目的:探讨并强调电子病历系统在医院信息化建设中的应用及前景。方法:了解目前国内电子病历系统现状,并结合本科室已建立的结构化电子病历系统应用经验,分析电子病历系统的利弊及在我国发展的需求前景。结果:电子病历系统的运行大大提高了医疗质量和工作效率。结论:以电子病历系统为中心的医院信息化建设势在必行。
The necessity and methods of systematic review or Meta-analysis of observational studies were introduced. The difference between the systematic review or Meta-analysis of observational studies and randomized controlled trials was also described.
ObjectiveTo understand the characteristics of and risk factors for nosocomial infection in a newly built branch of a university teaching hospital, in order to investigate the control measures for prevention and control of nosocomial infection. MethodsA total of 598 cases of nosocomial infection from April 2012 to June 2014 were enrolled in this study. We analyzed statistically such indexes as nosocomial infection rate, infection site, pathogen detection, and use of antibiotics. Meantime, infection point-prevalence survey was introduced by means of medical record checking and bedside visiting. ResultsAmong all the 44 085 discharged patients between April 2012 and June 2014, there were 598 cases of nosocomial infection with an infection rate of 1.36%. Departments with a high nosocomial infection rate included Intensive Care Unit (ICU) (9.79%), Department of Orthopedics (2.98%), Department of Geriatrics (2.62%), and Department of Hematology (1.64%). The top four nosocomial infection sites were lower respiratory tract (45.32%), urinary tract (13.21%), operative incision (8.86%), and blood stream (8.86%). The samples of 570 nosocomial infections were delivered for examination with a sample-delivering rate of 95.32%. The most common pathogens were acinetobacter Baumanii (17.02%), Klebsiella pneumoniae (14.21%), Escherichia coli (13.68%), Pseudomonas aeruginosa (11.93%), and Staphylococcus aureus (9.12%). And urinary tract intubation (42.81%), admission of ICU (28.60%), and application of corticosteroid and immunosuppressive agents (26.42%) were the top three independent risk factors for nosocomial infection. ConclusionGeneral and comprehensive monitoring is an effective method for the hospital to detect high-risk departments, factors and patients for nosocomial infection, providing a theoretical basis for prevention and control of nosocomial infection.
In this study, loop-mediated isothermal amplification (LAMP) assay in conjunction with calcein for visualized detection of Mycobacterium tuberculosis (MTB) was established. Firstly, four LAMP primers were designed according to the region of 16S rDNA sequences of MTB. Secondly, clinical sputum samples were collected, decontaminated and their DNA was extracted. Thirdly, standard MTB strains were used to evaluate the specificity and sensitivity of LAMP. At the same time, electrophoresis was used for products detection and calcein was used for visualized verification. At last, Chi-squared test function in SPSS 17.0 software was used for consistency evaluation of LAMP assay as compared with the gold standard (culture method). Results showed that there was no nonspecific amplification appeared in the specificity assay and the detection limit was 10 copies/tube in the sensitivity assay. In addition, visualized method by calcein had a comparable sensitivity with that of electrophoresis method. After evaluation of clinical practicability, the sensitivity of LAMP was calculated as 94.74% and the specificity was 90%, respectively. And Chi-squared test showed that LAMP and culture method had no statistic difference, and the two methods were in good consistency (P>0.05). In conclusion, LAMP assay introduced in our study has the characteristics of high efficiency and visualized detection so that this technique has great application prospects in the resource-limited environment, such as work field and primary care hospitals.
ObjectiveTo compare the point prevalence of nosocomial infection in a comprehensive hospital between 2014 and 2015, and to put forward prevention and control measures so as to reduce the incidence of nosocomial infection. MethodsBy means of reviewing electronical medical records and beside investigation, the prevalence rates of nosocomial infection in patients hospitalized on June 4, 2014 and June 16, 2015 were investigated. Data were collected by a uniform questionnaire and analyzed by Excel 2007 and SPSS 18.0. ResultsThe nosocomial infection rates in those two time points were respectively 4.51% and 3.21% without a significant difference (χ2=2.246, P=0.134). Intensive Care Unit, Department of Neurosurgery and Department of Orthopedics were listed in the top five in terms of nosocomial infection rate for two consecutive years. The nosocomial infection sites were mainly lower respiratory tract, and a total of 64 strains were detected including mainly G? bacteria accounting for 76.6%. Antimicrobial agent usage covered 34.05% and 33.33% at those two time points. The purpose was mainly for therapy, and the pathogenic bacteria specimen detection rate was 68.06% and 59.73%, without statistically significant difference (χ2=0.114, 3.311; P>0.05). ConclusionThe prevalence of nosocomial infection in this hospital is at average national level but higher than the average level in Sichuan Province. Infection surveillance, prevention and control measures should be strengthened in key departments and key infection sites, and antimicrobial agent should be rationally used so as to reduce the incidence of nosocomial infection.
