优势专科建设的效应

通过本院优势专科第一周期建设中取得的绩效,重点阐述了科研、人才培养、社会效应和经济效应等几个方面,充分体现了优势专科建设的必要性和优越性,明确了今后的目标和任务,重视优势专科建设,促进医院医疗水平再上新台阶.     

Lower rates of emergency department injury visits among Latino children in the USA: no association with health insurance.

BACKGROUND AND OBJECTIVE: Latino children have lower rates of injury visits to emergency departments (EDs) than non-Latino white and African American children. This study tests the hypothesis that this difference reflects health insurance status. DESIGN: Secondary analysis. Patients/ SETTING: Children under 19 years of age visiting EDs in the USA, sampled in the National Hospital Ambulatory Medical Care Survey of EDs (NHAMCS-ED) from 1997 to 2001. MAIN OUTCOME MEASURES: Rates of ED injury visits; ED injury visit rates by race/ethnicity stratified by health insurance and adjusted for other covariates; subtypes of injury visits; and procedures and hospital admissions by race/ethnicity. RESULTS: Injuries accounted for >56 million, or 40.5%, of total ED visits among pediatric patients. Injury visits occurred at lower rates for Latino children (9.9 per 100 person years) than non-Latino white and African American children (16.2 and 18.3, respectively), although total ED visit rates were similar. Regardless of health insurance status, Latino children had lower rates of injury visits than non-Latino white and African American children. Latino children had lower rates of the three major subtypes of injury visits (sports, accidental falls, struck by/between objects). Latino children had similar rates of procedures and hospital admissions to non-Latino white children. CONCLUSIONS: Irrespective of their insurance status, Latino children have lower rates of ED injury visits in the USA than non-Latino white children. Possible reasons for this difference include different healthcare seeking behavior or different injury patterns by race/ethnicity, but not differences in health insurance status or barriers to accessing ED care.     

The Evaluation of Suspected Pediatric Sexual Abuse

Children with suspected sexual abuse often present to the ED, not infrequently like those in the 2 cases described. Most children who are sexually abused have normal genital examinations, which should be explained in discussions with caretakers and investigators. Interviewing of the child should be avoided by the physician, except to establish current symptoms that may impact examination or testing. Exams should not be forced on children. The hymen is extremely sensitive in the unestrogenized female and should not be touched. Speculum examination is never performed in the prepubertal child, except under anesthesia by a practitioner experienced in child sexual abuse evaluation or gynecology. Examination under anesthesia by a physician experienced in surgical repair is indicated with active vaginal or rectal bleeding. In cases in which the examination is abnormal or inadequate, the subspecialist should be consulted. Patients with contact less than 72 hours before presentation may need forensic evidence collection, which should be coordinated with the subspecialist. Prepubertal females with vaginal discharge seen on examination should have testing sent not only for STDs, but also for non-STD etiologies including group A streptococcus and enterics. Postexposure prophylaxis (pregnancy, STD, HIV) should be considered when appropriate. There are many conditions that may be mistaken for sexual abuse. Detailed documentation of the history and the physical examination (written, drawings, and ideally photographs) is essential.     

我院2002-2003年急诊科用药分析

目的:了解我院急诊科治疗药物的应用情况.方法:采用药物利用分析法对我院急诊科2002-20∞年所用药物的销售金额、品种及应用频度进行分析.结果:2002-2003年急诊科用药的销售金额和用药频度呈增长趋势.结论:急诊科用药结构稳定,用药情况基本合理.     

我院儿科门诊抗生素用药分析

目的:为了了解目前儿科门诊抗生素的使用情况,促进临床抗生素的合理使用,提供参考.方法:随机抽取2003年7月～9月门诊西药处方11703张,统计抗生素处方占处方总数的百分比,两种口服抗生素联合用药和两种注射抗生素联合用药方式,前10位两种注射抗生素联用品种以及前10位两种口服抗生素联用品种.结果:含有抗生素的处方占处方总数的64.75%,口服抗生素处方占含抗生素处方的34.99%,注射抗生素处方占含抗生素处方的65.01%.结论:抗生素使用率较高,剂量偏大,个别联合用药方式有的无理论根据,有的明显不合理,有的甚至属滥用.     

门诊口腔科医院感染因素分析与对策

目的进一步探讨引起门诊口腔科医院感染的因素,采取有效控制措施. 方法 2002年3月～2003年2月对门诊口腔科医疗器械、物体表面、医护人员手进行了目标性监测.将2001年3月～2002年2月进行的监测资料作为对照组;将加强管理后2002年3月～2003年2月期间的监测资料作为观察组;比较两组合格率. 结果采取有效管理前门诊口腔科医疗器械合格率77.08%,物体表面合格率72.92%,医务人员手合格率81.25%;采取管理措施后,门诊口腔科医疗器械合格率100.00%,物体表面合格率95.83%,医务人员手合格率100.00%. 结论医疗器械、物体表面、医护人员手易受污染,可引起医院感染,加强医院感染管理工作能有效控制门诊口腔科的医院感染.     

精神科与综合科护士工作压力源调查分析

目的:了解精神科护士工作中主要的压力来源及程度,为减轻护士的压力提供科学依据.方法:采用问卷调查法,对精神科109名护士和综合科124名护士进行护士工作压力源的调查和对照分析.结果:两组在压力源量表5个子条目均分的比较无显著性差异(P＞0.05),但在各分条目的比较中存在差异.精神科护士在护理专业及工作方面的问题压力程度较高,在病人护理方面,担心出现差错事故、病人不礼貌、病人不合作、3个压力源与综合科护士相比差异有显著性意义(P＜0.05-0.01),在其他3项有差异的分条目比较中,精神科护士的压力程度均低于综合科护士.结论:精神科护士的压力源主要来自服务对象及精神科专业方面.提示:提高精神科护士的福利待遇和社会地位,增强安全设施,降低职业风险是减轻精神科护士工作压力的有效措施.     

对我国急诊医学发展的思考与探讨

回顾了我国急诊医学发展历程,找出了我国综合性医院急诊科的现状和所存在的问题,分析了我国急诊医学发展落后的原因,提出了促进我国急诊医学发展的一些新思路.     

3D打印在眼科血管性疾病的应用进展

近年3D打印技术在各个领域广泛应用,在医学领域的应用也日趋增多,为医学研究的发展提供了新的方向。作为一种数字化制造技术,3D打印在对眼科疾病的评估、研究和治疗中发挥了重要作用。目前,3D打印的生物材料、细胞、组织和器官在眼科逐渐投入应用并引起重视,同时展现出巨大的潜力。随着医学成像技术的发展和打印技术的进步,3D打印与各种医学成像技术结合使眼部血管可视化,有助于眼科血管性疾病的研究和诊断。本文主要对3D打印在眼科血管性疾病的应用进展进行简要综述。