我院92例药品不良反应报告分析

目的：掌握我院ADR发生的特点,旨在避免严重ADR的发生,为临床合理用药提供参考。方法：分析我院2007—2008年间收集到的92例ADR报告,按照年龄、性别、用药情况、ADR涉及器官或系统及临床表现、ADR的结果等,对报表进行汇总分析。结果：92例ADR报告中,抗感染药所占比例最大（占44．57％）,其次为中药制剂（占31．52％）。结论：ADR的发生与药物自身特性,患者体质、临床用药途径等多种因素有关。开展ADR监测工作是医疗机构的一项重要任务,尤其是医务人员在其中起着举足轻重的作用。     

行政干预对减少医院感染漏报的作用

目的 研究行政干预对减少医院感染漏报的作用.方法 采用同顾性调查的方法,对医院2002-2007年住院患者的医院感染病例进行漏报调查及统计分析;观察自2005年采取行政干预等措施后,医院感染的漏报病例是否有所减少.结果 6年问共检查住院病历9550份,发现医院感染漏报49例,其中2005年前3年漏报32例(65.3%),经加强医院感染知识培训和行政干预后,2005年后3年漏报17例(34.7%),两者比较差异有统计学意义(χ~2=10.67,P<0.05);漏报较多的科室为手术科室,漏报较多的部位为下呼吸道、上呼吸道、皮肤软组织、泌尿道.结论 针对医院感染漏报率较高的科室,加强医院感染知识培训和行政处罚相结合,可减少医院感染的漏报.     

气肿性膀胱炎并高血糖高渗状态1例报告并文献复习

目的:认识气肿性膀胱炎并高血糖高渗状态的发病机制及临床特点.方法:回顾性分析1例气肿性膀胱炎并高血糖高渗状态的诊疗体会并结合文献复习.结果:经补液、尿液引流、膀胱冲洗、抗生素的应用及控制糖尿病等治疗3周后患者好转出院.结论:气肿性膀胱炎是罕见的泌尿系感染,有诱发糖尿病患者高血糖高渗状态的可能.治疗时应积极处理诱因,行尿液引流、膀胱冲洗、加强抗感染等治疗措施.     

法定传染病疫情报告卡填写质量分析与监管措施改进探讨

目的评价近期我院法定传染病疫情报告卡填写质量,提出改进措施。方法对773份传染病疫情报告卡填写质量进行分析、评价。结果 773份传染病疫情报告卡中不合格148份,其中最主要的有患者地址不详细(58份,占39.19%),字迹潦草(33份,占22.3%),错别字(29份,占19.59%)。结论法定传染病疫情报告卡填写质量不佳,存在问题及原因较多,医院相关部门应时时提醒、常检查、勤督导,确保对传染病早发现、早上报、早治疗,发现问题及时提出有效的整改措施,可有效控制传染病。     

Acute reactions after a homologous primary COVID-19 vaccination series: Analysis of Taiwan V-Watch data

IntroductionThe ChAdOx1 nCoV-19 (ChAd), mRNA-1273 (m1273), MVC-COV1901 (MVC), and BNT162b2 (BNT) COVID-19 vaccines received authorization for emergency use in Taiwan beginning in February 2021. We investigated acute reactions to homologous primary COVID-19 vaccination series in adults aged ≥ 18 years.MethodsIn this prospective observational study based on smartphone data (Taiwan V-Watch), we calculated the frequencies of self-reported local and systemic acute reactions within 7 days of a COVID-19 vaccination, and the health effects up to 3 weeks after each dose. Those who reported adverse reactions after both doses were assessed by the McNemar test.ResultsDuring 22 March 2021–13 December 2021, 77,468 adults were enrolled; 59.0 % were female and 77.8 % were aged 18–49 years. For both doses of all four vaccines, the local and systemic reactions were minor in severity and highest on days 1 and 2 after vaccination, and declined markedly until day 7. For 65,367 participants who provided data after the first and second doses, systemic reactions were more frequent after dose 2 of the BNT and m1273 vaccines (McNemar tests: both p < 0.001), while local reactions were more frequent after dose 2 of the m1273 and MVC vaccines (both p < 0.001), compared with dose 1 of the homologous vaccine. Among the participants aged 18–49 years, the percentage who missed work on the day after vaccination was slightly higher among women (9.3 %) than among men (7.0 %).ConclusionsAcute reactogenicity and impact of work absenteeism for the four COVID vaccines in the V-Watch survey were mild and of short duration.     

