Intraoperative single administration of neutrophil peptide 1 accelerates the early functional recovery of peripheral nerves after crush injury

Neutrophil peptide 1 belongs to a family of peptides involved in innate immunity. Continuous intramuscular injection of neutrophil peptide 1 can promote the regeneration of peripheral nerves, but clinical application in this manner is not convenient. To this end, the effects of a single intraoperative administration of neutrophil peptide 1 on peripheral nerve regeneration were experimentally observed. A rat model of sciatic nerve crush injury was established using the clamp method. After model establishment, a normal saline group and a neutrophil peptide 1 group were injected with a single dose of normal saline or 10 μg/mL neutrophil peptide 1, respectively. A sham group, without sciatic nerve crush was also prepared as a control. Sciatic nerve function tests, neuroelectrophysiological tests, and hematoxylin-eosin staining showed that the nerve conduction velocity, sciatic functional index, and tibialis anterior muscle fiber cross-sectional area were better in the neutrophil peptide 1 group than in the normal saline group at 4 weeks after surgery. At 4 and 8 weeks after surgery, there were no differences in the wet weight of the tibialis anterior muscle between the neutrophil peptide 1 and saline groups. Histological staining of the sciatic nerve showed no significant differences in the number of myelinated nerve fibers or the axon cross-sectional area between the neutrophil peptide 1 and normal saline groups. The above data confirmed that a single dose of neutrophil peptide 1 during surgery can promote the recovery of neurological function 4 weeks after sciatic nerve injury. All the experiments were approved by the Medical Ethics Committee of Peking University People's Hospital, China(approval No. 2015-50) on December 9, 2015.

Trends in oxycodone and oxycodone-containing analgesics administration for back pain in emergency departments in the USA(2007–2018)

BACKGROUND:To describe trends in oxycodone and oxycodone-containing analgesic prescribing for the treatment of back pain among adults in emergency departments(EDs) in the USA from 2007 to 2018.METHODS:Data were gathered from the National Hospital Ambulatory Medical Care Survey(NHAMCS) from 2007 to 2018.The study population included individuals of all ages presenting to USA EDs.The NHAMCS reasons for visit and oxycodone drug ID codes were used to isolate patients with back pain.The main outcome was the proportion of oxycodone and oxycodone-containing analgesics prescribed for back pain in the EDs over the specified time period.RESULTS:There was a relative decrease in the overall administration of oxycodone for back pain in the EDs by 62.3% from 2007(244,000 visits) to 2018(92,000 visits).The proportion of ED patients prescribed with oxycodone-containing analgesics for back pain increased among patients aged 45 years and older(from 43.8% to 57.6%),female patients(from 54.5% to 62.0%),black patients(from 22.5% to 30.4%),and Hispanic/Latino patients(from 9.4% to 19.6%).Oxycodone/acetaminophen was most prescribed and accounted for 90.2% of all oxycodone-containing analgesics in 2007,with a decrease to 68.5% in 2018.Pure oxycodone was the second most prescribed medication,accounting for 6.1% in 2007 and 31.5% in 2018.CONCLUSION:The overall number of oxycodone-containing analgesics decreased significantly from 2007 to 2018.However,that number trended upward in 45-year-old and older,female,black,or Hispanic/Latino patients from 2007 to 2018.The total amount of pure oxycodone increased significantly from 2007 to 2008.

公用事业民营化的行政法思考

公用事业民营化改革对我国行政法治建设和宪政制度建设具有良性推动作用。公用事业民营化改革的关键是处理好政府角色、功能的合理定位问题,同时要处理好政府、公用事业企业、消费者三方的关系。具体途径是设立独立的管制机构,实现政府从公用事业的垄断经营者向竞争性经营的组织者的角色转变;积极落实政府信息公开和听证制度,实现政府管制程序的法治化;要从完善公共财政制度建设着手,进一步规范政府对公用事业领域的财政支出;要积极打造诚信政府,强化和完善政府责任的落实和追究。

