4R问题分析法结合反向教学在小儿手术室护理教学中的应用

目的 探讨4R问题分析法结合反向教学在小儿手术室护理教学中的应用。方法 本研究将2020年8月至2022年8月分配到湖南省儿童医院手术室实习的护生480人作为研究对象,按进科先后顺序分为对照组和观察组,每组240人。对照组采用传统教学,观察组采用4R问题分析法结合反向教学。实习结束后比较两组实习护生的综合能力考核成绩、护理教学认可度及教学满意度。采用SPSS 22.0进行t检验和卡方检验。结果 观察组实习护生理论知识、基本护理技能、手术室专科护理技能及综合护理技能考核成绩得分均明显高于对照组,差异有统计学意义（P<0.05）。观察组实习护生护理教学认可度明显优于对照组,差异有统计学意义（P<0.001）。两组实习护生教学满意度比较差异有统计学意义（χ²=118.35,P<0.001）。结论 4R问题分析法结合反向教学可有效提高小儿手术室实习护生的护理教学质量和教学满意度,使实习护生更好地掌握理论和实践技能。     

武汉市旅店业卫生间三大卫生用品消毒前后细菌污染调查

目的了解武汉市旅店业卫生间用品的卫生状况。方法随机采样监测了武汉市１０家旅店卫生间三大卫生用品（坐便器座垫、浴池、洗面盆）消毒前后细菌污染情况。结果武汉市旅店业卫生间三大卫生用品细菌污染较严重;消毒处理后,细菌总数均值虽有降低但仍较高,并可检出大肠菌群。结论旅店卫生间清洗消毒工作不力,亟待加强     

淮北农村改建深井为主的简易集中供水防制腹泻病效果研究

１９９７年～１９９８年,对两个县６个改水村和６个对照村的１００９２农村居民的饮水与腹泻病进行入户调查。结果表明,不同饮水类型的腹泻病发病率高低顺序是沟、河、塘水（１９．８０％）、浅水并（１２．６７％）,混和水（１０．０６％）和简易自来水（５．９２％）,饮用以深井为主的简易自来水的改水地区腹泻病发病率显著低于非改水地区。用Ｌｏｇｉｓｔｉｃ回归分析筛选出腹泻病的影响因素是厕所类型（ＯＲ ３．６５２ Ｐ＜０．０１）、饮水类型（ＯＲ ２．４４６ Ｐ＜０．０１）、冷饮（ＯＲ１．３０ Ｐ＜０．０１）、砧板（ＯＲ１．３５６ Ｐ＜０．０１）、聚餐（ＯＲ１．１９７Ｐ＜０．０１）和凉拌菜（ＯＲ　１．１８４ Ｐ＜０．０１）等,控制混杂因素后,归因于饮用非自来水的ＡＲ％为５９．１％,表明改建以深井为主的简易自来水可降低５９．１％的腹泻病人。     

江苏省集中式供水卫生监督管理现状

为全面了解我省集中式供水单位卫生监督管理的基本情况,我们对 １９９８年度全省 １３个市的市、县、乡和村级水厂进行了调查,结果表明：乡、村两级水厂未受到有效监督和管理,其卫生许可证持证率、自检能力、消毒剂和净水剂应用、对水源水和末梢水的监测率都明显低于市级水厂（Ｐ＜０．０１）。全省水厂消毒问题较突出,乡、村级水厂消毒率仅为５１．９％、５．７％,全省以地下水为水源的水厂消毒率仅１９．５％;全省乡和村级水厂出厂水余氯达标率分别为５７．１％、２０．７％,末梢水分别为５７．４％、２２．４％。加强对乡、村两级水厂的监督管理显得十分重要。     

简易鼻塞式CPAP治疗新生儿呼吸衰竭50例

目的：探讨简易鼻塞式持续呼吸道正压给氧对新生儿呼吸衰竭的治疗效果。方法：对５０例新生儿呼吸衰竭应用简易鼻塞式持续呼吸道正压给氧,并与４０例对照组进行比较。结果：治疗组治愈率为５２％;死亡率为２１％;对照组治愈率为２０％,死亡率为６７５％。两组比较Ｐ＜００１有极显著差异。结论：简易鼻塞式持续呼吸道正压给氧是基层治疗新生儿呼吸衰竭的最有效的方法,值得推广。     

Dietary Restriction Reduces the Prevalence of Osteonecrosis of the Caput Femoris in Spontaneously Hypertensive Rats

We investigated the effects of dietary restriction (DR), an experimental intervention known to suppress several strain-specific diseases, on the prevalence of osteonecrosis of the caput femoris in spontaneously hypertensive rats (SHR). At 6 weeks of age, the food intake of DR rats was restricted to 65% of the mean intake of control rats fed ad libitum (AL). Acute osteonecrosis of the caput femoris without reparative tissue response (RTR) was observed at 10 and 15 weeks in both DR and AL groups; no such acute lesion was seen at 20 and 30 weeks. The prevalence of osteonecrosis, osteonecrosis with/without reparative tissue response was significantly reduced in DR rats at 15 and 20 weeks, but not at 10 weeks. DR reduced the body weight by 30% and the length of the femur by 10%. Ossification of the caput femoris, known to be delayed in AL rats compared with Wistar Kyoto rats, was also restored by DR. Our results showed that dietary restriction reduced the prevalence of osteonecrosis and modulated the mechanical factors involved in the lesion. They also indicate that utilization of dietary restriction is a useful research tool for investigating the underlying mechanisms of osteonecrosis of the caput femoris in SHR. Received: 4 March 1997 / Accepted: 9 July 1998     

