1380例Ⅰ、Ⅱ类手术切口围术期抗菌药物的调查研究

目的 调查某院围术期预防性使用抗菌药物的基础数据,为医院实施监控措施、采取临床干预提供科学依据.方法 根据事先设计好的调查表,按统一方法和标准,调查分析2008年胆囊切除、乳腺手术、结肠切除和髋关节置换4种手术患者预防手术部位感染抗菌药物使用情况.结果 髋关节置换术有约50.00%未在麻醉诱导期预防性使用抗菌药物;而手术时间>3 h有约85.00%在术中未追加抗菌药物;术后使用抗菌药物约80.00%均>24 h;60.50%乳腺手术使用喹诺酮类抗菌药物预防手术部位的感染.结论 为减少耐药菌株产生,降低患者、社会的经济负担,控制医院感染,规范围术期抗菌药物的合理使用迫在眉睫,应制定完善的围手术期抗菌药物合理应用管理策略,探索嗣术期抗菌药物合理应用管理的一种有效的、可行的模式.     

骨髓间充质干细胞移植治疗系统性红斑狼疮

BACKGROUND: The non-specific immune suppression method is generally used for treatment of systemic lupus erythematosus, but poor prognosis, such as infection and high recurrence rate, exists. OBJECTIVE: To evaluate the therapeutic effect of bone marrow mesenchymal stem cell transplantation on systemic lupus erythematosus in mice. METHODS: Sixteen mice with systemic lupus erythematosus were equivalently randomized into control and experimental groups, or then subjected to passage 3 bone marrow mesenchymal stem cell transplantation or the equal volume of normal saline via the tail vein, respectively. Mouse urine samples were collected to detect urine protein levels by Bradford method. Blood samples from the tip of the mouse tail were extracted to detect serum anti-ds-DNS antibody concentration by radioimmunoassay. Mouse kidney tissues were taken and observed pathohistologically through hematoxylin-eosin staining and immunohistochemistry staining under microscope. Flow cytometry was used to detect the expression of CD4+CD25+T cells in the inner canthus blood, fresh spleen and thymus. RESULTS AND CONCLUSION: Within 10 weeks after cell transplantation, the urine protein levels in the two groups were gradually increased, and the rising velocity was higher in the control group than in the experimental group. From the 4th to 10th week, the urine protein levels in the experimental group were significantly lower than those in the control group (P < 0.05). In the control group, lymphocyte infiltration was visible in the kidney tissues with a few of plasmocytes, and pathological findings showed the mice presented with interstitial nephritis; in the experimental group, the mice had no pathological changes in the kidney. In the two groups, immune complexes were found in the mesangial area, which showed a patch-like distribution in the control group and a punctate distribution in the experimental group; the relative proportion of the occupied area in the experimental group was significantly lower than that in the control group. The expression level of CD4+CD25+T cells in the blood and thymus were significantly higher in the experimental group than the control group (P < 0.05), and the expression level of CD4+CD25+T cells in the spleen was slightly higher in the experimental group than the control group with no significant difference (P > 0.05). The serum anti-ds-DNA antibody concentration in the experimental group was significantly lower than that in the control group (P < 0.05). Taken together, bone marrow mesenchymal stem cell transplantation can improve the pathological damage in systemic lupus erythematosus mice, and has a certain therapeutic effect on systemic lupus erythematosus.       

四川省农村卫生适宜技术服务对象满意度影响因素的再评价

[目的]征求农村卫生适宜技术推广应用建议,评价四川省农村卫生适宜技术服务对象满意度影响因素。[方法]采用问卷调查农村卫生适宜技术服务对象。[结果]项目研究结题后,四川省相关示范县仍然坚持农村卫生适宜技术应用工作且服务对象满意度高;适宜技术宣教的详细性是服务对象满意度的主要影响因素;有效性、安全性和规范性名列适宜技术推广应用建议的前三位。[结论]四川省示范县农村卫生适宜技术持续应用情况较好,但是仍应坚持适宜技术推广应用原则,多方面共同努力,强化技术宣教工作,进一步提升我国适宜技术服务对象对于技术服务的接受度和满意度。     

