目的:分析以眼睑下垂为首发症状的甲亢性眼肌病的误诊原因。方法:对我院10例不典型的甲亢性眼肌病进行系统分析。结果:误诊为重症肌无力5例、颅内动脉瘤2例、颅底炎症1例、脑干腔隙性梗死1例、糖尿病性周围神经病变1例。结论:以眼睑下垂为首发症状的甲亢性眼肌病极易误诊,加强对该病的认识及尽早进行甲状腺功能检查,可有效减少误诊机会。
目的 探讨全人/整体护理对晚期癌症患者生活质量的影响。 方法 将2007年11月－2008年7月60例确诊为晚期癌症的患者随机分为试验组和对照组，均规范接受阿片类药物镇痛和针对其他痛苦症状的药物控制治疗。在此基础上，试验组再增加躯体照护、心理疏导、灵性关怀等全人/整体护理，并就两组在疼痛缓解、活动能力和生活质量改善等方面的效果进行比较。 结果 观察期内，试验组在疼痛缓解、活动能力及生活质量改善方面明显优于对照组，两组比较差异均有统计学意义（P＜0.05）。 结论 在药物治疗基础上，运用全人/整体护理能够明显提高晚期癌症患者及其家属的生活质量。
ObjectiveTo evaluate the viability, short-term clinical efficacy, and safety of ultrasound-guided radioactive seed 125I permanent implantation in tissue in patients with advanced colorectal cancer. MethodsA total of 9 patients were recruited in this study. All of the patients came from China-Japan Union Hospital of Jilin University from October 2012 to October 2014, which had been selected after strict screening. Five cases of male patients, 4 cases of female patients; the age was between 46-78 years old, the median age was 54 years old. There were 5 cases of patients with pain. There were 14 lesions in total, 1 lesion was local tumor recurrence, 2 lesions were pelvic metastasis, 8 lesions were liver metastases, and 3 lesions were abdominal lymph node metastasis. CEA increased in 6 cases before implantation. All patients were confirmed metastasis by CT, MRI examination or pathology. The 125I radioactive seed implantation was guided by real-time ultrasound. CT scanning was taken in two months after treatment. The degree of pain relief, tumor local control, and the occurrence of complications were observed. ResultsIn 2 months after implantation of 125I radioactive particles, the CT scanning results showed that 2 cases obtained complete response (CR), 5 cases obtained partial response (PR), 1 case got stable disease (SD), and 1 case got progress disease (PD). Total effective was 7/9, and disease control was 8/9. Five cases with pain symptoms were relieved after treatment. One walk metal particle in the abdominal cavity was found by abdominal CT scanning in 1 case. There were no serious complications intraoperative and postoperative. ConclusionsUltrasound guided radioactive seeds 125I implantation in the treatment of advanced colorectal cancer can significantly relieve the clinical symptoms, improve the quality of life, and can effectively control the metastasis. It is safe and feasible, and the postoperative hospitalization time is short, it has the avantages of safety, effectiveness, and low incidence of complications.
Objective To investigate the current situation of sterile supply management in primary healthcare institutions in Pudong New Area of Shanghai, analyze the existing problems, and provide a scientific basis for formulating and implementing follow-up improvement measures. Methods The primary healthcare institutions in Pudong New Area were surveyed from June to July 2024. The contents of the questionnaire included the nature of the institution, sterile supply mode, personnel, facilities and equipment configuration, quality monitoring and sterile supply management. Results A total of 71 valid questionnaires were collected, including 25 public institutions and 46 non-public institutions; 29.6% used the sterile supply mode outside the hospital, and 70.4% used the sterile supply mode inside the hospital. In primary healthcare institutions with in-hospital sterile supply mode, part-time staff accounted for 46.1%, staff under the age of 40 accounted for 69.5%, professional qualification holding rate was high (94.3%), and their education was mainly junior college (60.3%). Healthcare institutions were all equipped with steam sterilizers, and the configuration rate of cleaning and disinfection machines (92.0%) were high, but the configuration rate of water treatment and drying equipment (70.0%), information traceability system (48.0%) and low-temperature sterilizers (10.0%) were low. Disinfection and sterilization quality monitoring had been widely carried out (96.0%), but the cleaning quality monitoring rate was low (88.0%). The implementation rate of multiple requirements exceeded 96%, but the utilization rate of information traceability system was low (36.0%). The proportion of primary healthcare institutions with out-of-hospital sterile supply mode that conducted quality monitoring, requested quality reports and carried out on-site inspection on the goods provided by the service provider were less than 80%. The proportion of healthcare institutions with full-time personnel, contaminated equipment collection and temporary storage room and sterile goods handover and distribution room did not exceed 80%, and the utilization rate of information traceability system was also less than 50%. Conclusions There are still deficiencies in personnel allocation, equipment and facilities, quality monitoring and system implementation of sterile supply management in primary healthcare institutions in Pudong New Area.
