幽门螺杆菌感染血液透析患者营养状况分析及护理对策

目的预防和改善幽门螺杆菌感染血液透析患者的营养不良状况，提高患者的生活质量。方法调查分析我院幽门螺杆菌感染血液透析患者的营养状况，依据引起其营养不良的相关因素，制定有针时性的护理时策。结果通过时营养不良患者护理措施的实施，有效的改善了患者的营养不良状况。结论去除导致营养不良的病因和诱因，合理的营养和膳食，加强心理护理，可有效的改善营养不良状况，提高患者的生活质量。     

当前社会环境下医院公关策略的研究

文章对现阶段医院面临社会困境的原因进行了研究,探讨了应用公关策略提升医院形象的理论依据和实施途径,为改善医院生存环境、建立和谐医患关系提出了新方法。     

Large-Bore Aspiration Thrombectomy versus Catheter-Directed Thrombolysis for Acute Pulmonary Embolism: A Propensity Score–Matched Comparison

PurposeTo compare effectiveness and safety of large-bore aspiration thrombectomy (LBAT) with catheter-directed thrombolysis (CDT) for treatment of acute massive and submassive pulmonary embolism (PE).Materials and MethodsThis retrospective review included patients with acute PE treated with LBAT or CDT using tissue plasminogen activator (tPA) between December 2009 and May 2020. A propensity score based on Pulmonary Embolism Severity Index class and PE severity (massive vs submassive) was calculated, and 26 LBAT cases (age 60.2 y ± 17.1, 14/26 women) were matched with 26 CDT cases (age 59.7 y ± 14.2, 14/26 women).ResultsThe CDT group had 22.1 mg ± 8.1 tPA infused over 21.2 h ± 6.6. Both groups demonstrated similar initial and final systolic pulmonary artery pressure (PAP) (LBAT: 54.5 mm Hg ± 12.9 vs CDT: 54.5 mm Hg ± 16.3, P = .8, and LBAT: 42.5 mm Hg ± 14.1 vs CDT: 42.6 mm Hg ± 12.1, P = .8, respectively) and similar reductions in heart rate (LBAT: −5.4 beats/min ± 19.2 vs CDT: −9.6 beats/min ± 15.8, P = .4). CDT demonstrated a higher reduction in Miller score (−10.1 ± 3.9 vs −7.5 ± 3.8, P = .02). LBAT resulted in 1 minor hemorrhagic complication and 2 procedure-related mortalities, and CDT resulted in 1 minor and 1 major hemorrhagic complication.ConclusionsLBAT and CDT resulted in similar reductions of PAP and heart rate when used to treat acute PE. CDT reduced thrombus burden to a greater degree. Although hemorrhagic complications rates were not significantly different, the LBAT group demonstrated a higher rate of procedure-related mortality. Larger studies are needed to compare the safety of these techniques.     

Activation of Stratification Strategies and Results of the interventions on frail patients of Healthcare Services (ASSEHS) DG Sanco Project No. 2013 12 04

To face the challenge of active and healthy ageing (AHA), European Health Systems and services should move towards proactive, anticipatory and integrated care. Health care systems thus need to personalize services, put patients at the centre of care and provide services using the adequate resources. Population health risk management is emphasized through the use of tools to stratify people with chronic diseases according to their risk. Effective screening of frailty is vital for optimizing the care of frail populations at risk. The Activation of Stratification Strategies and Results of the interventions on frail patients of Healthcare Services (ASSEHS) EU project (N° 2013 12 04) is an international effort whose aim is to bring together stratification-related professionals from Health Services, Academia and Research in the EU in order to (i) study current existing health risk stratification strategies and tools, (ii) spread their use and application on frail elderly patients, (iii) minimize deterioration of conditions and/or (iv) prevent emergency or hospital admissions. The analysis of Risk Stratification in different Health Systems will generate conclusions and risk stratification solutions, which will be transferable to a variety of regions in the future. ASSEHS is in line with Area 4 of the B3 Action Plan of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA).     

