基层医院健康促进效果评价

目的了解基层医院健康促进的效果。方法制定政策支持,改善医院环境,提高和发展个人健康技能,实行全员培训,大力开展社区健康服务,调整服务方向。结果制定和统一了医院健康促进的规章制度,并得到实施,发表健康促进有关学术论文10篇,母乳喂养知识知晓率干预组达到97.68%,显著高于对照组73.42%(P<0.05);住院期间和产后第1个月、第4个月纯母乳喂养率,干预组分别为97.68%,82.48%,86.41%,对照组分别为97.71%,71.71%,60.29%,其中,两组之间第1个月,第4个月有显著差异(P<0.05);2005年医院职工健康教育知识知晓率比2002年明显提高(P<0.01);社区居民健康知识知晓率有明显提高,健康行为形成率提高不明显。结论创建健康促进医院是新时期确保基层医院可持续发展的有效方法之一。     

高等职业学校护理专业中医教学现状调查

目的了解高等职业学校护理专业中医教学的现状.方法对省内外具有代表性的医学职业学校进行问卷调查,了解其护理专业中医课程设置情况及教学情况.同时,对职业大专毕业生进行问卷调查,了解其在临床护理工作中中医知识的运用情况.选择具有代表性的各级医院,对其管理人员及临床医生进行问卷调查,了解其在临床护理工作中中医知识的运用情况及对中医教学的建议.结果在护理实践中多数护士需要运用中医知识护理患者,但临床护士的中医知识贫乏,尤其是对中医护理的操作技能和中药方剂知识了解甚少,影响临床运用.学校的中医教学由于教学时数偏少等多种原因,无法安排充足的实践教学时间,有的操作只能看录像,学生没有动手的机会,更谈不上学以致用,出现了教学与临床严重脱节的局面.结论中医护理教学应进行改革,以适应护理专业学生和临床护理工作的需要.     

升学与就业——班主任的心得体会

在中职教育面临严峻的升学与就业压力面前，我们如何适应当前形势，教育学生正确对待升学与就业，最终提高升学率与就业率，这是我们需要研究的一个重要课题。     

病案复印工作的信息化管理

目的为了将病案复印管理工作由传统的手工统计分析升级为信息化管理,运用计算机技术开发研制《病案复印管理系统》。方法依据病案复印流程的要求设计、建立数据库,根据工作需要设置检索查询,应用VisualBasic6.0编程工具和Access数据库实现程序设计。结果病案复印管理系统设计规范,具有良好和人机界面和操作性能,并提供了丰富的数据查询和统计分析功能。     

The design of a cervical vertebra titanium plate-interbody fusion cage

Objective： To study the biomechanical feature of a newly designed cervical vertebra internal fixation device and its clinical applications. Methods： Some functional spinal units were fixed respectively with titanium plate, fusion cage and new device designed by ourselves, then a controlled biomechanical study including flexion, extension, torsion and lateral bending was performed and the results were analyzed. Results： As to the mechanical performance, fusion cage showed poor performance in extension test and so did the titanium plate in the distortion test. However, the new device showed good performance in every test. Conclusion： Both simple titanium plate fixation and simple fusion cage fixation have biomechanical defaults, but they are complementary. The titanium plate-interbody fusion cage avoids the defaults and has specific advantages.     

Four-dimensional sonographic assessment of fetal facial expression early in the third trimester.

OBJECTIVE: To evaluate the characteristic patterns of facial expression in fetuses aged from 28 to 34 weeks using 4-dimensional (4-D) ultrasonography. METHODS: The faces of 10 healthy fetuses aged from 28 to 34 weeks were recorded continuously for 15 min with a 4-D ultrasonographic machine performing up to 25 frames per second. The occurrence rates of blinking, mouthing, yawning, tongue expulsion, smiling, scowling, and sucking were evaluated. RESULTS: Mouthing was the most frequent facial expression (median, 6.5; range, 2-19) whereas the least frequent were scowling (median, 1; range, 0-9) and sucking (median, 1; range, 0-2). Mouthing was evident in all fetuses and significantly more frequent than any other movement (P<.05). Yawning (median, 3; range, 0-6), smiling (median, 2; range, 0-9), and blinking (median, 1.5; range, 0-6) were observed in most cases. Tongue expulsion (median, 1.5; range, 0-5), scowling, and sucking were each observed in 6 cases. CONCLUSION: 4-D sonography provides a means of evaluating fetal facial expression early in the third trimester. It may be a key to predicting fetal brain function and well-being and an important modality in future fetal neurophysiologic research.     

