血液净化中心信息化管理系统在我院的应用

通过对我科室运用信息化管理系统前后医护人员工作效率进行分析和对比,可以看出应用系统后显著降低了医护人员在分诊、上机前准备、治疗中数据采集、治疗后评估、数据录入分析及制作报表的时间,医护人员的工作效率显著提高,保障了治疗安全,提高了医疗质量。     

医疗器械流通现状分析与医疗机构的对策

本文主要以医院为视角,从医疗器械流通的发展、流通领域的管理现状以及存在的问题等方面进行分析,探讨了针对性的管理措施,以提升医院医疗器械的管理水平。     

Laparoscopic versus open pancreatoduodenectomy: an individual participant data meta-analysis of randomized controlled trials

BackgroundRandomized trials have compared laparoscopic pancreatoduodenectomy (LPD) to open pancreatoduodenectomy (OPD) with conflicting results. An IPDMA may give more insight into the differences between LPD and OPD, and could identify high-risk subgroups.MethodsA systematic literature search was performed in the Pubmed, Embase, and the Cochrane library databases (October 2019). Out of 1410 studies, three randomized trials were identified. Primary outcome was major complications (Clavien-Dindo grade ≥ III). Subgroup analyses were performed for high-risk subgroups including patients with BMI of ≥25 kg/m2, pancreatic duct <3 mm, age ≥70 years, and malignancy.ResultsData from 224 patients were collected. After LPD, major complications occurred in 33/114 (29%) patients compared to 34/110 (31%) patients after OPD (adjusted odds ratio (OR) 0.62; 95% confidence interval (CI) 0.3–1.4, P = 0.257). No differences were seen for major complications and 90-day mortality LPD 8 (7%) vs OPD 4 (4%) (adjusted OR 0.2; 95% CI 0.02–1.3, P = 0.080). With LPD, operative time was longer (420 vs 318 min, p < 0.001) and hospital stay was shorter (mean difference ?6.97 days). Outcomes remained stable in the high-risk subgroups.ConclusionLPD did not reduce the rate of major postoperative complications as compared to OPD. LPD increased operative time and shortened hospital stay with 7 days.     

FIZZ1对平滑肌细胞清道夫受体A表达的影响

背景FIZZ1是一个与炎症相关的有丝分裂因子,具有刺激肺动脉平滑肌增殖、收缩血管、促进血管新生等作用。我们曾经报道FIZZ1在动脉粥样硬化中的作用,但对其作用机制尚未进一步探讨。目的探讨FIZZ1对氧化低密度脂蛋白(ox-LDL)诱导的小鼠平滑肌细胞清道夫受体A(SR-A)表达的影响。方法用ox-LDL以及终浓度分别为3×10-6、9×10-6、2.7×10-5mmol/L的FIZZ1刺激培养的平滑肌细胞,激光共聚焦显微镜对SR-A表达进行定位,流式细胞术检测不同剂量的重组FIZZ1对ox-LDL诱导的平滑肌细胞SR-A表达的影响。结果ox-LDL能诱导平滑肌细胞SR-A表达,SR-A表达主要位于细胞膜,重组FIZZ1能明显剂量相关地促进ox-LDL诱导的平滑肌细胞SR-A表达(与对照组比较,P<0.01)。结论FIZZ1明显促进ox-LDL诱导的平滑肌细胞SR-A表达,提示FIZZ1可能通过促进平滑肌细胞SR-A表达促进动脉粥样硬化进展。     

老年高血压病和糖尿病患者颈动脉粥样硬化的临床研究

目的　研究老年高血压病、糖尿病患者颈动脉粥样硬化的特征。方法　 82例住院患者分为高血压病组 (EH ,2 2例 )、糖尿病合并高血压病组 (DM EH ,4 6例 )、糖尿病组 (DM ,14例 ) ,比较 3组患者血脂改变及颈动脉超声检测结果。结果　DM组和DM EH组患者血浆TG水平均明显升高。DM组和DM EH组颈动脉阻力指数均显著升高 ,3组颈总动脉内膜 中膜厚度明显增厚。DM EH组患者斑块指数较单纯EH组明显增高。结论　老年高血压合并糖尿病者 ,并发颈动脉粥样硬化的危险性明显增加。     

