医院危急值信息系统设计与实现

分析传统模式下医院危急值报告制度特点和不足,构建基于消息队列技术的危急值信息系统,详细阐述系统流程、功能及应用效果,指出该系统有助于提高信息传输高效性和稳定性,促进医院危急值制度落实。     

Investigation and influencing factors about well-being level of elderly chronic patients during COVID-19 postpandemic period in Beijing

The Corona Virus Disease 2019 (COVID-19) pandemic has huge impacts on the world, including human health and economic decline. The COVID-19 has severe infectivity, especially the elderly with chronic diseases will cause various complications after infection and accelerate the disease process. In addition, COVID-19 will also affect their mental health. Therefore, the mental health of elderly patients with chronic diseases cannot be ignored. The aim of this study was to investigate the well-being level of elderly people with chronic disease during COVID-19 postpandemic period in Beijing and analysis related influencing factors, so as to provide a basis for improving the well-being level of elderly chronic patients during the postpandemic period.Elderly patients with chronic diseases who met the inclusion criteria in 5 different administrative regions in Beijing were selected to carry out a questionnaire survey. The contents of the questionnaire included general data, the Memorial University of Newfoundland Happiness scale and the awareness situation of the COVID-19 pandemic. A total of 500 questionnaires were distributed by WeChat and 486 valid questionnaires were collected. The t test and one-way analysis of variance were used to compare Memorial University of Newfoundland Happiness scores between 2 or more groups, multiple linear regression analysis was used to conduct multiple factor analysis to explore the related factors about well-being level of elderly chronic patients.A total of 109 cases (22.43%) were evaluated high well-being level, 319 cases (65.64%) were evaluated moderate well-being level and 58 cases (11.93%) were evaluated low well-being according to the Memorial University of Newfoundland Happiness (MUNSH) scores rating. The multiple linear regression indicated that the education level, number of chronic diseases, medical expenses, frequency of children''s visits, taking care of grandchildren or not, and group activity frequency significantly affected the well-being of patients with chronic diseases during COVID-19 postpandemic period in Beijing (P < .05).Most elderly patients with chronic diseases had moderate or above sense of well-being during postpandemic period, but we should still pay attention to the mental health of those elderly chronic patients with low education level, much comorbidity, more medical expenses, less visits by children, not take care of grandchildren and never participate in group activities.     

直肠腔内三维超声和MRI对中下段直肠癌壁外血管侵犯程度的评估效果

目的:比较直肠腔内三维超声(3D-ERUS)和核磁共振成像(MRI)对中下段直肠癌术前壁外血管侵犯(EMVI)的诊断结果,探讨3D-ERUS在评估中下段直肠癌术前EMVI中的临床价值.方法:选取94例术后病理均诊断为直肠癌患者,术前均行3D-ERUS和MRI检查,均采用EMVI 5级评分(0～4分)进行评估.采用受试者...     

间隙连接蛋白43突变与皮肤疾病相关性研究

间隙连接蛋白(Cx)在保证细胞间物质信息传递及维持皮肤屏障稳态方面发挥着重要作用,其基因突变,甚至表达水平异常均会引起多种疾病,严重影响患者生活质量。在编码人类Cx家族的21个基因中,与Cx基因突变相关的临床伴随疾病至少有14种。其中,Cx43分布最广,不仅在大多数器官组织中均有报道,也是伤口愈合、皮肤角质化,以及皮肤肿瘤发展等重要生理病理过程中的关键调控节点。本文总结了近年来Cx43基因(GJA1)在皮肤屏障中的作用、GJA1基因突变相关皮肤疾病及其潜在致病机制这几个快速发展领域中的研究成果,以期为Cx43临床伴发疾病防治及相关研究提供参考。     

家庭医疗废物管理的研究进展及启示

本文通过综述国外家庭医疗废物的管理经验和研究进展,对我国家庭医疗废物的产生种类和管理现状进行分析,提出了完善家庭医疗废物管理法规,明确政府及管理机构职责,建立回收渠道,尽快发布家庭医疗废物分类和处置指南等建议,为进一步规范家庭医疗废物管理及开展相关研究提供参考.     

The effects of case management for breast cancer patients: A protocol for systematic review and meta-analysis

Background:Female breast cancer is the most common cancer nowadays, and its treatment has a significant impact on patients both physically and psychologically. Many randomized trials have proved that case management (CM) can effectively care for patients. However, there is a lack of systematic scientific evaluation, so this systematic evaluation aims to explore the impact of CM on breast cancer patients.Methods:PubMed, Embase, Cochrane Library, Scopus, CINAHL were searched. Chinese repositories included China National Knowledge, Infrastructure Database (CNKI), Wan fang Database, China Biology Medicine Database. We will also search unpublished literature at ClinicalTrials.gov. Randomized controlled trials were collected from them. The literature will be screened according to inclusion and exclusion criteria, and 2 researchers will extract the literature independently. The primary outcome indicator for this study will be patient satisfaction. Statistics were performed using RevMan 5.4 software. The quality of each outcome will be evaluated using the Grading of Recommendations Assessment, Development, and Evaluation.Results:This study will provide the most recent evidence for evaluating the impact of CM on breast cancer patients.Conclusion:To evaluate the impact of CM on patients with breast cancer.Registration number:DOI:10.17605/OSF.IO/ZJKHX.     

