标准化防护流程在压疮管理中的应用

目的探讨标准化防护流程在提高压疮护理质量中的应用。方法成立压疮监控学组,制订压疮标准化护理评价量表,规范压疮评估与呈报,对住院压疮及高危患者从入院到出院整个过程都实施标准化防护流程,进行全程质量监控和效果评价。结果提高了护士对压疮的风险评估准确率和防护措施正确率(P0.01),降低了院内压疮发生率(P0.01),提高了院外带入压疮的治愈/好转率(P0.01)。结论标准化防护流程,能有效规范护理行为,保障护理措施落实到位,提高压疮防护质量和管理水平,有效保障患者安全。     

实验鱼类标准化研究概况

综述了斑马鱼、青鱼将、稀有鲫、红鲫、剑尾鱼等几种实验用鱼在生物学特性、遗传背景、微生物控制、人工繁殖等方面的研究现状,以期为以后的应用研究提供参考。     

Effect of airway inflation pressure on forced expiratory maneuvers from raised lung volume in infants.

The raised lung volume technique is increasingly used to measure forced expiratory maneuvers in infants. However, there is no consensus regarding the optimal airway inflation pressure (P(inf)) required for such maneuvers, or the influence of small changes in P(inf) within and between infants. The aim of this study was to assess the effect of small differences (0.2-0.3 kPa) in P(inf) on forced vital capacity (FVC), forced expired volume in 0.5 sec (FEV(0.5)), and forced expired flow at 75% of vital capacity (FEF(75)), all derived from the raised volume rapid thoraco-abdominal compression (RVRTC) technique. Randomized paired forced expiratory maneuvers were obtained in 32 healthy infants ( 3.9-39.3 weeks old, 3.8-9.9 kg) with the safety pressure relief valve for P(inf) set to 2.7 kPa or 3.0 kPa (27 or 30 cm H(2)0). When mean (SD) P(inf) was increased by 8.4 (2.8)%, there was a significant (P < 0.01) increase in mean (SD) FVC, FEV(0.5), and FEF(75) by 5.8 (5.7)%, 6.1 (6)%, and 8.3 (16.2)%, respectively. In conclusion, relatively small differences in P(inf) will result in significant differences in FVC, FEV(0.5), and FEF(75) by RVRTC technique. Precision in setting and reporting the applied P(inf) is therefore essential, particularly if data are to be compared between centers.     

Standardization of activated protein C resistance testing: effect of residual platelets in frozen plasmas assessed by commercial and home-made methods

We investigated 42 plasmas prepared at different centrifugation speeds with three activated protein C (APC) resistance methods. The APC ratio for fresh platelet-poor plasma declined significantly after freezing and thawing. This effect was more evident with the original method (average reduction 11.3%) than with either the home-made (3.8%) or the modified method (3.2%). No significant decrease in the APC ratio was observed after freezing and thawing of platelet-free plasmas from the same patients. When frozen platelet-poor plasma was centrifuged at high speed after thawing and before testing, there was no significant decrease in the APC ratio, in comparison with fresh platelet-poor plasma using the home-made and modified methods.     

The use of platelet-rich plasma to treat chronic tendinopathies: A technical analysis

Platelet-rich plasma (PRP) is blood plasma with a high concentration of autologous platelets which constitute an immense reservoir of growth factors. The clinical use of PRP is widespread in various medical applications.

Although highly popular with athletes, the use of PRP for the treatment of tendinopathies remains scientifically controversial, particularly due to the diversity of products that go by the name of “PRP.” To optimize its use, it is important to look at the various stages of obtaining PRP.

In this literature review, we take a closer look at eight parameters which may influence the quality of PRP: 1) anticoagulants used to preserve the best platelet function, 2) the speed of centrifugation used to extract the platelets, 3) the platelet concentrations obtained, 4) the impact of the concentration of red and while blood cells on PRP actions, 5) platelet activators encouraging platelet degranulation and, hence, the release of growth factors, and 6) the use or nonuse of local anesthetics when carrying out infiltration. In addition to these parameters, it may be interesting to analyze other variables such as 7) the use of ultrasound guidance during the injection with a view to determining the influence they have on potential recovery.     

