细化生活方式联合屈螺酮炔雌醇片(Ⅱ)、二甲双胍治疗多囊卵巢综合征合并高胆固醇血症不孕症患者的临床效果及对Betatrophin水平的影响

目的探讨细化生活方式联合屈螺酮炔雌醇片(Ⅱ)、二甲双胍治疗多囊卵巢综合征(PCOS)合并高胆固醇血症不孕症患者的临床效果及对Betatrophin水平的影响。方法选择2021年1月至8月在河北省承德市中心医院生殖医学科确诊的30例PCOS合并高胆固醇血症不孕症患者,根据不同治疗方案分为A组和B组,各15例。A组给予平衡膳食、运动管理联合屈螺酮炔雌醇片(Ⅱ)和二甲双胍治疗,B组给予屈螺酮炔雌醇片(Ⅱ)和二甲双胍治疗。比较两组的体重指数、总胆固醇、性激素及血清Betatrophin水平、排卵和妊娠情况。结果治疗后A组体重指数、总胆固醇、黄体生成素、雄烯二酮、Betatrophin水平低于B组(P<0.05);两组排卵、临床妊娠率比较,差异无统计学意义(P>0.05)。结论细化生活方式联合屈螺酮炔雌醇片(Ⅱ)、二甲双胍治疗PCOS合并高胆固醇血症不孕症患者,可有效改善脂代谢紊乱,降低黄体生成素、雄烯二酮、血清Betatrophin水平。

Present situation and the countermeasures of health human resources in Guangxi general hospitals at the county - level

[目的] 了解广西县级综合医院卫生人力资源状况,为进一步推进县级医院改革提供建设性意见. [方法]通过问卷调查法、数理统计法等综合分析广西县级综合医院卫生人力资源现状.[结果]广西县级综合 医院在岗人员在编率为41.56%,医护比为1： 1.68, 67.12%的卫生技术人员职称为初级及以下,超七成拥有 大专及以上学历.[结论]广西县级综合医院卫生技术人员在编率较低,医护比、职称及学历结构不合理,整 体年龄偏低,需通过综合措施加以改善.

Effects of Acupoint Massage Combined with Psychological Nursing on Depression and Hope Level and Coping Style in Hospitalized Patients with Hepatocirrhosis

OBJECTIVE: To explore the effects of acupoint massage combined with psychological nursing on depression and hope level and coping style in hospitalized patients with hepatocirrhosis, and to provide scientific basis for clinical treatment. METHODS: A total of 86 patients with hepatocirrhosis hospitalized in The Sixth Hospital of Handan from June 2015 to June 2018 were selected and divided into 2 groups according to the nursing method. The control group, with a total of 42 patients, were given psychological nursing intervention. The observation group, with a total of 44 patients, were given acupoint massage and psychological nursing intervention. Changes in depression levels, hope levels, and coping style scores were compared between the 2 groups. RESULTS: There was no significant difference in depression, hope level and coping style before the intervention between the 2 groups(P > 0.05). In the observation group, the self-rating depression scale(SDS) score of depression before intervention was 55.16 ± 4.17; and the positive attitude score was 8.40 ± 2.02; the positive action score was 8.33 ± 3.05; and the intimate score was 8.13 ± 2.44. The negative response score was 30.14 ± 3.31, and the positive response score was 30.49 ± 3.26. Before the intervention, the SDS score in the control group was 56.81 ± 4.39, and the positive attitude score was 8.29 ± 1.98. The positive action score was 8.04 ± 2.57, and the intimate score was 8.06 ± 2.31. The total level of hope score was 24.07 ± 3.11. The negative coping score was 30.55 ± 3.06, and the positive coping score was 30.93 ± 3.17. After intervention the SDS scores of the observation group were lower than those of the control group(P < 0.05). The SDS score of the observation group was 36.19 ± 4.19, and the SDS score of the control group was 42.95 ± 3.71. The total level of hope in the observation group was higher than that in the control group after intervention(P < 0.05). The positive attitude score of the observation group was 16.10 ± 2.15, and the score of positive action was 14.74 ± 3.11; the score of intimate relationship was 15.08 ± 5.45; and the total score of hope was 45.71 ± 5.63. The positive attitude score of the control group was 10.92 ± 2.07; the score of positive action was 11.38 ± 3.14; the score of intimate relationship was 10.92 ± 2.33; and the total score of hope was 34.09 ± 5.77. The patients in the observation group had lower response scores after intervention than the control group, and the positive response scores were higher than those in the control group(P < 0.05). The negative response score of the observation group was 20.14 ± 2.19; the positive response score was 38.92 ± 4.33; the negative response score of the control group was 26.61 ± 2.34; and the positive response score was 34.08 ± 2.69. CONCLUSION: Acupoint massage combined with psychological nursing can effectively improve depression in hospitalized patients with hepatocirrhosis, improve the patient's hope level, help patients cope with lifestyle changes from negative to positive, which is worthy of clinical promotion.

