情景急救模拟演练在急诊科专科护士的培训应用

目的：探讨应用情景模拟急救演练在急诊专科护士的培训运用效果,旨在提高急诊专科护士在急救过程中的综合素质。方法：选急诊常见的危重症,如心脏猝死、过敏性休克、颅脑外伤及创伤性休克病例,以情景模拟的形式进行急救演练,演练结束后进行考核评价。结果：使参加的急诊科专科护士身临其中,寓教于乐,在有经历感的工作环境中,更加深理解和记忆,提高急诊护士的抢救配合能力。结论：情景急救模拟演练在急诊专科护士中的培训效果显著,特别是使低年资护士综合素质得以提高。     

实施应急预案演练 提高护士急救能力

目的探讨模拟仿真急救演练的方法,提高急诊科护士急救能力。方法对急诊科护士开展应急预案学习及仿真模拟急救演练,即采用确定内容、制订计划、拟定演练方案、角色配置、现场实景模拟急救,演练结束后进行分析、总结。结果急诊科护士经4次的演练,2007年基本技能操作评分、综合能力评分较2006年明显(P均<0.01)。结论模拟急救演练是全面提高急诊科护士综合素质,急救能力和整体协调能力的有效方法。     

应急预案演练提高护士综合能力的效果评价

目的:提高急诊科护理人员应对突发公共卫生事件的能力和强化急救意识.方法:制定突发公共卫生事件应急预案,模拟演练突发公共卫生事件的应急处理流程,观察模拟演练前后护士的急救综合能力.结果:急诊科护士的临床护理急救技能考核成绩和医生对护理人员的抢救配合满意度均较演练前提高(P＜0.01).结论:突发事件应急预案情景演练,能够稳步提高护理人员的急救综合素质,更好地应对突发性公共卫生事件.     

急诊科低年资护士应急能力的培训模式研究

目的提高急诊科低年资护士的应急能力。方法以湖北省护理质量控制中心制定的《急诊科专科护士培训大纲》的内容及要求为培训指南,应用VCD光盘学习、操作演练、情景模拟、护理教学查房等培训模式,对急诊科工作0~5年的护士进行常见急危重症的抢救流程和急救技能的培训。结果培训3个月后低年资护士理论、模拟应急能力、实际应急能力的考核成绩显著高于培训前(均P0.01)。结论对急诊科低年资护士进行规范化的应急能力培训有助于急诊科护士应急能力和急救能力的提高。     

情景模拟抢救配合演练在急诊专科护士培训中的应用

目的探讨应用情景模拟抢救配合演练在急诊专科护士培训中的运用效果,旨在提高急诊专科护士在抢救过程中的综合素质。方法选择急诊常见危重症的病例,以情景模拟的形式进行急救演练,演练结束后进行考核评价。结果情景模拟法使护士进一步提高了自身的临床操作技能水平,使护士进一步提高了自身应对突发事件的能力和团队协作能力,且对于护士评判性思维方式的培养起到了良好的促进作用。结论在急诊专科护士培训中应用情景模拟抢救配合演练,取得的效果明显,有助于提高护士的综合素质。     

多部门联合急救演练提高护士综合能力的效果评价

目的：提高病区护理人员应对突发事件的能力、强化急救意识,缩短抢救配合的时间。方法：运用情景演练的模式,模拟各类危重症患者的抢救,观察模拟演练前后护士的急救综合能力。结果：护士完成演练配合所需时间较演练前缩短,护士的应急配合能力考核较演练前提高（P〈0.01）。结论：多部门联合的急救演练,能够提高护士综合能力,更好的应对突发情况下的急救配合。     

初级创伤救治培训模式在急诊科护士培训中的应用效果

目的：探讨初级创伤救治（ PTC）培训对提高急诊科护士的初级创伤救治能力的影响。方法按PTC教程的要求,对急诊科护理人员40人进行创伤急救技能理论培训、技能操作培训、综合模拟演练。培训前及培训后对接受培训的每位护士进行理论考核、技能操作考核和现场演练考核,比较培训前后的各项考核指标的变化。结果培训后40位护士理论考核合格率为87．50％（35／40）,明显高于培训前的52．50％（21／40）（P＜0．05）;培训后技能操作考核、现场演练考核各项目合格率均明显高于培训前（P＜0．05）。结论 PTC培训能有效提高急诊科护士的初级创伤救治能力。     

分层级规范化培训对提高急诊科护士急救能力的影响

目的：探讨分层级规范化培训对提高急诊科护士急救能力的影响。方法针对我院急诊科护士现状,制订分层级规范化培训计划,内容包括理论知识、急救技能、常见急诊分诊急救程序、护患沟通技巧等,采用多种形式结合进行培训。比较实施分层级规范化培训前后护士的理论与技能考核成绩、应急能力、抢救配合及医生对护士工作的满意度。结果经分层级规范化培训,急诊科护士的理论与技能考核成绩、应急能力、抢救配合及医生对护士工作满意度较实施前均明显提升（ P ＜0．01或 P ＜0．05）。结论分层级规范化培训能有效提高急诊科护士的急救综合能力,使医护配合更加默契。     

急救护理路径在培养年轻护士应急能力中的应用

目的探讨应用急救护理路径培养年轻护士的应急抢救能力。方法制定呼吸内科常见急症的急救护理路径,以模拟演练与实际抢救相结合,有计划有针对性地对年轻护士进行专科理论知识和应急能力培训。结果明显提高了年轻护士的应急能力和专科护理水平,护理综合技能有不同程度的提高。结论专科急救护理路径培训和其他培训考核有助于提高年轻护士的应急能力和整体业务素质。     

案例学习法结合情景模拟在手术室低年资护士应急能力培训中的应用

目的探讨案例学习法结合情景模拟在手术室低年资护士应急能力培训中的应用效果。方法根据多年抢救患者的经验,应用案例学习法结合情景模拟的方法,对手术室工作0～5年低年资护士进行应急能力的培训。并反复强化演练,培训小组每月逐个进行考核,实行个体评价。结果通过培训,手术室低年资护士的急救知识、急救操作技能、临床综合应急能力和医生的手术配合满意度明显提高。结论案例学习法结合情景模拟可以强化手术室低年资护士急救意识、增强临床应急能力、拓展急救理论知识、增强交流沟通能力和团队凝聚力、提高护士的自信心、减轻护士的心理压力,适合手术室的工作特点。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…