤维瘤。结论:应广泛宣传妇女常见病、多发病的防治知识及乳腺自检方法,以降低生殖道感染发生率。     

肺动脉栓塞多排螺旋CTA血管成像

目的探讨肺动脉栓塞多排螺旋CTA血管成像扫描延迟时间的最佳值，最佳肺动脉血管成像。方法收集了45例肺动脉栓塞多排螺旋CTA血管成像，造影剂用量按1．5ml／kg，注射速率3ml／sec。扫描延迟时间用Bolus Tracking第一组20例；test Bolus为二组15例；常规计算时间为一组10例。准直器宽度2．5mm，层厚3mm。数据重建用最大密度投影（MIP）和容积显示（VR3D）等常规方法。一、二、三组图像分别由两位高年资医师阅片。结果第一组20例中19例和第二组15例图像肺动脉均清晰显示。第三组10例中4例图像模糊，第三组与第一、二组图像质量有显著差异。结论肺动脉栓塞CTA血管造影中扫描延迟时间用Test Bolus和Bolus Tracking较优，常规计算时间延迟图像质量较差。     

RP-HPLC法测定汉防己甲素的血药浓度

目的 :测定汉防己甲素在家兔血浆中的浓度。方法 :采用兔耳缘静脉注射给药方式 ,按不同时间间隔颈动脉取血 ,采用HypersilODS C18柱 ,以甲醇 水 ( 4 5∶5 5 )为流动相 ,检测波长 2 10nm ,以延胡索乙素为内标。结果 :标准曲线回归方程为Y =0 .5 318X 0 .0 6 88,(γ =0 .996 2 ) ,汉防己甲素在 0 .5 6 2 5～ 18μg·ml-1浓度范围内与峰面积比值呈良好的线性关系 ,平均加样回收率 88.5 % ,日内及日间RSD分别为 3.1%和 4 .7%。结论 :本方法简便、快速、可靠 ,可为汉防己甲素的其他生物样品分析提供参考     

人参皂苷Rg1抗衰老作用可能与改变p16、cyclin D、CDK4的表达有关

目的 :探讨人参皂苷Rg1对抗三丁基过氧化氢 (t BHP)诱导的WI 38细胞衰老作用及其可能细胞周期调控机制。方法 :将WI 38细胞随机分为 4组 ,用不同剂量Rg1预处理。从 30代开始 ,隔代用t BHP作用 ,每次 1h ,共 4次 ,诱导细胞衰老。从光镜、透射电镜观察细胞形态及超微结构 ;流式细胞术分析G1期细胞比例 ;以及SA β 半乳糖苷酶的细胞化学染色 ,确定Rg1的抗衰老作用。并采用免疫印迹技术对CDK4、cyclinD1和p16等表达情况进行检测。结果 :Rg1预处理组与单纯t BHP处理组相比 ,细胞形态体积小、胞体不如后者扁平 ,次级溶酶体减少 ,G1期细胞比例下降 ,SA β 半乳糖苷酶染色阳性细胞百分比下降 ,说明Rg1在t BHP诱导细胞衰老模型中有抗衰老作用。进一步发现用Rg1预处理后 ,p16、cyclinD1表达水平降低、CDK4表达水平增加。结论 :提示Rg1可能通过改变细胞周期调控因子的表达而发挥其抗t BHP诱导的WI 38细胞衰老作用。     

Multi‐center Retrospective Study of Factors Affecting Perioperative Transfusion of Packed Red Blood Cells for Pelvic Fracture Patients

ObjectiveTo analyze the use of packed red blood cells (PRBCs) for patients with pelvic fracture and evaluate factors associated with PRBC transfusion for patients with pelvic fracture.MethodsThis retrospective cohort study collected 551 patients with pelvic fractures from six hospitals between September 1, 2012, and June 31, 2019. The age span of patients varied from 10 to 95 years old, and they were classified into two groups based on high‐energy pelvic fractures (HE‐PFs) or low‐energy pelvic fractures (LE‐PFs). The study''s outcome was the use of PRBCs, fresh frozen plasma (FFP), and albumin. Demographic data, characteristics, laboratory tests, clinical treatment details, and clinical outcomes were compared between the two groups. Factors that were statistically associated with perioperative PRBCs in univariate analyses were included to conduct an optimal scale regression to determine the independent factors for perioperative PRBCs.ResultsA total of 551 patients were screened from six hospitals, and after inclusion and exclusion, 319 were finally included and finished the follow‐up from admission to discharge, while four patients died during hospitalization. Three hundred and nineteen patients were classified into two groups by their injury mechanisms. A total of 230/319 (72.1%) patients were classified into the HE‐PF group, and 89/319 (27.8%) patients were classified into the LE‐PF group. Patients in the HE‐PF group were transfused with 4.5 (3–8) units of PRBCs, 300 (0–600) ml of FFP, and 0 (0–30) g of albumin, while patients in the LE‐PF group were transfused with 3.5 (2–4.5) units of PRBCs, 0 (0–295) ml of FFP, and 0 (0–0) g of albumin (all P < 0.001). There were higher proportions of male patients and patients under 65 in the HE‐PF group (all P < 0.001). HE‐PF group patients were more severely injured and likely to take external fixation. The optimal scale regression revealed four significant factors associated with perioperative transfused PRBCs, which were patients on admission with hemorrhagic shock (importance = 0.283, P = 0.004), followed by fracture types identified by Tile classification (importance = 0.156, P < 0.001), hemoglobin levels below 70 g/L on admission (importance = 0.283, P = 0.004), followed by fracture types identified by Tile classification (importance = 0.156, P < 0.001), hemoglobin levels below 70 g/L on admission (importance = 0.148, P = 0.039), and methods of pelvic fixation (importance = 0.008, P = 0.026), ranked by the importance.ConclusionPatients with HE‐PFs had increased transfusions of PRBCs, FFP, and albumin, and hemorrhagic shock on admission, Tile classification, Hb levels, and stabilization methods were found to be associated with perioperative PRBCs.     

核苷类似物联合人工肝治疗慢性重型肝炎疗效观察

研究核苷类似物联合人工肝治疗慢性乙型重型肝炎疗效。将58例慢性乙型重型肝炎患者分为三组,核苷类似物联合人工肝治疗组、单用人工肝治疗组、单用核苷类似物治疗组,观察治疗效果。联合治疗组病死率22.22%,胆红素下降明显,白蛋白回升,凝血酶原活动度好转,HBV DNA转阴或载量下降。血浆置换治疗可降低血清HBV DNA水平。核苷类似物联合人工肝治疗可加快肝功能好转,缩短病程,降低病死率,降低血清HBV DNA水平。