布地奈德雾化吸入治疗婴幼儿支气管肺炎60例的疗效观察

目的：探讨布地奈德雾化吸入治疗婴幼儿支气管肺炎的疗效,及其其临床应用价值进行评价。方法：60例支气管肺炎患儿随机分为治疗组和对照组两组,治疗组在常规治疗的基础上加用布地奈德雾化吸入治疗,对照组在常规治疗的基础上给予a-糜蛋白酶雾化吸入。结果：治疗组总有效率为100％,对照组总有效率为80％,统计学分析两组具有显著性差异（P〈0．01）。结论：布地奈德雾化吸入治疗对婴幼儿支气管肺炎具有很好的疗效。     

各国及地区药学教育实践培养模式比较及启示

对比各国及地区药学教育中的实践培养模式,找出特点及有益的经验,包括延长实践时间,内容设置与临床应用、新药开发等使理论与实践联系紧密,更具有针对性;拓宽实践渠道,突出培养特色;加强实践与人文教育相结合;严格药剂师准入制度及提高继续教育考评标准,从而创立符合我国国情的药学人才实践培养道路。     

人工合成胰岛素的哲学思考

1965年我国科学家在世界上首次人工合成胰岛素获得成功。这一举世瞩目的科学成就不仅开创了人工合成蛋白质的新时期，而且丰富了辩证唯物主义的生物观，这项科学研究的历史为我们提供了许多思想启示。     

正常人呼气相高分辨CT研究

目的探讨正常人呼气相HRCT扫描所见,分析其相关影像学表现。方法对28例正常人行吸气相加呼气相HRCT扫描,定量分析扫描结果。结果吸气相与呼气相HRCT比较,肺野CT值平均上升(224.84±97.98)Hu(70.14~544.05Hu);呼气相全肺野CT值上升幅度与其面积减少正相关,相关系数r=0.693,P<0.001。仰卧位时双肺承重区域CT值上升幅度大于非承重区域,P<0.001;俯卧位测试结果与之相同,P<0.001。呼气相CT值增加幅度随年龄的增加而降低。结论正常受试者呼气相肺野CT值较吸气相平均上升224.84Hu;正常人呼气相HRCT肺野CT值上升程度与肺野面积减少正相关;正常人呼气相HRCT承重区CT值上升幅度大于非承重区,与体位无关;正常人呼气相CT值增加幅度随年龄增加而减低。     

Sternocleidomastoid muscle deoxygenation in response to incremental inspiratory threshold loading measured by near infrared spectroscopy

This study investigated the pattern of changes in muscle oxygenation, deoxygenation and blood volume in the sternocleidomastoid (SCM) in comparison with the parasternal (PS) and intercostal (IC) muscles during a bout of incremental inspiratory threshold loading (ITL) in healthy subjects using near-infrared spectroscopy. During progressive loading, the PS and IC showed a significant increase in oxygenated hemoglobin (5.9 ± 2.3 and 6.8 ± 2.4 μM, P<0.05) and the SCM showed an increase in deoxygenated hemoglobin (17.3 ± 3.8 μM, P<0.05). Total hemoglobin also steadily increased in the SCM whereas it decreased in the quiescent vastus lateralis muscle (20.7 ± 6.1μM vs. -6.6 ± 2.4 μM, P<0.05), which was used as the control muscle during the ITL. Our data suggests that the SCM is recruited progressively during progressive ITL and is accompanied by an increased blood volume and maintenance of O(2)Hb. Blood redistribution away from the nonactive limb muscles during the ITL may provide one source of maintaining inspiratory muscle blood volume and oxygenation during high respiratory motor output.     

美国FDA药品监督检查与抽验模式分析及启示

目的:为进一步完善我国药品抽验模式提供参考。方法:通过查阅相关文献对美国FDA的药品监督检查与抽验机构和模式进行分析,并结合相关案例,探讨此种模式对我国的启示,并提出建议。结果与结论:我国应重视企业的《药品生产质量管理规范》(GMP)检查,特别是实验室检查;药品质量抽验与GMP和《药品经营质量管理规范》(GSP)检查结合;贯彻质量风险评价为核心的理念;对监督检查中发现有质量问题的药品应进行原因追溯。美国FDA监督检查与抽验结合的过程控制理念很值得我国学习与借鉴。     

发达国家医学教育的特点与启示

进入21世纪以来,随着人民群众卫生服务需求的日益增长,卫生服务模式发生了重大变革,国际医学教育的发展趋势对医学生的素质提出更高的要求.本文从发达国家医学教育管理的角度出发,总结其医学教育的特点,学习借鉴其先进之处,分析我国家医学教育现状,探讨适合我国医学教育的管理理念和管理制度,为促进我国医学教育的发展,提高我国医学教育的水平和质量奠定理论基础.     

日本医院管理方式对我国医院管理的启示

日本在医院管理方面积累了许多成熟的经验,值得我国医院管理者参考、借鉴。通过介绍日本医院的三级医师查房模式,学术预演会制度及医学外语论文抄读会制度,结合我国医院管理的现状,探讨医院查房制度、科研管理的改进措施,以提高我国医务人员的诊疗技术水平、科研能力和外语水平,更好地为广大人民群众提供医疗保健服务。     

日本护生临床实习方法的启示

目的通过对日本护生临床实习的学习感悟,探讨提高我国护生教育质量的方法。方法回顾性总结了在日本参与护生实习的半年研修体会,从实习计划安排、实习前教育、实习过程和实习后评价等方面介绍日本大分大学医学部附属医院的临床护理实习情况,结合我国目前情况进行对比分析。结果日本护生临床实习前教育到位,实习中注重综合实践能力的培养,实习后注重对护生和指导教员的双向评价。结论我国护生实习前可增加护患情景模拟演练的内容;选择适宜的病例进行护生和病人一对一的完整护理程序带教;带教中可尝试每日下午组织实习讨论会。     

Impact of adjuvant radiotherapy on biological and clinical parameters in right-sided breast cancer

PurposeIn patients with right-sided breast cancer (BC) the liver might be partially irradiated during adjuvant radiotherapy (RT). Thus, we performed a prospective observational study to evaluate the dose delivered to the liver, and its potential biological impact.Patients and methodsWe enrolled 34 patients with right-sided BC treated with adjuvant RT. The RT schedules were either the Canadian (42.5 Gy in 16 fx) or standard fractionated (50 Gy in 25 fx) regimen respectively with 9 (26.5%) and 25 (73.5%) patients each, ± a boost of 10–16 Gy. Each patient had a complete blood count and liver enzymes analysis, before starting and during the last week of treatment.ResultsA significant decrease in white blood cells and thrombocytes counts was observed during RT. We observed a significant correlation between certain hepatic parameters and the volume of the irradiated liver and/or the mean liver dose. A significant correlation between the volume of the right lung and the liver mean dose was found (P = 0.008). In the bivariate analysis, a significant correlation between fatigue and the white blood cell count's evolution was observed (P < 0.025).ConclusionWith the standard RT technique, incidental irradiation of the liver was documented in a large number of patients, and some significant hepatic parameters alterations were observed, without an apparent clinical impact, but this study cannot exclude them. The liver mean dose was correlated with the right lung volume suggesting that deep inspiration breath hold (DIBH) techniques may represent a way to decrease the liver dose. These findings need to be evaluated in further larger studies.