The Evidence Base for Diabetes Technology: Appropriate and Inappropriate Meta-Analysis

When we are interested in making decisions about best use, comparative therapeutic efficacy, or cost-effectiveness of diabetes technologies such as insulin pump therapy [continuous subcutaneous insulin infusion (CSII)] or continuous glucose monitoring, meta-analysis for the purpose of literature summary is inappropriate and may be misleading. Instead, “decision-making meta-analysis” is more appropriate and should involve either preselection of trials based on intended use [e.g., elevated baseline hemoglobin A1c or hypoglycemia rate for trials of multiple daily injections (MDI) versus CSII] or metaregression of summary effect sizes in different trials against potential effect-modifying covariates such as baseline risk, or models of the covariates that determine effect size using individual patient data. Appropriate meta-analysis should also only include trials that are of sufficient duration to accurately measure outcomes such as severe hypoglycemia, and they should not use obsolete technology that is of proven inferiority to current technology. The use of appropriate decision-making meta-analysis is illustrated by the change in the rate ratio for severe hypoglycemia in randomized controlled trials of MDI versus CSII in type 1 diabetes from 1.56 (95% confidence interval 0.96–2.55; p = .074) for literature-summary meta-analysis to 2.0 (1.08–3.69; p = .027) for decision-making meta-analysis of all patients and 3.91 (1.35–11.36; p = .01) for trials in children.     

分合式（Y型）输液器在优质护理服务中的效果体会

目的探讨分合式输液器在优质护理服务中的应用。方法选择2012年6～12月在胸外科静脉输液的患者，对照组（n=520）使用普通输液器；试验组（n=542）使用分合式输液器，采取单盲方法，收集每日更换液体的次数、输液器异常情况次数、患者的满意度，进行统计学分析。结果更换液体的次数、异常情况次数及患者的满意度，两组差异有统计学意义（P〈0．05）。结论使用分合式输液器，可以有效减少护士耗费在静脉治疗上的时间，提高工作效率，减轻患者及家属的恐慌，增加患者的满意度，便于优质护理工作的开展和完善。     

门诊输液护理差错原因分析与防范对策

目的 分析门诊输液护理差错发生的原因,并提出防范对策.方法 回顾性分析2011年5月～2014年5月本院门诊输液室发生26例护理差错的资料.结果 护理差错类型包括医嘱转抄错误、注射错误及液体外渗等,护理差错主要发生在白班,工作年限5年内护士护理差错的发生率高于其他工作年限的护士（P＜0.05）.结论 未严格执行“三查七对”是发生差错的重要原因.科学管理、完善各项规章制度是预防门诊输液护理差错的主要对策.     

“尿道滴白”患者尿道分泌物与前列腺液的对比研究

目的探讨"尿道滴白"患者尿道分泌物成分,评价尿道滴白是否来源于前列腺液。方法选取78例"尿道滴白"患者,分别取患者尿道分泌物和前列腺液,对尿道分泌物进行细菌培养、常规镜检和酸性磷酸酶活性检测,对前列腺液进行前列腺常规检测,比较两种标本的相关性,评价尿道滴白是否来源于前列腺液。结果 72例患者细菌培养结果阳性,结合查体及前列腺常规、尿常规检测确诊为前列腺炎,6例患者单纯表现为"尿道滴白"症状,细菌培养阴性;78例患者前列腺液及尿道分泌物酸性磷酸酶活性检测结果差异显著,提示"尿道滴白"主要来源并非前列腺液。结论 "尿道滴白"是前列腺炎的临床症状之一,并非前列腺液,可能为尿道腺分泌物。     

唇腭裂围手术期的护理体会

目的探讨唇腭裂患儿围手术期的护理措施和注意事项。方法将我院唇腭裂患儿120例给予手术整复治疗，并给予系统的护理措施。随访观察医护效果。结果本组108例患儿获得临床I期愈合，治愈率90．00％。经1—2年随访，所有患儿均有不同程度的语音功能改善，仅1例患儿出现腭瘘，术后给予二期手术后获得痊愈出院。结论系统全面的护理措施能有效提高唇腭裂患儿的手术治疗效果，并引导其身心健康发展。