山东省卫生健康行业网络安全调查与分析

目的/意义调查分析山东省卫生健康行业网络安全现状,精确定位行业网络安全短板,提升风险管理决策能力。方法/过程以问卷方式采集数据,从医疗机构等级和地域分布两个维度进行网络安全差距分析。结果/结论针对当前山东省基层医疗卫生机构信息化建设管理和技术防护层面的问题,提出卫生健康行业网络安全治理具体措施。     

滑膜炎超声影像在评估早期类风湿性关节炎中的诊断价值

[目的]探讨超声检查滑膜炎影像证据应用于2010ACR/EULAR类风湿关节炎(RA)分类标准对评估RA早期诊断的价值.[方法]严格选取54例疑似RA的早期患者,所有患者进行38关节超声检查[GSUS≥1及PDUS(+)]和临床体格检查,分别统计受累关节的数目和部位,将上述三种方法统计的受累关节结果应用于2010ACR/EULAR分类标准评分,统计评分结果.同时对患者进行ACR1987分类标准进行评分.依据《2010ACR/EULAR分类标准联合倡议》以患者使用DMARDs治疗或(和)风湿专科医生判断为RA作为诊断RA的"金标准",计算不同分类标准的敏感性和特异性等指标.比较不同分类标准(方法)间的差异.[结果]54例中以上述标准最终诊断RA37例,符合2010ACR/EULARGSUS≥1标准39例,符合2010ACR/EULARPDUS(+)标准21例,符合2010ACR/EULAR临床体检标准27例,符合ACR1987标准18例.超声不同评估标准GSUS≥1,PDUS(+)与临床体检对"受累关节"检出率比较,GSUS≥1全部关节检出率,PDUS(+)跖趾关节检出率,GSUS≥1总检出率高于临床体检,差异具有统计学意义(P<0.05).2010ACR/EULAR超声不同标准敏感性均高于2010ACR/EULAR临床体检标准及ACR1987标准;其中以2010GSUS≥1敏感性最高,ACR1987最低;特异性PDUS(+)最高,2010GSUS≥1最低;诊断符合率2010GSUS≥1最高,ACR1987最低;约登指数最高为PDUS(+),Kappa值最高为2010GSUS≥1;诊断可靠性(AUC)以2010PDUS(+)最高.[结论]超声不同评估标准能够在多个关节检出临床体检无法发现的亚临床滑膜炎,其中GSUS≥1全部关节、PDUS(+)跖趾关节检出率较高.超声不同评估标准提供关节受累证据应用于2010ACR/EULAR分类标准后该标准诊断效能均高于ACR1987标准及2010ACR/EULAR临床体检标准,诊断效能以2010PDUS(+)提供关节受累证据较高.     

Validity of establishing pediatric reference intervals based on hospital patient data: A comparison of the modified Hoffmann approach to CALIPER reference intervals obtained in healthy children

Objectives

To compare pediatric reference intervals calculated using hospital-based patient data with those calculated using samples collected from healthy children in the community as part of the CALIPER study.

Methods

Hospital-based data for 13 analytes (calcium, phosphate, iron, ALP, cholesterol, triglycerides, creatinine, direct bilirubin, total bilirubin, ALT, AST, albumin and magnesium), measured on the Vitros 5600, collected between 2007 and 2011 were obtained. The data for each analyte were partitioned by age and gender as previously defined by the CALIPER study. Outliers in each partition were removed using the Tukey method. The cumulative distribution function (cdf) was then determined for each analyte value following which, the inverse cdf values of a standard Gaussian distribution were calculated. The analyte values were plotted against the inverse cdf of the standard Gaussian distribution. Piece-wise regression determined the linear portion of the resulting graph using the statistical software R. Linear regression determined an equation for the linear portion in each partition and reference intervals were calculated by extrapolating to identify the 2.5th and 97.5th centiles in each partition based on the inverse cdf values (which would correspond to the values − 1.96 and 1.96 of the Gaussian distribution). Using the 90% confidence intervals for the reference intervals defined by CALIPER and the Reference Change Value (RCV) as the criteria, these calculated reference intervals were compared to those reported previously by CALIPER. Reference samples were also measured on the Vitros 5600 analyzer in an attempt to validate the calculated reference intervals.