行政司法中当事人的诉讼救济选择

当事人对行政司法行为不服的诉讼救济选择之所以非常艰难,其实质在于行政与民事争议的竞合。当前司法实践存在几个突出的问题:行政判决与民事判决结果矛盾,影响了司法的公信力;当事人与法院无所适从,导致争议的起诉与管辖不确定;单独的行政诉讼或民事诉讼既没有解决行政争议,也没有解决民事争议,出现反复诉讼。因此,必须正确认识行政司法是行政权扩张的结果,是现代积极行政的产物;是现代服务行政的特定现象,有行政与司法的双重性质。不服行政司法的诉讼外在表象主要是行政诉讼,实质是民事诉讼。其解决之道只有采用行政附带民事诉讼方式,对应的实体法不仅有公法也有私法。行政司法的诉讼选择途径是惟一的,其适用范围也是特定的。因此,行政诉讼法对此应回应现实,作出规定。

Factors Associated with Voluntary Cosmetic Depigmentation in Schools in the Collines Department (Benin)

Skin depigmentation is a worrying practice that is gaining popularity, particularly among young girls. However, this practice poses health risks. It also reflects a negative view of black skin color. This was a cross-sectional study carried out between April and May 2023 which involved 1039 female students from schools and universities in the Collines department selected by stratified sampling. Data was collected during a face-to-face interview using a questionnaire providing information on the demographic, socio-cultural, and economic characteristics of the girls. The depigmentation products used were identified as well as the complications caused by the use of these products. Statistical analysis made it possible to calculate the frequencies and logistic regression made it possible to identify the factors associated with depigmentation. The prevalence of depigmentation among the girls surveyed was 78.2%. The main products used were soaps based on mercurial derivative and hydroquinone (21.6%) and lotions based on hydroquinone and corticosteroids (75.7%). The factors associated with the practice of depigmentation were the ethnicity of the respondents (OR = 2.52;95% CI = [0.47 - 13.33], p = 0.001);the average monthly income of the parents (OR = 3.26;95% CI = [1.71 - 6.09], p = 0.003);the opinion of the respondents on depigmentation (OR = 2.48;95% CI = [0.84 - 7.3], p < 0.001) and the value given to light skin versus black skin (OR = 3.41;95% CI = [2.32 - 5.01], p < 0.001). In conclusion, the prevalence of depigmentation among the girls surveyed is high. Consequently, reinforced awareness measures and stricter control of bleaching products are imperative to address this high prevalence of the phenomenon.

Perceptions of Rural Emergency Department Providers regarding Telehealth-Based Care: Perceived Competency, Satisfaction with Care and Tele-ED Patient Disposition

Introduction: This study assesses rural providers’ perceptions of their ability to deliver high quality care via telehealth compared to usual care, and whether attending providers perceive that emergency department (ED) telehealth visits influence clinical reasoning in regard to patient disposition, specifically in tele-behavioral and tele-neurological cases. Methods: A cross-sectional survey was conducted of 134 ED providers (nurses [n = 126] and physicians [n = 8]) who were working in five Midwestern critical access hospitals (response rate 83%). Descriptive, correlational and stepwise regression analyses were employed to evaluate provider perceptions of 1) competency level in telehealth delivery, 2) patient health outcomes, 3) access to continuing education in telehealth, and 4) clinical influence of telehealth visit. Evaluation of preliminary set of N = 100 telehealth cases were assessed for influence of telehealth on clinical reasoning of attending physicians regarding patient disposition. Results: The majority (67%;n = 90) of participants had at least minimal experience with telehealth care delivery, with an average of 1 - 2 visits in teleneurology, and 3 - 4 visits in telebehavioral cases. Providers rated their overall mean competency level in telehealth care delivery as 3.01/5.00 based on a 5 point “novice (1) to expert” (5) scale. Mean scores for providers perceived competency level in 7 evidence-based sub-categories for telehealth care delivery were self-reported as relatively low to mid-range values, ranging from 2.64 - 3.57/5.00. Stepwise linear regression analysis of whether all providers “would recommend telehealth to their family and friends” revealed two predictors for model of best fit (n = 81;p 2 = 0.598): 1) their perceptions of telehealth experience compared to usual care;and 2) perceptions of patient health outcomes with telehealth compared to usual care. Providers rated “neutral” to “very unlikely” that they “would recommend telehealth to family and friends” (2.75/5.00;n = 122;91%). Attending physicians reported that for a majority of cases, telehealth visits influenced patient disposition and transfer decision-making (58.4%), and the influence of telehealth visits on patient disposition was statistically significantly higher for behavioral health cases (p Discussion: This study will be followed on to inform administrators/policy makers about 1) perceived level of competency of providers who implement tele-emergency care, 2) potential importance of telehealth equipment used and teamwork between rural providers and distant specialist, and 3) how use of telehealth may enhance ability of rural ED providers to improve quality of care. Perceived influence of telehealth on patient disposition is reported to be highest for telebehavioral patients. Healthcare educators need to place a priority on addressing provider competencies in telehealth through health professions degree programs and continuing education. Further research is needed to promote application and testing of evidence-based provider competencies in telehealth, and potentially relevant health communication models, to increase providers’ perceived efficacy and competency in telehealth care delivery, thus supporting high quality patient health outcomes.