体外着床模型中人孵化后早胚细胞角蛋白和肌动蛋白的表达

目的:建立理想的体外胚胎着床模型,并检测模型中人孵化后早胚细胞角蛋白、肌动蛋白和hCG。方法:孵化后早胚与人子宫内膜蜕膜化的基质细胞共培养,观察胚泡在基质细胞层上的定位、黏附、铺展和侵入过程;用免疫荧光染色技术,测定共培养系统中的细胞角蛋白和肌动蛋白;用免疫荧光分析技术,测定培养液中的hCG水平。结果:胚泡和基质细胞共培养5h起,胚泡开黏附在基质细胞层上,最终侵入蜕膜化的基质细胞间。共培养48h后,细胞角蛋白仅仅在滋养层细胞中表达;肌动蛋白在人蜕膜化的基质细胞和滋养层细胞中均有表达。囊胚与子宫内膜基质细胞共培养的培养液中的hCG水平明显高于囊胚单独培养的(P<0.01)。结论:成功建立了一个能反映人胚泡黏附、铺展及侵入到人子宫基质细胞的体外着床模型,细胞角蛋白、肌动蛋白和hCG在着床早胚细胞中起相应变化。     

双胎妊娠一胎死亡后期待治疗14例分析

目的:探讨双胎妊娠孕中晚期一胎死亡后期待治疗的临床效果。方法:回顾性研究分析1994年1月至2004年4月同济医院双胎妊娠一胎死亡的病例共14例。结果:期待治疗时间最长为61天,最短为3小时,平均保胎时间为12天,分娩平均孕周为32周。无一例出现明显凝血功能障碍。先兆子痫和胎膜早破发生率最高(35.7%)。胎儿畸型是胎死宫内的重要原因。结论:双胎妊娠一胎死亡后可采取期待治疗,在严密监测存活胎儿宫内安危,积极处理母体合并症或并发症的条件下,尽量延长存活胎儿在宫内生长的时间,提高存活胎儿的生存质量。     

Age transition of tuberculosis patients in Taiwan, 1957-2001.

BACKGROUND: The incidence of tuberculosis (TB) has been falling in many developed countries; however, there is a trend of an increasing proportion of TB among the elderly. The aim of this study was to evaluate the age transition of patients with TB in Taiwan from 1957 to 2001. METHODS: Data on the number of TB cases and patient age were collected from the National Tuberculosis Registry for three different 5-year periods: 1957-1961, 1977-1981, and 1997-2001. The distribution of TB cases in these three different periods was analyzed. RESULTS: The age distributions of TB patients were different among the 1957-61 (n = 26,000), 1977-81 (n = 31,363) and 1997-2001 (n = 71,447) groups. During the 1957-61 period, the most common age group was 25-44 years (50.9%). During 1977-81, the most common age group was 45-64 years (44.9%). In 1997-2001, the most common age group had shifted to people aged 65 years or older (43.7%). For the whole period from 1957 to 2001, after adjusting for age shifts in the general population, the proportion of TB patients had significantly increased in persons 65 years or older, slightly increased in persons aged 0-14 years, and decreased in the 15-24, 25-44, and 45-64-year-old age groups. For the period 1977-2001, age-specific registered case rates increased with age. CONCLUSION: The age of TB patients in Taiwan showed a rising trend from 1957 to 2001. A high index of suspicion and prompt investigation of elderly patients with signs and symptoms characteristic of TB may allow earlier diagnosis and treatment.     

Successful treatment of imported cerebral malaria with artesunate-mefloquine combination therapy.

Treatment of cerebral malaria with intravenous quinine is frequently associated with life-threatening cardiotoxicity. We report a case of imported cerebral malaria successfully treated with artesunate-mefloquine combination therapy. The 27-year-old woman presented with fever, sudden onset of binocular blindness and altered consciousness 10 days after a short stay in Indonesia. Hyperparasitemia with Plasmodium falciparum and P. vivax in more than 5% of red blood cells was demonstrated on peripheral blood smear. She was admitted to the intensive care unit due to shock, jaundice and acute renal failure. Because of a shortage of intravenous quinine, intravenous artesunate was given as an alternative. Her condition stabilized on the 3rd day of therapy, with resolution of fever and disappearance of parasitemia. Consolidation therapy with oral mefloquine and primaquine was then given to prevent recrudescence and relapse. The only adverse event associated with artesunate was transient reticulocytopenia, which resolved after discontinuation of therapy. Her vision completely recovered, along with renal and liver function.