Guidelines for microplate techniques in liquid-phase blood grouping and antibody screening

Summary. This document is an introduction to microplate serology prepared at a time of very active research and development. Antibody detection techniques are expected to improve during the lifetime of this document. Approximately 25% of hospital blood banks are ABO and D grouping by microplate techniques. Antibody screening by microplate techniques is only being carried out by a small percentage of hospital blood banks but there is likely to be a change to antiglobulin tests by microplate procedures as soon as the methods have been thoroughly tested and approved. There are one or two weak links in these procedures which could give rise to serious errors:— (1) Antiglobulin reagents standardized for spin-tube tests may be subject to prozones in liquid phase microplate tests. Each new batch of antiglobulin reagent must be standardized by the microplate procedure in use to show that the reagent is at its optimum anti-IgG dilution for use. However dilutions greater than 1:2 may seriously compromise the anti-complement activity of the reagent. (2) Automated cell washers for microplates are currently under development and should be evaluated by replicate tests with weak anti-D sensitized cells. (3) The combination of diluted anti-IgG and poor washing procedures may lead to neutralization of anti-IgG and cause false negative errors. Future development for improved antiglobulin tests in microplates by a solid phase system is now well advanced and workers proposing to change to antibody screening by microplates are advised to bear this in mind. It is hoped that microplate methodology will move towards standardization based on national guidelines using standard antibody reagents for the validation of new microplate procedures.     

“四结合法”教学模式在超声专业住院医师规范化培训中的应用研究

通过首次采用＂四结合法＂教学模式,即理论知识、工程技术、基础和临床医学知识与超声影像相结合的教学模式,对超声专业住院医师进行规范化培训,并与传统带教模式进行比较,探索超声影像医学教育的新模式,在此基础上摸索适合超声住院医师规范化培训的教学方案。     

《中风病中医标准化术语集》的研究思路

对中风病中医术语标准化工作现状进行研究并提出《中风病中医标准化术语集》的研究思路.从目前风病中医术语标准化工作中存在的问题出发,通过文献与临床需求相结合的方式,搭建一个可提供简单查询和检索功能中风病中医标准化术语数据库,并在此基础上通过专家意见、临床检验、会议讨论等方法不断修订完善,形成分类与编码编制完善,最终适用于机器语言识读及有较好互动的中风病中医标准化术语集,提升机器语言识读的效率,完善在此基础上搭建的临床科研信息共享平台,从推动中风病中医术语标准化工作开始,使临床信息采集、存储、交流、共享的过程更加科学和客观.     

The consortium for the standardization of influenza seroepidemiology (CONSISE): a global partnership to standardize influenza seroepidemiology and develop influenza investigation protocols to inform public health policy

CONSISE – The consortium for the Standardization of Influenza Seroepidemiology – is a global partnership to develop influenza investigation protocols and standardize seroepidemiology to inform health policy. This international partnership was formed in 2011 and was created out of a need, identified during the 2009 H1N1 pandemic, for timely seroepidemiological data to better estimate pandemic virus infection severity and attack rates to inform policy decisions. CONSISE has developed into a consortium of two interactive working groups: epidemiology and laboratory, with a steering committee composed of individuals from several organizations. CONSISE has had two international meetings with more planned for 2013. We seek additional members from public health agencies, academic institutions and other interested parties.     

Comparison of grey scale median (GSM) measurement in ultrasound images of human carotid plaques using two different softwares

Grey scale median (GSM) measured on ultrasound images of carotid plaques has been used for several years now in research to find the vulnerable plaque. Centres have used different software and also different methods for GSM measurement. This has resulted in a wide range of GSM values and cut‐off values for the detection of the vulnerable plaque. The aim of this study was to compare the values obtained with two different softwares, using different standardization methods, for the measurement of GSM on ultrasound images of carotid human plaques. GSM was measured with Adobe Photoshop^® and with Artery Measurement System (AMS) on duplex ultrasound images of 100 consecutive medium‐ to large‐sized carotid plaques of the Beta‐blocker Cholesterol‐lowering Asymptomatic Plaque Study (BCAPS). The mean values of GSM were 35·2 ± 19·3 and 55·8 ± 22·5 for Adobe Photoshop^® and AMS, respectively. Mean difference was 20·45 (95% CI: 19·17–21·73). Although the absolute values of GSM differed, the agreement between the two measurements was good, correlation coefficient 0·95. A chi‐square test revealed a kappa value of 0·68 when studying quartiles of GSM. The intra‐observer variability was 1·9% for AMS and 2·5% for Adobe Photoshop. The difference between softwares and standardization methods must be taken into consideration when comparing studies. To avoid these problems, researcher should come to a consensus regarding software and standardization method for GSM measurement on ultrasound images of plaque in the arteries.