Gastroenterology; Infection; Patience; analyse
In order to understand the infection situation of inpatients in gastroenterology department, the infection factors and characteristics of patients were analyzed, and the relevant control measures and methods were put forward. In particular, 40 inpatients in the Department of Gastroenterology in our hospital from June 5438+February 2008 to June 5438+February 2000 were analyzed retrospectively.
Clinical data of 1
1. 1 Nosocomial infection: There were 40 inpatients in the Department of Gastroenterology (infection rate was 3. 1%, incidence rate was 3.5%), including 24 males (60%), 0/6 females (40%) and 22 patients over 60 years old. There were 12 cases with hospitalization days less than one month, 16 cases with hospitalization days ranging from one month to two months, and 12 cases with hospitalization days exceeding two months.
1.2 infection sites: lower respiratory tract infection 15 cases (37.5%), upper respiratory tract infection 12 cases (30%), gastrointestinal tract infection (6 cases 15%) and urinary tract infection (3 cases).
Pathogens isolated from 1.3: 60 strains (58%) were isolated. There are 49 strains of gram-negative bacilli (accounting for 8 1.7%), including Pseudomonas aeruginosa 13 (accounting for 2 1.7%), Klebsiella pneumoniae 10 (accounting for 16.7%) and Escherichia coli. Fungi 1 1 strain (accounting for 18? 3%), of which 6 strains were Candida albicans (accounting for 65,438+00%), 3 strains were white (accounting for 5%) and 2 strains were other fungi (accounting for 3.3%).
1.4 drug resistance of main cocci: Klebsiella pneumoniae has the highest drug resistance rate to ticarcillin and the lowest drug resistance rate to imipenem.
2 discussion
According to this survey, there are 22 cases (55%) over 60 years old; There were 12 cases with hospitalization days less than one month, 16 cases with hospitalization days ranging from one month to two months, and 12 cases with hospitalization days exceeding two months. From these data, it can be concluded that older age and longer hospitalization time are the susceptible factors of hospital infection. The primary diseases were digestive tract nausea and tumor, liver cirrhosis, upper gastrointestinal bleeding, gastric and duodenal ulcer, chronic gastritis, pancreatitis and chronic colitis. These malignant diseases (except pancreatitis) belong to chronic wasting malignant diseases. Due to the infiltration of tumor group, the resistance function of patients with malignant tumor is reduced, and various radiotherapy and chemotherapy treatments can reduce the resistance function to varying degrees. In patients with liver cirrhosis, the function of hepatic reticuloendothelial system decreased, and the function of biliary tract and gastroduodenal system was impaired. In this survey, the nosocomial infection sites were lower respiratory tract, upper respiratory tract, gastrointestinal tract and urinary tract in turn. Respiratory tract infection is the most common, which is basically consistent with previous studies, and urinary tract infection is low, which may have nothing to do with urine monitoring and testing. Because the patient is older, has a serious illness and stays in bed for a relatively long time, the probability of lower respiratory tract infection will increase relatively. People who hold medical positions do not pay attention to cleaning up oral secretions and foreign bodies in the early stage. Although they pay attention to cleaning up foreign bodies again in the later stage, they can only remove some foreign bodies, and foreign bodies that have been inhaled into the bronchus in the early stage will still cause lung infection. Also, due to the discomfort of the digestive system, it is easy to discharge food reflux and secretions, blood and nasopharyngeal cavity. Because of this, we should pay special attention to the prevention and control of respiratory tract and use antibacterial drugs accurately and reasonably.
Gram-negative bacilli are the main pathogens of infection in this group, among which Pseudomonas aeruginosa ranks first and Klebsiella pneumoniae ranks second, which is completely consistent with the research results in recent years. Intrinsic risk factors are mainly related to iatrogenic factors and unscientific or wrong application of medical methods. The resistance rate of Pseudomonas aeruginosa to commonly used antimicrobial agents is on the rise, the sensitivity rate to imipenem is 89.2%, and piperacillin has the highest resistance rate of 76.4%, which leads to the abuse of antimicrobial agents. Imipenem, cefepime and amikacin are the most sensitive antimicrobial agents to Escherichia coli. Acinetobacter baumannii had the lowest resistance rate to imipenem (2.8%), followed by amikacin, cefotaxime, ceftazidime and cefepime (12.8%, 38.3%, 32.8% and 26. 1%). Other antimicrobial agents also have different degrees of drug resistance, and the multi-drug resistance rate is high.
Fungal infection mostly occurs in elderly patients, which is related to weakness, malnutrition, decreased resistance and a large number of preventive or combined use of antibiotics. So far, the drug resistance of fungi is not very serious, but it is quite difficult to treat. Because patients with fungal infection are generally seriously ill, complicated and have a high mortality rate, the scope of antifungal drugs is not large.
refer to
Su Zhijun, Zhang Yifei. Prospective study on nosocomial infection in patients with liver disease. Chinese journal of nosocomiology, 2000, 10 (5): 32 1 ~ 323.
Ye Huifen, Chen, et al. Distribution and drug resistance of Klebsiella pneumoniae in Guangzhou. Journal of Practical Medicine, 2006,22 (7): 833 ~ 835.
Ping Li, Lu Xiancheng, Deng Jisu, et al. Study on the mechanism of acquired infection and widespread transmission in intensive care unit. Chinese journal of nosocomiology, 2000, 10 (6): 404 ~ 406.
