The Higher Incidence of COVID-19 in Patients With Non-Tuberculous Mycobacterial Pulmonary Disease: A Single Center Experience in Korea

The aim of our study was to investigate the incidence of and risk factors for coronavirus disease 2019 (COVID-19) in patients with non-tuberculous mycobacterial-pulmonary disease (NTM-PD). A total of 3,866 patients with NTM-PD were retrospectively identified from a single center. Compared to the general population of Korea, patients with NTM-PD had a substantially increased age-standardized incidence of COVID-19 from January 2020 to February 2021 (2.1% vs. 0.2%). The odds of being infected with COVID-19 was particularly higher in patients who received treatment for NTM-PD than in those who did not receive treatment for NTM-PD (adjusted odd ratio = 1.99, 95% confidence interval = 1.09–3.64, P = 0.026). Patients with NTM-PD might be regarded as a high-risk group for COVID-19 and may need a more proactive preventive strategy for COVID-19 and other pandemics in the future.     

Impact of COVID-19 on Liver Transplant Activity in the USA: Variation by Etiology and Cirrhosis Complications

Background and AimsThe COVID-19 pandemic has impacted the care of patients with liver disease. We examined impact of COVID-19 on liver transplant (LT) activity in the USA.MethodsLT listings in the United Network for Organ Sharing (UNOS) database (April 2018–May 2021) were analyzed to examine the impact of COVID-19 pandemic on the LT activity based on etiology: hepatitis C virus (HCV), alcohol-associated liver disease (ALD), alcoholic hepatitis (AH), and nonalcoholic steatohepatitis (NASH) complications: hepatocellular carcinoma (HCC) and acute-on-chronic liver failure (ACLF) grade 2 or 3) and Model for End-Stage Liver Disease (MELD) score. Joinpoint regression models assessed time trend changes on a log scale.ResultsOf 23,871 recipients (8,995 in the COVID era, April 2018–February 2020), mean age 52 years, 62% men, 61% Caucasian, 32% ALD, 15% HCC, 30% ACLF grades 2–3, and mean MELD score 20.5), monthly LT changes were a decrease of 3.4% for overall LTs and 22% for HCC after September 2020, and increase of 4.5% for ALD since 11/2020 and 17% since 03/2021 for ACLF grade 2–3. Monthly MELD scores increased by 0.7 and 0.36 after June 2020 for HCV and HCC respectively.ConclusionsThe COVID-19 pandemic has impacted LT activity, with a decrease of LTs especially for HCC, and an increase of LTs for ALD and severe ACLF. Strategies are needed to reorganize cirrhosis patients to overcome the aftereffects of COVID-19 pandemic.     

安徽省公立医院护士医用防护用品知识现状调查

目的了解安徽省公立医院护士对医用防护用品知识掌握现状,分析其薄弱项和影响因素,为开展进一步的培训工作提供依据。方法根据国家卫健委文件和文献综述结果自行设计调查问卷,采用方便抽样法通过问卷星对56家安徽省公立医院6 586名护士进行调查,并采用多元线性回归法分析护士医用防护知识的影响因素。结果最终收到有效问卷6 502份。知识总分为(54.42±5.73)分,条目回答正确率为40.31%～99.71%。单因素分析显示不同最高学历、医院等级、科室、是否参与过传染病救治、是否在新冠肺炎一线工作、是否接受过防护用品知识培训的护士得分差异有统计学意义(均P<0.05)。多元线性回归分析显示:最高学历、是否参与过传染病救治、是否在新冠肺炎一线工作、是否接受过防护用品知识培训是知识得分的影响因素(均P<0.05)。结论防护用品适用范围和摘除流程是安徽省公立医院护士个人防护知识的薄弱项。本科及以上学历、参与过传染病救治、在新冠肺炎一线工作、接受过防护用品知识培训的护士知识得分较高。管理者除了理论知识培训外,可以通过情景模拟、操作演示等技能培训方法提高护士职业防护技能。     

公立医院绩效薪酬分配方法演进研究

目的梳理并分析公立医院绩效薪酬分配方法的演进过程,为公立医院绩效薪酬改革提供参考。方法运用文献分析法和政策分析法,剖析公立医院内部绩效考核与分配方法。结果经济导向的绩效考核模式存在追逐经济利益倾向;KPI与BSC虽然可以根据考核要求设置具体指标,但指标取数困难,容易机械化;以工作量为基础的综合绩效考核模式备受欢迎。结论RBRVS与DRGs组合,综合考虑了工作数量与工作质量,逐渐成为医院绩效管理新方向。公立医院需根据自身发展阶段与需求,选择适宜的绩效分配模式。     