Sit-to-stand is an indispensable functional activity in human daily life, which requires high muscle strength, not only to control the lower limbs, but also to ensure the stable ascension of the trunk. This paper describes in detail the trajectory and speed of the joints through the human sit-to-stand test, analyzes the change rule of the angle of the joints, the angular velocity and the position of the center of mass in the human sit-to-stand, and records in detail the change of the plantar pressure of the subjects in this process. Through the study on joint motion and plantar pressure changes in the process of sit-to-stand, this paper summarizes the kinematics of human body in this process, aiming to provide a basis through the results of this paper for the design of human sit-to-stand assistive devices, which may be used in the future to analyze the sit-to-stand state of patients with lower limb disorders, and carry out the corresponding treatment and rehabilitation training.
Objective To discuss the feasibility and clinical outcomes of fast-track (FT) surgery for elderly patients (≥70 years) with colorectal carcinoma. Methods Between November 2007 and January 2009, 103 elderly patients were analyzed prospectively, who were divided into FT group and traditional group randomly. All 103 patients had completed the entire study. Postoperative complications and early rehabilitations were studied and compared. In addition, completion of FT courses was recorded. Results ① In early rehabilitation, the time of first ambulation was (1.96±0.89) d and (2.92±1.43) d, oral intaking was (2.41±0.92) d and (3.62±1.40) d, and first flatus was (3.88±1.05) d and (4.52±1.29) d in the FT group and the traditional group, respectively. The early rehabilitation indexes in the FT group were significantly earlier than those in the traditional group (Plt;0.05). ② Postoperative hospital stay was (9.27±1.87) d and (12.75±7.05) d in the FT group and the traditional group, respectively, in the FT group which was shorter than that in the traditional group (Plt;0.05). ③ The mortality rate and readmission rate was 0 on 2 weeks after operation in two groups. ④ The total morbidity rate was 11.76% (6/51) in the FT group, in the traditional group was 28.85% (15/52), there was significant difference between two groups (Plt;0.05), while there was no significant difference in general complications and surgical complications between two groups (Pgt;0.05).Conclusions FT surgery for elderly patients with colorectal carcinoma is feasible and could enhance recovery, cut down morbidity rate and shorten postoperative hospital stay. If the FT courses are more completed, the clinical outcomes could be better.
Objective To assess the effect of integrated traditional Chinese medicine with western medicine (ICWM) in the treatment of SARS. Methods We searched MEDLINE, EMBASE, and Chinese BioMed Database ( CBM ) , and the Intemet performed handsearching in Chinese journals and reference lists. We included randomised controlled trials and prospective controlled studies of integrated Chinese medicine with western medicine versus western medicine alone in people with SARS. Three independent reviewers collected details of study population, interventions, and outcomes using a data extraction form. We conducted meta-analysis for similar data of studies.Results Nine studies (n =812) were included, all with the possibility of containing serious bias. ICWM in the treatment of SARS was associated with the following reductions: case fatality [ OR 0.32, 95% CI (0.14,0.71 ) ] , fever clearance time [ WMD -1.17, 95% CI ( -1.83, -0.50 ) , symptom remission time [ WMD-1.47, 95% CI ( - 1.96, - 0. 98) ] and the number of inflammation absorption cases [ MD 1.63, 95% CI(0.95, 2.80 ) ], having no significant difference in symptom scores of convalescents [ WMD -1.25, 95% CI ( -2.71, 0.21 ) ], cumulative dose of corticosteroids [ WMD - 236.96, 95% CI ( - 490.64, 16.73) ] and inflammation absorption mean time [ WMD 0.63, 95% CI ( - 1.33, 2.59) ] .Conclusions Due to the methodological limitations of the studies, the effect of ICWM for SARS is unclear. The apparent improvements in cases fatality, fever clearance time, syndromes remission time and numbers of inflammation absorption cases warrant further evaluation with high quality and large scale trials to be expected.
Radiopharmaceutical dynamic imaging typically necessitates intravenous injection via the bolus method. However, manual bolus injection carries the risk of handling errors as well as radiological injuries. Hence, there is potential for automated injection devices to replace manual injection methods. In this study, the effect of micro-bolus pulse injection technology was compared and verified by radioactive experiments using a programmable injection pump, and the overall bubble recognition experiment and rat tail vein simulation injection verification were performed using the piezoelectric sensor preloading method. The results showed that at the same injection peak speed, the effective flushing volume of micro-bolus pulse flushing (about 83 μL/pulse) was 49.65% lower than that of uniform injection and 25.77% lower than that of manual flushing. In order to avoid the dilution effect of long pipe on the volume of liquid, the use of piezoelectric sensor for sealing preloading detection could accurately predict the bubbles of more than 100 μL in the syringe. In the simulated injection experiment of rat tail vein, when the needle was placed in different tissues by preloading 100 μL normal saline, the piezoelectric sensor fed back a large difference in pressure attenuation rate within one second, which was 2.78% in muscle, 17.28% in subcutaneous and 54.71% in vein. Micro-bolus pulse injection method and piezoelectric sensor sealing preloading method have application potential in improving the safety of radiopharmaceutical automatic bolus injection.