案例教学法在消化内科见习课的应用效果评价

目的探讨案例教学法在消化内科见习课的教学效果和体会。方法选取2017年10月—2017年12月在消化内科进行见习课的2015级39-40班护理本科学生44例(全部为女生),抓阄分成对照组(22人)和试验组(22人),对照组给予传统的带教方法,试验组给予案例教学法教学,比较两组护生在理论、技能、综合能力和对带教满意度方面有无差异。两组学生在性别、年龄、专业前的课程成绩比较,差异无统计学意义(均P>0.05)。结果观察组在理论考核成绩、操作考核成绩、教学满意度等方面均高于对照组。结论案例教学法能提高护理教学的教学效果,增加学生的理论、操作能力,提高护理临床思维能力,提升学生的学习主动性和积极性。     

Epidemiology of Musculoskeletal Symptoms Among Milkers and Dairy Farm Characteristics in Sweden and Germany

International studies have shown that musculoskeletal symptoms (MSS) and disorders (MSD) are common among dairy farm milkers. Although dairy production is diverse, it has so far not been possible to explain the high risk by production parameters. Two national studies carried out under similar conditions were the incentive to merge the data and increase the sample size. The Standardized Nordic Questionnaire was used to assess MSS prevalence among 92 Swedish and 116 German male and female milkers. Eighty-four percent and 85% of the Swedish and German milkers reported MSS in at least one body part. Highest prevalence was reported in the lower back, shoulder, and neck. Females showed a significantly higher risk of MSS. Apart from that, small significant influence of MSS was found for other risk factors. These findings indicate that technical and organizational modifications of the work place design in milking parlors are needed.     

不同海拔高原官兵亚健康状态的调查研究

目的：调查研究不同海拔高度官兵的亚健康状态。方法抽取4种海拔(1500、3700、5380、5390 m)的高原边防和后勤官兵共344名，进行康奈尔健康量表测评。测评结果建立数据库，用SPSS 17.0进行数据分析，测量相关数据的前后变化。结果数据结果显示不同海拔高度的官兵健康状况随海拔高度的变化存在差异，而高原边防和后勤官兵的整体健康状况差异不大。结论高原官兵要改善亚健康状态，应该从思想教育，心理调整和保障制度等多方面着手，切实保障官兵健康和提高部队战斗力。     

易筋经与核心稳定性训练的比较分析

对易筋经与核心稳定性训练的锻炼方式及作用效果的研究进行比较分析。从两者的训练状态及对形体、呼吸、意识的调节方式入手,并结合其在增强肌力、提高平衡力、预防运动损伤方面所起的共同疗效进行深入思考,探讨易筋经锻炼可能对人体核心稳定性的影响,为进一步研究易筋经的作用机制提供理论依据。     

Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery: Diagnoses and Surgical Results in 12 Pediatric Patients

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital condition. It responds well to early diagnosis and treatment, but otherwise the prognosis is poor. We present our case series of 12 patients (mean age, 2 ± 2.58 yr; age range, 2 mo–8 yr), emphasizing the diagnostic process and discussing our surgical results. The diagnosis of ALCAPA should be suspected in infants who have dilated cardiomyopathy with electrocardiographic changes that suggest ischemia, and in older children who have isolated mitral regurgitation. When clinical suspicion is high, the results of 2-dimensional echocardiography combined with color-flow Doppler studies in expert hands can establish the diagnosis, thus avoiding angiography in critically ill infants. The treatment of choice in our patients was transfer and reimplantation of the left coronary artery onto the ascending aorta. There were 2 deaths: both were infants in extremis who underwent emergency surgery. An older child with severe ventricular dysfunction was given mechanical ventricular assistance and then heart transplantation. As of this report, all 10 survivors remained well and asymptomatic.     

A comparison of the relationships between psychosocial factors,occupational strain,and work ability among 4 ethnic teacher groups in China

The present study compared the level of occupational strain and work ability among Han, Hui, Uygur, Hui, and Kazakh teachers, and explored ethnic differences based on the associations of psychosocial factors at work, occupational strain, and work ability. A cross-sectional survey was conducted among 2,941 teachers in primary and secondary schools in Xinjiang Province, China. Psychosocial factors, occupational strain, and work ability were measured using the Occupation Stress Inventory—Revised Edition (OSI-R) and Work Ability Index. Han and Hui teachers experienced reduced work ability compared with Uygur and Kazakh teachers, and this finding was caused, in part, by exposure to psychosocial factors at work. The vocational and psychological strains caused by these factors play an important role in reduced work ability among all ethnic teacher groups. The findings indicate the importance of taking action to reduce occupational strain for promoting teachers' work ability in multiethnic workplaces.     

An open‐label phase I/II study of cyclophosphamide,bortezomib, pegylated liposomal doxorubicin,and dexamethasone in newly diagnosed myeloma

We conducted a phase 1/2 trial evaluating the combination of cyclophosphamide, bortezomib, pegylated liposomal doxorubicin, and dexamethasone (CVDD) for newly diagnosed multiple myeloma (MM). The primary objective of the phase 1 was to evaluate the safety and tolerability of maximum planned dose (MPD) and the phase 2 was to assess the overall response rate. Patients received 6–8 cycles of CVDD at four dose levels. There were no dose‐limiting toxicities. The MPD was cyclophosphamide 750 mg/m² IV on day 1, bortezomib 1.3 mg/m² IV on days 1, 4, 8, 11, pegylated liposomal doxorubicin 30 mg/m² IV on day 4, and dexamethasone 20 mg orally on the day of and after bortezomib (21‐d cycle). Forty‐nine patients were treated at the MPD of which 22% had high‐risk myeloma. The most common grade ≥3 toxicities included myelosuppression, infection, and fatigue. Overall response and complete response rates were 91% and 26% in standard‐risk, and 100% and 58% in high‐risk cohort, respectively. After a median follow‐up of 34 months, the median progression‐free survival was 31.3 months. The 2‐yr overall survival was 91.1% in the standard‐risk and 88.9% in the high‐risk cohort, respectively. CVDD regimen was well tolerated and was highly active in newly diagnosed MM.