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大剂量核素131Ⅰ治疗分化型甲状腺癌术后患者的健康教育

131Ⅰ是一种放射性物质,能在甲状腺组织中蓄积,临床上用其β射线对甲状腺组织的破坏作用来达到降低分化型甲状腺癌术后复发和治疗转移病灶的目的。患者在治疗过程中,需要进行隔离观察。患者多出现恐惧心理,不同程度的放射性反应。本文回顾总结了20例分化型甲状腺癌术后131Ⅰ治疗的护理体会,重点在于做好心理护理、健康教育、及时发现并发症并作出相应处理,有效地帮助患者渡过一周隔离期。

SPTAN1基因突变所致伴中央颞区棘波的自限性癫痫患儿一例并文献复习

急诊修复左胫骨缺损合并小腿皮肤完全撕脱

结肠透析治疗慢性重症乙型肝炎患者便秘及腹胀的护理

目的　总结结肠透析治疗慢性重症乙型肝炎患者便秘及腹胀的护理方法及疗效。 方法　对2010年7月－2011年7月45例慢性重症乙型肝炎合并便秘及腹胀患者结肠透析治疗中，所采用的护理措施及效果进行回顾性分析。 结果　45例患者一个疗程结束后，其中10例便秘及8例腹胀症状缓解显著，13例便秘及10例腹胀症状有所缓解，2例便秘及2例腹胀患者症状无改善。 结论　结肠透析对治疗慢性重症乙型肝炎患者便秘及腹胀一定疗效，是一条新的治疗途径。

无菌保护套在体外循环心脏手术中的应用

Bibliometric analysis of the application of artificial intelligence in the field of healthcare-associated infection

Objective To use bibliometrics to identify research hotspots and emerging trends in the use of artificial intelligence (AI) in healthcare-associated infections (HAI), as well as to offer a resource for more relevant research. Methods The literature on AI and HAI from the Science Citation Index Expanded database of the Web of Science Core Collection was retrieved through computer searches, covering the period from January 1, 1994, to January 22, 2024. VOSviewer (v1.6.19) and CiteSpace (v6.1. R6) software were utilized for bibliometric analysis, creating knowledge maps that include research cooperation networks and keyword analysis. Results A total of 305 documents were included, and both the number of early publications and the frequency of citations were at a very low level for a long time before showing an annual increase trend after 2018. The United States had the most published documents among the 50 countries/regions from where they were sourced. Harvard University was the scientific research institution with the most publications, while Professor Evans HL of the Medical University of South Carolina was the scholar with the most publications. Research on AI in the field of HAI primarily focused on three aspects: AI algorithms and technologies, monitoring and prediction of HAI, and the accuracy of HAI diagnosis and prediction. These findings were based on keyword co-occurrence and clustering analysis. Conclusions A new phase of AI research in the subject of HAI has begun. More in-depth research can be done in the future for the hot direction, as there is still a gap between China’s academic accomplishments in this subject and the advanced level of the world.

Analysis of Prognostic Factors for Short-term Outcome in Patients with Hepatitis B Virus-related Acute-on-chronic Liver Failure Treated with Artificial Liver

ObjectiveTo learn the outcomes of hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF) cases after artificial liver support system (ALSS) treatment and the relevant factors correlated with the clinical outcomes. MethodsIn the period from January 2011 to June 2014, 321 patients with HBV-ACLF were admitted to West China Hospital. The clinical data at baseline, before and after treatment were analyzed by univariate and multivariate logistic regressions to identify the independent risk factors correlated with 30-day outcomes. ResultsOf all the 321 patients, 233 survived and 88 died by the end of a 30-day observation. The univariate analysis identified that the incidences of cirrhosis, hepatorenal syndrome and peritonitis in the death group were significantly higher (P<0.05). The model for end-stage liver disease values, white blood cells (WBC), blood ammonia, creatinine and total bilirubin (TBIL) at different stages in the death group were significantly higher than those in the survival group (P<0.05). In the death group, the HBV-DNA, TBIL decrease after triple ALSS treatments, baseline prothrombin time activity (PTA) and PTA level after triple ALSS treatments were significantly lower (P<0.05). The multivariate logistic regression indicated that WBC (OR=2.337, P<0.001) and TBIL level after triple ALSS treatments (OR=4.935, P<0.001) were independent predicting factors for death within 30 days after ALSS treatment; HBV-DNA (OR=0.403, P<0.001), the decrease of TBIL after triple ALSS treatments (OR=0.447, P<0.001) and PTA level after triple ALSS treatments (OR=0.332, P<0.001) were protecting factors for the 30-day prognosis. ConclusionThese five factors including WBC, HBV-DNA, PTA, TBIL and TBIL decrease after triple ALSS treatments influence the short-term prognosis for HBV-ACLF patients, which are valuable for decision making in clinical practices.

