消毒供应中心设备管理App的设计与应用

目的 探讨设备管理App在消毒供应中心设备故障报修和维保管理中的应用效果。方法 将2020年8月至2021年4月在用的56台设备为对照组,采用常规人工手工管理;2021年8月至2022年4 月同批设备为观察组,采用设备管理App进行管理。比较两组维修响应时间和设备定期维护保养超期次数。结果 观察组维修响应时间短于对照组,定期维保超期次数少于对照组,差异有统计学意义（均P＜0.05）。结论 设备管理App应用于消毒供应中心设备维护管理中,实现了消毒供应中心设备的可视化、可追溯化、便捷化、精细化管理,保证设备正常运行,确保性能稳定,提高了工作效率,保障了无菌医疗器械的供应质量。     

两种布局后装机房辐射防护效果比较

目的:从理论和实验两方面考察不同布局的后装机房各监测点（电缆孔、控制台、防护门、候诊位）的周有效剂量,为改善职业人员辐射防护提供数据支持。 方法:依据射线强度衰减所遵从的平方反比定律及指数规律,推导出各监测点的周有效剂量计算公式,依次计算放射源处于不同位置时各监测点的周有效剂量;用MEDCOM射线检测仪测量后装机放射源活度最大时,放射源处于不同位置各监测点的空气比释动能率,计算周工作负荷,即可得各监测点的周有效剂量。 结果:考虑距离因素后,各监测点（电缆孔、控制台、防护门、候诊位）的周有效剂量理论值分别由13.00、30.90、0.012 10、1.200 μSv降至2.08、2.29、0.004 75、0.564 μSv;实验值则分别由4.32、25.60、2.01、1.96 μSv降至2.16、2.96、1.55、1.41 μSv。 结论:考虑距离因素的后装机房布局能显著降低职业人员的周有效剂量。     

Efficacy and safety of once‐weekly oral trelagliptin switched from once‐daily dipeptidyl peptidase‐4 inhibitor in patients with type 2 diabetes mellitus: An open‐label,phase 3 exploratory study

Introduction

Trelagliptin, a novel once‐weekly oral dipeptidyl peptidase‐4 (DPP‐4) inhibitor, has shown favorable efficacy and safety in type 2 diabetes mellitus patients. Trelagliptin was launched in Japan, and is expected to be initially used for switchover from a daily DPP‐4 inhibitor in the clinical setting. Thus, the present study was carried out to explore the efficacy and safety of trelagliptin after a daily DPP‐4 inhibitor was switched to it.

Materials and Methods

This was an open‐label, phase 3 exploratory study to evaluate the efficacy and safety of trelagliptin in Japanese type 2 diabetes mellitus patients who had stable glycemic control on once‐daily sitagliptin therapy. Eligible patients received trelagliptin 100 mg orally before breakfast once a week for 12 weeks. The primary end‐point was blood glucose by the meal tolerance test, and additional end‐points were glycemic control (efficacy) and safety.

Results

Altogether, 14 patients received the study drug. The blood glucose did not markedly change from baseline at major assessment points in the meal tolerance test, and a decrease in blood glucose was observed at several other assessment points. Adverse events were reported in 42.9% (6/14) of patients, but all adverse events were mild or moderate in severity, and most were not related to the study drug. No cases of death, serious adverse events or hypoglycemia were reported.

Discussion

It is considered possible to switch a once‐daily DPP‐4 inhibitor to trelagliptin in type 2 diabetes mellitus patients with stable glycemic control in combination with diet and exercise therapy without any major influences on glycemic control or safety.     

Smoking among Secondary School Students in Kota Tinggi,Johor, Malaysia - Findings from a Cross-Sectional Study

