病案质量整体管理的做法

病案质量是衡量临床工作质量的重要标志。目前，因重效益轻质量、重科研轻临床现象突出，致病案质量有所下降。因此，应加强病案质量整体管理，建立医院、科室、个人三级病案质量控制体系；以病案内涵质量为核心内容，制定完善科学的病案质量评价标准；加强岗前培训，抓人员素质的提高；强化病案过程质量管理和终末质量管理，重视病案质量信息反馈作用。     

Effect of mite-impermeable mattress encasings and an educational package on the development of allergies in a multinational randomized, controlled birth-cohort study – 24 months results of the Study of Prevention of Allergy in Children in Europe

BACKGROUND: Sensitization to house dust mite (HDM) is an important risk factor for the development of asthma and allergic disease in childhood. Higher levels of HDM allergen are linked to increased sensitization to HDM. OBJECTIVE: To study the effect of mite-impermeable mattress encasings and an educational package on the development of allergies in a newborn cohort. METHODS: Six hundred and ninety-six newborns at high risk of developing allergies were enrolled in three European countries (Germany, Austria, UK) in a prospective, randomized, controlled birth-cohort study. Children were randomly assigned to an intervention and control group. Intervention measures included the use of mite-impermeable mattress encasings for the child's bed and a simple educational package on allergen avoidance. The control group received basic information about allergies. Children were followed up at age 6, 12, 18 and 24 months. RESULTS: 80.9% of the children were followed up to the age of 24 months. No difference in the prevalence of sensitization to HDM (control vs. intervention group: 8.4% vs. 6.1%, P=0.33) or the development of symptoms (recurrent wheezing 10.3% vs. 10.7%, nocturnal cough 12.5% vs. 12.5%) or allergic diseases (asthma 3.5% vs. 5.1%, eczema 20.0% vs. 19.6%, rhinitis 28.9% vs. 25.8%) could be found between the control and intervention group. CONCLUSION: In this study, HDM avoidance did not show a protective effect on the development of sensitization to HDM or symptomatic allergy in children at age 24 months.     

常规医疗设备招标存在问题的思考和对策--决策学多属性效用理论的实践探索

通过对常规医疗设备招标存在问题的思考,采用决策学多属性效用理论作为一种对策方法,并在实际操作中进行了尝试探索,以取得更好的效果.     

Post-Transplant Lymphoproliferative Disorders Occurring After Renal Transplantation in Adults: Report of 230 Cases From the French Registry

Post-transplant lymphoproliferative disorders (PTLD) are a rare but serious complication after organ transplantation. A French Registry of PTLD was set up in a nationwide population of kidney transplant recipients. We prospectively enrolled all adult kidney recipients developing PTLD between January 1, 1998, and December 31, 2003. We analyzed the incidence, risk and prognostic factors of PTLD by Kaplan-Meier and Cox analyses. Totally 230 cases of PTLD were referred to the French Registry. Cumulative incidence was 1.18% after 5 years. Older age (per year, AHR = 2.19, CI = 1.22-3.94) and recipient Epstein-Barr virus seronegativity (AHR = 3.01, CI = 1.57-5.08) were associated with an increased risk of PTLD. Patients with PTLD had a reduced survival rate (61% at 5 years). Graft PTLD had the best prognosis with an 81% survival rate after 5 years. Infection with hepatitis C or B virus (HCV or HBV), late-onset PTLD, multiple sites involvement and high Ann Arbor staging were risk factors for patient death. Use of azathioprine was associated with a poorer survival rate. PTLD incidence and risk factors in French recipients are in line with the international or American PTLD series. We highlighted the role of HBV or HCV in patient mortality and described the relevant prognosis factors for patients with post-transplant lymphoproliferations.     

不经胸食管钝性剥离拔脱术的临床应用

应用不经胸食管钝性剥离拔脱术治疗26例咽下癌与高位食管癌,效果良好,术后5例发生开发症,其中颈部吻合口痿3例,暂时性咳呛1例,腹部切口局限裂开1例。手术死亡率7.6%(2/26)。介绍了手术方法,对不经胸施术、胃体缝缩、颈部食管胃Gambee氏吻合法应用进行了讨论。     

Recommendations for the Conduct of Acute Inhalation Limit Tests

This paper reviews the scientific issues related to exposureconcentrations and particle sizes used in acute inhalation limittests. The current United States Environmental Protection Agency(USEPA) recommended exposure concentration for such tests is5 mg/liter, while this level is very high, it is often achievable.On the other hand, its toxicological relevance is questionable.The USEPA recommendation that 25% of the particle distributionbe less than 1 µm is a more difficult issue to address.Physical laws for aerosol particle generation and behavior limitthe minimum size of particles in an exposure atmosphere at aconcentration of 5 mg/liter. Particle size also influences depositionsite in the respiratory tract. Since damage to any region ofthe respiratory tract can produce lethality, and it is not possibleto predict, a priori, the most responsive region of the tractor the most harmful particle size of an untested agent, acutelimit testing should employ particles in a size range that depositsthroughout the entire rodent respiratory tract. Particles between1 and 4 µm mass median aerodynamic diameter (MMAD) arewell suited for such studies. It is, therefore, recommendedthat the limit test concentration should be the highest concentration(up to 5 mg/liter) that can be achieved while still maintaininga particle size distribution having an MMAD between 1 and 4µm.     

钡离子(Ba~■)诱发心室肌细胞自发电活动的实验

用心肌细胞跨膜电位记录,证实高浓度Ba~■(4mol/L)可诱发豚鼠心室肌自发电活性,这种自发电活性主要来自延迟后除极电位(DAD)及触发活动,且可被维拉帕米(异搏定)阻断,提示DAD的产生与钙离子内流有关。     

全国各省法定传染病疫情动态摘抄(200604期)

内蒙古：2006年5月报告病例1215例，比上月上升42．6％，比去年同期上升2．88％，病例主要集中在锡林郭勒盟（358例）、乌兰察布市（347例）、呼伦贝尔市（234例）、赤峰市（94例）及兴安盟和通辽市（各83例）。职业以农民和牧民为主，分别占61．07％和23．78％。     

对医院药事管理委员会系统工程管理的初探

本文通过对医院药事管理委员会的组织形式以及在医院药学事业中的特殊地位、工作任务、工作职责及职能效应的初步探讨,指出医院药事管理委员会在发展和建设医院药学事业中具有十三种职能、七大效应。认为加强医院药事管理委员会建设,是发展医院药学事业和保证医院药品质量的一种好方式。