目的 了解新疆疏附县人民医院心脑血管疾病发病趋势和分析高血压发病相关危险因素,为高血压及其相关的心脑血管疾病的综合防治提供依据。方法 回顾性分析2007—2011年疏附县人民医院住院患者资料,按年份统计慢性非传染性疾病(以下简称慢性病)住院人数情况,并采用Logistic回归分析法分析维吾尔族人群高血压发病的相关危险因素。结果 新疆疏附县人民医院心脑血管疾病住院人数逐年增长,5年增长了约2.7倍,其中因高血压住院人数增长了3.5倍。BMI、血钠水平升高、血脂异常、年龄是维吾尔族人群高血压的危险因素。结论 新疆疏附县人民医院住院患者中以高血压为主的心脑血管疾病逐年增长。当地高血压及其相关的心脑血管疾病的防治采取生活方式干预基础上给予降压、降脂治疗的综合策略是优选。

Objective To investigate the incidence trend of cardio-cerebrovascular disease and the related risk factors about hypertension in Shufu people's hospital of Xinjiang. Moreover, to provide evidence of making prevention and controlling strategies for hypertension and the related cardio-cerebrovascular diseases.Methods A retrospective review was did on case data of the inpatients in Shufu people's hospital during 2007-2011.We counted the number of inpatients of chronic non-communicable diseases(NCDs)by year and collected the information of hypertensive inpatients and non-hypertensive inpatients to analyze the risk factors of hypertension in Uygurs using Logistic regression.Results The number of inpatients with cardio-cerebrovascular disease in Shufu people's hospital was increased by 2.7 times in 5 years, while the number of hypertensive inpatients was increased by 3.5 times. BMI, elevated blood sodium, and dyslipidemia, age are risk factors for hypertension in Uygur population.Conclusion The inpatients with cardio-cerebrovascular disease especially those with hypertension in Shufu people's hospital were increasing in recent 5 years. The strategy of lifestyle intervention combined with antihypertensive as well as lipid-lowering therapy is better to the prevention and treatment of hypertension and the related cardio-cerebrovascular diseases.

目的 了解住院老老年心房颤动(atrial fibrillation,AF)患者的临床特征及抗凝现况。方法 收集2015年6月—2017年9月住院老老年(≥80岁)房颤患者的抗凝用药,合并疾病,合并用药等临床信息,统计并分析,非正态分布的计量资料以中位数表示,采用秩和检验,两组计数资料采用χ²检验。结果 621例老老年患者根据性别分为男女两组,男354人,女267人,159例患者(25.6%)使用华法林,33例患者(5.31%)使用达比加群,30例患者(4.83%)使用利伐沙班,抗凝总人数为222例(35.75%)。174例患者(28.02%)使用阿司匹林,27例患者(4.35%)使用氯吡格雷,抗血小板总人数为201例(32.37%)。余198例患者(31.89%)未使用任何抗血小板或抗凝药物。结论 老老年房颤患者目前抗凝率低,抗凝药物以华法林为主。

Objective This study investigated the clinical characteristics and antithrombotic status in elderly patients with atrial fibrillation AF. Methods In this study, we collected, analyzed and characterized the data of the patients hospitalized at the First Affiliated Hospital of Shihezi Medical University from June 2015 to September 2017. Results 621 cases of elderly patients were divided into two groups according to their gender between men and women, 159 patients (25.6%) take warfarin, 33 patients (5.31%) with dabigatran, 30 patients (4.83%) uses of rivaroxaban, the total number of anticoagulation is 222 (35.75%),174 patients (28.02%) were treated with aspirin, and 27 patients (4.35%) used clopidogrel, and the total number of antiplatelet agents was 201 (32.37%). 198 patients (31.89%) did not use any antiplatelet or anticoagulant drugs. Conclusion patients with atrial fibrillation anticoagulant rate is low, and the anticoagulant is mainly warfarin.

