建立大型活动公共卫生风险评估指标体系初探

[目的]梳理大型活动可能面临的公共卫生风险及其来源,为开展风险评估提供客观指标. [方法]采用两轮德尔菲咨询法进行指标筛选,建立两级指标体系.[结果]大型活动公共卫生风险评估指标体系由4项一级指标、17项二级指标组成,其中一级指标包括:(1)风险发生的可能性;(2)风险造成的影响和后果;(3)人群的公共卫生脆弱性;(4)具备的预防处置能力.风险分值计算公式为:p(R)=k[p(H)×p(V)]-AC.两轮专家征询后,所有17项二级指标必要性评分分值的变异系数均小于0.25,但仍有9项二级指标的可获得性评分变异系数大于0.25. [结论]利用公共卫生风险评估指标体系开展风险评估可降低专家的主观性对结果的影响.本指标体系的特点包括:适用范围较广,并不局限于单一类型的大型活动;将预防处置能力纳入评估内容,使评估结果更科学,也对后续应对措施的确定提供更多参考依据.     

肾阳虚证动物模型现代研究概况

肾为先天之本,藏真阴而寓元阳,为水火之脏,只宜固藏,不宜泄漏,所以肾多虚证。肾阳虚证动物模型常用的检测指标有：①一般生命质量评价。②生物化学指标的检测：包括内分泌代谢的检测（包括酶的含量变化,肾上腺、睾丸、血清睾酮水平,微量元素测定）;神经系统的检测;免疫系统的检测。③分子生物学指标。     

新生儿无创正压通气护理质量评价指标体系的构建研究

目的：构建新生儿无创正压通气护理质量评价指标体系,为评价新生儿无创正压通气的护理质量提供依据。方法：以“结构-过程-结果”三维质量评价模型为理论框架,采用文献分析、半结构式访谈、Delphi法和层次分析法确立新生儿无创正压通气护理质量评价指标体系。结果：两轮函询问卷的有效回收率分别为80%、100%,专家权威系数均为0.90,肯德尔和谐系数分别为0.367、0.357（P＜0.001）。最终确立的新生儿无创正压通气护理质量评价指标体系包括一级指标3项、二级指标12项和三级指标66项。结论：构建的新生儿无创正压通气护理质量评价指标体系科学性、可靠性较好,可为新生儿无创正压通气护理质量评价提供依据。     

基于马斯洛需求层次理论农村留守老年人社会支持需求评估体系的构建

目的 构建农村留守老年人社会支持需求评估体系,为科学评估留守老年人的社会支持需求现状提供依据。方法 基于马斯洛需求层次理论,采用文献研究、焦点小组、德尔菲法建立农村留守老年人社会支持需求评估体系,于2020年3—7月对14名专家进行2轮专家咨询,应用SPSS 23.0计算专家积极系数、权威系数与协调系数,经小组讨论后对条目进行修改,应用Yaahp 确定各级指标权重与组合权重。结果 2轮专家函询的有效回收率分别为100%和93%,专家权威系数分别为0.797和0.810,2轮专家Kendall's W系数为0.236~0.529（均P<0.001）。最终形成的农村留守老年人社会支持需求评估指标包括5个一级指标、11个二级指标、56个三级指标。5个一级指标的权重分别为0.315、0.315、0.118、0.192和0.060。结论 本研究构建的农村留守老年人社会支持需求评估体系具有科学性和可靠性,可用于判断农村地区留守老年人的社会支持需求,以构建有针对性的社会支持体系,为养老服务的建设提供参考。     

妇炎舒胶囊联合头孢噻肟钠治疗慢性盆腔炎的临床研究

目的探讨妇炎舒胶囊联合头孢噻肟钠治疗慢性盆腔炎的临床效果。方法选择2020年2月—2020年10月在河南大学淮河医院治疗的74例慢性盆腔炎患者,随机分成对照组和治疗组,每组各37例。对照组静脉滴注注射用头孢噻肟钠,每次2 g加入生理盐水100 mL,2次/d;治疗组在对照组的基础上口服妇炎舒胶囊,5粒/次,3次/d。两组患者均治疗3周。观察两组患者临床疗效,比较治疗前后两组患者临床症候积分,血清血红素氧合酶1(HO-1)、细胞间黏附分子-1(ICAM-1)、粒细胞-巨噬细胞集落刺激因子(GM-CSF)、白细胞介素-26(IL-26)和基质金属蛋白酶-2(MMP-2)水平,Smad-3、miRNA-224-3P和Smad-7水平,子宫血流动力学指标子宫血流搏动指数(PI)、血流最大峰值流速(Vs)和血流阻力指数(RI)。结果治疗后,治疗组总有效率为97.30%,明显高于对照组的81.08%(P0.05)。治疗后,两组中医症候评分均显著降低(P0.05),且治疗组降低更明显(P0.05)。治疗后,两组血清HO-1、ICAM-1、GM-CSF、IL-26、MMP-2水平均明显下降(P0.05),且治疗组下降更明显(P0.05)。治疗后,两组血清Smad-3水平明显降低,而miRNA-224-3P和Smad-7明显升高(P0.05),且治疗组改善更明显(P0.05)。治疗后,两组PI、RI均下降,而Vs均显著增高(P0.05),且治疗组改善更明显(P0.05)。结论妇炎舒胶囊联合注射用头孢噻肟钠治疗慢性盆腔炎可有效改善患者临床症状,降低机体炎症反应,改善血流动力学,其抗炎作用与调节miRNA-224-3P、Smad信号通路有关。     

