升降汤加减治疗食管癌术后胃肠功能紊乱的疗效观察

目的 探讨对食管癌术后胃肠功能紊乱患者采用升降汤进行治疗的效果及对生活质量的影响。方法 选取2015年1月—2019年1月在我院进行食管癌手术的患者,遴选术后出现胃肠功能紊乱及符合纳入标准的患者60例作为本研究对象,根据随机原则分为对照组（30例,采用西药治疗）与观察组（30例,采用西药联合升降汤加减治疗）,比较两组患者的治疗效果及生活质量。结果 经过不同方案的治疗后,与对照组比较,观察组患者总有效率与生活质量更高,差异有统计学意义（P <0.05）;与对照组比较,观察组患者临床症状评分与并发症发生率的更低,差异有统计学意义（P <0.05）。观察组患者经治疗后肠鸣音恢复时间、首次排便时间及首次排气时间较对照组更短,差异有统计学意义（P <0.05）。结论 食管癌术后胃肠功能紊乱患者采用升降汤加减进行治疗后,能有效改善患者的临床症状,提高生活质量,且治疗后的并发症率较低,可在临床上进行推广使用。     

荆州市两所医院护士睡眠质量及其相关因素调查分析

目的了解护士睡眠质量并分析影响睡眠的相关因素。方法采用整群抽样的方法,以匹兹堡睡眠质量指数（PSQI）、爱泼沃斯思睡量表（ESS）以及睡眠质量影响因素调查表评定两所三级甲等医院护士的睡眠情况和影响因素。结果发出问卷290份,收回有效问卷245份。PSQI得分（5．88±3．46）分,27．3％的护士睡眠质量较差。ESS得分与PSQI睡眠指数呈明显的负相关,ESS评分越高,护士睡眠质量越差。结论采取措施,改善环境,提高睡眠质量,加强护理人员的睡眠知识教育。     

The role of electronic medical records in improving health care quality: A quasi-experimental study

The Teleprimary Care—Oral Health Clinical Information System (TPC-OHCIS) is an updated electronic medical record (EMR) that has been applied in Malaysian primary healthcare. Recognizing the level of patient satisfaction following EMR implementation is crucial for assessing the performance of health care services. Hence, the main objective of this study was to compare the level of patient satisfaction between EMR-based clinics and paper-based clinics.The study was a quasi-experimental design that used a control group and was conducted among patients in 14 public primary healthcare facilities in the Seremban district of Malaysia from May 10, to June 30, 2021. Patient satisfaction was assessed using the validated Short-Form Patient Satisfaction Questionnaire, which consisted of 7 subscales. All data were analyzed using the IBM Statistical Package for Social Sciences version 21.A total of 321 patients consented to participate in this study, and 48.9% of them were from EMR clinics. The mean score for the communication subscale was the highest at 4.08 and 3.96 at EMR-adopted clinics and paper-based record clinics. There were significant differences in general satisfaction and communication subscales, with higher patient satisfaction found in clinics using EMR.With the utilization of EMR, patient satisfaction and communication in delivering healthcare services have improved.     

Impact of Dietitian-Led Nutrition Therapy of Food Order on 5-Year Glycemic Control in Outpatients with Type 2 Diabetes at Primary Care Clinic: Retrospective Cohort Study

The aim of this retrospective cohort study was to evaluate the effect of 5-year follow-up of dietitian-led medical nutrition therapy (eating vegetables before carbohydrates) on glycemic control in outpatients with type 2 diabetes (T2DM) at a primary care clinic. A total of 138 patients with dietitian-led medical nutrition therapy (intervention group) and 104 patients without dietitian-led nutrition therapy (control group) were compared for glycemic control, serum lipid, blood pressure, and diabetic complications for 5 years. Each patient in the intervention group received dietary education focused on food order (eating vegetables before carbohydrates) by dietitians. A significant improvement in HbA1c after 5 years in the intervention group [8.5 ± 1.7% (69 mmol/mol) to 7.6 ± 1.1% (59 mmol/mol), p < 0.001] was observed, whereas no change was observed in the control group [7.9 ± 1.2% (62 mmol/mol) to 8.0 ± 1.2% (63 mmol/mol)]. Dietary intake of protein, fat, carbohydrates, cholesterol, and salt in the intervention group demonstrated significant reduction, while the intake of dietary fiber significantly increased after the dietary education. Simple dietary education of ‘eating vegetables before carbohydrates’ presented by dietitians achieved good glycemic control after a 5-year period in outpatients with T2DM at primary care clinic.     

