联合教学模式在麻醉科住院医师规范化培训临床紧急事件处理教学中的应用

目的 探讨基于案例学习(CBL)结合迷你临床演练评估(Mini-CEX)教学模式在麻醉科住院医师规范化培训(规培)处理临床紧急事件中的应用效果。方法 选择2020—2021年20名麻醉科规培医师作为观察组,2018—2019年20名麻醉科规培医师作为对照组,分别采用CBL结合Mini-CEX教学模式和传统规培教学模式对紧急事件处理进行临床教学。规培1年后,记录临床理论考试成绩和应急案例分析成绩以及问卷调查结果(教学生动性、教学吸引性、学员参与度、分析全面性、印象深刻程度等教学反馈结果)和对教学方法的满意情况。结果 规培1年后,观察组理论考试成绩为(93.5±1.6)分,应急案例分析考核成绩为(89.8±2.2)分,对照组理论考试成绩为(89.0±1.8)分,应急案例分析考核成绩为(83.9±1.7)分,观察组临床理论考试成绩和应急案例分析成绩明显高于对照组(P<0.05)。观察组教学反馈结果和对教学方法的满意率明显高于对照组(P<0.05)。结论 CBL结合Mini-CEX教学模式在麻醉科规培临床紧急事件处理教学中的应用效果优于传统规培教学模式,能够明显提高规培医师的临床综...     

县级医院护士工作压力源分析与干预

护士作为医院的一线工作人员,其工作性质和时间相对于一般企事业员工来说有更强的不稳定性,而且护士必须经常面对患者及其家属、医生及其他与工作相关的人员,这些因素都会使护士产生工作压力.工作压力不但会影响护士身心健康,还会影响其工作质量.目前国内对三级医院护士所做的工作压力源及工作疲溃感的调查研究较多,但针对县级医院护士的调查不多见[1,2].     

脊髓胶质细胞在小鼠骨癌痛形成中的作用

Objective To evaluate the role of gliocyte in the spinal cord in the development of bone cancer pain (BCP) in mice. Methods Forty male C3H/He mice aged 8-10 weeks weighing 18-22 g were randomly divided into 4 groups ( n = 10 each) : group I sham operation (group S) , group II BCP, group Ⅲ PBS and group IV minocyline (group M) . In group BCP, PBS and M, bone cancer pain was produced by injection of NCTC2472 fibrosarcoma cell suspension (2 x 105 cells) 10 μl into medullary cavity of calcaneus bone, while in group S, PBS solution 10 μl was injected instead of cancer cell suspension. In group PBS and M, PBS 5 μl and minocyline 5 μl (dissolved to 0.2 mmol/L in PBS)_were given IT immediately before cancer cell inoculation once a day for 11 consecutive days respectively. Mechanical pain threshold was measured at 1 d before cancer cell inoculation, and at 0, 3, 5, 7, 9 and 11d after cancer cell inoculation. Cold pain threshold was measured at 3, 7, 9 and 11d after cancer cell inoculation. The animals were killed after measurement of pain threshold and L4-6, segment of spinal cord was removed for determination of GFAP and CD11b expression by Western blot. Results Compared with group S, mechanical pain threshold was significantly increased at 3-11 d after cancer cell inoculation in group BCP and PBS, and at 3 and S d after cancer cell inoculation in group M, and cold pain threshold was significantly increased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was up-regulated in group BCP, PBS and M ( P < 0.05) . Compared with group BCP, mechanical pain threshold was significantly decreased at 3-11 d after cancer cell inoculation, cold pain threshold was significantly decreased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was down-regulated in group M ( P <0.05) . ConclusionThe activiton of gliocyte in the spinal cord is involved in the development of bone cancer pian in mice.     

围麻醉期过敏反应的原因及其防治策略

过敏反应作为围麻醉期最常见的临床急症之一,是一种威胁生命的并发症.不同国家和地区围麻醉期过敏反应发生率为1/20000～1/1380,死亡率高达3％～9％,约占麻醉期间总死亡的5％～7％[1] ,但到目前为止,在全国没有确切的统计数据.本研究回顾了本院近两年接受手术室内麻醉患者的麻醉记录单,分析过敏反应的发生情况及其诊...     

金州区马家镇马家村一起霍乱疫情的调查报告

目的：通过流行病学调查分析,查找金州区马家镇马家村一起霍乱爆发的原因。方法收集金州区马家镇马家村霍乱疫情流行病学资料,采用描述性研究的方法对其进行分析。结果自2013年8月25日-9月5日共发生71例腹泻病例,6例霍乱确认病例：轻型1例,中型3例,重型2例。6例病人均入院进行隔离治疗,全部治愈出院。确诊病例人群分布：病例最大年龄为85岁,最小年龄为2个月。2例男性,4例女性。其中3例为家务,1例为民工,1例为散居儿童,1例为农民;腹泻病人的时间分布：发病高峰在8月27日和9月1日腹泻病人的职业分布：农民占比例较大;腹泻病人的人群分布：35~60岁发病较多,马家村水井供水范围内腹泻病人多,占90%。结论经流行病学调查分析,认为引起此次霍乱爆发的原因是由于马家村水塔防水层破损或管网渗漏使水受到污染引起的O1群霍乱弧菌稻叶型的水型爆发。     

