手术室非惩罚性护理不良事件报告制度的建立

手术室护理不良事件发生率影响因素较多,建立非惩罚性护理不良事件报告制度是非常有效的控制不良事件的方法。通过在本院手术室建立非惩罚性护理不良事件报告制度,对上报的护理不良事件分析发生的根本原因并提出修正方案及预防措施,提升护理质量,完善护理流程及管理制度。     

CT检查中造影剂不良反应的预防、处理及对影像学检查的影响分析

目的：在CT等医学影像检查过程中,常需要应用造影剂。在造影剂的使用常常发生不良反应,掌握不良反应的发生率,减少或减轻患者的不良反应,能够使CT增强扫描顺利进行,提高检查安全性。方法：搜集我院2011年10月至2012年9月间的1500例CT造影增强检查患者,包括冠状动脉CT血管成像（冠脉CTA）、头部CT血管成像（头CTA）、肝脏增强、泌尿系三维成像（CTU）以及双下肢血管成像（双下肢CTA）,进行造影剂的不良反应类型、造影剂药物剂量、注射速度等统计分析,总结造成不良反应发生的因素及处理方法。结果：不良反应的类型包括发热、呕吐、荨麻疹、面色潮红、局部疼痛、流泪、血压下降、喉头水肿、休克等。使用非离子型造影剂出现不良反应者85例,占5．67％。其中轻度反应65例,占4．33％;中度反应16例,占1．06％;重度4例,占0．27％。结论：在CT增强扫描过程中,造影剂的用量及注射速度与不良反应的发生有相关性。cT检查过程总应该认真执行操作流程,密切观察病人情况,积极防治,正确处理,将造影剂不良反应降低到最低程度,使患者更加安全。     

双膦酸盐类药物致不良反应回顾性分析

目的:分析双膦酸盐类药物所致不良反应情况。方法:检索中国期刊全文数据库(CNKI)、万方数据库(Wan Fang)、中文科技期刊数据库(VIP)2004年1月至2013年8月国内有关双膦酸盐致不良反应的个案报道,按年龄、性别、原发病、药物名称、给药途径、不良反应发生时间、临床表现症状、治疗与转归等进行分类统计分析。结果:48例不良反应包括运动系统、消化系统、感官系统、循环系统、神经系统及全身性损害,高年龄段与女性发生率较高。结论:临床上应重视双膦酸盐类药物所致不良反应,坚持合理用药。     

我院2010年度药物不良反应分析

目的分析药物不良反应(ADR)发生的特点与规律,促进临床合理用药。方法回顾性分析2010年1~12月我院上报的401份ADR报告,按患者年龄、性别、给药途径、引起ADR的药品种类、涉及器官或系统以及临床表现等进行统计、分析。结果静脉给药较其他给药途径更易发生ADR(336例,占83.89%);抗感染药物引发ADR的比例最高(159例,占39.65%),其次为营养药、消化系统药物及抗肿瘤药物;头孢菌素类药物是引发ADR的主要抗菌药物(15种,28.85%),其次为青霉素类(10种,19.23%)。ADR主要累及皮肤及附件损害为主,其次涉及到消化系统以及神经系统损害。结论临床科室应重视ADR监测,减少ADR的发生,提高合理用药水平。     

甘肃省麻疹减毒活疫苗强化免疫疑似接种异常反应分析

目的分析甘肃省2010年和2011年麻疹减毒活疫苗(Measles vaccine,live MV)强化免疫活动中疑似预防接种异常反应(Adverse events following immunization,AEFI)发生特征,评价AEFI监测工作。方法收集2010年和2011年甘肃省AEFI监测系统报告数据,采用描述性流行病学方法对相关数据进行分析。结果甘肃省2010年和2011年MV强化免疫活动共报告AEFI病例346例,报告发生率为14.17/100万,男性略多于女性。一般反应报告发生率为12.82/100万,异常反应报告发生率为1.19/100万,异常反应主要以过敏性皮疹为主。接种MV后,发生AEFI的时间多在1 d之内,占总报告病例数的76.41%,并呈现随着年龄增大发生率逐渐降低的趋势。结论两次MV强化免疫活动AEFI报告发生率较低,接种MV后的1 d之内需要重点监测,加强主动监测,提高AEFI的预防和处理水平。     

Modeling daily flowering probabilities: expected impact of climate change on Japanese cherry phenology

