注射用白眉蛇毒血凝酶在妇科手术中的应用研究

目的探究注射用白眉蛇毒凝血酶在妇科手术中的应用疗效。方法选取本院2017年6月至2020年6月收治的50例行妇科手术的患者,按照随机数表法分为实验组与参照组,各25例。实验组术前给予注射用白眉蛇毒血凝酶2 U静脉注射,参照组给予等计量0.9%氯化钠溶液,比较两组出血时间、单位面积出血量、血红蛋白、活化部分凝血活酶时间、凝血酶原时间、凝血酶时间及空腹血糖指标。结果实验组出血时间短于参照组,单位面积出血量少于参照组,血红蛋白高于参照组,作用总有效率(96.00%)明显高于参照组(72.00%),差异有统计学意义(P<0.05);术后,实验组活化部分凝血活酶时间、凝血酶原时间、凝血酶时间及空腹血糖与术前比较差异无统计学意义。结论注射用白眉蛇毒血凝酶应用于妇科手术可减少单位面积出血量和出血时间,凝血状态差异较小,无不良反应,值得临床推广应用。     

断指再植术后应用脉搏血氧饱和度仪早期发现血管危象的研究

[目的]早期发现血管危象的发生,提高再植指成活率。[方法]将病人分为A组和B组,A组56例76指,于断指再植术后1d~5d内应用脉搏血氧饱和度仪监测再植指和对侧相应健指的经皮血氧饱和度(SpO2);B组为30例48指断指再植术后发生血管危象的病人,于危象时立即监测再植指和对侧相应健指的SpO2变化。[结果]A组再植指与健指SpO2变化无统计学意义(P>0.05),而B组再植指与健指SpO2差异有统计学意义(P<0.01)。[结论]应用脉搏血氧饱和度仪对再植指进行SpO2监测,能及时发现血管危象,并有助于分析血管危象的类型。     

Do Ratings of Swallowing Function Differ by Videofluoroscopic Rate? An Exploratory Analysis in Patients After Acute Stroke

ObjectiveTo determine differences between continuous videofluoroscopic swallow studies (VFSS) with a pulse rate and frame rate of 30 and the same swallows reduced to 15 frames per second (fps) on measures of swallowing function in patients after acute ischemic stroke.DesignBlinded comparison.SettingAcute hospital.ParticipantsPatients after ischemic stroke (N=20).InterventionsNot applicable.Main Outcome MeasuresSingle and sequential sips of thin liquids, single sips of nectar liquids, pudding, and cookie boluses were rated on measures of timing of swallowing events, Modified Barium Swallowing Impairment Profile component scores, and Penetration-Aspiration Scale scores. The ratings for videos at 15 fps and 30 fps were compared by Wilcoxon signed rank tests.ResultsPharyngeal transit time was longer and bolus entry into the hypopharynx was later for 30 fps than for 15 fps. Components of Oral Residue and Pharyngoesophageal Segment Opening ratings were more severe for 15 fps than 30 fps, whereas Bolus Transport and Initiation of Pharyngeal Swallow were rated as more severe for 30 fps than for 15 fps. There was no difference between 30 fps and 15 fps on the remaining measures, including Penetration-Aspiration Scale scores.ConclusionContinuous VFSS recorded at 30 fps and their down-sampled 15 fps duplicates yielded contrasting results on certain durational and functional measures of swallowing, though not on others. VFSS should be administered continuously or at 30 pulses per second for valid assessment of swallowing while using other methods to reduce radiation exposure.     

The effects of antifungal stewardship programs at a tertiary-care teaching hospital in Japan

Patients with invasive fungal diseases (IFDs) generally have a high mortality rate, and resistance to antifungal drugs and the high costs associated with it have led to recent problems, necessitating the appropriate use of antifungals. To this end, we launched Antifungal Stewardship Programs (AFSPs) in our hospital. Patients who were systemically administered antifungals from January 2011 to December 2016 were enrolled this study and divided into pre-intervention and intervention groups. No significant difference was observed in defined daily doses per 1000 patient-days (23.3 ± 8.0 vs 20.4 ± 10.8, p = 0.251) between the groups. The monthly average for the days of therapy per 1000 patient-days was significantly lower in the intervention group (15.1 ± 3.1 vs 12.7 ± 4.3, p = 0.009). The cost of the antifungals reduced over the 3-year period by $260,520 (13.5%). Furthermore, a decreasing trend was observed in both the 30-day mortality (40.9% vs 30.0%, p = 0.414) and in-hospital mortality (63.6% vs 36.7%, p = 0.054) in patients with candidemia. Our results indicate that AFSPs are efficacious and cost-effective approaches.     

A test of the resource security and the body mass index reference point hypotheses of body dissatisfaction amongst adolescents in eight countries

Objective. This study aimed to identify cultural-level variables that may influence the extent to which adolescents from different cultural groups are dissatisfied with their bodies.

Design. A sample of 1730 male and 2000 female adolescents from Australia, Fiji, Malaysia, Tonga, Tongans in New Zealand, China, Chile, and Greece completed measures of body satisfaction, and the sociocultural influences on body image and body change questionnaire, and self-reported height and weight. Country gross domestic product and national obesity were recorded using global databases.

Results. Prevalence of obesity/overweight and cultural endorsement of appearance standards explained variance in individual-level body dissatisfaction (BD) scores, even after controlling for the influence of individual differences in body mass index and internalization of appearance standards.

Conclusions. Cultural-level variables may account for the development of adolescent BD.     

iPod Touch在住院病人用药管理中的应用

目的分析口服药物按次包装结合iPod Touch在病房应用的效果。方法选取2013年1-12月妇科住院患者共1200例,随机分为对照组和实验组。对照组共600例患者,以传统的药盒摆药,统计口服药物11258份;实验组600例,运用自动摆药机摆药,采用一次性透明薄膜袋按次包装摆药,并结合iPod Touch的使用,统计口服药物11310份。对两组在药物安全管理、护理满意率等方面进行评价。结果实验组在药物安全管理、护理满意度等方面均较对照组有提高,差异有统计学意义（P＆lt;0.01）。结论口服药物按次包装联合iPod Touch的使用能提高药物安全管理,减少差错的发生,提高护理满意率,提升护理服务水平。