Perspectives of Medical Experts’ on Health Culture for Human Papillomavirus (HPV) Vaccination Compared to Auxiliary Health Workers

Background and Objectives: The viewpoints of Shahid Beheshti University of Medical Sciences medical experts’’ were compared with those of auxiliary health workers regarding health culture related to human papillomavirus vaccination in 2020. Methods: In this cross-sectional study, 220 medical experts’ (gynecologists, cultural, psychological, infectious, dermatological, and educational) and auxiliary health workers were randomly selected and investigated. The required data were collected using a researcher-made questionnaire modeled on international questionnaires. These questionnaire contained demographic information on the subjects’ age and sex as well as health culture was also assessed by measuring the knowledge, attitude, and practice of the subjects. Results: The mean age of the included medical experts’ and auxiliary health workers was 38.0 3±8.3 and 35.2±7.5 years old, respectively. There was a significant difference in the knowledge of auxiliary health workers as 55.3 ± 3.8 in comparison with the medical experts’ as 51.6 3± 6.3 (p <0.002). There was a significant difference on whether changing cultural attitudes about the need for vaccination could be effective on reducing sexually transmitted diseases between the auxiliary health workers  and medical experts’  (p <0.001). There was a significant difference in the knowledge of auxiliary health workers 55.3 ± 3.8 in comparison with the psychology and cultural experts’ as 48.5± 6.3, 48.3± 6.8 (p<0.001) respectively. Conclusion: Knowledge among the auxiliary health workers was significantly different from that of psychology and cultural experts’ in relation to health culture for human papillomavirus vaccination. It was indicated that these experts need to upgrade their health culture knowledge to increase the rate of community participation in human papillomavirus vaccination.     

Pediatric metabolic liver diseases: Evolving role of liver transplantation

Metabolic liver diseases (MLD) are the second most common indication for liver transplantation (LT) in children. This is based on the fact that the majority of enzymes involved in various metabolic pathways are present within the liver and LT can cure or at least control the disease manifestation. LT is also performed in metabolic disorders for end-stage liver disease, its sequelae including hepatocellular cancer. It is also performed for preventing metabolic crisis’, arresting progression of neurological dysfunction with a potential to reverse symptoms in some cases and for preventing damage to end organs like kidneys as in the case of primary hyperoxalosis and methyl malonic acidemia. Pathological findings in explant liver with patients with metabolic disease include unremarkable liver to steatosis, cholestasis, inflammation, variable amount of fibrosis, and cirrhosis. The outcome of LT in metabolic disorders is excellent except for patients with mitochondrial disorders where significant extrahepatic involvement leads to poor outcomes and hence considered a contraindication for LT. A major advantage of LT is that in the post-operative period most patients can discontinue the special formula which they were having prior to the transplant and this increases their well-being and improves growth parameters. Auxiliary partial orthotopic LT has been described for patients with noncirrhotic MLD where a segmental graft is implanted in an orthotopic position after partial resection of the native liver. The retained native liver can be the potential target for future gene therapy when it becomes a clinical reality.     

腔镜辅助小切口甲状腺手术技巧探讨

目的探讨腔镜辅助小切口甲状腺手术的手术技巧。方法回顾性分析在2006-10/2013-09月在作者医院对610例实施腔镜辅助小切口甲状腺手术的患者。结果 610例均成功完成手术。术后颈前感觉异常减退、吞咽不适、24 h疼痛很少发生。绝大部分患者对切口外观的满意度较高。术后出现4例颈部皮下血肿,5例暂时性喉返神经损伤,5例暂时性甲状旁腺功能减退。结论腔镜辅助小切口甲状腺手术是一种新型的手术方式,需要术者掌握一定的手术技巧,包括建腔技术、器械配合、操作手法、超声刀使用技巧等。掌握了这些技巧后,可降低术后并发症的发生率,缩短手术时间,使手术难度下降。腔镜辅助小切口甲状腺手术是一种具有安全、微创、美容特点的手术方式,手术变通性好,容易被患者接受,是一种值得在临床上推广的手术。     

Awareness About Needle Stick Injures and Sharps Disposal: A Study Conducted at Army College of Dental Sciences

Background

The present study aims to assess the knowledge and attitude about needle stick injuries and sharps disposal.

Methods

A self designed questionnaire of 15 questions was handed out to 200 participants including undergraduate students (group 1), postgraduate students (group 2), faculty members (group 3) and auxiliary staff members (group 4). The data was collected and analyzed using Chi square test.

Results

Sixty-one percent of total participants reported of experiencing needle stick injury and 25.5 % knew that there could be several causes for this. Only 22 % of total population studied got the source tested. Immunization status of group 4 was very low and they also lacked the knowledge of sharps disposal and hepatitis C being spread by needle stick injuries. 57 % participants confirmed that there was no reporting facility and 66 % were not familiar with the guidelines of reporting.

Conclusions

There is a definite scope of improvement in terms of reporting and prevention of needle stick injuries. There is a need to improve knowledge and awareness of dental health care workers about the post exposure protocol.     

