河南省食品安全综合示范区小麦及其制品安全监管模式研究

目的做好小麦及其制品安全监督,保证从农田到餐桌的食品安全。方法鹤壁市政府牵头,监管部门分段对小麦及其制品安全进行全程监督研究。结果经2003-2005年研究,创建了本地特色的食品安全法规文件体系、标准体系、组织管理体系、检验检测体系、企业信用体系、监管队伍体系、培训体系、评价体系,形成了小麦产品及其制品的食用安全链条监管模式。结论监管部门分工协作的食品安全链条监管模式,完善科学的监管体系提高了示范区小麦及其制品的产品质量,保证了从农田到餐桌的食用安全。     

A cross-platform model for secure Electronic Health Record communication

During the past decade, there have been many regional, national and European projects focused on the development of platforms for secure access and sharing of distributed patient information. A platform is needed because present local or enterprise-wide information systems are typically not intended for cross-organisational secure access of patient data. Most of the present secure platforms are local or regional. Commonly used platform types in the health care environment vary from secure point-to-point communication systems to internet-based portals. This paper defines an enhanced cross-security platform which makes it possible for different kinds of local, regional, and national health information systems to communicate in a secure way. The proposed evolutionary way interconnects regional or national security domains with the help of a cross-platform zone. A more revolutionary model based on peer-to-peer Grid like networks and dynamic security credentials is also discussed. The proposed evolutionary model uses cross-domain security and interoperability services to ensure secure communication and interoperability between different security domains. The platform supports both communication defined beforehand and adhoc dynamic access to distributed electronic health records (EHRs). The internet is proposed as the "glue" between different regional or national security domains.     

异丙酚在人工流产术中的镇痛效果及安全性

目的:研究异丙酚静脉麻醉对孕妇人工流产的镇痛效果及安全性。方法:受检者分为观察组及对照组,观察并记录检查前和给药后1、5min患者收缩压(SBp)、舒张压(DBp)、平均动脉压(MBP)、血氧饱和度(SpO2)和心率(HR)等生理指标的变化和出现的不良反应。结果:异丙酚静脉麻醉镇痛效果满意,麻醉诱导后1、5min患者SBp、MBP、DBp、SpO2、HR与对照组比较显著降低(P<0.01),但无需特殊处理。均未引起严重不良反应。扩宫颈容易、手术时间短,与观察组比较有显著性差异;人工流产综合征基本消除,不增加出血量。结论:异丙酚静脉麻醉下进行人工流产术安全、有效,值得推广应用。     

成都市8382例老年住院患者医疗费用的描述性分析

目的 探讨老年人住院医疗费用特点,为建立有效的医疗费用控制机制提供依据.方法 对成都市某三级甲等医院8,382例年龄在60岁以上的老年人住院医疗费用进行描述性分析.结果 (1)老年人例均住院费用12,237元,高出全院平均费用8,597元的42.3%.(2)老年人例均住院费用和例均药品费与成都市住院患者平均水平的比较差别显著(P＜0.05).(3)70岁～79岁年龄段老年患者平均药费和平均检查治疗费高出一般患者的65.2%和61.9%.结论 应针对医院实际情况,进一步加强对老年住院患者住院天数、例均住院医疗费用,药品比例等指标的考核,提倡合理检查,合理用药,控制医疗费用的过快增长.     

Accuracy of on-line databases in determining vital status

Ascertainment of vital status is important for epidemiological and clinical trial research. Two free databases based on the Social Security Administration Death Master File have become available on the Internet. The accuracy of these databases is unknown. A cohort of 124 patients known to be dead and a cohort of 203 patients not known to be dead were identified. The on-line databases were searched with both of these cohorts following a specific search algorithm. The results for both on-line databases were identical. The optimal algorithm had a sensitivity of 0.82 (95% confidence interval 0.74–0.89) for identification of deaths. The sensitivity excluding deaths that occurred during the first year of life (n = 118) was 0.86 (95% CI 0.79–0.92). The specificity was 1.00. This study found that free and convenient on-line databases based on the Social Security Administration Death Master File can be useful in the accurate ascertainment of vital status.     

