目的 了解血液科护士在对患者抗肿瘤药物治疗护理过程中的防护现状。 方法 2009年12月-2010年3月对血液科一、二病区和骨髓移植层流病房的护理人员,采用便利抽样方式进行问卷调查。 结果 血液科化学疗法防护现状与国际水平有差距,护理人员虽有一定的防护意识,但仍较薄弱。 结论 加强护理人员化学治疗药物毒性及防护知识的教育,提高防范意识,并制定严格的防护措施及管理制度是确保护理人员职业安全的根本与途径。
Antimicrobial stewardship (AMS) is an important means to control bacterial resistance. The unique situation of intensive care unit (ICU) poses a challenge to AMS. This article reviews the literature on AMS in the ICU at home and abroad in recent years, and summarizes the related measures of AMS. Effective AMS measures in the ICU include setting up a multidisciplinary AMS team, using rapid microbial diagnosis technology to shorten the time of diagnosis, using non-culture methods to assess the necessity of antimicrobial therapy for patients with suspected sepsis, and evaluating the effectiveness of antimicrobial therapy as early as possible and optimizing it. These initiatives aim to increase the rational use of antimicrobials in ICU, reduce the risk of multidrug-resistant infections, and improve patients’ condition.
In the expert consensus published by the Pediatrics in 2013, it was first proposed that anti-VEGF drugs can be considered for retinopathy of prematurity (ROP) with stage 3, zone Ⅰ with plus disease. However, there are many problems worth the attention of ophthalmologists, including the advantages and disadvantages of anti-VEGF therapy compared with traditional laser therapy, systemic and ocular complications after anti-VEGF therapy, and what indicators are the end points of anti-VEGF therapy. Combined with this consensus and numerous research findings, we recommend that the first treatment for anti-VEGF or laser therapy should be considered from disease control effects. For the threshold and pre-threshold lesions, the effect of anti-VEGF therapy for zoneⅡ lesions is better than that for zone Ⅰ lesions and the single-time effective rate is high. So, it is suggested that anti-VEGF therapy should be preferred for the first treatment. The choice of repeat treatment should be considered from the final retinal structure and functional prognosis. Laser therapy is advisable for the abnormal vascular regression slower and abnormalities in the posterior pole. It can reduce the number of reexaminations and prolong the interval between re-examinations. However, the premature use of laser has an inevitable effect on peripheral vision field. Excluding the above problems, supplemental therapy can still choose anti-VEGF therapy again. Most of the children with twice anti-VEGF therapy are sufficient to control the disease. Anti-VEGF therapy should be terminated when there are signs such as plus regression, threshold or pre-threshold lesions controlled without recurrence, peripheral vascularization, etc.
目的 了解我院住院患者抗菌药物的临床应用现状及存在问题,为临床合理使用抗菌药物提供参考。 方法 采用回顾性调查方法,对本院2008年11月-2009年4月的出院病历资料进行统计、分析。 结果 共调查病历1 000份,抗菌药物总使用率58.70%;其中预防用药使用率62.35%,治疗用药使用率37.65%;联合用药的比例为37.31%;不合理用药占19.76%。 结论 抗菌药物使用率较高,且使用存在一些不合理现象。医院应加强监管,对存在的问题应制订相应措施。
Objective To investigate the effect of bromocriptine on rats with experimental autoimmune uveoretinitis.Methods Tweenty-four Wistar rats were immunized by bovine soluble antigen and randomly divided into treatment and control group. The rats in treatment group took bromocriptine orally with the dosage of 5 mg/(kg·d), which could inhibit prolactin (PRL) deliverance, while the rats in control group took glucose solution orally with the dosage of 50 g/(L·d). The clinical changes of all the rats and the delayed type hypersensitivity (DTH) response were detected. The rats were anesthetized and killed after im munized for 21 days, and the eyes were removed and examined histologically.Results The occurrence of EAU and histology scores of rats in treatment group were lower than the controls (P<0.05,P<0.001). The DTH response of two groups had no statistic difference (P>0.05). Conclusions Bromocriptine can generally inhibit PRL deliverance, and may also inhibit the occurrence of EAU in rats through neuroendocrine-immune regulating network. (Chin J Ocul Fundus Dis,2003,19:34-37)
Improving the rate of pathogen examination before antibiotic treatment is of great significance for clarifying pathogen diagnosis and curbing bacterial resistance, and is also one of the important goals for improving national medical quality and safety. In response to the current problem of low pathogen examination rates, Chengdu Women’s and Children’s Central Hospital adopts a FOCUS-PDCA model, has explored measures such as current situation investigation, root cause analysis, intervention plan formulation, countermeasure implementation, and effect evaluation to improve the rate of pathogen examination before antibiotic treatment in inpatients. This article mainly elaborates on the above model, which has practical significance for ensuring the rational use of antibiotics in inpatients.