Awareness of Fathers Regarding Newborn Danger Signs: Evidence from a Tertiary Level Hospital of Kathmandu, Nepal

The neonatal period is a critical period of childhood carrying the highest risk of mortality per day than any other period during the childhood. In Nepal, a country where a neonatal mortality rate is high, raising awareness among fathers regarding newborn danger signs is crucial. This research aims to measure the awareness of fathers regarding newborn danger signs. A hospital based cross sectional descriptive study was done in maternity ward and birthing center of Tribhuvan University Teaching Hospital (TUTH) hospital. Non-probability purposive sampling technique was used to select fathers of neonate. The study was conducted on 103 fathers having newborn baby up to 7 days admitted in Maternity Ward and Birthing Center. Respondents were selected without any discrimination of education, ethnicity, economical status, marital status, religion, etc. The findings of the study showed that out of 103 respondents, most of the respondents had moderate level of awareness (63.1%), 28.2% had low level and minority of the respondents had high level of awareness (8.7%). The researcher concluded that most of the respondents had a moderate level of awareness and minority of the respondents had a high level of awareness on newborn danger signs. The findings show greater need of health education to increase awareness about newborn danger signs among fathers.

Assisting Nurses in Basic-Level Hospitals to Improve Three Capacities

The importance of scientific study has received more and more attentions from various levels of hospitals,while paper writing,topic declaring,and achievement and patent grasping have become the fundamental tasks for the hospitals. As nurses in basic-level hospitals,howto find and implement excellent scientific research thoughts in busy work has become a challenge in front of them. Nursing of Integrated Traditional Chinese and Western M edicine attempts to establish a Special Fund for Nursing of Integrated Traditional Chinese and Western M edicine( "Special Fund"for short),aiming to support and assisting nurses in basic-level hospitals to conduct nursing-associated scientific research project approval,achievement declaration and publication,and to promote the co-improvement of scientific research level,academic level and quality of journals in domestic nursing field of integrated traditional Chinese and western medicine by assisting the nurses in basic-level hospitals to improve their declaring,executing and summarizing capacities on nursing research topics.

柳钢中板双机架轧机LevelⅡ控制系统开发

针对柳钢2 800 mm双机架中厚板轧机,自主设计开发了完整的L eve lⅡ计算机控制系统.L eve lⅡ系统由数据通讯模块、模型设定模块、模型自学习模块、轧件跟踪模块、数据管理模块等多个模块组成.数据通讯模块负责L eve lⅡ控制系统和其他系统之间的数据通讯;数据管理模块包括数据采集与数据记录,为模型计算查询模型参数,记录每块轧件的实际工艺过程参数等;轧件跟踪模块负责轧件从出炉到轧制结束全过程位置和数据的跟踪,并在不同的触发点调用其他功能模块,进行自动轧钢的轧件调度控制和轧制节奏控制;模型设定模块利用数学模型,计算轧制规程;模型自学习模块包括长期自学习和短期自学习.通过各功能模块的协作,可以实现轧机生产过程的模型自动设定和全自动轧钢控制.该系统已经成功应用于生产现场,且应用效果良好.

Assessment of Indoor and Outdoor Noise Pollution at a University Hospital Based on Acoustic Measurements and Noise Mapping

This paper describes an analysis of the sound pressure levels at the exterior fa&ccedil;ade and inside the Hospital de Clínicas of the Federal University of Paraná. Measurements were taken at a total of 45 points, 24 at the exterior facade and 21 points inside the hospital on all the floors of the main building and in the maternity building. These 45 measurements were used to calculate the acoustic map of the hospital, which is located on General Carneiro Street, in the city of Curitiba, state of Paraná, Brazil. A comparison of the measured outdoor sound pressure levels against those established by Curitiba Municipal Law No. 10625 revealed that they all exceeded the daytime limit of 55 dB(A) permitted for areas around hospitals. The indoor sound pressure measurements and the noise levels for acoustic comfort established by the Brazilian technical standard ABNT NBR 10152 were compared, indicating that all the measured points, including those in the neonatal intensive care unit, exceeded the established limit of 35 dB(A) to 45 dB(A).

