国产吻合器行痔上黏膜环切术的并发症及应用价值

目的：探讨国产吻合器痔上黏膜环切术（PPH）的并发症及应用价值。方法：总结吻合器痔上黏膜环切术治疗严重Ⅱ度、Ⅲ度、Ⅳ度痔病63例的临床资料。结果：手术时间10-20min，术后平均住院2～5d，无肛门狭窄、无肛门失禁、无复发等并发症。结论：国产痔吻合器是治疗重度痔的一种安全有效方法，创伤少，并发症少，价格低廉，有望替代传统的痔切除术。     

Colorectal Cancer Screening Pilot Program for Underserved Women in Cumberland County,Maine

Over 800 Maine residents will be diagnosed with colorectal cancer (CRC) this year, and nearly 300 will die from the disease. While CRC screening can reduce these rates, it is only among insured populations that screening rates exceed 50%. This project aimed to reduce barriers to, and increase rates of CRC screening among underinsured and uninsured women, ages 50 years and over, residing in Cumberland County, Maine. The existing network of the Maine Breast and Cervical Health Program (MBCHP) was used to reach the target population. A packet containing (1) an offer for no-cost fecal occult blood test (FOBT) screening and CRC-related educational materials, and (2) a stamped, addressed postcard specifying the woman’s interest in these resources, was mailed to 300 MBCHP enrollees residing in Cumberland County. Women requesting screening were contacted by phone to further determine eligibility. Ninety-three women (31%) requested FOBT kits and 29 of these women requested educational materials. Ten women were ineligible for screening because of previous colonoscopy. Fifty-two completed FOBT kits (63%) were returned; all were negative. An additional 42 (14%) women requested educational materials only. To reduce the burden of CRC in Maine and nationally, disparate populations must be reached with efficient and effective screening services. Established networks are proven means for reaching uninsured and underinsured individuals with education, screening services, and necessary follow-up care. This project serves as a model for the future development of similar programs statewide and nationally.     

Overview of Disease Management Approaches

Corporations have engaged in sponsorship of health management programs and, more recently, disease management programs to facilitate healthy and productive work environments. The purpose of this review is to examine the health and financial outcomes from these corporate-sponsored disease management programs. This article focuses on seven diseases or chronic conditions (arthritis, asthma, cancer, depression, diabetes mellitus, heart disease, and migraine) that potentially impact employee productivity (both in time away from work and in loss of effectiveness at work) and health status including medical and pharmaceutical utilization and costs.Corporate-sponsored disease management programs typically focus on education and screening for selected diseases or chronic conditions. Partnerships have been formed with health plans and third-party program providers to reach employees with interventions and treatment. The typical outcome measures from these programs have primarily been clinical indicators and medical utilization. Measures of productivity need to be incorporated as important outcome measures for disease management programs.The estimated financial opportunity for the corporation is a reflection of the cost differential for a given disease and the prevalence of that disease within the employee population. Primary diseases, chronic conditions, and health risks contribute to increased medical utilization and decreased productivity within the corporation. Promoting programs that focus on the whole person, including health risks, chronic conditions, and diseases, will likely increase the possibility of success in helping the employee to better self-manage their health conditions and consequently provide gains for both the individual and the corporation.     

Selective internal iliac artery oxaliplatin infusion: Another facultative treatment to unremitting hematuria in stage T4 bladder carcinoma

Objective  

To observe and evaluate the value of utilizing selective internal iliac artery infusion and selective internal iliac artery embolization for the treatment of unremitting gross hematuria of stage T4 bladder carcinoma.     

基层公共卫生人员心身健康状况分析

目的了解基层公共卫生人员心身健康状况及影响因素,为提高其健康水平和工作质量提供科学依据。方法应用中国心身健康量表,采用分层整群抽样的方式,抽取胶州、嘉祥、兖州和邹城疾病预防控制中心及下属防保站的公共卫生人员584名进行问卷调查。结果基层公共卫生人员心身障碍发生率为39.43%,其中最高为骨骼系统14.17%,其次为神经系统12.73%;呼吸系统、心血管系统、焦虑、抑郁、精神病性5项因子评分小于全国常模;运用二分类Logistic逐步回归分析显示,从事本行业年限的增加是引起眼和耳疾病的危险性因素（OR=1.067）,职务的增高是导致心血管系统（OR=1.878）、消化系统（OR=1.675）、精神病性（OR=1.841）疾患的危险性因素;核心家庭（OR=0.136）、扩展家庭（OR=0.143）是降低抑郁发生的保护性因素。结论相关部门应采取综合措施,从工作和家庭环境等方面入手,提高基层公共卫生人员的心身健康水平。     

我院物价与收费管理工作的实践

<正>中日友好医院直属中华人民共和国卫生部领导,以疑难疾病、危急重症诊治为重点,以中西医结合为特色,融医疗、教学、科研、康复和预防保健等多项功能为一体。多年来我院在做好医院物价及收费管理工作中,积累了经     

Nosocomial infections and risk factors in intensive care unit of a university hospital in Turkey

The aim of this study was to determine the types nosocomial infections (NIs) and the risk factors for NIs in the central intensive care unit (ICU) of Trakya University Hospital. The patients admitted to the ICU were observed prospectively by the unit-directed active surveillance method based on patient and the laboratory over a 9-month-period. The samples of urine, blood, sputum or tracheal aspirate were taken from the patients on the first and the third days of their hospitalization in ICU; the patients were cultured routinely. Other samples were taken and cultured if there was suspicion of an infection. Infections were considered as ICU-associated if they developed after 48 hours of hospitalization in the unit and 5 days after discharge from the unit if the patients had been sent to a different ward in the hospital. The rate of NIs in 135 patients assigned was found to be 68%. The most common infection sites were lower respiratory tract, urinary tract, bloodstream, catheter site and surgical wound. Hospitalization in ICU for more than 6 days and colonization was found to be the main risk factor for NIs. Prolonged mechanical ventilation and tracheostomy, as well as frequently changed nasogastric catheterization, were found to be risk factors for lower respiratory tract infections. For bloodstream infections, both prolonged insertion of and frequent change of arterial catheters, and for urinary tract infections, female gender, period and repeating of urinary catheterization were risk factors. A high prevalence rate of nosocomial infections was found in this study. Invasive device use and duration of use continue to greatly influence the development of nosocomial infection in ICU. Important factors to prevent nosocomial infections are to avoid long hospitalization and unnecessary device application. Control and prevention strategies based on continuing education of healthcare workers will decrease the nosocomial infections in the intensive care unit.