军队医院合同制医务人员任期考评的实践

为加强军队医院合同制医务人员的用工管理，采用任职期内德，能，勤，绩四个方面定期考评打分，量化综合素质和工作业绩，为其福利待遇及上下岗提供合理依据。任期考适应军队医院合同制医务人员正规化管理要求，有利于合同制医务人员的素质培养及聘用技术队伍的建设与稳定。     

免疫检查点抑制剂治疗少见突变非小细胞肺癌疗效的研究进展

驱动基因的发现及针对驱动基因的靶向治疗已显著提高了肺癌患者的生存质量和时间,但目前对于BRAF、HER2、MET、RET等少见驱动基因改变肺癌患者的靶向药物的选择仍然较少。近年来免疫检查点抑制剂在肺癌治疗中取得了一定的疗效,但因为少见驱动基因突变的肺癌患者本身样本量少,开展大规模临床随机对照试验尚存在一定的困难,目前此类患者接受免疫检查点抑制剂治疗的疗效情况仍不明确。本文将对目前已掌握的免疫检查点抑制剂治疗BRAF、HER2、MET、RET等少见驱动基因改变肺癌患者的临床研究结果进行综述,以期在一定程度上为临床工作提供一些依据和参考。     

患者满意度对护理质量的监督促进作用

目的 :通过调查患者满意度 ,促进护理工作质量的提高。方法 :每月末 ,护理部事先不通知 ,发放调查问卷并当场收回 ,于 2 4h内及时反馈患者的意见 ,由科室制定整改措施。结果 :年护理质量对照差异有显著性 (P <0 0 1) ,各项护理指标均显著上升。结论 :调查患者满意度 ,增强了护士主动服务的意识和护患沟通 ,落实了基础护理、健康教育等 ,保证了护理安全 ,护理管理更具有人性化 ,护理质量全面提高     

孕妇对产前检查的依从性及其影响因素的调查分析

目的调查孕妇对产前检查的依从性及其影响因素，为提高孕妇产前检查的依从性提供思路和方法。方法采用自拟问卷，对广州市某三级甲等医院妇产科住院孕产妇共100例进行现场问卷调查，了解孕妇对产前检查的依从性及影响产前检查依从性的因素，并对结果进行分析。结果68．4％的孕妇产检次数未达标，平均次数为5次。年龄≤30岁和年龄〉30岁的孕妇产检次数未达标率分别为70．4％、65．9％，二者比较差异无统计学意义，P〉0．05。学龄≤9年和学龄〉9年的孕妇产检次数未达标率分别为83.3％和50．0％，不定期做产检率分别为59．3％和29．5％，差异均有统计学意义，P〈0．01。本地人口比流动人口产检次数的达标率要高，二者比较差异有统计学意义，P〈0．01。家庭收入〉3000元／月比家庭收入≤3000元／月的孕妇对产检的依从性好，P〈0．05。70％以上的孕妇认为有无妊娠危险因素、丈夫是否支持、当地医疗条件以及医务人员服务态度这4个因素对自己是否去做产检有影响。结论产前检查在低学历、流动人VI和家庭收入低的孕妇群体中依从性较差。针对影响产检的因素，如何提高这类孕妇的产检依从性值得进一步研究。     

Evaluation of the accuracy of “ChE check mobile” in measurement of acetylcholinesterase in pesticide poisoning

Background: Acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) are used in clinical management to confirm the diagnosis and indicate the severity of organophosphorus and carbamate poisoning. ChE check mobile is a new portable cholinesterase testing system developed in Germany. The study aims to evaluate the accuracy of ChE check mobile compared to the standard reference method and Test-mate ChE system.

Methods: Patients with organophosphorus and carbamate poisoning were recruited from two general hospitals in Sri Lanka between September 2013 and November 2014. The AChE was measured using the three methods.

Results: Blood samples were collected from 185 self-poisoned patients (170 organophosphorus and 15 carbamate) and 20 normal individuals. ChE check mobile correlated well with spectrophotometer readings (Pearson’s correlation coefficient 0.87) but gave higher values (Mean bias for AChE: +6.55 (95% CI: ?11 to 24) U/g Hb). A similar positive bias from Test-mate results was also observed. Applying a correction factor derived from the volunteer samples (dividing by 1.353) greatly improved agreement in pesticide poisoned patients.