临床专业化服务的探索与实践

本文结合我院临床专业化服务实践,阐明多学科融合是专业化服务的基础,并从制度建设、机制创新、人才培养、人才引进以及资源配置与整合等方面探讨了临床专业化服务的路径与方法,为我国大型综合医院开展临床专业化服务提供有益的借鉴     

PKRP治疗高危良性前列腺增生症的围手术期护理

目的 探讨PKRP治疗高危良性前列腺增生症的围手术期护理。方法 对121例高危良性前列腺增生症的术前、术后护理进行分析、总结。结果 121例患者中无出现不良后果，均痊愈出院。结论 加强和完善围手术期的准备和护理，对BPH患者的康复有较大益处。     

进一步巩固和发展村级农村卫生适宜技术推广应用工作

[目的]掌握四川省村级农村卫生适宜技术持续推广应用状况并制定相应发展对策。[方法]采用问卷方式，调查村级农村卫生适宜技术推广者。[结果]在农村卫生技术推广示范研究项目结题后，广大村级技术推广者仍然坚持提供相应的适宜技术服务，但是也有一些地方有待改进与完善。[结论]四川省示范县村级农村卫生适宜技术持续应用情况较好。应该积极呆取对策，进一步巩固和发展村级农村卫生适宜技术推广应用工作。     

我国药品临床前研究机构建设的思索

加入WHO对我国医药行业的发展既是机遇又是挑战.本文探讨通过确立目标,制定规划,优化组合,加强合作和管理等几方面的工作,以加快药品临床前研究机构建设,开创新药研究的新局面.     

经胸三维超声心动图测定扩张型心肌病患者左室心肌重量的 …

为了比较经胸一维（１Ｄ），二维（２Ｄ）和三维（３Ｄ）超声心动图及核磁共振方法在扩张型心肌病患者左室心肌重量测定上的相关性，选择３６例扩张型心肌病患者分别接受了经胸常规（１Ｄ，２Ｄ）超声心动图，以及心脏核磁共振（ＭＲＩ）检查，并计算左室心肌重量量。结果显示：１Ｄ数据与ＭＲＩ测值较好的相关关系。与１Ｄ和２Ｄ测值比较，３Ｄ测值与ＭＲＩ值有明显高的一致性（１Ｄ：３９９．２ｇ；２Ｄ：２８５．９ｇ；３Ｄ：１７     

成都地区中老年人群LDLC升高的流行状况及影响因素

目的探讨成都城乡地区中老年人群LDLC升高的流行状况及影响因素,为今后本地区脂代谢异常防治奠定基础。方法样本的获取采用分层整群抽样的方法,以社区(村)为单位,抽取城乡社区40~79岁有代表性人群5 230人进行LDLC及相关因素的调查。结果成都地区中老年人群LDLC升高的患病率2.18%。标化患病率为2.03%。40~74岁人群随年龄增大LDLC升高的患病率逐渐增高;75岁以后患病率略有下降。男女两性及城乡患病率差异均无显著性(P均0.05)。成都地区中老年男性人群LDLC升高的危险因素为年龄、糖尿病,适度饮酒为保护因素;中老年女性人群LDLC升高的危险因素为分娩巨大儿、腹型肥胖、糖尿病,保护因素为适度饮酒、体力锻炼。结论成都地区中老年人群LDLC升高的患病率较低,明显低于全国水平。成都乃至四川地区冠心病的相对低发可能与人群高LDLC血症的低患病率有关。防治糖尿病、适度饮酒、合理体力锻炼对预防LDLC升高可能有积极意义。     

应用Delphi法建立四川省农村卫生适宜技术筛评指标体系

[目的]建立四川省农村卫生适宜技术筛评指标体系.[方法]运用Delphi法对指标进行筛选和确定.[结果]通过3轮咨询,共筛选出一级指标4个,二级指标9个.[结论]建立和完善科学、系统、实用的农村卫生技术筛评指标体系,是农村卫生适宜技术筛选的前提条件.