适时护理推送模式在自体造血干细胞移植患者中的应用

目的观察适时护理推送模式在自体造血干细胞移植患者中的应用效果。方法选择适时护理推送模式实施前2018年1—10月我院行自体造血干细胞移植患者43例作为对照组,将实施后2018年11月至2019年8月于我院行自体造血干细胞移植患者43例为试验组,对照组接受自体造血干细胞移植术常规护理,试验组接受适时护理模式干预,对两组干预后的各观察指标进行比较。结果试验组患者焦虑抑郁自评分值、消化道并发症发生率显著低于对照组,护理满意度评定分值显著高于对照组,(P<0.05)。结论采用适时护理推送模式对自体造血干细胞移植患者实施干预,可明显改善患者心理困扰,降低并发症风险,提高护理满意度。     

医疗器械检验检测现状及发展趋势探索

目的 该文旨在迎接我国医疗器械检验检测行业的新业态和新挑战,探索行业的未来发展方向。方法 在概述医疗器械检验检测行业现状的基础上,采用专家访谈和线上问卷的方式,调研40家医疗器械检验检测机构及相关企事业单位,重点关注科技创新能力和形式、行业发展瓶颈等重要问题。结果 通过整理和分析调研数据,得出行业发展的5个积极趋势：完善机构整体布局,加强区域特色中心建设;完善第三方合作研究组织和第三方评审机构的准入与监管机制;鼓励科技创新,优化人才队伍,赋能检验检测技术高质量发展;构建医疗器械安全监管信息化共享平台;加强在用医疗器械设备的安全监测。创新之处 采用专家访谈和循证研究的方法,获取客观可靠的数据,为行业发展趋势的研究和探索提供了有力的依据。     

穴位注射在眼科的应用

摘要：穴位注射是以中医基础理论为指导,将药物注入穴位,通过经络循行激发人体气血,恢复正气的一种治疗方法。药物、穴位、经络三者相互作用于机体,从而达到更好的预防、治疗、改善的目的。因其操作简便、高效安全被常用于眼科疾病治疗,穴位注射在眼科方面,为一些疑难眼病的治疗提供了有效的治疗方法,药物可以高效直接地作用于眼部穴位,改善眼部微循环,穴位注射可以治疗眼表疾病和内障眼病,以及眼科一些围手术期或加快手术治疗后恢复的过程,同时也为治疗视网膜及视神经病变等疾病的治疗提供新的中西医结合的有效思路,具有简便廉验的优点,应该临床推广。     

导师制 PBL TBL科研实践教学模式对医学本科生科研认知状态的影响

目的: 探讨科研实践教育模式创新对临床医学本科生科研认知的影响。方法：在临床医学本科生的见习期,采用导师制 PBL TBL的教学方式,对60名学生进行科研培训。培训前后分别完成问卷调查,分析该教学模式对学生科研认知状态的影响。结果：满意度评分显示52名同学（86.6%）表示非常满意,仅3名同学对科研实践教学不满意。培训前后学生对科研喜爱程度评分分别为1.12（95%可信区间：0.65,1.59）及5.87（95%可信区间：5.34,6.39）,p<0.001。愿意主动参与科研实践的学生比例从培训前的35% （n=21）上升至培训后的88.3%（n=53）,p<0.001。有信心发表统计源期刊论文的学生数在培训前后分别为6及45名,p<0.001。有信心发表SCI论文学生数在培训前后分别为0及9名（p = 0.003）。结论：导师制 PBL TBL教学方式能较好地激发学生们对科研的兴趣,使他们他们对科研活动的认知状态更积极。     

