先天性白内障手术中预防后发障的方法

目的　探讨小儿先天性白内障手术中预防后发障的方法。方法　对 46例 ( 4 6眼 )先天性白内障 ,以白内障超声乳化仪的注吸I/A系统吸净晶状体植入人工晶状体后 ,进行后囊连续环形撕囊及前段玻璃体切除联合手术 (A组 ) ,同期施行的3 2例 ( 3 2眼 )先天性白内障 ,以同样的方法行白内障摘出人工晶状体植入后 ,进行单纯后囊连续环形撕囊术 ,不做前段玻璃体切除 ,作为对照组 (B组 )。术后随访 2年以上。结果　后发障发生的情况 ,A组 2眼 ( 4 4% ) ,B组 7眼 ( 2 1 9% ) ,两组对比差异具有显著性意义 (P <0 0 5 )。两组均未发现眼底并发症。结论　先天性白内障术中行后囊连续环形撕囊联合前段玻璃体切除术 ,是预防后发性白内障的有效方法。     

类风湿性关节炎对绝经后妇女骨质疏松的影响

目的了解类风湿性关节炎（RA）患者骨密度（BMD）的变化和骨质疏松（OP）的发生情况。 方法采用双能X线骨密度仪（DEXA）对40例55～70yr的RA绝经女性患者和60例正常健康绝经女性进行腰椎（L1-4）、左股骨上端（股骨颈、Ward’s三角区、大转子）BMD测定，所得数据进行统计分析。 结果RA组无论腰椎或股骨上端的骨量丢失均较健康对照组有显著性差异（P〈0．05），RA患者BMD明显低于健康对照组，OP患病率达85％。 结论RA患者存在着明显的骨质丢失情况。     

我国公立医疗机构职工岗位工资制度再设计

目的提出我国公立医疗机构职工岗位工资制度的构想。方法查阅国内外公立医疗机构岗位工资制度相关资料．组织专家小组讨论．意向调查卫生从业人员。结果（1）根据9项岗位分配要素得分．建立了16个等级9个级别岗位工资序列．与121个公立医疗机构岗位相对应；（2）利用公务员收入模拟测算岗位工资水平．等级工资从4039.1元到75792.7元不等;（3）初步建立了岗位描述。     

心脏手术后低氧血症

心脏手术后常常发生低氧血症，但常常不引起外科医牛的重视。有些低氧血疗是一过性，对机体不会造成严重影响。但有些低氧血症会明显延长心脏手术后ICU日及平均住院日，增加死亡率。常见原因有心源性、肺源性（包括原有肺的疚病或无肺的基础疾病）。本文就无肺的基础疾病的心脏手术后产生低氧血症的一些情况进行阐述。肺不张、急性肺损伤、心脏手术后隔肌麻痹、手术方式等都是引起心脏手术后低氧血症的常见原因。心脏手术后隔肌麻痹不易诊断。本文就此问题叙述了几种常用方法的利和弊。研究认为在手术早期给予恰当的呼吸末正压及肺活量充气策略可以改善氧合状态。     

Screening for Trauma-Related Sleep Disturbance in Women Admitted for Specialized Inpatient Treatment

Abstract

The authors designed a Sleep Disturbance Screening questionnaire to assist clinicians in disentangling trauma-related factors that contribute to sleep disturbance from other common factors, such as depression. They administered the questionnaire to 129 female psychiatric inpatients, most of whom were treated in a specialty program for trauma-related disorders. Confirmatory and exploratory factor analyses distinguished four sleep disturbance scales, two pertaining to sleep disturbance generally (Insomnia, Hypersomnia) and two pertaining to sleep-related fear (Intrusive, Phobic). Correlations of the sleep disturbance scales with the Childhood Trauma Questionnaire (Bernstein et al., 1994), Impact of Event Scale-Revised (Weiss & Marmar, 1997), Dissociative Experiences Scale (Bernstein & Putnam, 1986), Beck Depression Inventory (Beck & Steer, 1993), and selected scales of the Millon Clinical Multiaxial Inventory (MCMI-III; Millon, 1994) show evidence of convergent and discriminant validity for the Sleep Disturbance Screening. The findings point to the potential diagnostic value of screening for trauma-related sleep disturbance, with the Sleep Disturbance Screening providing a small set of key questions that may be used in psychometric form or incorporated into routine diagnostic clinical interviews.     

Terror Suicide: How Is It Possible?

How it is possible for people who apparently do not suffer from distress or pathology to commit violent, cruel suicides? Based on the distinction between causes for suicide and facilitators of suicide, I contend that terror suicide is based largely on processes that facilitate suicide rather than on personal distress. Under this premise, terror suicides are examined in terms of enthusiastic determination to achieve a goal, ideological rage, glorification of the post self, heavenly rewards, materialistic benefits for families, induced dissociative processes, and linguistic mediation. Also described are the processes and preparations by which the idea of terror suicide and its facilitators are induced. Further, a theoretically inferred profile of the suicide attacker is also suggested.     

感染科住院医师规范化培训的实践与探索

住院医师规范化培训是医学生毕业后教育的重要组成部分,是培养合格的、具有综合素养的青年医师的重要手段。西安交通大学第二附属医院感染科在住院医师规范化培训的实践与探索中,逐步建立了符合专业特点的规培管理体系,包括规培管理梯队、规培实施细则、三阶段评价反馈体系、教学相长双向培训模式、三维评价体系等,旨在以岗位胜任力为导向,从理论知识、临床技能、医学人文素养、科研能力、人际沟通能力,多维度高质量的进行住院医师规范化培训工作。