TMIS中央系统LEVEL Ⅱ测试的分析和改进

作者对TMIS中央系统应用程序开发初级阶段使用的LEVELⅡ测试系统的概念进行了阐述,对LEVEL Ⅱ测试系统和实际将要运行的TMIS中央系统的主要区别进行了分析,对LEVEL Ⅱ测试系统中的MPJ的工作原理进行了探讨。为了提高开发效率,作者对LEVEL Ⅱ测试系统提出了两点改进意见。

康妇消炎栓联合屈螺酮炔雌醇片(Ⅱ)在人工流产术后患者中的应用效果

目的观察对人工流产术后患者实施康妇消炎栓联合屈螺酮炔雌醇片(Ⅱ)治疗对其预后效果的影响。方法将2021年10月至2022年10月本院收治的122例人工流产术后患者作为研究对象,根据随机数字表法分为观察组和对照组,各61例,对照组采用康妇消炎栓治疗,观察组则在对照组的基础上联用屈螺酮炔雌醇片(Ⅱ)治疗,于治疗当日、出院前1 d对比两组患者的康复指标、并发症发生率、炎性介质水平及子宫动脉血流水平。结果治疗前1 d,两组炎性介质水平及子宫动脉血流水平对比差异无统计学意义(P>0.05);出院前1 d,观察组患者康复指标、并发症发生率、炎性介质水平及子宫动脉血流水平均低于对照组(P<0.05)。结论实施康妇消炎栓联合屈螺酮炔雌醇片(Ⅱ)能够改善人工流产术后患者炎性介质水平和子宫动脉血流水平,降低其预后并发症的发生率,从而缓解阴道流血情况。

无水Ⅱ型石膏活性激发及应用研究现状

工业副产石膏由于杂质含量高制约了其资源化利用,目前采用的低温煅烧处理工艺无法有效脱除杂质,导致产品质量存在问题,通过高温煅烧可以有效解决该问题。综述了煅烧副产石膏制备无水Ⅱ型石膏的工艺控制条件,归纳了无水Ⅱ型石膏水化机理及各类型活性激发技术的特点,探讨了无水Ⅱ型石膏在化工填料和自流平砂浆方面的应用现状及开发前景,以期为工业副产石膏以无水Ⅱ型石膏的形式实现资源化利用提供参考。

Geriatric nursing competence of clinical nursing staff at different hospital levels in Chongqing,China:A cross-sectional study

Objectives:This study aimed to survey the geriatric nursing competencies of clinical nursing staff in Chongqing City,China,and provide suggestions to enhance these competencies.Methods:This study was conducted in 204 hospitals in Southwest China from December 24,2022 to January 7,2023.The“Geriatric Nursing Competence of Clinical Nurse Investigation Tool”was used to explore factors that influence geriatric nurses’competencies via stratified sampling.The survey was conducted by distributing and collecting questionnaires through the online platform Wenjuanxing.Results:A total of 10,692 nurses answered the questionnaires.Of these questionnaires,9,442 were valid.The total geriatric nursing competence score of the clinical nursing staff was 2.29±0.81,the secondary hospital score was 2.23±0.78,and the tertiary hospital’s overall mean score was 2.33±0.83.The factors that influenced secondary hospitals included the department of medicine,age of nurses and total length of career(P<0.05).The factors that influenced tertiary hospitals included the department of medicine,age of nurses,nurses’professional title,and geriatric practical advanced nurses’certification(P<0.05).Conclusions:Geriatric nursing competence among clinical nursing staff is imbalanced at a lower-middle level and is influenced by various factors.Thefindings highlight the need for further clinical training in geriatric nursing.The training of geriatric nurses should focus on necessary clinical skills and on preparing them to adequately manage comprehensive geriatric syndromes.