A Review of Research on Mechanical Properties and Durability of Concrete Mixed with Wastewater from Ready-Mixed Concrete Plant

The wastewater from ready-mixed concrete plants is currently being recycled as concrete mixing water. It has attracted significant attention from the construction industry and researchers since it promotes sustainable development through environmental protection, energy-saving, and emissions reduction. This article review first introduces the nature of wastewater in ready-mixed concrete plants in different regions. Then the effects of solid content in water on various properties of concrete, including working performance, durability and microscopic properties, are reviewed, respectively, when concrete is mixed with wastewater instead of tap water. Furthermore, the microscopic mechanism of action in concrete mixing with wastewater is discussed, and future work is recommended. This review provides fundamentals on the study of the properties of concrete after wastewater is mixed into concrete.     

参加暴露前预防的男男性行为者HIV自我检测试剂使用现状及影响因素分析

目的:分析参加暴露前预防（PrEP）MSM的HIV自我检测（自检）试剂使用现状及相关影响因素。方法:2018年12月至2019年12月,使用“金数据”平台（www.jinshuju.com）对沈阳市、北京市、重庆市和深圳市参与多中心PrEP研究的MSM进行现况调查。结果:共有1 222例MSM研究对象,年龄（31.5±...     

内镜治疗上消化道异物临床特点分析

目的 分析上消化道异物的临床特点,提高诊疗水平。方法 收集郑州颐和医院消化内镜中心自2014年1月至2021年6月内镜下诊治的上消化道异物108例,分析其临床特点。比较患者年龄、发生时间与异物种类的关系。分析消化道管壁损伤的危险因素。结果 108例上消化道异物中,食源性异物最多(73.15%)。异物最易滞留于食管上段及入口处(47.22%)。消化道管壁损伤以黏膜糜烂为主(50.93%)。不同季度食源性异物占全部异物的比率的总体比较差异有统计学意义(P=0.033),第一季度及第四季度食源性异物占比较高。不同年龄组食源性异物占全部异物的比率的总体比较差异有统计学意义(P<0.001),中年组食源性异物占比高于少年组(P<0.008)、老年组高于少年组(P<0.008)、老年组高于青年组(P<0.008)。中老年组患者、锐性异物消化道管壁损伤占比更高。结论 中老年人群和每年第一季度、第四季度是食源性异物高发人群和高发时期。中年人群、锐性异物是消化道管壁损伤的高危因素。可根据以上临床特点选取最合适的诊治方案,提高诊治效果。     

心房颤动对静脉溶栓治疗急性缺血性卒中转归的影响

目的 探讨心房颤动(atrial fibrillation,AF)对急性缺血性卒中患者静脉溶栓后临床转归和出血性转化(hemorrhagic transformation,HT)的影响.方法 回顾性纳入接受静脉重组组织型纤溶酶原激活剂溶栓治疗的急性缺血性卒中患者.90 d时改良Rankin量表评分0～2分定义为转归良好.采用多变量logistic回归分析确定AF与静脉溶栓后临床转归的相关性.结果 共纳入160例接受静脉溶栓治疗的急性缺血性卒中患者,其中67例(41.88％)合并AF.与非AF组相比,AF组年龄更大[中位数和四分位数间距:77(71 ～83)岁对69(59 ～78)岁;Z=4.142,P＜0.001],基线美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NHISS)评分更高[11(6～17)分对7(4 ～14)分;Z=2.623,P=0.009].AF组溶栓后24 h[3.0(1.0～4.5)分对2.0(0～6.0)分;Z=-0.312,P=0.775]和7 d[4.0(2.0～5.0)分对5.0(2.0～8.0)分;Z=1.574,P=0.115]时NIHSS评分较基线降低值以及90 d时转归良好患者比例(38.81％对25.82％;x2 =3.063,P=0.080)与非AF组差异均无统计学意义,但24 h内HT(14.93％对5.38％;x2=4.179,P=0.041)和90 d内死亡(16.42％对6.45％;x2 =4.073,P=0.044)患者比例显著高于非AF组.多变量logistic回归分析显不,AF与90 d时临床转归[优势比(odds ratio,OR0.95,95％可信区间(confidence interval,CI)0.381～2.366;P=0.912]、24 h内HT(OR1.992,95％ CI 0.580 ～6.369;P=0.285)以及90 d内死亡(OR 2.483,95％ CI0.727～8.586;P=0.146)均无独立相关性.结论 AF不是影响急性缺血性卒中患者静脉溶栓后90 d时临床转归和24 h内HT的独立危险因素.