运用激励机制 加强聘用护士的管理

随着军队编制体制改革的深入，聘用护士逐渐成为军队医院临床护理队伍的重要组成部分，是护理队伍建设和发展的主要力量，其整体素质决定着医院护理水平的高低。我院目前聘用护士已占全院护士总数的51．4％。在近4年的护理管理工作实践中，我们合理应用不同的激励机制，充分调动聘用护士的积极性，激发其内在潜力，大大提高了聘用护士的工作绩效，推动了医院整体护理质量的提高。     

军队医院对非军人护士实施有效管理的几点体会

随着军队医院编制改革逐步深入，护理队伍成分已发生了较大的变化，部队医院聘用非军人护士缓解护理人员的不足已具有普遍性，在聘用护士愈来愈成为医院护理队伍主体的今天，也给护理管理带来了需要探讨的新课题。作者结合工作实践，就如何加强对聘用护士的有效管理谈几点体会。     

浅析聘用护士的现状与管理

目的:建立完善聘用护士管理制度和体制,稳定护理队伍,提高医院护理质量.方法:总结2006～ 2011年医院聘用护士现状,管理采取的措施.结果:聘用护士学历低、素质不平衡；临床实践较少、应急能力不强；待遇不公正、稳定性差.结论:聘用护士的管理已成为医院管理的重要组成部分,聘用护士的专业素质和护理队伍的稳定,关系着医院整体护理的质量.     

坚持以人为本规范聘用护士管理

随着军队医院编制护理人员数量的不断减少，大量聘用地方护士已成为医院补充护理力量，缓解护理人员不足的重要手段。我院自1986—2005年共聘用护士160余人，现有聘用护士51人，占全院护士的84％。近年来，医院不断改善她们的政治生活待遇和工作学习环境，使聘用人员队伍思想稳定，工作安心，在医院建设中发挥着重要作用。[第一段]     

新形势下军队医院聘用护士所面临的问题及对策

近年来，随着部队精简整编政策的不断深入，军队医院中军人护士编制大幅度减少，而科室展开床位逐渐增加，军队医院大量聘用合同护士已成为一种必然趋势。聘用护士为军队医院弥补人力不足，顺利完成医疗、科研、教学发挥了很大作用，并逐渐成为军队医院护理队伍的重要组成部分。以我科为例，聘用人员常年在60．0％以上，且还在不断增加。但是，     

非现役文职护士培训需求及效果调查

随着军队用人体制的改革，军队医院的护理队伍发展呈现多元化格局。非现役文职护士成为继军人护士、聘用护士之后的新生力量，并成为新编制中的主体。加强文职人员队伍建设，探索科学培训方案，使其适应新时期军队医院发展的需要，从而在平战时发挥中坚力量的作用，是当前军队医院护理管理的工作重点之一。     

高原地区军队医院聘用护理人员的难题及对策

随着社会的发展和体制编制调整的深入，合同护士取代军人护士已成为必然的趋势。近年来，我院病人数量呈上升趋势，军人护士数量已严重不足。护士的工作量已达到了超负荷状态。为防止护理质量下降，加强聘用护理队伍建设已成为当前医院管理的新问题。作者结合本院聘用试用护士使用情况，谈几点看法。     

应用"以人为本"的理念抓好护理质量管理

目前军队医院护理队伍的人员构成已不同以往，聘用护士正成为护理人员的主体，对聘用护士的护理质量的管理，已是举足轻重的核心工作。在护理管理中如何应用“以人为本”的理念，对护士长的临床护理质量管理已是一个新的挑战。我科在此方面的做法和体会如下：     

军队聘用护士进行护士长适任培训的实践

聘用护士是军队医院适应新形势、谋求再发展的特殊条件下产生的新事物。随着聘用护士在军队医院工作阅历的增加，已具有相当的业务素质和军事素质。为保持军队医院护理队伍结构的优化，培养并保留护理后备人才，我院选拔优秀聘用护士进行了护士长适任培训，并在培训前后进行问卷调查。现报告如下。     

我区医院聘用护士的管理现状及对策探讨

在军队医院大幅度精简整编的背景下,各医院为了生存和发展,从1986年开始,陆续聘用地方护士。目前聘用护士已成为我区护理队伍的主力军。各医院聘用护士总计达1 100余人。医院是一个高风险的行业,护士工作的优劣直接关系到病人的生命安危,护士素质的高低也关系到医院的质量、声誉和发展。因此聘用护士的管理是当前军队医院管理的重要内容,也是一个新课题。笔者近期调查了我区医院聘用护士的管理现状,现将存在问题进行分析,并探讨其管理对策。1调查方法对全区9所医院聘用护士管理现状统计调查,其内容有:聘用护士占全院护士的百分比,聘用护士的…     