Optimization of pulmonary ultrasound in ultra-fast-track anesthesia for congenital heart disease surgery: A randomized controlled trial

ObjectiveTo investigate the effect of pulmonary ultrasound on pulmonary complications in ultra-fast-track anesthesia for congenital heart disease surgery.MethodsIn 2019, 60 patients with congenital heart diseases underwent ultra-fast-track anesthesia in Shenzhen Children's Hospital, including 34 males and 26 females with the age ranging from 1 month to 6 years. They were randomly divided into a normal group (group N, n=30) and a lung ultrasound optimization group (group L, n=30). Both groups were used the same anesthesia method and anesthetic compatibility. The group N was anesthetized by ultra-fast-track, the tracheal tube was removed after operation and then the patients were sent to the cardiac intensive care unit (CCU). After operation in the group L, according to the contrast of pre- and post-operational lung ultrasonic examination results, for the patients with fusion of B line, atelectasis and pulmonary bronchus inflating sign which caused the increase of lung ultrasound score (LUS), targeted optimization treatment was performed, including sputum suction in the tracheal tube, bronchoscopy alveolar lavage, manual lung inflation suction, ultrasound-guided lung recruitment and other optimization treatments, and then the patients were extubated after lung ultrasound assessment and sent to CCU. The occurrence of pulmonary complications, LUS, oxygenation index (OI), extubation time, etc were compared between the two groups.ResultsCompared with the induction of anesthesia and 1 hour after extubation of the two groups, the incidence of pulmonary complications in the group L (18 patients, 60.0%) was lower than that in the group N (26 patients, 86.7%, χ2= 4.17, P=0.040) and the rate of patients with LUS score reduction was higher in the group L (15 patients, 50.0%) than that in the group N (7 patients, 23.3%, χ2=4.59, P=0.032). The correlation analysis between the LUS and OI value of all patients at each time point showed a good negative correlation (P<0.05). Extubation time in the group L was longer than that in the group N (18.70±5.42 min vs. 13.47±4.73 min, P=0.001).ConclusionUltra-fast-track anesthesia for congenital heart disease can be optimized by pulmonary ultrasound examination before extubation, which can significantly reduce postoperative pulmonary complications, improve postoperative lung imaging performance, and help patients recover after surgery, and has clinical application value.

Research progress of the donor factors and experimental factors affecting adipogenic differentiation of adipose derived stem cells

Objective To summarize the donor factors and experimental factors that affect adipogenic differentiation of adipose derived stem cells, so as to provide reference for adipogenic differentiation of adipose derived stem cells. Methods The related research literature about donor factors and experimental factors affecting adipogenic differentiation of adipose derived stem cells in recent years was extensively reviewed and summarized. Results There are a lot of donor factors and experimental factors affecting adipogenic differentiation of adipose derived stem cells, but some of the factors are still controversial, such as donor age, health status, adipose tissue of different parts, and so on. These factors need to be further studied. Conclusion The donor factors and experimental factors that affect adipogenic differentiation of adipose derived stem cells should be deeply studied and the controversial issues should be clarified to lay a solid foundation for the application of adipose derived stem cells in adipose tissue engineering.

医务人员洗手依从性调查及分析

目的 了解感染性疾病中心医务人员洗手依从性情况并进行分析。 方法 根据世界卫生组织 2009 年颁布的《手卫生技术参考手册》中手卫生的 5 个时刻（接触患者前、无菌操作前、体液暴露后、接触患者后和接触患者周围环境后），自行设计洗手依从性执行情况观察表，应用隐蔽观察法，由经过专业培训的医院感染护士，对洗手依从性进行调查，观察应洗手和实际洗手情况，每个观察对象连续观察 20 min 以上，记录其洗手情况。 结果 传染科医务人员洗手依从性有待提高，其中医生、护士均在接触血液、体液后的洗手依从率较高（医生为 92.31%，护士为 97.22%），两者比较差异无统计学意义（P>0.05）；接触环境后最低（医生为 41.67%，护士为 70.37%），两者比较差异有统计学意义（P<0.05）。在接触患者前、无菌操作前、接触环境后的观察中，护士的洗手依从率均高于医生，差异有统计学意义（P<0.05）；虽然接触患者后，护士洗手依从率高于医生，但两者比较差异无统计学意义（P>0.05）。在调查的 73 名医务人员的洗手正确率中，副主任医生、主治医生和主管护士均为 100.00%，护师为 91.67%，护士为 77.22%，住院医生为 66.67%，实习医生为 58.33%，实习护士为 50.00%。 结论 医务人员洗手依从性较低，在临床工作中，应加强各级医务人员手卫生相关知识培训，提高洗手依从性及正确性；同时加强管理，端正态度，提高意识，培养慎独精神，从而有效地切断传播途径，最终降低医院感染的发生。