Influencing factors and effectiveness of community follow-up in patients with cardiac implantable electronic device / 中华全科医师杂志

Objective:To explore the influencing factors and effectiveness of community follow-up in patients with cardiac implantable electronic device (CIED) implantation.Method:A total of 132 patients who received CIED implantation in the Department of Cardiology of Tongren Hospital, Shanghai Jiao Tong University School of Medicine from February 2021 to February 2022 were enrolled in this prospective cohort study. Among them 33 patients were followed up in community health service centers associated with Tongren Hospital (community follow-up group) and 99 matched patients were followed up in the CIED outpatient clinic of the hospital (outpatient follow-up group) with a ratio of 1∶3. The clinical data of the selected patients were collected through a questionnaire survey; the follow-up data were extracted through the CarelinkExpress electronic follow-up platform and the CIED outpatient information system of Tongren Hospital. Adjustment of the treatment protocol or CIED parameters at follow-up, and the referral from the community health service centers were defined as visit with-an-action (VWA). The endpoint of follow-up was the occurrence of major adverse events. The multivariate logistic regression model was used to analyze the factors influencing patient selection for community follow-up.Results:The univariate analysis showed that the frequency of visits to community health service centers and the service contracting rate in community follow-up group were higher than those of outpatient follow-up group ( P<0.05). The multivariate logistic regression analysis showed that the contracted community physician service was an independent influencing factor of patient choosing community follow-up ( OR=2.143, 95% CI: 1.103-4.166, P=0.025). A total of 469 visits of followed up occurred in 132 patients, including 45 community visits and 424 outpatient visits. VWA accounted for 22.2% (10/45) in the community follow-up group, and 17.2% (73/424) in the outpatient follow-up group ( P>0.05). There was no significant difference in the safety and effectiveness indicators (VWA, major adverse events, and unplanned follow-up) between the two groups ( P>0.05). More patients in the community follow-up group walked to the hospital than the outpatient follow-up group ( P<0.05);and the main transportation for the later was by bus or taxi(42(42.4%)or 41(41.4%)). The average waiting time in the community follow-up group was significantly shorter than that in outpatient follow-up group ( P<0.05). The total time required for a single follow-up in the community follow-up group was 50.0 (45.0, 59.5) minutes, which was significantly shorter than that in the routine outpatient follow-up group (107.0 (90.0, 135.0) minutes, P<0.05). Conclusions:The contracting with community physicians is an independent influencing factor for CIED implanted patients to choose community follow-up. The safety and effectiveness of community follow-up are comparable to routine outpatient follow-up, and community follow-up is more convenient.

The influencing factors of particle formation during the configuration of rifampicin for injection were investigated / 现代医院

Objective To investigate the change of infusion particles and PH value of rifampicin for injection under dif-ferent configuration and application conditions,and to provide the best configuration method and the best infusion quality control strategy for rifampicin for injection.Methods The particle number and PH value of rifampin for injection were investigated and measured under different configuration and application conditions,and the factors affecting the formation of particles were ana-lyzed.Results The stable pH value of Rifampicin for injection was 7.2-8.1,and the number of particles was the least in the light filtering and 5%glucose 500 mL,and the number of particles was the least in 1～4 h after the configuration.Conclusion The optimal infusion quality control strategy is to filter rifampicin for injection by blocking light,500 mL of solute 5%glucose,1～4 h after configuration,and use of disposable precision filter infusion set.

Upgrading database with high availability and elastic architecture under Oracle 11g RAC / 医疗卫生装备

Objective To upgrade No.1 Military Medical Project from single operation to Oracle RAC to eliminate single failure of the operation system, protect medical data and lay a foundation for the following upgrade and deployment.Methods RAC software and hardware environment was constructed for database upgrade and deployment of Data Guard.Results The database was gifted with high availability and high performances, and database maintenance and upgrade could be carried out with the operation system less ceased than before.Conclusion The database is upgraded from a single-mode rigid architecture to a multi-mode elastic one, with the performances, safety and extendibility enhanced greatly.

Vaginal Sialidase Activity Assay in Bacterial Vaginosis Patients with Preterm Premature Rupture of Membranes / 中华围产医学杂志

Objective To study the relationship between the bacterial vaginosis (BV) and the preterm premature rupture of membranes and premature labor. Methods Qualitative and colorimetric test was used to detect the presence of bacterial sialidase level in 104 pregnant women with preterm premature rupture of membranes and 80 women with normal full term pregnancy. Results 38 cases were positive of BV in patients with premature rupture of membranes (36.54%) and nine cases were positive in normal full term pregnancy (11.25%) ( P