硬件还原技术在PACS报告工作站管理中的应用

本文阐述了通过硬件还原技术解决PACS报告工作站存在问题的方法。硬件还原技术的引入实现了报告工作站稳定、高效的运行,降低了软件维护时间与成本,提升了放射科医生的工作效率。     

Nebulizer and Spacer Device Maintenance in Children with Asthma

Objective. To evaluate inhalation device cleaning practices of children with asthma and its effect on their asthma morbidity. Methods. A survey of patients aged 4 to 18 years admitted to an urban pediatric emergency department (ED) with an acute asthma exacerbation. Questions included demographics, asthma history, preference of delivery devices, and frequency of device cleaning. Patients were followed until their disposition from the ED, or until the end of their hospitalization, if admitted. Results. 220 subjects completed the survey. Mean age was 9.2 (± 3.9) years-old. One hundred and four (47.3%) patients used both nebulizers and spacer devices, while 18 (8.1%) used spacers only and 98 (44.5%) used nebulizers alone. Seventy-seven (38.1%; 95%CI: 31.7%–45.0%) patients cleaned their nebulizers and 57 (46.7%; 95%CI: 38.1%–55.4%) cleaned their spacer devices after each use as recommended by the Centers for Disease Control. There were no detectable differences in visit admission rate, total number of previous admissions, number of asthma exacerbations per year, and number of ED visits in one year between users who cleaned their devices after every, or every other use, compared to those who cleaned their devices less frequently. Conclusion. Although the majority of patients did not follow accepted guidelines for inhalation device cleaning, further studies are necessary to correlate cleaning practices to patients' clinical outcome.     

Genetic and molecular identification of three human TPP1 functions in telomerase action: recruitment,activation, and homeostasis set point regulation

Telomere length homeostasis is essential for the long-term survival of stem cells, and its set point determines the proliferative capacity of differentiated cell lineages by restricting the reservoir of telomeric repeats. Knockdown and overexpression studies in human tumor cells showed that the shelterin subunit TPP1 recruits telomerase to telomeres through a region termed the TEL patch. However, these studies do not resolve whether the TPP1 TEL patch is the only mechanism for telomerase recruitment and whether telomerase regulation studied in tumor cells is representative of nontransformed cells such as stem cells. Using genome engineering of human embryonic stem cells, which have physiological telomere length homeostasis, we establish that the TPP1 TEL patch is genetically essential for telomere elongation and thus long-term cell viability. Furthermore, genetic bypass, protein fusion, and intragenic complementation assays define two distinct additional mechanisms of TPP1 involvement in telomerase action at telomeres. We demonstrate that TPP1 provides an essential step of telomerase activation as well as feedback regulation of telomerase by telomere length, which is necessary to determine the appropriate telomere length set point in human embryonic stem cells. These studies reveal and resolve multiple TPP1 roles in telomere elongation and stem cell telomere length homeostasis.     

Changes in Locus-of-Control Attitudes about Drug Misuse in a Self-Help Group in a Methadone Maintenance Clinic

Clients of a methadone-maintenance clinic in Brooklyn, New York participating in a clinically-guided self-help (CGSH) program plus standard treatment (methadone maintenance plus individual counseling) demonstrated statistically significant changes in locus-of-control beliefs, from external to internal causation, about personal responsibility for drug misuse. Members of two control groups—one participating in a didactic lecture program plus standard treatment and the other receiving only standard treatment—failed to demonstrate similar changes. This increase in internal locus of control in the CGSH group suggests the potential efficacy of CGSH as a relapse-prevention therapeutic technique.     

Tacrolimus for the prevention and treatment of rejection of solid organ transplants

Since its introduction to the antirejection armamentarium in 1994, tacrolimus has become the workhorse of transplant professionals for avoidance of solid organ transplant rejection. Not only does tacrolimus have potent immunosuppressive qualities that prevent rejection, but dosing is straight forward and it is generally well tolerated. However, in the long term, conditions such as calcineurin inhibitor nephrotoxicity can become a problem. A discussion of the compound, the pharmacokinetics, history, and current approved uses for tacrolimus is described. Indeed, tacrolimus is the most important drug for preventing transplant rejection. However, the increased appreciation for significant side effects, particularly in the long term, has led to building interest in new agents with different mechanisms of action and different metabolism.     

无接触无菌技术在妇科病人PICC维护中的应用效果观察

目的:探讨无接触无菌技术在经外周静脉置入中心静脉导管(PICC)日常维护中应用的临床效果。方法:按住院号的单双号把80例病人分成对照组及试验组,对照组使用PICC专门换药包进行PICC导管维护,试验组不使用换药包但执行无接触无菌技术。结果:两组病人在导管维护耗时、使用物料成本方面比较差异有统计学意义(P<0.05),试验组优于对照组,在并发症发生、病人满意度比较方面差异无统计学意义(P>0.05)。结论:无接触无菌技术用于PICC导管日常维护可以节省护士工作时间及物料消耗。     

各类医用电气设备标准间电气安全指标的差异

本文统计了各类医用电气设备标准，分析了各标准间电气安全指标的差异，以指导临床工程师在不同医用电气设备的安全测试、维修或预防性维护丁作中采用合适的电气安全标准。