The Use of a Peer Supervision Group by Social Work Clinicians

We describe the origin and structure of a peer supervision group organized by social workers and ongoing for five years. Peer supervision was our response to a felt need for the social work practitioner to continue to develop professionally. The group has met a wide range of professional needs for social work practitioners. Group members were generally eager for the opportunity to discuss case material with one another. We foresee such peer group supervision as a viable mechanism for providing consultation and continuing education for experienced clinicians.     

急性心源性肺水肿临床疗效与X线胸片的相关性分析

目的研究急性心源性肺水肿治疗效果和X线胸片表现之间的关系,为临床评估疗效提供帮助。方法由2名有经验的放射科医师采用盲法回顾性分析48例急性心源性肺水肿患者治疗前后的X线胸片好转率,所得的数据做χ2检验,并用Kappa检验对2人评判的结果做一致性分析。结果医师甲、乙所得的结论均为:急性心源性肺水肿临床治疗后好转者,X线胸片好转率的差异有统计学意义(P<0.05)。甲乙医师间阅片的一致性分析差异有统计学意义(P<0.05),说明甲乙2名医师对治疗前后X线表现好转与否的诊断结果有较好的一致性。讨论急性心源性肺水肿治疗过程中复查X线胸片,是评估临床疗效的一种有效的方法 。     

临床路径变异调查与分析

目的分析临床路径变异，以提高临床路径的管理水平。方法以大隐静脉曲张高位结扎剥脱术为例，按照疾病转归、医护、患者、医院和退出路径5方面的因素对临床路径变异进行回顾性调查和统计分析。结果主要的变异因素中患者方面的占36．46％，主要是患者提前出院；医护方面的占31．31％，主要是提前安排手术。结论临床路径变异主要是人的因素，加强变异管理，才能更好的实施临床路径。     

不典型性急性心肌梗死62例临床分析

目的探究有关于不典型急性心肌梗死的临床表现并进行分析,更深入的了解对于不典型急性心肌梗死的临床诊断的方法和意义。方法通过对62例病例的总结,并进行综合的分析评断,了解病例的心电图特征以及临床诊断。结果通过回顾分析2011年2月—2012年9月的62例不典型急性心肌梗死患者的临床分析,发现对于一些具有临床表现的患者,可以通过其他的方法,如结合心电图分析,实验室检查等对其进行确诊。结论不典型急性心肌梗死的诊断应该进行综合分析,进行血清酶学检查及心电图观测,才能最终确诊。     

Acceptability of a Reusable Insulin Pen,HumaPen® Ergo,by Patients with Type 1 and Type 2 Diabetes

Summary

A reusable insulin pen (HumaPen® Ergo) was tested for patient acceptability and safety in two multinational studies involving a total of 230 patients with either type 1 (27%) or type 2 (73%) diabetes. Prior to the studies, all patients used other insulin injection pen models. During the 5-7-week studies, the acceptability of HumaPen Ergo was assessed with a questionnaire which was issued to all patients. The HumaPen Ergo was considered easy/very easy with respect to learning to use (97%), reading dose numbers (95%) and correcting dose mistakes (97%), and 62% considered it easy/very easy to hold during use. HumaPen Ergo features considered easier/much easier compared to the previously used model of pen were ease of correcting dose (Study 1/Study 2:89%/93%), ease of reading the dose number (77%/61%) and ease of changing cartridge (54%/68%). At the end of the studies the majority of patients (60%/69%) said that they would continue to use HumaPen Ergo and would recommend it to other patients, even though they had expressed satisfaction with the pen that they had used previously. Health-care professionals evaluated HumaPen Ergo according to the same criteria as the patients and said that they would recommend the HumaPen Ergo owing to ease of dialling back without wasting insulin (80%) and reading dose numbers (74%). The HumaPen Ergo was well accepted by both patients and health-care professionals and provides an important tool to combat the trauma and inconvenience associated with insulin self-injection.     

血清肿瘤标志物研发及临床应用评价新进展

恶性肿瘤发生率及病死率居高不下,其根本原因是对恶性肿瘤缺乏早期发现及早期诊断。纵观恶性肿瘤的各种诊断方法,血清检测最为简便、快捷、经济实用,但是目前应用的各种血清标志物的诊断价值尚不能满足临床需求,且运用上尚存在许多不足。因此,如何研发出新的具有较好诊断价值的血清肿瘤标志物具有巨大的市场潜力,对其临床应用进行系统性评价具有重要的意义,将有助于提高我国恶性肿瘤患者的生存率和生活质量。     

康宁克通治疗腱鞘囊肿的临床疗效

目的:探讨康宁克通对腱鞘囊肿的治疗效果。方法:选择腱鞘囊肿患者48例,随机分为观察组与对照组各24例,观察组给予康宁克通-A注射封闭治疗,对照组给予醋酸泼尼松+2%利多卡因联合封闭治疗,观察两组疗效及不良反应。结果:观察组总有效率显著高于对照组,差异有统计学意义(χ2=5.169 2,P=0.023 0),两组不良反应发生率相比差异无统计学意义(χ2=0.167 2,P=0.682 6)。结论:康宁克通-A治疗腱鞘囊肿效果良好,安全可靠,对于不愿手术而选择封闭注射治疗的患者,可优先考虑。     

泌尿系统感染细菌病原学临床监测分析

目的了解近4年泌尿系统感染(UTI)细菌构成比与耐药性变化。方法采用多平板不同条件接种UTI患者尿标本进行细菌培养,采用BioMerieux VITEK2型全自动微生物仪与ID卡进行菌种鉴定,采用双纸片表型确证扩散法进行产超广谱β-内酰胺酶大肠埃希菌检测,采用Kirby-Bauer琼脂扩散法进行抗菌药物敏感试验,采用WHONET5.3软件进行数据统计分析。结果检出细菌768株,分布为G+菌/G-菌=26.4%/73.6%,大肠埃希菌占比49.2%。其他优势菌Sa、Se、ET、Kp、Ec及Pa占比分别为7.6%、6.8%、5.2%、6.5%、5.7%及4.9%,耐药率增高/持平/降低的品种分别为9/4/3、7/7/2、8/4/4、11/4/3、12/5/1及12/4/2个。134个药敏试验组合中82个(61.2%)为耐药率增高。结论 UTI细菌构成比例与耐药性在不断变化中,主要菌种对常用抗菌药的耐药率超6成在增高。提高标本送检率,加强临床监测,对减缓细菌抗药性蔓延与恶化有积极意义。