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争取国家与公民的双赢--评四中全会关于推进依法治国的《决定》
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作者 mary gallagher 《人民论坛》 北大核心 2014年第21期67-68,共2页
中共十八届四中全会通过的关于推进依法治国的决定,包含了对中国法律体系的重要改革。中国法律体系的实质改善需要公民意识的改变,需要为官员树立新的激励机制,也需要强化公民和律师的角色。法律当然可以是执政党更有效地治理国家的工具... 中共十八届四中全会通过的关于推进依法治国的决定,包含了对中国法律体系的重要改革。中国法律体系的实质改善需要公民意识的改变,需要为官员树立新的激励机制,也需要强化公民和律师的角色。法律当然可以是执政党更有效地治理国家的工具,但它也应该是公民在一个复杂和日新月异的社会中伸张自身权益的"武器"。 展开更多
关键词 四中全会 依法治国 公民意识
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The Keys to Optimising Breast Wounds: A Meta-Analysis
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作者 Stephanie mary Anne Vincent mary gallagher +3 位作者 Alison Johnston Risal Djohan Manvydas Varzgalis Michael Sugrue 《Advances in Breast Cancer Research》 2019年第3期87-111,共25页
Background: Breast disease and breast cancer management form a major part of healthcare delivery. Surgical site occurrence (SSO) poses septic and oncological risks to patients. This study undertook a meta-analysis to ... Background: Breast disease and breast cancer management form a major part of healthcare delivery. Surgical site occurrence (SSO) poses septic and oncological risks to patients. This study undertook a meta-analysis to identify key risk factors and interventions that may alter the incidence of SSO in patients undergoing breast surgery. Methods: An ethically approved, PROSPERO-registered meta-analysis following PRISMA guidelines and Cochrane Handbook for Systematic Reviews was undertaken of all published English articles using electronic databases from 2010 to 2017 incorporating MeSH terms “risk factors”, “surgical site infections”, “breast surgery”, and “interventions”. Articles scoring > 10 for non-comparative studies and >15 for comparative studies, using MINORS criteria were included. The OR or RR using random-effects, Mantel-Haenszel method were computed for each risk factor and intervention respectively with RevMan 5. Results: The pre-operative factors affecting breast surgery SSO were diabetes mellitus (OR = 2.52, CI = 1.78 - 3.59, p < 0.001), smoking (OR = 2.39, CI = 1.57 - 3.63, p < 0.001), ASA ≥ III (OR = 2.37, CI = 1.51 - 3.74, p < 0.001), obese versus non-obese (OR = 1.84, CI = 1.52 - 2.24, p < 0.001), over-weight/obese versus normal BMI (OR = 1.70, CI = 1.36 - 2.13, p < 0.001), hypertension (OR = 1.63, CI = 1.39 - 1.90, p < 0.001), and antibiotics prophylaxis (RR = 0.58, CI = 0.36 - 0.95, p = 0.03). The intraoperative factors were surgical wound classifications 3 - 4 (OR = 6.16, CI = 2.52 - 15.02, p < 0.001), surgical drains (OR = 2.80, CI = 1.06 - 7.38, p = 0.04), and axillary lymph node dissection (OR = 1.46, CI = 1.18 - 1.80, p < 0.001). The post-operative factors were adjuvant radiotherapy (OR = 1.77, CI = 1.26 - 2.50, p = 0.001), re-operated patients (OR = 1.65, CI = 1.01 - 2.70, p = 0.05), post-operative antibiotics (RR = 0.57, CI = 0.33 - 0.98, p = 0.04), and drain antisepsis care (RR = 0.15, CI = 0.03 - 0.82, p = 0.03). Conclusions: This study identified key factors associated with increased risk of breast surgery wound occurrence. It will facilitate the development of a peri-operative breast wound bundle to optimize outcomes. 展开更多
关键词 BREAST WOUND Care BREAST WOUND Infection BREAST Surgical Site ADVERSE Outcomes BREAST IMPLANT Loss Return to the Operating THEATRE
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