某市疾病预防控制机构突发公共卫生事件应急能力现况的调查与分析

目的通过对阜新市疾控机构卫生应急能力进行调查了解,找出薄弱环节,提出改进措施,为提高全市卫生应急能力提供参考依据。方法阜新市疾控机构人员结构、应急经费投入、实验室检测能力、应急预案制订、应急物资储备、培训和演练水平调查。结果调查全市8家疾控机构,市疾控中心应急能力基本满足突发事件处置工作的要求,县区疾控机构人员结构不合理,政府投入专项经费较少,实验室检测能力较低,突发公共卫生事件应急处置综合能力有待增强。结论提升突发公共卫生事件应急能力是一项长期的任务,需要提高政府对公共卫生的重视程度,应加强政策支持,加大经费及人员投入,尤其要加强对区级疾控中心的关注和投入。     

内地-港澳联合举办重大传染病防控“长城演练”

2006年11月13日，卫生部、广东省卫生厅、香港特区卫生署、澳门特区卫生局联合举办了内地-港澳重大传染病防控应急演练，又称为“长城演练”。根据内地、香港特别行政区和澳门特别行政区关于突发公共卫生事件应急机制合作协议，此项演练旨在进一步加强三地公共卫生信息通报和技术合作，完善三地对跨区域突发公共卫生事件应急处置的联防联控机制，提高卫生应急联动能力。     

广东职业卫生技术人员突发化学中毒处置培训需求调查

目的 了解广东省职业卫生技术服务人员突发化学中毒卫生应急处置培训需求,为更好地开展化学中毒应急处置培训提供依据.方法 采用横断面研究设计,通过调查问卷和自评的方式对职业卫生技术服务人员进行调查.结果 共调查278名职业卫生技术服务人员.152人(54.68％)曾参与应急培训或演练;对毒气采样、气象设备操作、佩戴防护手套等操作较为熟练,有毒气体报警器、呼吸防护器、防护服、毒物快速检测箱、气体检测仪等装备的使用技能评估情况不理想.182人(65.5％)有化学中毒应急培训需求.结论 职业卫生技术人员突发化学中毒应急处置技能有待提高,珠三角地区情况稍优于非珠三角地区,但不容乐观.今后需着重加强个人应急处置技能的培训及实践.     

情景演练法对提高急诊护士应对突发公共卫生事件能力的作用研究

目的:探讨情景演练法对提高急诊护士应对突发公共卫生事件能力的作用。方法:选择南方医科大学第五附属医院急诊科护士20名,2018年1月—2018年6月接受常规培训(培训前),2018年7月—2018年12月接受情景演练培训(培训后),比较接受情景演练培训前后急诊护士对突发公共卫生事件的专科理论知识水平、应急能力、沟通协调能力及总体业务能力,同时调查医师对接受情景演练培训前后护士护理工作满意度。结果:培训后护士专科理论知识水平、应急能力、沟通协调能力及总体业务能力成绩较培训前明显提高(P<0.05),培训后护士自我评价更优(P<0.05);培训后医生满意率较培训前明显增高(P<0.05)。结论:对急诊护士实施情景演练培训有助于提高其应对突发公共卫生事件的处理能力,同时可提高医生对护士工作的满意度。     

模拟应急演练在门诊护士急救技能培训中的应用

目的:探讨模拟应急演练在门诊护士急救技能培训中的效果。方法:门诊护士开展应急预案学习及模拟急救演练,演练结束后进行考评总结。结果:模拟应急演练培训前后护士的急救理论、急救技能、临床综合能力成绩比较,差异有统计学意义(P0.05)。结论:模拟应急演练是全面提高门诊护士应急反应能力和急救技能的有效方法。     

