广西壮族自治区交通运输厅自2018年起,开展了两届的优秀审计项目评选,本文介绍了评选工作的布置和考虑、所取得的经验和成效,以及未来的努力方向,在共同探讨交流的基础上,期待把这项工作开展得更好.

现如今我国老龄化进程加剧,慢性病井喷,解决困境的最佳选择即是走健康管理之路.近年来健康产业发展迅速,特别是体检市场需求旺盛,理念虽先进但专业技术相对滞后,造成市场需求和人才培养的严重脱节.培养高质量的专业人才去适应多样化的市场需求,成为各大专业院校高度关注的问题.本文旨在了解国内外健康管理专业人才需求现状,从需求出发谈培养模式,为加强我区健康管理专业人才队伍建设建言献策.

目的:建立多维矿物质片中维生素C的高效液相色谱检测方法.方法:色谱柱为Thermo ODS-2 HYPERSIL(250 mm×4.6 mm,5μm),流动相为0.1%草酸溶液-甲醇(98:2),流速为1.0 mL·min-1,柱温为25℃,进样量为20μL,检测波长为254 nm.结果:维生素C在6.91~27.0μg·mL-1浓度范围内线性关系良好(r=1),平均回收率为99.0%,RSD为1.31%(n=9).结论:该方法操作简单,精密度好,准确度高,可用于多维矿物质片中维生素C的含量测定.

经欧姆龙压缩式吸入器(NE-C28)吸入布地奈德雾化悬液治疗5岁以下儿童哮喘,可以显著改善患儿的咳嗽喘息症状.整个过程未引起明显的不良反应,安全性良好,病人的依从性好,值得在儿科临床中选用.我院拟通过医疗联合体一线医护人员,筛查出需要“气动雾化泵在儿科中应用”治疗的患者,行“气动雾化泵在儿科中应用术”;并对治疗效果、患者满意度、医疗费用等指标进行评估,对基层医师进行培训,以便使该适宜技术能够在更大范围内得到推广,造福广大患者.

不适当住院日又称无效住院日或无价值住院日,是指除了增加住院费用外而对患者治疗无意义的住院时间。不适当住院日的存在使得患者的住院日延长,不但增加了住院费用,而且对患者的诊疗无任何意义[1]。为了使患者的诊疗更加合理化,卫生部2009年颁发了《临床路径管理试点工作方案》,为纳入路径的病种选择了最优的诊疗流程。但在实际执行过程中,临床路径能否缩短患者的平均住院日,值得深入分析。现结合新疆某三级甲等医院的实际情况,参考住院日适当性评价方案(appropriateness evaluation protocol,AEP),对部分临床路径病种住院日的适当性进行评价,以发现不适当住院日并分析产生的原因。

目前,全球脂肪肝发病率呈上升趋势,其对健康的危害远远超过了慢性乙型肝炎感染.通过健康体检可发现大量无症状的脂肪性肝病人群.以往判定脂肪肝的肝纤维化程度较为困难.瞬时弹性扫描(FibroScan)是一种快速、无创、通过检测肝脏硬度值来诊断肝纤维化程度的方法.本研究旨在运用瞬时弹性扫描技术对脂肪肝纤维化程度进行评价并获得肝纤维化与年龄、性别、体重指数及部分生化指标的相关性分析.

目的：探讨幽门螺旋杆菌（HP）在维汉两民族之间的感染情况及相关影响因素。方法对新疆医科大学第一附属医院体检与健康管理中心检查14C尿素呼气试验的维汉两民族2864人进行分组分析。结果在接受检查的2864人中，阳性率48.46%；男性和女性的阳性率分别为49.75%和45.61%，两者差异具有统计学意义（P<0.05）；汉族和维族的阳性率分别44.16%和56.51%，两者具有明显的统计学差异（P<0.01）。结论本研究显示HP感染与性别、民族有明显的关系。

目的:观察黄葵胶囊联合盐酸贝那普利片治疗糖尿病肾病的临床疗效和安全性.方法:150例糖尿病肾病患者按随机数字表法均分为对照组和观察组.两组患者均给予降血糖、降血脂和优质低蛋白饮食控制等常规治疗.在此基础上,对照组患者给予盐酸贝那普利片10 mg,口服,每日1次;观察组患者在对照组治疗的基础上给予黄葵胶囊5粒,口服,每日3次.两组患者疗程均为8周.观察两组患者的临床疗效,治疗前后血清胱抑素C(Cys-C)、肌酐(Scr)、尿素氮(BUN)、24 h尿蛋白、β2-微球蛋白(β2-MG)、肿瘤坏死因子(TNF)-α、白介素(IL)-6水平及不良反应发生情况.结果:观察组患者总有效率显著高于对照组,两组比较差异有统计学意义(P＜0.05).治疗后两组患者24 h尿蛋白、β2-MG、Cys C、Scr、BUN、TNF-α、IL-6均显著低于同组治疗前,且观察组低于对照组,差异均有统计学意义(P＜0.05).两组患者治疗期间均未见明显不良反应发生.结论:黄葵胶囊联合盐酸贝那普利片治疗糖尿病肾病较单用盐酸贝那普利片疗效更显著,安全性较好.

