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以眼底病变为首发症状的Revesz综合征1例

神经棘红细胞增多症患者护理一例

肺部结节管理策略研究进展

多系统萎缩高血压伴直立性低血压患者的护理

目的　总结多系统萎缩高血压伴直立性低血压患者的护理干预措施。 方法　对2009年5月－2012年5月收治的20例多系统萎缩高血压伴直立性低血压患者，根据临床特点分别从用药指导、安全管理、并发症预防等多方面予以针对性护理干预。 结果　20例患者头晕等不适症状得到不同程度缓解，且无跌伤坠床等意外事件、呼吸道、泌尿道感染和压疮等并发症发生。 结论　积极的综合措施及个体化的护理对策，可提高患者的生存质量。

帕金森病合并痛风致关节溃疡护理一例

PNPLA6基因新突变致Oliver-Mcfarlane综合征1例

Innovative practice of auditing qualification documents of disinfectant, disinfection devices and disposable medical devices

The quality of disinfectant, disinfection devices and disposable medical devices is closely related to the patients' safety. Hospital infection management department must carry out the audit responsibilities for qualification documents of disinfectant, disinfection devices and disposable medical devices, to guarantee legality, safety and effectiveness of products used in hospital. This paper mainly introduces the implementation of qualification documents audit in West China Hospital, Sichuan University, including system construction, process reengineering, documents audit scope and key points, and document management.

Establishing Long-term Mechanism of Cross-inspection to Promote Continuous Quality Improvement of Hospital-acquired Infection Management

ObjectiveTo explore the supervision and inspection mechanism of hospital-acquired infection management at hospital-level in order to promote continuous quality improvement of hospital-acquired infection control. MethodsInstead of inspecting hospital departments only by hospital infection control professionals, the clinical hospital infection control nurses were also involved in the two cross-inspections carried out respectively in September and December, 2013, which shared the same contents, methods, and the inspectors. According to standard procedures, on-site view and inquiry methods were adopted to check the implementation of the system and measures and the infection control knowledge among medical staff. Inspection results were written down to feed back to each department with a unified form. The problems found during the two inspections were classified to be analyzed and solved. The results of the two inspections were compared to understand whether the effect of continuous quality improvement can be achieved through cross-inspections and subsequent work. ResultsThe excellent rate of department and overall accuracy rate of the second inspection increased with statistical significance compared to that of the first inspection (χ2=619.902, P=0.000; χ2=40.347, P=0.000). Meanwhile, the correct rate of each module and infection control knowledge among all kinds of medical staff also increased compared with the first inspection with statistically significant differences (P<0.05). ConclusionLong-term mechanism of cross-inspection involving hospital infection control nurses should be established to facilitate the continuous quality improvement of hospital-acquired infection management.

Differential gene expressions in peripheral blood mononuclear cells between Th2-driven classical asthma and cough variant asthma

Objective To reveal the differences in gene expression levels between Th2-driven classical asthma (CA) and Th2-driven cough variant asthma (CVA) in order to investigate the pathogenesis of asthma further. Methods Clinical data were collected from asthmatic patients in the Department of Respiratory and Critical Care of Sichuan Provincial People's Hospital from June 1, 2018, to December 31, 2019. The healthy control (HC) group was healthy adults from the physical examination center. Gene expression of peripheral blood mononuclear cells (PBMCs) in the CA group, CVA group, and HC group was determined by full-length transcriptome sequencing. Differential genes were screened by GO, KEGG analysis, and protein-protein interaction (PPI) network analysis. The results of interaction network analysis were visualized by Cytoscape. Finally, the candidate genes were verified by real-time quantitative polymerase chain reaction (RT-PCR). ResultsA total of 31 patients with asthma were included in the study, including 20 patients in the CA group and 11 patients in the CVA group. According to serum total IgE > 60 IU/mL and fractional exhaled nitric oxide (FeNO) > 40 ppb as the screening condition, 9 cases of Th2-driven CA and 5 cases of Th2-driven CVA were screened for analysis. Gene expression analysis showed 300 differentially expressed genes between the Th2-driven CA group and the Th2-driven CVA group, among which 155 genes were up-regulated, and 145 were down-regulated. GO enrichment analysis showed that differential genes were mainly enriched in drug response, nitrogen compound biosynthesis, cytoplasmic matrix, protein binding, ATP binding, etc. KEGG pathway analysis showed that differential genes were mainly concentrated in 2-oxy-carboxylic acid metabolism and cytotoxic signaling pathways mediated by natural killer cells. PPI analysis revealed extensive protein interactions between different genes. Ten candidate genes were screened for RT-PCR verification and finally found that CLU, GZMB, PPBP, PRF1, PTGS1, and TMSB4X were significantly differentially expressed between the Th2-driven CA group and the Th2-driven CVA group. Conclusions Asthma's occurrence results from the interaction of many genes and pathways. CLU, GZMB, PPBP, PRF1, PTGS1, and TMSB4X genes may be essential in developing Th2-driven CVA to Th2-driven CA.

安全注射的现状及管理对策

注射是医疗、预防、保健服务中最常使用的技术手段，而不安全注射已成为严重的公共卫生安全问题，在发展中国家尤为突出。不安全注射主要与缺乏安全注射的意识和知识、缺乏有效的方法和设备、经济利益趋势导致注射滥用以及缺乏安全注射监管体系等密切相关。安全注射不仅是医院感染防控和医务人员职业安全保障的基本措施，也体现了医疗卫生保健机构的整体管理水平和医疗质量。安全注射的管理是系统工程，涉及到国家政策和法规、教育培训、产品和技术改进及监督管理等方面，应积极采取有效措施推动和促进我国安全注射质量的持续改进，保障注射安全。