筋膜减张法在妇科腹腔镜手术第一穿刺中的应用

目的为避免妇科腹腔镜手术第一穿刺可能出现的严重并发症腹膜后血管损伤,找到最安全、省力的穿刺方法。方法观察组252例,以筋膜减张法进行的闭合性穿刺,对照组130例按常规闭合性穿刺。筋膜减张法穿刺是在常规闭合性穿刺气腹针形成人工气腹后,用尖刀切开部分筋膜,再穿入穿刺套管。通过分析两组病例穿刺的安全性和易操作性,探索筋膜减张法穿刺的实用价值。结果临床观察组比对照组穿刺更省力,一次成功率高,穿刺深度可控性强。结论在妇科腹腔镜手术中第一穿刺采用筋膜减张法进行闭合性穿刺省力、省时,一次穿刺成功率高,安全可控制性强。更加适用妇科女医生的操作,有推广价值。     

浅谈医院局域网的安全管理

阐述了医院局域网安全管理的重要性，针对局域网容易受到的安全威胁，提出具体的安全管理措施。     

Prestación por riesgo durante el embarazo e incapacidad temporal en una cohorte de trabajadoras del Parc de Salut Mar (Barcelona,España)

ObjectiveTo study the use of the Pregnancy occupational risk benefit (PORB) and non-work related sickness absence (NWSA) in a cohort of pregnant workers of Parc de Salut Mar, Barcelona (Spain).MethodRetrospective cohort study of 428 pregnant workers between 2010 and 2014, who were followed-up until delivery. Absences from work, both PORB and NWSA were recorded until the beginning of their maternity leave. The sequence analysis identifies four trajectories, which are described according to workers demographic and job characteristics.ResultsOf the total cohort, 56 (13.1%) accessed only the PORB, representing 6.126 days of absence; 68 (15.9%) also accessed PORB, with 7.127 days of absence, but had previously accumulated 102 episodes of NWSA with 1.820 days of absence. The majority of pregnant workers in the sample (69.9%) took only one or several episodes of NWSA without using PORB, with 545 episodes and 26,337 days of absence. Most were active during the first quarter and it is from the second quarter that episodes of long-term NWSA appeared. During the last month of pregnancy more than 80% of the workers were absent from work.ConclusionsPregnant workers remained at work for two thirds of their pregnancy. Absences were mainly due to episodes of NWSA. PORB represented one third of them. As in other similar countries, our results suggest a change in the management of social protection benefits for pregnant workers.     

尼贝沙坦联合胺碘酮治疗阵发性心房颤动的临床观察

目的：观察尼贝沙坦联合胺碘酮治疗阵发性心房颤动的临床效果与安全性。方法：将60例阵发性心房颤动患者平分为治疗组与对照组各30例,在各种常规治疗的基础上,对照组加用尼贝沙坦治疗,治疗组加用贝沙坦联合胺碘酮治疗。结果：经过治疗后,两组都无死亡患者,治疗组总有效率为90.0%,对照组总有效率为70.0%,治疗组的临床疗效明显好于对照组（P〈O.05）。而对照组的脑栓塞和脑出血发生率都明显高于治疗组（P〈0.05）。结论：尼贝沙坦联合胺碘酮治疗阵发性心房颤动的临床效果好,安全性好,值得推广应用。     

加强高校公共卫生安全保障的思考

良好的公共卫生安全是髙校安全稳定和校园和谐建设的需要,是维护高校正常教学秩序和科研活动的保障,也是高校管理工作的重要内容。本文对公共卫生、公共卫生安全和高校公共卫生安全的概念进行了诠释,分析了高校在公共卫生安全方面存在的问题,就如何发挥高校功能社区优势,建立高校突发公共卫生事件群防群控的工作格局,加强公共卫生安全保障进行了思考。