神经外科重症监护病房护理工作量的调查分析

目的 对神经外科重症监护病房(NCU)的护理工作量进行调查,根据工作量计算护士人数,并预见性地合理安排每班护士人数,提高护理效果.方法 运用护理活动评估量表(NAS)对住院患者每天的护理工作量和病区总的护理工作量进行评价研究,分析影响护理工作量的相关因素.结果 NCU患者当天需要的护理工作量得分为30.23～ 87.6分,平均54.39分.护理工作量与患者入住NCU的时间、不同转归情况及是否手术有关.结论 NCU护理人员处于缺编状态,护士已达到超负荷工作状态.NCU护士人力应以所收治患者实际需要的护理工作量进行动态合理分配.采用护理活动评分系统进行人力资源管理可提高NCU护理质量.     

基于统一网络存储的医院数据中心设计

目的：建立统一医院数据存储平台。方法：通过数据存储的升级,建立以FC SAN为核心,同时使用包括IP SAN、NAS的数据存储和备份系统,集成所有医院信息系统的数据集中服务。结果：建立了一个稳定可靠、系统先进、易于扩展、易于管理维护以及综合投入成本合理的统一存储系统。结论：有效保证了医院对数据存储的多样性和稳定性的要求。     

Pineal, Retinal, Serum Melatonin, and N-Acetylserotonin Rhythms in Chicks on Reversing Light Regimen Eye Covering

After reversing a 12:12-h light-dark regimen of environmental lighting, pineal and retinal melatonin levels of white leghorn chicks recorded at the first mid-darkness were greatly enhanced and reached maximum levels after three more days; those recorded during the light periods indicate gradual decline but were far from the nadir of the original light period, even at the end of the experiment. The first mid-darkness serum melatonin levels recorded after photoperiod reversal were not much different from their original mid-light values. However, on continuing with the reversed regimen, the next mid-darkness levels were sharply increased, and maximum levels were reached after a further 2 days. Under the same experimental conditions light had much more drastic effects, and 6 h on the reversed regimen were sufficient to bring down completely the high value of the original mid-darkness period to the level of the starting mid-light nadir. Retinal N-acetylserotonin (NAS) measured simultaneously had a pattern similar to that of melatonin, but the pineal NAS rhythm did invert completely, albeit gradually. Eye covering did not prevent inversion of pineal and serum melatonin rhythms, which were identical in eye-covered and sighted control chicks on the reversed regimen of light. However, retinal melatonin values of the light periods were significantly less depressed in eye-covered than in sighted control chicks. Moreover, eye covering completely prevented the retinal NAS depression under light but did not affect pineal NAS. During darkness retinal and pineal NAS elevation was sluggish in the eye-covered chicks.     

Systematic review and meta-analysis of Roux-en-Y gastric bypass against laparoscopic sleeve gastrectomy for amelioration of NAFLD using four criteria

Nonalcoholic fatty liver disease (NAFLD) prevalence is rising worldwide, as a direct consequence of the obesity epidemic. Bariatric surgery provides proven NAFLD amelioration, although questions remain regarding whether Roux-en-Y gastric bypass (RYGB) or laparoscopic sleeve gastrectomy (LSG) is more effective. To answer this question, we conducted a systematic review and meta-analysis exclusively comparing RYGB and LSG for amelioration of NAFLD using 4 separate criteria: alanine transaminase, aspartate transaminase, NAFLD activity score, and NAFLD fibrosis score. Our search included 1290 initial studies, which were narrowed to 20 final studies in the meta-analysis. Overall, both RYGB and LSG significantly improved alanine transaminase, aspartate transaminase, NAFLD activity score, and NAFLD fibrosis score postoperatively. Direct comparisons of RYGB to LSG in any of the 4 criteria failed to demonstrate superiority. Our findings corroborate the current literature showing that bariatric surgery significantly improves biochemical and histologic parameters in patients with NAFLD. The novel individual comparisons of 4 criteria failed to show superiority between RYGB and LSG in ameliorating NAFLD. Despite several limitations, our study can assist clinicians by supporting the notion that RYGB and LSG may be equally efficacious in ameliorating NAFLD.     

Evaluation of research activities and research needs to increase the impact and applicability of alternative testing strategies in risk assessment practice

The present paper aims at identifying strategies to increase the impact and applicability of alternative testing strategies in risk assessment. To this end, a quantitative and qualitative literature evaluation was performed on (a) current research efforts in the development of in vitro methods aiming for alternatives to animal testing, (b) the possibilities and limitations of in vitro methods for regulatory purposes and (c) the potential of physiologically-based kinetic (PBK) modeling to improve the impact and applicability of in vitro methods in risk assessment practice. Overall, the evaluation showed that the focus of state-of-the-art research activities does not seem to be optimally directed at developing in vitro alternatives for those endpoints that are most animal-demanding, such as reproductive and developmental toxicity, and carcinogenicity. A key limitation in the application of in vitro alternatives to such systemic endpoints is that in vitro methods do not provide so-called points of departure, necessary for regulators to set safe exposure limits. PBK-modeling could contribute to overcoming this limitation by providing a method that allows extrapolation of in vitro concentration-response curves to in vivo dose-response curves. However, more proofs of principle are required.     

Maternal hair cortisol levels as a novel predictor of neonatal abstinence syndrome severity: A pilot feasibility study

Neonatal abstinence syndrome (NAS) after in-utero opioid exposure remains a poorly understood condition with multiple factors contributing to severity. Exposure to maternal stress may be one contributing factor. Hair cortisol measurement represents a novel technique for assessing prenatal stress. In this pilot study, the association between maternal hair cortisol levels and NAS severity was examined in 70 postpartum women with opioid use disorder within 72 hr of delivery. Infants were monitored for NAS and treated according to institutional protocol. Forty-four (63%) of the infants were pharmacologically treated for NAS, with a mean length of hospital stay (LOS) for all infants of 14.2 (SD 9.0) days. The mean cortisol level in the mothers was 131.8 pg/mg (SD 124.7). In bivariate analysis, higher maternal hair cortisol levels were associated with shorter infant LOS (R = −.26, p = .03) and fewer infant opioid treatment days (R = −.28, p = .02). Results were no longer statistically significant in regression models after adjusting for maternal opioid and smoking. In conclusion, we demonstrated the feasibility of hair cortisol assaying within the first few days after delivery in mothers with opioid use disorder as a novel marker for NAS. The findings suggest that maternal stress may impact the severity of infant opioid withdrawal.