Background: Smoking is a learnt behavior during adolescence and understanding the factor/s associatedwith smoking will assist in identifying suitable measures in combating the rising prevalence of smoking amongadolescents. This research aimed to identify the factor/s associated with smoking among form four students inKota Tinggi, Johor. Multistage sampling was used to select a representative sample of students in 2008 and datawere collected using a self-administered validated questionnaire. This study revealed that the overall smokingprevalence was 19.0% with a significantly higher proportion of male smokers (35.8%) as compared to females(3.15%). Adolescents who were male (aOR 6.6, 95%CI 2.61-16.4), those who had peer/s who smoked (aOR 4.03,95% CI 1.31-12.4), and those who studied in rural areas and Felda Settlements ( aOR 4.59, 95 CI 1.11-18.0; aOR9.42, 95%CI 3.91-29.1) were more likely to smoke in the past one week. On the other hand, adolescents withbetter knowledge on the hazards of smoking and negative attitudes towards smoking were less likely to smoke(aOR 0.51, 95%CI 0.37-0.72; aOR 0.67, 95%CI 0.46-0.99). Future promotional and interventional programmeson smoking should be considered and the above identified risk factors integrated to reduce smoking prevalenceamong students of school-going ages in Kota Tinggi. Johor.     

周剂量DCF方案治疗晚期胃癌临床观察

目的：观察周剂量多西他赛联合顺铂、氟尿嘧啶（DCF）方案治疗晚期胃癌近期临床疗效及不良反应。方法：对21例晚期胃癌患者,采用多西他赛60mg／m2分两次静脉滴入,d1、d8;顺铂25mg／m2静脉滴入,d1-3亚叶酸钙150—200mg／m2。静滴d1-5,静滴2小时后,氟尿嘧啶750mg／m2持续静滴6小时以上或口服卡培他滨1000mg／m2,d-14,21d为1个周期,至少2个周期后评价疗效。结果：全组21例可评价疗效,结果PR5例,SD9例,总有效率66．7％。患者KPS及QOL评分改善。不良反应主要为骨髓抑制、消化道反应和脱发,Ⅲ／Ⅳ度骨髓抑制28．8％,消化道反应多为Ⅲ度,均为可逆性。结论：周剂量多西他赛联合顺铂、氟尿嘧啶治疗晚期胃癌近期疗效好,不良反应轻,患者耐受性好。     

Concurrent Weekly Cisplatin Versus Triweekly Cisplatin with Radiotherapy in the Treatment of Cervical Cancer: A Metaanalysis Result

Aims: To evaluate the adverse effect and survival outcome of weekly and triweekly cisplatin with radiotherapyin treatment of cervical cancer. Methods: After an extensive literature search between 1995-2011,we analyzed7 studies to compare weekly cisplatin and triweekly cisplatin combined radiotherapy. Results: Our analysisestablished that weekly cisplatin has a lower risk of hematologic toxicity than triweekly cisplatin with concurrentradiotherapy in the treatment of cervical cancer. However, there were no differences in progression free survivaland overall survival between weekly cisplatin and triweekly cisplatin (p>0.05). Conclusions: Weekly cisplatincombined with concurrent radiation has lower risk in hematologic toxicity than triweekly cisplatin, but does notimprove survival. Triweekly cisplatin treatment has longer intervals and is therefore more convenient. Cliniciansand patients can choose either weekly cisplatin or triweekly cisplatin combined radiotherapy for cervical cancer.     

Variability in and predictors of glycaemic responses after 24 weeks of treatment with exenatide twice daily and exenatide once weekly

The range of glycated haemoglobin (HbA1c) responses and characteristics associated with above‐average response to exenatide twice daily and once weekly were examined. Data were pooled from 8 exenatide‐twice‐daily and 5 exenatide‐once‐weekly studies. A baseline HbA1c‐corrected measure of change in HbA1c after 24 weeks identified high, average and low responses. Multiple linear regression and multivariate generalized estimating equation models identified factors associated with high response. Among 2355 participants (exenatide twice daily, n = 1414; exenatide once weekly, n = 941), baseline HbA1c correlated with change in HbA1c (P < .0001). Across baseline HbA1c levels, the 25th to 75th percentile of HbA1c change ranged from ?0.3% to ?3.2% with exenatide twice daily and from ?0.5% to ?3.6% with exenatide once weekly. Asian ethnicity and older age were significantly associated with high response to exenatide twice daily; no factors were significantly associated with response to exenatide once weekly. These data provide clinically useful information for estimating the likelihood that, depending on baseline HbA1c, an individual can achieve HbA1c goals. The association between Asian ethnicity, age and high response to exenatide twice daily may relate to the specific effects of exenatide twice daily on postprandial glucose.