论著

恶性梗阻性黄疸患者行经皮肝穿刺胆道引流术后出院准备度现状及其影响因素

Current status and influencing factors of discharge readiness in patients with malignant obstructive jaundice undergoing percutaneous liver puncture biliary drainage surgery

:1020-1026
 
目的 分析恶性梗阻性黄疸患者实施经皮肝穿刺胆道引流术后出院准备度情况,探究此类患者出院准备度的影响因素。方法 选择2020年9月—2023年4月于天津市人民医院消化内科接受经皮肝穿刺胆道引流术的80例恶性梗阻性黄疸患者,选择院内系统对入组患者的性别、年龄等资料进行统计,并使用出院准备度量表评估患者出院准备度,应用出院指导质量量表评估患者出院指导质量,选择Pearson相关性分析的措施对影响患者出院准备度和出院指导质量的关联进行分析,并分析患者出院准备度影响因素。结果 合并慢性疾病以及居住方式方面,不同亚组患者间出院准备度得分比较差异具有统计学意义(P<0.05);Pearson相关性分析显示出院准备度量表各维度得分与出院指导质量得分呈正相关(均P<0.05);Logistic回归分析显示,居住方式得分为出院准备度量表得分的独立影响因素(P<0.05)。结论 经皮肝穿刺胆道引流术恶性梗阻性黄疸患者出院准备度得分较低,通过改变患者居住方式、提高患者出院指导质量,将有助于提高患者出院准备度。
Objective To analyze the discharge readiness of patients with malignant obstructive jaundice after percutaneous transhepatic biliary drainage,and explore the influencing factors of discharge readiness of such patients.Methods A total of 80 patients with malignant obstructive jaundice who underwent percutaneous transhepatic biliary drainage in Tianjin People's Hospital from September 2020 to April 2023 were selected as the research objects.The data such as sex and age of the patients were statistically analyzed in the hospital system,and the discharge readiness scale was used to evaluate the discharge readiness of the patients.The discharge guidance quality scale was used to evaluate the discharge guidance quality of patients.Pearson correlation analysis was selected to analyze the relationship between the discharge readiness and the discharge guidance quality,analyze factors influencing patient discharge readiness.Results There was a statistically significant difference(P<0.05)in the comparison of discharge readiness scores between different subgroups of patients with combined chronic diseases and living habits.Pearson correlation analysis showed that the scores of each dimension of the discharge readiness measurement table were positively correlated with the scores of discharge guidance quality(all P<0.05).Logistic regression analysis showed that the residential style score was an independent influencing factor(P<0.05)for the discharge readiness scale score.Conclusions The discharge readiness score of patients with malignant obstructive jaundice undergoing percutaneous liver puncture biliary drainage was low.By changing the patient's living style and improving the quality of discharge guidance,will help to improve the patient's discharge readiness.
论著

