安徽省新冠肺炎定点医疗机构医院感染管理部门人力资源现状调查

目的 了解安徽省不同级别新冠肺炎定点医疗机构医院感染管理部门人力资源配置现状,分析存在问题及薄弱环节,为健全感控人才队伍建设提供依据。方法 通过调查问卷的形式,于2020年4月对安徽省各级新冠肺炎定点医疗机构医院感染管理部门基本情况、医院感染管理专职人员配置情况进行调查,并对结果进行分析。结果 共调查68所医疗机构,其中省级医院6所,市级医院19所,县级医院43所。省、市、县级医疗机构医院感染管理专职人员配比达标的医院分别占16.67%、26.32%、51.16%。全省医院感染管理专职人员中女性占84.82%;医院感染管理队伍以护理专业为主,占59.53%;高级职称人员仅占21.01%。不同级别医疗机构医院感染管理专职人员在专业、学历分布、医院感染管理工作年限方面比较,差异均有统计学意义（均P<0.05）。结论 安徽省新冠肺炎定点医疗机构医院感染管理部门存在专职人员配备不足、专业单一、学历偏低、职称晋升困难等情况,人力资源配置有待进一步优化,医疗机构及相关管理部门应加强感染监控人才队伍建设,推动疫情防控常态化下感染监控工作的有效落实。     

Mortality,Health Care Use,and Costs of Clostridioides difficile Infections in Older Adults

ObjectivesEstimate mortality, cost, and health care resource utilization for Medicare beneficiaries aged ≥65 years who suffered a primary Clostridioides difficile infection (CDI) episode only or any recurrent CDI, and understand how outcomes covary with death.DesignRetrospective observational claims analysis.Setting and ParticipantsPatients aged ≥65 years who had an inpatient or outpatient CDI diagnosis claim to Medicare and continuous enrollment in Medicare parts A, B, and D during the 12-month pre- and post-index periods.MethodsUsing 100% Medicare Fee-for-Service claims data for 2009–2017, primary (pCDI, n = 345,893) and recurrent (rCDI: n = 151,596) CDI episodes were identified. Demographic and clinical characteristics, mortality, health care resource utilization, and costs (per patient per month) were summarized for 12 months before and up to 12 months after episode start. Regression models were estimated for hospitalization risk, hospital length of stay (LOS), and cost to adjust for comorbidities.ResultsCDI-associated deaths were almost 10 times higher after recurrent CDI (25.4%) than primary CDI (2.7%). Compared with survivors, decedents were older, had higher Charlson Comorbidity Index scores, and were more likely Black. Adjusting for comorbidities, during follow-up, decedents had higher hospitalization rates [pCDI: odds ratio (OR) = 1.83, P < .001; rCDI: OR = 2.58, P < .001], and recurrent CDI decedents had more intensive care unit use (OR = 2.34, P < .001) compared with survivors. Decedents also had a longer length of stay (pCDI: +3.2 days, P < .001; rCDI: +2.6 days, P < .001), and higher total cost (pCDI: +303%, P < .001; rCDI: +297%, P < .001).Conclusions and ImplicationsCDI is an important contributing diagnosis to all-cause mortality, particularly for recurrences. Prior to death, older Medicare beneficiaries who experienced CDI received longer, more intensive, and more costly care compared with survivors. Clinicians should be particularly attentive to prevention, identification, and appropriate treatment of CDI in older adults. Better treatments to reduce primary C difficile infection and recurrences in this vulnerable population can lower both mortality and economic burden.     

手术绝经对身体脂肪分布影响的研究

目的：探讨手术绝经对身体脂肪分布的影响。方法：手术绝经者32例,进行术前及术后6个月的自身比较。用双能X线吸收仪（DEXA）测定体脂肪量、躯干脂肪量及下肢脂肪量,并计算体脂肪率、躯干脂肪量／下肢脂肪量比（T／L）、上半身型的百分比。结果：手术绝经者术后6个月下肢脂肪量明显低于手术前（P＜0．05）,T／L明显高于手术前（P＜0．01）,手术前后的上半身型各占19．4％和36．6％。结论：手术绝经也可能会使身体脂肪分布向上半身型移行,且最初可能是下肢脂肪量的减少。上半身型脂肪分布会引起一系列代谢合并症,应引起高度重视。     

肝毒性中药及其与药性和有效成分的关系——对55种中药肝毒性文献资料的分析报告

目的 :研究有关文献资料中中药肝毒性的报告及其与四气、五味、归经、有效成分之间的关系。方法 :应用文献研究方法 ,对 55种具有肝毒性的中药进行统计归类分析研究。结果 :中药四气、五味、归经及其有效成分与肝毒性有一定相关性。肝毒性主要集中在寒、热类 ,苦、辛类 ,归肝、脾、肾经类和有效成分中碱、甙类药物方面。结论 :中药药性理论及有效成分均与肝毒性有一定的关系 ,应用归类分析的方法对文献资料进行分析研究是中药毒性研究中确实可行的方法。     