Understanding the drivers of phenological events is vital for forecasting species’ responses to climate change. We developed flexible Bayesian survival regression models to assess a 29‐year, individual‐level time series of flowering phenology from four taxa of Japanese cherry trees (Prunus spachiana, Prunus × yedoensis, Prunus jamasakura, and Prunus lannesiana), from the Tama Forest Cherry Preservation Garden in Hachioji, Japan. Our modeling framework used time‐varying (chill and heat units) and time‐invariant (slope, aspect, and elevation) factors. We found limited differences among taxa in sensitivity to chill, but earlier flowering taxa, such as P. spachiana, were more sensitive to heat than later flowering taxa, such as P. lannesiana. Using an ensemble of three downscaled regional climate models under the A1B emissions scenario, we projected shifts in flowering timing by 2100. Projections suggest that each taxa will flower about 30 days earlier on average by 2100 with 2–6 days greater uncertainty around the species mean flowering date. Dramatic shifts in the flowering times of cherry trees may have implications for economically important cultural festivals in Japan and East Asia. The survival models used here provide a mechanistic modeling approach and are broadly applicable to any time‐to‐event phenological data, such as plant leafing, bird arrival time, and insect emergence. The ability to explicitly quantify uncertainty, examine phenological responses on a fine time scale, and incorporate conditions leading up to an event may provide future insight into phenologically driven changes in carbon balance and ecological mismatches of plants and pollinators in natural populations and horticultural crops.     

Accuracy and precision of gait events derived from motion capture in horses during walk and trot

This study aimed to create an evidence base for detection of stance-phase timings from motion capture in horses. The objective was to compare the accuracy (bias) and precision (SD) for five published algorithms for the detection of hoof-on and hoof-off using force plates as the reference standard.     

Large-scale observational studies of hypericum extracts in patients with depressive disorders—a systematic review

We present a systematic review of observational studies of hypericum extracts in the treatment of depressive disorders. We included non-randomized studies with at least 100 patients suffering from depressive disorders treated with hypericum mono-preparations for at least 4 weeks, which reported clinical outcomes. Potentially relevant studies were identified through searches in electronic databases (Medline, PubMed), contacts with manufacturers, and handsearching of proceedings of phytomedicine congresses. Information on patients, interventions, methods an results were extracted by two reviewers. Sixteen studies including a total of 34,804 (range 101-11,296) patients met the inclusion criteria. Most studies investigated short-term effects (4-6 weeks) in patients with mild to moderate depression. Response rates (according to physician assessment) varied between 65% and 100%, the proportion of patients dropping out due to side effects varied between 0.0% and 2.8%. Two studies investigated long-term effects (52 weeks). Reponse rates were 60% and 69%, respectively, and the proportions of patients dropping out due to side effects were 3.4% and 5.7%, respectively. Serious side effects or interactions were not reported in any study. The quality of reporting was insufficient in the majority of publications. The available studies show that hypericum extract are well tolerated and seem to be effective in routine treatment of mild to moderate depressive disorders.     

Phosphogenesis in the 2460 and 2728 million‐year‐old banded iron formations as evidence for biological cycling of phosphate in the early biosphere

The banded iron formation deposited during the first 2 billion years of Earth's history holds the key to understanding the interplay between the geosphere and the early biosphere at large geological timescales. The earliest ore‐scale phosphorite depositions formed almost at ~2.0–2.2 billion years ago bear evidence for the earliest bloom of aerobic life. The cycling of nutrient phosphorus and how it constrained primary productivity in the anaerobic world of Archean–Palaeoproterozoic eons are still open questions. The controversy centers about whether the precipitation of ultrafine ferric oxyhydroxide due to the microbial Fe(II) oxidation in oceans earlier than 1.9 billion years substantially sequestrated phosphate, and whether this process significantly limited the primary productivity of the early biosphere. In this study, we report apatite radial flowers of a few micrometers in the 2728 million‐year‐old Abitibi banded iron formation and the 2460 million‐year‐old Kuruman banded iron formation and their similarities to those in the 535 million‐year‐old Lower Cambrian phosphorite. The lithology of the 535 Million‐year‐old phosphorite as a biosignature bears abundant biomarkers that reveal the possible similar biogeochemical cycling of phosphorus in the Later Archean and Palaeoproterozoic oceans. These apatite radial flowers represent the primary precipitation of phosphate derived from the phytoplankton blooms in the euphotic zones of Neoarchean and Palaoeproterozoic oceans. The unbiased distributions of the apatite radial flowers within sub‐millimeter bands do not support the idea of an Archean Crisis of Phosphate. This is the first report of the microbial mediated mineralization of phosphorus before the Great Oxidation Event when the whole biosphere was still dominated by anaerobic microorganisms.