浅谈服毒病人心理分析及护理

生活中往往有一些人因种种原因悲观厌世，进而采取愚蠢的手段──服毒，以此来逃避人生，这些人由于所处的社会环境、生活环境各不相同，因此，其轻生原因也各不相同。我们在临床实施身心护理时，也各有侧重，现将病人的心理因素分析及相应的护理措施，介绍如下。1心理因素分析1．1服毒原因1．1．1情感方面：婚姻、恋爱；老无所养；缺乏家庭温暖等。1．1．2经济方面：失业、疾病等所造成的经济负担过重。1．1．3疾病方面：肿瘤、残疾、慢性病、传染病、精神、神经系统等，使身心倍受折磨的疾患。1．1．4事业方面：独生子女孤独任性；学习负…     

改良型Gamma钉治疗股骨转子间骨折远期疗效观察和并发症分析

目的：综合评估改良型Gamma钉治疗股骨转子间骨折的远期疗效，并分析并发症发生原因．方法：对术后平均2．7年的39例患者进行随访，采用主观症状、客观体征和双下肢功能评分，按得分评定疗效．统计本组57例患者发生的并发症．结果：患者远期疗效优良率达到81．6％．井发症中伤口问题（脂肪液化1例，血肿2例，感染1例）占7．0％；大转子继发骨折3例，占5．3％；加压螺钉穿出股骨头和髋内翻畸形各有2例（各占3．5％）；异位骨化3例（5．3％）；内固定断裂1例（1．8％）；术后股骨继发性骨折1例（1．8％）．结论；①改良型Gamma钉手术损伤小，…     

1980—2003年某机械集团工伤事故的调查分析

目的：研究机械企业工伤事故的发生规律及主要原因。方法：对某机械集团1980年1月至2003年12月间发生的工伤事故进行回顾性调查，用SPSS10.0建立数据库，并进行统计分析。结果：（1）工伤事故呈逐年下降的趋势，年平均工伤率从80年代的2．63‰职工下降到2000—2003年段的1．06‰职工，以夏季比例较高，集中在七月份；工伤事故时点分布均在9-10点间发生较高；（2）男性工伤例数显著高于女性；以30-40岁年龄居多，占32．7％；文化程度以高中比例较多，技术等级以中级为主；（3）工伤类别以物体打击和机械伤害为主，分别为工伤总数的40．1％和29．5％；受伤部位以上肢最高，占37．9％，头部（30．8％）其次；（4）违章作业（占40．2％）引起伤害的最主要原因。结论：加强安全教育、提高职工安全意识、改进设备和改善工作环境等方面综合入手，以减少工伤事故的发生。     

市场经济环境下医疗纠纷产生的原因及对策

本文探讨了目前市场经济环境下医疗纠纷产生的原因，并在4个方面进行了分析：(1)社会原因方面：①价值观念的转变；②医疗保障要求的提高；③医疗体制的改革；④经济责任的转嫁；⑤“医疗纠纷穴头”的兴起；(2)患者及家属方面的原因：①不良的经济动机；②医学知识的一知半解；(3)医务人员方面的原因：①劣质的服务态度；②不廉洁的医疗行为；③差强人意的临床技术水平；④受到冲击的责任心；(4)医院方面的原因：①经济利益的驱动；②不实事求是的作风；③不得力的行政管理。在谈到对策时提出了：(1)原则：①坚持依法办事的原则；②坚持实事求是的原则；③坚持维护医患双利益的原则；④坚持惩前毖后、治病救人的原则；(2)措施：①加强法制观念教育；②加强职业道德教育；③加强业务培训；④加强规章制度建设；⑤加强维护医务人员合法权益。     

全血细胞减少症78例病因分析

目的：了解全血细胞减少症在各系统疾病中的分布情况，提高诊断准确率。方法：对78例全血细胞减少症患者进行回顾性病因分析。结果：再生障碍性贫血（AA）26例，占33.3％，白血病（AL）17例，占21．8％，巨幼细胞贫血（MA）10例，占12．8％；骨髓增生异常综合征（MDS）8例，占10．3％，脾功能亢进5例，占6．4％；甲亢2例，占2．6％；系统性红斑狼疮（SLE）2例，占2．6％；特发性血小板减少性紫癜（ITP）1例，占1.3％；血栓性血小板减少性紫癜（TTP）1例，占1．3％；Evans综合征1例。占1．3％；原发性骨髓纤维化（MF）1例，占1．3％；金黄色葡萄球菌败血症1例，占1.3％；肺癌骨髓转移癌1例，占1．3％；原因不明2例。结论：全血细胞减少症的病种多，病因复杂，不能单从血液系统疾病考虑，也不能单凭骨髓涂片诊断而忽略其他检查，需要密切联系临床资料综合分析，减少全血细胞减少症的误诊和漏诊，提高诊断的正确率。     

