格林健康教育模式在本科护生职业防护干预中应用效果研究

[目的]改善本科实习护生的职业防护态度,提高知识水平,增强其职业防护行为能力。[方法]将本科实习护生189名以班为单位随机分为格林组(96名)和对照组(93名)。以格林模式为框架构建调查问卷,在实习前对两组护生职业防护现状进行调查与评估。依据评估结果对格林组护生进行系统持续的职业防护健康教育干预;对照组护生只接受传统的职业防护健康教育讲座。[结果]3个月后,格林组护生的职业防护态度、知识和行为得分均显著高于对照组(P0.01),格林组护生的职业暴露评分明显低于对照组(P0.01)。[结论]格林模式框架下的健康教育干预改善了护生的职业防护态度,提高了防护意识和知识水平,增强了职业防护行为能力,从而降低了职业暴露的发生。     

职业防护情境模拟教学对降低临床实习学生职业危害的影响

目的探讨职业防护情境模拟教学在预防临床实习学生职业危害中的效果。方法将87名学生随机分为试验组(44名)和对照组(43名)。试验组采用情境模拟教学法教授职业防护知识,对照组采用传统教学法。课程结束后对学生的职业防护态度、职业防护知识知晓情况进行调查,并在10个月的实习期结束后对学生的职业危害发生情况、职业危害自我防护行为进行调查。结果试验组学生的职业防护态度正向率、职业防护知识知晓率均高于对照组,差异具有统计学意义(P0.05);试验组学生职业危害自我防护行为得分为(41.56±8.20)分,对照组为(32.45±6.28)分,试验组得分高于对照组,差异具有统计学意义(P0.05);试验组学生曾发生1次及以上职业危害的人数为16名,对照组为29名,试验组职业危害发生率低于对照组,差异具有统计学意义(P0.05)。结论职业防护情境模拟教学能提高临床实习学生职业防护教学的质量和效果,有助于提高学生职业防护知识和职业防护行为,降低职业危害的发生。     

综合医院实习护生针刺伤的调查研究

目的调查实习护生针刺伤及防护行为的现状。方法选取431名实习护生作为调查对象,调查护生实习10个月内发生针刺伤的情况以及防护知识及防护行为。结果 76.10%的实习护生发生过针刺伤,只有77.03%的实习护生在实习医院接受过职业防护教育,发生针刺伤的实习护生对针刺伤相关职业防护知识和防护行为及依从性得分低于未发生针刺伤的实习护生(P0.01或P0.05)。结论实习护生针刺伤发生率高,对针刺伤防护知识缺乏,防护行为不规范,临床需要加强防护知识的培训,改善职业防护行为。     

格林健康教育模式用于实习护生对抗肿瘤药物自我防护的效果干预研究

目的 提高实习护生抗肿瘤药物认知水平，改善对肿瘤药物自我防护的态度，增进实习护生规范化使用抗肿瘤药物。方法 选取2021级及2022级来我院实习的护理本科生随机分为对照组（35例）和干预组（34例），在实习时长4～8周时进行抗肿瘤药物职业防护的认知、在使用抗肿瘤药物时所采用的防护措施的问卷调查。对照组采用常规带教方式，干预组根据格林模式框架制定系统地、有针对性的抗肿瘤药物自我防护健康教育干预。结果 干预组的抗肿瘤药物的认知及自我防护问卷得分显著高于观察组（P＜0.05），干预组在进过培训后其在规范化使用抗肿瘤药物得分显著高于培训前（P＜0.001）。结论 格林健康教育模式有效提高了实习护生对抗肿瘤药物知识的水平，端正了抗肿瘤药物自我防护的态度和意识，从而规范了抗肿瘤药物的使用，有效降低了职业伤害的发生。     

不同学历实习护生的职业防护现状调查分析与对策

目的 了解实习护生对职业防护的掌握程度,以提高实习护生对职业防护相关知识的认识.方法 对100名实习护生进行"职业防护现状"的问卷调查.结果 不同学历护生对职业防护知识的回答正确率具有差异性,本科生回答的正确率明显高于大专和中专生;在职业防护行为方面,各学历实习护生在腰背伤发生率、针帽回套率、配置消毒剂的手套穿戴率上的差异具有显著性(P＜0.05).结论 护生对职业防护教育和职业性危险因素的认识存在明显的不足,但不同学历护生的职业防护行为差别不大.对实习护生的自我防护教育十分必要.     

