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出生体重2000~2999g早产儿眼底疾病筛查结果分析

医护合作-快速康复模式在经输尿管镜钬激光碎石术中的应用及效果评价

目的 探讨医护合作-快速康复模式在经输尿管镜钬激光碎石手术中的临床应用及效果的评价。 方法 将 2015 年 10 月—2016 年 3 月入住的 166 例输尿管结石患者随机分为对照组和试验组各 83 例，对照组按传统方法进行住院治疗及围手术期护理，试验组按照医护合作-快速康复模式进行诊治及护理，包括门诊评估、术前检查的完善、麻醉评估、流程办理、家庭护理的注意事项、围手术期的饮食活动指导和疼痛管理、健康保健等。比较两组患者的住院时间、住院费用、术后并发症、术后首次进食时间和满意度的差异。 结果 试验组患者住院时间[（22.46±0.89）h]少于对照组[（76.46±0.75）h]，住院费用[（8 275.21±789.45）元]低于对照组[（12 859.11±1 047.54）元]，并发症发生率[10.8%（9/83）]低于对照组[41.0%（34/83）]，患者满意度[（99.87±5.12）%]高于对照组[90.66±5.95）%]，差异均有统计学意义（P<0.05）。 结论 医护合作-快速康复模式应用于输尿管镜钬激光碎石手术，能充分利用医疗资源，促进医患关系协调，缩短患者的住院日，减少患者的住院费用，降低术后并发症的发生，促进术后康复，早日恢复患者的正常生活。

优质护理服务在泌尿专科日间病房的开展与成效

目的　深化“以病人为中心”的服务理念，提升泌尿专科日间病房护理服务工作质量。 方法　对 2012年7月－11月入住日间病房的230例患者，实行责任制整体护理，包括加强基础护理，密切观察患者病情，协助医生实施诊疗，参与医生查房，积极与患者沟通，提供健康指导等护理工作，为患者提供全程、连续的优质护理服务。 结果　护理工作质量和患者满意度明显提高，整体满意度达到99.1%。优质护理服务开展前后各项指标满意度评分比较，差异有统计学意义(P＜0.05)。 结论　转变护理服务理念与模式，能全面提升对患者的服务品质，有效提高整体护理质量，提高患者满意度。

The Perioperative Nursing of Patients with Pelvic Organ Prolapse undergoing Pelvic Floor Reconstruction

目的　探讨加用网片盆底重建术（PROSIMA）治疗盆腔器官脱垂患者的围手术期护理方法。 方法　对2010年6月－2011年6月收治的23例盆腔脏器脱垂患者施行的PROSIMA护理措施进行回顾性总结。 结果　23例患者术后尿失禁症状明显好转，舒适感增加；仅1例发生尿潴留，予重置尿管后顺利排尿；治愈率达100%。术后6个月复查时均无阴道壁膨出或穹隆脱垂，未出现下尿路感染、网片侵蚀、下肢疼痛等并发症。 结论　有效的护理措施可减少PROSIMA术后并发症，对提高手术成功率、促进患者康复有明显作用。

维生素A缺乏症一例

肝细胞癌免疫治疗疗效预测与评价

Relationship of Magnetic Resonance DiffusionWeighted Imaging to Histology in Chronic Viral Hepatitis

【Abstract】ObjectiveTo investigate the relationship of magnetic resonance diffusion-weighted imaging (DWI) to histology in the patients of chronic viral hepatitis. MethodsThirty-five patients of chronic viral hepatitis who received liver biopsy and 10 healthy volunteers were included in this study. All of them underwent DWI on a 3.0T MRI device. Apparent diffusion coefficient (ADC) of the liver were measured respectively when b value were set as 100, 400, 600 and 800 s/mm2. Biopsy specimens were scored for fibrosis and necroinflammation according to the Knodell histology activity index (HAI). ResultsWhen b value was set as 800 s/mm2, statistical difference was showed between the fibrosis group and the nonfibrosis group, statistical difference was also shown among the different degrees of necroinflammation and fibrosis. ConclusionDWI is a valuable method for grading and staging of chronic viral hepatitis.

