Study on the measurement formula of intraocular lens in primary hospitals of minority areas / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To compare and study the differences of eyeball biometric measurements among Han, Hani and Yi nationality in Honghe Hani and Yi Autonomous Prefecture(Honghe Prefecture), and prediction accuracy of the intraocular lens(IOL)degree by SRK-T and Haigis formulas in the different eye axes, to provide further objective clinical evidence for the majority of basic-level hospitals and the blind prevention and treatment projects in minority areas.<p>METHODS: Selected 186 cases(200 eyes)cataract patients in our department, divided them into three groups according to different nations, get their eyeball biometric measurements(ocular axial length, anterior chamber depth and corneal curvature)by A-ultrasound combined with corneal curvature meter and corneal topography, and then compared the differences. According to the different eye axes, they were divided into three groups and then randomly divided into two groups. SRK-T and Haigis formulas were used to predict the IOL degree, and collected postoperative optometry results, calculated the absolute prediction error, then conducted statistical analysis. <p>RESULTS: There were no difference in the mean axial length, mean anterior chamber depth and mean corneal curvature(measured respectively by corneal topography and corneal keratometer)in the different ethnic groups(<i>P</i>>0.05), and the mean corneal curvature measured by the two methods had no difference(<i>P</i>>0.05). There were no difference of the mean corneal curvature measured by the two methods in the three axial eye groups(<i>P</i>>0.05)and in the same axial eye group(<i>P</i>>0.05). There were no difference in the absolute error of the two IOL measurement formulas in the three eye axis groups(<i>P</i>>0.05). The absolute error calculated by SRK-T formula for the short and the middle eye axis groups were smaller, while it calculated by Haigis formula for long eye axis group was smaller.<p>CONCLUSION: In our department, there are no statistical difference in the eye biometrics of Han, Yi and Hani nationality. Corneal curvature measured by corneal topography and corneal keratometer have no significant difference. SRK-T and Haigis formula both have high predictive value for IOL degree, SRK-T formula has smaller predictive error for patients which with short and middle eye axis, and Haigis formula has better predictive value for the long ones.

Problems and thoughts in the application of neonatal resuscitation technology in rural primary hospitals / 中国实用护理杂志

Neonatal resuscitation project to rural grass-roots development is different from urban promotion and application, need to adjust appropriate strategies and measures. Correct understanding of the effectiveness of resuscitation technology can improve the compliance of rural grass-roots promotion and application. According to "Renewal of International Neonatal Resuscitation Course and China′s Implementation Opinions", we should make the training of recovery teams as an important goal of long-term management, And adhere to "one case one preparation, one monitoring, one week one review". Rural grass-roots units should innovate and popularize application methods according to local conditions. It is suggested that the training system for neonatal resuscitation and post-resuscitation treatment should be gradually established in county (city) areas.

Exploration on application of 3D printed models in the orthopedic clinical internship teaching at basic-level hospital / 中华医学教育探索杂志

Objective To evaluate the effect of 3D printed skeletal model in orthopedic clinical in-ternship teaching . Methods From October 2015 to October 2016 , 30 undergraduate clinical medical internship students were divided into traditional teaching group and 3D model teaching group randomly. 1 teaching ward round was conducted for each student. Teaching rounds were conducted according to routine procedures in traditional teaching group, while the 3D model teaching group used the patient's 3D print skeletal model to assist in teaching rounds and perform simulated surgery. All students were tested in theory and practice, and the teaching evaluation was carried out by questionnaire. Data were imputed into SPSS 19.0 for comparison between the two groups using t-test. Results Students in 3D model teaching group significantly outperformed than those in traditional teaching group in theoretical achievement [(92.27±4.56) vs. (86.87±5.30)] and practical achievement [(90.07±4.61) vs. (82.53±5.03)] (P<0.01). In respects of pro-moting theoretical knowledge, enhancing surgical participation, hands-on ability exercise, teaching attraction and overall satisfaction, students in 3D model teaching group gave a better evaluation of teaching they had received than those in the traditional teaching group (P<0.01). Conclusion 3D printed skeletal model is an effective teaching tool, and its application in clinical internship teaching at basic-level hospital can signifi-cantly improve teaching effectiveness and satisfaction. It is worth further exploration and promotion.

