汶川地震医疗救援卫勤保障

5.12汶川地震发生后，医院随即武警四川总队成立抗震救灾领导小组，迅速组建多支医疗队，第一时间随救援部队奔赴重灾区。院本部和分院组建成立两个救援病区。作为医疗队队长，笔者根据自己的实践经验，总结了灾区医疗救援工作的经验。医院应把医疗救援培训作为医院继续教育的组成部分；每年组织全院医务人员进行战伤救护培训；储备完善的应急药品和医疗物资；突发公共卫生灾害事件，统一全院思想很重要；医疗队的食宿应全部实现自我保障；应实行军地合作，及时开展卫生防疫、重视加强心理干预，保障救援任务的顺利完成。     

从汶川地震谈山地孤岛医疗救援

作者总结了西南医院医疗队在山地孤岛-映秀镇进行医疗救援过程中伤员伤情伤类的特点、救治原则、营地选址原则、救援各阶段工作重点等方面的经验,指出了此次救援中存在的不足,提出了改进意见,希望为今后山地孤岛救援有所裨益.     

5·12地震救援中暑172例临床分析

1临床资料1.1一般资料汶川地震中参与平武县南坝镇救援工作的中暑人员172例,其中男性125例,女性47例;年龄<18岁32例,18~45岁104例,55~80岁36例。按照《职业性中暑诊断标准》(GB11508-89),先兆中暑92例,轻症中暑66例,重症中暑14例(热痉挛10例,热衰竭4例,热射病0例)。1.2临床表现     

我们在,生命在!——汶川地震医疗救援全记录

大雨滂沱，余震不断，交通阻隔,山洪危伺…… 每个人都清楚，这是一次生命的炼狱之旅。但是，在奔赴灾区的路上。没有人瞬间犹疑。 在千千万万与死神抢夺生命的白衣身影中。有几个身影是如此深刻地铭记在我们的印象中： 一位脚穿白凉鞋的中年护士，连日不眠不休地穿梭于废墟瓦砾之中。只要寻到一点生的气息,便锲而不舍地催促救援人员进行搜救；     

汶川地震应急医疗救援工作的做法及体会

在汶川地震的抗震救灾过程中,医院全体干部职工团结一心,众志成城,较好地完成了应急医疗救援任务,夺取了抗震救灾的阶段性胜利。作者认为科学的指挥调度、快速的医疗救治、良好的沟通协调、有力的后勤保障是做好灾后应急医疗救援的基础。     

从汶川地震救援看医学生专业素质培养

本文通过总结汶川地震救援的经验教训,指出汶川地震救援对医学生专业素质培养提出了新的要求:必须对医学生进行灾害救援意识教育,强化灾害救援技能训练,实施灾害救援管理教育,加强灾害卫生防疫和心理疏导技能训练,使医学生成为既能适应平时医疗卫生防治、又能适应各种应急救援的专业化人才.     

汶川地震一个月后救援部队官兵心理健康状况调查

目的:了解抗震救灾1个月后部队心理健康状况,探索重要相关事件对部队指战员心理健康的影响.方法:在应急救援开始后32～42 d对驻映秀镇成都军区某红军师炮兵团、济南军区某师炮兵团和四川武警部队三支主力部队指战员为研究对象,随机整群抽样170人,采用症状自评量表(SCL-90)进行调查.救援部队人员SCL-90因子分值分别与中国正常人常模和中国军人常模比较,采用两样本t检验确定差异显著性.结果:78份调查表符合要求纳入分析.救援部队官兵的SCL-90总分为130.25±33.07,阳性项目数为27.59±15.75,各因子分值在1.28～1.64之间;与中国正常人18～29岁常模相比,救援部队官兵躯体化症状因子偏高(P＜0.05),而人际关系敏感因子偏低(P＜0.01);与中国军人男子组常模比较,救援部队官兵强迫因子、人际关系敏感因子、抑郁因子、焦虑因子、偏执因子和精神病性因子均偏低(P＜0.05);比较参与和没有参与遇难者遗体挖掘处理的官兵,发现参与组在睡眠和饮食因子有较低的评分(P＜0.01),而阳性症状均分有较高的评分(P＜0.01).结论:地震救援部队官兵在震后32～42 d的心理卫生状况基本正常,某些阳性症状与遇难者遗体处理等抗震救灾相关事件相关,对官兵抗震救灾事件相关心理问题的定期监测能有效发现和干预可能的心理疾患.     

从汶川地震救援看医学生专业素质培养

本文通过总结汶川地震救援的经验教训,指出汶川地震救援对医学生专业素质培养提出了新的要求:必须对医学生进行灾害救援意识教育,强化灾害救援技能训练,实施灾害救援管理教育,加强灾害卫生防疫和心理疏导技能训练,使医学生成为既能适应平时医疗卫生防治、又能适应各种应急救援的专业化人才.     