Comparison of Alcohol Dependence in Subjects from Clinical, Community, and Family Studies

This study contrasts the prevalence of alcohol-related symptoms, ages of onset of alcoholism milestones, and lifetime prevalence of other psychiatric disorders in three samples of alcohol-dependent individuals: alcoholics sampled from a variety of clinical settings (not necessarily alcoholism treatment facilities), relatives of alcoholic probands who participated in a Family Study of alcoholism, and alcoholics identified in the St. Louis Epidemiologic Catchment Area survey. Alcohol dependence (with or without abuse) was assessed using DSM-III diagnostic criteria for all samples. Clinical alcoholics had significantly more lifetime alcohol symptoms than Family Study and Community alcoholics and a significant excess of many alcohol symptoms. Onset information indicated that the three groups were similar in terms of appearance of milestones of alcohol dependence. For females aged 45 or younger, lifetime prevalence of major depression was high in both Clinical and Family Study alcoholics compared with Community alcoholics; male alcoholics from the Community Study had an excess of drug dependence. Findings suggest that, although alcoholics identified in clinical settings may have more severe alcohol dependence, certain types of psychiatric comorbidity are present to a greater degree in other samples of untreated alcoholics.     

智慧图书馆用户行为数据的隐私保护策略

随着信息技术和智慧图书馆的发展,图书馆用户行为信息趋于数据化.对智慧图书馆用户行为数据进行了梳理,对用户行为数据面临的泄露风险和途径进行了分析,并从数据流动过程、数据清洗、馆员职业素养和用户安全防范意识等方面提出了用户行为数据的隐私保护策略.     

实行两级综合目标管理责任制后的思考

近年来，在医院内部实行的两级综合目标管理责任制，对推动医院各项工作的全面发展起到了积极的促进作用，但其负面效应也不可低估。我们对此项工作目前所面临的一些问题提出了思考与对策，特别是对奖金的核算和分配模式不尽合理之处提出一种调整核算和分配结构的模式，以“效益优先、兼顾公平”为原则，旨在不断完善运行机制，加强宏观管理，进一步增强职工队伍的凝聚力，使医院的各项改革循序渐进地健康发展。     

教学医院护理人员工作压力及其应对状况的调查研究

目的了解护理人员的压力及压力应对状况，为科学管理提供决策基础。方法采用普查的方法对同济医院护士进行问卷调查，对工作压力及其应对状况进行统计描述。结果压力得分段最多为52—62分组，占总人数的16．88％；其次为63～73分组．占总人数的15．99％。大多数护士采取积极应对的方式应对压力，应对质量较高。结论为护士提供工作压力相关知识的培训．以减轻工作压力对护士身心所造成的损伤，提高护理工作质量。     

草根组织在艾滋病防治工作中遇到的困难及对策探讨

目的本文是就中原地区部分草根组织(以为称小组)参与艾滋病防治工作中遇到的相应困难进行定性调查,并针对主要问题提出相应对策。方法采用定性调查的方法 ,对小组来自支持环境、小组本身及目标人群等方面的困难进行个人深入访谈及小组访谈。结果支持环境中存在信任不足、干预过多、关注问题的角度分歧等,小组存在资源短缺、开展活动与需求有差距,目标人群中存在曲解小组防治工作等三大方面的困难。结论政府的信任与支持是小组自身成长、发挥自身优势的良好平台,激发社区参与,利用潜在资源,真正体现全社会参与,多部门合作艾滋病防治理念。     

Report from the EPAA workshop: In vitro ADME in safety testing used by EPAA industry sectors

There are now numerous in vitro and in silico ADME alternatives to in vivo assays but how do different industries incorporate them into their decision tree approaches for risk assessment, bearing in mind that the chemicals tested are intended for widely varying purposes? The extent of the use of animal tests is mainly driven by regulations or by the lack of a suitable in vitro model. Therefore, what considerations are needed for alternative models and how can they be improved so that they can be used as part of the risk assessment process? To address these issues, the European Partnership for Alternative Approaches to Animal Testing (EPAA) working group on prioritisation, promotion and implementation of the 3Rs research held a workshop in November, 2008 in Duesseldorf, Germany. Participants included different industry sectors such as pharmaceuticals, cosmetics, industrial- and agro-chemicals. This report describes the outcome of the discussions and recommendations (a) to reduce the number of animals used for determining the ADME properties of chemicals and (b) for considerations and actions regarding in vitro and in silico assays. These included: standardisation and promotion of in vitro assays so that they may become accepted by regulators; increased availability of industry in vivo kinetic data for a central database to increase the power of in silico predictions; expansion of the applicability domains of in vitro and in silico tools (which are not necessarily more applicable or even exclusive to one particular sector) and continued collaborations between regulators, academia and industry. A recommended immediate course of action was to establish an expert panel of users, developers and regulators to define the testing scope of models for different chemical classes. It was agreed by all participants that improvement and harmonization of alternative approaches is needed for all sectors and this will most effectively be achieved by stakeholders from different sectors sharing data.