新辅助性原位部分肝移植动物模型的建立

目的 建立一种新的猪辅助性部分原位肝移植模型。方法 将供肝左叶在体外修肝时切除,右叶供肝作为移植肝。切除受肝左外叶,右叶供肝肝上下腔静脉与受肝肝上下腔静脉行端侧吻合,供肝门静脉与受肝门静脉行端侧吻合,受体脾动脉在结肠后与供体肝动脉端端吻合,胆总管置管外引流。结果 共进行移植模型5例,成功4例,成功率达80％,模型血流动力学稳定。结论 本移植术式在体外转流下行全肝血流阻断,门静脉淤血明显减轻,阻断时间缩短,可以有效防止受体肝的缺血再灌注损伤。血管处理简单,吻合质量高。术后出血少。成功率高,值得推广。     

加速康复外科在老年肝移植受者围手术期临床应用中的效果

目的  探索加速康复外科（ERAS）指导下的围手术干预策略在老年肝移植受者中的应用价值。方法  回顾性分析405例肝移植受者的临床资料,根据年龄分为老年组（≥60岁,122例）和非老年组（< 60岁,283例）,所有患者均进行ERAS指导下的围手术期干预处理,分析两组受者术中、术后相关指标,并发症发生情况及出院情况。结果  两组受者麻醉时间,手术时间,无肝期,出血量,输血量,关腹前乳酸水平,呼吸机辅助时间,重症监护室（ICU）入住时间,Caprini评分,CHIPPS评分,胃管、尿管、引流管拔除时间,首次饮水时间,首次下地活动时间和首次肛门排气时间差异均无统计学意义（均为P > 0.05）,老年组首次进食时间晚于非老年组（P < 0.05）。两组受者发热、腹腔积液、肺部感染、胃排空障碍、出血、非活动性静脉血栓发生率差异均无统计学意义（均为P > 0.05）。两组受者出院前天冬氨酸转氨酶、总胆红素、直接胆红素、血清肌酐水平及总住院时间差异均无统计学意义（均为P > 0.05）;老年组受者丙氨酸转氨酶值比非老年组低,差异有统计学意义（P < 0.05）。非老年组与老年组受者术后30 d内均无非计划再次手术发生,出院后30 d内再入院率差异无统计学意义（P > 0.05）。结论  ERAS干预策略有助于老年肝移植受者围手术期的恢复,达到与非老年肝移植受者同等的术后恢复水平。     

An auxiliary test to supplement the 60-min pad-weighing test and the patient's impression about the amount of urine loss

The clinical usefulness of an auxiliary pad-weighing test to supplement the 60-min pad-weighing test, which has been recommended by the International Continence Society, and the patient's impression about the amount of urine loss are reported. Our use of the 60-min test revealed that 134 (53%) of 253 patients lost more than 2.1 g/h of urine and 119 (47%) lost less than 2.0 g/h. Our auxiliary test was indicated in 153 patients who lost urine of less than 5.0 g/h. This test involved jumping 20 times with legs apart and rope-skipping 60 times. The use of this additional test increased the detection rate of urinary incontinence (more than 2.1 g/h) from 53% (134/253) to 75% (191/253). The patients' subjective impression was in accordance with the objective amount of urine loss in approximately half the cases. However, those patients whose leakage was less than 10.0 g/h claimed more often than other groups that their loss was less than usual. On the other hand, the patients with more than 10.1 g/h, tended to describe their loss as being overestimated.     

甘遂、大黄辅助治疗重症急性胰腺炎的临床疗效研究

目的 对比研究甘遂和大黄辅助治疗重症急性胰腺炎的作用。方法 将59例重症急性胰腺炎病人随机分为对照组，大黄组和甘遂组，分别观察用药后3组病人的腹痛，腹部压痛及肌紧张缓解时间，肝，肾功能及心电图的改变，血，尿淀粉酶恢复时间，血清肿瘤坏死因子－α（TNF-α）浓度的变化，平均住院日及病死率。结果 甘遂组病人腹部症状，体征的缓解时间和血，尿淀粉酶恢复时间及平均住院日较对照组和大黄组显著（P＜0．01，P＜0．05），甘组治疗1周后血清TNF－α浓度，胰腺和胰周感染的发生率明显低于对照组（P＜0．05）。但与大黄组比较无明显差异。结论 中药甘遂是西医治疗重症急性胰腺炎有效而可靠的辅助性治疗用药，且其疗效明显优于单纯西药治疗及大黄辅助治疗。     

PC机胃功能检测系统的研制

本文介绍了一种由ＰＣ微机外加传感器，胃电放大卡和Ａ／Ｄ卡组成的系统，只要一片１．２Ｍ３寸软盘即可通过人机对话实现人体胃电信号的实时采集，处理，存贮和显示，最后打印输出可供医生参考的辅助分析和诊断结果。在计算机越来越普及的今天。不乏是一种辅助检查胃功能疾病的简便而又无创伤、无痛苦的方法。     

结核感染T细胞斑点试验在辅助诊断骨结核中的应用价值

目的 探讨结核感染T细胞斑点试验(T-SPOT.TB)在辅助骨结核诊断中的应用价值.方法 回顾性分析137例疑似骨结核患者的临床资料,根据临床表现、影像学检查、组织病理学检查、病原学检查结果以及临床抗结核治疗效果进行诊断,确认或临床诊断骨结核患者69例,非骨结核患者68例.所有患者治疗前均行结核菌素纯蛋白衍生物(TB-PPD)试验及T-SPOT.TB,分析T-SPOT.TB在辅助诊断骨结核中的效能.结果 T-SPOT.TB辅助诊断骨结核的敏感度、特异度、阳性预测值、阴性预测值分别为98.5％、91.2％、91.9％、98.4％,均高于TB-PPD试验辅助诊断骨结核的敏感度、特异度、阳性预测值、阴性预测值的50.7％、77.9％、70.0％、60.9％,差异有统计学意义(P＜0.05).结论 T-SPOT.TB可辅助诊断骨结核,其具有较高的诊断敏感性、特异性.