药学专业六年制学-硕连读培养模式探索

以新的视角、新的思维、新的观念来审视未来高等药学教育发展的趋势 ,建立新的药学教育观、人才观和质量观 ,这是新世纪对高等药学教育提出的更高要求。根据药学学科最新进展、发展趋势及国内外药学教育的发展动向 ,阐述了北京大学药学院药学专业六年一贯制 ,学 -硕连读研究型人才的培养目标及方案     

三氯乙烯诱发SD大鼠产生免疫反应的模型研究

目的研究SD大鼠对三氯乙烯(trichloroethylene,TCE)免疫刺激的反应,拟建立大鼠对TCE免疫反应的模型.方法背部皮内注射体积分数为15%的TCE免疫SD大鼠,1周1次,免疫5次后于大鼠左后足跖膜下注射TCE攻击,6h称左右后足重量计算肿胀度.取TCE免疫大鼠心脏血,分离并培养单个核细胞.将培养的细胞与系列浓度的TCE共同培养2d后,检测细胞酸性磷酸酶的活性,据此判断细胞的活化增殖程度.结果 TCE免疫大鼠攻击足肿胀度与空白对照组大鼠的相比差异显著(P＜0.005).体积分数为3%的TCE可使培养的大鼠血单个核细胞的增殖达到峰值.结论重复皮内注射TCE可使SD大鼠产生某种免疫反应.SD大鼠的单个核细胞可被TCE刺激活化.     

肝爽颗粒对慢性乙型肝炎肝纤维化（S1和S2期）肝郁脾虚兼血瘀证的早期防治疗效

目的 探讨肝爽颗粒用于慢性乙型肝炎（CHB）肝纤维化（S1和S2期）肝郁脾虚兼血瘀证的防治效果。方法 将100例患者采用数字表法分为对照组（50例，脱失4例，剔除2例，最后完成44例）和观察组（50例，脱失5例，剔除2例，最后完成43例）。两组患者均给予口服恩替卡韦片，0.5 mg/次，1次/d，共12个月；并视情况口服谷胱甘肽片。对照组，口服肝爽颗粒模拟药，3 g/次，3次/d；观察组，口服肝爽颗粒，3 g/次，3次/d；共治疗12个月。进行肝穿刺病理检查，比较两组患者炎性活动度分级及纤维化程度分期情况；比较两组患者肝脏硬度值（LSM）、肝功能、乙型肝炎病毒（HBV） DNA、肝郁脾虚证评分、天冬氨酸氨基转移酶（AST）与血小板比值指数（APRI）和基于4因子的纤维化指数（FIB-4）。结果 治疗后，与对照组比较，观察组患者肝组织纤维化程度分期轻于对照组（P<0.05）；观察组患者肝组织炎性活动程度轻于对照组（P<0.05）；观察组患者炎性活动程度分级有效率为77.78%，高于对照组的45.83%（χ²=5.546，P<0.05）；观察组纤维化程度分期有效率为59.26%，高于对照组的16.67%（χ²=9.669，P<0.01）；观察组在治疗后6个月、12个月的LSM和肝郁脾虚证评分均低于对照组（P<0.05，P<0.01）；观察组患者丙氨酸氨基转移酶（ALT）、AST、碱性磷酸酶（ALP）水平低于对照组（P<0.01）；观察组APRI和FIB-4水平低于对照组（P<0.01）。结论 肝爽颗粒联合恩替卡韦用于CHB肝纤维化（S1和S2期）的防治，可减轻炎症活动情况和纤维化程度，能延缓而且具有逆转肝纤维化的作用，并具有保肝和改善中医证候的效果，值得临床使用与进一步的研究。     

Leadership in Gerontological Nursing

Leadership in gerontological nursing demands from the nurse an understanding of the social, political and health care systems which impinge upon the client and the profession. A theoretical perspective of conflict and power is used to explain the impact of scarce resources, a major problem in the health care environment of the eighties. Conflict management and power employment are seen as requisite tools for effective leadership. Suggestions for reshaping existing gerontological nursing practice, nursing research and educational patterns are offered. New modes of health care delivery can be established by gerontological nurses that focus on the provision of cost effective, quality health care.     

Stromal vascular fraction improves deep partial thickness burn wound healing

ObjectiveThe practice of early burn wound excision and wound closure by immediate autologous skin or skin substitutes is the preferred treatment in extensive deep partial and full-thickness burns. To date there is no proven definite medical treatment to decrease burn wound size and accelerate burn wound healing in modern clinical practice. Stromal vascular fraction is an autologous mixture that has multiple proven beneficial effects on different kinds of wounds. In our study, we investigated the effects of stromal vascular fraction on deep partial-thickness burn wound healing.MethodsIn this study, 20 Wistar albino rats were used. Inguinal adipose tissue of the rats was surgically removed and stromal vascular fraction was isolated. Thereafter, deep second-degree burns were performed on the back of the rats by hot water. The rats were divided into two groups in a randomized fashion. The therapy group received stromal vascular fraction, whereas the control group received only physiologic serum by intradermal injection. Assessment of the burn wound healing between the groups was carried out by histopathologic and immuno-histochemical data.ResultsStromal vascular fraction increased vascular endothelial growth factor, proliferating cell nuclear antigen index, and reduced inflammation of the burn wound. Furthermore, vascularization and fibroblastic activity were achieved earlier and observed to be at higher levels in the stromal vascular fraction group.ConclusionsStromal vascular fraction improves burn wound healing by increasing cell proliferation and vascularization, reducing inflammation, and increasing fibroblastic activity.     