高职护生职业防护知信行的调查与分析

目的通过调查了解护理实习生职业防护的知识、态度、行为情况,为进行针对性的职业防护教育提供依据。方法 2012年4月采用自行设计的高职护生职业防护知信行问卷对宁波卫生职业技术学院99名高职护生进行调查。结果高职护生知识部分总计得分(11.62±1.72)分,得分率77.5%;态度部分(135.58±9.60)分,得分率90.4%;行为部分(137.40±15.20)分,得分率76.3%。结论实习护生在职业防护方面存在不同程度的知识缺乏,职业防护态度较积极,但行为依从性较差,提示学校应重视其职业防护教育,减少护生实习期间职业暴露的发生,保证实习的顺利进行。     

护生实习前职业防护态度及认知的调查研究

[目的]了解北京中医药大学护理学院护生实习前职业防护态度及知识掌握的现状并比较不同学历护生对职业防护的态度及知识掌握情况的差异,为提高实习护生职业防护意识及开展职业防护培训提供依据.[方法]采用改编问卷对2014年7月即将实习的209名护生进行了职业防护态度及相关知识的现状调查.[结果]本科护生职业防护相关知识得分明显高于高职护生(P＜0.05),高职护生与本科护生职业防护态度得分均较高且差异无统计学意义(P＞0.05);护生职业防护态度与知识掌握情况呈正相关.[结论]护生实习前职业防护知识掌握情况与学历有关,职业防护态度与学历无关,职业防护态度与知识掌握情况有一定相关性.     

护生职业感染防护健康教育效果研究

[目的]评价护生实习前参加职业感染防护健康教育对职业感染防护意识和行为的影响.[方法]选择未接受过系统职业感染防护健康教育的2003级专科护生406名和接受过系统职业感染防护健康教育的2004级护理专业专科护生426名为研究对象,采用问卷调查法对2003级与2004级的全体护理大专生在实习结束后返校时进行问卷调查.[结果]接受系统职业感染防护健康教育的2004级护生各项护理职业防护相关知识知晓率和防护行为明显优于2003级护生(P＜0.01).[结论]实习前对护生集中进行系统职业感染防护教育能有效提高护生职业感染防护意识和行为.     

实习护生职业防护知识与行为的调查研究

[目的]了解实习护生职业防护知晓率,提高防护知识和技能,降低实习护生的职业伤害.[方法]岗前教育加强了护士职业防护知识,在实习过程中定期对实习护生职业防护措施落实情况进行监控.[结果]2007届实习护生职业防护知晓率、职业防护行为正确百分率、针刺伤发生次数,发生损伤后上报率比2006届实习护生有显著性提高.[结论]岗前进行系统的护生职业防护教育对提高实习护生职业防护知识和技能具有重大意义,定期对实习护生职业防护措施落实情况进行干预对减少职业伤害的发生有明显的效果.     

强化实习护生针刺伤职业防护教育的效果分析

目的增强实习护生的职业防护意识,降低实习护生针刺伤的发生率。方法对我院2013届132名实习护生进行针刺伤问卷调查,根据调查的结果,对2014届135名实习护生进行针对性职业防护强化教育,对比两届实习护生针刺伤的发生率及针刺伤相关知识知晓率、上报率。结果强化针刺伤职业防护教育的实习护生针刺伤的发生率明显下降,而针刺伤相关知识的知晓率、上报率明显上升。结论针刺伤职业防护强化教育能增强实习护生的职业防护意识,促进实习护生职业防护行为的形成,减少实习护生针刺伤的发生,提高实习护生针刺伤相关知识知晓率、上报率。     

儿童遗传性心律失常的诊治进展

回顾在遗传性心律失常领域最新发表的相关研究,主要关注与儿童心源性猝死关系密切的离子通道病,包括长QT综合征（LQTS）、短QT综合征（SQTS）、Brugada综合征（BrS）和儿茶酚胺敏感性多形性室性心动过速（CPVT）,总结它们在发病机制及诊治方面的进展。     