乳腺癌术后疼痛综合征发生情况及影响因素分析

The incidence and influencing factors of PMPS after breast cancer surgery

:1015-1019
 
目的 探讨乳腺癌术后疼痛综合征(PMPS)的发生率及影响因素。方法 选择2021年1月—2023年2月医院收治的82例乳腺癌患者为研究对象,采取手术治疗,统计PMPS发生率,分析PMPS的特征,比较PMPS患者和非PMPS患者的临床资料,采用 Logistic 逐步回归分析。结果 82例中有20例患者术后发生PMPS,发生率为24.39%,其中患侧腋窝45.00%、麻木样疼痛35.00%、中度疼痛60.00%、术后即刻疼痛50.00%、每日发作疼痛50.00%占比较高。PMPS患者和非PMPS患者的体质指数、教育程度、病理分期、肿瘤占位、手术方式、术前使用非甾体抗炎药、术前化学治疗、术后化学治疗比较差异均无统计学意义(P>0.05)。PMPS患者年龄低于非PMPS患者,负性情绪率30.00%高于非PMPS患者8.06%,清扫腋窝淋巴结率95.00%高于非PMPS患者72.58%,术后放射治疗率30.00%高于非PMPS患者6.45%(P<0.05)。年龄、负性情绪、清扫腋窝淋巴结、术后放射疗为PMPS发生的危险因素(P<0.05)。结论 乳腺癌术后较容易发生PMPS,主要表现为术后即刻腋窝疼痛、麻木,发作频率较高,疼痛较重,其中年龄小、术前焦虑、清扫腋窝淋巴结、术后放疗为引发PMPS的危险因素,需加强监测和针对性处理,研究价值较高。
Objective To investigate the incidence and influencing factors of post-mastectomy pain syndrome(PMPS)in breast cancer patients.Methods A total of 82 patients with breast cancer admitted to our hospital from January 2021 to February 2023 were selected as the research objects,and underwent surgical treatment.The incidence of PMPS was counted,the characteristics of PMPS were analyzed,and the clinical data of PMPS patients and non-PMPS patients were compared.Results Among the 82 patients,20 patients had PMPS after surgery,with an incidence of 24.39%.Among them,the affected axilla accounted for 45.00%,numbness pain 35.00%,moderate pain 60.00%,immediate postoperative pain 50.00%,and daily pain 50.00%.There were no significant differences in body mass index,education level,pathological stage of disease,tumor location,surgical method,preoperative use of non-steroid anti-inflammatory drugs,preoperative chemotherapy and postoperative chemotherapy between PMPS patients and non-PMPS patients(P>0.05).The age of PMPS patients was significantly higher than that of non-PMPS patients,the rate of negative emotion was 30.00%,the rate of axillary lymph node dissection was 95.00%,and the rate of postoperative radiotherapy was 30.00%,which was significantly higher than that of non-PMPS patients(P<0.05).Age,negative emotion,axillary lymph node dissection and postoperative radiotherapy were independent risk factors for PMPS(P<0.05).Conclusions PMPS is prone to occur after breast cancer surgery,mainly characterized by immediate postoperative axillary pain and numbness,with a high frequency and severe pain.Young age,preoperative anxiety,axillary lymph node dissection,and postoperative radiotherapy are independent risk factors for PMPS,which need to be strengthened monitoring and targeted treatment.
论著

153例住院儿童甲型流感病毒肺炎及混合感染的临床特征

Clinical characteristics of 153 hospitalized children with influenza A virus pneumonia and mixed infection

:1009-1014
 
