医联体基层师资队伍能力状况问卷调查及分析

目的  了解医联体全科医学基层实践基地师资现状，为更好地发挥牵头医院的优势及带头作用，以期切实地不断加强基层师资建设。 方法  2021年4月对北部医联体基层实践基地师资进行调查，内容包括一般情况、职业素养、临床工作能力、带教能力和可持续发展能力。共发放调查问卷16份，收回16份，回收率100%。结果  在职业素养中，基层师资对自身职业道德评分较高（9.15±0.99），对全科医学的热爱程度评分为8.69±1.11分，对教学工作的热爱评分为8.23±1.09分；在临床工作能力中，对急危重症初步处置和转诊评分较低（7.92±1.26）；在带教能力中，教案书写、教学方法与技巧、门诊带教和基本技能带教评分较低，分别为7.69±1.38、7.69±1.44、7.77±1.24和7.77±1.30；在可持续发展能力中，科研意识和论文撰写评分较低，分别为7.23±1.54和6.77±1.59。结论  北部医联体全科医学基层实践基地师资较为缺乏，带教能力需要进一步提升，可持续发展能力有待不断提高。     

IMB模型的理论框架与运用

<正>IMB模型(信息-动机-行为技巧模型,Information-Motivation-Behavioral Skills Model,简称IMB)由JD费舍尔和WA费舍尔在1992年最早提出,与以往的健康相关行为改变模式相比,将影响行为改变的各种因素分为信息、动机、行为技巧3个组分,并验证自身具有的预防疾病的信息和参与预防的动机可通过行为技巧引发预防行为的启动和维     

3种微生物菌肥对川芎生长发育、产质量和镉富集的影响

目的 探究3种微生物菌肥对川芎生长发育、产质量和镉（Cd）富集的影响。方法 以川芎苓种为材料，在川芎主产区（彭州、眉山）开展田间试验，采收期采收样品，测定川芎农艺性状、产量；采用2020年版《中华人民共和国药典》收载方法分析浸出物、挥发油、阿魏酸含量；采用电感耦合等离子体-质谱法（ICP-MS）测定镉含量；采用差异显著性分析、相关性分析、聚类分析进行数据处理。结果 适宜浓度的3种微生物菌肥对川芎均具有促生作用。在产量和质量方面，金无踪（1.50吨/hm²）（1吨=1 000 kg，下同）和翠京元（1.5 L·hm^-2）处理后川芎增产0.92%~46.34%；翠京元（1.8 L·hm^-2）和神锄（15，30 kg·hm^-2）处理后川芎水溶性浸出物增加了0.06%~18.79%，其中翠京元（1.8 L·hm^-2）增加显著（P<0.01）；金无踪（0.75，1.50，2.25吨/hm²），神锄（15，45 kg·hm^-2），翠京元（1.2 L·hm^-2）处理后川芎醇溶性浸出物降低了3.51%~22.94%（P<0.01）；金无踪（1.50吨/hm²）和神锄（30 kg·hm^-2）处理后川芎阿魏酸质量分数降低了2.14%~30.56%；3种微生物菌肥对川芎挥发油含量影响较小。在Cd富集方面，金无踪（0.75，1.50，2.25吨/hm²），神锄（15，30，45 kg·hm^-2）和翠京元（1.2 L·hm^-2）处理后土壤Cd浓度增加了11.33%~76.36%（P<0.01）；金无踪（0.75吨/hm²）和翠京元（1.8 L·hm^-2）处理后川芎Cd富集系数减小了2.58%~48.38%，Cd含量及Cd积累量分别降低了9.54%~25.96%，9.34%~18.88%。结论 3种微生物菌肥对川芎生长发育、物质积累及降低Cd含量有一定的积极作用，各指标受到产地和处理方法共同影响。综合各指标分析，金无踪（0.75，1.50吨/hm²）能较好地适应川芎根际土壤微生态环境，其在保障川芎药材产量的前提下能有效降低Cd含量。     

A Prenatal Ultrasound Scanning Approach: One-Touch Technique in Second and Third Trimesters

This study was aimed at evaluating the performance of the innovative technique Smart Fetus (SF) developed to recognize the planes and obtain the basic biometric measurements of fetuses automatically. This prospective study included 1005 uncomplicated singleton pregnancies undergoing routine examinations. For every pregnancy, planes, including the transverse section of the thalami, transverse section of the abdomen and longitudinal section of the femur, were acquired, and standard biometric measurements, including biparietal diameter, head circumference, abdominal circumference and femur length, were obtained using SF and traditional ultrasound technique (TUT). The accuracy, reproducibility and time required for the analysis of SF were compared with those of TUT. In 998 of 1005 cases (99.30%), SF successfully acquired the sections and made all measurements. The agreement between the techniques was high for all measurements. The time to obtain sections and measure biometric parameters or solely measure biometric parameters was significantly shorter with SF than with TUT. No significant differences were found in SF repeated measurements obtained by two independent observers. The SF technique helped in the acquisition of reliable standard sections and biometric measurements and saved time. It might serve as a novel ultrasound scanning approach and improve workflow efficiency.     

Adult‐onset inflammatory linear verrucous epidermal nevus: Immunohistochemical studies and review of the literature

Adult‐onset inflammatory linear verrucous epidermal nevus (ILVEN) is an uncommon cutaneous disease compared to childhood‐onset ILVEN. The typical histopathologic features are alternating parakeratosis and orthokeratosis with an absent granular layer underneath parakeratosis, in contrast to a thickened granular layer below the foci of orthokeratosis in psoriasiform epidermal hyperplasia. Herein, we present a 49‐year‐old woman with typical clinical and histopathologic characteristics of adult‐onset ILVEN, including linear arrangement of thick scaly papules and plaques localized on the medial side of her right leg, ankle, and foot. Immunohistochemical studies included involucrin, Ki‐67, and keratin‐10. Compared to the staining pattern in psoriasis, the expression of involucrin in this case was of lower intensity and localized to upper epidermal layers with relatively less extensive staining beneath regions of parakeratosis as compared to orthokeratosis; Ki‐67 showed lower basal layer proliferative activity; and keratin‐10 showed a greater intensity of staining within suprabasal epidermis.