棉织布与无纺布尘埃粒子数及抗渗液性能比较研究

目的比较棉织布与无纺布制作的手术衣和手术洞巾等在手术铺巾时空气中的尘埃粒子数及术中抗渗液性能，为有效控制外科切口感染和预防医患交叉感染提供参考。方法将棉织布与无纺布制作的手术布类各备15包，包内内容均相同，经灭菌处理。应用尘埃粒子计数仪测定两组铺巾时、铺巾后及收巾时空气中的尘埃粒子数，同时在手术过程中观察其抗渗液性能。结果无纺布组在铺巾时、铺巾后及收巾时产生的尘埃粒子数显著少于棉织布组（P〈0．05，P〈0．01）；其抗渗液率为100％，而棉织布组为0。结论无纺布抗渗液性能优，可减少手术环境中的尘埃粒子数，从而控制外科切口感染；其阻隔防护效能对患者和医护人员具有双重保护作用。     

Danish version of the Oswestry disability index for patients with low back pain. Part 2: Sensitivity, specificity and clinically significant improvement in two low back pain populations

In studies evaluating the efficacy of clinical interventions, it is of paramount importance that the functional outcome measures are responsive to clinically relevant change. Knowledge thereof is in fact essential for the choice of instrument in clinical trials and for clinical decision-making. This article endeavours to investigate the sensitivity, specificity and clinically significant improvement (responsiveness) of the Danish version of the Oswestry disability index (ODI) in two back pain populations. Two hundred and thirty three patients with low back pain (LBP) and/or leg pain completed a questionnaire booklet at baseline and 8 weeks follow-up. Half of the patients were seen in the primary (PrS) and half in the secondary sectors (SeS) of the Danish Health Care System. The booklet contained the Danish version of the ODI, along with the Roland Morris Questionnaire, the LBP Rating Scale, the SF36 (physical function and bodily pain scales) and a global pain rating. At follow-up, a 7-point transition question (TQ) of patient perceived change and a numeric rating scale relating to the importance of the change were included. Responsiveness was operationalised using three strategies: change scores, standardised response means (SRM) and receiver operating characteristic (ROC) analyses. All methods revealed acceptable responsiveness of the ODI in the two patient populations which was comparable to the external instruments. SRM of the ODI change scores at 2 months follow-up was 1.0 for PrS patients and 0.3 for SeS (raw and percentage). A minimum clinically important change (MCID) from baseline score was established at 9 points (71%) for PrS patients and 8 points (27%) for SeS patients using ROC analyses. This was dependable on the baseline entry score with the MCID increasing with 5 points for every 10 points increase in the baseline score. We conclude that the Danish version of the ODI has comparable responsiveness to other commonly used functional status measures and is appropriate for use in low back pain patients receiving conservative care in both the primary and secondary sector.     

低剂量甲基汞在小鼠体内分布及其对细胞周期进程的影响

连续９０天饮用含甲基汞浓度为１／１０００ＬＤ５０、１／１００ＬＤ５０、１／５０ＬＤ５０和１／１０ＬＤ５０的自来水的雄性昆明小鼠，各脏器中总汞含量均高于对照组（Ｐ＜０．０５～０．００５），并且随着染毒剂量增加，脏器中总汞含量也随之增高。同时采用ＦＡＣＳｃａｎ流式细胞仪和“ＣｅｌｌＦＩＴ”软件分析脾细胞周期进程，发现除１／１０００ＬＤ５０剂量组外，其余各剂量组从Ｇｏ／Ｇ１时相进入Ｓ时相的脾细胞百分数均明显高于对照组（Ｐ＜０．０５），与染毒剂量呈明显正相关。表明连续经口摄入低剂量甲基汞小鼠脾细胞周期进程加快，细胞ＤＮＡ复制增强。     

应用计算机网络系统提高门急诊管理水平

作者介绍的门急诊计算机管理网络系统，应用软件使用ＦＯＸＰＲＯ２．５ＦＯＲＤＯＳ语言，在两台网络服务器之间应用镜像技术，门诊号的录入使用光笔和条形码技术，实行划价、收费一体化，采用星型拓扑网络结构，保证了网络的先进性、安全性、稳定性和可扩充性。网络系统实现挂号、划价收费、调剂、药品使用管理、工作量统计及经济核算的全程闭环管理格局，有效地堵塞了管理和经济上的漏洞，提高了工作效率和管理水平。该系统已正常运行了１２个月，并通过省级科技成果鉴定。     

医院配电室和特种设备的安全管理

本文主要探讨对医院配电室和特种设备的安全管理，消除安全隐患，间接地为医院创造效益。     

现代医院手术室建设中的问题及动态研究

手术室是医学技术与工程技术结合的产物。随着医疗技术和新的手术工具的不断涌现,带动了手术量的迅猛上升。旧的手术室空间布局、实施标准、功能配置等方面已经无法满足新技术的应用要求,同时人们对手术环境和手术质量也提出了更高的标准。而今第四代手术室已开始步入我们的时代。洁净化、数字化和人性化则是其主要代表特征。本文分别从洁净手术室、数字化手术室和人性化手术室三个方面来探讨现代医院手术室建设中应注意的问题及动态研究。层流手术室已经是手术室建设不可逆转的发展趋势,除了按照《医院洁净手术部建筑技术规范》来建造外,其布局、人流、物流、质量监控等等都要进行合理的安排才能达到最优的手术环境。数字化手术室是将温度、湿度、压力、通风量、新风量等一切参数系统的由计算机来分配统筹,从而实现精确高效的手术管理。人性化手术室则是手术室建设的软件部分,是一种“以病人为中心”的服务理念,它打破了传统的生物医学模式,转变为生物—心理—社会模式,这是病人需求与市场竞争的必然选择。     

STRESS IN THE RURAL EMERGENCY ROOM

ABSTRACT: This study identifies stress-producing factors reported by registered nurses (RNs) attending serious incidents in an Australian rural hospital's emergency room. A Delphi approach was used to determine the six most significant stress-producing factors, and these factors were then ranked by two groups of nurses. The rankings were compared using the Spearman Rank Order Coefficient of Correlation and were found to be dependent on years of nursing experience of the RNs taking part in the study. The more experienced group nominated 'anxiety about nursing a family member or close friend' as the most significant stress-producing factor, while the less experienced group reported 'concerns about nursing a child' as the most important stress-producing factor. Possible reasons for the variation in rankings are discussed, and recommendations are made in the light of the study's findings.     

Increased yield of full GBA sequencing in Ashkenazi Jews with Parkinson's disease

Background

Variants in GBA are the most common genetic risk factor for Parkinson's disease (PD), and are especially prevalent in the Ashkenazi Jewish (AJ) population. However, most studies on GBA in AJ genotype only seven selected Gaucher-associated pathogenic variants rather than sequencing the whole gene, which may leave carriers of PD-associated GBA variants undiscovered.