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.
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.
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。
Objective To determine the effect of closed tracheal suction system versus open tracheal suction system on the rate of ventilator-associated pneumonia in adults. Methods We searched The Cochrane Library (Issue 1, 2007), PubMed (1966 to 2006) and CBM (1980 to 2007), and also hand searched relevant journals. Randomized controlled trials involving closed tracheal suction system versus open tracheal suction system for ventilator-associated pneumonia in adults were included. Data were extracted and the quality of trials was critical assessed by two reviewers independently. The Cochrane Collaboration’s RevMan 4.2.8 software was used for data analyses. Result Five randomized controlled trials involving 739 patients were included. Results of meta-analyses showed that compared to open tracheal suction system, closed tracheal suction system did not increase the rate of ventilator-associated pneumonia (RR 0.83, 95%CI 0.50 to 1.37) or case fatality (RR 1.05, 95%CI 0.85 to 1.31). No significant differences were observed between open tracheal suction system and closed tracheal suction system in the total number of bacteria (RR 0.83, 95%CI 0.50 to 1.37), the number of SPP colony (RR 2.87, 95%CI 0.94 to 8.74) and the number of PSE colony (RR 1.46, 95%CI 0.76 to 2.77). There was no significant difference between the two groups in the duration of ventilation and length of hospital stay. Conclusion Open or closed tracheal suction systems have similar effects on the rate of ventilator-associated pneumonia, case fatality, the number of SPP and PSE colonies, duration of ventilation and length of hospital stay. However, due to the differences in interventions and statistical power among studies included in this systematic review, further studies are needed to determine the effect of closed or open tracheal suction systems on these outcomes.