Changes in pelvic alignment in a woman before and after childbirth,using three-dimensional pelvic models based on magnetic resonance imaging: A longitudinal observation case report

3-dimensional pelvic models based on magnetic resonance images (MRI) can be used to investigate accuracy and specifics of changing pelvic alignment during pregnancy and after childbirth. Few studies have investigated changes of pelvic alignment during pregnancy and after childbirth using three-dimensional pelvic models. This case report documents the changes of pelvic alignment during late pregnancy and after childbirth using MRI-based three-dimensional (3D) pelvic models. This was a longitudinal observation case report. A woman was imaged with MRI at 28 and 39 gestational weeks, as well as 4 and 72 weeks after childbirth. Greater internal, anterior, and downward rotation of both innominates at week 39 was observed from that at gestation week 28. Decreased internal, anterior, and downward rotation of both innominates at week 4 after child birth was observed compared with that at gestation week 39. We report the first case in Japan of changes of pelvic alignment measured using an MRI-based 3D pelvic alignment model during pregnancy and after child birth. This case suggests that the small changes of pubic area and greater separation of anterior portions of sacroiliac joints. Internal, anterior, and downward rotation of both innominates was observed in a Japanese primipara woman having no pelvic pain.     

从贝尔蒙报告审视医疗器械临床试验的伦理问题

医疗器械临床试验是最直接最有效地检测医疗器械性能的方式，贝尔蒙报告是对基本的道德原则及方针的陈述，用来帮助在解决涉及人体实验对象的科研中所产生的道德问题。本文从贝尔蒙报告角度来审视医疗器械临床试验的伦理问题，介绍了贝尔蒙报告产生的背景概念和医疗器械临床试验的概念及基本流程；贝尔蒙报告中的三项原则尊重个人、善行和平等公正原则在医疗器械临床试验中的体现以及针对贝尔蒙报告来解决医疗器械临床试验中产生的伦理问题的重大意义。通过知情同意的具体体现、对风险和好处的评估及受试者的选择和研究成果的分配三方面来解决临床试验中产生的伦理问题。     

A Phase III,multicenter, randomized,double-blind,active comparator-controlled study to evaluate the safety,tolerability, and immunogenicity of V114 compared with PCV13 in healthy infants (PNEU-PED-EU-1)

BackgroundV114 (15-valent pneumococcal conjugate vaccine [PCV]) contains all serotypes in 13-valent PCV (PCV13) and additional serotypes 22F and 33F. This study evaluated safety and immunogenicity of V114 compared with PCV13 in healthy infants, and concomitant administration with DTPa–HBV–IPV/Hib and rotavirus RV1 vaccines.MethodsV114 and PCV13 were administered in a 2+1 schedule at 2, 4, and 11–15 months of age. Adverse events (AEs) were collected on Days 1–14 following each vaccination. Serotype-specific anti-pneumococcal immunoglobulin G (IgG) was measured 30 days post-primary series (PPS), immediately prior to a toddler dose, and 30 days post-toddler dose (PTD). Primary objectives included non-inferiority of V114 to PCV13 for 13 shared serotypes and superiority of V114 to PCV13 for the two additional serotypes.Results1184 healthy infants 42–90 days of age were randomized 1:1 to V114 (n = 591) or PCV13 (n = 593). Proportions of participants with solicited AEs and serious AEs were comparable between vaccination groups. V114 met pre-specified non-inferiority criteria for all 13 shared serotypes, based on the difference in proportions of participants with serotype-specific IgG concentrations ≥0.35 μg/mL (response rate; lower bound of two-sided 95% confidence interval [CI] >−10.0) and IgG geometric mean concentration (GMC) ratios (lower bound of two-sided 95% CI >0.5), and pre-specified superiority criteria for serotypes 22F and 33F (lower bound of two-sided 95% CI >10.0 for response rates and >2.0 for GMC ratios). Antibody responses to DTPa–HBV–IPV/Hib and RV1 vaccines met pre-specified non-inferiority criteria, based on antigen-specific response rates to DTPa–HBV–IPV/Hib and anti-rotavirus IgA geometric mean titers.ConclusionsAfter a 2+1 schedule, V114 elicited non-inferior immune responses to 13 shared serotypes and superior responses to the two additional serotypes compared with PCV13, with comparable safety profile. These results support the routine use of V114 in infants.Trial registration: ClinicalTrials.gov: NCT04031846; EudraCT: 2018-003787-31     

普洱市墨江县哈尼医药发展概述

目的:墨江县是全国唯一的哈尼族自治县,为促进哈尼医药的传承与保护,开展哈尼族医药调研。方法:通过文献查阅、人物访谈、问卷调查的方法,了解哈尼医药在墨江县发展的现状。结果:墨江县当地重视哈尼医药的发展,哈尼医药文化保留较为完整,墨江县中医院成立了哈尼医生传承工作室,并运用20余种哈尼民间草药,当地居民对哈尼医药认可度较高,哈尼医药对当地的疾病防治发挥了积极作用。结论:发展哈尼医药应继续加强资金与政策的扶持,重视哈尼医药人才培养,加大哈尼医药相关产品的开发与宣传。