随着我国医疗卫生体制改革的深入推进,如何解决老百姓“看病难、看病贵”的问题日趋迫切.目前,在中国优质医疗资源紧缺与相对不足的现状下,建立“医疗联合体”(下称“医联体”),推进医疗资源纵向整合,是当前提高医疗服务体系整体效率,提升基层医疗服务能力的重要手段.

Objective To investigate the status quo and influencing factors of health literacy in nursing homes of Urumuqi.Methods Fifteen out of twenty-seven registered nursing homes were extracted by using stratified cluster random sampling method during September 2011 and June 2012.A questionnaire was developed by Health Education Center of China.The influencing factors and dimensional relations of health literacy were explored through one-way ANOVA,multiple linear regression and Pearson correlation analysis.Results A total of 317 elderly people (average age (77.5 ± 9.2) years old) were interviewed,and their health literacy scores were (72.9 ± 31.3).The single factor analysis showed that the health literacy score was affected by race,education level and previous profession (t =3.190,F values were 19.609 and 9.777 ; all P ＜ 0.05).In multiple linear regression analysis,race,education level and previous profession (managers,professional and technical personnel,production personnel) were the major factors affecting health literacy in elderly people (t values were 6.624,-3.121,4.471,3.727 and 3.256 respectively ; all P ＜0.05).Health knowledge (r =0.965),attitude (r =0.809),behavior (r =0.569) and skills (r =0.732)were correlated with health literacy.The strongest correlation was found between health knowledge and health literacy (r=0.965),while the weakest was identified between health attitude and skills (r=0.410).Conclusions The health literacy may be low in nursing homes of Urumuqi.Minority,lower education level and previous profession could be its major influencing factors.

Objective To investigate and analyze narcotic and psychotropic drugs use in the central pharmacy of our hospital in 2011,and to provide the basis for the management of the use of special drugs.Methods The amount of medication,medication frequency(DDDs),daily expense(DDC) and the amount of drug scheduling and DDDs sort ratio were used as the evaluation index.Results In 2011,11 narcotic drugs were used,psychotropic drugs of category Ⅰwas 1,psychotropic drugs of category Ⅱ was 12.Conclusion The usage of narcotic drugs and psychotropic drugs in our hospital is basically rational.

目的采用超声测量壮、汉族胎儿双顶径(BPD)及枕额径(OFD),为优生优育及民族工作提供参考。方法随机选取2007-2011年该院门诊和住院的正常单胎、无妊娠并发症的柳州市壮族孕妇100例作为观察组,并随机选取同期汉族孕妇100例作为对照组。测定2组胎儿BPD及OFD,计算两者比值(BO),预测胎儿头颅外形特征。结果观察组胎儿平均BO值为(0.8079±0.0466)小于对照组胎儿的(0.8247±0.0496),差异有统计学意义(P<0.05)。结论壮族胎儿头颅外形较汉族偏长圆,对研究人种学及壮族群体的起源与繁衍有否帮助,还有待进一步研究。

目的通过筛选复方雪莲软胶囊胶皮处方,改善其在储存期内随时间延长崩解迟缓这一突出问题。方法根据单因素考察结果,以平衡溶胀量(Seq)为指标,通过正交试验优选胶皮处方。结果筛选出了能够有效改善复方雪莲软胶囊崩解的胶皮处方,即柠檬酸用量为明胶的6%,甘氨酸用量为明胶的5%,甘油和山梨醇的比例为2∶1。结论在软胶囊胶皮处方中加入柠檬酸、甘氨酸有助于缓解崩解迟缓现象的发生。

目的:了解我院住院部抗菌药物的使用情况,为临床合理应用抗菌药物提供参考。方法:对我院住院部2009～2011年抗菌药物的种类、销售金额等进行统计分析。结果:在抗菌药物使用中占据主导地位的是头孢菌素类、青霉素类和喹诺酮类药物,其中头孢菌素类品种最多,消耗量最大。结论:我院抗菌药物的使用基本合理,头孢菌素类使用最广泛。

