维和医疗分队轮换工作的实践

目的:总结维和医疗分队完成联合国驻非洲某国维和卫勤保障部队轮换工作的经验。方法:2004年12月至2005年7月,某部第二批维和医疗分队圆满完成了维和卫勤保障任务。在部队实施跨洲际远程部署到非洲某国后,采取分批次成建制轮换模式,前后分别2次完成维和任务交接。结果:实现了维和卫勤保障与维和任务区各相关部门的密切合作、联军协调、联军行动和连续工作,检验了维和医疗分队战备训练和卫勤保障的实际能力和水平。结论:通过参加联合国维和行动卫勤保障部队的轮换,全面锻炼了部队,适应了未来日益复杂的国际环境和维护国家领土完整和反恐行动的需求,对扎实地做好军事斗争准备具有重要的现实意义。     

维和医疗分队(中国)卫勤保障方案的几个问题

联合国卫勤保障旨在为维和行动提供一个与平时医疗保障体系接轨的医疗保健标准。维和医疗分队（中国）在充分学习和掌握联合国的卫勤保障体系和政策基础上，对影响卫勤保障任务的各类因素进行全面的综合分析，并结合中国军队特点，制订出符合联合国要求的卫勤保障计划。     

维和卫生士官应具备的基本素质

近年来,我军多次向国外成建制派出维和医疗分队,执行联合国赋予的维和卫勤保障任务。卫生士官是维和医疗分队的重要一员,在医护人员的指导下开展医疗护理、卫生防疫、健康教育、战（现）场救护等工作。维和行动任务特殊,对卫生士官各方面素质提出了更高的要求。笔者通过参加维和卫勤保障行动,总结、分析了维和卫生士官应具备的素质,以进一步提高其卫勤保障能力。     

维和二级医院口腔科工作展开和实践

2004年3月，根据联合国的要求，我军向利比里亚派遣了二级医疗分队，为联合国维和人员提供卫勤保障任务。在远离祖国万里之遥的非洲为维和人员提供口腔医疗服务，是我军口腔医疗史上的首次，本文就口腔医疗工作的展开作一探讨。     

维和医疗分队(中国)医疗装备管理和维护经验

中国赴利比里亚维和医疗分队在利比里亚执行着特殊的使命,各类医疗卫生装备对确保维和医疗分队开展各项医疗活动意义重大,它是维和医疗分队开展正常工作的物质基础.维和医疗分队任务区的服务对象是受命于联合国,执行维和任务的外军部队、民事人员及当地居民等.在为这些特殊人群提供医疗服务时,不允许有任何医疗差错,否则就有可能引起医疗纠纷,小则影响维和任务的执行,大则会造成国际影响,正所谓“外交无小事”，在医疗服务上不能有漏洞,更不能因为医疗仪器管理维护与使用上的原因而影响医疗服务质量.因此,必须确保医疗仪器使用的完好率.遵照维和医疗分队（中国）卫勤保障方案总体要求,为加强医疗仪器的管理和维修,结合中国驻利比里亚维和医疗分队自身的工作实际和当地的气候特点,制订了医疗仪器管理办法和维修实施细则.     

中国维和二级医院门诊接诊室配置与工作概况

随着世界和平进程的不断推进，中国越来越多的参与到国际事务中去。中国向联合国各任务国派遣的维和军事分队也在不断增多。本文结合中国首批赴利比里亚维和医疗分队在完全自我保障条件下建制维和二级医院的实际工作情况，对维和二级医院的门诊设施及人员配置，工作内容概况及一些特殊事项进行详细总结。     

情商在维和护理管理中的作用

自2003年4月中国维和医疗分队在刚果(金)维和任务区建立中国第一所维和医院以来,赢得了上至联合国,下至当地百姓的赞誉[1]。但随着维和保障对象对医疗管理和医疗服务质量要求越来越高,医务工作者特别是护理人员面临的工作环境趋向复杂化,其心理压力越来越大,     

维和医疗分队(中国)待命训练实施方案初探

维和待命训练是联合国维和医疗分队形成维和保障能力的重要环节和保证。以《谅解备忘录》和《联合国维和行动训练与考核大纲》为依据，结合维和医疗工作和我军的具体实际，制订切实可行的维和待命训练方案，统筹安排维和医疗分队的待命训练工作。     

赴黎维和医疗分队国内集训经验体会

近年来,随着中国国力的不断增强,中国参与的维和行动日益增多。目前已先后向刚果(金)、利比里亚、苏丹、黎巴嫩等维和任务区派遣了多支维和医疗分队执行卫勤保障任务[1]。2011年8月,本单位受命组建第八批赴黎维和医疗分队,历经2个多月的集训,于10月下旬赴黎执行维和医疗任务。任务期间作者深感维和任务的圆满完成与集训工作的开展有着直     

部队医院卫勤应急保障分队建设问题分析及改进对策

部队医院卫勤应急保障分队（以下简称“分队”）建设是新时期武警部队做好非战争军事行动卫勤准备的重要内容。为进一步加快分队规范化建设,提高分队卫勤应急保障和灾害医疗救援能力,笔者采用问卷调查、实地调研等方法对21个武警总队和机动师医院在分队建设中面临的主要问题或困难进行了调查分析,并提出了相应的改进对策。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.