核事故及医学应急救援

近几年来，找国秦山核电厂、大亚湾核电厂相继投入运行，这标志着我同已进入核能利用的新时期。“九五”期间我国的核电将有更大的发展。核电厂是安全的，发生核事故的可能性极小，但是还必须做好应急准备，以防万一。1993年8月4日，国务院发布的《核电厂核事故应急管理条例》指出：“中国人民解放军为核事故应急工作的重要力量，应当在核事故应急中实施有效的支援”。我军卫生系统在核事故中担负着重要的医学应急救援任务。因此，各级卫生机关和广大医务人员了解和掌握核事故及核事故医学救援的有关知识，明确军队卫生系统的任务和实施方法…     

核事故医学应急准备

核事故医学应急准备吴生财周军郭剑英核能发电是一种清洁、安全和经济的能源，无论从核电厂的选址、设计、建造、运行和退役的各个阶段，或是从核电厂的运行管理，均有一套非常严格的核安全措施，其发生事故的概率非常低。但是，从核电的运行史来看，发生事故的潜在危险尚...     

日本福岛核电站核事故应急处置的经验和教训

日本福岛核事故后,应日本同行的邀请,我们访问了日本核医学应急的相关单位,并到相关地区进行了考察。本文探讨了日本福岛核事故应急处置过程中存在的问题,提出了我国核应急力量建设过程中应注意的问题及相关对策。     

ICP-MS在核事故应急监测中的应用

目的：研究电感偶合等离子质谱仪（ICP－MS）测量技术在核事故应急监测中的应用,提高核事故后食和水中放射性污染检测技术水平。方法：采用微波消化、标准参考物质质控,内标法测量等方法。结果：几种标准参考物质的测定值与刻度比值在95％－109％之间,食物和水样测定结果近似于其他报告结果,结论：由于ICP－MS在测量元素时结果较好,在核事故应急监测中的应用尚需要进行进一步研究。     

核事故应急医学救援相关准备的探讨

随着涉核军事和民用设施的增加,发生核事故的概率亦随之增加。如何提高涉核灾害和事故的应急医学救援能力,是摆在军队医院机动卫勤分队面前的重要课题。我院根据任务需求,在核事故应急医学救治反复推演中,就其相关准备工作进行了深入探讨。现分析报告如下。     

核事故应急医学救援保障能力短期形成的实践与体会

近年来,我院根据保障任务要求,认真抓好核事故应急医学救援队伍建设,努力克服既无规范依据,又无指导大纲的困难,一点一滴抓理论学习,一步一动抓实际操作,先后开展了人装结合训练、勤务训练、救治流程演练等,仅3个多月时间,初步形成了核事故一级救治支援及二级救治保障能力。     

核事故应急医学救援力量建设中军地联动机制的探讨

日本福岛核事故发生后,我们按照上级指示精神,围绕如何提高核事故应急医学救治保障能力,尤其是在构建军地协同机制上做出了一些有益探索^[1],形成了与被保障单位指挥上联动、力量上联合的工作新局面。但核事故应急医学救援工作中仍存在响应相对滞后、协同机制有时不顺畅、军地一时难以形成合力等问题。现就核事故应急医学救援力量建设中军地联动机制探讨如下。     

核事故一二级应急医学救援的组织与实施要点探讨

随着核技术的广泛应用,特别是核电事业的发展,核安全问题愈来愈为世界各国所关注。虽然核设施在选址、设计、建造、调试运行和退役等各阶段都已严格按照标准和法规进行,但仍不能完全排除发生核事故     

国家核辐射突发事件卫生应急队员心理健康状况评估

目的 本研究旨在评估国家核辐射突发事件应急队员的心理健康状况、人格特质,为提高队员心理健康水平提供参考依据。方法 对52名在职国家核辐射突发事件卫生应急队员进行调查研究,采用症状自评量表(SCL-90)、卡特尔16种人格量表(16PF)评估心理健康水平和人格特质特点,经独立样本t检验、单因素方差分析和Pearson相关性分析进行队员与常模症状自评量表(SCL-90)和卡特尔16PF结果的比较。结果 应急队员的SCL-90多个因子和阳性项目均分均低于常模,差异有统计学意义(t=-4.77~-2.04, P<0.05),筛选阳性率占21.15%,出现躯体化、强迫症状、抑郁等阳性症状。队员人格特质表现为高聪慧性、稳定性,低敏感性、怀疑性等。文化程度、生活满意度、卡特尔16PF多因素与SCL-90多因子显著相关(r=-0.569~0.627,P<0.05)。结论 核辐射突发事件卫生应急队员心理健康水平优于常人。遴选队员和进行心理干预时应考虑队员的文化程度、生活满意度、人格特质等心理健康相关特征。     