Correlation of heterogeneous blood flow and fatty acid uptake in the normal dog heart

Summary Blood flow heterogeneity in normal myocardium may be caused by heterogeneous metabolic demand. We studied, from 80 tissue samples of the left ventricle (LV) of eight anesthetised, open-chest dogs (with prior -blockade (metoprolol) in four dogs), the radioactivity of²⁰¹Thalliumchloride (²⁰¹Tl), an indicator of blood flow, and of the fatty acid¹³¹-Iodine-heptadecanoic acid (¹³¹I-HDA), an indicator of metabolic demand, 3 min after intravenous injection. Global LV uptake (in percent of injected dose ×10^–2, per g tissue; mean ±SD) was 4.94±0.71 for²⁰¹Tl and 4.48±0.58 for¹³¹I-HDA in the dogs without -blockade, and 2.08±0.26 and 1.69±0.20, respectively, in dogs with -blockade (p<0.05). Beta-blockade thus decreased the fraction of cardiac output delivered to the LV, concurrently with a decreased heart rate and arterial blood pressure (p<0.05) and, thus, global metabolic demand and fatty acid uptake. Regional radioactivities per gram were normalized for mean LV radioactivities and heterogeneity was expressed as the coefficient of variation (CV). For pooled data (n=320) in dogs without -blockade, regional²⁰¹Tl and¹³¹I-HDA radioactivities varied from a factor of 0.1 to 1.6 and 0.3 to 1.8 of mean radioactivities, with a CV of 22.9 and 19.4%, respectively, and correlated (r=0.77, p<0.005). For pooled data (n=320) in dogs with -blockade, regional²⁰¹Tl and¹³¹I-HDA radioactivities varied from a factor of 0.2 to 1.5 and 0.2 to 1.6 of mean radioactivity and CV was 23.6% and 24.8%, respectively: r=0.92 (p<0.005). The endo/epi ratio for both radioactivities exceeded unity in each dog. In normal myocardium, blood flow and fatty acid uptake are thus heterogeneous, both transmurally and circumferentially, and matched, concomitantly with coupling of global blood flow to global metabolic demand and fatty acid uptake. This supports the idea that heterogeneous myocardial O₂ supply reflects heterogeneous metabolic demand.     

Failure to find a relationship between mnestic skills of octogenarians and aluminum in drinking water

Summary High concentrations of aluminum (>80 g/l) in drinking water have been related to an elevated incidence of Alzheimer's disease. Mnestic and naming skills of residents living for >15 years in districts with high (98 g/l) or low (4 g/l) aluminum concentrations [Al] in the drinking water were evaluated in a population survey by examining 800 residents aged 81 to 85 using the mnestic subtest of the Mini Mental Status test (Zurich variant). The mnestic and naming performance of the octogenarians did not differ between the high- and low-content-areas. Since 73% of dementias are at least partly caused by Alzheimer's disease in the area examined and because the short test used discriminates demented from healthy octagenarians as well as tests involving extensive examinations, the findings of this study suggest with a high probability that the [Al] of drinking water is not an essential factor in the pathogenesis of senile dementia. The serum [Al] the urinary [Al] and the urinary [Al]/creatinine ratio were measured twice in ten clinically diagnosed Alzheimer patients and ten controls in both areas. No significant difference was found, which confirms the negative epidemiological findings.Parts of this study were presented at the joint meeting of the Swedish and Swiss Neurological Association in Interlaken, Switzerland, on May 22, 1990     

H1 and H2 receptor antagonists and hepatic oxygen supply-demand relationship in pigs

The hypothesis that histamine receptor (H1 and H2) blockade beneficially affects the hepatic oxygen supply-demand relationship was tested during experiments performed on 13 miniature pigs. Hepatic arterial and portal blood flows were measured with electromagnetic flowmeters. Cardiac output was determined by thermodilution. H1 and H2 receptor blockade was achieved with promethazine, 5 mg.kg-1 and cimetidine 30 mg.kg-1 IV, respectively. The study demonstrated no significant effect of H1 and H2 receptor blockade on hepatic oxygen uptake and no noticeable effects of cimetidine on hepatic circulation. However, promethazine decreased total hepatic blood flow, primarily by decreasing portal blood flow; this resulted in an increase in oxygen extraction as reflected in a decreased oxygen content in hepatic venous blood. The results reject the posed hypothesis: H1 receptor antagonist promethazine decreased, while H2 receptor antagonist cimetidine did not affect hepatic blood flow and oxygen supply; hepatic oxygen demand remained unaffected during H1 and H2 receptor blockade.     

Bone involvement pattern in hypervascular lesions

The pattern of the focal bone lesion which consists partly or wholly of rounded holes with comparatively smooth edges is discussed.Twenty-two bone lesions were studied by angiography. The hypervascular pattern occurred in five cases of widely different histology, all with strong intraosseous hypervascularity. Different pathogenic mechanisms in the creation of this pattern are discussed. It is probably the result of both destructive and reparative processes in the bone.