基于NSGA-Ⅱ的频控阵发射波束优化

为了改善频控阵波束方向图,达到波束宽度、旁瓣电平的整体最优,提出一种基于非支配排序遗传算法(Non-dominated Sorting Genetic AlgorithmⅡ,NSGA-Ⅱ)的频控阵发射波束优化方法。该方法将距离维主瓣波束宽度和最大旁瓣电平作为优化目标,采用NSGA-Ⅱ优化频率偏移求解Pareto最优解集。仿真结果表明该方法可以得到分布均匀、多样性良好的Pareto前沿,结合实际应用需求可以从Pareto最优解集中选择一组合适的频率偏移,与现有的频控阵相比具有更好的目标定位能力。

基于TIG模式的层级培训对妇幼医院急诊护士核心能力及岗位胜任力的影响

目的 探讨基于TIG模式的层级培训对妇幼医院急诊护士核心能力及岗位胜任力的影响。方法 选取2020年6月—2022年5月妇幼医院急诊护士68名,采用随机数字表法分为对照组(34名)和研究组(34名)。对照组采用传统培训,研究组采用基于TIG模式的层级培训。对比两组护士培训结束时理论及操作考核成绩、核心能力及岗位胜任力。结果 研究组护士理论及操作考核成绩与对照组比较均明显升高,差异明显(P<0.05)。研究组护士岗位胜任力评估量表各维度评分与对照组比均明显升高,差异明显(P<0.05)。研究组护士核心能力量表各维度评分与对照组比均明显升高,差异明显(P<0.05)。结论 基于TIG模式的层级培训有助于提升妇幼医院急诊护士理论及操作考核成绩、核心能力、岗位胜任力。

基于全流程仿真创伤救治模拟演练下的县域医院创伤救治现状分析

目的通过仿真创伤全流程早期救治模拟演练分析我国县域医院创伤救治能力现状。方法2018年7月—2022年7月在全国40家县域医院举办了中国创伤救治培训基层版(China trauma training basic,CTCT?-B),培训包括仿真的创伤早期全流程救治模拟演练。本研究对演练中创伤院前急救、院前院内信息联动、院内早期评估与处置、院内救治模式和流程、影响救治结局因素等进行归纳统计分析。结果40家县域医院,其中二级医院29家,三级医院11家;院前急救模式:依托型32家,指挥型6家,独立型2家;院前急救能力方面:院前规范处置31家,不规范处置7家,不处置2家;院前院内信息联动方面:电话/微信24家,院前急救系统8家,中国创伤联盟紫云系统6家,无信息交互2家;院内交接和早期评估:能够按照创伤救治规范化培训要求进行评估和处置23家,不规范17家;创伤救治模式方面:以急诊科为主导的多学科会诊模式34家,创伤科主导的创伤救治模式4家,专科主导多学科会诊模式2家;实体创伤病房6家,急诊病房23家,无病房11家;40名模拟创伤患者16人死亡,其余存活,死亡原因为早期评估和处置不规范,输血流程不合理、创伤相关核心技术缺乏,有效运行的创伤多学科团队缺乏。结论县域创伤救治过程中存在创伤早期评估和核心技术不足、缺乏院内高效的多学科救治团队、创伤集中收治模式尚未普及等问题,亟须重视解决。

3所三级甲等综合医院护士组织沉默现况及其影响因素分析

目的了解3所三级甲等综合医院护士组织沉默现状,探讨其影响因素。方法采用便利抽样法,2023年4月—8月采用一般资料调查表、护士组织沉默问卷、医院磁性要素量表(the essential of magnetism scale,EMO)对西安市3所三级甲等综合医院的874临床护士进行调查,并采用多重线性回归分析其组织沉默的影响因素。结果共855名护士完成研究。护士组织沉默总分(56.33±8.55)分;医院磁性水平总分(107.63±12.85)分。护士组织沉默与医院磁性水平呈负相关(r=-0.318,P<0.010)。医院磁性水平、年龄、职称、护龄是护士组织沉默的影响因素(均P<0.001),共同解释其62.60%的变异。结论护士组织沉默与医院磁性水平处于中等偏低水平。护士年龄小、职称低、护龄短、医院磁性水平低,其组织沉默水平较高,护理管理者可通过提高医院磁性水平来减少护士的组织沉默。

四川大学华西医院四位一体中层干部考核体系构建实践

目的:综合运用多种考核方法构建平时考核、年度考核、专项考核、任期考核四位一体的适宜公立医院高质量发展的中层干部考核体系。方法:通过改良专家咨询法,结合工作实际,确定不同维度中层干部的考核指标及权重赋值。结果:以团队业绩体现干部个人业绩,实绩量化建立中层干部四位一体的考核体系。咨询专家对一级指标的重要性、合理性、可测量性、可考核性评分和认可度均较高。结论:统筹兼顾、综合运用各类考核评价,使其相互补充、相互印证,可增强考核体系的完整性和系统性。科学合理、客观公正的干部考核体系有利于培育一支忠诚、干净、担当的高素质专业化干部队伍。