目的 探讨住院儿童甲型流感病毒肺炎合并其他病原菌感染的临床特征。方法 通过回顾性研究方法,分析2021年6月—2023年6月广州市妇女儿童医疗中心住院治疗的153例甲型流感病毒肺炎患儿的临床资料,针对有无合并其他病原菌感染,分为混合感染组及非混合感染组两组,分别为98例及55例,分析并对比两组的临床特征。结果 甲型流感病毒肺炎患儿以发热、咳嗽、呕吐/腹泻等症状为主,其中混合感染组患儿呕吐/腹泻症状占比高于非混合感染组(P<0.05);两组患儿其他症状及并发症对比差异无统计学意义(P>0.05);儿童甲型流感病毒肺炎患儿检出合并细菌感染的患儿65例(29.41%),合并肺炎支原体感染的患儿33例(21.57%);合并病毒感染的患儿20例(13.07%)。与非混合感染组比较,混合感染组患儿乳酸脱氢酶水平更高,白细胞计数<4×109/L的人数占比更少(P<0.05);其他实验室指标对比差异无统计学意义(P>0.05);经过抗病毒及对症治疗后,150例(98.04%)患儿痊愈出院,3例出现严重并发症,其均伴有其他病原菌感染。与非混合感染组比较,混合感染组患儿住院天数更长、住院费用更高(P<0.05);其他预后指标对比差异无统计学意义(P>0.05)。结论 甲型流感病毒肺炎患儿易感染其他的病原菌,导致疾病治疗难度加大,因此临床要提高警惕,以防混合感染情况发生,尽早采取有效的诊治措施,提高疾病早期治愈率。
Objective To explore the clinical characteristics of hospitalized children with influenza A virus pneumonia complicated with other pathogens.Methods The clinical data of 153 children with influenza A virus pneumonia hospitalized in Guangzhou Women and Children Medical Center in the past two years(June 2021 ~ June 2023)were analyzed retrospectively. According to whether they were infected with other pathogens,they were divided into mixed infection group and non-mixed infection group,with 98 cases and 55 cases respectively.The clinical characteristics of the two groups were analyzed and compared.Results Fever,cough,vomiting and diarrhea were the main symptoms in children with influenza A virus pneumonia,and the proportion of vomiting and diarrhea in children with mixed infection group was higher than that in children without mixed infection group(P<0.05).There was no significant difference in other symptoms and complications between the two groups(P>0.05).There were 65 children(29.41%)with influenza A virus pneumonia and 33 children(21.57%)with mycoplasma pneumonia,20 children(13.07%)with virus infection.Compared with non-mixed infection group,the level of lactate dehydrogenase in children with mixed infection group was higher,and the proportion of children with white blood cell count<4×109/L was less(P<0.05).There was no significant difference in other laboratory indexes(P>0.05).After antiviral and symptomatic treatment,150 cases(98.04%)were cured and discharged,and 3 cases had serious complications,all of which were accompanied by other pathogens.Compared with non-mixed infection group,children in mixed infection group had longer hospitalization days and higher hospitalization expenses(P<0.05).There was no significant difference in other prognostic indicators(P>0.05).Conclusions Children with influenza A virus pneumonia are easily infected with other pathogens,which makes it more difficult to treat the disease.Therefore,we should be vigilant in clinic to prevent mixed infection and take effective diagnosis and treatment measures as soon as possible to improve the early cure rate of the disease.
论著

