新源县一起甲型流感暴发调查

2007-01-07/16,新源县哈拉布拉乡二中发生一起甲型流感暴发,经过对患者采取隔离治疗,对易感密切接触者采取居家留观等综合预防措施,疫情得到有效控制,现将调查结果分析如下。1基本情况该校距乡政府所在地500m,由小学部和初中部组成的合校,全校有1632人,职工81人,其中男生896人,女生736人,小学部课堂在平房,初中部课堂在教学楼,小学1～6年级18个班774人,初中部的7～9年级16个班858人,全校民族学生526人,占全校学生的32.23%,学生来源为该乡辖区内各村学生,部分学生在校住宿,住校人占总人数的29.73%。2流行病学特征2.1地点分布本次流感主要在哈…     

Neonatal mortality amongst Scottish preterm singleton births (1985–1994)

Objective To provide a valid estimate of singleton neonatal mortality based on birthweight and gestational age at delivery.
Design Record linkage of maternity data and neonatal mortality data.
Setting Scotland, UK.
Population All singleton preterm deliveries from 24 to 36 weeks inclusive between 1985 and 1994.
Main outcome measure Neonatal death.
Results There were 625,646 liveborn singleton deliveries over the study period, of which 33,912 were preterm (5.4%). The overall neonatal mortality in the preterm group was 41/1000 and the data have been presented by both gestational age and birthweight. The neonatal mortality rate fell with advancing gestation from 795/1000 live births at 24 weeks to 9/1000 live births at 36 weeks and was higher at the extremes of birthweight for a given gestational age. There was a significant increase in the proportion of babies delivered iatrogenically over the study period (χ test for trend   P < 0.001  ).
Conclusion This is the largest recent series to consider neonatal mortality using both birthweight and gestational age. These figures will be of use in obstetric management when elective preterm delivery is considered, and for providing prognostic guidance following preterm delivery.     

多媒体网络教学的构成及其解决方案

作为一所教学医院，如何更好的提供教学服务，培养出高质量的军事医疗人员，在未来的战争中做好医疗保障是我们教学的目标。利用计算机多媒体网络技术将临床、科研和教学有效的组织起来，为优化教学内容、提高教学质量奠定了基础。     

Asthma medication use in pregnancy and fetal growth

BACKGROUND: Given the high prevalence of asthma in pregnancy, it is important to understand the relationship between asthma medications and fetal growth in the context of appropriate treatment. OBJECTIVE: This study examines the effect of inhaled corticosteroids, systemic corticosteroids, and beta(2)-agonists on fetal growth in 654 infants born to women with asthma compared with 303 infants born to controls without asthma. METHODS: Subjects for this prospective study were enrolled throughout North America between 1998 and 2003 and followed up by the Organization of Teratology Information Services. Incidence of small for gestational age (SGA) infants and mean birth size measures were compared among groups. RESULTS: Mean birth weight of full-term infants born to mothers who used systemic corticosteroids (3373 g) was lower than in the beta(2)-agonist group (3552 g) and controls without asthma (3540 g; P < .05) after adjustment for other risk factors. However, no differences in the incidence of SGA for weight were observed among groups. Adjusted mean birth length was slightly shorter in the systemic steroid group compared with controls (P=.02). Incidence of SGA for length and head circumference and mean head circumference did not vary among groups (P>.05). CONCLUSION: The treatment of asthma with systemic corticosteroids resulted in a deficit of about 200 g in birth weight compared with controls and exclusive beta(2)-agonist users and no increased incidence of SGA. These results suggest that asthma management with beta(2)-agonists and/or inhaled corticosteroids during pregnancy does not impair fetal growth, whereas systemic corticosteroids have a minimal effect which should be weighed against the necessity to control severe asthma.     

专科医院住院部各科医疗质量综合评价的初步探讨

目的：探讨专科医院住院各科工作情况综合评价方法,向临床科室提供医疗质量信息,促进医疗质量的提高。方法：以医院工作报表为数据来源,用秩和比法从诊疗质量,工作强度和经济效益三方面量化科室医疗质量考核指标。结果：综合数能更全面、有效、合理地评价住部各科医疗质量优劣等级,提出科室改进的指标。结论：此评价方法简便,实用,有利于深化院内改革,强化行政部门管理。     

计算机2000年问题对医院的影响及对策

计算机２０００年问题对医院最明显的影响是计算机系统届时交病的信息丢失,财务系统不能正常工作,网络瘫痪等。此外,由于嵌入式问题将造成医疗设备运行混乱,从而危及病人的生命和健康。医院应采取的对策是：认知计算机２０００年问题,产品清查,确定问题范围,对问题进行评估,制定应急计划,制定解决方案,具有体实施和检验验证。     

儿童青少年近视普查信息化管理专家共识（2019）

为了保障儿童青少年近视普查工作的规范化、科学化开展,引导各地近视普查工作有序进行,专家组已经制定出查的基本内容和规范流程,并对用到的检测和数据采集设备及设置的标准化达成共识。信息化是客观精准获取近视本底数据的重要保障,也是数据安全存储和快速传递的有效路径,同时又是国家政府层面的大数据分析的前提和基础,故近视普查的规范化流程需要实现信息化管理。因此我们组织专家组,经过大量调查研究和临床实践,形成《儿童青少年近视普查信息化管理专家共识（2019）》,旨在为近视普查工作的信息化管理提供指导性意见。内容包括：信息化管理实现的功能、数据表的结构化设计、信息系统的架构和模块、信息化应用规范和指南、统计分析等。详述如下。     

多胎妊娠中联体胎儿的超声诊断

正联体双胎的发病率为(1～2)/10万,在多胎妊娠中是一种很少见并且较复杂的畸形~([1])。联体双胎一般只发生在单绒毛膜单羊膜囊双胎妊娠中(即单卵),是在双胎妊娠中受精第13天后胚盘不完全分离而形成的。胚盘不分离的时间早晚不同,不分离的程度也不相同,双胎融合的部位及程度也不同,联体双胎的类型不同则超声表现也不相同。大多数联体双胎为早产,40%为死胎,且出生后其家庭将面临许多社会问题,及早对联体双胎及其类型作出正确的诊断,对采取相应的干预措施有重要意义~([2])。本研究回顾性分析近年来产前超声诊断的联体双胎6例,讨论联体双胎超声声像图特征及检查技巧。     

术前留置输尿管内支架管在导引鞘下输尿管软镜治疗婴幼儿肾结石的应用研究

目的探讨术前留置输尿管支架管在输尿管导引鞘下输尿管软镜治疗婴幼儿肾结石的临床疗效。 方法我院2015年6月至2018年6月收治24例肾结石婴幼儿（观察组）,行输尿管软镜下激光碎石,术前留置输尿管支架,被动扩张输尿管2周后再置入输尿管软镜导引鞘完成输尿管软镜下激光碎石术,并对比分析同期17例未置入输尿管软镜导引鞘行输尿管软镜下激光碎石术（对照组）的患者资料。 结果观察组结石清除率为87.5%,手术时间（56±14） min,术后发热1例,较对照组结石清除率76.5%明显提高,术后泌尿系感染发生率降低。 结论术前行输尿管支架被动扩张后置入输尿管软镜导引鞘提高输尿管软镜下碎石治疗婴幼儿肾结石手术的成功率及安全性。