哈尔滨市综合医院手术室病人安全管理现状与对策研究

采用随机抽样的方法,在哈尔滨市随机抽取5家三级、5家二级综合医院的手术室进行病人安全管理现状调查。从手术室护理人员构成、人员培训、规制、布局流程、设备配置、病人辨识、消毒灭菌、医护配合8个方面全面分析了目标医院在手术室病人安全管理方面存在的问题,并提出改进对策,旨在改善手术室管理现状,保障手术室病人安全。     

长期住院老年患者感染的鲍曼不动杆菌耐药性分析

为了解复旦大学附属华东医院长期住院老年患者感染的鲍曼不动杆菌的耐药性特征,本研究收集了2011年9月~2012年8月临床分离自老年病区长期住院患者的52株鲍曼不动杆菌,分析菌株的耐药性、产酶类型、生物膜形成能力及耐药基因的携带情况。结果显示,菌株主要分布在呼吸重症监护室,分离的标本以痰标本为主,占86.54%。52株鲍曼不动杆菌中,多重耐药菌株最高,占76.92%。对头孢哌酮/舒巴坦耐药率最低,为30.77%,对其余抗菌药物耐药率均在50%以上。产酶阳性率为82.69%,其中产其他水解酶的菌株最多,占63.46%。生物膜形成的检出率为5.77%。6株广泛耐药菌株共检出9种耐药基因。结果提示,从老年病区长期住院患者分离的鲍曼不动杆菌耐药现状严重。因此,医院感染控制应以呼吸重症监护室为重点,同时加强对生物膜阳性菌株所分布病区的耐药性监测和消毒隔离,以预防和控制耐药菌的产生和传播。     

Synthetic lethality-mediated precision oncology via the tumor transcriptome

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社会冲突理论视角下的医疗纠纷解决方式

随着社会经济的发展和人们生活水平的提高,人们的健康需求指数越来越高,法律意识也越来越强。与此同时,由医疗事故等原因导致的医疗纠纷案件正呈逐年上升趋势。有效地解决医疗纠纷,有助于建立和谐的医患关系,而和谐的医患关系是构建和谐社会一个主要的组成部分。本文在社会学视角下,运用达伦多夫和科塞的社会冲突理论来分析当前的医疗纠纷,从而促进医疗纠纷的解决。     

The pathology clinic – pathologists should see patients

S. Manek The pathology clinic – pathologists should see patients This invited review describes why and how a pathologist should talk to patients in order to enhance the patient care pathway. The pathologist–patient interaction should become a natural extension to multidisciplinary team decision making, and also become the forum in which patients are helped to understand important aspects of their conditions and the pathological basis for their treatment plans. There is a vast amount of information available through the internet and to digest this can be a difficult process for a patient who is already having to cope with a medical condition. The pathologist is often best placed to sieve through this information and offer the patient the relevant detail necessary to understand the condition and the management pathway. Pathologists can provide up‐to‐date, simple information about malignant and even certain significant benign conditions, and they can do this with the help of several pictorial tools. In this way, the pathologist becomes an even more active member of a clinical team and helps both clinicians and patients to deal with illnesses in a novel way hitherto not considered.     

DC‐CIK cells derived from ovarian cancer patient menstrual blood activate the TNFR1‐ASK1‐AIP1 pathway to kill autologous ovarian cancer stem cells