microRNA-29b对子宫内膜癌细胞增殖、迁移和侵袭的影响

Effect of microRNA-29b on proliferation,migration and invasion of endometrial cancer cells

:1002-1008
 
目的 探讨微RNA-29b(miR-29b)对子宫内膜癌细胞增殖、迁移和侵袭的影响。方法 子宫内膜癌HEC-1-B细胞分为miR-29b模拟物组(MM组)、miR-29b阻遏物组(MR组)和阴性对照物组(MNC组),分别转染miR-29b拟似物、miR-29b阻遏物和miR-29b阴性对照物,每组设置6个复孔。以实时定量逆转录PCR检测miR-29b表达,以水溶性四氮唑(WST-1)检测miR-29b对HEC-1-B子宫内膜癌细胞增殖的影响,以Transwell小室检测HEC-1-B子宫内膜癌细胞迁移和侵袭的影响,以Western blot法检测磷酸酶张力蛋白同源物(PTEN)-蛋白激酶 B(AKT)通路蛋白表达水平。结果 MNC组、MM组、MR组miR-29b相对表达量分别为(2 032.1±873.4)、(19 272.8±2 087.9)、(472.7±105.6),组间比较差异有统计学意义(P<0.05)。MM组0、3、5、7 d时OD值分别为(0.32±0.06)、(0.53±0.08)、(1.13±0.12)和(1.92±0.14),MNC组0、3、5、7 d时OD值分别为(0.34±0.09)、(0.71±0.08)、(1.67±0.21)和(3.49±0.24),MR组0、3、5、7 d时OD值分别为(0.38±0.09)、(0.84±0.18)、(2.43±0.24)和(5.67±0.15),3组0 d时OD值比较差异无统计学意义(P=0.216),三组3 d、5 d、7 d时OD值比较差异存在统计学意义(P<0.001)。MNC组、MM组和MR组迁移细胞数分别为(403.9±23.8)(102.6±15.7)和(685.7±46.8)个,上述3组侵袭细胞数分别为(82.1±12.7)(38.2±10.6)和(124.6±21.6)个,MM组和MNC组上述指标比较差异均有统计学意义(P<0.05),MR组和MM组上述指标比较差异均有统计学意义(P<0.05)。MNC组、MM组、MR组PTEN蛋白相对表达量分别为(0.25±0.08)、(0.69±0.11)、(0.11±0.05),上述3组p-AKT蛋白相对表达量分别为(0.58±0.10)、(0.13±0.06)和(0.79±0.08),上述3组AKT蛋白相对表达量分别为(0.38±0.09)、(0.37±0.11)和(0.37±0.08),MM组与MNC组PTEN、p-AKT水平比较差异有统计学意义(P<0.05),AKT水平比较差异无统计学意义(P>0.05);MR组与MNC组、MM组PTEN、p-AKT水平比较差异有统计学意义(P<0.05),AKT水平比较差异无统计学意义(P>0.05)。结论 过表达miR-29b对子宫内膜癌细胞增殖、迁移和侵袭具有抑制作用,靶向PTEN-AKT可能是其重要作用途径。
Objective To investigate the effects of microRNA-29b on proliferation,migration and invasion of endometrial cancer cells.Methods The endometrial cancer HEC-1-B cells were divided into micro29b mimetic group(MM group),micro29b repressor group(MR group)and negative control group(MNC group),and the micro29b mimetic,micro29b repressor and micro29b negative control were transfected into each group,six compound holes with each group.The real-time quantitative reverse transcription polymerase chain reaction(RT-PCR)was used to detect the expression of mi29b,WST-1 was used to detect the effect of mi29b on the proliferation of HEC-1-B endometrial cancer cells,Transwell chamber was used to detect the migration and invasion of HEC-1-B endometrial cancer cells,and Western blot was used to detect the expression level of PTEN-AKT pathway protein.Results The relative expression levels of microRNA-29b in MNC group,MM group and MR group were(2 032.1±873.4),(19 272.8±2 087.9)and(472.7±105.6),respectively,and there were significant differences between groups(P<0.05).OD values of MM group at 0 d,3 d,5 d and 7 d were(0.32±0.06),(0.53±0.08),(1.13±0.12)and(1.92±0.14)respectively.The OD values of MNC group at 0,3,5 and 7 days were(0.34±0.09),(0.71±0.08),(1.67±0.21)and(3.49±0.24)respectively.The OD values of MR group at 0 d,3 d,5 d and 7 d were(0.38±0.09),(0.84±0.18),(2.43±0.24)and(5.67±0.15)respectively.There was no significant difference in OD value between the three groups on day 0 (P=0.216).There were significant differences in OD value between the three groups on day 3,day 5 and day 7(P<0.001).The number of migrating cells in MNC group,MM group and MR group were(403.9±23.8)cells,(102.6±15.7)cells and(685.7±46.8)cells,respectively.The number of invasive cells in the above three groups were(82.1±12.7)cells,(38.2±10.6)cells and(124.6±21.6)cells.There were significant differences in the above indexes between MM group and MNC group(P<0.05),also between MR group and MM group(P<0.05).The relative expression levels of PTEN protein in MNC group,MM group and MR group were(0.25±0.08),(0.69±0.11)and(0.11±0.05).The relative expression levels of p-AKT protein in the above three groups were(0.58±0.10),(0.13±0.06)and(0.79±0.08).The relative expression levels of AKT protein in the above three groups were(0.38±0.09),(0.37±0.11)and(0.37±0.08),respectively.Compared with MNC group,the levels of PTEN and p-AKT in MM group had statistical significance(P<0.05),but there was no statistical difference in AKT level(P>0.05).Compared with MNC group and MM group,the levels of PTEN and p-AKT in MR group had statistical significance(P<0.05),and there was no statistical difference in AKT level(P>0.05).Conclusions Overexpression of microRNA-29b can inhibit the proliferation,migration and invasion of endometrial cancer cells,and targeting PTEN-AKT may be an important pathway.
论著