谈紧急医疗救援体系的建设

为加强和完善紧急医疗救援网络建设和管理，泸州市建立起一套完善的、适合泸州实际的管理体系。将急救体系的管理分为以下几部分：独立设置指挥机构；建设医疗急救网络；建立城市联动机制；建立完整的管理制度：制定人员培训计划。运行一年，成效显著。     

汶川特大地震应急期救灾人员躯体化和强迫症状调查

目的 了解汶川特大地震救灾人员强迫症状和躯体症状的特点及其影响因素.方法 地震应急期,在灾区采用症状自评量表(SCL-90)对救灾人员进行测评,并选择救灾预备队人员作为对照,比较两组人员强迫和躯体因子分,并分析其相关因素.结果 (1)两组人员强迫、躯体化因子分间差别有统计学意义(P＜0.05);(2)躯体症状中,腰痛、感到身体软弱无力、肌肉酸痛的检出率最高;强迫症状中检出率较高的是忘性大、担心自己的衣饰及仪态、做事必须反复检查并做得很慢、不能集中注意力;(3)躯体因子分与救灾地区、参与救灾时间、军龄、文化程度相关(P＜0.05);强迫因子分与救灾地区、参与救灾时间、文化程度相关(P＜0.01).结论 在特大地震应急期,现场救灾人员躯体化和强迫症状突出,呈现明显时间、地域和文化背景特征.     

地震灾害中对儿童紧急救治的临床研究

目的通过最早抵达汶川地震中心区域的第三军医大学医疗救援队对于儿童的紧急救治,研究地震等自然灾害发生后的儿童紧急救治所面临的问题。方法收集收治儿童的临床资料,包括年龄、日期、受伤情况、疾病、手术等进行比较。结果 10 d内收治的患者总数为882例次,年龄低于18岁的儿童为192例,占21.8%,其中,学龄期儿童数量最多(105例,55%),其次为青春期儿童(60例,31%),而幼儿(14例,7%)、婴儿(8例,4%)和新生儿(5例,3%)数量相对较少。192例儿童有256处创伤,受伤的最多的部位是四肢(106处,55.2%),其次是身体表面(67处,34.9%)。127例为简单放开性损伤(66.2%),106例骨折(55.2%)。轻度创伤121例(63.0%),中度损伤56例,(29.7%),重度创伤8例(4.2%),致死性创伤7例(3.7%)。结论收治的伤病员中超过20%是儿童,尤其以学龄期儿童数量最多,早期紧急救援中骨科和普通外科医生任务繁重,儿科医生在早期紧急救治中应起更大作用,而后期感染性疾病的控制变得更加重要。     

地市级突发公共事件应急救援高端仿真训练系统设计与构建

通过利用虚拟仿真技术和优化Sim Man 3G高端模拟仿真系统,构建出突发公共事件虚拟救援场景;提高训练救援人员在复杂现场确定救援策略的能力,同时强化其整体救援技能.新的培训模式也提供了更加科学的强化培训内容,能显著提高救援人员在应急救助中的技术水平和心理适应.     

洪涝灾害公共卫生风险评估指标体系的构建及应用

目的: 构建洪涝灾害公共卫生风险评估指标体系,为灾害期间公共卫生风险等级评估提供定量化判断依据。方法: 采用德尔菲法和专家会商法构建洪涝灾害公共卫生风险评估相关指标及其评分标准,运用层次分析法获得指标的权重,并进一步应用于安徽省2016年洪涝灾害公共卫生风险评估中。结果: 构建并确定了五大类17个洪涝灾害公共卫生风险评估指标、评分标准及其权重。根据构建的指标体系,2016年安徽省洪涝灾害公共卫生风险总分为0.26分,风险判断结果为"灾害期间卫生应急措施有效,公共卫生风险有效控制"。结论: 本研究构建的洪涝灾害公共卫生风险评估指标体系可为灾害现场开展定量评估提供技术支持,同时也可为其他类型灾害现场评估提供参考。     

Omics Approaches for Exploring Pneumoconiosis: A Review

Pneumoconiosis,a fatal lung disease caused by dust inhalation and deposition,is one of the leading occupational diseases worldwide[1].The dust is primarily inorganic particles,such as silica particles,coal dust,and asbestos fibers.If the diameter of dust is less than 5μm,it is defined as‘respirable dust’that can easily reach the distal airways and alveoli[2].     

汶川地震灾后心理干预的特点及思考

根据汶川地震灾后心理干预的主要特点,结合以往我国地震灾后群体心理及心理干预的实证研究,提出了对汶川地震灾后心理干预的思考:(1)灾区现场的心理干预活动不同于在心理咨询室进行的咨询;(2)灾区现场的心理干预有特定要求,并非所有的心理干预者都适合在灾区现场进行心理干预工作;(3)灾区心理干预工作者应以团队形式开展工作;(4)应做好对灾区心理干预工作者的援助;(5)心理援助工作者应避免预设立场后开展工作;(6)心理学专业工作者要引导整个社会科学地对待受灾群众,防止其被"爱心"所伤;(7)应加强对地震灾后心理干预工作的研究.     