目的 探讨揭阳地区急性下呼吸道感染住院患儿病毒病原学特点。方法 对2 125例急性下呼吸道感染患儿应用直接免疫荧光法(DIF)进行A型流感病毒(甲型流感病毒IFA)、B型流感病毒(乙型流感病毒IFB)、呼吸道合胞病毒(RSV)、腺病毒(AdV)、副流感病毒1(PIVⅠ)、2(PIVⅡ)和3型(PIVⅢ)进行病毒学检测。结果 2 125例患儿鼻咽部分泌物标本中有538例检测出至少1种病毒,总阳性率25.3％,其中RSV 阳性率(19.7%)明显高于其他病毒,具有统计学意义。春、夏、冬季的RSV阳性率大致相当,明显高于秋季。婴儿期组RSV阳性率(27.2%)最高,幼儿期组(18.7%)次之,均显著高于学龄前期、学龄期,后2组阳性率无统计学差异,青春期组未检出RSV。结论 病毒是急性下呼吸道感染的重要病原体,而其中又以RSV为著,RSV感染具有显著的季节性和年龄特征性。

Objective To investigate the viral etiology feature in hospitalized children with acute lower respiratory infection in Jieyang area. Methods A total of 2 125 children with acute lower respiratory tract infection were screened by direct immune fluorescence assay (DIF) for influenza virus A (IFA), influenza virus B (IFB), respiratory syncytial virus (RSV), adenovirus (AdV), parainfluenza virus I (PIV Ⅰ), PIV Ⅱ and PIV Ⅲ. Results In 2 125 cases of nasopharyngeal secretory specimens, 538 cases were detected at least one kinds of viruses. The total positive rate was 25.3%, of which the positive rate of RSV (19.7%) was higher than that of other viruses. The positive rate of RSV was similar in spring, summer and winter, much higher than that in autumn.The positive rate of RSV in infancy group (27.2%) was the highest,then the second was the toddler's age(18.7%), both of which were higher than that in preschool age group and school age group. There was no significant difference in the positive rate between preschool age group and school age group. In addition, RSV was not detected in the adolescence group. Conclusion Virus is an important pathogen of acute lower respiratory tract infection. The most common virus is RSV, infection of which has seasonal and age characteristics.

目的 通过评估非直属附属医院临床教学质量的影响因素,探讨保障非直属附属医院同质化教学的方法。方法 将实习同学分为院校组和混合组两组,运用德尔菲法调查法对非直属附属医院临床教学过程中所遇到的困难进行分析,并提出教学改革的意见和评价。结果 得出的调查结论对教师、学生、医院教学管理人员和学校教学管理人员都提出了更高的要求,可以为达到同质化教学提供参考。结论 有针对性的开展临床教学工作,变被动教学为主动的教与学,使临床教学达到同质化,从而达到更佳的教学效果。

Objective To explore the methods of guaranteeing homogeneity teaching in Non-affiliated hospitals by assessing the factors affecting the quality of clinical teaching in Non-affiliated hospitals. Methods Divide the students into two groups:college group and mixed group,to meet the process of clinical teaching in Non-affiliated hospitals in difficulty were analyzed by using the Delphi survey method, and put forward opinions and evaluation. Results the survey findings put forward higher requirements for teachers, students, hospital teaching administrators and school teaching administrators, which can provide references for achieving homogeneity teaching. Conclusion targeted clinical teaching should be carried out to change passive teaching into active teaching and learning, so that clinical teaching can be homogenized, so as to achieve better teaching effect.

目的 探讨入院准备中心制度在我院乳腺外科住院预约统筹管理的实践情况。方法 2017年1月—12月广州市第一人民医院入院准备中心对乳腺外科30张床位实施病床集中预约管理,依据患者病情进行预约,合理安排患者入院。结果 2017年1至12月我院乳腺外科共预约入院1225人/次,成功办理预入院1096人/次,约占乳腺外科总入院人数的77.85%。预入院进行手术患者415人/次,其中3日内手术患者为285人/次,预入院三日内手术率为68.67%。结论 预入院制度对乳腺外科病床进行集中预约管理能有效保证床位充分使用,为患者提供方便、有效的医疗服务,值得基层医院推广。