Practice of Infection Prevention and Control Strategies in Risk Departments during the COVID-19 Epidemic

Objective: To explore the practice and application of infection prevention and control strategies in risk departments during the COVID-19 epidemic, and to formulate the infection prevention and control measures to provide advice and guidance in risk departments. Methods: According to the latest plan of diagnosis and treatment, prevention and control issued by the National Health Commission, expert advice and consensus, combined with the actual situation in our hospital, a series of infection prevention and control measures of COVID-19 in risk department was formulated. Results: During the epidemic period, the prevention and control measures of nine risk departments including emergency operation, anesthesiology, endoscopy center, blood purification center, otolaryngology, stomatology, medical imaging department, medical cosmetology department and pulmonary function room were established from six aspects, including pre-examination and screening, medical technology control, personnel management, personal protection, environmental disinfection, medical waste disposal, etc. Conclusion: During the epidemic period, the infection prevention and control strategy of risk departments is one of the key links to control the spread of the epidemic, and risk departments must pay attention to and strictly implement various infection prevention and control measures.

Effect of the Implementation of Emonc in the Reduction of Maternal Deaths in the Department of Collines from 2018 to 2022

Background: Maternal and neonatal mortality remains a public health problem in Benin. Each year, approximately 1500 maternal deaths and more than 12,000 newborn deaths are recorded there. In order to correct the situation, strategies such as the implementation of Emergency Obstetric and Neonatal Care (EmONC) were initiated. Objective: Determine the rates of maternal deaths in EmONC centers in the Collines department from 2018 to 2022. Framework and Methods: The study took place in Benin precisely in the Collines department. This was a descriptive cross-sectional study. Data collection was carried out during the first two weeks of January 2023 and covered data from the 09 Basic Emergency Obstetric and Neonatal Care centers (BEMONC) and the Obstetric and Neonatal Care centers of Complete Emergency (CEmONC) of the Collines department from 2018 to 2022. An estimate of the ratios of maternal deaths occurring at the level of the EmONC centers of the Collines department from 2018-2022 was carried out followed by constructive suggestions. Results: During the five years (2018 to 2022), the Collines department recorded 42,582 live births with 148 maternal deaths, i.e. a ratio of 348 maternal deaths per 100,000 live births. Between 2018 and 2022, the highest maternal death ratio was recorded in 2019, i.e. 425 maternal deaths per 100,000 live births for all EmONC centers and 607 maternal deaths per 100,000 live births in EmONC centers. The highest maternal death ratio at the BEmONC center level was recorded in 2020, i.e. 129 maternal deaths per 100,000 births. Conclusion: These results suggest that despite the implementation of EmONC in the Collines department, maternal deaths have not decreased. To improve these outcomes for a reduction in maternal deaths, urgent action must be taken.