医疗服务体验和满意度监测结果对社区卫生服务质量管理的启示

利用北京市某社区卫生服务中心和服务站的患者体验和满意度监测调查资料,分析社区卫生服务机构患者的就诊时间、健康危险因素和从医生处获得所需信息、机构环境和设施以及患者对医生服务的评价等代表性问题,通过访谈该社区卫生服务中心主任,探讨问题出现的原因,并针对性地提出顺应政策、扩大服务范围、环境整治和设施建设、医务人员技能培训及加强沟通的改进建议。     

Human Adipose-derived Mesenchymal Stem Cells: A Better Cell Source for Nervous System Diseases Application

In order to suggest an ideal source of adult stem cells for treatment of nervous system diseases, neuronal differentiation capacity of human mesenchymal stem cells from adipose tissue (hADSCs) and bone marrow (hBMSCs) were studied in terms of nissl body and synapse structure formation, neural factors secretion function for the first time. The hADSCs and hBMSCs were isolated and differentiated to the neuron-like cells with rat brain-conditioned medium which is potentially a rich source of signals promoting neuronal differentiation. The specific proteins of neurons and neural factors secreted by the cells were detected with immunohistochemistry and ELISA analysis, respectively. Flow cytometric analysis showed that these cells had similar phenotypes and cell growth curves showed that hADSCs proliferated more quickly than hBMSCs. Both kinds of cells were capable of osteogenic and adipogenic differentiation. The morphology of hADSCs and hBMSCs changed during neuronal differentiation and presented neuron-like cell appearance after 14 days differentiation. hADSCs and hBMSCs could differentiated into neuronal-like cells, which were identified by neuron specific proteins: β-Tubulin-Ш, neuron-specific enolase (NSE), and nissl body and their ability to secrete brain derived neurophic factor (BDNF) and nerve growth factor (NGF). Assessment of synaptophysin and growth-associated protein-43 (GAP-43) suggested synapse structure formation in differentiated hADSCs and hBMSCs. The present results demonstrated that hADSCs have a similar neuronal differentiation potential with hBMSCs but with higher proliferation capacity. Adipose tissue is an abundant and easily available, which would be a potential ideal source of adult stem cells for neural-related clinical research and application.     

A Better Instrument for Screening Diabetes in Rural Areas of China: An Equation Developed from Multivariate Logistic Regression or a Simplified Scoring Form

Diabetes has become a major public health concern in the world and the total number of diabetic patients is considered to soar to 366 million in 2030 [1] . Emerging evidence has suggested that earlier detection of type 2 diabetes, glycaemic control improvement and intensified risk factor management     

Efficacy and safety of high-dose esomeprazole–amoxicillin dual therapy for Helicobacter pylori rescue treatment: a multicenter,prospective, randomized,controlled trial

Background:High-dose dual therapy (HDDT) with proton pump inhibitors (PPIs) and amoxicillin has attracted widespread attention due to its favorable efficacy in eradicating Helicobacter pylori (H. pylori). This study aimed to compare the efficacy and safety of high-dose PPI–amoxicillin dual therapy and bismuth-containing quadruple therapy for H. pylori rescue treatment.Methods:This was a prospective, randomized, multicenter, non-inferiority trial. Patients recruited from eight centers who had failed previous treatment were randomly (1:1) allocated to two eradication groups: HDDT (esomeprazole 40 mg and amoxicillin 1000 mg three times daily; the HDDT group) and bismuth-containing quadruple therapy (esomeprazole 40 mg, bismuth potassium citrate 220 mg, and furazolidone 100 mg twice daily, combined with tetracycline 500 mg three times daily; the tetracycline, furazolidone, esomeprazole, and bismuth [TFEB] group) for 14 days. The primary endpoint was the H. pylori eradication rate. The secondary endpoints were adverse effects, symptom improvement rates, and patient compliance.Results:A total of 658 patients who met the criteria were enrolled in this study. The HDDT group achieved eradication rates of 75.4% (248/329), 81.0% (248/306), and 81.3% (248/305) asdetermined by the intention-to-treat (ITT), modified intention-to-treat (MITT), and per-protocol (PP) analyses, respectively. The eradication rates were similar to those in the TFEB group: 78.1% (257/329), 84.2% (257/305), and 85.1% (257/302). The lower 95% confidence interval boundary (−9.19% in the ITT analysis, − 9.21% in the MITT analysis, and −9.73% in the PP analysis) was greater than the predefined non-inferiority margin of −10%, establishing a non-inferiority of the HDDT group vs. the TFEB group. The incidence of adverse events in the HDDT group was significantly lower than that in the TFEB group (11.1% vs. 26.8%, P < 0.001). Symptom improvement rates and patients’ compliance were similar between the two groups.Conclusions:Fourteen-day HDDT is non-inferior to bismuth-containing quadruple therapy, with fewer adverse effects and good treatment compliance, suggesting HDDT as an alternative for H. pylori rescue treatment in the local region.Trial registration:Clinicaltrials.gov, {"type":"clinical-trial","attrs":{"text":"NCT04678492","term_id":"NCT04678492"}}NCT04678492.