痛风方剂颗粒质量标准研究

目的 建立痛风方剂颗粒的质量控制方法,确保制剂质量稳定可控、安全、有效.方法 对展开剂及展开条件进行筛选,采用薄层色谱法定性鉴别制剂中的防己、黄柏、当归;采用高效液相色谱法测定痛风方剂颗粒中粉防己碱的含量.结果 分别以正己烷-氯仿-甲醇(7.5∶4∶2)、正丁醇-冰醋酸-水(7∶1∶2)、石油醚-乙酸乙酯(4∶1)为展开制,可对痛风颗粒制剂中的防己、黄柏、当归进行定性鉴别.采用Kromasil C8柱(250 mm×4.6 mm,5μm)为分析柱,以含0.6%三乙胺的0.01 mol/L磷酸二氢钾缓冲液(用磷酸调pH至3.O)-甲醇-乙腈(50:20:30)为流动相.可对痛风颗粒制剂中的粉防己碱含量进行测定.粉防己碱的质量浓度线性范围为4.0-40.0 p.g/mL(r=0.999 8),平均回收率为99.41%,RSD=1.63%(n=9).结论 所建立的薄层色谱鉴别方法和高效液相色谱法专属性强、重复性好,可分别用于痛风颗粒制剂的质量控制.     

军队医院在非战争军事行动中药材保障的做法与探讨

目的 探讨部队医院在非战争军事行动中的药材保障方法.方法 以医院在抗击非典和甲流、载人航天实验任务、抗震救灾、奥运会等非战争军事行动中的药材保障做法为基础,进行总结和分析.结果 非战争军事行动药材需求和保障有其特点,可引入现代药材保障的新技术、新方法,提高非战争军事行动药材保障能力.结论 非战争军事行动中药材保障是非战争军事行动卫勤保障的重要组成部分,需要在实际行动中不断总结经验,开展系统研究,提高保障能力.     

Application of a Modified Healthy Eating Index (HEI-Flex) to Compare the Diet Quality of Flexitarians,Vegans and Omnivores in Germany

Interest in plant-based nutrition has steadily increased in the western world in the recent years. The number of people following a meat-reduced, flexitarian diet is growing continuously. However, little is known about the diet quality of flexitarians compared to vegans or omnivores. Therefore, in this cross-sectional study, the food intake of 94 participants aged between 25–45 years was recorded via a validated food frequency questionnaire and 28 self-designed questions about the consumption of plant-based alternatives. An adapted Healthy Eating Index, HEI-flex, was developed to evaluate the diet quality of flexitarians, vegans and omnivores. Higher score points (SP) of the HEI-flex are associated with higher compliance with the official diet recommendations (V_max = 100 SP). Finally, flexitarians scored significantly more highly when compared to omnivores (54 ± 8 vs. 47 ± 9 SP; p = 0.008) but lower than vegans (54 ± 8 vs. 61 ± 10 SP; p = 0.010). The results showed that the HEI-flex is a useful tool for assessing and comparing the diet quality of flexitarians, vegans and omnivores. Despite the consumption of highly processed plant-based alternatives, reduction in meat and meat products seems to be accompanied by increased overall diet quality.     

静脉用药调配中心1559例不合理用药分析

目的促进临床合理用药,保障患者安全用药。方法总结医院静脉用药调配中心2010年6月至2011年6月不合理用药医嘱,并归类、分析。结果不合理用药医嘱计1 559份,分别为溶剂选择、药物用量、药物用法、配伍禁忌、医嘱录入错误、中西药合用等不合理。通过干预,医师纠正1 502份,纠正率96.34%。结论药师运用药学专业知识审核医嘱,可以有效提高临床合理用药水平。