微生物实验室如何应对突发公共卫生事件

目的:本研究的目的在于探讨微生物实验室如何应对突发公共卫生事件。方法:通过查阅国内外微生物实验室应对突发公共卫生事件的相关资料和总结微生物实验室实际工作经验提出应对方案。结果:通过研究,提出了建立预案、进行人员培训、对仪器设备不断进行更新配备与核查、适量储备消耗性材料、选择合适的方法、充分利用当地医疗机构的资源、配备必要的生物安全设施及与流行病学医生等合作与沟通的一整套方案。结论:微生物实验室在面对突发公共卫生事件时,采取上述方案能够快速、有效地应对突发公共卫生事件,变被动为主动,从而认为该方案是安全有效的工作方式。     

我国恶性肿瘤防治的难点及公共政策选择

目的探讨我国恶性肿瘤防治中存在的问题和不足,为加快我国恶性肿瘤防治工作步伐提供参考。方法通过对我国肿瘤防治资料的收集和分析,借鉴国外防治肿瘤的成功经验,结合公共管理学和公共财政中的相关理论,提出相应的公共卫生政策及卫生经济政策建议。结果发现目前我国恶性肿瘤防治工作存在投入偏低,组织机构不适应卫生改革的要求,防治机构的监督管理乏力,信息建设不完善等问题。结论应加大财政投入和政策倾斜,发挥政府在肿瘤防治中的主导作用,加强政府的组织、监管职能,使防治工作得以顺利进行。     

激光心肌血运重建联合大网膜移植的研究

目的采用激光心肌血运重建术(TMLR)联合大网膜移植作用于犬的缺血心脏,观察缺血心肌血供的变化和新生毛细血管的增生情况。方法将24条实验犬随机分为缺血组(I组)、激光打孔组(L组)、大网膜移植组(O组)、激光打孔联合大网膜移植组(L O组)。3个月后再行99~m锝(Tc)心肌同位素灌注显像。然后处死,取心肌组织,观察各组新生毛细血管的增生情况。结果L O组干预后同位素图像上感兴趣区(region of interest,ROI)比值(ROI比值=干预区ROI同位素计数/正常区ROI同位素计数)明显提高(P＜0．01),其增幅明显高于其他3组(P值均＜0．05)。L组干预后ROI比值明显高于干预前(P＜0．001),但其增幅与I组、O组的差异无显著性(P值均＞0．05)。I组、O组干预前、后ROI比值的差异无显著性(P值均＞0．05)。高倍镜下,L O组和L组孔道区(孔道为中心0．5mm范围)的新生毛细血管数明显多于孔道周围区(离开孔道1个低倍视野以上,P＜0．01、0．05)。L O组与L组孔道区的差异无显著性(P＞0．05)。结论以TMLR联合大网膜移植较单一使用这两种方法能够更明显改善缺血心肌的灌注。     

社区外来工孕产妇保健模式的调查研究

目的:调查研究深圳外来工孕产妇保健管理模式、保障外来人口的母婴健康。方法:政府增加投入,引进高级人才设备,以社区为基础,社康中心为核心,建立1790名外来工孕产妇个人健康档案,实行社康与医院双向转诊模式,孕产妇保健、产前检查、高危妊娠筛查、健康教育由社康中心完成;产前检查、高危孕妇管理、住院分娩、社区医务培训等转由公立综合医院服务,产妇档案转社区,社康中心负责产妇访视、全面管理上报。结果:1790例外来工孕产妇建卡率由77.87%增加到99.10%,产检率由66.67%增长到95.59%,住院分娩率由84.95%增长到100%,产妇死亡率由132.74/10万降至18.0/10万,围产儿死亡率147.49/10万降至35.97/10万,初步达到同期866例常住孕产妇保健指标。结论:本方法适合深圳外来工孕产妇保健模式,外来孕产妇母婴健康可得到保障。     

Brain deviations in adult obese-hyperglycemic mice (ob/ob)

In the brain of adult obese-hyperglycemic mice (ob/ob) deviations, such as reduced brain weight, diminished myelination, and reduced amount of DNA were found. These findings cannot be explained by hypothyroidism in adults since above mentioned deviations could only have been caused by a reduced thyroidal activity in the first weeks of postnatal life. Therefore, our data are in support of the earlier hypothesis of congenital hypothyroidism.