The acoustic characteristics of the skull

Many investigators have stated that the difficulties of imaging with acoustical energy through the skull result from the marked attenuation of the energy by the skull. In the literature measurements of total attenuation have been confused with those for absorption.Measurements made by us show that absorption by compact bone varies between 2–3 dB cm^?1 MHz^?1 and, in the low megaHertz region appears to be directly proportional to frequency.It has also between shown that the convoluted inner surface of the ivory bone of the inner table of the skull may degrade the collimation and directionality of the beam by refraction.Cancellous bone, such as is present in the dipole of the skull, greatly attenuates the energy. It is postulated that this largely results from scattering. It is also postulated that the energy propagates through cancellous bone as two components, one in the soft tissues and the other partly in the bony spicules. Observations suggest that attenuation due to scattering much more markedly affects the latter of these components and scatters more greatly the higher frequencies in a pulse of broad bandwidth.The energy in each component has varying propagation paths so that the later cycles in the pulse of each component are subject to increasing interference as a result of the variations in propagation times. The two components moreover may have different propagation times so that interference may occur between the pulses of each component as well.All of these phenomena degrade the collimation, coherence, directionality, beam width, pulse length, frequency and other properties of the ultrasonic energy upon which imaging through the skull depends.The interference effects described above are least for the first cycle in the pulse which usually is not the cycle of highest amplitude. Since, in the free field, most of the energy is concentrated around the beam axis, most of the energy in the field which is deflected from its normal propagation path is deflected away from the beam axis. Thus the directionality of the beam is least degraded in the beam axis. The effects of the skull in degrading the properties of the ultrasonic pulse would therefore be lessened if the amplitude of the first cycle of the pulse and the directionality of its energy could be used for imaging.     

Organ Preservation: Current Concepts and New Strategies for the Next Decade

SUMMARY: Organ transplantation has developed over the past 50 years to reach the sophisticated and integrated clinical service of today through several advances in science. One of the most important of these has been the ability to apply organ preservation protocols to deliver donor organs of high quality, via a network of organ exchange to match the most suitable recipient patient to the best available organ, capable of rapid resumption of life-sustaining function in the recipient patient. This has only been possible by amassing a good understanding of the potential effects of hypoxic injury on donated organs, and how to prevent these by applying organ preservation. This review sets out the history of organ preservation, how applications of hypothermia have become central to the process, and what the current status is for the range of solid organs commonly transplanted. The science of organ preservation is constantly being updated with new knowledge and ideas, and the review also discusses what innovations are coming close to clinical reality to meet the growing demands for high quality organs in transplantation over the next few years.     

2017年呼吸疾病主要进展

2017年,国内外学者在呼吸系统疾病的临床和基础领域均进行了深入研究,不仅对相关指南进行了更新,并且针对一些临床热点、难点问题达成专家共识,现就2017年呼吸疾病相关进展作一简单介绍。     

家族性噬血细胞性淋巴组织细胞增生症1例并文献复习

目的加强对家族性噬血细胞性淋巴组织细胞增生症（familially hemophagocytic lymphohistiocytosis,FHL）的认识。方法报道确诊为FHL的新病例1例,结合国内外报道的FHL的病例,对该病的临床特点进行汇总分析。结果FHL2常与PRF1基因突变相关,约20%~40%的患者存在穿孔素基因突变。结论对于有阳性家族史,基因诊断明确,应尽早行化疗或者造血干细胞移植。若无家族史,未发现与继发性HLH相关的原发病因,可考虑行基因筛查以明确是否存在FHL的可能。     

COVID‐19 and COVID‐19 vaccine‐related dermatological reactions: An interesting case series with a narrative review of the potential critical and non‐critical mucocutaneous adverse effects related to virus,therapy, and the vaccination

This narrative review article was conducted to lay out a summarized but exhaustive review of current literature over mucocutaneous manifestations in 4 dimensions of SARS‐CoV‐2 pandemic: virus itself, treatment‐related, vaccine‐induced, and alteration of chronic dermatologic diseases following infection. Virus and vaccine‐related were mainly self‐limited and non‐severe. Treatment‐related reactions could be life‐threatening.     

