ABSTRACT
In the context of the prevention and control for coronavirus disease (COVID), public health emergency governance has been incorporated into an important part of the national governance system, and the "combination of peacetime and wartime" has become an important principle of public health emergency governance. Based on the experience of public health emergency management in large cities and the theory of collaborative governance, this study analyzed the problems and obstacles of general hospitals in coping with emerging respiratory infectious diseases. It is proposed to select general hospitals above tertiary level in the region to build peacetime and wartime combined emergency hospital, establish standardized conversion procedures and strengthen the construction of key elements of integrated emergency hospitals, so as to provide new ideas for the construction of emergency medical system "combination of peacetime and wartime" mechanism and improve the "combination of civilian and combat" public health emergency governance system.
ABSTRACT
Establishing fever clinic was an important achievement of the fight against severe acute respiratory syndrome (SARS) in 2003, and played an important role in the subsequent outbreaks of H1N1, H7N9 and Middle East respiratory syndrome (MERS). Fever clinics have significant emergency characteristics, but there are no rescue conditions in the fever clinics. Consequently, the problem of establishment and management of fever clinics is still outstanding. Based on the development of fever clinics, this paper analyzes the operational dilemma of fever clinics, explores the measures of establishment and management of fever clinics, and constructs the operational mechanism of fever clinics in order to provide the basis for the emergency management system of public health emergencies, which is suitable for Chinese health system.
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The United Kingdom is the longest-serving community in the welfare states, and has been serving for more than sixty years so far. The construction of community care service supply model in the United Kingdom is deeply influenced by the neo-liberalism and neo-managerialism, which dominated the reform and development of pur-chasing community care services. Presently, China is actively promoting the government to purchase pension services of public health care combined with the long-term care, especially policy and determination of community-based de-velopment of an elders' service model. Based on the purchased services experience of the United Kingdom combined with the situation in China, this paper puts forward some suggestions such as the repositioning the role of the govern-ment, actively supporting the development of civil service organizations and perfecting the legal system of care serv-ices to be purchased, supporting the development of proposals to reduce the burden on the government and enhance the efficiency of care services through improving their quality.
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Objective To study the function, effect and mechanism of prevention of pressure sore formation with stimulation of the dorsal ramus of spinal nerve root by transcutaneous pulse using plateshape surface electrode. Methods According to the odd number and even number of admission date, 81 patients were divided into the control group (41 cases) and the observation group (40 cases). The control group received standard pressure sore prevention nursing according to Basic Nursing, the observation group received stimulation of the dorsal ramus of spinal nerve root by transcutaneous pulse using plate-shape surface electrode based upon routine nursing. Results 1 case caught grade Ⅰ pressure sere,1 case with grade Ⅱ pressure sere, and the incidence rate was 4.88% in the observation group, while in the control group, 5 cases caught grade Ⅰ pressure sore,4 cases with grade Ⅱ pressure sore, and the incidence rate was 22.50%. Conclusions Combination of routine prevention method with stimulation of the dorsal ramus of spinal nerve root by transcutancous pulse to prevent pressure sore formation can reduce the incidence rate of pressure sore in high risk population. This technique is easy, painless, noninvasive, and is a novel method for early prevention of pressure sore.
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Objective To detect the levels of tumor necrosis factor (TNF)-a,interleukin (IL)-1β,IL-2,1L-6,IL-8,1L-10,IL-12 and interferon (IFN)-α in the serum and cerebrospinal fluid of the patients with epidemic encephalitis B,and to investigate the roles in pathogenesis of epidemic encephalitis B.Methods Approximately of 2 mL serum and 2 mL cerebrospinal fluid from 24 patients with epidemic encephalitis B during acute phase were collected,and 2 mL serum from 20 healthy controls were collected.The levels of eytokines in serum and cerebrospinal fluid were detected by enzyme linked immunosorbent assay (ELISA).Means of multi-sample were compared by analysis of variance and means of two-sample were compared by t test.Results The levels of TNF-α,IL-1β,IL-6,IL-8,IL-10 and IFN-α in eerebrospinal fluid were (24.5±6.6),(7.8±2.4),(16.0±5.7),(17.6±4.8),(130.2±33.6) and (45.2±10.8) ng/L,respectively,and in serum were (25.3±11.2),(7.1±3.2),(14.5±6.2),(16.0±6.5),(82.0±27.8) and (42.5±16.2) ng/L,respectively.The levels of TNF-α,IL-1β,IL-6,IL-8,IL-10 and IFN-α in serum and cerebrospinal fluid from patients with epidemic encephalitis B were all higher than those in serum of healthy controls [(12.7±7.9),(2.6±1.0),(6.2±2.2),(9.6±3.3),(71.4±12.8) and (30.0±14.0) ng/L;F value was 14.10,29.46,23.38,14.78,32.59,7.52;all P＜0.01];while the levels of IL-2 and IL-12 were not increased significantly.The levels of IL-1β,IL-6,IL-8,IL-10,IL-12 and IFN-α in cerebrospinal fluid were higher than those in serum,while the levels of TNF-± and IL-2 in cerebrospinal fluid were lower than those in serum.The levels of IL-6 and IL-8 in cerebrospinal fluid from patients with severe type of epidemic encephalitis B were (18.8±5.4) ng/L and (20.7±2.7) ng/L,and were higher than those with common type [(12.1±3.0) and (13.3±3.3) ng/L;t=3.50,t=5.96;P＜0.05],while the levels of IL-2 in serum and in cerebrospinal fluid from patients with severe type were lower than those with common type. Conclusions Oversecretions of TNF-α,IL-1β,IL-6,IL-8,IL-10 and IFN-a are involved in the inflammatory damage of epidemic encephalitis B,while under-secretions of IL 2 and ILl2 may be involved in cellular immune responses.
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AIM: To evaluate acrylic resin bone cement in combination with percutaneous kyphoplasty to treat spinal metastatic tumor and reconstruct spinal stability. METHODS: Thirty-three cases with spinal metastatic tumor underwent percutaneous kyphoplasty in the Department of Spinal Surgery, Shenzhen People's Hospital between October 2006 and January 2008. All affected spines were complicated by destruction of bone or compression fracture. Under monitoring by G-arm X-ray machine, bilateral pedicle puncture was performed, followed by balloon expanding and acrylic resin bone cement injection in thoracic vertebra (3.6 mL) and lumbar vertebra (4.8 mL). All patients were followed up for 6 months to evaluate biocompatibility, vertebral height changes, pain degree pre-and post-surgery and movement ability. RESULTS: Of 49 affected vertebras in 33 cases, 43 were one-off successful, and 5 cases died of tumor metabasis. Finally, 43 vertebras were included in final analysis. The paired t-test showed the post-surgery anterior and posterior vertebral heights were significantly higher than pre-surgery [(2.6?0.6) cm, (2.2?0.6) cm; (2.9?0.7) cm, (2.6?0.6) cm; P