ObjectiveTo explore low-seniority nurses' attitudes regarding adverse events reporting. MethodA total of 200 low-seniority nurses were investigated with the Chinese version of Reporting of Clinical Adverse Events Scale from October to December 2013. Epidata software was used to collect and manage data and SPSS 17.0 software was applied to analyze the collected data. ResultsThe nurses who once witnessed or experienced adverse events accounted for 76%, of whom 74.3% reported adverse events. The mean score of reporting of clinical adverse events among low-seniority nurses was 48.5±7.2. Age was positively associated with the global scores of reporting of clinical adverse events, when compared with other variables (r=0.20, P=0.01). ConclusionsOverall, low-seniority nurses' attitudes toward reporting adverse events are negative. Age is positively associated with attitudes toward reporting adverse events. Therefore, a non-punitive culture should be established and an efficient reporting system is good to enhance the quality of care.
目的 分析原發性乳腺淋巴瘤（PBL）的臨床病理特點、診斷、治療及預后。 方法 回顧分析2000年12月－2011年10月收治的19例PBL患者的臨床資料和治療隨訪情況。 結果 19例PBL患者均為女性，年齡34～72歲。根據Ann Arbor臨床分期，Ⅰ期患者9例，Ⅱ期7例，Ⅲ期3例，而病理類型以彌漫大B淋巴瘤為主（13/19）。全部患者隨訪時間為6～113個月，中位隨訪時間為45個月，5年生存率為36.8%。 結論 PBL其預后與病理類型、分期及治療方式有關。手術聯合放射化學療法為主要治療方式，腋窩淋巴結清掃有一定的意義，但對PBL預后的影響值得商榷。此外，PBL易出現中樞神經系統轉移，應定期復查。
Macular edema is a common cause of visual loss in patients with retinal vascular diseases represented by diabetic retinopathy and retinal vein occlusion. Laser photocoagulation has been the main treatment for this kind of diseases for decades. With the advent of antagonist of vascular endothelial growth factor and dexamethasone implant, diabetic macular edema and macular edema secondary to retinal vein occlusion have been well controlled; the use of laser therapy is decreasing. However, considering possible risks and complications, lack of extended inspection of efficacy and safety of intravitreal pharmacotherapy, laser therapy cannot be replaced by now. Therefore, the efficacy and safety of laser therapy will improve by sober realization of role of photocoagulation and proper selection of treatment indication.
ObjectivesTo systematically review the efficacy and safety of fast track surgery in perioperative patients with adrenalectomy.MethodsPubMed, EMbase, Web of Science, CNKI, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy and safety of fast track surgery in perioperative patients with adrenalectomy from inception to January 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 11 RCTs involving 1 034 patients were included. The results of meta-analysis showed that: fast track surgery in perioperative patients with adrenalectomy could shorten first exhaust time (MD=?17.16, 95%CI ?21.86 to ?12.46, P<0.000 01), postoperative catheter indwelling time (MD=?43.44, 95%CI ?46.65 to ?40.23, P<0.000 01) and drainage tube indwelling time (MD=?39.91, 95%CI ?57.58 to ?22.23, P<0.000 01), and reduce the incidence of complications after adrenalectomy (OR=0.26, 95%CI 0.1 to 0.39, P<0.000 01). There were no statistically differences in operation time (MD=?1.18, 95%CI ?3.22 to 0.86, P=0.26) and blood loss (MD=0.25, 95%CI ?2.84 to 3.34, P=0.88) between two groups.ConclusionsCurrent evidence shows that, compared with the conventional rehabilitation group, fast track surgery can promote postoperative recovery of patients with adrenalectomy more safely and effectively, which has clinical promotion value. Due to limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusion.
目的:探討氟西汀聯合心理干預治療心血管疾病患者伴焦慮抑郁癥狀的臨床療效。方法:選擇伴有抑郁、焦慮情緒障礙的85例冠心病患者(心功能Ⅱ、Ⅲ級),并將其隨機分成研究組和對照組。觀察6w,對照組患者僅給予常規的治療,研究組患者在常規治療基礎上給予氟西汀聯合心理干預治療。觀察治療前后兩組患者采用漢密頓焦慮量表( Hamilton Anxiety Scale,HAMA) 評定焦慮癥狀,漢密頓抑郁量表( Hamilton Depression Scale,HAMD) 評定抑郁癥狀;并對治療后心功能分級(NYHA)恢復到Ⅰ級的例數及左室射血分數進行分析評價。結果:治療6 周 后,研究組均較對照組的漢密頓焦慮量表及漢密頓抑郁量表評分下降顯著( P lt;0.01),研究組抗焦慮顯效率為87.16%、抗抑郁顯效率為82.26%,對照組分別為43.75%、45.36%,研究組均顯著高于對照組( P lt;0.01);研究組患者的左室射血分數顯著高于對照組 ( P lt;0.05),心功能分級(NYHA)恢復到Ⅰ級的例數顯著高于對照組 ( P lt;0.05)。結論:氟西汀聯合心理干預治療不僅能改善心血管疾病伴焦慮抑郁患者的焦慮、抑郁情緒障礙,還能改善患者的心功能,療效顯著優于單用心血管藥物治療。