目的 调查广州市市级(三级)妇幼医院与广州市农村地区区级(二级)妇幼医院护士离职意愿与工作满意度情况。方法 以广州市某三级甲等妇幼医院和4所(花都、南沙、从化、增城)地区二级妇幼医院的3 026名护士为研究对象。应用护士工作满意度量表(MMSS)及离职意愿量表(TIQ)进行问卷调查,并比较分析不同级别妇幼医院护士的离职意愿和工作满意度的差异。结果 相比二级妇幼医院,三级妇幼医院护士的平均年龄较大、学历、职称和奖金均较高、有编制人数所占比例较大,差异有统计学意义(P<0.05)。二、三级妇幼医院护士离职意愿平均得分依次为(2.38±0.682)分、(2.87±0.570)分,工作满意度平均得分依次为(3.34±0.702)分、(3.00±0.482)分。差异均有统计学意义(P<0.05)。结论 相比二级妇幼医院,三级妇幼医院护士离职意愿更强,工作满意度更低,护理管理者可采取有效措施提高护士工作满意度。

Objectives To investigate the current status of nurses' turnover intention and job satisfaction in secondary and tertiary women and children's hospitals in Guangzhou. Methods 3 026 nurses were enrolled in this study, which were from a tertiary hospital in Guangzhou urban area and another 4 secondary hospitals located in rural districts, namely Huadu, Nansha, Conghua, Zengcheng. Systematic sampling was adopted. The Mueller/McCloskey Nurse Job Satisfaction Scale (MMSS) and Turnover IntentionQuestionaire(TIQ)were applied to carry out this investigation. Differences of nurses' turnover intention and job satisfaction between different levels' hospitals were compared and analyzed. Results Compared with those in the secondary hospitals, nurses in the tertiary maternity hospital were at higher average age, had better academic backgrounds with higher professional titles, more bonus and more positions of establishment. The differences all were statistically significant (P<0.05). The average scores of turnover intention for nurses from the secondary and tertiary hospitals were2.38±0.682 and 2.87 ±0.570 respectively. All the differences were statistically significant (P<0.05). Conclusion Compared with those in the secondary maternal and child health hospitals, nurses in the tertiary hospitals were more willing to leave and had lower job satisfaction. Nurse's managers may take effective measurses to increase nurse's satisfaction.

目的 探讨急性心肌梗死患者入院首次中心粒细胞/淋巴细胞比值(neutrophil/lymphocyte ratio,NLR)与院内主要不良心血管事件(MACE)发生的相关性。方法 回顾分析2016年1月—2016年12月入住我院的急性心肌梗死患者179例,分为发生院内不良事件组(n=46)和未发生组(n=133)。采用单因素及多因素Logistics回归分析评估NLR与MACE风险的相关性。结果 179例患者中,46例患者发生院内MACE。发生院内MACE组患者的淋巴细胞计数低于未发生组(P<0.05),NLR高于未发生组(P<0.05),发生院内MACE组患者入院时的心、肾功能较未发生组差(P<0.05)。单因素回归分析显示,NLR水平与院内MACE发病率相关(OR=1.079,95%CI:1.014～1.147, P＜0.05)。多因素logistic回归分析校正性别、年龄、高血压病史、糖尿病史、Killip II级以上、收缩压、入院首次白细胞、eGFR、超敏C反应蛋白、左室射血分数及多支病变后显示,NLR是院内MACE的独立危险因素(OR=1.182,95%CI:1.034～1.352,P＜0.05);此外,超敏C反应蛋白及LVEF<50也是院内MACE的独立危险因素(P＜0.05)。结论 入院首次高NLR与急性心肌梗死患者发生院内MACE相关,是患者发生院内MACE的独立危险因素。

Objective To explore the correlation between first neutrophil/lymphocyte ratio(NLR) and in-hospital major adverse cardiac events (MACE) in patients with in patients with acute myocardial infarction. Methods Total of 179 patients with acute myocardial infarction in Guangzhou First People's Hospital from Jan 2016 to Dec 2016 were enrolled. MACE was defined as malignant arrhythmia, recurrence of myocardial infarction, target vascular reconstruction, acute left heart failure, stroke, cardiac shock and death.Baseline data and in-hospital clinical adverse events were compared among two groups. All patients were divided into two groups:MACE(+) group and MACE(-) group. Univariate and multivariate logistic regression was used to assess the correlation between NLR and in-hospital MACE. Results In-hospital MACE occurred in 46(25.7%)patients. Univariate logistic analysis showed that NLR was strongly related with MACE incidence(OR=1.079,95%CI:1.014～1.147, P＜0.05). Multivariate logistic regression analysis found that after adjusting other traditional risk factors including female gender, age, hypertension,diabetes, overKillip II grade, systolic blood pressure,first white blood cells after admitted,basic renal dysfunction,Hs-CRP,LVEF and multivessel lesions. NLR was still a significant independent predictor of in-hospital MACE in patients with acute myocardial infarction. Additionally, hs-CRP and LVEF<50% were also associated with in-hospital MACE(P＜0.05). Conclusion NLR is the independent risk factor for in-hospital MACE occurrence in acute myocardial infarction at the early admission.