全面触发工具在新生儿医源性皮肤损伤不良事件中的应用研究

:997-1001
 
目的 研究探讨全面触发工具(GTT)在新生儿医源性皮肤损伤(ISI)不良事件监测中的应用,检验其有效性与适用性。方法 根据GTT白皮书中推荐的护理模块触发器,结合江西省妇幼保健院医院新生儿科ISI发生的特点和实际情况,建立科室审查团队,回顾性分析我院新生儿科重症监护室(NICU)2021年1月—2021年9月168例新生儿的病历。初级审查员负责审查病历;高级审查员负责对确定的ISI和伤害分级作最终决策,对ISI不良事件发生率进行综合的分析,制定符合科室的不良事件触发器,评价GTT在提高新生儿医源性不良事件检出率的优势。结果 168份病历中,设计的14项触发器中14项显示为阳性,触发器阳性检测率为100.00%,触发器阳性总频次为66次,阳性检出频次12例,阳性预测值为18.18%;168份病历GTT检出不良事件频次12次,涉及患儿8例,GTT检出率4.76%;GTT检出E级5例(2.98%),F级3例(1.79%);自愿上报E级3例(1.79%),F级2例(1.19%),均未发生G级、H级、I级事件;自愿上报事件5例,上报率为(2.98%)。结论 建立新生儿ISI不良事件触发器,并规范皮肤管理、规范和监督ISI医疗护理工作,可以最大限度保证患儿安全,提高新生儿综合救治能力,提升医疗护理服务水平。
论著

131I治疗儿童及青年格雷夫斯病疗效及影响因素分析

Efficacy and affecting factors in 131I therapy for children and young people with Graves' disease

:991-996
 
I')">131I,outcome" split="">Graves' diseaseI')">131I,outcome" split="">children and adolescentI')">131I,outcome" split="">131I')
目的 探讨131I治疗儿童及青年格雷夫斯病(GD)的疗效及其影响因素。方法 回顾性分析2013年—2022年在简阳市人民医院核医学科院接受131I治疗且年龄≤22岁的儿童及青年GD患者的临床资料。采用个体计算剂量法,每克甲状腺组织的计划用量为80~140 μCi,依据甲状腺吸碘率及甲状腺质量,确定131I的用量。依据131I治疗后3~6个月的甲状腺功能指标,进行疗效评价,甲状腺功能恢复正常或发生甲减视为治愈。统计分析治愈组与非治愈组间的临床疾病特征参数,评估可能影响疗效的因素。结果 纳入患者71例:男23例、女48例,年龄11~22岁。患儿甲状腺质量4.8~60.0 g,均值22.1 g。131I的用量在6~24 mCi,均值11.3 mCi。49例(69%)患者获得治愈,22例(31%)未获治愈。单因素分析显示年龄、性别、促甲状腺激素受体抗体的滴度、甲状腺吸碘率、甲状腺质量及131I用量等,治愈组与非治愈组间比较差异均无统计学意义(均P>0.05)。结论 以每克甲状腺组织80~140 μCi的计划用量,确定131I用量治疗儿童青年GD的疗效可达69%。
Objective To investigate the effect of 131I on Graves' disease(GD)in children and young adults and its influencing factors.Methods The clinical data of GD patients aged ≤22 who received 131I treatment in Nuclear Medicine Department of Jianyang People's Hospital from 2013 to 2022 were retrospectively analyzed.The planned dosage of 131I was 80~140 μCi per gram of thyroid tissue,and the dosage of 131I was determined according to the iodine uptake rate and thyroid mass.According to the thyroid function indicators of 3 to 6 months after 131I treatment,the curative effect was evaluated,and the thyroid function returned to normal or hypothyroidism occurred were considered as cured.The clinical characteristic parameters of the cured group and the non-cured group were analyzed to evaluate the factors that might affect the curative effect.Results Seventy-one patients were included:23 males and 48 females,aged 11-22.The thyroid mass of the children ranged from 4.8 to 60.0 g,with an average of 22.1 g.The dosage of 131I ranges from 6 to 24 mCi,with an average of 11.3 mCi.Forty-nine patients(69%)were cured and 22(31%)were not cured.Univariate analysis showed that there were no significant differences in age,sex,titer of thyrotropin receptor antibody,thyroid iodine uptake rate,thyroid mass and 131I dosage between the cured group and the non-cured group(all P>0.05).Conclusions With the planned dosage of 80~140 μCi per gram of thyroid tissue,the efficacy of 131I in the treatment of GD in children and young adults can reach 69%.
综述

