直升机飞行员改装体检结果分析

正改装体检是为了判断飞行员的身心状况是否胜任驾驶另一种对身心要求更高、更严的飞行器而进行的体检。高性能武装直升机改装时间尚短,相关问题的研究刚刚开始。本文对2013年78名直升机飞行员改装体检结果进行分析,为改装后高性能武装直升机飞行员的航卫保障提供参考。1对象和方法 (1)对象:2013年在我院进行改装体检的78名直升机飞行员,均为男性,年龄25~49岁,飞行时间274~4624 h。(2)方法:78名直升机     

彩超高频探头诊断血吸虫病早期门脉高压的价值观察

目的观察彩色多普勒超声诊断仪高频探头早期诊断血吸虫病门静脉高压的价值。方法应用彩超低频、高频探头分别检查慢性与晚期血吸虫病人肝实质、肝被膜及脐静脉。结果无论在慢血组109例中还是在晚血组88例中,彩超高频在检测肝被膜分级与低频检测肝被膜分级结果相比差异均有统计学意义(χ2=20.227、13.474,P0.01);低频探头检测肝实质分级与高频探头检测肝被膜分级两者呈正相关关系(r=0.824);无论在慢血组还是在晚血组,高频探头检测到的脐静脉重开率均高于低频探头(P0.001)。结论彩超加高频探头更具有早期诊断血吸虫病门静脉高压的价值。     

体外超声探头及阴道超声探头微生物污染现况调查

目的研究医院体外超声探头、阴道超声探头微生物污染状况。方法对北京市5家医院超声科已清洁、消毒体外超声探头和阴道超声探头进行采样。样品4 h内送实验室进行活菌计数和微生物种类鉴定,同时以金黄色葡萄球菌、铜绿假单胞菌及白假丝酵母为目标菌,测其检出率。结果北京市5家三级甲等综合医院采集体外超声探头173份,菌落总数超标率90.17%,8份体外超声探头上检出金黄色葡萄球菌,1份探头上检出铜绿假单胞菌,未检出白假丝酵母;采集阴道超声样品63份,菌落总数超标率98.41%,金黄色葡萄球菌、铜绿假单胞菌及白假丝酵母均未检出。结论医院超声检查使用的体外超声探头及阴道超声探头细菌污染严重,卫生状况堪忧,存在医院感染风险,亟待寻求合适的消毒方式。     

下排式蒸汽灭菌器改装为脉动真空灭菌器研究

本文介绍了一种将普通下排式蒸汽灭菌器改装为脉动真空灭菌器的方法,具有结构简单、成本低、不易出故障等特点,而使用功能可与新购设备媲美。     

关于医院船改装的思考

分析旧医院船改装中存在的问题，提出相应的对策。分别阐述医院船合理布局、医疗救护系统完善及医疗设备更新的方法及意义，着重论述模块化医院船的改装理念、改良方法等。     

临床超声探头性能指标及使用注意事项

超声探头是医用超声仪器的心脏,是临床超声设备用于诊断的重要部件,它的性能决定了图像质量的好坏。本文主要描述了临床B超探头的分类、结构、性能和使用过程中应该注意的一些问题。     

下排式蒸汽灭菌器改装为脉动真空灭菌器研究

本文介绍了一种将普通下排式蒸汽灭菌器改装为脉动真空灭菌器的方法，具有结构简单，成本低，不易出故障等特点，而使用功能可与新购设备媲美。     

超声探头的故障与维修

论述了超声设备的关键部件——超声探头在使用过程中所产生的故障现象、故障原因及各类故障的处理方法。     

保鲜膜用于胎心监护仪探头隔离防护

胎心监护仪是产科常见设备,使用频率高,探头的污染是医务人员较为关注的问题,常规乙醇消毒又易导致探头的损害,杀菌型耦合剂进入市场后解决了此问题,但是费用相对较高.笔者在临床工作中用一次性保鲜膜覆盖于探头,使探头和患者皮肤间形成一层保护膜,起到了隔离作用,符合医院感染要求,对听诊及监护未造成影响,减轻了患者负担.     

情绪化负为正人生从此不同

很多时候,当我们遇到一个在当时觉得迈不过去的坎时,就会想,为什么这样倒霉的事都让自己遇到;为什么这种无法理喻的人都让自己碰到.殊不知,那时候遇到的事为我们提供了解决问题的机会,那时候栽的坑、上的当正好成为我们的阅历.只要我们善于总结反思、善于发掘自己的能量,不断地学习、狠心地逼自己一把,任何困难都会给我们带来收获.学会...     

Incorporating what Promotoras Learn: Becoming Role Models to Effect Positive Change

Promotoras (community health workers) play an important health promotion role and must be continuously trained, but little is known about how much of their learning they actually put into practice. This non-randomized, longitudinal study examined knowledge and home environmental outcomes of an asthma and healthy homes training offered to promotoras using a train-the-trainer model. Eighty-five promotoras received the training and pre- and post-test surveys were used to measure training outcomes. Results showed a statistically significant increase in asthma and healthy home-related knowledge (P < .001). At 12-months post-intervention, a majority of the promotoras (69%) reported they made household changes to improve their indoor environment as a result of the training. This study suggests that effective trainings can improve promotoras knowledge and behaviors for the promotion of healthy homes in the community. Further evaluation is needed to investigate whether these trainings allow promotoras to serve as role models within their communities "by educating through example" and thereby enhance their credibility as health educators.     