Gastroenterology Model II: Attempt and Problem Analysis of Bilingual Teaching in Gastroenterology [Keywords] Gastroenterology; bilingual education
What is English for bilingual teaching? Bilingual? , that is? Two languages? It refers to the method of teaching in two languages in the classroom, which is the general trend of educational internationalization and an important measure of higher education reform [1]. In recent years, bilingual teaching of gastroenterology has been carried out in seven-year undergraduate teaching in our college, and good teaching results have been achieved. The application experience and problems in the teaching process are summarized as follows, and the corresponding optimization teaching measures are put forward.
Application of Bilingual Teaching in 1 Gastroenterology
1. 1 Focus on interactive teaching.
Bilingual teaching should emphasize teacher-student interaction and advocate all-round second language interaction such as teaching environment and teaching resources. Only when foreign languages are used in the teaching of medical knowledge, and when two different languages, foreign language and mother tongue, can be freely switched in students' thinking and communication, can we think that "bilingual teaching" has been successful. Communicate fully with students before bilingual teaching, get some feedback information, and choose the appropriate proportion of Chinese and English accordingly, so as to teach students in accordance with their aptitude. Pay attention to the students' reaction at any time in class, and ask students if they can understand this part better, so as to understand the students' absorption degree and adjust the speaking speed in class in time. Ask students questions about difficult or incomprehensible points in time to decide whether to repeat the key points. When necessary, the key points or difficulties can be explained repeatedly in Chinese, but try to use less mother tongue.
1.2 Pay attention to teaching students in accordance with their aptitude
In the bilingual teaching of gastroenterology, according to the teaching objectives of our school and the actual level of students' foreign languages, self-made foreign language textbooks are formed and sent to students for preview two weeks in advance. Identify the difficult medical vocabulary involved in the preview textbook separately and explain it in Chinese, so that students can preview and expand their medical foreign language vocabulary in advance and avoid being at a loss when giving lectures. According to students' reaction to classroom teaching, the proportion of Chinese and English used in bilingual teaching can be dynamically adjusted, which is convenient for understanding and absorbing new content in classroom and greatly improving teaching efficiency.
1.3 emphasizes the diversity of teaching methods.
In practical application, we should pay attention to the following points: ① Choose appropriate courseware: the courseware used includes both self-made multimedia courseware and English medical teaching courseware published abroad. ② Choose a suitable electronic dictionary: The widely used "Full Medical Dictionary" (at least four popular versions at present) is a very useful tool for bilingual medical teaching because of its comprehensive collection of medical vocabulary and most of them are pronunciations. ③ Use diversified teaching methods, such as pictures, multimedia and videos, to concretize and visualize abstract concepts in medicine as much as possible, so as to help students better understand medical professional knowledge. ④ Auxiliary network technology [2]: In the teaching process, we use our own local area network to access the Internet through FTP or file sharing, which is convenient for students to inquire and submit homework at any time; In addition, a teaching forum has been set up to facilitate students to ask questions and solve problems.
Two Problems in Bilingual Teaching of Gastroenterology
2. 1 The quality of both teachers and students affects the promotion of bilingual teaching.
Teachers are the main body of bilingual teaching, and the level of teachers is the first factor affecting the effect of bilingual teaching. The level of teachers determines the quantity and quality of effective information provided by "preaching, teaching and solving doubts" [3]. At present, most teachers in our school have not received formal bilingual teaching training, and most teachers only have the teaching ability to teach a certain subject, and their ability to teach professional knowledge in foreign languages is relatively lacking and their level is not high. At the same time, although the overall English level of seven-year students is high, there are also uneven levels. Therefore, teachers' own ability to start classes and students' foreign language foundation affect the actual effect of bilingual teaching.
2.2 Lack of excellent bilingual teaching materials
In principle, bilingual teaching should use foreign original textbooks. Without the original textbook, bilingual teaching is like water without a source, a tree without a foundation. However, at present, international textbooks are expensive, and it is difficult for ordinary universities to bear the high cost of textbooks, so it is difficult to introduce foreign original textbooks. Therefore, different teachers use textbooks, some are original foreign textbooks, some are excerpts from foreign textbooks, and some are teachers' own handouts. Version and content are not unified, and teaching is arbitrary. In addition, the difficulty of textbooks also affects the actual effect of bilingual teaching.
Bilingual teaching is an inevitable requirement for China's higher education to connect with the international community, meet the challenges of the new century and cultivate internationally competitive talents, and it is also the focus and hot spot of current teaching reform. Although bilingual teaching has achieved initial results, its exploration will still be huge, complex and arduous. Only by in-depth study and thinking, careful analysis and research, and clear thinking can bilingual teaching be carried out more effectively.
[References]
[1] Lu, Wang Bin, et al. Difficulties and countermeasures of bilingual teaching [J]. Practical Preventive Medicine, 2004, 1 1(4):839-840.
[2] Li Lei, Liu Lu, Xing Xuan, et al. Multimedia and network technology challenge modern teaching mode [J]. Continuing Medical Education, 2003, 17 (4): 46-48.
Luo Yulin Zhang. Discussion on medical bilingual teaching mode [J]. china journal of modern medicine, 2003,13 (13):147-149.
Discussion on related problems of model articles in gastroenterology papers;
1.
2. Gastroenterology nursing papers.
3. Talking about the model essay of clinical medical education
4. Talking about the model essay of community nursing.
5. Model essay on internal medicine nursing.