During the outbreak of novel coronavirus pneumonia(NCP)in Wuhan,public hospitals have played an important role in intensive care,case guidance and scheme optimization.At the same time,it also faces unprecedented chall...During the outbreak of novel coronavirus pneumonia(NCP)in Wuhan,public hospitals have played an important role in intensive care,case guidance and scheme optimization.At the same time,it also faces unprecedented challenges and tests.Based on the treatment of severe patients in Wuhan,combined with the treatment practice in Tongji Hospital affiliated to Tongji Medical College,Huazhong University of Science and Technology,this paper puts forward the urgency of further strengthening the construction of public hospitals,discusses the feasible path for promoting the development of public hospitals,so as to meet the growing medical needs of the people,improve the ability to respond to major public health emergencies,and effectively guarantee the safety of people's lives and the promotion of a healthy China construction.展开更多
Safety is one of the most critical themes in any large-scale railway construction project.Recognizing the importance of safety in railway engineering,practitioners and researchers have proposed various standards and p...Safety is one of the most critical themes in any large-scale railway construction project.Recognizing the importance of safety in railway engineering,practitioners and researchers have proposed various standards and procedures to ensure safety in construction activities.In this study,we first review four critical research areas of risk warning technologies and emergency response mechanisms in railway construction,namely,(i)risk identification methods of large-scale railway construction projects,(ii)risk management of large-scale railway construction,(iii)emergency response planning and management,and(iv)emergency response and rescue mechanisms.After reviewing the existing studies,we present four corresponding research areas and recommendations on the Sichuan-Tibet Railway construction.This study aims to inject new significant theoretical elements into the decision-making process and construction of this railway project in China.展开更多
目的:构建应急标本信息采集系统,评价其在无网络条件下实现重大传染病疫情防控中的标本采集工作的规范性和准确性。方法:采用Sybase Power Builder开发工具,将Microsoft Access作为后台数据库,选取客户端与服务器(C/S)架构模式,以医院...目的:构建应急标本信息采集系统,评价其在无网络条件下实现重大传染病疫情防控中的标本采集工作的规范性和准确性。方法:采用Sybase Power Builder开发工具,将Microsoft Access作为后台数据库,选取客户端与服务器(C/S)架构模式,以医院实验室信息系统(LIS)或第三方系统为基础,构建能够应对重大传染病大规模标本采样工作的应急标本信息采集系统,对比不同标本信息采样方式的应用效果。结果:应急标本采集系统采集信息的信息录入完整率、正确率及时效性均优于手工方式,差异有统计学意义(x^(2)=89.97、109.83,P<0.05)、(t=146.74,P<0.05),提高了标本采集的效率,减少信息差错率,还可降低交叉感染风险,使重大传染病疫情防控中的标本采集工作更加规范和便捷。结论:应急标本信息采集系统在应对重大传染病大规模采样工作中起到重要作用,能够提升工作效率,保障信息的安全性和准确性。展开更多
目的本文以大学附属教学医院的卒中急救绿色通道培训医师为主要研究对象,旨在提高新进医疗岗位医师的学习效率,改善临床工作的多种质控指标。方法设计多元化教学方法,包括临床案例式协作教学法、基于问题教学法、翻转课堂、一带一学习...目的本文以大学附属教学医院的卒中急救绿色通道培训医师为主要研究对象,旨在提高新进医疗岗位医师的学习效率,改善临床工作的多种质控指标。方法设计多元化教学方法,包括临床案例式协作教学法、基于问题教学法、翻转课堂、一带一学习、情景模拟及临床疗效反馈等,以一家教学医院区域性高级卒中中心的绿色通道患者和医师为调查对象,收集多环节时间点的质控指标以及教学互评反馈来评价教学效果。结果纳入2021年6月—2023年7月急诊卒中绿色通道诊疗环节中符合条件的患者194例,其中接受单纯静脉溶栓治疗者171例(88.14%),桥接治疗或者直接机械取栓者23例(11.86%),纳入观察学员为低年资住院医师10名,高年资住院医师5名。培训前收治患者88例(45.36%),培训后收治患者106例(54.64%),人口学基线特征差异无统计学意义。中位入院至静脉溶栓时间(door-to-needle time,DNT)缩短了4 min(44 min vs.48 min,P=0.150),DNT≤60 min比例分别为73.86%、65.09%(P=0.188)。培训后,中位知情同意谈话时间缩短了3.5 min(6.5 mi n vs.10 min,P=0.001);溶栓相关出血事件减少(培训前:牙龈出血1例,硬膜下血肿1例,消化道出血1例;培训后:无相关事件);大血管闭塞患者血管内治疗比例提升(16.98%vs.5.68%,P=0.015)。高年资与低年资住院医师对多元化教学模式绿色通道教学方法的认可度、对绿色通道学习方式的兴趣程度、病例质控环节提升满意度、影像库对解决问题适配度、文献指南库对解决问题适配度和自我学习能力提升6个方面的满意度相当,差异均无统计学意义。结论多元化培训方案可以提高绿色通道医师的卒中急救应对能力、谈话沟通技能及诊疗水平,改善工作质量和教学满意度,而且对低年资和高年资住院医师的临床学习均有帮助。展开更多
文摘During the outbreak of novel coronavirus pneumonia(NCP)in Wuhan,public hospitals have played an important role in intensive care,case guidance and scheme optimization.At the same time,it also faces unprecedented challenges and tests.Based on the treatment of severe patients in Wuhan,combined with the treatment practice in Tongji Hospital affiliated to Tongji Medical College,Huazhong University of Science and Technology,this paper puts forward the urgency of further strengthening the construction of public hospitals,discusses the feasible path for promoting the development of public hospitals,so as to meet the growing medical needs of the people,improve the ability to respond to major public health emergencies,and effectively guarantee the safety of people's lives and the promotion of a healthy China construction.