Comparing 11 early warning scores and three shock indices in early sepsis prediction in the emergency department

BACKGROUND:This study aimed to evaluate the discriminatory performance of 11 vital sign-based early warning scores(EWSs)and three shock indices in early sepsis prediction in the emergency department(ED).METHODS:We performed a retrospective study on consecutive adult patients with an infection over 3 months in a public ED in Hong Kong.The primary outcome was sepsis(Sepsis-3 definition)within 48 h of ED presentation.Using c-statistics and the DeLong test,we compared 11 EWSs,including the National Early Warning Score 2(NEWS2),Modified Early Warning Score,and Worthing Physiological Scoring System(WPS),etc.,and three shock indices(the shock index[SI],modified shock index[MSI],and diastolic shock index[DSI]),with Systemic Inflammatory Response Syndrome(SIRS)and quick Sequential Organ Failure Assessment(qSOFA)in predicting the primary outcome,intensive care unit admission,and mortality at different time points.RESULTS:We analyzed 601 patients,of whom 166(27.6%)developed sepsis.NEWS2 had the highest point estimate(area under the receiver operating characteristic curve[AUROC]0.75,95%CI 0.70-0.79)and was significantly better than SIRS,qSOFA,other EWSs and shock indices,except WPS,at predicting the primary outcome.However,the pooled sensitivity and specificity of NEWS2≥5 for the prediction of sepsis were 0.45(95%CI 0.37-0.52)and 0.88(95%CI 0.85-0.91),respectively.The discriminatory performance of all EWSs and shock indices declined when used to predict mortality at a more remote time point.CONCLUSION:NEWS2 compared favorably with other EWSs and shock indices in early sepsis prediction but its low sensitivity at the usual cut-off point requires further modification for sepsis screening.

行政诉讼证据法制化与治安行政处罚证据

行政诉讼证据的法制化建设对治安处罚证据的要求主要有:证据种类、形式、要求的法定化,公安机关的取证行为的规范化,证据效力的形式化,证明力的等级化,以及证据判断标准的明确化。这些都为办案民警在治安管理处罚认证中高度主观化的自由裁量权提供了客观化的标准,极大地促进了公安机关在治安处罚适用过程中牢固树立法制观念,严格依法行政,做到严格、公正、文明执法。

Building a Business and Strategic Intelligence Policy as a Strategy for Promoting Congolese Business Progress and Healthy Economic Development in Eastern DRC

The aim of this study was to verify the existence of business and strategic intelligence policies at the level of Congolese companies and at the state level, likely to foster progress and healthy development in the east of the DRC. The study was based on a mixed perspective consisting of objective analysis of quantitative data and interpretative analysis of qualitative data. The results showed that business and strategic intelligence policies have not been established at either company or state level, as this is an area of activity that is not known to the players in companies and public departments, and there are no units or offices in their organizational structures responsible for managing strategic information for competitiveness on the international market. In addition, there is a real need to establish strategic information management units within companies, upstream, and to set up a national strategic information management department or agency to help local companies compete in the marketplace, downstream. This reflects the importance and timeliness of building business and strategic intelligence policies to ensure economic progress and development in the eastern DRC. Business and strategic intelligence provides companies with an appropriate tool for researching, collecting, processing and disseminating information useful for decision-making among stakeholders, in order to cope with a crisis or competitive situation. The study suggests a number of key recommendations based on its findings. To the government, it is recommended to establish the national policy of business and strategic intelligence by setting up a national agency of strategic intelligence in favor of local companies;and to companies to establish business intelligence units in their organizational structures in favor of stakeholders to foster advantageous decision-making in the competitive market and achieve progress. Finally, the study suggests that studies be carried out to fully understand the opportunities and impact of business and strategic intelligence in African countries, particularly in the DRC.

口服咪达唑仑清醒镇静术在儿童牙科充填治疗中的应用效果评价

目的评价口服咪达唑仑在儿童牙科充填治疗过程中的镇静效果。方法本研究为随机、双盲、对照临床实验,选择5～10岁(平均7.3岁)需进行牙科充填治疗的患儿40名,随机分为两组。试验组术前20分钟口服咪达唑仑(0.5mg/kg),空白对照组术前20分钟口服安慰剂 VitminC 液5ml,两组患儿均配合使用儿童专用束缚带和无痛局麻注射泵。治疗过程拍摄录像,双盲评价治疗依从性和治疗过程中的患儿精神状态情况。同时通过询问患儿,评价顺行性遗忘情况。结果两组患儿治疗过程中的行为和生理指标都有显著性差异,尤其是治疗依从性方面,咪达唑仑组与对照组比较有非常显著性差异(P<0.001)。结论口服咪达唑仑用于儿童牙科治疗镇静术是安全和有效的。同时,由于口服药易于被儿童接受的特点,必将促进这一方法在临床的快速推广。