脊髓胶质细胞在小鼠骨癌痛形成中的作用

Objective To evaluate the role of gliocyte in the spinal cord in the development of bone cancer pain (BCP) in mice. Methods Forty male C3H/He mice aged 8-10 weeks weighing 18-22 g were randomly divided into 4 groups ( n = 10 each) : group I sham operation (group S) , group II BCP, group Ⅲ PBS and group IV minocyline (group M) . In group BCP, PBS and M, bone cancer pain was produced by injection of NCTC2472 fibrosarcoma cell suspension (2 x 105 cells) 10 μl into medullary cavity of calcaneus bone, while in group S, PBS solution 10 μl was injected instead of cancer cell suspension. In group PBS and M, PBS 5 μl and minocyline 5 μl (dissolved to 0.2 mmol/L in PBS)_were given IT immediately before cancer cell inoculation once a day for 11 consecutive days respectively. Mechanical pain threshold was measured at 1 d before cancer cell inoculation, and at 0, 3, 5, 7, 9 and 11d after cancer cell inoculation. Cold pain threshold was measured at 3, 7, 9 and 11d after cancer cell inoculation. The animals were killed after measurement of pain threshold and L4-6, segment of spinal cord was removed for determination of GFAP and CD11b expression by Western blot. Results Compared with group S, mechanical pain threshold was significantly increased at 3-11 d after cancer cell inoculation in group BCP and PBS, and at 3 and S d after cancer cell inoculation in group M, and cold pain threshold was significantly increased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was up-regulated in group BCP, PBS and M ( P < 0.05) . Compared with group BCP, mechanical pain threshold was significantly decreased at 3-11 d after cancer cell inoculation, cold pain threshold was significantly decreased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was down-regulated in group M ( P <0.05) . ConclusionThe activiton of gliocyte in the spinal cord is involved in the development of bone cancer pian in mice.     

脊髓胶质细胞在小鼠骨癌痛形成中的作用

Objective To evaluate the role of gliocyte in the spinal cord in the development of bone cancer pain (BCP) in mice. Methods Forty male C3H/He mice aged 8-10 weeks weighing 18-22 g were randomly divided into 4 groups ( n = 10 each) : group I sham operation (group S) , group II BCP, group Ⅲ PBS and group IV minocyline (group M) . In group BCP, PBS and M, bone cancer pain was produced by injection of NCTC2472 fibrosarcoma cell suspension (2 x 105 cells) 10 μl into medullary cavity of calcaneus bone, while in group S, PBS solution 10 μl was injected instead of cancer cell suspension. In group PBS and M, PBS 5 μl and minocyline 5 μl (dissolved to 0.2 mmol/L in PBS)_were given IT immediately before cancer cell inoculation once a day for 11 consecutive days respectively. Mechanical pain threshold was measured at 1 d before cancer cell inoculation, and at 0, 3, 5, 7, 9 and 11d after cancer cell inoculation. Cold pain threshold was measured at 3, 7, 9 and 11d after cancer cell inoculation. The animals were killed after measurement of pain threshold and L4-6, segment of spinal cord was removed for determination of GFAP and CD11b expression by Western blot. Results Compared with group S, mechanical pain threshold was significantly increased at 3-11 d after cancer cell inoculation in group BCP and PBS, and at 3 and S d after cancer cell inoculation in group M, and cold pain threshold was significantly increased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was up-regulated in group BCP, PBS and M ( P < 0.05) . Compared with group BCP, mechanical pain threshold was significantly decreased at 3-11 d after cancer cell inoculation, cold pain threshold was significantly decreased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was down-regulated in group M ( P <0.05) . ConclusionThe activiton of gliocyte in the spinal cord is involved in the development of bone cancer pian in mice.     

大连市金州区糖尿病的流行病学调查与分析

为明确我区糖尿病流行特点及影响因素 ,于2 0 0 0年对我区的两个居民委、两个村的 872人进行了糖尿病的流行病学调查。现将结果分析报告如下。1　一般资料1.1对象和方法1.1.1调查对象　抽取金州区先进街道的八里和二十二居民委以及三十里堡镇的东山后村和东三十里村 ,选择年龄     

亚甲蓝用于脊柱侧弯矫形术患者围术期顽固性低血压一例

<正>患者,男,31岁,151 cm, 39 kg, 因“发现胸背部隆起不对称17年”入院。2006年发现胸背部隆起不对称,未予特殊处理,现胸背部隆起不对称明显加重,出现腰背部疼痛,正常行走时呼吸困难。既往外院行肩关节骨折复位。查体心肺无明显异常。脊柱正侧位片：颈椎曲度变直,胸腰椎明显侧弯,呈S型。ECG示：窦性心律,V1导联R/S>1,r波递增不良,顺钟向转位。心脏彩超示：二尖瓣、三尖瓣轻度反流,EF 59.5%(脊柱侧弯心脏受压变形)。