广东省县区级医院感染管理质量控制中心的现状调查

目的调研广东省县区级医院感染管理质量控制中心现实情况,为本省院感质控中心对县区级院感质量控制中心质控管理方案的制定提供参考依据,并探讨相应的管理对策。方法通过问卷星问卷调查平台对广东省2023年12月31日前成立的县区级质控中心进行调研,内容包括医院感染管理专业质控中心的成立时间、人员架构、信息化水平、管理、质控及培训工作情况等。结果广东省有68家县区级院感质控中心,覆盖率达50.37%,近五年成立的占95.59%。专家以临床和护理为主(分别占23.75%、62.97%),学历以本科为主(占71.06%)。仅13%有运行经费。39家已建医院感染信息化监测,23家未配备,6家在建。20家进行质控督导出具质控报告,占29.41%;41家举办培训,占60.29%。结论广东省医院感染管理质量控制组织体系县区级覆盖率正在稳步提升,但是未完全覆盖所有县区,缺乏政策、经费支持,人员配备、人员专业覆盖面不足。卫生健康行政部门及县区级院感质控中心需统一监测标准、质控规范及考核评价方案,提升院感质控能力,完善“四级”管理与培训体系,以有效推动提升基层医疗机构的质量安全管理水平。

关于甘肃省某三甲公立医院医务人员职业满意度的研究

以甘肃省某三甲公立医院为研究对象,了解医务人员职业满意度情况,探究影响医务人员职业满意度的因素,以此为依据,制定提升医护人员职业满意度的相关策略,为提高三甲公立医院人力资源管理水平,激励医务人员全身心投入医疗卫生事业奠定基础。

口腔专科医院非计划二次手术的回顾性分析

目的探讨口腔专科医院非计划二次手术发生的特点及影响因素。方法选取北京大学口腔医院2016—2021年所有二次手术患者信息,对非计划二次手术的病种、发生原因等进行统计分析,通过logistic回归进一步分析舌恶性肿瘤非计划二次手术的相关性因素。结果2016—2021年共发生非计划二次手术468例(1.17%),与第一次手术的间隔时间为0~20 d。构成比排在前3位的病种为颌面部恶性肿瘤、颌面部良性肿瘤、颌面部感染,导致非计划二次手术的主要原因为皮瓣血管危象、手术后血肿出血,占比为90.17%(422/468)。非计划二次手术组男性319例,女性149例,男女之比为2.14∶1,年龄53.00(36.00,62.00)岁,住院时间14.00(12.00,18.00)d,总费用为68694.91(51773.01,89850.04)元;对照组男性19932例,女性19495例,年龄31.00(18.00,53.00)岁,住院时间7.00(4.00,10.00)d,总费用为12338.96(8869.90,28650.17)元,比较差异有统计学意义(P<0.05)。非计划二次手术术式以有皮瓣为主,占比为76.07%。2016—2021年三四级手术中非计划二次手术发生率为3.62%(397/10966),高于一二级手术的0.25%(71/28929)。年龄、饮酒史、高血压、皮瓣手术是影响舌恶性肿瘤非计划二次手术的主要危险因素(P<0.05)。结论应针对口腔颌面外科专业非计划二次手术危险因素,加强围手术期和手术分级管理,以提升医疗质量。

2010-2021年新疆某三甲医院专利现状及对策分析

目的统计新疆某三甲医院2010年-2021年专利申请及授权情况,研究并分析知识产权管理工作存在的问题,为应对三级公立医院绩效考核提出专利管理及转化相应对策。方法整理2010年-2021年医院专利数据并建立数据库,对2010年-2021年专利申请与授权情况、授权专利类型分布及专利有效率、授权专利分布等情况进行分析。结果2010年-2021年医院共计申请专利1061项,授权专利974项;获授权专利中,实用新型专利964件(占比99.0%),发明专利7件(占比0.7%),外观设计专利3件(占比0.1%);总有效率为74.3%,失效专利数250件,失效比例高达25.7%。科室之间的申请专利数量和授权专利数量差别较大,专利申请数量前三的科室分别为临床医学中心(69件)、临床检验中心(53件)和骨科中心(49件),专利授权数量前三的科室为临床医学中心(69件)、骨科中心(49件)和检验中心(40件)。结论医院专利的申请数量、授权数量以及有效率整体水平呈上升趋势,但无权专利仍然占有很大比例,专利质量有待进一步提高,专利转化率非常低。建议加强相关宣传,增强专利维护意识,另外加大培训,提高专利申报书的质量。