Self Evaluation in Department of Communicable Diseases, Faculty of Medicine, Tehran University of Medical Sciences

Introduction: Self evaluation is a process that defines and collects required data to judge about decision making issues at educational system on whether the educational department is fit to educate students? The objective of this study was determining the quality of the structural elements of the department of Communicable Diseases & determining the strengths, weaknesses, opportunities and threats to improve the quality of activities in the department under research. Materials and Methods: The employed method was Mixed methods (qualitative & quantitative research), on the basis of 10 procedural steps and within 8 sections dealing with evaluated factors;such as 1) organizational and management structure 2) scientific board members 3) students 4) Manpower 5) Space of educational research and health care 6) Equipment 7) curriculum 8) satisfaction of graduates, which were studied using 61 criteria and 172 indicators. Five-point Likert Scale was used for the responses in the questionnaire (1 - 1.75 = undesirable, to 4.2 - 5 completely desirable). Finally the data were analyzed using descriptive statistics indices and the assessment software of the Educational Development Center of TUMS. The instruments used in this method included assessment software, interview, observation and self-prepared questionnaire which consisted of 7 questionnaires and 2 check lists. Finding: The results of the research showed that general average of 8 investigating sections was 56.9% as a rather desirable research work. Conclusions: Therefore, it was concluded that function of the educational management in that group was directly in line with evaluation process, but continuing the process of evaluation seems necessary.

新公共行政学:范式替代抑或是改进

2008年第三次明诺布鲁克会议的召开标志着新公共行政运动已经走向了贫民化、全球化。但仅就学术走向而言,新公共行政已经从20世纪70年代的主流走向21世纪今天的困顿局面,原创性和规范性的缺乏,政治行政二分法的迷失,实践的困难是造成这种状况的直接原因。尽管后来的新公共行政学者作了种种努力,然而囿于理论基础的薄弱,其主要价值观念偏离于资本主义社会的取向,概念的连贯性和定义准确性的缺乏造成了新公共行政学虽然在改进却没有成为一种范式的替代。

ICU层流病房空气质量影响因素的探讨与管理

目的 探讨ICU层流病房空气质量影响因素及管理对策.方法 采用平板暴露采样法,对不同人员数及活动状态、不同湿度、回风口过滤网不同清洗时间的细菌菌落数进行对比研究.结果 ①相对静止状态细菌菌落数少于活动状态时,两组有显著性差异(P＜0.05).②在不同湿度状态下湿度控制在40%～50%和50%～70%两组对比细菌菌落数差异无显著性(P＞0.05).③清洗回风口过滤网后第7、14、21、28 d采样,结果过滤网清洗时间细菌菌落数无显著性差异(P＞0.05).结论 对ICU进行科学的工作流程和管理是保持室内空气洁净的有效方法.

Therapeutic Effect of Oral Administration and External Therapy of Traditional Chinese Medicine on Cervical Tuberculous Lymphadenopathy

Objective:To analyze the clinical effect and value of oral administration and external therapy of traditional Chinese medicine for treatment of cervical tuberculous lymphadenopathy.Methods:A total of 56 patients with cervical tuberculous lymphadenopathy admitted to our hospital from January 1 to January 2018 were recruited.By using double-blind method,the patients were divided into control group(n=28)and experimental group(n=28).Control group comprised of patients with conventional anti-tuberculosis treatment,while the experimental group comprised of patients treated with oral administration and external therapy of traditional Chinese medicine.Total effective rate,incidence of complication and level of T lymphocyte subsets were compared between the two groups of cervical tuberculous lymphadenopathy patients.Results:Post-treatment data of total effective rate,complication rate,CD3+,CD4+,CD8+,CD4+/CD8+of the experimental group were compared with the control group.P<0.05;statistical analysis showed statistical significance.Post-treatment data of CD3+,CD4+,CD8+,CD4+/CD8+of both control and experimental groups were compared with pre-treatment data.P<0.05;statistical analysis showed statistical significance.Conclusion:Oral administration and external therapy of traditional Chinese medicine possesses significant effect in treatment of cervical tuberculous lymphadenopathy.