核电厂操纵人员心理健康相关因子的初步研究

目的 探讨核电厂操纵人员的心理健康状况,及其与安定性、活泼性、焦虑性、紧迫性因子的相关性.方法 采用整群随机取样法,抽取3个核电基地255名男性操纵人员作为研究对象,以61名某高校四年级男性学生作为对照,应用苏州大学附属第二医院自主研发的《中国核电厂操纵人员心理健康和神经行为测评系统》对受试者进行心理健康测试,记录心理健康人格因素及4项主要人格因素(安定性、活泼性、焦虑性、紧迫性)的得分.结果 掩饰性因子得分均＜8分,表示测试结果可信.操纵人员心理不佳者占1.57％ (4/255),欠佳者占3.92％( 10/255),一般者占27.84％ (71/255),优良者占66.7％(170/255),而对照组心理不佳者占9.84％ (6/61).操纵人员在心理健康人格因素、安定性、焦虑性、紧迫性因子得分上与对照组比较,差异有统计学意义(t=3.437、4.423、-2.493和-2.093,P＜0.05).27岁以上组及工龄5年以上组在焦虑性、紧迫性、心理健康人格因素、安定性因子得分上与27岁以下组及工龄5年以下组比较,差异有统计学意义(t=-3.407、-2.138、2.585和2.349;t=-2.941、-2.256、2.606和2.947,P＜0.05).心理健康与安定性、活泼性呈正相关(r=0.721、0.650,P＜0.05),与焦虑性、紧迫性呈负相关(r=-0.809、-0.693,P＜0.05).结论 中国核电厂操纵人员大多数处于良好的心理健康状态,但应重视不同年龄和工龄人员的心理健康.     

The reliability and validity of the Q-angle: a systematic review

The quadriceps or Q-angle is an index of the vector for the combined pull of the extensor mechanisms and the patellar tendon. It is used as an indicator for patellofemoral joint dysfunction. The purpose of this article is to systematically review and appraise the literature to determine the reliability and validity of this test. An electronic database search was performed accessing AMED, British Nursing Index, CINAHL, the Cochrane database, EMBASE, ovid Medline, Physiotherapy Evidence Database (PEDro), PsycINFO, Pubmed and Zetoc to April 2008. All English language, human subject, clinical trials, assessing the inter- or intra-tester reliability, or the criterion validity, were included. The Critical Appraisal Skills Programme appraisal tool was used to establish the methodological quality of each study. Ten articles including 569 control and 179 patellofemoral disorder knees were reviewed. The findings suggest that there is considerable disagreement on the reliability and validity of the clinical Q-angle measurement. This may be due to a lack of standardisation in the measurement procedure. Further study is advocated to re-evaluate this topic using well-designed, and sufficiently large observational studies of specific patellofemoral dysfunction populations.     

航天职工心理健康状况调查分析

目的调查分析航天在职职工的心理健康状况,并提出相应的干预建议及思考。方法采用抑郁和焦虑量表对航天在职员工的心理健康状况进行调查,并就结果进行统计分析。结果 26.7%的职工存在不同程度的心理问题,其中有抑郁倾向的占24.7%。结论航天在职职工的抑郁心理倾向较重,低学历和工人的抑郁倾向较多。     

Extracardiac findings on coronary CT angiography: A systematic review

Coronary computed tomography angiography (CCTA) is of growing importance in noninvasive diagnosis of coronary artery diseases. The CT data allow evaluation not only of coronary arteries but also of adjacent anatomical territories. Our objective was to review, to analyze, and to quantify the spectrum and the prevalence of extracardiac findings (ECF) in CCTA. Therefore, we searched MEDLINE, EMBASE, and ISI Web of Science. Prior to quantitative analysis, we categorized the ECF of all included studies into clinically significant and clinically non-significant findings. First, we calculated the average prevalences of ECF and clinically significant ECF performing a meta-analysis for proportions using the double arcsine transformation. Second, we analyzed the spectrum and location of clinically significant ECF. Third, we identified ECF of acutely life-threatening potential as well as malignancies and calculated their prevalences. Thirteen studies with a total of 11,703 patients were found to meet the inclusion criteria. The average prevalence of overall ECF was 41.0% (95% confidence interval [95% CI]: 27, 56; P < .0001) and 16.0% (95% CI (9, 24; P < .0001) for clinically significant ECF. Clinically significant ECF were most commonly detected in the lungs (50.2%), the abdomen (26.7%), the vessels (13.1%), the mediastinum (3.6%), and in other adjacent anatomical territories (6.4%). The prevalence of acutely life-threatening and malignant ECF accounted for 2.2% (95% CI: 1.9, 2.5; P < .0001) and 0.3% (95% CI: 0.2-0.4; P < .0001), respectively. In conclusion, clinically significant and acutely life-threatening ECF are common. Reading CCTA for ECF may lead to earlier detection of relevant disease.ConclusionClinically significant and acutely life-threatening ECF are common. Reading CCTA for ECF may lead to earlier detection of relevant disease.     