我国海上医学救援药事应急管理存在的问题及对策探析

目的为改善海上医学救援的药事应急管理提供参考。方法通过多方调研与专家咨询交流,分析我国目前海上医学救援中的药事应急管理存在的问题,并提出相应的建设性对策。结果我国海上医学救援的药事应急管理主要存在统一指挥机制不完善、缺乏系统的应急药品储备体系与保障体系、总体应急能力不足等问题。结论现阶段应通过构建集中统一的药事应急指挥组织、完善应急药品的储备与保障体系,加强应急演练与培训来提升海上医学救援的药事应急救援能力。     

情景模拟演练在急诊护士应急能力培训中的应用效果

目的：探讨情景模拟演练对急诊护士应急能力培训的效果。方法选择2012年5月~2014年5月本院急诊护士及基层卫生院到本院进修的急诊护士共80名为研究对象,依据对护士有无进行情景模拟演练培训进行分组,未进行情景模拟演练培训的分为培训前组;进行情景模拟演练培训的分为培训后组。分别对进行情景模拟演练培训前后护士所掌握的理论知识、应急反应总能力、急救操作能力进行评分,对比进行培训前后的评分情况。结果培训后组应急反应总能力评分显著高于培训前组,差异有统计学意义(P<0.05),两组操作能力及理论知识比较,差异无统计学意义(P跃0.05)。培训后组预见性思维能力及实施抢救的时效性明显高于培训前组,差异有统计学意义(P<0.05)。结论情景模拟演练对急诊护士应急能力培训有显著效果,可有效提升急诊护士的应急反应能力,经济投入较少,值得临床进一步推广应用。     

浙江省食品药品安全应急管理处置体系现状调查与对策研究

目的：推动浙江省构建上下统一的食品药品安全应急管理处置体系,为建立合理、有效的应急管理体系提供实证依据。方法：通过抽样调查,对该省市县级食品药品监督管理机构的应急管理现状、人力资源、硬件设备资源进行实证调查与分析。结果：当前浙江省市、区（县）级食品药品监督管理机构的应急管理人员数量相对不足,专业知识培训较为薄弱;在应急管理设备配备方面,基本硬件设施与设备的配备率较低,应急管理的相关软件或系统建设较为落后。结论：应增加食品药品安全应急管理的人力资源投入,加强对应急管理人员的在岗培训,优化知识结构。逐步提高应急管理基本设备的配备水平,完善应急管理信息系统,实施食品药品应急管理协同计划,增强各部门的协同能力。     

城市社区脑血管病的预防技术推广探讨

目的提高城市社区医生对脑血管病的病因和危险因素进行有效的干预、诊断治疗知识和实际处理脑血管病病例的能力,提高群众脑血管病的知晓率。方法采取现场调查模式,首先调查基层卫生服务机构的医生对脑血管病的干预及合理用药的掌握情况。结果参照脑血管病防治指南,编写出一套简单易学的脑血管病的干预及合理用药手册。结论发放调查问卷的方式分别抽取目标培训单位90%的医师在培训前、后进行问卷调查并当场回收,比较参加培训人员培训前后对脑血管病的干预及合理用药手册了解及掌握情况进行评价。     

实景演练在重症医学科应急预案培训中的应用

目的探讨重症医学科护理应急预案培训的方法与效果。方法应用实景演练的形式对重症医学科50名护理人员进行应急预案培训。结果通过培训降低了重症医学科风险事件的发生率，提高了护理人员有效应对危机事件的能力，降低了重症医学科的护理风险。结论实景演练的培训方法能有效提高重症医学科应急预案培训效果，缩短护士培训周期，提高重症医学科的工作质量与效率。     

Affective and Anxiety Disorders and Alcohol and Drug Dependence:

Depression and anxiety frequently coexist in patients with substance use disorders. This clinically-oriented article examiens the relationship between these conditions and emphasizes data showing that substances of abuse can cause signs and symptoms of both depression and anxiety. These substance-related syndromes appear to have a different course and prognosis than uncomplicated, independent anxiety and major depressive disorders, and clinicians should consider the role of alcohol and other drugs in all patients presenting with these complaints. The authors will also outline an approach for diagnosing and managing patients with the combination of a substance use and depressive or anxiety disorder.     