Assessment of Satisfaction in the Reception and Emergency Department of a Health Center

Introduction The main objective of any healthcare establishment must be to ensure the quality of patient care and customer satisfaction. It is necessary to regularly assess patient satisfaction. The aim of this study was to assess the level of satisfaction of customers aged over 18 years attending the emergency department of the health center. Methodology This was a descriptive and analytical cross-sectional study of patients aged 18 years and over, who attended the Samu Municipal emergency department between 02 and 30 May 2023. The satisfaction index was determined using the adapted 2009 SAPHORA-MCO questionnaire and the Likert satisfaction scale. Results A total of 400 patients were surveyed. The average age was 35 years, with a standard deviation of 14.7. Of those surveyed, 51% were women, 87% were educated, 50% lived in Grand Yoff and 59.5% were unemployed. Satisfaction levels linked to perception of the cost of care (72%), waiting time (64.3%), information given to patients (69.1%) and pain management (74 .5%) are fair. On the other hand, the levels of satisfaction linked to administrative procedures (82.5%), staff attitudes towards patients (84%), staff availability (86.4%), patient privacy (89.2%), general atmosphere (87.2%), staff competence (87.3%), and the effectiveness of care (89.4%) were satisfactory. The average waiting time was 38 minutes. However, 32% of patients waited less than 30 minutes and 92% less than an hour. The satisfaction index linked to administration and reception was 72.9% and 79.85%, respectively. The satisfaction index linked to the administration and technical quality of care is equal to 85.8% and 83.7%, respectively. The overall satisfaction index is equal to 80.6%;the level of satisfaction of users of the health structure is satisfactory. Conclusion Patient satisfaction is an essential part of quality care. Patient satisfaction must be based on effective communication from the healthcare team and the creation of a patient-caregiver relationship.

论行政责任与民事责任的严格区分——以现行交通事故相关处理规定为例

行政责任是指违反国家行政法规所规定的行政义务或法律禁止事项而应承担的法律责任。其特征是:(一)行政责任以行政义务的存在为前提;(二)行政责任是违反行政义务的行为人应承担的法律责任;(三)行政责任种类呈多样化形式。民事责任是民事主体违反民事义务所应承担的法律后果,它是法律责任中一种独立的责任。其特征是:(一)民事责任以民事义务的存在为前提;(二)民事责任是违反民事义务的行为人应承担的法律责任;(三)民事责任主要是财产责任。严格区分行政责任和民事责任是促使立法质量“与时俱进”的重要因素之一。

Laboratory or Department?Exploration and Creation in Computer Science and Technology

In the very beginning,the Computer Laboratory of the University of Cambridge was founded to provide computing service for different disciplines across the university.As computer science developed as a discipline in its own right,boundaries necessarily arose between it and other disciplines,in a way that is now often detrimental to progress.Therefore,it is necessary to reinvigorate the relationship between computer science and other academic disciplines and celebrate exploration and creativity in research.To do this,the structures of the academic department have to act as supporting scaffolding rather than barriers.Some examples are given that show the efforts being made at the University of Cambridge to approach this problem.

耐甲氧西林金黄色葡萄球菌感染79例抗菌药物临床应用分析

目的探求控制耐甲氧西林金黄色葡萄球菌(MRSA)感染的抗菌药应用现状,以利于指导临床合理用药。方法对79例确认病例进行用药全程的回顾性分析;统计各品种对MRSA的敏感度及不同时段的用药频度变化。结果79例MRSA感染病例,涉及用药35种,平均每例用药24.5d、6.65种、药费10840元。药敏试验前使用对MRSA敏感品种不足40%,但却占用药天数和品种数的70%。药敏结果报告后,用药准确率可达90%以上。万古霉素类仍为目前对MRSA最敏感(100%)和使用最多(55%)的品种。结论及早进行MRSA的分离确认和药敏试验,对缩短疗程、节省抗生素资源及药费,均有积极的指导意义。