全身免疫炎症指数与心血管疾病相关研究进展

Research progress on systemic immune inflammation index and cardiovascular disease

:985-990
 
慢性炎症是心血管疾病的常见发病机制,它主要通过损伤内皮细胞、氧化应激和刺激血栓形成影响疾病发展。全身免疫炎症指数(SII)作为一种新型炎症指标,最早用于肿瘤患者的预后评估,现已在多学科领域广泛使用,它由中性粒细胞、血小板、淋巴细胞计算得到,更加全面地反映机体炎症状态。SII已经在多项研究中被证实具有良好的预测价值,该文对SII的优势和在心血管疾病的临床研究进展进行综述,为研究的进一步开展提供参考。
Chronic inflammation is a common pathogenesis of cardiovascular disease,which mainly affects disease progression by damaging endothelial cells,oxidative stress and stimulating thrombosis.As a new type of inflammatory index,the systemic immune inflammatory index(SII)was first used to evaluate the prognosis of cancer patients,and has been widely used in multidisciplinary fields.SII has been confirmed to have good predictive value in a number of studies,and this article reviews the advantages of SII and the progress of clinical research in cardiovascular diseases,so as to provide reference for further research development.
专家述评

弥漫性大B细胞淋巴瘤的放射治疗进展

Recent progress in radiation therapy for diffuse large B-cell lymphoma

:974-984
 
弥漫性大B细胞淋巴瘤(DLBCL)是最常见的高度异质性非霍奇金淋巴瘤(NHL),不同的疾病阶段或临床亚型预后不尽相同。放射治疗作为无交叉耐药的理想局部治疗技术,应用于DLBCL可有效改善患者预后。初治DLBCL通过放射治疗联合化学治疗、免疫治疗等综合治疗可使约60%~70%患者疾病缓解。对于不同预后影响因素,如年龄、肿瘤体积、淋巴结外侵犯等,联合放射治疗也可取得更佳疗效。在复发性/难治性DLBCL的治疗中,自体造血干细胞移植(ASCT)和嵌合抗原受体T细胞免疫治疗(CAR-T)是目前的研究热点,而放射治疗无论是作为ASCT与CAR-T术前的桥接治疗或失败后的挽救性治疗均有助改善患者预后。随着放射治疗技术的日益优化,放射治疗在综合治疗方案中扮演着越来越重要的角色。
Diffuse large B-cell lymphoma(DLBCL)is a highly heterogeneous type of non-Hodgkin lymphoma(NHL)and its prognosis is different for different disease stages or clinical subtypes.Radiation therapy(RT)is a local treatment technique that does not cause cross-resistance and can effectively improve the prognosis of patients with DLBCL.When combined with chemotherapy and immunotherapy,RT can alleviate the disease in more than 60% of patients.Furthermore,RT can achieve better results for different prognostic factors such as age,tumor volume and external nodal invasion.For treating relapsed / refractory DLBCL,autologous stem cell transplantation(ASCT)and chimeric antigen receptor T cell immunotherapy(CAR-T)are currently being researched,while RT can help as bridging therapy before ASCT and CAR-T or salvage therapy after failure.With the increasing optimization of technology,radiotherapy plays an increasingly important role in combined treatment options.
专家述评