实时动态血糖监测系统在白族糖尿病合并老年多器官功能不全综合征患者中的临床应用优势

目的 探讨实时动态血糖监测系统(RT-CGMS)在白族糖尿病合并老年多器官功能不全综合征(MODSE)患者治疗中的临床应用价值。方法 纳入2018年1月至12月在大理白族自治州人民医院老年病科住院的白族糖尿病合并MODSE、急性生理和慢性健康状况APACHE Ⅱ评分>15分的患者112例。患者分为2组,RT-CGMS组和自我血糖监测(SMBG)组,每组56例。比较2组患者的一般临床资料、血糖波动指标、低血糖发生率、平均每日胰岛素用量、住院时间及28d病死率。采用SPSS 16.0软件进行统计分析,2组间比较采用t检验或χ²检验。结果 与观察第2天相比,SMBG组患者第3天的血糖水平标准差(SDBG)显著降低[(3.2±1.1)和(2.9±1.0)mmol/L;P<0.05],RT-CGMS组患者第3天的平均血糖水平[MBG,(10.8±2.5)和(8.8±1.9)mmol/L;SDBG,(2.8±0.8)和(1.8±0.7)mmol/L]、最大血糖波动幅度[LAGE,(8.9±3.6)和(7.2±1.6)mmol/L]、平均血糖波动幅度[MAGE,(6.3±1.0)和(5.0±0.4)mmol/L]均显著降低(P＜0.05)。观察第2天,与SMBG组患者相比,RT-CGMS组患者SDBG显著降低[(2.8±0.8)和(3.2±1.1)mmol/L;P<0.05];观察第3天,与SMBG组患者相比,RT-CGMS组患者MBG[(8.8±1.9)和(10.9±2.8)mmol/L]、SDBG[(1.8±0.7)和(2.9±1.0)mmol/L]、LAGE[(7.2±1.6)和(9.6±3.1)mmol/L]均显著降低(P＜0.05)。与SMBG组相比,RT-CGMS组患者的低血糖发生率(16.1%和3.6%)、平均每日胰岛素量[(38.2±6.8)和(32.1±5.4)IU/d]、住院时间[(14.6±4.2)和(12.1±4.0)d]均显著降低(P＜0.05)。结论 RT-CGMS的应用可降低糖尿病合并MODSE患者的血糖波动,对提高抢救成功率、延长生存期及减少平均住院日具有重要的临床意义。     

Associations between work schedule characteristics and occupational injury and illness

DE CASTRO A.B., FUJISHIRO K., RUE T., TAGALOG E.A., SAMACO‐PAQUIZ L.P.G. & GEE G.C. (2010) Associations between work schedule characteristics and occupational injury and illness. International Nursing Review 57 , 188–194 Background: Nurses often endure working irregular day, night and evening shifts as well as mandatory overtime (i.e. employer‐imposed work time in excess of one's assigned schedule). While these work characteristics are examined as potential risks for nurses' safety and health, it is not clear whether negative health impacts occur simply because of working long hours or in combination with other mechanisms. Aim: This study investigates how these work characteristics are associated with nurses' work‐related injury and illness over and above long work hours. Methods: In this cross‐sectional study, questionnaire data were collected from a sample of 655 registered nurses in the Philippines. Multiple logistic regression was used to assess associations of shift work and mandatory overtime with four work‐related health outcomes. Results: After weekly work hours, shift length and demographic variables were accounted for, non‐day shifts were associated with work‐related injury [odds ratio (OR) = 1.54; 95% confidence interval (CI): 1.07, 2.24] and work‐related illness (OR = 1.48; 95% CI: 1.02, 2.16). Also, frequency of working mandatory overtime was associated with work‐related injury (OR = 1.22; 95% CI: 1.06, 1.41), work‐related illness (OR = 1.19; 95% CI: 1.04, 1.37) and missing more than 2 days of work because of a work‐related injury or illness (OR = 1.25; 95% CI: 1.08, 1.44). Conclusions: These findings suggest that non‐day shifts and mandatory overtime may negatively impact nurses' health independent of working long hours. Mechanisms through which these work characteristics affect health, such as circadian rhythm disturbance, nurse‐to‐patient ratios and work–family conflict, should be examined in future studies.     

Dietary instructions focusing on meal-sequence and nutritional balance for prediabetes subjects: An exploratory,cluster-randomized,prospective, open-label,clinical trial

BackgroundAlthough lifestyle modifications are known to be effective in type 2 diabetes (T2D) as well as in prediabetes, adherence to a healthy diet is difficult for some, and interventions of lifestyle modifications need to be revised occasionally. Meal sequence has been gaining attention as a part of a healthy diet among T2D individuals to improve glycemia and body weight. In addition, a dietary instruction program, SMART Washoku®, which can help individuals to consume a more nutritionally balanced diet, has been developed.MethodsThe current exploratory trial was designed to examine the effects of dietary instructions focusing on meal sequence and nutritional balance in individuals with prediabetes in the Japanese national health check-up and guidance program. Participants were cluster-randomized into three groups: Group A, receiving a conventional health guidance program (n = 11); Group B, receiving health guidance with dietary instructions focusing on meal sequence (n = 18); and Group C, receiving health guidance with dietary instructions focusing on nutritional balance (n = 13). Participants received health guidance education and various measurements before and 6 months after the instructions.ResultsBody weight in Group B was significantly reduced compared to that in Group A, with similar adherence, while the effects on glycemia were similar between the two Groups. Body weight reduction was greater in Group C compared to that in Group A, although adherence in Group C was significantly lower than that in Group A.ConclusionThe group receiving health guidance with dietary instructions focusing on meal sequence exhibited similar adherence and greater reduction in body weight than the group receiving conventional health guidance.