中心静脉穿刺新进针点的可行性研究

Objective To evaluate the feasibility of a new approach to internal jugular vein (IJV) catheterization. Methods Sixty patients undergoing cardiac surgery were randomly divided into two groups (n=30). In group Ⅰ, a new method was used. In group Ⅱ, IJV catheterization from a high medial approach. The overall succcess rate of puncture, the success rate of puncture at first attempt, the success rate of cannulation and complication were recorded. Chest X-ray was taken for confirmation of the position of catheter in subclavian vein. Results The overall success rate of puncture was 100% and the success rate of puncture at first attempt was 93.33% in group Ⅰ, which is significantly higher than those in group Ⅱ(P<0.05). No complication occurred in group Ⅰ including arterial puncture, pneumothorax, hematothorax and difficult catheter placement. In group II there were 3 arterial punctures. Con-clusion This new method is a reliable and safe technique in patienst as compared with the high medial approach.     

高等医学基础综合课程体系的实践研究

采用理论研究与实践研究相结合的手段,第三军医大学将高等医学基础课程结构布局调整为7门综合理论课程和6门综合实验课程.在此基础上,综合优化教学内容、教学方法、教学手段,创建并顺利运行了跨学科的教学组织和管理机制.四年的实践表明,新的医学基础综合课程教育模式有利于培养学生获得知识和综合运用知识的能力,有益于培养学生创新精神、创新能力和实践动手能力.创立的高等医学基础综合课程教育模式具有较高的理论水平和实践推广价值.     

中心静脉穿刺新进针点的可行性研究

Objective To evaluate the feasibility of a new approach to internal jugular vein (IJV) catheterization. Methods Sixty patients undergoing cardiac surgery were randomly divided into two groups (n=30). In group Ⅰ, a new method was used. In group Ⅱ, IJV catheterization from a high medial approach. The overall succcess rate of puncture, the success rate of puncture at first attempt, the success rate of cannulation and complication were recorded. Chest X-ray was taken for confirmation of the position of catheter in subclavian vein. Results The overall success rate of puncture was 100% and the success rate of puncture at first attempt was 93.33% in group Ⅰ, which is significantly higher than those in group Ⅱ(P<0.05). No complication occurred in group Ⅰ including arterial puncture, pneumothorax, hematothorax and difficult catheter placement. In group II there were 3 arterial punctures. Con-clusion This new method is a reliable and safe technique in patienst as compared with the high medial approach.     

大学公共选修课现状分析研究

本文具体分析了综合型大学开设选修课的意义和开设选修课过程中存在的主要问题,从学生、教师、学校管理三方面提出一些建议,切实提高选修课教学质量,最终达到开设选修课的目的。     

乌鲁木齐空港口岸化学恐怖事件应急处置演练情况分析

目的积极应对我国西北边境口岸日益严重的恐怖威胁,加强乌鲁木齐机场口岸应对化学恐怖事件的处置能力。方法按照《有害气体泄漏事件应急处置演练脚本》,启动《核生化突发公共卫生事件应急处置预案》,通过合理安排,多部门协作,展开对涉恐化学泄漏事件的应急处置演练。结果演练过程基本按照《演练脚本》的预定规程进行,通过演练提高了口岸检验检疫部门相关人员的专业水平和应对能力。结论现有《核生化突发公共卫生事件应急处置预案》的实用性得到了检验,检验检疫人员以往的培训成果得以发挥,同时在演练现场也暴露出若干问题,如：部分仪器过于老旧,预案体系完整性不足等,需要进一步加强完善。     

垃圾焚烧烟气汞的治理技术与评价

介绍了当前垃圾焚烧烟气中汞形态分布,对利用现有设备脱汞、Na2S喷射、吸附剂捕集等方法在烟气脱汞运用中的优缺点进行分析,建立实验室规模的活性炭吸附-脱附系统,对比氮气氛围不同活性炭对气态汞的吸附性能,以更好地控制垃圾焚烧烟气中气态汞的排放行为。     