Glutamine supplementation in vitro and in vivo,in exercise and in immunodepression

In situations of stress, such as clinical trauma, starvation or prolonged, strenuous exercise, the concentration of glutamine in the blood is decreased, often substantially. In endurance athletes this decrease occurs concomitantly with relatively transient immunodepression. Glutamine is used as a fuel by some cells of the immune system. Provision of glutamine or a glutamine precursor, such as branched chain amino acids, has been seen to have a beneficial effect on gut function, on morbidity and mortality, and on some aspects of immune cell function in clinical studies. It has also been seen to decrease the self-reported incidence of illness in endurance athletes. So far, there is no firm evidence as to precisely which aspect of the immune system is affected by glutamine feeding during the transient immunodepression that occurs after prolonged, strenuous exercise. However, there is increasing evidence that neutrophils may be implicated. Other aspects of glutamine and glutamine supplementation are also addressed.     

Temporal changes in the oxidation state in in vitro blood

The rates at which the paramagnetic compounds deoxyhemoglobin (Hb) and methemoglobin (MHb) form in vivo within an area of hemorrhage are unknown. The present experiment establishes the baseline concentrations and rates of change in paramagnetic hemoglobin concentrations, as well as the pH in normal heparinized and clotted human blood maintained in vitro at 37 degrees C under anaerobic conditions over 30 hours. There was a moderate increase in Hb concentration in normal heparinized blood (average increase was 15.5%, rate = 0.50%/hour) and a slight increase in MHb concentration in the heparinized blood and clots (average increase was 1.4%, rate = 0.044%/hour). A second experiment was done to verify the activity of the RBC systems responsible for maintaining the hemoglobin molecule in the reduced state. Conversion of MHb to Hb in these samples proceeded at a rate of 5.6%/hour. In a third experiment, blood from 11 normal subjects maintained at 4 degrees C 25 degrees C was analyzed for MHb concentration over the course of 28 days. The level of MHb formation remained in the range of normal for at least 11 days in all subjects. The authors conclude that at basal conditions created in vitro, the blood levels of both Hb and MHb remain at relatively low levels. Therefore, if the accumulation of Hb and/or MHb occurs in acute in vivo hematomas it must be driven by intrinsic tissue factors.     

Carcinoma in situ in cryptorchid testes in post-pubertal patients]

The pathohistologic analysis of testis sections of 37 postpuberty patients with different types of cryptorchism is performed. The tissue samples were taken during orchiopehy, fixed in Bouin's solution and treated by the standard histologic techniques. The morphologic criteria are presented for identification of the presence of the so called carcinoma in situ cells found in two cases. Besides, in 13 patients rare, mainly single, atypical germinative cells were found in a smaller number of the seminiferous tubules. It has been concluded that the presence of carcinoma in situ cells in undescended testes of some patients and considering the simple way of sampling, lack of complications and high reliability of the diagnostic procedure, it is absolutely justified to take routine biopsy of testes during orchiopexy in each postpuberty and perhaps prepuberty patient.     

我国医用辐射防护研究概况

医学放射学技术的迅速发展及介入放射学在临床广泛应用，使更多的人受到电离辐射的照射，同时也促进了医疗照射防护工作的发展。文中重点综述了我国医用辐射防护工作者近年来在Ｘ射线ＣＴ的医疗照射防护、对介入放射学工作者的剂量监测以及应用医疗照射防护体系，降低医疗照射剂量等方面所作出的成绩和研究进展     

新时期军医学院人才培养的思考

在新的历史条件下 ,军医学院迎接未来高技术局部战争的挑战 ,适应部队武器装备的不断更新以及医学科技、社会发展对人才素质提出的新要求 ,必须在更为广阔的时空背景下找准人才培养的着眼点 ,科学确立人才培养方向 ,提高人才培养质量。现就人才培养思考如下 :1　改变教育观念 ,     

成批煤气爆燃烧伤的救治体会

报道治疗因煤气泄漏爆炸烧伤病员7例，经应用MEBT技术积极救治，其中6例于伤后17天痊愈出院，另一例特重伤员也于伤后30天康复出院。作者认为：应严格按照MEBT／MEBO要求进行规范治疗，正确处理生命体征、休克、感染、脏器功能和创面的辨证关系。同时，不能忽视外科营养在过程中的重要作用，它是创面修复的物质保证。