海上批量伤员分类救治信息系统的结构功能与应用

目的：实现海上批量伤员伤情与救治信息的快速采集、存储、转发和利用,实现对海上批量伤员的快速分类、进行伤员信息自动化管理,提升我军海上卫勤保障能力及信息化水平。方法：利用现代信息技术,开发研制海上批量伤员战创伤评分系统,并结合＂军卫一号＂系统以及＂北斗＂卫星通讯系统,进行数据的自动统计、存储和传输。结果：海上批量伤员战创伤评分系统能够快速的进行批量伤员的战创伤评分,并结合数据库技术和卫星通讯技术进行数据的自动分类、传输和存储,确实能提高我军海上卫勤保障能力。结论：海上批量伤员战创伤评分系统可大大提高海上批量伤员的分类、评分速度,实现了伤员信息的智能化管理,保证了信息传输的时效性和连续性,对提升我军海上卫勤保障能力及信息化水平具有重要作用。     

我军血液保障沿革与启示

本文回顾了我军血液保障的发展,重点从我军历次作战的血液供应、储运设备的进步、血液质量及对伤员救治影响等方面,查找我军血液保障机构存在的不足,提出创建我军新型血液供应模式的设想。     

单兵战伤电子信息卡及其传输系统

伤票(emergencymedicaltag,EMT)是战时伤员后送过程中随身携带的卡片,用来记载伤员负伤时间、伤部、伤类、诊断、救治措施和后送注意事项等,以便接收单位迅速了解伤员情况和治疗。我军在解放战争中,开始使用伤票;朝鲜战争中,普遍使用伤票。然而我军的伤票一直采用卡片纸印刷,存     

美军战术区伤员救护气道管理及启示

介绍美军战术区作战伤员气道管理的技术特点和设备保障,阐述不同救护阶段的急救技术范围,重点介绍鼻咽管通气、体位通气、环甲膜切开通气术等三种核心技术.据此,对我军做好战术区伤员气道管理,提出优化配置战术区伤员气道管理的急救药材、科学设计战术区典型伤情气道管理的规则等建议.     

5.12四川地震转运伤员返川工作

10 373名地震伤员安全转至省外救治后,伤员转运工作组遵照省委、省政府领导指示,迅速调整工作职责为以"伤员返川接收工作数据统计及伤员治疗信息统计"为重点,制定新的工作流程,高度关注,定期或不定期的各省市联系,了解伤员救治情况.一是建立了沟通机制,及时与卫生部前方协调组、各兄弟省市卫生行政部门沟通;二是配合民政部门,建立了地震伤员返川接收安置协作机制,在车站和机场设置了分诊点,对需康复治疗和因有基础疾病、慢性病需继续治疗的返川伤员建立了护送制度和接收制度,妥善安排到相关医疗机构康复和继续治疗;三是对现仍在外省治疗的危重伤员建立了情况通报制度.密切关注伤员返川情况.     

运输车后送伤员附加设备

我军和外军利用载重汽车运输伤病员已有三、四十年的历史(苏军从卫国战争开始,我军从抗美援朝战争开始)。其利用方式有“回程空车”(回空型)与“临时救护车”(改装型)两种。它们各有优缺点,所以同时存在,互为补充。由于“回程空车”受战争条件多变的影响,往往不能保证伤员的及时后送。从1979年对越自卫还击作战的经验来看,由上     

基层医院野战医疗装备的使用现状及展望

为打赢未来信息化条件下局部战争,在救灾等自然灾害前挽救更多的生命,我军配备了野战医疗装备系统。野战医疗装备是伴随部队机动、供部队实施战救和应对突发事件救援保障任务所编配的伤病员急救、治疗、运输、卫生防疫、防护等设备器材的总称。其组成部分主要包括统一编配的急救装备、手术装备、特诊装备、检验装备、消毒供应装备、防疫防护装备、医疗箱组、卫生技术车辆、医用方舱、伤员运输工具和各军兵种专用卫生装备。我院于2007年先后配发了野战急救车、野战手术车、野战防化车、野战X线车、卫生帐篷等一系列装备,本文将其装备的使用现状总结报告如下。     

美军战术作战伤员液体复苏管理

介绍美军战术作战伤员液体复苏的技术特点和药材保障,主要从补液通道的建立、复苏液体的选择、液体复苏的实施等三个方面进行阐述.据此,对我军做好战术区伤员液体复苏管理提出建议,包括:①合理配置战术区复苏药材品类;②大力提高战术区血液保障能力;③深入研究战术区创伤复苏理论.     

卫生装备配置优化研究

基于战时伤员流向与流率等特点，应用网络理论对战时救治区域卫生装备展开的布局进行了优化研究。应用排队论扣线性规划技术，研究了不同后送工具的不同组合优化，分别建立了静态和动态卫生装备配备模型，提供了队长——服务强度——服务台快速计算表，可快速实现对我军卫生装备配置数量的估算。根据研究结果，对我军现行卫生装备标准提出了修改建议。     

我军简易战伤评分意识状态评估改进

快速准确的伤情评估是批量伤员有序分流及成功救治的基础.介绍当前我军简易战伤评分方法及存在的问题,分析AVPU评级方法与GCS评分方法的相关性,提出在战场救治中使用AVPU评级方法并以此设计火线伤票,用于伤员源头数据采集.     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.