Synthesis and anti-nociceptive and anti-inflammatory effects of gaultherin and its analogs

The synthesis of gaultherin (1) and its analogs was carried out to provide 11 glycosides under phase-transfer catalytic conditions. The activities of all synthesized compounds were evaluated by nitric oxide production inhibitory assay in vitro. Methyl 2-O-(4-O-β-d-galactopyranosyl)-β-d-glucopyranosylbenzoate (5f) showed significantly anti-nociceptive and anti-inflammatory effects by the evaluation in vivo. Structure–activity relationships within these compounds were discussed.     

Modelling and simulation of variability and uncertainty in toxicokinetics and pharmacokinetics

Two important methodological issues within the framework of the variability and uncertainty analysis of toxicokinetic and pharmacokinetic systems are discussed: (i) modelling and simulation of the existing physiologic variability in a population; and (ii) modelling and simulation of variability and uncertainty when there is insufficient or not well defined (e.g. small sample, semiquantitative, qualitative and vague) information available. Physiologically based pharmacokinetic models are especially suited for separating and characterising the physiologic variability from the overall variability and uncertainty in the system. Monte Carlo sampling should draw from multivariate distributions, which reflect all levels of existing dependencies in the intact organism. The population characteristics should be taken into account. A fuzzy simulation approach is proposed to model variability and uncertainty when there is semiquantitative, qualitative and vague information about the model parameters and their statistical distributions cannot be defined reliably.     

成骨细胞的功能与损伤和骨质疏松的防治

骨质疏松是一种全身性骨骼疾病,导致骨折风险增加。成人的骨量通过破骨细胞的骨吸收和成骨细胞的骨形成作用来维持动态平衡,治疗骨质疏松症的理想策略是抑制破骨细胞的骨吸收和/或增强成骨细胞的骨形成功能。目前针对保护成骨细胞及增强其功能的骨质疏松疗法相对较少。因此,本文针对成骨细胞相关功能蛋白、各种细胞损伤机制（内质网应激、氧化应激、机械过载、微小RNA和长链非编码RNA的影响等）及骨质疏松的治疗与预防作一综述,以期为针对增强成骨细胞功能的骨质疏松治疗策略提供新思路。     

Self-stimulation and amphetamine: Tolerance to d and l isomers and cross tolerance to cocaine and methylphenidate

The effects of the d and l isomers of amphetamine on self-stimulation responding were tested following acute and chronic administration. Tolerance and post-drug depression of responding occurred in tests with both isomers, indicating no role for p-hydroxynorephedrine (PHN) which is one of the metabolites of d-amphetamine. In the second experiment, d-amphetamine, methylphenidate and cocaine all produced quantitatively and qualitatively similar effects on self-stimulation responding following acute administration. Following chronic administration of d-amphetamine, animals showed tolerance to all three drugs, indicating cross-tolerance among them. These data are consistent with an hypothesis that tolerance and post-drug depression following chronic amphetamine treatment are the result of decreases in postsynaptic receptor sensitivity, which would lead to a decreased effectiveness of all three drugs, regardless of their pre-synaptic mechanisms.     

益生菌与肿瘤防治

益生菌广泛存在于自然界中,通过维持宿主体内菌群平衡、影响肠屏障功能和调节免疫应答等作用,提高宿主健康水平,被公认为"肠道健康卫士".一些益生菌可以增强机体的免疫功能,抑制致癌物质,影响肿瘤细胞的基因表达,对肿瘤具有拮抗作用.大量研究表明,益生菌在未来的肿瘤防治中有很好的应用和发展前景.     

