视神经萎缩的治疗临床研究

目的 探讨视神经萎缩的有效治疗方法。方法 对324例526例眼视神经萎缩患,用胞二磷胆碱、肌苷做球后注射。结果 临床治愈88例,显效261例,进步106眼,有效率86．9％,收到了较满意的效果。结论 胞二磷胆碱、肌苷可通过卵磷脂的合成改善视神经周围的血液循环,刺激和促进视神经纤维的生物修补,从而导致视神经功能的改善和恢复。     

高频电汽化切除并注射THP治疗浅表膀胱癌18例

目的：探讨高频电汽化切除后粘膜下注射及膀胱内灌注抗癌药物治疗浅表膀胱肿瘤的效果。方法：经尿道高频电汽化膀胱肿瘤、肿瘤周围粘膜下和基底部注射盐酸吡柔比星（THP）,术后间断膀胱内灌注THP。结果：本组18例浅表膀胱肿瘤,术中、术后均无输血,无膀胱穿孔,未引起组织坏死。术后随访（6－15）月,未引起骨髓抑制,未见肿瘤复发。结论：此方法操作简单、安全、恢复快,并发症低。粘膜下注射并膀胱内灌注抗癌药物重点部位突出,药液扩散均匀,既可杀灭存留的肿瘤细胞,又对微小癌灶产生毒性作用,对治疗和预防浅表肿瘤复发疗效可靠。     

高校校长办公室工作的思考

院长办公室是学校的重要窗口 ,它的服务态度、工作质量和效率直接影响到学校的形象。校长办公室应不断加强自身建设 ,充分发挥参谋和助手作用 ,着力强化协调综合功能 ,脚踏实地开展督促检查 ,使办公室在沟通上下、协调左右、联系内外的过程中 ,不断提高工作质量 ,提升服务水平 ,真正成为校领导指挥全局、运筹决策的参谋部。     

Efecto sobre el comportamiento de dexmedetomidina como premedicación anestésica en la población pediátrica: Estudio prospectivo observacional

Premedication in the pediatric population is of vital importance to reduce anxiety and facilitate anesthetic induction. Midazolam and ketamine have been used for this purpose, drugs that have shown long-term changes in neurodevelopment. Dexmedetomidine promotes a sedative, analgesic effect and lacks neurotoxic effects, its intranasal application is easy and minimally invasive. We studied the sedative and behavioral effect of intranasal dexmedetomidine 2 mcg/kg in ASA 1 and 2 children for elective surgery. They were evaluated at 10, 20 and 30 minutes of administered, in the separation of the parents and placement of the mask for inhalation induction with behavioral and sedation scores (classified from 1 to 4), we considered acceptable for admission to operating room categories 3 and 4.ResultsThirty patients between 1 and 10 years old were included in the period from September 2017 to April 2018. The sedation score obtained at 30 minutes was acceptable in 46.6% of the patients and the behavior score was in 96% of the cases. In 63% of cases the acceptance of the facial mask placement for inhalation induction was achieved. The procedure was well tolerated in all cases and parents were satisfied in 100% of the cases.     

Successful navigation of late career transitions

The purpose of this educational review was to describe the challenges that may face the anesthesiologist near the end of their career and to propose strategies that will enable the individual to continue to be a productive and valued member of their Department, both clinically and by other contributions.     

基于医务人员视角的远程医疗服务使用意愿和关键问题研究

目的分析我国医务人员远程医疗服务使用意愿和关键问题,以完善远程医疗服务体系。方法2019年10—11月,对福建、海南、河南、湖南、贵州、四川和青海7个省份中已参与过远程医疗的邀请方和受邀方医务人员进行电子问卷调查,主要内容为医务人员对远程医疗的使用意愿、满意度情况和认知评价情况等。通过描述性统计分析和非参数检验,探索不同省份和区域的医务人员继续使用意愿、满意度及存在问题。结果共回收有效问卷1084份,医务人员对所参与远程医疗服务整体满意度为98.62%,继续使用意愿程度为98.25%,且东部和西部省份使用意愿较高。医务人员视角下目前存在的主要问题为:会诊开展和反馈信息不及时,等待时间长;网速偏低,网络信号不稳定、不通畅;系统设备不完善,操作不便捷;无法实现远程查体和全面了解病情以及提供病历资料不规范、不全面、质量差等。结论医务人员对所参与远程医疗服务满意度和使用意愿较高。建议以问题为导向,强化远程医疗基础建设,优化服务流程,提升医务人员参与远程医疗服务积极性。     

COVID-19 vaccination intention and activation among health care system employees: A mixed methods study

BackgroundAchieving high COVID-19 vaccination rates among employees is necessary to prevent outbreaks in health care settings. The goal of the study was to produce actionable and timely evidence about factors underlying the intention and decisions to obtain the COVID-19 vaccine by employees.MethodsThe study was conducted from December 2020 – May 2021 with employees from a VA health care system in Southeastern US. The study used a convergent mixed methods design comprising two main activities: a cross-sectional survey conducted prior to COVID-19 vaccine distribution, and semi-structured interviews conducted 4–6 months after vaccine distribution. Data were collected about participant characteristics, vaccination intention prior to distribution, vaccination decision post-distribution, determinants of vaccination intention and decision, activating factors, sources of information and intervention needs. Data from the survey and interviews were analyzed separately and integrated narratively in the discussion.ResultsPrior to vaccine distribution, 77% of employees wanted to be vaccinated. Post vaccine distribution, we identified 5 distinct decision-making groups: 1) vaccine believers who actively sought vaccination and included those sometimes described as “immunization advocates”, 2) go along to get along (GATGA) individuals who got vaccinated but did not actively seek it, 3) cautious acceptors who got the COVID-19 vaccine after some delay, 4) fence sitters who remained uncertain about getting vaccinated, and 5) vaccine refusers who actively rejected the COVID-19 vaccine. Participants identifying with Black or multiple races were more likely to express hesitancy in their vaccination intention.ConclusionThe findings of our study highlight distinct decision-making profiles associated with COVID-19 vaccination among employees of a VA health care system, and provide tailored recommendations to reduce vaccine hesitancy in this population.     

Effects of centrally administered neuropeptide Y (NPY) and NPY13–36 on the brain monoaminergic systems of the rat

Summary The effects of centrally administered NPY on the brain monoamine systems were investigated in the rat. Neuropeptide Y (0.2–5.0 nmol), its C-terminal 13–36 amino acid (a.a.) fragment, NPY_13–36 (0.4–10.0 nmol), or saline were injected into the right lateral cerebral ventricle of unrestrained rats. After l h the animals were decapitated, and the brains were taken out. Two cortical regions (frontal and parietal), the striatum, the hypothalamus, and the brain stem were dissected out. The tissue contents of noradrenaline (NA), dopamine (DA) and serotonin (5-HT), as well as of their major metabolites, 3-methoxy-4-hydroxy-phenylethylené glycol (MHPG), 3,4-dihydroxyphenylacetic acid (DOPAC) and 5-hydroxy-indole acetic acid (5-HIAA) were measured. The most consistent finding was a dose-related increase of both DA and DOPAC levels after treatment with NPY. This effect was reproduced by NPY_13–36 in cortical tissue, whereas, in the sub-cortical regions, NPY_13–36 only reproduced the effects of NPY on the DOPAC levels. Less consistent effects were found on the NA systems, in which NA levels showed a tendency to increase following low, and decrease after high doses of NPY. These effects were largely reproduced by NPY_13–36. In addition, NPY increased tissue levels of MHPG in frontal cortical tissue in a dose-related manner. The brain 5-HT systems were not affected.