Analysis of anticoagulation in 926 patients with atrial fibrillation / 中国基层医药

Objective To analyze the anticoagulation in patients with atrial fibrillation.Methods A retrospective analysis of anticoagulant therapy situation in 926 patients with atrial fibrillation was conducted,in order to sum up experience and improve the understanding of atrial fibrillation.Results In 926 patients with atrial fibrillation,there were no anticoagulant therapy in 675 patients,accounting for 72.89%,while only 251 cases received the treatment of anticoagulation,accounting for 27.11%.Only 66 patients aged>75 years were treated with anticoagulant therapy,accounting for 33.17%.The patients with coronary heart disease,in 17.60% and with anticoagulation treatment,the patients with diabetes in 28.37% and received anticoagulation therapy,28.32% patients with anticoagulation therapy in patients with hypertension,30.77% patients with cardiac insufficiency with anticoagulant therapy.Choice of treatment of aged>75,hypertension,coronary heart disease,clinical treatment strategies and patients were the main factors that affected the use of warfarin,but only>75 years of age,coronary heart disease,choice of treatment factors with statistical significance of three factors(OR=7.02,12.73,4.79,all P<0.05).675 cases without anticoagulant therapy in 101 patients with non warfarin treatment indications without the use of warfarin anticoagulation treatment,accounted for 14.96%.In addition,there were 574 AF patients with warfarin treatment indications and treatment with warfarin,analysis of its causes:63 cases had anticoagulant contraindications,172 cases for the doctor too much about bleeding complications,440 patients were not in accordance with the requirements of the detection of INR.Conclusion The positive effect of warfarin in prevention of ischemic stroke,but in basic hospital application of warfarin anticoagulation in patients with severe AF deficiency,should raise the awareness of risk of grassroots medical staff and patients of atrial fibrillation complicating embolism,do a good job of educating patients,to reduce the incidence of embolic events in patients with atrial fibrillation.

Analysis of capabilities of microscopic examinations of Plasmodium in Dongxihu District,Wuhan City / 中国血吸虫病防治杂志

Objective To investigate and analyze the capabilities of Plasmodium microscopic examinations in medical and health organizations in Dongxihu District,Wuhan City,so as to provide evidences for achieving the standard of malaria elimina?tion and malaria control in the future. Methods The basic information of the laboratorians and the hardware facilities in 15 mi?croscopic examination stations of Plasmodium were collected and analyzed from 2010 to 2015. Meanwhile,the quality of mak?ing,dyeing,cleanliness of all the negatives blood smears were evaluated,and all the positive smears were re?checked in the dis?trict during the period above mentioned. Results Totally,there were 28 laboratorians and 9 qualified microscopes in 15 micros?copy stations in Dongxihu District. The age of the laboratorians in the first?level and third?level organizations was mainly from 40 to 50 years old,but the age of those in the second?level organizations was from 20 to 30 years old. The years for microscopic ex?amination working of most of the laboratorians in the first?level and third?level organizations were more than 15 years,while the working years of those in the second?level organizations were mainly less than 10 years. The education level of the laboratorians in the first?level organization was mainly(50.00%)junior college,while the education levels of those in the second and third or?ganizations were mainly bachelor. From 2010 to 2015,8 561 blood smears were produced and 539 of them were reviewed,the co?incidence rates of review were all 100%,and the average qualified rates of making,dyeing,and cleanliness of the negative blood smears were 82.08%,79.92%and 83.33%,respectively. All the rates mentioned above in 2015 were higher than those in 2010(χ2=26.45,16.85,13.93,all P<0.01). Conclusion The capability of microscopic examinations of Plasmodium has improved obviously in Dongxihu District,but the human resources construction and hardware input in this district should be im?proved,meanwhile,the check on the quality control of microscopic examinations of Plasmodium should be continued,so as to guarantee the sustainable and healthy development of malaria control work in this district.