我国男性青年人体质量的分布

目的　探讨我国男性青年人体质量的几何分布。方法　采用CT 图像分析法对 5 0例 18～ 2 3岁我国男性青年进行了全身CT横断层扫描、影像分析和测算。结果　获得了样本各环节的质量数据 ,与国外有关数据比较 ,整体质量最大绝对误差为 2 .94kg ,平均绝对误差为 0 .88kg ;最大相对误差为 5 .0 0 % ,平均相对误差为 0 .34 %。结论　为建立我国男性青年人体惯性参数模型奠定了基础。     

The optimal usage of the ISCP by trainee and trainer

The Intercollegiate Surgical Curriculum Programme (ISCP) provides the Curriculum with the specialty syllabus, trainee’s portfolio of activity, and the process and recording of assessment. It is an excellent resource and in order to gain the optimal benefit trainees and trainers are recommended to invest some time in navigating through the site and understand its functionality. The launch of the 2021 Surgical Curricula is an important change with the new assessment tool of the Multiple Consultant Report (MCR) and the trainee input with their self-assessment. The ISCP has incorporated the MCR assessment process (Generic Professional Capabilities and Capabilities in Practice) into the learning agreement structure such that the progression through to the higher-level outcome of the curriculum, defined as a day 1 consultant in a specialty, is enhanced by frequent and focussed feedback specific to the trainee. To achieve the optimal outcomes, it is important to have strong engagement with the ISCP and the useability has been enhanced to facilitate this.     

白芍总苷对胶原诱导性关节炎大鼠长期给药的组织分布研究

目的 研究白芍总苷的主要成分芍药苷、芍药内酯苷对胶原诱导性关节炎（collagen-induced arthritis,CIA）大鼠长期给药后的组织分布。方法 建立超高效液相色谱串联质谱（UPLC-MS/MS）法,测定白芍总苷长期给药后大鼠心、肝、脾、肺、肾、小肠、胸腺、滑膜等组织中芍药苷和芍药内酯苷的分布情况。结果 长期给药后,芍药苷和芍药内酯苷主要分布于小肠和肾,其次为脾、胸腺、滑膜、肝、肺、心。2种成分在CIA大鼠中的组织分布大多低于正常大鼠。结论 揭示了白芍总苷长期给药后的组织分布特征,为探讨白芍总苷治疗类风湿性关节炎的靶器官以及疗效的改进提供了参考。     

Natural Convection Heat Transfer in a Porous Cavity with Sinusoidal Temperature Distribution Using Cu/Water Nanofluid: Double MRT Lattice Boltzmann Method

In this study, natural convection flow in a porous cavity with sinusoidal temperature distribution has been analyzed by a new double multi relaxation time (MRT) Lattice Boltzmann method (LBM). We consider a copper/water nanofluid filling a porous cavity. For simulating the temperature and flow fields, D2Q5 and D2Q9 lattices are utilized respectively, and the effects of different Darcy numbers (Da) (0.001-0.1) and various Rayleigh numbers (Ra) ($10^3$-$10^5$) for porosity ($ε$) between 0.4 and 0.9 have been considered. Phase deviation ($θ$) changed from 0 to $π$ and the volume fraction of nanoparticles (Ø) varied from 0 to 6%. The present results show a good agreement with the previous works, thus confirming the reliability the new numerical method proposed in this paper. It is indicated that the heat transfer rate increases at increasing Darcy number, porosity, Rayleigh number, the volume fraction of nanoparticles and phase deviation. However, the most sensitive parameter is the Rayleigh number. The maximum Nusselt deviation is 10%, 32% and 33% for Ra=$10^3$, $10^4$ and $10^5$, respectively, with $ε = 0.4$ to $ε = 0.9$. It can be concluded that the effect of Darcy number on the heat transfer rate increases at increasing Rayleigh number, yielding a maximum enhancement of the average Nusselt number around 12% and 61% for Ra=$10^3$ and Ra=$10^5$, respectively.     

Exploratory assessment of treatment‐dependent random‐effects distribution using gradient functions

In analyzing repeated measurements from randomized controlled trials with mixed‐effects models, it is important to carefully examine the conventional normality assumption regarding the random‐effects distribution and its dependence on treatment allocation in order to avoid biased estimation and correctly interpret the estimated random‐effects distribution. In this article, we propose the use of a gradient function method in modeling with the different random‐effects distributions depending on the treatment allocation. This method can be effective for considering in advance whether a proper fit requires a model that allows dependence of the random‐effects distribution on covariates, or for finding the subpopulations in the random effects.