Objective To understand our hospital department of the use of antibacterials,for clinical rational use of antibacterial agents to provide reference.Methods Analyze sales amount of antibacterial drug types,DDDs(DDDs) data of inpatient department in our hospital in 2012.Results My courtyard in antibacterial drug use is dominated by penicillins cephalosporins and quinolones,these three classes of drugs;wherein,cephalosporins varieties largest,the biggest wastage,amount of medication is relatively high,and the DDDs ranking the top 20 drugs according to the class distribution,cephalosporins remains at the top.Conclusion The use of antibacterial drugs in our hospital is basically rational,cephalosporins is currently the most widely used antibacterial drugs.

Objective:To know our hospital antibiotic drug use in inpatients of evaluation,analysis,aims to discover the problems,find out the reasons,so as to guide the use of antibacterial drugs in our hospital more reasonable.Method:With drug expenditure and average length of stay and other indicators in our hospital in January of 2011～June of 2012,to evaluate comprehensively the use of antibacterial drugs in inpatient department.Results:Antibacterial drug costs accounted for the total cost of the scale to show downtrend;use and non use of antimicrobials mean length of hospital stay without distinction.Conclusion:The use of antibacterial drugs in our hospital is basically rational,but there are still some problems,should increase administrative strength,make use of antimicrobial agents is more safe,effective,reasonable,economy.

目的:对住院患者抗菌药物使用情况进行评价、分析,旨在发现问题、查找原因,从而指导抗菌药物的使用更加趋于合理。方法:以抗菌药物使用品种数及天数、病原菌检测率及药敏试验情况等指标对住院部抗菌药物使用情况进行全面评价。结果:抗菌药物使用品种1～2种,使用天数5～8天;病原学检测率、病原菌检出率、药敏试验相符率呈逐渐上升的趋势。结论:抗菌药物的使用基本合理,但是仍存在一定问题,应加大管理力度,使抗菌药物的使用更加安全、有效、合理、经济。

目的采用高效液相色谱法测定双氯芬酸钠盐酸利多卡因注射液中有关物质吲哚酮的含量并对其进行定性分析。方法：用八烷基硅烷键合硅胶填充柱,以甲醇：磷酸二氢钠(0.8g/L,用磷酸调PH至2.5)63：37为流动相；流速为1.0mL/min；检测波长为254nm。结果：所建立的方法分离度符合规定,满足注射液中吲哚酮定量要求,且可对吲哚酮进行初步定性。结论：该方法简便,准确,较TLC法更能适合于该品种的质量控制。

Objective To discuss the use of antibiotics in the outpatient of our hospital after the intervence of clinical pharmacists.Methods Analysed the use of antimicrobials in our hospital during 2008 to 2010.Results The total dasage of antibiotics in the outpatient decreased,It had decreased from 15.79% in 2008 to 9.24% in 2010,and the rate of the usage of antimicrobial injection had decreased from 44.70% in 2008 to 24.55% in 2010.The rate of antibiotic oral dosage had increased.It was 47.73% in 2008,60.61% in 2009 and reached 71.36% in 2010.Conclusion Proper multifaceted intervence can reduce the usage of antibiotics,enhance the rational use of antibiotics.

目的 对中国西部地区12个省(直辖市、自治区)政府办医院门诊与住院服务情况进行综合评价,为相关机构制定政策提供参考依据.方法 应用秩和比法进行统计分析.方法 将中国西部地区12个省(直辖市、自治区)政府办医院的门诊与住院服务情况分为4档,其中评价结果为优的省份包括云南、四川;为良的包括贵州、陕西;为中的包括广西、新疆、甘肃、内蒙古、重庆;为差的包括青海、宁夏、西藏.中国西部地区地域辽阔,整体经济欠发达,但西部地区12个省(直辖市、自治区)地理环境、人口数量、医疗机构数量存在较大差异,政府办医院门诊与住院服务情况有着多方面的不均衡性.本文将评价指标体系进行标准化,评价结果符合实际情况.例如:四川在综合评价中是优,实际中四川省地区政府办医院门诊与住院服务情况的各项指标均处于中国西部地区前列;再如:西藏、宁夏、青海政府办医院门诊与住院服务情况各项指标均处于中国西部地区后列.同时也可发现,中国西部地区政府办医院门诊、住院服务情况中差别最小的指标是急诊抢救成功率,表明西部地区政府办医院急诊抢救水平差别较小.结论 秩和比法适用于各类资料的综合评价,能够科学反映中国西部政府办医院门诊与住院的服务情况.