Résumé
In recent years, the contradiction between the construction of backward first aid system and the demand for emergency services in rural areas in China is increasingly serious. In order to further improve the quality and efficiency of first aid, the state has vigorously promoted the construction of the " Five Centers" , namely chest pain centers, stroke centers, trauma centers, critical maternal treatment centers, and critically ill children and neonatal treatment centers in rural areas, in an effort to develop an efficient rural emergency service network. The authors collected relevant policy documents and summarized practices of the " Five Centers" construction. On such basis, they referred to experiences of overseas emergency systems and medical rescue centers, and made focused analysis for on the functionality and mechanism of the " Five Centers" in building an innovative first-aid system, in terms of internal and external environment, institutional function positioning, resource integration, and operation mechanism. In view of the integration among " Five Centers" , pre-hospital emergency and in-hospital first aid in rural areas, information construction, personnel first aid capacity building and interest allocation, policy recommendations are proposed.
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Objective To investigate the effect of continued nursing on postoperative outcomes of discharged patients with chronic suppurative otitis media.Methods Toally 198 discharged patients were randomized into the control group (n=98) and the observation group (n=100).The patients in both groups received normal health education and additionally the continued nursing was used in the observation group for health education by way of phone call follow-up,on-the-spot consultation and QQ consultation.The mastery of related knowledge and skills,incidence of secondary tympanic membrane and readmission rate were compared.Results Six months after discharge,the observation group was significantly better than those the control group in the mastery of related knowledge and skills (P＜0.05).The incidence of secondary tympanic membrane perforation was not statistically significant between the groups(P＞ 0.05).The readmission rate at the second week and the third week between the two groups had no statistically significant difference (P＞ 0.05).However,the readmission rate at the first,second,third and sixth month were statistically different (P＜0.05).Conclusion Continued nursing to the postoperative discharged patients with chronic suppurative otitis media can improve the follow-up rate after discharge and self-nursing capacity,and as a result promote their recovery.
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Objective To provide evidences for fall prevention through environmental safety assessment of elderly patients admitted in different grade hospitals. Methods 24 different levels hospitals located in 10 cities in southwest of China were surveyed with assessment form of fall-related factors of hospital environment for elderly patients. Results Hospital public environment and ward public environment were assessed well by elderly patients which were 4.10 points and 4.06 points, but the scores for ground channel environment and toilet environment were lower which were 3.92 points and 3.65 points;Scores of tertiary-class hospitals were better than that in second-class hospitals, including ward facilities (t=-2.756, P0.05). Conclusions Public hospital environment and public ward environment got higher scores, and the scores of ground-channel environment and the bathroom environment were relatively lower. Environment in second-class hospitals need to improve in order to prevent fall of elderly patients. Assessment form of fall-related factors of hospital environment for elderly patients is helpful to disclose the unsafety factors of the hospital environment, and should be windely used in futher clinical practice.
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Objective To examine the association between the polymorphisms of brain-derived neurotrophic factor (BDNF)gene with heroin dependence.Methods Genomic DNA was isolated from the venous blood leukocytes of 308 unrelated patients with heroin dependence and 31 7 healthy individuals.Seven single nucleotide polymorphisms (SNPs)were genotyped using MassARRAY system.Data were analyzed using HaploView 4.0 and SPSS 20.0 software.Results There was a significant difference in the genotype frequency of rs6265 between heroin dependence group and healthy control group (χ2 =1 5.1 5 1,P =0.001).The rs6265 G allele was significantly higher than in controls (χ2 =9.864,P =0.002,OR =1.429,95% CI =1.143 -1.786).Furthermore,there was also a significant difference in the genotype frequency of rs13306221 between heroin dependence group and control group (χ2 =7.699,P =0.006).The rs13306221 G allele was significantly higher than in controls (χ2 =7.137,P =0.008,OR =0.539,95% CI =0.340-0.853).Strong linkage disequilibrium (LD)was observed in one block (D’> 0.9;r 2 >0.8),and significantly less G-G haplotype frequency of block 1 (χ2 =4.546;P =0.033)was found in heroin dependence group. Conclusion Our findings support the role of BDNF rs6265 and rs13306221 polymorphisms in heroin dependence and may guide future studies to identify other genetic risk factors for heroin dependence.
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Objective:To investigate the relationship between polymorphism of leptin gene -2548A/G and leptin receptor gene ( LEPR) Gln223Arg and asthma and metabolic syndrome.Methods: 82 asthma-combined metabolic syndrome patients,114 asthma patients,100 metabolic syndrome patients and 96 normal controls were conducted.The polymerase chain reaction and restriction fragment length polymorphism ( PCR-RFLP) analysis were performed to investigate the polymorphism of leptin gene -2548A/G and LEPR gene Gln223Arg site.In addition, asthma was graded into mild AS and mod-severe AS according to lung function.Then the associations between the polymorphism of leptin gene -2548A/G and LEPR gene Gln223Arg and different grades of asthma were performed.Results:①The biochemical indicators were different compared between each group.②The genotype and allele frequencies in leptin gene polymorphism -2548A/G were significantly difference between metabolic syndrome patients(P=0.047 and 0.046), asthma-combined metabolic syndrome patients( P=0.038 and 0.044) ,mod-severe asthma patients( P=0.019 and 0.028) and control group.③There was a significant difference of genotype and allele frequencies in LEPR gene Gln223Arg between metabolic syndrome patients and controls(P=0.037 and 0.023);between metabolic syndrome patients and asthma patients(P=0.000 and 0.000).There was a significant difference of allele frequencies in LEPR gene Gln223Arg between asthma-combined metabolic syndrome patients and asthma(P=0.032) .Conclusion: Polymorphisms of the leptin gene -2548A/G site may be associated with metabolic syndrome and mod-severe asthma.Polymorphisms of the LEPR gene Gln223Arg site may be only associated with metabolic syndrome.The two genes would be the candidate genes in early prevention and control.