针刺平行随机对照试验通常没有准确报告试验组和对照组的干预方法.为促进标准化,国际上有经验的针刺医师和研究者组成的小组制定了一些原则,即针刺临床对照试验中干预措施报告的标准(缩写为STRICTA).在征求意见过程中,一些期刊编辑协助对此标准进行了修改,使之与随机对照试验报告的标准(CON-SORT)格式一致,作为该指南对针剌研究报告的延伸.参与此事的杂志编辑已确定要发表该标准,建议其作者群按照此标准准备论文,并将邀请更多杂志采用该标准.目的是使针剌对照试验的干预措施充分报告,从而有利于对这些研究的严格评价、分析及这些措施的推广.
ObjectiveTo systematically interpret the updated risk of bias in non-randomized studies of interventions version 2 (ROBINS-I V2) in 2024, summarizing its key improvements, operational procedures, and clinical application value. MethodsThrough literature review and case studies, the improvements of ROBINS-I V2 were compared with the 2016 version, including the expansion of bias domains, refinement of signaling questions, and optimization of decision flowcharts. A retrospective study in stomatology was used to demonstrate the practical application of the tool. ResultsThe ROBINS-I V2 tool has restructured the hierarchy and refined the definitions of bias domains, optimized the evaluation processes across seven risk-of-bias dimensions, and minimized subjective judgment errors through standardized decision flowcharts. ConclusionROBINS-I V2 significantly improves the rigor of bias assessment in non-randomized intervention studies through its scientific design and standardized workflow. It is recommended for evidence quality grading and decision-making support in clinical research.
In recent years, an increasing amount of systematic reviews have been published; however, few reviews adequately considered and reported details of interventions, which not only limited the usability of systematic reviews but also wasted resource. In order to improve reporting of intervention details in systematic reviews, BMJ recently published recommendations. This paper interprets the recommendations to improve usability of systematic reviews.
目的 了解医院外科患者手术部位感染的危险因素，以采取预防与控制干预措施，降低手术部位感染率。 方法 以回顾性调查方法对2011年1月－6月外科手术患者统计手术部位感染率；以前瞻性调查的方法对2012年1月－6月外科手术部位患者进行目标性监测。 结果 2011年1月－6月手术部位感染率为1.01%，2012年1月－6月手术部位感染率为0.63%，两者比较，差异有统计学意义（P＜0.05）。患者年龄、手术类型、手术时间、手术性质是手术部位感染的高危因素。 结论 实施目标性监测，加强危险因素管理，采取干预措施，能有效降低外科手术部位感染率。
目的 对烧伤层流病房多重耐药菌感染的相关因素进行分析，通过护理干预来预防和减少烧伤病房多重耐药菌感染的发生。 方法 回顾性分析2011年1月－12月收治的629例烧伤患者，其中发生多重耐药菌感染74例，感染率为11.8%。 结果 感染部位：创面分泌物培养感染占70.2%，痰液标本培养感染占9.4%，血液标本培养感染占16.2%，其他占4.2%。感染病原菌：以金黄色葡萄球菌为主，占77.0%；鲍曼不动杆菌占4.2%，铜绿假单胞菌占10.8%，肺炎克雷伯菌占6.7%，真菌感染占1.3%。 结论 对发生医院内多重耐药菌感染的原因进行分析并及时采取相应的护理干预措施，及可行的医院感染管理控制措施，对烧伤患者预后有重要的意义，可有效降低院内感染率的发生。
Objective To know the status quo of multidrug-resistant organism (MDRO) infection in primary general hospitals, analyze the differences among various intervention measures, and put forward guiding principles for MDRO infection control in primary general hospitals. Methods We investigated all patients (n=51 612) admitted into the hospital between January 2013 and December 2015, and found out 6 types of MDRO. Pre-interventional investigation was carried out between January 2013 and June 2014 (before intervention) during which no intervention measures were taken; Intervention was carried out between July 2014 and December 2015 (after intervention). All departments in the hospital (6 groups) were matched with intervention measures (6 groups) randomly. Then, we compared the MDRO detection rate, nosocomial infection case rate and intervention