Results

In general, the reference intervals calculated from hospital-based data were generally wider than those calculated by CALIPER. None of the reference intervals calculated using the Hoffmann approach fell completely within the 90% confidence intervals calculated by CALIPER.

Conclusions

These results suggest that calculating pediatric reference intervals from hospital-based data may be useful, as a guide, in some cases but will likely not replace the need to establish reference intervals in healthy pediatric populations.     

凯里市2001-2006年食品及公共场所从业人员乙型肝炎检测结果分析

目的为了解凯里市食品及公共场所从业人员乙肝表面抗原(HBsAg)携带状况,为公共卫生监督提供依据。方法对2001-2006年到我中心进行健康体检的19383名从业人员采血用ELISA法检测乙肝感染指标。结果6年HBsAg阳性率为4.06%,其中男性(5.27%)高于女性(3.46%);20岁以下年龄组HBsAg阳性率最高(5.89%),随着年龄的增加,阳性率有降低的趋势;从民族来看HBsAg阳性率最高的是苗族(5.81%),最低的是汉族(2.56%);从文化程度来看HBsAg阳性率最高的是具有初中及以下学历的从业人员(4.68%)。2001-2003年有52.79%体检HBsAg阳性者进行两对半检测,将近1/3的受检者(为模式1、3)正处于急性乙肝病毒(HBV)感染或复制期,2004-2006年有65.56%HBsAg阳性者进行HBeAg检测。结论为了阻断HBV传播,首先,必须加强卫生监督执法和监测工作,对查出具有传染性的人员必须调离该工种;其二,定期进行卫生知识培训;其三,要立法对HBsAg阴性者进行乙肝疫苗的强制接种;其四,加强餐饮娱乐场所环境和物品的消毒和监测。     

医疗机构临床试验质量控制标准实践研究

目的:建立机构内部的临床试验质量控制标准,规范临床试验质量控制工作.方法:根据质量控制实施阶段及侧重点,对质控进行分类;制定以项目启动质控细则及知情同意书、筛选入选表、研究者文件夹等单元模块质控细则,并依照已制定的质量控制标准实施质量控制.结果:制定以质控分类、质控标准细则、质控流程、质控问题判定为内容的临床试验质量控...     

Characterization of process air emissions in automotive production plants

During manufacturing, particles produced from industrial processes become airborne. These airborne emissions represent a challenge from an industrial hygiene and environmental standpoint. A study was undertaken to characterize the particles associated with a variety of manufacturing processes found in the auto industry. Air particulates were collected in five automotive plants covering ten manufacturing processes in the areas of casting, machining, heat treatment and assembly. Collection procedures provided information on air concentration, size distribution, and chemical composition of the airborne particulate matter for each process and insight into the physical and chemical processes that created those particles.     

观光医疗发展行业标准初探

观光医疗作为新兴产业，发展迅速，在印度、泰国等国家已形成一定规模，并创造了巨大的效益。文章总结了观光医疗在这些国家的发展特色’对观光医疗行业标准进行了初步探讨。同时，对我国观光医疗的发展做了一些思考，并提出了几占、建议。     

Exposure of children and adolescents to alcohol advertising on Australian metropolitan free-to-air television

Aim   This study investigated the exposure of underage youth to alcohol television advertising on metropolitan free-to-air television in the five mainland capital city markets of Australia.
Design   Exposure levels (target audience rating points; TARPs) were obtained for all alcohol advertisements screened from November 2005 to October 2006 in each capital city market for: children 0–12 years; underage teens 13–17 years; young adults 18–24 years; and mature adults 25+ years. The 30 most exposed advertisements across age groups were then content-analysed for elements appealing to children and underage youth.
Results   In each of the five metropolitan markets, mature adults were most exposed to alcohol advertising. Children were exposed to one-third the level of mature adults and underage teens to approximately the same level as young adults. However, there was considerable variation in media weight between markets, such that underage teens in two markets had higher advertising TARPs than young adults in other markets.
All 30 highest exposed advertisements contained at least one element known to appeal to children and underage youth, with 23 containing two or more such elements. Fifteen of the 30 advertisements featured an animal.
Conclusions   The self-regulation system in Australia does not protect children and youth from exposure to alcohol advertising, much of which contains elements appealing to these groups.