探讨无保护会阴接生法与传统接生法对会阴裂伤程度的效果比较

目的探讨无保护会阴接生法与传统接生法对会阴裂伤程度的效果比较。方法选取我院2013年11月~2014年3月间接收的516例临产妇作为观察对象,随机分为观察组和对照组各258例,观察组采取无保护会阴接生法,对照组采用传统接生法,比较两组产妇会阴裂伤程度。结果对照组产妇的会阴裂伤程度明显比观察组严重,比较有明显差异,P0.05。结论无保护会阴接生法相对于传统接生法能够明显降低产妇的会阴撕裂程度。     

A Comparative Study of Paediatric Thermal Burns Treated with Topical Heparin and Without Heparin

Following reports of heparin use in burn treatment, an ethics-committee-approved prospective randomized study with controls compared results obtained using traditional usual burn treatment without heparin with results in similar patients similarly treated with heparin added topically. The subjects were 100 consecutive burn patients (age <15 years) with second-degree superficial and deep burns of 5–45 % total body surface area size. Two largely similar cohort groups—a control group (C) and a heparin group (H) with 50 subjects per group—were randomly treated. The 50 control group patients received traditional routine treatment, including topical antimicrobial cream, debridement, and, when needed, skin grafts in the early postburn period. The 50 heparin group patients, without topical cream, were additionally treated, starting on day 1 postburn, with 200 IU/ml sodium aqueous heparin solution USP (heparin) dripped on the burn surfaces and inserted into the blisters two to four times a day for 1–2 days, and then only on burn surfaces for a total of 5–7 days, before skin grafting, when needed. Thereafter, control and heparin group treatment was similar. It was found that the heparin patients complained of less pain and received less pain medicine than the control patients. The heparin group needed fewer dressings and oral antibiotics than the control group. The 50 heparin group patients had 4 skin graftings (8 %), while the 50 control group patients had 10 (20 %). Five control group patients died (mortality 10 %). No heparin group patients died. The number of days in hospital for the heparin group versus control group was significantly less (overall P < 0.0001): 58 % of heparin group patients were discharged within 10 days versus 6 % of control group patients; 82 % of heparin group patients were out in 20 days versus 14 % of control group patients; 98 % of the heparin group versus 44 % of the control group were out in 30 days; and while 100 % of heparin group patients were discharged by day 40, 56 % of the control group required up to another 10 days. Burns in heparin group patients healed on average in 15 days (maximum period 37 days) versus an average of 25 days (maximum >48 days) in control group patients (P < 0.0006). Procedures and costs in the heparin group were much reduced compared with the control group. Differences between the heparin and control groups are presented for the sake of comparison. It was concluded that heparin applied topically for 5–7 days improved burn treatment: it reduced pain, pain medicine, dressings, and use of antibiotics; it significantly reduced IV fluids (P < 0.04), days in hospital (P < 0.0001), and healing time (P < 0.0006); and it reduced skin grafts, mortality, and costs.     

右美托咪啶联合用药新方案用于重症医学科长时间镇静的研究

目的比较在重症医学科内长时间镇静状态下不同镇静方案的差别，找出较适合长时间镇静的方案。方法选取在我院重症医学科住院的患者80例，随机分为4组，即右美托咪啶持续泵注联合咪达唑仑间断应用组（A组，n=20），右美托咪啶与咪达唑仑联合持续泵注组（B组，n=20），咪达唑仑单独持续泵人组（C组，n=20），右美托咪啶单独持续泵人组（D组，n=20）。镇静目标为肌肉活动评分法（monitor activity assessment scale, MAAS）3分．镇静过程中持续心电监护，监测镇静满意程度，记录4组患者3日用药量变化，并监测患者不良反应发生率。比较4组患者后3种指标的差别。结果A、B两组较C、D两组镇静满意程度显著增高，用药量变化幅度较小，不良反应较少，其中又以A组不良反应为最少，且与B组相比咪达唑仑用药量显著减少。结论右美托眯啶持续泵注联合咪达唑仑间断应用可显著减少长时间镇静所需药物用量．且减少不良反应。     

医院满意度综合测评体系的建立及实施分析

目的:对医院各科室的满意度进行测评,着力提升医院服务品质。方法:通过文献回顾、专家咨询等方法制定测评方案,设计问卷调查表,分别对患者及院内工作人员进行问卷调查。结果:通过每月的问卷调查获得各科室满意度,并与绩效挂钩;及时反馈意见和建议,为改善医疗服务提供依据。结论:建立的医院综合满意度测评体系覆盖医院所有科室,对进一步提高服务质量,全面提升医院的服务意识及管理能力起到积极的推动作用。