医学生伟大抗疫精神普遍认同机理及其培育路径

培育医学生对伟大抗疫精神的普遍认同是新时期医科院校贯彻立德树人教育方针的重要体现。医学生普遍认同伟大抗疫精神，才能自愿、自觉、自主地将伟大抗疫精神转化为肩负中国健康战略和中华民族复兴重任的精神动力和现实行动。医学生伟大抗疫精神普遍认同遵循社会认同的一般规律，但也有着与自身专业特色相适应的特定认同机理(“辩其道”“明其义”“行其理”)。将伟大抗疫精神融入医学生日常思想政治教育，这是培育医学生伟大抗疫精神普遍认同的有效现实路径。     

医院文化建设路径初探

本文结合医院文化建设的实践,重点从以下几个方面对医院文化建设的路径进行了探索：注重院领导的参与并明确医院文化建设的管理思路;深入调研,掌握医院文化建设的第一手资料;分析调研结果,构建医院文化建设的总体思路;设计理念体系,制定岗位规范;开展以医院文化为核心内容的员工培训。     

医院感染管理执行倡导慎独精神

目的 为预防和控制医院感染事件的发生,发挥医院感染管理积极的作用,提升医院感染管理绩效.方法 通过倡导、强化、培训、感染管理路径规程推广应用,将慎独精神融入临床医疗活动的每一个工作环节中,培养员工养成践行精益工作的习惯,形成制度、规范和标准,自觉遵照执行.结果 将医院感染管理执行文化建设、慎独精神融入合作团队的愿景中,使团队成员加深对医院感染预防控制重要性的认知度,发挥好每一名医务人员主动参与医院感染管理的积极性,提高医院感染管理的有效性.结论 医院感染管理工作涉及多学科及医院工作的各个层面,是一个多主体、多层次的体系,各个主体之间互为关联;倡导慎独精神融入医疗活动的每一流程细节中,强化系统之间沟通配合,执行到位,有效预防医院感染的发生.     

石油企业医院文化建设的探索与实践

本文阐述了对石油企业医院文化建设的认识和培育石油企业医院文化的必要性;介绍了石油企业医院文化体系建设的具体实践.笔者认为,在改革与发展的探索道路上,应从精神形态文化、物质形态文化和制度形态文化三个层次,推动医院文化体系建设.     

后抗疫时期健康管理建设的新路径

经过了新冠肺炎抗疫后,人们社会行为发生了改变,原来的健康管理建设路径也应该发生相应的变化。论文通过分析不同抗疫时期的社会行为学变化过程,论证了当前健康管理建设路径需要改变的必要性和可能性,提出了以家庭为中心的健康管理新路径,探讨了目前家庭健康管理亟待解决的主要内容是扩充家庭入户单元、建设学习与运动单元等,为后抗疫时期的健康管理提供了思路。     

医务社工助力医院文化品牌建设的实践与探索

医院文化品牌建设是一项系统工程,是医院可持续、高质量发展的动力源泉。其中,医务社工作为医学人文关怀的推动者,成为营造医院文化氛围和打造品牌建设的重要角色和有益补充。以复旦大学附属儿科医院为例,阐述医务社会工作在医院文化建设中的探索路径,并系统梳理医务社工助力医院文化品牌建设的实践举措和取得的阶段性成效,最后结合实际工作的开展,对推动医院文化品牌建设的路径进行探讨,提出坚持党建引领、文化先行;完善制度体系建设,构建医务社工发展的良好氛围;发挥医务社工专业力量,服务医院文化品牌建设等,进而创新发展医院特色文化品牌、开创医院文化建设新局面。     

浅议医院文化建设的基本内容

医院文化是医院支配一切管理活动的灵魂，是医院的核心竞争力，只有通过构建医院文化体系和培育医院精神，激发职工的责任感，增强职工的积极性，使医院成为一个生机勃勃的、能够适应环境、克服困难、备发向上的有机体。加强医院文化建设，首先必须了解医院文化建设的基本内容，本文从内涵、原则、重点、意义四个方面对其进行阐述。     

基于新冠肺炎疫情防控常态化的综合医院抗疫全体系储备动态调整

新冠肺炎疫情全员防控已成为大型医院管理的新常态,通过快速建设钢结构用房、改建固定式抗疫用房、足量储备抗疫物资、健全院外支援及院内应急队伍梯队、建立常态化应急预案等措施,探索动态调整抗疫全体系储备,并实行全院封闭式管理,健全疫情防控手段,有效控制院内感染.     