Conclusions: ChE check mobile system allowed for rapid determination of AChE activity but gave somewhat higher AChE compared to other methods. Applying a correction factor of 1.353 provide a good agreement to both reference and Test-mate ChE machine in this setting.     

从军队医院会计核算原则谈药品核算的局限性

本文从会计核算的一般原则入手,对《军队医院会计核算办法》中药品核算进行剖析,指出药品核算在遵循可比性原则、配比原则、真实性原则、全面性原则和清晰性原则方面存在一定的局限性,影响药品核算信息的准确性,并基于此在核算科目设置、具体业务处理等方面提出修改建议。     

2007-2010年南充市高坪区新生入学入托预防接种证查验效果

目的评价南充市高坪区新生入学入托预防接种证查验补种效果,探索查验补种活动模式。方法对2007-2010年南充市高坪区新生入学入托摸底调查、查验登记、补证补种记录资料收集统计,采用描述流行病学方法进行分析研究。结果 2007-2010年南充市高坪区共有小学和幼儿园92所,入学入托新生累计40 429人,预防接种证查验率达100%,其中,漏证7 756人,占新生总数的19.18%;漏种11 608人,占新生总数的28.71%,累计漏种疫苗种类5种,计19 145剂次,按程序补种疫苗5种18 552剂次,补种剂次率为96.90%,疫苗可控传染病与同期相比下降97.47%。结论南充市高坪区新生入学入托预防接种证查验效果明显,对疫苗可控制相关传染病不在学校发生和流行起到了关键作用,应坚持继续完善和推广查验补种工作。     

Implementation of an electronic identification system in the setting of perioperative autologous cell salvage transfusion: Experience at a university hospital

Perioperative autologous cell salvage (PACS) is one of the effective strategies in patient blood management (PBM). However, mistransfusion, in which the wrong blood is transfused to the wrong patient, of PACS units has been reported. In this study, we implemented a bar code-based electronic identification system (EIS) for blood transfusion in the setting of PACS transfusion. Between February 2009 and December 2020, a total of 12341 surgical patients (9% of whom received surgical interventions) received blood transfusion, among whom 6595 (54 %) received autologous blood transfusion alone, 2877 (23 %) both autologous and allogeneic blood transfusions, and 2869 (23 %) allogeneic blood transfusion alone. Among autologous blood conservation techniques, PACS units were transfused to 7873 patients (83 %) without a single mistransfusion. Rates of overall compliance with the electronic pre-transfusion check at the bedside for all autologous units and PACS units were 98.8 and 98.5 %, respectively. Our observations suggest that a bar code-based EIS can be successfully applied to PACS transfusion, as well as allogeneic blood transfusion in operating rooms.     

1496名大学生心理健康状况调查

\t\t\t\t\t  目的  \t\t\t\t\t掌握大学生心理健康状况, 为心理健康教育提供科学依据。\t\t\t\t\t  方法  \t\t\t\t\t运用90项症状自评量表对1496名大学生进行测查。\t\t\t\t\t  结果  \t\t\t\t\t调查组学生心理健康水平低于全国常模, 心理障碍检出率为20.72%;大学生心理障碍的种类与性别有关, 来自农村的大学生心理健康水平低于来自城市的大学生, 文科学生与理科学生心理健康水平无显著性差异, 各年级心理障碍检出率无显著性差异。\t\t\t\t\t  结论  \t\t\t\t\t应有针对性地开展大学生心理健康教育。     

祛痰消脂益肝汤治疗脂肪肝的临床探索

目的：探索祛痰消脂益肝汤治疗脂肪肝。方法：将84名50～60岁检查出脂肪肝的机关工作人员,随机分为两组,治疗组服祛痰消脂益肝汤治疗,对照组服降血脂西药治疗,连续治疗3个月,经血脂检查和B超判断治疗效果。结果：在上述各项检查中治疗组的效果都优于对照组。结论：祛痰消脂益肝汤治疗脂肪肝有肯定的疗效。