兔激素性股骨头坏死的血液流变学改变

目的　探讨血液流变学指标在激素性股骨头坏死过程中的变化规律及其作用。方法　20只兔随机分成2组，每组10只。A组（激素性股骨头坏死动物模型组）：间隔24h耳缘静脉内2次注射大肠杆菌内毒素，每次40μg/kg，注射内毒素后注射醋酸泼尼松龙20mg/kg。B组（正常对照组）。两组分别在注射后24h、72h、7d、14d 及21d，进行血浆黏度、全血黏度、血小板计数及血脂测定，21d取股骨头和肝脏行病理组织学观察。结果　A组用药后24h血浆黏度、全血黏度升高，血脂升高(P<0.01)血小板计数减少(P<0.01)，用药后72h、7d、14d 及21d，持续异常，与B组相比差异显著。A组21d时病理切片见股骨头骨细胞和肝细胞变性、坏死。结论　在激素性股骨头坏死动物模型中，血液流变学指标异常在引起血栓前状态，形成血栓导致骨坏死过程中可能发挥了重要作用。     

高温致神经管畸形动物模型的建立及其形态发生的研究

将妊娠第８ｄ的金黄地鼠腹部置４２℃水浴２０ｍｉｎ，建立了一个致畸率高、致死率低、效果稳定、操作简便的高温致畸动物模型，并在此模型上，探讨了高温致ＮＴＤ的形态发生机理。结果表明：高温有明显的胚胎毒和致畸作用，且与高温值和持续时间明显相关。     

幼儿攻击性行为游戏矫正的倒返设计研究

目的：探讨幼儿集体游戏用于矫正幼儿攻击性行为的效果。方法：采用倒返实验，对三名被试进行了游戏矫正。结果：三名被试在实验的基线阶段有明显的攻击性行为，游戏介入后攻击性行为明显减少，游戏取消后攻击性行为再度增加，游戏再次介入后，攻击性行为再次明显减少；方差检验的结果表明，被试在基线阶段的攻击性行为与游戏矫正后的攻击性行为差异极显著。结论：运用自然的幼儿集体游戏可以矫正幼儿的攻击性行为。     

呼吸功能不全综合实验改革的探索

目的:为了探索如何在一次教学实验中将生理学、病理生理学和药理学三个机能学科的实验有机地结合起来, 形成综合性实验以培养学生的综合思维和实验研究能力。方法:在病理生理学的呼吸功能不全实验的基础上, 增加了呼吸的生理调节和不同类型的呼吸衰竭采用不同的针对性药物治疗, 并且采用启发式教学方法。结果:学生学习兴趣明显提高, 学生不仅学到了更多的研究方法, 而且综合分析和科研创新能力都有明显提高。结论:这种改进明显提高了实验课的教学水平和教学质量。     

关于头部组织材料性能敏感性对颅内压力响应的研究

应用有限元法 (finiteelementmethod)和试验设计技术 (design of experimentDOE)研究人头部颅骨(skull)、脑脊液 (cerebral spinal fluidCSF)和脑髓 (brain)材料性能的敏感性对颅内因撞击而产生的压力响应。该研究采用头部的有限元模型 ,用三因子、三层次的因子试验设计对影响颅内因撞击而引起的压力的颅骨、脑脊液和脑髓的材料性质的敏感性进行分析。研究结果进一步证实了颅骨、脑脊液、脑髓的材料性能对颅内因撞击而引起的压力的重要影响。本研究为进一步的头部的有限元分析提供了新的见解 ,并提出了对头部组织的材料性能作更进一步的探索。     

Assessing the Effectiveness of Front of Pack Labels: Findings from an Online Randomised-Controlled Experiment in a Representative British Sample

Front of pack food labels (FOPLs) provide accessible nutritional information to guide consumer choice. Using an online experiment with a large representative British sample, we aimed to examine whether FOPLs improve participants’ ability to identify the healthiness of foods and drinks. The primary aim was to compare ability to rank between FOPL groups and a no label control. Adults (≥18 years), recruited from the NatCen panel, were randomised to one of five experimental groups (Multiple Traffic Light, MTL; Nutri-Score, N-S; Warning Label, WL; Positive Choice tick, PC; no label control). Stratification variables were year of recruitment to panel, sex, age, government office region, and household income. Packaging images were created for three versions, varying in healthiness, of six food and drink products (pizza, drinks, cakes, crisps, yoghurts, breakfast cereals). Participants were asked to rank the three product images in order of healthiness. Ranking was completed on a single occasion and comprised a baseline measure (with no FOPL), and a follow-up measure including the FOPL as per each participant’s experimental group. The primary outcome was the ability to accurately rank product healthiness (all products ranked correctly vs. any incorrect). In 2020, 4504 participants had complete data and were included in the analysis. The probability of correct ranking at follow-up, and improving between baseline and follow-up, was significantly greater across all products for the N-S, MTL and WL groups, compared to control. This was seen for only some of the products for the PC group. The largest effects were seen for N-S, followed by MTL. These analyses were adjusted for stratification variables, ethnicity, education, household composition, food shopping responsibility, and current FOPL use. Exploratory analyses showed a tendency for participants with higher compared to lower education to rank products more accurately. Conclusions: All FOPLs were effective at improving participants’ ability to correctly rank products according to healthiness in this large representative British sample, with the largest effects seen for N-S, followed by MTL.     