Diagnosis and treatment pathway of neoadjuvant immunotherapy for esophageal cancer in Henan province

Esophageal cancer is a highly prevalent tumor species in Henan province, which brings heavy medical burden to families and society. Surgical treatment plays a dominant role in the treatment of non-advanced esophageal cancer. However, cancer cells in esophageal cancer lesions are highly invasive, postoperative recurrence and metastasis rates are pretty high. More effective systemic and comprehensive treatment is urgently needed to improve the prognosis. We invited 52 doctors in esophageal surgery, oncology, pathology, imaging, and radiation therapy of 32 hospitals at all levels in Henan province, to repeatedly negotiate and fully discuss in combination with evidence and clinical practice experience. Finally, “diagnosis and treatment pathway of neoadjuvant immunotherapy for esophageal cancer in Henan province” was formulated. In this treatment pathway, seven recommendations were proposed from seven perspectives including target population, patient evaluation, protocol selection, surgical timing, postoperative management, organ preservation, and general principles to offer reference for medical personnel related to esophageal cancer surgery.

Treatment of Naloxone for Moderate and Severe Neonatal Hypoxia-ischemic Encephalopathy:A Meta-analysis

ObjectiveTo objectively evaluate the effect and safety of naloxone for the treatment of moderate and severe neonatal hypoxia-ischemic encephalopathy (HIE). MethodsResearch articles published from inception to June 2015 on Cochrane library, PubMed, Web of science, Chinese Science and Technology Journal Full-text Database, Digital Full-text Journal Database and Chinese Journal Full-text Database were searched, which were relevant to naloxone in the treatment of moderate and severe neonatal HIE. And two authors extracted information via standardized data extraction form and assessed the quality of included studies independently. RevMan 5.2 software was used for Meta-analysis. ResultsAt last, 20 randomized controlled trials (involving 1 519 neonates; 783 in the treatment group and 736 in the control group) were included. The results of meta-analysis showed that the effect of naloxone for moderate and severe HIE was significantly superior to the control group[OR=5.07, 95%CI (3.61, 7.12), P < 0.000 01]. The neurobehavioral scores in neonates treated by naloxone after 5, 7, 10, and 14 days were higher than those in the control group[WMD=6.61 points, 95%CI (5.70, 7.51) points, P < 0.000 01; WMD=4.27 points, 95%CI (2.63, 5.91) points, P < 0.000 01; WMD=2.40 points, 95%CI (1.47, 3.34) points, P < 0.000 01; WMD=2.58 points, 95%CI (1.00, 4.16) points, P=0.001], respectively; while the neurobehavioral scores after 3-day treatment between the two groups had no statistically difference[WMD=0.00 points, 95%CI(-0.76, 0.77) points, P=0.99]. What's more, the disappeared time of clinical symptoms and signs (breathing improvement time, recovery time, convulsions disappearance time, and signs disappearance time) in naloxone group was superior to the control groups[WMD=-3.78 hours, 95%CI (-6.93, -0.64) hours, P=0.02; WMD=-9.66 hours, 95%CI (-14.25, -5.06) hours, P < 0.001; WMD=-2.81 hours, 95%CI (-5.28, -0.35) hours, P=0.03; WMD=-1.02 days, 95%CI (-1.84, -0.20) days, P=0.01], respectively. ConclusionsNaloxone has certain therapeutic on moderate and severe HIE. Further high-quality randomized controlled trials should be carried out to provide more reliable evidence.

Application of evidence-based medicine combined with problem-based learning method in clinical teaching: a meta-analysis

ObjectivesTo systematically review the application of evidence-based medicine (EBM) combined with problem-based learning (PBL) method in clinical teaching.MethodsDatabases including WanFang Data, CNKI, VIP, CBM, PubMed and EMbase were searched to identify eligible randomized controlled trials that compared EBM plus PBL with traditional lecture based learning (LBL) method in clinical teaching from inception to March 28th, 2020. Two reviewers independently screened literature, extracted data and assessed risk bias of included studies. Statistical analysis was performed using Stata 14.0 software.ResultsA total of 33 randomized controlled trials with 2 855 students were included. The results showed that students in EBM combined with PBL group obtained better scores of specialized theory (WMD=6.87, 95%CI 5.08 to 8.66, P<0.001), skills examination (WMD=10.57, 95%CI 8.98 to 12.16, P<0.001) and case analysis (WMD=9.79, 95%CI 4.71 to 14.88, P<0.001), comparing with those in LBL group. Besides, EBM combined with PBL method improved students’ overall ability including independent learning capability, clinical thinking ability, problem-solving capability, literature exploring capacity, communication and presentation skills and team-work ability.ConclusionsApplication of EBM combined with PBL method can improve clinical teaching quality.