2013—2019年宁夏学校传染病突发公共卫生事件流行特征分析

目的 了解宁夏2013—2019年学校传染病突发公共卫生事件的发生特点。方法 采用描述流行性病学分析方法,对宁夏2013—2019年学校传染病突发公共卫生事件进行分析。结果 2013—2019年学校传染病突发公共卫生事件报告101起,报告2 238例,罹患率为1.71%,无死亡。呼吸道传染病的罹患率为1.62%,肠道传染病为2.59%。呈春、冬季2个报告高峰,均以水痘为主。小学报告的事件数最多,报告67起,占67.07%。幼儿园的罹患率较高,为2.59%。结论 做好学校传染病疫情监测、预警、处置,加强传染病健康教育,积极推广二类疫苗接种等措施,能有效预防和控制学校传染病突发公共卫生事件发生。     

基于加权秩和比法评价广东省公共卫生资源配置

目的 评价2019年广东省不同地市（除中山市）的公共卫生资源配置状况。方法 从《2019年广东省卫生健康统计年鉴》中选取专业公共卫生机构数、专业公共卫生机构床位数、专业公共卫生机构执业(助理) 医师数、专业公共卫生机构注册护士数和每万人口公共卫生人数五个评价指标,利用加权秩和比法综合评价广东省不同地市的公共卫生资源配置差异。结果 WRSR与Probit的回归方程为[AKY^5]=0.250Probit-0.745（F=362.461,P<0.05,R=0.980）;将不同地市公共卫生资源配置分为四档,肇庆市、广州市、佛山市、深圳市四市公共卫生资源配置处于较高水平,则汕尾市、潮州市则较为落后。结论 广东省公共卫生资源整体上逐年提升,但每万人口公共卫生人数与目标相比还具有差距;不同地区间公共卫生资源配置差异大,人均获得资源不均衡。     

Health services reforms: political and managerial aims--an international perspective

Health policy everywhere is in flux. In marked contrast with the impenetrable orthodoxy and inaction characteristic of past decades, health policy currently is in the midst of large-scale upheaval. Many of the fundamental assumptions and principles that long guided health-sector development are in the process of being turned upside down. Whether a country is rich or poor, it matters not. Virtually every country either has or is contemplating major reforms in its provisions for the organization and financing of health services. Moreover, the differences in health services structure which divided nations, are becoming smaller--to the point where formerly shunned international exchanges now are considered useful mediums for the exposition of common tensions and the exploration of choices for adapting health care to complex and new economic realities.     

马克思关于人类社会阶段“跨越”发展的辩证法

马克思曾设想俄国农村公社有可能跨越资本主义制度“卡夫丁峡谷”而直接进入共产主义社会。本文运用马克思主义理论辩证地阐述了人类社会实现跨越发展所必备的条件内在因素、外在条件、动力以及跨越的内容。     

对我国卫生资源配置和使用几个深层次问题的思索

我国卫生资源既贫稼又浪费已成为内人士的共识,但又是一个我国卫生事业发展的实际而又紧迫的问题,这个问题不好,就会人为地降低我国卫生事业的公益性和福利性的“含金量”。作者认为,要使我国有限的卫生资源能充分而合理地使用好,就要立足于我国的基本国情,在确保市场的微观调节的前提下,必须运用政府的宏观调控行为和政策指导手段,尽可能为管理体制的改革扫除障碍和给予法制上的保障。     

The diagnostic accuracy of rapid diagnostic tests for Ebola virus disease: a systematic review

BackgroundEbola virus disease (EVD) is a dangerous condition that can cause an epidemic. Several rapid diagnostic tests (RDTs) have been developed to diagnose EVD. These RDTs promise to be quicker and easier to use than the current reference standard diagnostic test, PCR.ObjectivesTo assess the diagnostic accuracy of RDTs for EVD.MethodsA systematic review of diagnostic accuracy studies.Data sourcesThe following bibliographic databases were searched from inception to present: MEDLINE (Ovid), Embase, Global Health, Cochrane Central Register of Controlled Trials, WHO Global Index Medicus database, Web of Science, PROSPERO register of Systematic Reviews, and Clinical Trials.Gov.Study eligibility criteriaDiagnostic accuracy studies.ParticipantsPatients presenting to the Ebola treatment units with symptoms of EVD.InterventionsRDTs; reference standard, RT-PCR.Assessment of risk of biasQuality Assessment of Diagnostic Accuracy Studies-2 tool.Methods of data synthesisSummary estimates of diagnostic accuracy study were produced for each device type. Subgroup analyses were performed for RDT type and specimen material. A sensitivity analysis was performed to assess the effect of trial design and bias.ResultsWe included 15 diagnostic accuracy studies. The summary estimate of sensitivity for lateral flow assays was 86.1% (95% CI, 86–86.2%), with specificity of 97% (95% CI, 96.1–97.9%). The summary estimate for rapid PCR devices was sensitivity of 96.2% (95% CI, 95.3–97.9%), with a specificity of 96.8% (95% CI, 95.3–97.9%). Pre-specified subgroup analyses demonstrated that RDTs were effective on a range of specimen material. Overall, the risk of bias throughout the included studies was low, but it was high in patient selection and uncertain in the flow and timing domains.ConclusionsRDTs possess both high sensitivity and specificity compared with RT-PCR among symptomatic patients presenting to the Ebola treatment units. Our findings support the use of RDTs as a ‘rule in’ test to expedite treatment and vaccination.     

浅谈护士长的公关意识及作用

本文从5个方面论述了公关意识及其临床作用。即①塑造形象的意识;②服务公众的意识;③沟通交流的意识;④创新审美的意识;⑤真诚互惠的意识。通过对其作用的论述,旨在引起广大护理工作者对公共关系的重视,从而促进护理学科发展。     

Long-term survival of patients with multiple myeloma and acute renal failure at presentation

Eight patients presented with simultaneous multiple myeloma and acute renal failure requiring hemodialysis. Patients had no known pre-existing renal disease nor exposure to nephrotoxic agents or x-ray contrast dye. Renal failure was attributed to light chain nephropathy in all cases. In 4 of these patients the diagnosis of myeloma was initially unsuspected. Renal biopsies in 3 of these patients, and post-mortem material in a fourth revealed the changes of "myeloma kidney." No patient regained renal function and all required chronic hemodialysis. Among these eight patients, three survived for periods greater than 21 months.     

A training program on exclusive breastfeeding in maternity wards.

OBJECTIVES: To estimate whether a 3-day training program for health professionals was followed by changes in maternity ward practices and in the rate of exclusive breastfeeding. METHODS: A retrospective study in the maternity ward of a French university hospital involved two cross-sectional samples of 323 mother-infant pairs in 1997 and 324 in 2000. RESULTS: The rate of exclusive breastfeeding at discharge increased from 15.8% (12.0-20.2) in the before sample to 35.2% (30.0-40.6) in the after sample (P<0.01). This result persisted in the multivariable analysis [adjusted odds ratio, 2.74 (1.72-4.37)]. Infants in the before sample were less likely to be breastfed within 1 h of birth (9.2% vs. 16.9%, P=0.01), to room-in 24 h/day (56.6% vs. 72.6%, P<0.01), and were more likely to receive formula supplementation (77.6% vs. 54.0%, P<0.01). CONCLUSIONS: A training program for health professionals can be effective in improving maternity ward practices and increasing exclusive breastfeeding rate at discharge.