What is the impact of day care on older people with long-term conditions: A systematic review

There is a lack of robust evidence regarding outcomes for day care use among older people living with long-term conditions (LTCs). Day care is provided by independent, private and voluntary and charitable sectors. This systematic review aims to establish current evidence of outcomes for older people with LTCs attending day care services and outcomes on carers, across all service models. Narrative synthesis of quantitative and qualitative data was undertaken. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic literature search was carried out across eight electronic databases and reference lists of key journals between 2004 and October 2020 were searched. Searches returned 1,202 unique titles. Forty-five articles from 16 countries met the criteria on review of title, abstract and full article. There is limited evidence suggesting improved levels of perceived psychological health, quality of life, perceived general health, physical health and functioning for older people attending day care who have LTCs. The respite function of day care resulted in positive outcomes for carers. Studies evaluating outcomes for participants or carers were limited in quantity and quality. There is limited information regarding outcomes for day care attendance for older people with multiple LTCs from existing literature. Further research focusing on LTCs and day care attendance would benefit this field.     

日间手术对控制医疗费用的应用效果探讨

目的通过对出院主诊断为"子宫内膜息肉"的日间手术和非日间手术患者病案首页数据进行对比分析,探讨日间手术的推广带来的经济效益和社会效益。方法采用回顾性研究,从某三甲综合医院病案首页系统中提取2019年全年出院诊断为"子宫内膜息肉"的日间手术和非日间手术患者的数据,建立数据库,运用SAS9.4软件进行对比分析。结果"子宫内膜息肉"患者采用日间手术治疗较非日间手术相比,能有效降低患者医疗总费用;从费用结构来看,日间组患者的综合医疗服务类、诊断类、药品类和其他类费用支出均低于非日间组;日间组和非日间组患者在治疗费和医用材料费的差别无统计学意义。结论日间手术的开展能有效提高医院床位使用效率,有助于降低患者的住院医疗费用,有利于提高医院社会效益。     

2016—2019 年天津市河北区流行性感冒监测分析

目的 了解 2016—2019年天津市河北区流感流行特征,为有效防控流感提供相应科学依据。方法 对 2016—2019年天津市河北区流感样病例(Influenza-likecases,ILI)监测资料、病原学监测数据及暴发疫情信息进行分析。结果 2016—2019 年共采集IL咽拭子标本 2 962份,流感病毒核酸检测阳性标本为 715份,阳性率为 24.14%;2016—2019年共报告流感样病例暴发疫情 10起,均发生在中小学校。2016—2019 年天津市河北区流感样病例百分比 (IL%)在每年 11 月—次年 2 月出现一个高峰,呈现明显的季节性特征;2016—2019 年流感病原监测结果显示,天津市河北区流行毒株以甲型 H3N2 型和甲型 H1N1型交替出现为主,2017 年甲型与乙型 Yamagata 系混合流行,2019 年甲型 H3N2 型呈优势毒株。结论 2016—2019 年天津市河北区流感病毒以甲型 H3N2 型和甲型 H1N1 型为主,每年的流行毒株各不相同,呈交替或混合流行。应加强监测和流感防控并提高重点人群流感疫苗接种率。     

内蒙古4盟市后天梅毒报告病例数据质量调查

目的　了解内蒙古自治区梅毒报告病例数据的质量,发现存在的问题,提出改进措施。方法　选取2018年7月1日—2019年6月30日内蒙古自治区4个盟市的30家医疗机构的895例后天梅毒报告病例进行调查,包括核对传染病报告卡、临床和实验室原始资料等,评价其信息质量指标和诊断质量指标。结果　4个盟市的报卡填写完整率、正确率、信息录入正确率、病例报告及时率、过度报告率、重复报告率分别为97.65%、92.63%、89.16%、91.06%、13.85%、3.46%。不同盟市的报告卡的填写正确率、病例报告及时率、过度报告率和重复报告率的差异均有统计学意义（P均＜0.05）。后天梅毒病例诊断正确率为66.93%,不同地区间差异有统计学意义（χ2=45.963,P=0.000）。不同地区间一期梅毒分期正确率、隐性梅毒分类正确率的差异均有统计学意义（P均＜0.05）。皮肤性病科、非皮肤性病科报告病例正确率分别为74.90%、57.63%,差异有统计学意义（χ2=29.967,P=0.000）。结论　内蒙古自治区梅毒疫情报告质量参差不齐,梅毒诊断正确率、分期正确率低,影响梅毒发病率与发病趋势的分析,须加强梅毒报告、诊断标准的培训,切实提高病例数据的质量。     