compliance rate among the groups. Results We detected altogether 611 MDRO cases (without duplication) out of the 51 612 cases. The total detection rate of MDRO was 1.18%. The detection rate of MDRO before and after intervention was 1.37% and 1.01%, respectively. The difference between the two was of statistical significance (P<0.05). After the intervention, the detection rate in groups 1, 5 and 6 was significantly lower than before (P<0.05); the differences in detection rate among groups 2, 3, and 4 were not significant (P> 0.05). Nosocomial infection rate decreased from 0.28% before intervention to 0.14% after intervention (P<0.05). After the intervention, MDRO nosocomial infection case rate of groups 1, 5 and 6 was significantly lower than before (P<0.05); the rate was lower in groups 3 and 4 than before without any significance (P>0.05); no MDRO cases were detected in group 2 and comparison was meaningless. The knowledge rates of medical workers and of nursing staff increased from 52.97% and 20.00% before intervention to 78.76% and 66.34% after intervention, respectively (χ2=30.670, 38.604;P<0.05). The compliance to all kinds of protection measures improved significantly (P<0.05) except compliances to equipment of hand antiseptic agent and patient transfer order (P> 0.05). Conclusion Promoting the compliance rate to hand hygiene and environmental cleaning and disinfection, primary general hospitals can decrease the detection rate and nosocomial infection case rate of MDRO.
ObjectiveTo explore the corresponding intervention measures to reduce maternal mortality rate by analyzing the causes and problems of maternal deaths. MethodsA retrospective analysis was conducted to analyze all cases of maternal mortality from January 2005 to June 2013 in West China Second University Hospital. ResultsAmong the 14 cases of maternal deaths, the main diseases of the patients were pregnancy complicated with heart disease, hypertensive disorders, obstetric hemorrhage, amniotic fluid embolism and ectopic pregnancy. Four cases got prescriptive prenatal care during pregnancy, accounting for 28.6% (4/14), while 10 cases did not, accounting for 71.4% (10/14). Six patients died in prenatal period which accounted for 42.9% (6/14), while 8 died in postnatal period which accounted for 57.1% (6/14) and 5 died within 24 hours which accounted for 62.5% (5/8). Seven underwent cesarean section and 6 fetuses survived. Two went through trial of labor and no fetus survived. There was no ordered postmortem. ConclusionIntensifying education of prenatal care during pregnancy, improving quality of obstetrical service and diathesis of healthcare professionals, strengthening the supervision of high-risk pregnancy and timely choosing the time and manner of delivery are the main measures to decrease the maternal mortality.
目的 探讨心理干预措施对改善妇科恶性肿瘤患者的生命质量的作用及有效性。 方法 对2008年11月－2010年11月收治的87例妇科恶性肿瘤患者，随机分为试验组与对照组，试验组43例，实施心理干预及常规治疗；对照组44例，采取常规治疗；并对两组患者入院后及出院前生存质量、心理状况以问卷调查方式进行资料收集，用以比较、评价心理干预对改善妇科恶性肿瘤患者生命质量的作用及效果。 结果 妇科恶性肿瘤患者抑郁发生率为56.3%（49/87），焦虑发生率为62.1%（54/87）； 心理干预后两组患者组间各指标比较，试验组患者的总体健康状况、生存质量、角色功能、情绪功能、认知功能得分比对照组增高（P＜0.05）；试验组患者疲倦、恶心呕吐、失眠、食欲下降、便秘症状、抑郁、焦虑得分比对照组得分下降（P＜0.05）。 结论 心理干预可改变妇科肿瘤患者的负性心理倾向，缓解抑郁、焦虑等情绪，减轻化疗药物所引起的系列副作用，能有效提高其生活质量。