摘要:目的:了解老年住院患者發生尿路感染的病因,為臨床治療提供依據。方法:回顧性分析我院2007年1月至2007年12月發生尿路感染的老年住院患者臨床資料,分別統計各種病因。結果:共收集52例臨床資料,發生上尿路感染17例,下尿路感染35例。前列腺增生或前列腺炎6例,尿路結石7例,單純尿路感染10例。結論:老年人由于器官衰老萎縮和免疫功能減退,抗病毒能力下降,尿路感染是老年人常見的疾病之一,應引起重視,注意根據尿細菌培養結果與尿藥物敏感結果使用敏感抗生素,并注意保護腎功能。
目的:討論規范急診科儀器設備的管理，提高護士搶救患者的質量和效率。方法:對監護室的急救儀器設備定點定位放置，規范管理；設計操作保養維修流程圖，規范護士的行為；加強培訓考核力度，使護士熟練掌握急救技能。結果:急救儀器設備地完好率、患者搶救的成功率、醫生對護士的滿意度均有所提高。結論:規范了急救設備的管理，有效的提高了護理質量，及時杜絕了護理隱患的發生。
As a new discipline, the cardiac surgery has a great development in the modern age, but still faces many problems and disputes. The emergence of the evidence-based medicine(EBM),which emphasizes the best evidence, and combines the doctor’s clinical experience to make the best judgment, gives the development of the cardiac surgery a new thinking . Four systematic reviews published in The Cochrane Library (Issue 3, 2004) have interprated the importance of EBM on how to resolve the actual problems in different field of the cardiac surgery.
Early endovascular interventional therapy can effectively improve the prognosis of patients with acute ischemic stroke. Dual-source CT dual-energy scanning, as a new CT imaging technology developed rapidly in recent years, with its unique technical characteristics and advantages, shows potential and application prospects in early endovascular interventional therapy of acute ischemic stroke. This article discusses the value of dual-source CT dual-energy scanning in the early screening and evaluation, the identification of postoperative iodine contrast agent extravasation and secondary cerebral hemorrhage, and the prediction of prognosis of patients with early endovascular interventional treatment of acute ischemic stroke. The purpose is to provide a theoretical basis for better application of dual-source CT dual-energy scanning in early endovascular interventional treatment of acute ischemic stroke.
Parkinson’s disease is a common chronic progressive neurodegenerative disease, and its main pathological change is the degeneration and loss of dopaminergic neurons in substantia nigra striatum. Vitamin D receptors are widely distributed in neurons and glial cells, and the normal function of substantia nigra striatum system depends on the level of vitamin D and the normal expression of vitamin D receptors. In recent years, from basic to clinical research, there are some differences in the conclusion of the correlation of vitamin D and its receptor gene polymorphism with Parkinson’s disease. This paper aims to review the research on the correlation of vitamin D and vitamin D receptor gene polymorphism with Parkinson’s disease, and discuss the future research direction in this field.
Acute cerebral infarction is characterized by high incidence rate, high recurrence rate, high disability rate and multiple complications. Early evaluation and treatment of acute cerebral infarction is particularly important to improve the survival rate and prognosis of patients. As an easily available clinical laboratory indicator, blood routine test can reflect the pathological changes in the body to a certain extent. In recent years, many studies have shown that the indicators such as red cell volume distribution width, mean platelet volume, neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in blood routine examination have important values in the onset, severity and prognosis of acute cerebral infarction. This article reviews the correlations of the above parameters and ratio parameters with acute cerebral infarction, in order to provide some reference and basis for clinical diagnosis, treatment and prognosis evaluation of acute cerebral infarction.
Objective To investigate the correlation between grip strength and subjective cognitive decline (SCD) in maintenance hemodialysis (MHD) patients of different genders. Methods Patients who underwent outpatient MHD in the Wenjiang Hemodialysis Unit, Department of Nephrology, West China Hospital, Sichuan University between March and June 2024 were selected as the research subjects. Multiple linear regression analysis was used to explore the relationship between grip strength and SCD in MHD patients of different genders. Results A total of 171 patients were investigated, with 76 in the non-SCD group and 95 in the SCD group. The results of multiple linear regression analysis showed that educational level (P=0.039), nutritional status (P=0.026), and grip strength (P=0.042) were the influencing factors of SCD in male MHD patients. Work status (P=0.001) and nutritional status (P=0.011) were the influencing factors of SCD in female MHD patients. Conclusions Educational level, nutritional status, and grip strength are influencing factors of SCD in male MHD patients. Work status and nutritional status are influencing factors of SCD in female MHD patients. Grip strength may serve as an indicator for evaluating SCD in male MHD patients.
Objective To analyze the causes of drug dispensing errors and reduce the error rate through scientific precautions, and improve the quality of pharmaceutical service. Methods According to the PDCA cycle, existing problems were found in dispensing between January and June 2013, and the causes were analyzed. Then, from July 2013, strategies were developed to decrease the dispensing error rate. The variation trend of dispensing error rate from January 2013 to June 2017 were observed. Result The dispensing error rate decreased since the beginning of PDCA cycle, from 0.042‰ (the first quarter of 2013) to 0.003‰ (the second quarter of 2017). Conclusion The PDCA cycle is an effective intervention to detect the errors during drug delivery in inpatient pharmacy, which could improve the quality of pharmaceutical service and insure the patients’ safety.
Spine is a common site of metastasis in patients with malignant tumors, and tumor metastasis to the spine can lead to pain, pathological fractures, and nerve compression. In order to optimize the diagnosis and management of patients with spinal metastases and metastatic spinal cord compression (MSCC), the National Institute for Health and Care Excellence (NICE) in the UK proposed the first diagnostic and treatment guidelines for patients with MSCC (or at risk of MSCC) in 2008. In recent years, with the rapid advancement of spinal surgery and radiotherapy technology, the standardized process of MSCC diagnosis and treatment urgently needs to be updated. In 2023, NICE launched new guidelines for spinal metastases and MSCC. Based on a thorough study of the guidelines, this article discusses and interprets pain management, corticosteroid treatment, application of bisphosphonates and denosumab, tools for assessing spinal stability and prognosis, radiation therapy, surgical timing and approach, etc., providing reference for clinical diagnosis and treatment in China.
The coexistence of cognitive impairment and physical frailty in maintenance hemodialysis (MHD) patients is known as cognitive frailty. It has emerged as a novel complication in MHD patients and increases the risk of adverse outcomes such as falls, fractures, functional impairment and death. Timely intervention can delay or even reverse the development of cognitive frailty to dementia, thereby reducing the risk of adverse outcomes and improving the quality of life of patients. Based on this literature review method, this article summarizes the domestic and foreign research progress on the epidemiology, assessment tools, influencing factors and intervention measures of cognitive frailty in MHD patients, aiming to provide reference for clinical staff to carry out early screening and intervention of cognitive frailty in MHD patients.