目的 为科学合理的测算公立医院人员编制以及编制管理改革提供参考。方法 对各省市公立医院机构编制标准以及相关文献进行系统分析,系统总结编制影响因素以及编制测算方法。结果 公立医院人员编制受多方面因素影响,而现阶段人员编制测算主要以床位数与门诊量为主要考量因素,其他因素为辅。结论 结合我国公立医院人事管理改革方向,在公立医院人员编制管理上,首先需要科学核定医院应配备人员总量,全方位考虑各影响因素,并设定一定的可伸缩区间,使医院可根据实际情况在一定范围内自主选择。

Objective To provide references for public hospital personnel calculation and personnel system reform. Methods The related standards of public hospitals in various provinces and literatures were analyzed systematically to sum up influence factors and calculation methods. Results Public hospital personnel complement is affected by various factors. At this stage that was mainly measured by the number of beds and outpatient service,and supplemented by other factors. Conclusion With the reform of personnel management in public hospitals in our country, in the management of public hospital staff, the first need to scientifically measure the total amount of personnel that hospital should be equipped with considering various factors. And to set an interval, the hospital may make an independent choice according to the actual situation.

目的 调查我院处方错误的数量和分类,保障门诊患者用药的安全性、有效性和经济性。方法 采用回顾性分析方法,对我院2016年1月—6月的门诊电子处方统计,对不合理处方及时电话沟通和改正,并将错误处方登记入册分析。结果 其中登记入册的错误处方占总处方数的0.24%,主要包括药物用法用量不合理、给药途径不当、药物相互作用不合理、禁忌证用药、重复用药、电脑输入剂量或单位错误等。结论 我院门诊电子处方仍存在一定的不合理现象,临床药师通过处方审核进行干预,并与医院管理和医师有机结合,努力开展药学监护,提高我院处方质量,促进合理用药,共同保证患者用药正确,有效,安全,经济,合理,降低医疗纠纷的发生。

目的 调查分析中山市某三甲医院抗菌药物不良反应的发生和分布情况,为临床合理应用抗菌药物提供相关信息。方法 以中山市某三甲医院2013—2015年上报国家药品不良反应监测系统的528例抗菌药物的不良反应为考察对象,按照给药途径、不良反应严重程度、年龄、性别、药物种类、不良反应累及的系统-器官、不良反应发生时间进行分类、整理、归纳和总结。结果 累及系统-器官涉及皮肤及其附件、血液系统、神经系统、消化系统、泌尿系统等。其中皮肤及其附件损害、神经系统、胃肠道反应容易发现,消化系统、血液系统、泌尿系统、肝胆系统的反应具有隐匿性。结论 临床在使用抗菌药物时,既要关注其抗菌效应,也要高度警惕其不良反应的危害性。避免无指征用药,合理选用抗菌药物,科学地开展ADR 监测工作,确保临床安全、有效、合理用药。

Objective To investigate occurrence and distribution of adverse drug reaction ADR of antibiotic drugs in a hospital of Zhongshan, in order to provide relevant information for clinical rational use of antibacterial drugs. Methods We classified and analyzed 528 cases of adverse drug reaction of antibiotic drugs which was reported to National center for ADR Monitoring during 2013～2015, according to the administration route、the severity of ADRs、age、sex、types of drugs、the organs systems involved by ADRs, the time of ADRs occurrence. Results Adverse drug reaction of antibiotic drugs involved in skin and its appendix、hematological system、nervous system、digestion system、urinary system and so on. Among them skin and its appendix、nervous system and gastrointestinal reactions were easy to acquire, others were obscure and difficult to find. Conclusion When the clinical use of antibacterial drugs, should not only focus on its antibacterial effect, also need to keep high vigilance against the dangers of its adverse reactions. To ensure the clinical safety, effective and rational drug use, we need to avoid no indication of medicine, take rational use of antibiotic drugs,scientifically to carry out the ADR monitoring.