An expert system to teach troubleshooting of common problems associated with the automated anesthesia recordkeeper

Automated anesthesia recordkeepers have been used to monitor patients during surgery in up to 90% of cases at The Ohio State University. The record-keeping devices are complex and can be difficult to troubleshoot. The 1st-CLASS Fusion Program, an expert system shell-program, has been programmed to allow the resident or nurse anesthetist to solve the two most common types of problems associated with the recordkeeper: printer problems and patient monitor problems. Use of this program allows the resident or nurse anesthetist to troubleshoot the recordkeeper quickly and accurately and promotes in the user a sense of competence and control over the technology.     

A Study on the Compliance of the Patients with Ocular Fundus Diseases

Purpose: To investigate the compliance of the patients with ocular fundus diseases with recommendation for follow-up examination after laser treatment, and the underlying reasons for non-compliance.Methods: 53 patients with ocular fundus disease were asked to fill in a questionnaire which includes the socio-demographic characteristics, fear of the fundus disease, conception of the laser treatment and the motivation for staying healthy. Variables were compared for the compliers group and the non-compliers group by chi-square test. Result; Of the 53 subjects, 35 were classified as non-compliers and 18 were classified as compliers. There was no statistically significant difference between the two groups on all selected socio-demographic factors, conception of the laser treatment and the motivation for staying healthy. Significant difference was found between the two groups on two of those items concerning the fear of the diseases (P<0. 05). About half of the participants showed the lack of knowledge about     

Physicians and death: Comments and behaviour of 605 doctors in the north-east of Italy

The aim of this study was to determine the influence of socio-demographic and professional factors on physicians' attitudes to the terminally ill. Between May 1992 and May 1993, a survey was conducted in the province of Pordenone (north-east, Italy) in order to analyse a number of specific issues, such as emotional involvement, the need for aggressive treatments and the communication of diagnosis and prognosis. After obtaining a list of board-certified physicians from the Medical Association office in Pordenone, a modification of the cancer questionnaire of Haley and Blanchard (QSPT) was mailed to 916 doctors. Of these, 605 (60%; 487 male, 118 female; mean age 41 ± 11 SD) returned the completed questionnaire. Within the group of responders, we identified three main subgroups, according to their type of activity: general practitioners (175, 29%), hospital doctors (235, 39%) and other doctors (195, 32%). In age, sex and activity, the only significant difference between responders and non-responders was age (mean age 41 and 43 years respeetively). Most of the responders (77%) stated that they were able to deal with the terminally ill patient and his/her needs; 44%, however, admitted that patients' anxiety is sometimes unbearable. For the vast majority of the doctors polled (91%), providing a comfortable environment for an incurable patient was more important than pursuing aggressive treatment, but only 44% were convinced of the uselessness of aggressive care. To the question on whether to disclose information about imminent death to allow patients to prepare spiritually, 37% answered No, 38% Yes, and 25% were uncertain. Almost all responders (95%), however, believed in the beneficial effect of hope on the terminally ill. Ourresults suggest that doctors' professional and, most of all, sociodemographic and cultural factors determine the relationship with the patient on both the emotional and the clinical decision-making levels.     

RT-PCR法检测SARS的临床诊断意义

目的 探讨早期、快速诊断严重急性呼吸综合症(SARS)的实验室诊断方法。方法 在己经确诊为SARS的100例患者中随机抽取40例作为实验组;随机抽取40例正常人作为对照组:从标本中提取RNA,经反转录和巢式PCR扩增出相应大小的DNA片段。对这些片段克隆后进行DNA序列分析,并将序列与SARS冠状病毒和其他己知冠状病毒进行同源性分析。结果 对照组的阳性率为1%,病人组的阳性率为80%,经卡方检验X2=5.1,P<0.05有显著性差异。结论 该方法对临床早期诊断有一定的意义。     

“非典”患者康复出院6个月后免疫功能分析

目的 :检测和分析“非典”患者康复出院半年后的免疫功能。方法 :对 2 8例“非典”康复者出院半年后外周血分别进行免疫功能 :免疫球蛋白、补体、T淋巴细胞亚群检测和分析。结果 :“非典”患者康复出院后 6个月后免疫功能免疫球蛋白、补体、T淋巴细胞亚群检测值和对照组比较差异均无显著性 (P >0 0 5 )。结论 :SARS患者出院 6个月后虽仍存在不同程度的免疫功能异常 ,但与正常对照组比较无显著性差异。其免疫功能异常的原因可能与疾病本身、有基础病及年龄高有关。     

传染性非典型肺炎临证点滴

传染性非典型肺炎 (SARS)属于中医学温病范畴。我们于 2 0 0 3年 4月 2 2日进驻朝阳区SARS医院 ,收治了 2 4名非典患者 (其中危重症 6人 )。SARS重症运用中西医结合治疗 ,亦收到了显著疗效。提示中西医结合治疗SARS可缩短疗程 ,提高疗效。已经使用激素的患者 ,配合中药治疗 ,撤减激素用量 ,减轻激素的副作用。出院 1个月后 ,对 19例痊愈出院的非典患者进行了追访 ,1例因感染结核再次住院 ,激素用量大的恢复较慢 ,尚有胸闷、气短、乏力等症状 ,其余预后良好。1　诊断标准传染性非典型肺炎临床诊断标准———按卫生部5月 4日公布的试行…     

SARS辨证论治及其中医现代化琐议

今年初SARS袭击我国,警示了我们必须认真研究当代各种医学方法.同时提标我们对中医的认识还有很多不正确的地方,特别是中医的辨证论治基本思想;进而涉及到中医现代化问题.力图从历史,从认识论的层面探讨中医现代化的一些现实问题,以求得到同行的共识.     

放疗病房发生医院感染的原因分析

为了解放疗病房医院感染的发病情况，对1995年8月～1996年7月间所有的放疗科的160例住院病人进行回顾性分析。结果发现年医院感染发病率为19．4％（31／160），年例次发病率为21．3％（34／l160）。有无基础病的发病率差异显著，接受抗癌治疗的病人处在多种致病危险因素之中。以抑制免疫功能、降低抵抗力为主要致病原因。感染发生的疾病前三位为临床败血症、急性支气管炎、肺部感染。因此，提醒人们发生在放疗病房的医院感染有其特殊性，要加强对放疗科各级医务人员的医院感染知识的教育，以便对发生的感染能够及时、有效的控制。     

肿瘤患者合并肺部念珠菌感染药敏测定研究

采用ＲＰＭＩ１６４０及ＦＤＡ抗生素３号两种培养基的微量稀释法对肿瘤患者合并肺感染分离出５１株念珠菌进行药敏对比测定。结果显示二性霉素Ｂ在两种培养基中均具有非常好的抗菌活性，敏感率均为９８．０％，其次酮康唑也显示出良好的抗菌活性，敏感率均为９４．１％。相比之下，在ＲＰＭＩ培养基中伊曲康唑和氟康唑的敏感性稍差，敏感率分别为９２．２％和９０．２％，但在ＦＤＡ抗生素３号培养基中，伊曲康唑和氟康唑敏感性明显下降，敏感率分别为７０．６％和６６．７％。为此我们建议抗真菌药敏试验，尤其是咪唑类药物应该选用ＮＣＣＬＳ推荐的ＲＰＭＩ１６４０培养基做药敏试验