Nivel de conocimiento respecto a la planificación familiar en gestantes que acudieron al Hospital Universitario San José, Popayán, Colombia, 2014-2015 / Knowledge about contraception among pregnant women coming to San José University Hospital in Popayán, Colombia, 2014-2015

Objetivos: determinar el nivel de conocimiento mínimo aceptable existente sobre planificación familiar que tienen las pacientes obstétricas que acuden al Hospital Universitario San José (HUSJ), e n Popayán. Materiales y métodos: estudio transversal en gestantes que acudieron a un hospital público universitario de referencia, de tercer nivel de complejidad, ubicado en el suroccidente de Colombia en los años 2014-2015. Se excluyeron aquellas con información inconsistente, las que por su situación de salud física o mental no pudieran contestar la encuesta y aquellas que no firmaron el consentimiento informado. Se definió como nivel de conocimiento mínimo aceptable aquellas encuestas con más de un 90 % de ítems correctos. Tamaño de muestra: 361 pacientes. Se realizó muestreo aleatorio sistemático; se evaluaron las variables biológicas, sociales y demográficas. Respecto al conocimiento del método se indagó sobre aspectos relacionados con su uso, reacciones adversas y riesgo de falla. Se realizó análisis descriptivo. Resultados: se evaluaron 361 mujeres, 94,46 % manifestaron conocer al menos un método de planificación. El 70,09 % de los embarazos no fueron planeados. Cerca de un cuarto de las pacientes estaban usando algún método de planificación familiar al momento del embarazo. Se encontró en un nivel de conocimiento mínimo del 90 % en el 26,23 % de las pacientes, siendo el más bajo para anticonceptivos (11,85 %). Conclusiones: a pesar de que el 94 % de las gestantes entrevistadas conocían la existencia de métodos de planificación, en cuanto al conocimiento de cómo usarlos y las reacciones adversas asociadas, el 26 % tuvo un nivel mayor al 90 % en ambos aspectos.

Objectives: To determine the level of basic acceptable knowledge on contraception among obstetric patients coming to the Hospital Universitario San José (HUSJ) in Popayán. Materials and methods: Cross-sectional study in pregnant women coming to a Level III referral public university hospital in Southwestern Colombia during 2014 and 2015. Patients with inconsistent information, or who could not complete the survey because of their mental or physical conditions, or those who did not sign inform consent, were excluded. Basic level of knowledge was defined as more than 90 % correct items on the questionnaire. A systematic random sampling was performed, and the biological, social and demographic variables were analysed. In terms of knowledge of the contraception method, there were questions regarding use, adverse reactions and risk of failure. A descriptive analysis was performed. Results: Of a total of 361 women included in the assessment, 94.46 % reported having knowledge of at least one contraception method. Of the pregnancies, 70.09 % were unplanned. Close to one-fourth of the patients were using some form of contraception at the time of pregnancy. A basic level of knowledge of 90 % was found in 26.23 % of the patients, the lowest level being related to the knowledge about oral contraceptives (11,85%). Conclusions: Despite the fact that 94% of the pregnant women interviewed knew of the existence of contraception methods, only 26% of them were found to have a level of knowledge greater than 90% concerning their use and associated adverse reactions.

Investigation and Analysis of the Cognition of Basic Medical Staff to the National Essential Medicine System in Xinjiang / 中国药房

OBJECTIVE:To provide reference for further developing the use of national essential medicine system and formulat-ing the plan for essential medicine that is consistent with the local situation. METHODS:A questionnaire survey was conducted on site to collect the 1 800 medical staffs chosen from 35 community health service institutions in Xinjiang with multi-stage stratified random cluster sampling to investigate the cognition to the national essential medicine,and it was statistically analyzed by SPSS 13.0 software. RESULTS:Totally 1 800 questionnaires were sent out and 1 642 were effective received with effective recovery of 91.2%. 26.5% acquired such specialized knowledge through professional training,and 50.0% by books and Internet;62.4% did never participated in training. Only 20.2% shared it for patients. The average score of recognition for the system was(6.09±2.86) scores,which was related to age,education,profession,work experience and the title (P<0.01). 75.2% supported this system. CONCLUSIONS:The basic medical staff just have some know of the concept of national essential medicine,but the understanding is still low. It is suggested to improve the cognition level by seminars and continuing training to strengthen reliability of all ethnic groups on essential medicine,change their bad medication habits,popularize common sense of rational drug use and form a good atmosphere for the implementation of the national essential medicine system in the whole society.