上尿路结石围手术期尿细菌检测的临床意义

目的 分析上尿路结石患者围手术期尿细菌谱及其药敏结果,指导抗生素治疗,减少术后发热和感染并发症.方法 2009年1月至2010年9月,148例上尿路结石患者行经皮肾镜取石术,对患者术前中段尿、术中感染性结石、术后肾造瘘管末端进行细菌培养,选择敏感药物行抗感染治疗,并对细菌谱、术后发热及感染并发症进行总结分析.结果 148例患者中段尿细菌培养阳性38例(25.7%),其中大肠埃希菌17例(44.7%)、表皮葡萄球菌4例、奇异变形杆菌3例、肺炎克雷伯杆菌3例、铜绿假单胞菌2例、屎肠球菌2例、溶血葡萄球菌2例、鲁氏不动杆菌1例、弗氏柠檬杆菌1例、酵母样菌1例、摩氏摩根菌1例、腐生葡萄球菌1例;感染性结石10例,细菌培养阳性8例,其中大肠埃希菌和奇异变形杆菌各3例,酵母样菌和铜绿假单胞菌各1例;肾造瘘管细菌培养阳性25例(16.9%),其中表皮葡萄球菌5例、溶血葡萄球菌5例、铜绿假单胞菌5例、屎肠球菌3例、科氏葡萄球菌2例、沃氏葡萄球菌2例、蜡样芽孢杆菌1例、产气肠杆菌1例、粪肠球杆菌1例.3种标本共培养344例次,阳性71例次,总阳性率20.6%.培养阳性者常用敏感药物包括亚胺培南、头孢吡肟、万古霉素、呋喃妥因等.术后发热患者41例(27.7%),包括术前中段尿培养阳性10例和肾造瘘管培养阳性患者9例;术后出现感染性休克1例.结论上尿路结石术前尿细菌以革兰阴性杆菌为主,术后末期革兰染色阳性球菌常见;术前中段尿培养能指导抗生素应用,有效控制围手术期尿路感染,减少并发症.

Abstract：

Objective To analyze the bacterial distribution and resistance in upper urinary tract stone patients, then choose suitable antibiotics and reduce infectious complications accordingly.Methods Middle flow urine, infectious stone and the end of kidney drainage tube were taken for culture in 148 patients who underwent percutaneous nephrolithotomy between January 2009 to September 2010. Antibiotics were used according to the culture results and the complications secondary to infection were analyzed. Results Urinary pathogens presented in 38 (25.7%) patients before operation.There were 112 strains of bacteria. The predominant strains included: Escherichia coli (17 cases,11.5%), Staphylococcus epidermidis (4 cases) and Proteus mirabillis (4 cases). Escherichia coli and Proteus mirabillis were common in stone culture. Staphylococcus epidermidis (5 cases),Pseudomonas aeruginosa (5 cases) and Staphylococcus haemolytcus (5 cases) were found in renal drainage tube culture which were positive in 25 patients. Imipenem, cefepime, vacomycin, nitrofurinton were sensitive and commonly used antibiotics. Forty-one patients (27.7 %) had fever postoperatively, including 10 positive for middle urine culture and 9 positive for drainage tube culture. One infective shock was diagnosed postoperatively. Conclusions Gram-negative bacilli are predominant in the upper urinary tract stone patients preoperatively. Gram-positive ones are common postoperatively.Suitable antibiotics, based on middle flow urine culture, could reduce urinary infective complications.     

石河子大学学生膳食营养知识态度行为

了解石河子大学学生的营养知识、态度和膳食行为现状,并探讨其影响因素,为开展营养知识教育提供依据.方法 采用自制的大学生营养调查问卷,随机抽取石河子大学14个学院2 656名大学生进行营养知识、态度及行为调查.结果 大学生膳食营养知识平均得分为(3.40±1.80)分,医学生得分(3.71±1.69)高于非医学生(3.28±1.82),差异有统计学意义(Z=-5.57,P<0.05);女生得分(3.71±1.70)高于男生(3.13±1.83),差异有统计学意义(Z=-8.46,P<0.05);汉族学生得分(3.57±1.77)高于少数民族学生(2.62±1.70),差异有统计学意义(Z=10.73,P<0.05).电视(57.6%)、网络(51.4%)是大学生获取营养相关信息和知识的主要途径.结论 大学生营养知识得分不高,不同学院、性别、民族是大学生营养知识得分的主要影响因素.     

临床医学专业学生社区预防医学教学模式的实践

在48届世界卫生大会第20次全体会议上(1995年5月12日)通过了"实现人人享有卫生保健的医学教育和实践的再定向决议".同时又提出对21世纪医生的培养目标:能促进人们形成健康生活方式;能进行预防保健、治疗和康复相结合的综合服务;能从伦理、经济的角度合理使用新技术;能协调病人、家庭和社区之间的卫生保健需求;能协调卫生机构内部和卫生与其他机构之间的合作.