从4340份精液检查结果分析探讨不育的主要因素

 目的 回顾性分析4340份男性生殖系统疾病患者精液标本实验室检查结果,探讨不育的主要因素。方法 采用西班牙SCA精液分析系统,按照第5版《WHO人类精液检查与处理实验手册》要求对收集的4340份精液标本进行常规分析,用迈瑞BS-480生化分析仪检测精浆果糖含量。结果 4340份就诊患者标本,全完正常的1857份(43％),异常的2483份(57％),异常标本中,液化异常44份(1.77％),pH异常54份(2.17％),精液量异常303份(12.20％),密度异常616份(24.81％),活力异常1423份(57.31％),精浆果糖异常411份(16.55％),无精子症138份(5.56％),血精52份(2.09％),白细胞精子症89份(3.58％)。结论 精液质量降低是导致不育的主要因素,其中以精子活力影响最大。     

新生儿重症监护病房死亡危险因素分析

目的 :探讨新生儿重症监护病房 ( NICU )患儿死亡的危险因素。方法 :采用多元 Logistic回归和相关分析 ,回顾性研究各危险因素对死亡的影响。结果 :通过单因素分析 ,低体重、低胎龄、机械通气时机、严重酸中毒、持续高血糖、器官衰竭时间及个数为预测患儿死亡的危险因素。结论 :严重酸中毒、持续高血糖、器官衰竭个数是判断其预后的独立危险因素。     

住院病人检查检验报告单归档的管理

目的提高病案质量，防范医疗纠纷。方法从2005年1月～2007年12月30，357份住院病案中随机抽取1500份病案进行调研。结果有40份病案检查检验报告单缺失，主要有病人原因、医生原因及辅助科医生原因，分别各占43．8％、37．5％、18．7％。采取相应对策，保证住院病案的完整性，使得检查检验报告单能够及时归档，提高医院甲级病案率。结论病案质量问题应该引起医院管理者、病案管理人员、医护人员的重视。     

健康随访管理模式在早期诊断恶性肿瘤中的实践探讨

目的:探讨通过建立健康体检随访管理模式,对早期筛查恶性肿瘤的临床价值。方法:对2007年-2009年106033人健康体检人群中筛查出的肿瘤早期疑似病例,建立健康档案进行随访检查与跟踪。结果:通过健康管理随访,从5796例疑似人群中筛查出早期恶性肿瘤患者84人,检出率为79.22/10万,其中肺癌(19.8/10万)、肾癌(13.2/10万)、肝癌(8.5/10万)占据检出率前3位。结论:健康体检结合疑似病例健康管理随访检查与跟踪是早期发现恶性肿瘤的重要手段与有效途径。     

支气管肺泡灌洗液细菌定量培养在慢性支气管炎病原菌诊断上的应用

本文报导了34例次慢性支气管炎患者进行支气管肺泡灌洗液细菌定量培养结果,其中急性发作期20例、临床缓解期14例;还有10例对照组的结果。20例慢支急性发作期病人中,17例病人共培养出定量值≥1×10~5cfu/ml的致病菌25株,这些细菌浓度平均为10~(5.66±0.52)cfu/ml显著高于临床缓解期10~(3.19±0.81)cfu/ml(p<0.01)。和对照组10~(2.27±0.78)cfu/ml(p<0.01)。说明支气管肺泡灌洗液细菌定量培养法能较准确地分离出引起慢支急性发作的病原菌。     

难治性血细胞减少伴多系发育异常的回顾性诊断分析

目的回顾分析难治性血细胞减少伴多系发育异常(RCMD)患者依据不同的分型标准所得分型结果,进而探讨RCMD的临床特征、实验室检查及形态学特点。方法选取按FAB中MDS诊断标准(FAB-MDS)诊断的难治性贫血(RA)/伴环形铁粒幼细胞增多的难治性贫血(RAS)患者59例,按WHO-MDS分型标准进行回顾性诊断分析,比较两者之间的异同。结果59例患者中,50例RA患者按WHO-MDS诊断标准,有14例(28.0%)仍归入了RA中,36例(72.0%)归入了RCMD;另外9例RAS患者,5例仍诊断为RAS,4例归入了RCMD-RS中。结论依据不同的分型标准,部分RCMD患者的归属类型不同。准确掌握RCMD的临床特征,有利于RCMD的准确定型。     

The Impact of Pharmacy Students’ Remediation Status on NAPLEX First-Time Pass Rates

Objective. To determine whether there is a difference in pass rates on the North American Pharmacist Licensure Examination (NAPLEX) between students who did and did not require remediation for deficient course grades.Methods. Student-specific data were collected regarding course grade deficiencies and completion of a comprehensive examination or course for remediation. Student-specific first-time NAPLEX performance data for the graduating classes of 2008, 2009, and 2011were provided by the National Association of Boards of Pharmacy (NABP).Results. A significant difference was found in first-time NAPLEX mean pass rates between students who did not need to undergo remediation versus those who did ( 97% vs 70%).Conclusion. Students requiring remediation for deficient course grades had a lower pass rate on the NAPLEX compared with those who did not require remediation. The difference can be attributed to several factors and therefore further study is needed.     

Generating political priority for newborn survival in three low-income countries

Deaths to babies in their first 28 days of life now account for more than 40% of global under-5 child mortality. High neonatal mortality poses a significant barrier to achieving the child survival Millennium Development Goal. Surmounting the problem requires national-level political commitment, yet only a few nation-states have prioritised this issue. We compare Bolivia, Malawi and Nepal, three low-income countries with high neonatal mortality, with a view to understanding why countries prioritise or neglect the issue. The three have had markedly different trajectories since 2000: attention grew steadily in Nepal, stagnated then grew in Malawi and grew then stagnated in Bolivia. The comparison suggests three implications for proponents seeking to advance attention to neglected health issues in low-income countries: the value of (1) advancing solutions with demonstrated efficacy in low-resource settings, (2) building on existing and emerging national priorities and (3) developing a strong network of domestic and international allies. Such actions help policy communities to weather political storms and take advantage of policy windows.     

A simulated passive intervertebral motion task: observations of performance in a cross-sectional study

Abstract

Introduction: Passive motion palpation is an integral component in examination, diagnosis or classification, and treatment of persons with mechanical disorders of the cervical spine. If the magnitude of force application during passive movement assessment is associated with greater palpatory accuracy has not been established.

Methods: This investigation used a novel mechanical model as a basis for assessing the palpatory force of students and clinicians. The model included multiple palpable resistance and displacement levels similar to that observed in humans. The ability of the subjects to discriminate the various levels of resistance and displacement offered by the model was concurrently measured.

Results: Large variability occurred in the amount of force applied by the subjects in completing the palpatory examination. The data indicated no major differences in palpatory accuracy across the student and clinician groups with different training and experience levels beyond basic competency. Those subjects applying less force in the palpatory exam demonstrated greater accuracy of palpatory assessment with one measure.

Discussion: The data indicate training and experience had minimal relationship to palpatory interpretation precision beyond the basic level and individual natural discriminatory ability may be a factor in accuracy of palpatory skill. The results demonstrate remarkable inconsistency in palpatory force among examiners and suggest that palpatory accuracy may be related to less force application.