Student evaluation of simulation in undergraduate nursing programs in Australia using quality indicators

Student evaluation of the implementation of evidence‐based quality indicators for simulation experiences in undergraduate nursing programs in 2012 was explored in this study. The evaluation instrument used five specific measures derived from quality indicators. Students evaluated 10 simulation learning experiences in the first and second years of undergraduate nursing programs at two universities in Australia. Overall, students (n = 85) reported that simulation contributed to their achievement of objectives, but they did not always feel supported in these sessions. Student preparation and orientation was scored lower than other components of the simulation experience. Students reported very good scores for perceived realism and fidelity of simulation sessions, particularly the silicone mask and high‐fidelity sessions, which implies that learning from simulation is transferable into the clinical practice setting. However, patient charts and other clinical documents were not always considered to be realistic. Debriefing was scored very highly overall and for both approaches used for debriefing. The student‐evaluation instrument was an effective means of measuring student‐related quality indicators across a range of simulation sessions. It identified areas for the improved delivery of simulation sessions.     

The effectiveness of an indicator gel in the detection of exposed dentine

Objectives: To investigate the effectiveness of an indicator gel in revealing exposed dentine.

Methods: Teeth prepared into dentine and then stained with the indicator gel were sectioned for histological examination.

Results: The indicator gel was found to stain dentine and thin layers of enamel.

Conclusion: The gel is suggested to be an effective indicator as an aid to acid etching and in the preparation of teeth for resin-bonded restorations.     

Glycine and GABAA receptor-mediated chloride fluxes in synaptoneurosomes from different parts of the rat brain

Strychnine-sensitive, inhibitory glycine receptors have not until lately been considered to play a significant role in neurotransmission in mammalian forebrain regions. In order to investigate the role of glycine as a neurotransmitter in brain we have measured glycine induced chloride fluxes in different adult rat forebrain areas using synaptoneurosomes and a chloride-sensitive fluorescent indicator. The results have been compared to those obtained with GABA. The synaptoneurosomes from every brain area investigated responded to both glycine and GABA with chloride fluxes in a picrotoxin sensitive manner. The effect of glycine was inhibited by strychnine, which had no effect on the GABA-induced Cl⁻ flux. Bicuculline inhibited the effect of GABA, but had no effect on the glycine-induced Cl⁻ flux. Addition of GABA did not affect the response to glycine and vice versa. The endogenous content of glycine and GABA in the synaptoneurosome preparations was about the same and synaptoneurosomes from every brain area investigated released both glycine and GABA upon depolarisation with KCI. The depolarisation induced release of both GABA and glycine was partly Ca²⁺-dependent and partly Ca²⁺-independent. These results indicate that glycine can induce inhibitory Cl⁻ fluxes distinct from GABA induced fluxes in every investigated brain area and that glycine can be released upon depolarisation.     

Critical appraisal of clinical performance measures in Germany.

BACKGROUND: One of the tasks of the Federal Co-ordinating Committee, as part of the self-governing health care system in Germany, is to develop clinical performance measures (CPMs). As these measures generally exert a strong impact on health care delivery, their methodological quality should meet the highest standards. OBJECTIVE: To develop, for use in the German health care system, methodological quality requirements for CPMs and performance assessment programs. MATERIALS AND METHODS: We assembled and reviewed internationally available materials on CPMs. From these we prepared lists of requirements for appraising the methodological quality of CPMs and CPM programs. PRODUCTS: Lists of criteria for use in appraising the appropriateness of the development, content, format and application of CPMs and their value to the health care system for performance measurement; a checklist for assessing the methodological quality of CPMs/CPM programs. CONCLUSION: The methods applied and the products from this project offer a useful framework for prospective CPM/CPM program developers and set a high threshold for the development of methodologically rigorous clinical performance measurement.     

医院实行年度科室综合目标管理考核的尝试

介绍某医院年度科室综合目标管理考核的实践,探讨医院业务科室年终业绩考核指标和考核方法,旨在建立适应现代医院管理需要和医疗市场经济要求的科学、公平和公正的业绩考核体系,促进医院全面、协调和可持续发展.