目的 分析多功能空气消毒机在普通内科病房的动态消毒效果，为病房空气质量的控制提供参考依据。 方法 2010年9月－2011年4月对普通内科病房在动态状态下进行细菌检测并使用多功能空气消毒机消毒，并就消毒前后的空气细菌菌落总数进行分析比较。 结果 在动态状态下，病房关门关窗并开启空调机时，使用多功能空气消毒机消毒前的空气细菌菌落总数显著高于消毒后，差异有统计学意义（P＜0.05）；病房在开门开窗时，使用多功能空气消毒机消毒前后的空气细菌菌落总数比较，差异无统计学意义（P＞0.05）。 结论 普通内科病房在关门关窗并开启空调机动态状态下，使用多功能空气消毒机可以降低空气细菌菌落总数，改善房间空气质量。
An adaptive inertia weight particle swarm algorithm is proposed in this study to solve the local optimal problem with the method of traditional particle swarm optimization in the process of estimating magnetic resonance (MR) image bias field. An indicator measuring the degree of premature convergence was designed for the defect of traditional particle swarm optimization algorithm. The inertia weight was adjusted adaptively based on this indicator to ensure particle swarm to be optimized globally and to avoid it from falling into local optimum. The Legendre polynomial was used to fit bias field, the polynomial parameters were optimized globally, and finally the bias field was estimated and corrected. Compared to those with the improved entropy minimum algorithm, the entropy of corrected image was smaller and the estimated bias field was more accurate in this study. Then the corrected image was segmented and the segmentation accuracy obtained in this research was 10% higher than that with improved entropy minimum algorithm. This algorithm can be applied to the correction of MR image bias field.
Objective To study the disinfection effect of hand disinfectants containing alcohol after heating, and the comfortable feeling of using warm disinfectants among the medical staff in operation rooms. Methods Between November 2016 and January 2017, we analyzed the disinfection effect of two alcohol-containing hand disinfectants after heating in operation rooms through on-the-spot disinfection and inspection. Questionnaire was used to investigate the comfortable feeling of using warm hand disinfectants. Results After standing for 7 days at a temperature of 37℃, the major content of the two disinfectants decreased by less than 10%. Three minutes of disinfection by using the two kinds of disinfectants had an average natural-bacteria killing logarithm higher than 1.00, and they both had a qualified disinfection effect. Moreover, 96.7% of the medical personnel believed that warm disinfection products were more comfortable. Conclusion After heating, the two kinds of alcohol-containing hand disinfectants are effective in hand disinfection and more comfortable to use, which can improve hand hygiene compliance in surgical staff.
Objective To observe the effects of vitrectomy combined with endotamponade on severe endophthalmitis. Methods The clinical data of 44 patients (44 eyes) of posttraumatic and 22 patients (22 eyes) of postoperative severe endophthalmitis were retrospectively analyzed. All patients were treated by vitrectomy and endotamponade. Intraocular foreign body removal (19 eyes), lens extraction (25 eyes), intraocular lens removal (six eyes) and scleral buckling (16 eyes) were performed. Tamponade with silicone oil (52 eyes) or C3F8 gas (14 eyes) was also performed. Postoperative follow-up ranged from two to 25 months, with the mean of 7-9 months. The visual acuity（VA）and intraocular pressure before and after surgery were comparatively analyzed. Results Inflammation of all the patients were controlled，the effective rate was 5.10%. There was no recurrence and retinal detachment. Among the 66 eyes, postoperative VA of 58 eyes (87.90%) increased,five eyes（7.60%）didn't change and three eyes（4.55%）decreased, the difference was statistically significant（chi;2=45.27，P＜0.05）. The postoperative intraocular pressure was higher than that before surgery，the difference was statistically significant（t=-3.23，P＜0.05）. Conclusions Vitrectomy combined with endotamponade is an effective way to cure severe endophthalmitis. It can improve the visual acuity and intraocular pressure.