Acamprosate and naltrexone treatment effects on ethanol and sucrose seeking and intake in ethanol-dependent and nondependent rats

Rationale  Two pharmacotherapies are approved for treating alcohol craving (acamprosate and naltrexone), but both have shown mixed findings in animals and humans. Objectives  The present experiments utilized a “reinforcer blocking” approach (i.e., rats were able to consume ethanol during treatment) to better understand the efficacy of these treatments for ethanol seeking and drinking using ethanol-dependent and nondependent rats. Materials and methods  In “nondependent” experiments, drugs (acamprosate 50, 100, and 200 mg/kg; naltrexone 0.1, 0.3, and 1.0 mg/kg) were administered over 3-week periods prior to operant sessions with a low response requirement to gain access to reinforcers for 20 min. For “dependent” experiments, rats were made dependent in vapor/inhalation chambers. Results  Acamprosate and naltrexone had similar effects on intake in nondependent and dependent rats; neither drug was selective for ethanol over sucrose drinking. In nondependent animals, naltrexone was more efficacious at more doses than acamprosate, and acamprosate’s effects were limited to a dose that also had adverse effects on body weight. Both pharmacotherapies showed more selectivity when examining reinforcer seeking. In nondependent rats, acamprosate and naltrexone had response-attenuating effects in ethanol, but not sucrose, groups. In dependent animals, acamprosate had selective effects limited to a decrease in sucrose seeking. Naltrexone, however, selectively decreased ethanol-seeking in nondependent rats. Conclusions  The naltrexone-induced decreases in seeking suggested a change in incentive motivation which was selective for ethanol in nondependent rats. The “nondependent” paradigm may model early stages of “problem drinking” in humans, and the findings suggest that naltrexone could be a good intervention for this level of alcohol abuse and relapse prevention.     

Antiinfective and encrustation-inhibiting materials--myth and facts

Catheters, urethral and ureteral stents and other urological implants are frequently affected by encrustration and infection due to their permanent contact with urine. Indwelling urinary catheters provide a haven for microorganisms and thus require extensive monitoring. Several surface modification techniques have been proposed to improve the performance of devices including the immobilization of biomolecules, the incorporation of hydrophilic grafts to reduce protein adsorption, the creation of hydrophobic surfaces, the creation of microdomains to regulate cellular and protein adhesion, new polymers and antimicrobial coatings. Physico-chemical explanation to elucidate the mechanism of such encrustation or infection inhibiting materials is still not available. Our series of experiments showed a marked decrease of silver-activity in biological fluids which corresponds with the controversial clinical results obtained with silver coated urinary catheters. Rifampicin/minocycline coated catheters had very low activity against Gram-negative rods, enterococci and Candida spp., the main causing organisms of urinary catheter infection. Surface engineered materials and antimicrobial drug delivery systems will be the next generation of sophisticated urinary catheters and stents, if both efficacy as well as efficiency has been proved clinically.     

Alprazolam and lorazepam single and multiple-dose effects on psychomotor skills and sleep

Summary The effects of alprazolam 0.5 mg and lorazepam 2 mg on cognitive and psychomotor skills were assessed in twelve normal volunteer subjects in a randomised, double-blind, crossover design. Single and multiple dose effects were monitored using a battery of tests comprising critical flicker fusion threshold (CFFT), choice reaction time (CRT), simulated car tracking, and subjective ratings of perceived sedation (LARS) and of sleep behaviour (LSEQ). Compared with placebo baseline scores, treatment with lorazepam 2 mg (both single and multiple doses) resulted in a widespread impairment of CRT, tracking accuracy, and CFFT. Single doses of alprazolam 0.5 mg reduced CFFT with respect to the placebo baseline. Single and multiple dose treatment with both drugs resulted in subjective reports of sedation, a reduction of sleep onset latency, and improved sleep quality. Only lorazepam 2 mg significantly disrupted the integrity of behaviour on waking from sleep. These results suggest important pharmacodynamic differences between the two drugs in the doses used.