Current status of healthcare-associated infection management in 118 basic level private medical institutions / 中国感染控制杂志

Objective To investigate the current situation of healthcare-associated infection (HAI)management in basic level private medical institutions.Methods 118 basic level private medical institutions in a district of Chengdu were investigated through visiting and questionnaire.Results Of 118 medical institutions,only 2 had HAI manage-ment personnel,4 had HAI management system.22.03% had hand washing facilities in therapeutic rooms and con-sulting rooms,37.29% of institutions stored aseptic items in accordance with the requirements,55.93% of institu-tions disposed medical waste at disposal center;99.15% handled reusable items by users.Conclusion HAI manage-ment status is worried,health administrative department should strengthen support and supervision,especially in-tensified the supervision of private dental clinics.

Ward round presided over by hospital director to improve health care workers’hand hygiene compliance / 中国感染控制杂志

Objective To investigate the influence of participation of healthcare-associated infection (HAI)man-agement department in ward round presided over by hospital director on hand hygiene compliance of health care workers (HCWs)in a basic-level hospital.Methods Implementation of hand hygiene in January-June 2012 (control group :HAI management department didn’t participate ward round)and January-June 2013 (trial group :HAI management department participated ward round)were investigated,the compliance of hand hygiene of two groups of HCWs and consumption of hand hygiene products of each department were compared.Results HAI case rate in trail group was significantly lower than control group (1.49% vs 2.01% )(χ2= 4.31,P<0.05);HCWs’hand hy-giene compliance rate was significantly higher than control group (71 . 56% [3 249/4 540 ]vs 44. 00% [1 914/4 350]),hand hygiene compliance rates in nurses were higher than doctors of both groups(χ2= 151.30,179.92, respectively,bothP<0.001),hand hygiene compliance rate in trial group from high to low was department of pedi-atrics,obstetrics and gynecology,surgery,and internal medicine. The consumption of rapid hand disinfectant of trail group and control group was 5.38mL/bed-day and 1.88 mL/bed-day respectively,the consumption of hand sanitizer was 11.51 mL/bed-day and 7.03 mL/bed-day respectively.Conclusion Hand hygiene checked during the ward round presided over by hospital director can improve HCWs’hand hygiene compliance,reduce the incidence of HAI,and ensure medical safety.

Application of acetic acid-indigo carmine dyeing in diagnosis of early gastric cancer and precancerous lesions in basic level hospital / 局解手术学杂志

Objective To explore the approaches to improve the detection of early gastric and precancerous lesions for basic level hospi-tals. Methods The 72 patients with abnormal gastric mucosa observed by gastroscope arranged with pathology after acetic acid-indigo car-mine dyeing were considered as the dyeing group, and 68 patients with abnormal gastric mucosa observed by gastroscope directly arranged with pathology were considered as the control group. The dyeing conditions of gastric mucosa were observed and compared to pathology detec-tion. The detection rate of early gastric cancer and precancerous lesions in the two groups were compared. Results After acetic acid-indigo carmine dyeing, there were 16. 7% of demonstrated discoloration, 63. 9% of poor dyeing, and 14. 3% of even dyeing. The detection rate of early gastric cancer and high grade intraepithelial neoplasia in patients with mucosa discoloration (91. 7%) was obviously higher than that in patients with poor dyeing (8. 6%) or even dyeing (0. 0%). The detection rate of low grade intraepithelial neoplasia or intestinal metaplasia in patients with poor dyeing (82. 6%) was obviously higher than that in patients with mucosa discoloration (8. 3%) or even dyeing (14. 3%). The detection rate of early gastric cancer and precancerous lesions in dyeing group (13. 9%,63. 9%) was obviously higher than that in control group (2. 9%,29. 4%). Conclusion The acid-indigo carmine dyeing could increase the diagnosis of early gastric cancer and precancerous lesions in basic level hospital. It is adaptable to extend approach in basic level hospital for its low cost and simple operation.

Experimental intervention study of safe injection in basic-level hospitals in Hunan by medical staff / 中南大学学报(医学版)