The evidence for improving balance by strengthening the toe flexor muscles: A systematic review

BackgroundPoor postural balance in the upright position is strongly correlated to morbidities, such as falls in older adult populations and to lower limb injuries in the younger populations. Good postural balance depends on muscular strength and the integration of neurological and muscular feedback mechanisms throughout the body. Since the interface with the ground is the plantar surface of each foot, an improved understanding of the role of foot muscles in postural balance is warranted.Research questionDoes improved toe flexor strength result in better postural balance, across the lifespan?MethodsA systematic review was conducted of papers from 1900 to 2019 inclusive, from five databases. Inclusion and exclusion criteria were established prior to selection. Inclusion criteria were: observational and longitudinal studies, healthy subjects, at least one balance and one toe flexor strength test conducted. Exclusion criteria were: subjects with a pathology/disability, case study, systematic or literature review. Two examiners assessed a study’s suitability for inclusion in this review, based on the above criteria. Study quality was assessed using the Critical Appraisal Skills Program Tools. The type of studies and methodological heterogeneity precluded the feasibility of conducting a meta-analysis.ResultsNine studies were included. In each study, participants were over sixty years of age, and over 73 % of them were female. No study was found for a younger population group. There were seven cross-sectional studies, two randomized control trials and there was one case-control study. All studies provided evidence of directly proportional, clinically significant correlations between toe flexor strength and postural balance.SignificanceToe flexor strength contributes to improved postural balance for people over the age of 60. Research is needed to establish the relationship between foot muscle strength and balance in younger adults and children.     

Responding to threat of war in the nuclear age

Nine papers were presented at a colloquium on the psychological and behavioural effects of nuclear threat. These summarized questionary results, reviewed some national surveys, and outlined ongoing and proposed research.     

The effect of trunk muscle fatigue on postural control of upright stance: A systematic review

BackgroundFatigability and postural control deficits are both serious concerns in a variety of chronic musculoskeletal conditions. Research has shown that muscle fatigue may adversely affect postural control. This is while the evidence on the relevance of fatigue to postural control has never been summarized nor critically appraised.Research questionIs there sufficient and strong enough evidence to accept trunk muscle fatigue as a contributing factor to postural control alterations during upright standing posture?.MethodsEMBASE, Scopus, ELSEVIER, PubMed, ProQuest, Google scholar and reference lists of the relevant articles were searched through April 2018. Studies having investigated the trunk muscle fatigue effect on postural control in asymptomatic individuals were included in the study. Only those studies having assessed postural control in terms of center of pressure driven variables were included.ResultsTwelve studies (218 asymptomatic participants) matched the inclusion criteria of this systematic review. Their results supported the hypothesis that fatigue has a significant effect on postural control in terms of the time domain variables. Sway velocity was consistently found to be affected by fatigue. The results were inconsistent in the frequency domain. The only study on the structural dynamics of center of pressure displacements also confirmed such a relationship.SignificanceThe present review indicates that postural control is altered in asymptomatic individuals following trunk muscle fatigue. This may suggest that trunk muscle endurance training is crucial to address postural impairment in chronic spine musculoskeletal conditions.     

Effects of a holistic health program on women''s physical activity and mental and spiritual health

Intervention studies aimed at promoting increased physical activity have been trialled in many different settings including primary care, worksites and the community. Churches are also potential settings for physical activity promotion. However, little is known about the effectiveness of this setting for promoting physical activity, particularly in Australia. The purpose of this study was to evaluate the effectiveness of a mind, body and spiritually based health promotion program in increasing physical activity and promoting mental and spiritual health. Nineteen women completed the 8-week intervention, and 30 women in a non-health related 8-week program at the same church comprised a comparison group. Pre- and post-program surveys assessed outcome measures. Between-group differences over time were examined using one-way MANOVA's. Physical activity was higher in the intervention group than the comparison group. In contrast to the comparison group, both mental health (depression symptoms) and spiritual health improved significantly more among intervention participants. The data highlight the potential for a church-based setting and holistic approach to health promotion as a successful means of increasing physical activity and promoting mental and spiritual health among Australian women.