和谐医患关系视角下对山东省医院文化建设的探讨

以医院文化的相关理论作为切入点,对当前山东省医院文化、医患关系的现状进行透视和分析。通过对样本医院医护人员的问卷调查,构建医院文化与医患关系的作用路径,分析在医院文化中影响医患关系的主要因素为行为文化,其次为医院精神文化,进而提出和谐医患关系视角下医院文化建设的政策建议。     

强化精神文化建设推进医院持续发展

医院精神文化建设是医院文化建设的核心内容,也是推动医院可持续发展的强大动力。随着医疗卫生体制改革的逐步深入,医院精神文化建设的内涵和外延正在逐步丰富和拓展,其对医院全面建设和发展的推进作用也日益突出。本文详细阐述了包括医院主题建设、院训、院徽等具有自身特色的第三军医大学西南医院精神文化建设,实现了以精神文化增强员工向心力、凝聚力,扩大医院幅射力,增强医院吸引力、感召力,提升医院综合竞争力,构建和谐医院的目标。     

长春新碱过量引起严重毒副反应1例的护理体会

报道1例霍奇金淋巴瘤患者因误用长春新碱（VCR）10mg一次性静脉推注后治疗护理情况。其出现间断性神志恍惚、眼睑闭合不全、言语不清、口腔黏膜糜烂、全身疼痛、麻痹性肠梗阻、尿潴留、手足麻木等症状,经积极解救,禁食,持续胃肠减压、胃管内注入麻油、开塞露、生理盐水灌肠,合理应用肠外营养,注重疼痛、心理护理,做好口腔、肛周护理,预防感染加重,患者病情得到控制好转出院。     

Correlates of stages of change of smoking among inhabitants of deprived neighbourhoods

BACKGROUND: This study examines the prevalence and correlates of stages of change of smoking, in terms of psychosocial, structural and sociodemographic factors, among inhabitants of deprived neighbourhoods. METHODS: Cross-sectional data were obtained from a survey on health related behaviour. Subjects were 2009 current and former smokers, aged 20-46, living in deprived neighbourhoods in Rotterdam, the second largest city in the Netherlands. Three groups of smokers were formed according to the stages of change-definitions of the Transtheoretical Model: smokers not planning to quit (precontemplators), smokers planning to quit (contemplators/preparators) and former smokers (actors/maintainers). Smokers planning to quit and smokers not planning to quit were compared regarding psychosocial factors (attitude, social norm, self-efficacy), structural factors (neighbourhood problems, material deprivation, financial problems, employment status) and sociodemographic factors (age, gender, marital status, cultural background, educational level). Former smokers were compared with smokers planning to quit regarding structural and sociodemographic factors. Logistic regression was used to assess correlates of stages of change. RESULTS: Smokers planning to quit (prevalence = 19%) reported a more positive attitude, stronger social norms and higher self-efficacy expectations in quitting smoking than smokers not planning to quit (prevalence = 57%). Smokers planning to quit less often were Dutch-born, more often had attended higher vocational schooling or university and more often reported experiencing two or more neighbourhood problems compared to smokers not planning to quit. Former smokers (prevalence = 24%) were older, more often Dutch-born, married, employed and higher educated, compared to smokers planning to quit. Furthermore, former smokers less often reported material deprivation and financial problems than smokers planning to quit. CONCLUSION: Among people living in deprived neighbourhoods, different factors correlate with different stages of change of smoking. Implications for health promotion are discussed.     

Choice of measures of vaccination and estimates of risk of pediatric pertussis

BackgroundVaccination uptake at the individual level can be assessed in a variety of ways, including traditional measures of being up-to-date (UTD), measures of UTD that consider dose timing, like age-appropriate vaccination, and risk reduction from individual doses. This analysis compared methods of operationalizing vaccination uptake and corresponding risk of pertussis infection.MethodsCity-wide case-control study of children in Philadelphia aged 3 months through 6 years, between 2001 and 2013. Multiple logistic regression was used to isolate the independent effects of each measure of vaccination uptake and the corresponding relative odds of pertussis.ResultsBeing UTD on vaccinations was associated with a 52% reduction in risk of pertussis (OR 0.48, 95% CI: 0.34, 0.69). Evaluation of delayed receipt of vaccine versus on-time UTD yielded similar results. There was a decrease in risk of pertussis for each additional dose received with the greatest reduction in pertussis infection observed from the first (OR 0.48, 95% CI: 0.28, 0.83) and second dose (OR 0.17, 95% CI: 0.08, 0.34). Additional doses conferred minimal additional protection in this age group.ConclusionExamining vaccination status by individual doses may offer improved predictive capacity for identifying children at risk for pertussis infection compared to the traditional UTD measure.     

两种不同肌瘤剔除术治疗子宫肌瘤的临床疗效比较

目的:比较腹腔镜子宫肌瘤剔除术与腹式子宫肌瘤剔除术的临床疗效。方法:回顾分析63例腹腔镜子宫肌瘤剔除术与61例腹式子宫肌瘤剔除术的临床资料,比较2种手术方式的手术时间、术中出血量、肛门排气时间、使用抗生素时间、术后感染率、体温恢复正常时间、住院时间等情况。结果:两组患者接受子宫肌瘤剔除术顺利完成,腹腔镜组手术时间长于开腹组(P0.05),腹腔镜组术中出血量及剔除肌瘤个数均少于开腹组(P0.05),术后腹腔镜组体温恢复正常时间、肛门排气时间、抗生素使用及住院时间均短于开腹组,两组患者最多随访6个月,腹腔镜组平均康复时间较开腹组短(P0.05),两组随访B超均未发现明显肌瘤结节。结论:腹腔镜子宫肌瘤剔除术损伤小,恢复快,住院时间短,是值得推广的微创手术。     