Burkitt's lymphoma of maxillary gingiva: A case report

Burkitt's lymphoma(BL) is an aggressive form of nonHodgkin's B-cell lymphoma with three variants namely endemic, sporadic, and immunodeficiency-associated types. It is endemic in Africa and sporadic in other parts of the world. While the endemic form is widely reported to occur in early childhood and commonly involves the jaw bones, the sporadic form typically presents as an abdominal mass. This presentation reports a rare case of sporadic form of BL clinically manifesting as a generalized gingival enlargement in an immunocompetent adult male which demonstrated an aggressive behavior. The patient reported with a prominent anterior gingival swelling of 6 mo duration which slowly enlarged in size and associated with multiple lymph node involvement. Microscopic examination of the lesion using H, E and immunohistochemical diagnosis confirmed the diagnosis as BL. The patient succumbed to the disease before any therapy could be instituted. Since a wide array of causes can be attributed to gingival enlargements, it is necessary to consider malignancies as one of the important differential diagnosis so as to facilitate the need for appropriate diagnosis and prompt treatment.     

Real‐life effectiveness of biological therapies on symptoms in severe asthma with comorbid CRSwNP

BackgroundWe aimed to evaluate the effectiveness of different antibody therapies on nasal polyp symptoms in patients treated for severe asthma.MethodsWe performed a retrospective analysis of patients with severe asthma and comorbid CRSwNP who were treated with anti‐IgE, anti‐IL‐5/R or anti‐IL‐4R. CRSwNP symptom burden was evaluated before and after 6 months of therapy.ResultsFifty patients were included hereof treated with anti‐IgE: 9, anti‐IL‐5/R: 26 and anti‐IL‐4R: 15 patients. At baseline median SNOT‐20 was similar among groups (anti‐IgE: 55, anti‐IL‐5/R: 52 and anti‐IL‐4R: 56, p = 0.76), median visual analogue scale (VAS) for nasal symptoms was 4, 7 and 8 (p = 0.14) and VAS for total symptoms was higher in the anti‐IL‐4R group (4, 5 and 8, p = 0.002). After 6 months SNOT‐20 improved significantly in all patient groups with median improvement of anti‐IgE: −8 (p < 0.01), anti‐IL‐5/R: −13 (p < 0.001) and anti‐IL‐4R: −18 (p < 0.001), with larger improvement in the anti‐IL‐4R group than in anti‐IgE (p < 0.001) and anti‐IL‐5/R (p < 0.001) groups. VAS nasal symptoms improved by median anti‐IgE: 0 (n.s.), anti‐IL‐5/R: −1 (p < 0.01) and anti‐IL‐4R: −3 (p < 0.001), VAS total symptoms by anti‐IgE: −1 (n.s.), anti‐IL‐5/R: −2 (p < 0.001) and anti‐IL‐4R: −2 (p < 0.001).ConclusionsTreatment by all antibodies showed effectiveness in reducing symptoms of CRSwNP in patients with severe asthma, with the largest reduction observed in anti‐IL‐4R‐treated patients.     

经颅黑质超声诊断帕金森病的临床评价

目的 通过对帕金森病患者及正常对照组进行经颅超声(transcranial sonography,TCS)检查,结合帕金森病患者的Hoehn Yahr（H Y）分级及帕金森病统一评分量表评分结果,了解我国大陆地区帕金森病患者有无黑质(substantia nigra, SN)回声增强表现。方法 对入选对象进行TCS检查,并对检查结果进行评价。结果 帕金森病患者 SN阳性率明显高于正常对照者（P＜0.05）。帕金森病SN异常组 H Y 分期明显高于帕金森病SN正常组(P＜0.05),表明帕金森病患者SN高回声面积与H Y分期相关。TCS检查对帕金森病的敏感性为80.5%,特异性为79.9%。结论 我国帕金森病患者SN强回声检出率显著高于对照组,说明我国帕金森病患者也存在SN回声增强这一现象,与国内外报道相一致。TCS检查对帕金森病的诊断具有一定的意义,敏感性及特异性较高。