Nurse Decision-making for Suspected Urinary Tract Infections in Nursing Homes: Potential Targets to Reduce Antibiotic Overuse

ObjectivesTo determine what information is most important to registered nurses' (RNs) decisions to call clinicians about suspected urinary tract infections (UTIs) in nursing home residents.DesignWeb-based discrete choice experiment with 19 clinical scenarios.Setting and ParticipantsOnline survey with a convenience sample of RNs (N = 881) recruited from a health care research panel.MethodsClinical scenarios used information from 10 categories of resident characteristics: UTI risk, resident type, functional status, mental status, lower urinary tract status, body temperature, physical examination, urinalysis, antibiotic request, and goals of care. Participants were randomized into 2 deliberation conditions (self-paced, n = 437 and forced deliberation, n = 444). The degree to which evidence- and non–evidence-based information was important to decision-making was estimated using unconditional multinomial logistic regression.ResultsFor all nurses (22.8%) and the self-paced group (24.1%), lower urinary tract status had the highest importance scores for the decision to call a clinician about a suspected UTI. For the forced-deliberation group, body temperature was most important (23.7%), and lower urinary tract status was less important (21%, P = .001). The information associated with the highest odds of an RN calling about a suspected UTI was painful or difficult urination [odds ratio (OR) 4.85, 95% confidence interval (CI) 4.16–5.65], obvious blood in urine (OR 4.66, 95% CI 3.99–5.44), and temperature at 101.5° (OR 3.80, 95% CI 3.28–4.42). For the self-paced group, painful or difficult urination (OR 5.65, 95% CI 4.53–7.04) had the highest odds, whereas obvious blood in urine (OR 4.39, 95% CI 3.53–5.47) had highest odds for the forced-deliberation group.Conclusions and ImplicationsThis study highlighted the importance of specific resident characteristics in nurse decision-making about suspected UTIs. Future antimicrobial stewardship efforts should aim to not only improve the previously studied overprescribing practices of clinicians, but to improve nurses' assessment of signs and symptoms of potential infections and how they weigh resident information.     

正常分娩综合性实验在产科护理教学中的应用研究

目的探讨在产科护理教学中应用正常分娩综合性实验教学取得的效果研究。方法选取2018年9月—2019年6月在该院实习120名护理本科生作为研究对象,依据奇数偶数分配原则分为两组,其中对照组60名学生进行常规的消毒操作和外阴清洁考核,观察组的60名学生应用正常分娩综合性实验进行考核,对比两组学生护理技能测试成绩以及取得的教学效果。结果观察组优良率(98.33%)高于对照组(88.33%),差异有统计学意义(P<0.05);观察组团队协作能力、学习兴趣、解决问题能力、沟通能力及操作能力评分高于对照组,差异有统计学意义(P<0.05)。结论产科护理教学中应用正常分娩综合性实验教学取得的效果显著,能提升教学成绩,让实习护理本科生更快掌握护理技巧,为医院输送优质护理人才,能缓解产科护理人员缺乏的现象,正常分娩综合性实验教学方案值得应用。     

板兰根冲剂致药疹1例

1　病例介绍患者冯某,男,18岁,入院前4天因自觉咽喉疼痛,遂自服“板兰根冲剂(北京同仁堂制药二厂生产)2包。因药后症状未缓解,也未再服用。入院前1日在腹部出现红色细小斑丘疹,微痒,未予重视。夜间皮疹逐渐增多,泛发全身,尤以面部、胸腹部为多,自觉瘙痒,伴见口苦咽痛,便干尿黄,纳差,眠差,舌质红苔黄,脉弦数。于1998年9月26日入院。查体:神差懒言,咽部充血(),心肺无异常。T:37.7℃,R:17次/分。皮肤科检查:全身泛发鲜红色斑丘疹,针尖至米粒大小,密集成片,皮疹尤以面部、胸腹部为多,皮温高。血常规检查示:白细胞15.4×109/L,中性36%,淋巴64%…     

补肾健脾方药对卵巢切除大鼠骨密度、骨矿含量影响的实验研究

为探讨补肾健脾方药对卵巢切除大鼠骨密度、骨矿含量的影响,取10月龄SD雌性大鼠40只,随机分为模型组、正常对照组、E3阳性对照组、中药组,每组10只,正常对照组行假手术,其余3组行完整双侧卵巢除术。术后第3天开始灌胃给药,连续用药满12周后处死,分离L3腰椎体及左侧股骨,进行骨矿密度、骨矿含量、表观骨密度测定。结果显示补肾健脾方药能明显维持切除卵巢大鼠椎体及股骨的骨矿密度、骨矿含量和表观密度。