圆形分布法在探讨蝇类季节消长规律中的应用

目的确定蝇类季节消长的高峰日和高峰时段，科学制定防制策略。方法用圆形分布法统计分析赤峰市区1998～2000年蝇类密度监测数据。结果赤峰市区1998～2000年蝇类平均密度高峰日为7月13日，高峰时段为5月25日至9月1日。其中1998年蝇类季节消长高峰日为7月20日，高峰时段为5月31日至9月7日；1999年蝇类季节消长高峰日为6月30日，高峰时段为5月15日至8月16日；2000年蝇类季节消长高峰日为7月23日，高峰时段为6月3日至9月12日。结论3年中蝇类的活动高峰有明显的季节性；圆形分布法可适用于蝇类的季节性分析。     

Rates of Change to a Positive Result in Subsequent Screening Mammography in Korean Women: A Retrospective Observational Study

Objectives:

This retrospective cohort study aimed at calculating some parameters of changes in the findings of the subsequent screening mammography (SSM) in female Korean volunteers.

Methods:

The study included screenees aged 30 to 79 years who underwent SSM voluntarily after testing negative in the baseline screenings performed between January 2007 and December 2011. A change to a positive result was defined as category 4 or 5 by using the American College of Radiology Breast Imaging Reporting and Data System. The proportion of results that had changed to positive (CP, %) was calculated by dividing the number of cases with results that were positive in the SSM by the total number of study participants. The rate of results that had changed to positive (CR, cases per 100 000 screenee-months) was calculated by dividing the number of cases with results that were positive in the SSM by the total number of months of the follow-up period.

Results:

The overall CP and CR in all age groups (n=77 908) were 2.26% and 93.94 cases per 100 000 screenee-months, respectively. The median CP interval in the subjects who had positive SSM results was 30 to 36 months, while that in the age group of 30 to 39 years was shorter.

Conclusions:

Different screening intervals should be considered among women aged between 30 and 59 years. In addition, a strategy for a screening program should be developed for the age group of 30 to 39 years, in particular.     

Positive Parenting Practices Associated with Subsequent Childhood Weight Change

We aimed to identify positive parenting practices that set children on differential weight-trajectories. Parenting practices studied were cognitively stimulating activities, limit-setting, disciplinary practices, and parent warmth. Data from two U.S. national longitudinal data sets and linear and logistic regression were used to examine association of initial parenting practices with subsequent change in body mass index (BMI) Z-score and being overweight, stratified by income and gender. Lower change in BMI Z-score and lower likelihood of being or becoming overweight occurred among girls if parents engaged in cognitively stimulating activities or set bedtime; among low-income girls if parents helped with art and set bedtime; among high-income girls if they participated in dance or music, parents talked about nature or visited a museum or library, or parents had rules about number of hours for watching television; among low-income boys if they participated in dance or parents built something with them or set bedtime; and among high-income boys if they participated in dance or music. Greater expression of warmth was associated with lower change in BMI Z-score. Parenting practices facilitating cognitive stimulation, setting limits, and expressing warmth are associated with lower likelihood of being or becoming overweight and can be promoted by healthcare professionals.     

A Case-Based Approach to Noninvasive Positive Pressure Ventilation

Abstract

Noninvasive positive pressure ventilation (NIPPV) has revolutionized the concept of mechanical ventilation with the major benefit of avoiding invasive mechanical ventilation in specific situations, thereby preventing associated complications. Noninvasive positive pressure ventilation has emerged as the first line of management of hypercapnic respiratory failure (due to chronic obstructive pulmonary disease and neuromuscular weakness) and cardiogenic pulmonary edema in addition to standard therapy in the acute setting. There is improvement in gas exchange, relief of respiratory muscle fatigue, and clinical outcome with reduced morbidity and mortality. Nevertheless, contraindications and failures need to be identified early, as delaying endotracheal intubation is associated with increased morbidity and mortality. Despite overwhelming evidence to support its use, NIPPV is underused. Residents and hospitalists need to identify NIPPV as a treatment option in acute respiratory failure.     

Single-Session Motivational Enhancement Counseling to Support Change Toward Reduction of HIV Transmission by HIV Positive Persons

Given the enormous successes in treating HIV disease with antiretroviral therapies, there is a burgeoning population of healthy, sexually active HIV+ men and women. Because HIV prevention counseling has focused traditionally on persons at risk of becoming infected, there is an urgent mandate to explore ways to engage HIV+ persons in transmission risk reduction counseling. Using two case examples, this article presents an overview of motivational interviewing in a single counseling session as a promising treatment for addressing ambivalence about safer sex with HIV+ persons.     

Positive patch test for mercury possibly from exposure to amalgam

Objectives Mercury allergy is a serious health problem. We investigated the relationship between positive patch test for mercury and sources of mercury exposure, indicated by concentrations in biological samples from healthy medical students. Methods Patch tests for mercury (Hg-PT) were performed on 580 students. For a group of 55 students with a positive Hg-PT result (Hg-PT(+)) and a reference group of 79 students with a negative Hg-PT result (Hg-PT)(−)), mercury concentrations in urine (Hg-u) and hair (Hg-h) were measured. In our search for environmental indicators of mercury exposure, the level of fish intake and mercurochrome usage were determined using a self-administered questionnaire. The oral cavity was investigated and the numbers of decayed teeth filled with amalgam (NA) were counted by dentists. Results For the male Hg-PT(+) group, Hg-u and Hg-h were higher than those of a male reference Hg-PT(−) group; Hg-u values obtained in the early morning and after supper were significantly different. Multiple regression analysis with Hg-u as the objective variable among all students showed that increases in the level of fish intake, mercurochrome usage, and the NA independently increased Hg-u measured in the early morning for both gender groups. NA significantly affected Hg-u. Conclusions We showed that a higher NA was related to a higher Hg-u measured in the early morning. Therefore, exposure to amalgam may increase Hg-u. It was suggested that Hg-PT(+) might be related to a high Hg-u, and possibly to a high NA.