基金This study was supported by the National Natural Science Foundation of China(Grant No.71942006)the Fundamental Research Funds for the Central Universities(2019RC053).
文摘Safety is one of the most critical themes in any large-scale railway construction project.Recognizing the importance of safety in railway engineering,practitioners and researchers have proposed various standards and procedures to ensure safety in construction activities.In this study,we first review four critical research areas of risk warning technologies and emergency response mechanisms in railway construction,namely,(i)risk identification methods of large-scale railway construction projects,(ii)risk management of large-scale railway construction,(iii)emergency response planning and management,and(iv)emergency response and rescue mechanisms.After reviewing the existing studies,we present four corresponding research areas and recommendations on the Sichuan-Tibet Railway construction.This study aims to inject new significant theoretical elements into the decision-making process and construction of this railway project in China.
文摘目的:构建应急标本信息采集系统,评价其在无网络条件下实现重大传染病疫情防控中的标本采集工作的规范性和准确性。方法:采用Sybase Power Builder开发工具,将Microsoft Access作为后台数据库,选取客户端与服务器(C/S)架构模式,以医院实验室信息系统(LIS)或第三方系统为基础,构建能够应对重大传染病大规模标本采样工作的应急标本信息采集系统,对比不同标本信息采样方式的应用效果。结果:应急标本采集系统采集信息的信息录入完整率、正确率及时效性均优于手工方式,差异有统计学意义(x^(2)=89.97、109.83,P<0.05)、(t=146.74,P<0.05),提高了标本采集的效率,减少信息差错率,还可降低交叉感染风险,使重大传染病疫情防控中的标本采集工作更加规范和便捷。结论:应急标本信息采集系统在应对重大传染病大规模采样工作中起到重要作用,能够提升工作效率,保障信息的安全性和准确性。
文摘目的本文以大学附属教学医院的卒中急救绿色通道培训医师为主要研究对象,旨在提高新进医疗岗位医师的学习效率,改善临床工作的多种质控指标。方法设计多元化教学方法,包括临床案例式协作教学法、基于问题教学法、翻转课堂、一带一学习、情景模拟及临床疗效反馈等,以一家教学医院区域性高级卒中中心的绿色通道患者和医师为调查对象,收集多环节时间点的质控指标以及教学互评反馈来评价教学效果。结果纳入2021年6月—2023年7月急诊卒中绿色通道诊疗环节中符合条件的患者194例,其中接受单纯静脉溶栓治疗者171例(88.14%),桥接治疗或者直接机械取栓者23例(11.86%),纳入观察学员为低年资住院医师10名,高年资住院医师5名。培训前收治患者88例(45.36%),培训后收治患者106例(54.64%),人口学基线特征差异无统计学意义。中位入院至静脉溶栓时间(door-to-needle time,DNT)缩短了4 min(44 min vs.48 min,P=0.150),DNT≤60 min比例分别为73.86%、65.09%(P=0.188)。培训后,中位知情同意谈话时间缩短了3.5 min(6.5 mi n vs.10 min,P=0.001);溶栓相关出血事件减少(培训前:牙龈出血1例,硬膜下血肿1例,消化道出血1例;培训后:无相关事件);大血管闭塞患者血管内治疗比例提升(16.98%vs.5.68%,P=0.015)。高年资与低年资住院医师对多元化教学模式绿色通道教学方法的认可度、对绿色通道学习方式的兴趣程度、病例质控环节提升满意度、影像库对解决问题适配度、文献指南库对解决问题适配度和自我学习能力提升6个方面的满意度相当,差异均无统计学意义。结论多元化培训方案可以提高绿色通道医师的卒中急救应对能力、谈话沟通技能及诊疗水平,改善工作质量和教学满意度,而且对低年资和高年资住院医师的临床学习均有帮助。
