去乳糖奶粉喂养联合专案管理对新生儿抗生素相关性腹泻患儿预后的影响

[目的]探讨去乳糖奶粉喂养联合专案管理对新生儿抗生素相关性腹泻患儿预后的影响。[方法]选取本院新生儿科收治的新生儿抗生素相关性腹泻(AAD)患儿96例,根据随机数字表法将病人分为对照组及观察组各48例,对照组常规护理及去乳糖奶粉喂养,观察组在对照组基础上实施专案管理,比较两组患儿胃肠功能改善情况、治疗效果及家属满意率。[结果]观察组腹胀消失时间、腹泻消失时间、腹痛消失时间、肠鸣音恢复时间显著短于对照组(P<0.05)。观察组治疗总有效率及家属满意率均高于对照组(P<0.05)。[结论]去乳糖奶粉喂养联合专案管理能有效减轻新生儿抗生素相关腹泻患儿临床症状,促进患儿康复,提高家属治疗满意率。     

医院信息系统与医保联网的问题与对策

医疗保险是国家医疗保险体制改革的重要举措,具有极其重要的意义,建立医保中心与医院信息系统（hospital information system,HIS）的联网,对于提高医保患者的结算效率与医保中心的管理能力,有着重要作用。但各医院在联网与实施过程中会有一些共性的问题,本文就这些问题,提出了对应的解决措施。     

Expertises judiciaires au pénal dans le contexte des désignations par le tribunal correctionnel

Transgressive antisocial acts, which are committed in particular by adolescents and young adults, are more frequent today in France, because the way of life in this changing world has been modified technologically, economically and ethically. This is due maybe to a widening of exchanges and the dissemination of transgressive images through social networks. In France, judges are increasingly calling on psychiatric experts for crimes. This recourse is even compulsory for subjects placed under the protection of justice. Conceptual psychoanalytic data allowed a better assessment of the psychopathological traits affecting the personality of the offenders. The psychiatrist who has to carry out forensic examinations must take into account the psychopathological aspects, personality traits and mixed symptomatology, as well as impulsive acts, aggression, violent affects, borderline states, sociopathic organization and addictions. He/she should also consider the determinism of their actions and the role of interactions with those around them. The goal the psychiatrists must be between protecting and caring before punishing. Courts want to better understand the mechanism of action (often impulsive) but also the nature of the care project promoting rehabilitation. Courts are concerned about the capacity for discernment and self-control, but also about the risk of recidivism.     

佛山市生活垃圾卫生填埋场BOT项目介绍

介绍佛山市高明苗村白石坳生活垃圾卫生填埋场BOT项目的背景、运作过程及其运行效果,分析、总结采用BOT模式建设和运营生活垃圾填埋场项目招标谈判的经验.     

广东省44家口腔诊所牙科X射线诊断放射防护现状及常见问题探讨

目的 掌握广东省44家口腔诊所牙科X射线诊断项目放射防护的相关措施,探讨常见问题。方法 根据放射防护三原则及国家有关法律法规和标准规范,结合放射卫生现场调查、放射防护检测等结果,分析放射卫生防护及管理现况。结果 44家诊所56间机房的平面布局（基本）合理;56台设备的防护性能和质量控制检测均符合标准要求;56间机房的周围剂量当量率为本底～1.47μSv/h,能满足国家标准要求;电离辐射警告标志、工作状态指示灯及门灯联锁、自动闭门、通风及个人防护用品等符合率为85.70%～98.20%;口腔影像医师和专（兼）职管理人员的配置、职业健康监护、放射防护相关管理制度及放射卫生档案等符合率为79.5%～100.0%。结论 牙科X射线诊断机房的放射防护及管理现状较好,需出台或健全相关国家法规、标准等,以规范锥形束CT的质量控制检测、口腔诊所场址要求及放射工作人员的配置等。     

运用护理专案降低血液透析导管相关性感染发生率

目的探讨运用护理专案降低血液透析导管相关性感染发生率的效果。方法选取2019年1月—3月(护理专案实施前)血液透析中心181名血液透析患者为对照组,对血液透析中心血液透析导管相关性感染发生率展开现况调查,分析原因。成立专案团队,与医院感染管理科合作,开展“降低血液透析导管相关性感染发生率”的专案活动,选取2019年4月—8月(护理专案实施后)血液透析中心198名血液透析患者为观察组。比较2组患者血液透析导管相关性感染发生率。结果观察组血液透析导管相关性感染发生率为5.05%,低于对照组的13.81%,差异有统计学意义(P<0.05)。结论护理专案的实施可有效降低血液透析导管相关性感染发生率。     

The Effects of Manual Physical Therapy and Therapeutic Exercise on Peripartum Posterior Pelvic Pain: Two Case Reports

Abstract

Peripartum posterior pelvic pain is a clinical enigma commonly encountered by physical therapists. It is hypothesized that the release of relaxin hormone during pregnancy may result in ligament laxity, which could lead to sacroiliac instability resulting in pain and decreased function. The purpose of these case reports was to describe the effects of manual physical therapy and therapeutic exercise on a peripartum patient with reports of posterior pelvic pain. Two patients referred to physical therapy by their obstetrician during their pregnancy were recruited for these case reports. During the initial examination, both patients completed a number of self-report measures including the Oswestry Disability Index, a body diagram, and the Numeric Pain Rating Scale. Both patients were treated with muscle energy techniques directed at pelvic and sacral positional faults and therapeutic exercise consisting of transverse abdominis and multifidus neuromuscular re-education; isometric hip abduction and external rotation; and a force closure sacroiliac stabilization program directed at neuromuscular re-education of the anterior and posterior oblique sling systems (hip adductors-contralateral obliques and gluteus maximus-contralateral latissimus dorsi combinations). At the time of discharge, both patients again completed the self-report outcome measures as well as a global rating of change. Both patients demonstrated a clinically meaningful improvement in their pain levels as well as perceived disability. In addition, both rated their global rating of change as "a great deal better." These case reports provide preliminary evidence suggesting that manual physical therapy and therapeutic exercise may be an effective intervention strategy for peripartum patients reporting posterior pelvic pain.     

国家自然科学基金青年科学基金项目立项前系统化管理研究

文章从科研管理的角度,分析了医院对国家自然科学基金青年科学基金项目立项前系统化管理的方法与措施.提出了项目申报动员、前期研究准备、专业培训辅导、逐份修改项目申报书、形式审查和内容审查相结合等方法和途径,以完善国家自然科学基金青年科学基金项目立项前系统化管理,为医院科技发展提供借鉴.     

我国医学科研项目结题验收评估工作存在的问题与思考

项目验收评估是科研项目管理中的重要一环.本文通过总结分析当前我国医学科研项目管理工作在评估内容、评估方法、评估模式方面存在的主要问题,结合国际科研项目管理实践经验,提出平衡定性与定量的评估、兼顾指标与内容评估、提高同行评议科学性、依托科技信息服务平台、引入第三方评估机制、建立项目全过程评估体系等观点.本研究可为进一步构建科学、客观的医学科研项目验收评估模式,推动医学科研产学研用一体化发展提供理论基础.