Ovarian cancer stem cells (OCSCs) are highly carcinogenic and have very strong resistance to traditional chemotherapeutic drugs; therefore, they are an important factor in ovarian cancer metastasis and recurrence. It has been reported that dendritic cell (DC)‐cytokine‐induced killer (CIK) cells have significant killing effects on all cancer cells across many systems including the blood, digestive, respiratory, urinary and reproductive systems. However, whether DC‐CIK cells can selectively kill OCSCs is currently unclear. In this study, we collected ovarian cancer patient menstrual blood (OCPMB) samples to acquire mononuclear cells and isolated DC‐CIK cells in vitro. In addition, autologous CD44+/CD133+ OCSCs were isolated and used as target cells. The experimental results showed that when DC‐CIK cells and OCSCs were mixed and cultured in vitro at ratios of 5:1, 10:1 and 50:1, the DC‐CIK cells killed significant amounts of OCSCs, inhibited their invasion in vitro and promoted their apoptosis. The qPCR and Western blot results showed that DC‐CIK cells stimulated high expression levels and phosphorylation of TNFR1, ASK1, AIP1 and JNK in OCSCs through the release of TNF‐α. After the endogenous TNFR1 gene was knocked out in OCSCs using the CRISPR/Cas9 technology, the killing function of DC‐CIK cells on target OCSCs was significantly attenuated. The results of the analyses of clinical samples suggested that the TNFR1 expression level was negatively correlated with ovarian cancer stage and prognosis. Therefore, we innovatively confirmed that DC‐CIK cells derived from OCPMB could secret TNF‐α to activate the expression of the TNFR1‐ASK1‐AIP1‐JNK pathway in OCSCs and kill autologous OCSCs.     

Situación funcional como factor independiente asociado con el mal pronóstico de pacientes ancianos ingresados en Cuidados Intensivos

Objective

To assess the association of previous functional status in elderly patients admitted to the ICU, estimated by the Barthel and Short Form-Late Life Function and Disability instrument scales, and the relationship with prognosis and functional capacity at hospital discharge.

Evaluación de las complicaciones clínicas de los pacientes con fractura de cadera y sus factores asociados en una Unidad de Agudos de Ortogeriatría

Introduction

The incidence of clinical complications in hip fracture (HF) patients is high and variable due to their heterogeneous nature. The aim of the study was to assess the clinical complications and their associated factors in HF patients admitted to the Orthopaedic Geriatric Unit of a 283 bed University Hospital. An average of 200 HF patients is attended yearly.

Melanotropin-potentiating factor isolated from filtrate of uremic patients suffering from melanosis and carbohydrate intolerance

Summary Following the characterization of a hexadecapeptide,-endorphin, melanotropin-potentiating factor (MPF) was isolated from the filtrate of uremic patients suffering from melanosis and carbohydrate intolerance. The structure of MPF has been determined on the bases of chemical and physicochemical examinations which included HPLC, Edman sequence analysis combined analysis of the amino acid composition and FAB-MS analysis. An accumulation of MPF might be a cause of melanosis in uremic patients.Abbreviations Et₃N triethylamine - TFA trifluoroacetic acid - HF hydrogen fluoride - CH₃CN acetonitrile - DCC dicyclohexyl-carbidimide - HOBT N-hydroxybenzotriazole - OBzl benzyl ester - Boc tert-butoxycarbonyl - Z bebzyloxycarbonyl - EtOH ethanol - ECUM extracorporeal ultrafiltration method - FAB-MS fast atom bombardment spectrometry - HPLC high-performance liquid chromatography - TLC thin-layer chromatography - AcOH acetic acid - AP-M aminopeptidase-M - PTH phenylthiohydantoin     

一氧化氮合酶(NOS)等活性变化对肺癌早期诊断的研究——纤支镜活检组织50例的观察

用酶组织化学方法探讨经支气管纤维镜（简称纤支镜）活检组织,对肺癌的早期诊断。包括一氧化氮合酶（ＮＯＳ）、细胞色素氧化酶（ＣＣＯ）、乳酸脱氢酶（ＬＤＨ）、琥珀酸脱氢酶（ＳＤＨ）、酸性磷酸酶（ＡＣＰ）等。酶组织化学反应结果显示为肺癌组病人ＮＯＳ、ＬＤＨ、ＣＣＯ、ＡＣＰ的活性显著增高,分别为强阳性（）,少数呈最强阳性（）;而ＳＯＨ活性为弱阳性（＋）,较正常人组显著下降。可疑组病人ＳＤＨ活性增高呈强阳性（）或最强阳性（）,但ＮＯＳ、ＬＤＨ、ＡＣＰ的活性较肺癌组下降,分别为弱阳性（＋）或中等阳性（）。上述结果提示：ＮＯＳ等活性的变化,可作为提高肺癌早期诊断的重要指标之一。