我国"乡聘村用"政策典型地区实践经验与启示

目的:分析我国"乡聘村用"政策进展和典型地区实践经验,分析推进"乡聘村用"政策的问题与挑战,为推进乡村医生队伍建设提供政策建议。方法:利用我国卫生健康统计年鉴相关数据进行定量分析;收集我国典型地区政策、报告等资料,进行案例分析。结果:"乡聘村用"在我国具有一定的政策基础,在全国范围内已经具有一定实践规模。从人员资质、人事管理和养老保障及资金来源方式等角度看,在典型地区的实践对推进"乡聘村用"政策的挑战是增加财政支出、乡村医生队伍老龄化和县乡管理能力不足。结论与建议:典型地区经验表明"乡聘村用"政策是转变乡村医生身份、解决乡村医生养老等社会保障问题的有效途径。建议各地借鉴典型经验积极推进"乡聘村用"政策,加大地方财政支持力度;加强县级和乡镇卫生院管理能力;同时,稳步推进政策,避免各类乡村医生之间产生矛盾。     

产科并发症与精神分裂症的病例对照研究

目的 探讨产科并发症与精神分裂症的关系。方法 病例对照研究,单因素、多因素分析。并计算相对危险度和95%的可信限。结果 单因素分析显示,孕期并发症（OR=4.63,95%CI=1.27-20.66）、生产并发症（OR=3.29,95%CI=1.06-11.29)达到统计学意义。特别分层分析,男性生产并发症发生率明显高于对照组。多因素分析,孕期营养差、孕期并发症与精神分裂症有密切的关系,OR（95%CI）分别为3.98(1.13-14.07),4.93(1.44-16.86)。结论 精神分裂症的发生与孕期、生产期环境因素密切相关,孕期、生产期损伤者为精神分裂症的高危人群。     

斯蒂克勒综合征5例分析

目的 探讨斯蒂克勒综合征的眼部及其他临床表现。方法 对一个家第三代５例患者进行临床分析。结果 ５例患者主要眼部表现为不同程度的近视、白内障、玻璃体变性、尖发难治的视网膜脱离。患者身材疲长,下颌稍小,无关节病和脊柱异常。结论 我勒综合征是一种罕见的以眼部症状为特征的遗传性闰病。     

Differences in incidence and fatality of COVID-19 by SARS-CoV-2 Omicron variant versus Delta variant in relation to vaccine coverage: A world-wide review

We aim to evaluate the evolution differences in the incidence and case fatality rate (CFR) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta and Omicron variants. The average incidence and CFRs were described between different countries. A gamma generalized linear mixed model (GLMM) was used to compare the CFRs of Delta and Omicron variants based on vaccination coverage. Totally, 50 countries were included for analyses. The incidence of coronavirus disease 2019 (COVID-19) ranged from 0.16/100,000 to 82.95/100,000 during the Delta period and 0.03/100,000 to 440.88/100,000 during the Omicron period. The median CFRs were 8.56 (interquartile range [IQR]: 4.76–18.39) during the Delta period and 3.04 (IQR: 1.87–7.48) during the Omicron period, respectively. A total of 47 out of 50 countries showed decreased CFRs of the Omicron variant with the rate ratio ranging from 0.02 (95% confidence interval [CI]: 0.01–0.03) (in Cambodia) to 0.97 (95% CI: 0.87–1.08) (in Ireland). Gamma GLMM analysis showed that the decreased CFR was largely a result of the decreased pathogenicity of Omicron besides the increased vaccination coverage. The Omicron variant shows a higher incidence but a lower CFR around the world as a whole, which is mainly a result of the decreased pathogenicity by SARS-CoV-2's mutation, while the vaccination against SARS-CoV-2 still acts as a valuable measure in preventing people from death.     

体外冲击波碎石治疗输尿管结石646例报告

目的：探讨ESWL治疗646例输尿管结石效果,分析了20例治疗效果较差的原因。方法：采用低能量增加冲击次数的治疗方法,治疗前行B超,KUB,同位素肾图及IVU等检查,治疗后行B超,KUB或IVU复查及临床随访,结果：一次成功53．9％,复治率46．1％,总成功率96．9％。结论：提示采用低能量增加冲击次数,同样可以联得较好的碎石效果。