上海市某医院骨科平均住院日影响因素分析

对上海市某医院2003年-2007年骨科出院病人的住院日描述性分析．2003年-2007年骨科的床位利用指数与平均住院日相关性分析．2003年-2007年骨科床位与医护比例分析．2007年骨科前10大病种平均住院目影响因素分别进行单因素相关性分析和多因素逐步回归分析（STATA软件）。通过对骨科10大病种住院日影响因素分析,术前等待天数、手术类型、是否输血分别对10个、9个和8个病种的住院目有影响。输血因素和手术类型是医院不可控、由病人的病情决定的,术前等待天数是管理因素,是最值得医院重视的影响因素。     

性发育异常发病机制的研究进展

正常的性腺分化可分为3个过程：原始性腺形成、性别决定和卵巢/睾丸发育。在任一环节中,基因表达或调控发生异常均有可能导致性发育异常疾病的发生。性发育异常是指染色体、性腺和解剖性别不典型。随着分子生物学技术的发展,不断地发现新的基因或信号通路参与性腺分化和发育,如SRY、SF1、WT1、Sox9等基因与睾丸发育密切相关,Wnt/Rspo1/B连环蛋白通路、Dax1、Foxl2等基因在卵巢分化中发挥着重要作用,一些非编码RNA和转化生长因子也有重要的调节功能,且睾丸和卵巢发育均为主动过程,即使在出生后因某些基因的改变两者间也可出现横向分化。这些为揭示性分化异常的发病机制提供了可能。     

尘肺病患者145例死因调查

目的分析汉中市尘肺病的发生、发展和死亡原因，以提高尘肺病患者的生存质量。方法对145例尘肺病患者的死因进行回顾性分析，计算其平均发病年龄、死亡年龄及患尘肺病后的存活年限。结果矽肺的平均发病年龄和死亡年龄均早于煤工尘肺和石棉肺，尘肺病的主要死因为患肺部疾患，患尘肺病后的平均存活年限为12a。结论加强职业健康体检工作，对尘肺病人做到早发现早治疗和预防并发症的发生。     

One-year stability of the Measure of Processes of Care

BACKGROUND: The Measure of Processes of Care (MPOC) is a 56-item self-administered measure designed to examine what parents of a child with a chronic health problem think of the services they and their child receive, and to measure the extent to which these services are family-centred. Reliability and validity of the MPOC were established in prior studies. The aim of the present study was to assess the 1-year stability of the MPOC to justify its use as an evaluative tool. METHODS: Nine paediatric rehabilitation centres in the Netherlands participated in this short longitudinal survey study. Subjects were 205 parents (response rate 74.8%) of children aged 1-18 years who received care in one of the participating paediatric rehabilitation centres. All subjects filled out two MPOCs with a 1-year interval. RESULTS: All correlations between the scale scores of the MPOC at the first and second administration were relatively high and significant (range: 0.443-0.609, all P < 0.001), demonstrating high inter-individual stability. However, all mean scale scores, except for Providing General Information, significantly reduced after 1 year. CONCLUSIONS: The MPOC has a moderate 1-year stability. However, because of its tendency to score lower when repeated after 1 year, its use as an evaluative follow-up instrument to assess the effectiveness of a programme intervention is restricted.     

儿童皮质发育畸形的MRI诊断

目的探讨儿童皮质发育畸形(MCD)的MRI表现特点,为MCD的早期诊断提供依据。 方法选择2010年1月至2012年12月在四川省医学科学院·四川省人民医院放射科经MRI检查确诊为MCD的44例患儿为研究对象。回顾性分析及总结其MRI影像学特征。本研究遵循的程序符合四川省医学科学院·四川省人民医院人体试验委员会制定的伦理学标准,得到该委员会批准,征得受试对象及其监护人知情同意,并与监护人签署临床研究知情同意书。 结果本组44例经MRI确诊为MCD患儿中,巨脑回-无脑回为17例,多小脑回为14例,灰质异位为9例,脑裂畸形为4例。MCD的MRI特点中,巨脑回表现为脑回增宽、皮质增厚及白质变薄;无脑回表现为正常脑沟、脑回消失,皮质增厚及白质变薄;多小脑回表现为脑回增多、细小;灰质异位表现为皮质下及侧脑室周围深部白质区结节状、团块状或带状病灶,信号与灰质信号相同;脑裂畸形表现为从侧脑室到脑表面贯穿大脑半球的裂隙,表面覆盖灰质。 结论MRI是诊断儿童MCD的可靠影像学方法。     

244株真菌鉴定结果分析

目的 了解某院2000～2001年各类真菌的检出率。方法 用酵母样真菌同化试验编码鉴定板TH-15进行编码鉴定。结果 真菌分离率为8．85％；244株真菌分为10种，其中以白色念珠菌和热带念珠菌较高，分别占真菌总数的75．41％和11．47％；检出真菌的主要标本是痰和阴道分泌物。结论 及时进行真菌培养，有利于合理使用抗菌药物和控制真菌感染。