Objective:To experimentally intervene safe injection by medical staff in basic-level hospitals and observe the recent and long-term effect atfer the intervention and to provide practical measures to improve safe injection. Methods:We used random sampling methods to set up groups in county hospitals and township hospitals of Hunan Province, and offered lectures, delivered safe injection guide, brochure and on-site guidance in the experimental group. We surveyed the 2 groups atfer the intervention at 1 month and 6 months to compare the effect of unsafe injection behaviors and safe injection behaviors. Results:One month after the intervention, the unsafe injection rate in the experimental group decreased from 27.8%to 21.7%, while in the control group injection the unsafe injection rate rose from 26.0%to 27.9%, with signiifcant difference (P<0.01). Six months atfer the intervention, the unsafe injection rate in the experimental group declined to 18.4%while the unsafe injection rate in the control group also dropped to 22.4%, with signiifcant difference (P<0.01). Unsafe injection rate was decreased in the experimental group at different intervention points, with signiifcant difference (P<0.01). The safe injection behavior scores in the experimental group were higher than those in the control group after the intervention of 1 month and 6 month intervention (P<0.01);the experimental group got higher scores atfer the intervention (P<0.01). Conclusion:Training of safe injection, distribution of safe injection guide, and comprehensive intervention model can significantly change the primary care practitioners’ behaviors in unsafe injections and it is worth promoting.

Investigation and reflection on employment and job satisfaction of medical vocational students / 中华医学教育探索杂志

555 medical vocational students were surveyed with questionnaire to data regarding their employment intentions. The study showed that the employment rate in basic-level medical organizations and the degree of job satisfaction of college students were low. The main factors were economic benefits, living environment, hospital equipment status, self-awareness. Therefore, in order to encourage medical vocational students to choose basic-level medical organizations, it is important to train health talents which is suitable for the grass-roots level, develop basic-level medical organization service qualities and pays more attention to the employment guidance in higher vocational schools, which can help medical vocational students cultivate proper views of employment.

Internship problems and countermeasures of foreign students in basic-level hospital / 中华医学教育探索杂志

In recent years many basic-level hospitals formed teaching cooperation relationshipwith the medical universities and colleges. And more and more basic-level hospitals successfully become affiliated hospitals indirectly under medical colleges. Some medical universities and colleges make bold attempt to put foreign students in the affiliated hospitals indirectly under medical colleges. This essay analyzes the problems and deficiencies of foreign students' practice in such hospitals in combination with receiving foreign students practice experience, puts forward concrete proposals to solve the problem and gives some suggestions.

Establishment of the curriculum system for fostering practical medical talents / 中华医学教育探索杂志

For the employment orientation of graduates in clinical medical major from three-year medical eduction,a curriculum system,which will be used to foster practical medical talented person for urban and rural communities,has been proposed in this paper.We will take measures,which not only further defines training target and requirement for the practical medical person from the short school system and guides students to alterate their ideological concept but also reconstructures new curriculum system and reforms teaching methods,to ensure the implementation of the training objectives

23 cases of COPD patients with acute exacerbation of chronic respiratory failur disease by non-invasive treatment on BiPAP synchrony / 中国实用内科杂志

Objective To explore the treating effects of COPD(chronic obstructive pulmonary disease)patients with acute exacerbation of chronic respiratory failure by the BiPAP Synchrony(Bi-level positive airway pressure).Methods45 cases of COPD patients with acute exacerbation of chronic respiratory failure are randomly divided into the observation group(23 cases)and the control group(22 cases).For the observation group,beside routine treatment,non-invasive treatment on BiPAP Synchrony is adopted.For the control group,Nikethamide is added in the routine treatment.Compare patients' heart beat rates,breathing rates and oxygen concentrations as well as patients' own feeling in these two groups.ResultsIn the observation group,the patients' heart beat rates,breathing rates and oxygen concentrations as well as patients' own feeling are better than those in the control group(P

Management of Disposable Medical Daily Necessities in Basic-level Medical Organization:Potential Risks and Countermeasures / 中华医院感染学杂志

OBJECTIVE To study the way to solve the problem of management of disposable medical daily(necessities) in basic-level medical organization.METHODS To understand the state of management of the disposable medical daily necessities in basic-level medical organization,we investigated actively and inquired the medical(organization) in our county.RESULTS The(rate) of their usage was 100% including syringes,implements of(perfusion),catheters,gastric tubes,drainage tubes and vaginal dilators in basic-level medical organization,but their quality could not be guaranteed due to unregulated management;few of medical organization had specialized management,and(special) and classified storage.CONCLUSIONS The reason of unregulated management in(disposable) medical daily necessities in basic-level medical organization lies in themselves;the way to solve these questions is to put emphasis on training medical staff in basic-level medical organization,strengthen the(superintendence),and increase the consciousness of controlling hospital infection.