内毒素与慢性肝病的关系研究进展

内毒素是存在于革兰氏阴性杆菌细胞壁外膜以脂多糖为主的成分,细菌死后或快速生长时释放出来,是广泛存在于自然界的致病原。其主要的致病成分脂多糖(lipopolysaccharide,LPS)是一类具有高度活性的大分子物质,可依赖LPS结合蛋白(lipopolysaccharide binding protein,LBP)和CD14系统作     

The association between the disruption of motor imagery and the number of depressive episodes of major depression

Background

Mental rotation performance may be used as an index of mental slowing or bradyphrenia, and may reflect, in particular, speed of motor preparation. Previous studies suggest depressive patients present the correlates of impaired behavioural performance for mental rotation and psychomotor disturbance. The aim of this study is to compare the mental rotation abilities of patients with a first episode of depression, recurrent depression and healthy control subjects with regard to hand tasks.

Methods

We tested 32 first episode of depression, 38 recurrent depression and 36 healthy control subjects by evaluating the performance of depressed patients with regard to the hand mental rotation tasks.

Results

First, the first episode and recurrent depression subjects were significantly slower and made more errors than controls in mentally rotating hands. Second, the first depressive episode but not the recurrent depression displayed the same pattern of response times to stimuli at various orientations relative to control subjects in the hand task. Third, in particular, recurrent depression subjects were significantly slower and made more errors during the mental transformation of hands than first depressive episode relative to control subjects and the differences were significantly larger in female than male subjects in the mental rotation hand task.

Limitations

Patients were on antidepressant medication.

Conclusions

These results suggest that the impaired behavioural performance for mental representation processing are related to the number of previous episodes. Moreover, the recurrent major depressive episodes may contribute to the reinforcement of cognitive impairments and further the development or maintenance of mental representation dysfunctions, especially in female patients. A deficit on mental rotation in the depressive patients may be potential biomarkers for recurrence chronically.     

The Association of Socioeconomic Status and Discharge Destination with 30-Day Readmission after Ischemic Stroke

ObjectivesThis study aimed to explore the association of socioeconomic status and discharge destination with 30-day readmission after ischemic stroke.Materials and MethodsWe examined 30-day all-cause readmission among patients hospitalized for ischemic stroke in states of Arkansas, Iowa, and Wisconsin in 2016 and 2017 and New York in 2016 using Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases.ResultsAmong the 52301 patients included, 51.1% were female. The 30-day readmission rates were 10.2%, 8.2%, 9.3%, 10.4%, 11.6%, and 11.2% for age group 18-34, 35-44, 45-54, 55-64, 65-74, and ≥75 years, respectively (p<0.001). In Generalized Estimating Equation analysis, patients with Medicare and Medicaid insurance were more likely to be readmitted, compared with private insurance, (adjusted Odds Ratio [aOR] 1.37, 95% CI 1.23-1.53; and aOR 1.26, 95% CI 1.09-1.45, respectively). Patients in the bottom quartile of zip code level median household income had higher 30-day readmission rate (12.4%) than those in the 2nd, 3rd and 4th quartile (10.3%, 10.1%, and 10.7%, respectively, p<0.001). Compared with those discharged home with self-care which had the lowest readmission rate (8.4%), patients who left against medical advice had the highest readmission rate (18.6%; aOR 2.23, 95% CI 1.75-2.83), followed by rehabilitation and skilled nursing facilities (13.2%; aOR 1.33, 95% CI 1.22-1.46), and home with home health care (11.3%, aOR 1.18, 95% CI 1.08-1.28).ConclusionsSocioeconomic status and discharged destination affect readmission after stroke. These results provide evidence to inform vulnerable patient population as targets for readmission prevention.