气管插管患者意外拔管事情发生的原因及防护对策

目的：收集气管插管患者意外拔管事情发生的病例，总结其发生原因并制定防护对策以减少对病人的伤害。方法：收集我们科自2012年1月至2014年6月实施气管插管的病例286例和意外拔管的病例22例对其原因进行分析。结果：患者因素：疼痛不适3例（13．6％）；意识状态改变7例（31．8％）；年龄因素4例（18．1％）。医护因素：导管固定不佳2例（9．1％）；肢体约束或镇静不佳3例（13．6％）；医护人员疏忽或经验不足1例（4．5％）；沟通不足2例（9．1％）。结论：意外拔管的发生有医患双方的因素，家属加强监护，医护人员正确规范操作，双方有效沟通十分重要，应该从细节做起及早发现积极防护确保病人安全。     

传染病、寄生虫病测验题

一、填空：1．感染性休克时，补液基本充足的计量指标主要有：①＿＿；②＿＿；③＿＿；④＿＿；⑤＿＿；2．流行性脑脊髓膜炎最常见的死亡原因是：①＿＿；②＿＿。3．乙型肝炎具有传染性的实验室指标有：①＿＿；②＿＿；③＿＿；④＿＿；⑤＿＿。     

特苏尼^TM（托拉塞米注射液）

【药品名称】通用名：托拉塞米注射液。 商品名：特苏尼6TM。 【性状】本品为无色澄明液体。 【适应症】1．发生于多种组织多种原因所致的中、重度水肿；2．各种原因所致的脑水肿；3．急、慢性心力衰竭；4．肝硬化腹水；5．少尿型急、慢性肾功能衰竭；6．急性毒物／药物中毒、原发性高血压危象以及MOSF等急症的抢救。     

透明质酸受体在膀胱癌中的表达特点

目的：探讨透明质酸受体CD44v6和RHAMM在膀胱癌中的表达形式及其生物学意义。方法：免疫组织化学。结果：CD44v6在膀胱表浅肿瘤(Tis—T1)阳性率为64．5％；浸润性肿瘤(T2—T4)为42．4%；细胞分级G1阳性率：75．0%，G2：55．9%；G3：40．9%。RHAMM在正常膀胱粘膜阳性率20．0%；在Tis—T1为48．4％；T2—T4为72．7％；细胞分级G1阳性率：12．5％；G2：67．5％；G3：68．2％。结论：①CD44v6表达频率在膀胱表浅肿瘤和浸润性肿瘤之间有显著差异；②RHAMM的表达与膀胱癌病理分期及细胞分级正相关。     

驾驶疲劳流行病学调查

1驾驶疲劳与道路交通事故 根据公安部交通管理局1999年与2000年的统计结果表明：驾驶疲劳产生的交通事故只占1．4％和1．2％；产生的死亡率分别是2．5％和2．2％。但是疏忽大意、判断错误、措施不当三项相加分别是18．8％和20．3％；产生的死亡率是18．6％和20．8％。在这三项事故原因中可能夹杂着驾驶疲劳；因为驾驶疲劳会使驾驶员产生反应迟钝、判断错误、忽视重要的信息、对     

Finding a faster route to practice: from medical student to board certified physician

An examination of two types of educational tracks used by medical students seeking a faster route to practice: 1) "3+3" programs that combined the final year of medical school with the first year of a primary care residency, and 2) graduating from medical school after only three years. The "3+3" programs were discontinued despite reports indicating their success. Three year medical school options are still available at a handful of medical schools. Finally, the paper will explore why and how medical schools might wish to enact a three year curricular option.     

Preparing faculty to teach in a problem-based learning curriculum: the Sherbrooke experience.

Over the last 6 years Sherbrooke Medical School has undertaken a major reform of its undergraduate curriculum. A new student-centred, community-oriented curriculum was implemented in September 1987. Problem-based learning (PBL) is now the main educational method. To adequately prepare teachers for the curriculum a series of faculty development programs in pedagogy were offered: first, a 2-day introductory workshop to initiate teachers into educational principles and their application in the new program; second, a 1-year basic training program in medical pedagogy; third, a 1-day workshop on PBL; and fourth, a comprehensive 3-day training program in PBL tutoring. Over 60% of all full-time teachers attended the introductory program and 80% the tutor training program. The 1-year basic training program was completed by 33% of the faculty members. The implementation of these programs, coupled with a high participation rate, resulted in a more student-centred educational philosophy and a greater interest in medical education. This had a significant impact when the new curriculum was instituted. Lessons learned from the experience are discussed.     

Augmentation of special-needs services and information to students and teachers "ASSIST"--a telehealth innovation providing school-based medical interventions

An innovative school-based telehealth technology was introduced in Hawaii with the purposes of: (1) evaluating students for medical/developmental conditions with educational implications, (2) providing a professionally-monitored Internet-based system of learning/development, and (3) delivering medically-based physical and occupational therapy at the students school. Electronically recorded satisfaction surveys from parents, teachers, and providers revealed significant improvement in all three areas.     