脊柱结核的外科治疗研究进展

The progress in surgical treatment research for spinal tuberculosis

:963-973
 
脊柱结核是脊柱感染性疾病中最为常见的类型。本文综述了脊柱结核外科治疗的现状及最新进展。在早期治疗阶段,规范化的抗结核药物治疗能够有效缓解疼痛,改善患者生活质量。但对于中后期,特别是椎旁脓肿较大,椎体骨质破坏较大而导致脊柱不稳定的患者,手术治疗往往是必要且必需的辅助手段,手术可以最大限度清除病变的椎间盘、椎体和脓肿,也应该最大限度保留健康的骨质。其主要原则包括病灶彻底清除、脊髓充分减压、脊柱稳定性重建等步骤。在手术治疗中,一期前路手术作为经典入路已经得到广泛应用,而单纯后路手术治疗也逐渐受到重视。近年来,随着微创手术技术的发展,其在脊柱结核治疗中的应用越来越广泛。微创手术的优势在于术中创伤更小、恢复更快,为患者带来了更好的治疗体验和临床效果。然而,对于手术的选择,临床医师需要综合考虑患者的个体差异性、临床表现及特征、影像学资料和手术适应证等多种因素,以确定最合适的治疗方案。只有充分考虑各种治疗手段的优劣,采取个性化、综合性的治疗方案,才能更好地提高患者的生活质量和治疗效果。
Spinal tuberculosis is the most common types of infectious diseases affecting the spine.This article reviews the current status and progress of surgical treatment for spinal tuberculosis.In the early and initial stages,standardized anti-tuberculosis drug therapy can effectively alleviate pain and improve patients' quality of life.However,for more complex cases in the middle and late stages,surgical treatment is needed,including thorough lesion clearance,adequate spinal cord decompression,and reconstruction of spinal stability.In surgical treatment,anterior approach surgery,as a classical method,has been widely applied,and posterior approach surgery alone has gradually gained attention.In recent years,with the development of minimally invasive surgical techniques,their application in the treatment of spinal tuberculosis has become increasingly widespread.The advantages of minimally invasive surgery lie in smaller intraoperative trauma and faster recovery,providing patients with better treatment experience and clinical outcomes.However,for the selection of surgery,clinicians need to consider multiple factors such as individual differences,clinical manifestations and characteristics,imaging data and surgical indications to determine the most suitable treatment plan.Only by fully considering the advantages and disadvantages of various treatment modalities and adopting personalized,comprehensive treatment plans can the quality of life and treatment outcomes of patients be effectively improved.
医学教育

错题析因在高校实验室安全管理中的意义

Analysis of the mistakes made in laboratory safety test provides hints for the critical control point in laboratory safety management

:1231-1236
 
目的 探讨学生实验室安全知识盲区,以提高高校实验室安全管理工作的成效。方法 考试人数192人,共计235次考试,根据考试系统的统计分析结果,观察各题目错误率和各选项构成比;结合统计描述和χ2检验,探讨影响学生实验室安全考试成绩的原因和所存在的知识盲区。结果 41%的考生身份为在读硕士研究生,59%的考生为在读本科生,男生占48%,女生占52%,且比较不同身份的性别构成比,差异无统计学意义;题目被归纳分为“行为规范”“应急自救技能”和“事故防范能力”三大部分,比较“行为规范”和“应急自救技能”类题目的错误率,差异存在统计学意义(χ2=7.570,P=0.006),“应急自救技能”类题目的错误率为3.14%,高于其余两类。结论 高校学生对应急自救技能类可能存在较多的知识盲区,应以之作为实验室安全管理工作关键控制点,加强应急自救技能培训可以极大地降低事故的严重程度。
Objective To enhance the efficiency of laboratory safety management in colleges,we analyzed the insufficiency of students in the knowledge about laboratory safety. Methods A total of 192 college students had attended the education tests of laboratory safety and totally 235 tests had been successfully recorded.According to the statistical analysis results,we observed the error ratio and the and the composition of the options for each question in the tests.With statistical description and Chi-square test,the impact of the test scores and the main insufficiency in the knowledge about laboratory safety were discussed. Results 41% of the students were pursuing master's degree,59% of them were pursuing bachelor's degree,48% are males and 52% are females,there was no significant difference in gender composition among different identities.All the questions had been categorized into three types,which were principle for conduct in laboratory,the skills of self rescue and the capability to prevent accidence.There was statistical significance between types of questions on principle for conduct in laboratory and the skills of self rescue(χ2=7.570,P=0.006),the error ratio of the question type of skills of self rescue was 3.14%,which was higher than the other types. Conclusions The insufficiency in the knowledge of skills of self rescue might probably be the critical control point in laboratory safety management,which should set as the key point of lab security,improve the self rescue skill of students may decrease thu severity accidence.
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