构建医学院校医学伦理道德教育经常性机制的思考

当前医学伦理道德教育的单一课程模式不符合医学伦理道德教育的规律性，也束缚了医学伦理课程教学改革的深入，使构建以贯穿于医学人才培养全部过程为特征的经常性教育机制成为必要。一是要建立立体的医学伦理道德教育体系；二是要不断创新医学伦理道德教育的内容和方式；三是要营造良好的医学教育和医学伦理教育环境。     

我国高等医学教育结构的研究

目的:通过对我国高等医学教育结构的分析,找出存在问题及其相关因素,提出相应对策,促进医学教育的改革和发展。资料与方法:利用《中国教育统计年鉴》等的数据,采用构成比进行统计描述。结果和结论:通过对院校类型结构、种类结构、体制结构、区域分布结构、层次结构、专业结构等的分析,得出了医学教育办学层次偏低、举办医学教育的学校增加速度过快、举办者过于复杂、医学教育学制混乱等结论。建议:加强医学教育宏观管理,控制医学教育规模,不断优化医学教育结构。     

高等医学教育特殊规律及其特性探析

高等医学教育是高等教育的重要组成部分,高等医学教育既具有高等教育普遍的客观规律,同时又有其自身的特殊规律.本文主要从以下5个角度揭示了高等医学教育特殊规律及其特性：（1）高等医学教育是一种精英教育;（2）高等医学教育具有5大基本特点;（3）高等医学教育是由3个教育阶段组成的连贯性教育过程;（4）高等医学教育人才成长过程经历4个重要环节;（5）高等医学教育与附属医院具有密不可分的隶属关系.     

An experimental case-conference programme for obstetrics and gynaecology clinical students.

Since the founding of the University of Limburg (1974), in The Netherlands, an innovative medical curriculum has been guided by educational principles of problem-orientation, continuous assessment, student initiative and attitude development. The teaching of medical ethics was built into the preclinical curriculum from the start. However, the clinical years remained largely unaffected, and only recently has an effort been made to extend the educational philosophy to this more or less traditional part of medical education. Within this context, an experiment of clinical ethics teaching was introduced in the Obstetrics and Gynaecology (Ob/Gyn) clerkships. The objectives, methods and results of this experimental programme are described in this paper. The success of the teaching is based on three features of the programme: 1) its student-centred approach; 2) the programme is designed in a way similar to regular patient conferences; 3) the programme is taught by a team consisting of both clinician and ethicist. Before starting a longitudinal programme of ethics teaching during the clinical years, it proved very helpful to experiment with a well designed and evaluated pilot programme.     

河北省医学教育现状分析与未来发展的战略思考和建议

对河北省高、中等医学教育现状进行系统分析归纳,目前存在的主要问题有（：1）培养规模与需求不相匹配,供求矛盾突出;（2）学历结构不合理,与社会卫生服务人才需求不相适应;（3）专业结构和布局不合理,人才过剩与短缺并存;（4）部分学校办学条件不足,人才培养质量缺乏保障;（5）人才培养内涵缺乏新意,课程设置和教学内容亟需深化改革。为此,对河北省医学教育未来发展提出以下建议：（1）进一步完善高、中等医学院校的基础教育和包括在岗的毕业后教育、继续教育在内的连续统一的医学教育体系;（2）进一步提高教育教学质量,加快医学人才培养模式创新;（3）进一步调整教育规模和学历层次结构,优化医学教育的整体发展;（4）进一步优化专业结构和布局,主动适应社会卫生服务需求;（5）进一步深化教学改革,构建核心课程模式和综合性课程模式课程的设置,精心培养适应未来社会发展的医学人才;（6）进一步加大对医学教育质量的督导和检查力度,完善教育评估制度,逐步形成科学的医学教育质量评价体系;（7）采取有力措施,大力改善学校办学条件,提高办学能力;（8）继续加强对农村、社区医药卫生人才的培养,为全面提高居民健康水平提供人才保障;（9）加强行政主管部门对医学教育业务指导,确保医学教育健康发展。     

比利时高等医学教育的启示

欧洲国家是世界上医学的发达国家。本文从教学理念、教学条件、教学方法和教育体制等方面对比利时高等医学教学的优势和特点进行了分析,这些也是我国医学教育改革中值得学习和借鉴的地方。     

Adult smoking and environmental tobacco smoke: a persistent health threat to children

This article is the third in a series of four providing up-to-date information about the tobacco problem and how physicians can effectively intervene. Three of the four articles are accredited for free continuing medical education (CME) credit for physicians. To obtain AMA PRA Category 2 Credit for this article, please go online to www.pedseducation.org, your source for free Continuing Medical Education from Nemours. Choose Online Education, the article, and complete the post-test as directed. CME accreditation for this educational presentation is provided at no cost as a service of Nemours, one of the nation's largest children's health systems. Nemours is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physcians. Nemours designates this educational activity for a maximum of .5 AMA PRA Category 1 Credit(s). Physicians should only claim credit commensurate with the extent of their participation in the activity. This article reviews the health effects of adult smoking on children. It focuses on the impact of environmental tobacco smoke (ETS). By reading the article and completing the post test it is anticipated that the following learning objectives will be met: 1) physicians will become familiar with the health effects of ETS on children, 2) physicians will become familiar with parental knowledge gaps and at risk populations and 3) physicians will understand the benefits of addressing the issue of adult smoking with parents.