运动方式对人体骨峰值的影响

为了探讨运动方式对人体骨健康的作用效果和机理,随机选取华南师范大学体育系和化学系171名在校男生作为研究对象,应用单光子吸收法（SPA）和标准体质测量法对其骨密度（BMD）和体质指标进行了检测。采用SPSS8.0软件包对数据进行分析处理。结果显示(1）短跑组、足球组、篮球组、武术组、中长跑组和体育人口组具有比对照组较高的骨密度值（BMD）,尤其是短跑组、武术组与对照组有高度显著性差异（P＜0.01）;(2）运动强度、运动史与骨密度值（BMD）呈正相关,而运动频率大于3次/周具有较佳的健骨效果;(3）肌力指标、肌力/身高指标与骨密度值（BMD）有显著正相关(r=0.661,r=0.623),而其它体质指标则不具有显著相关性。提示提高青年时期骨峰值、预防骨质疏松症的运动处方应为持之以恒地进行频率大于3次/周、每次运动时间不少于半小时的适宜于自身条件的高强度运动。     

Differential effectiveness of solar UVB subcomponents in causing cell death,oncogenic transformation and micronucleus induction in human hybrid cells

Purpose : (1) To determine the biological effectiveness of two solar ultraviolet (UVB) spectra with different lower wavelength thresholds for oncogenic transformation and micronucleus induction in CGL1 cells; (2) to investigate whether the action spectra for short- and long-term effects are similar; and (3) to investigate possible links between transformation and other delayed effects. Material and methods : Two spectra were derived from a solar UV simulator by using two filters: the first transmitted radiation with 5 > 284 nm, the second with 5 > 293 nm. The resulting spectra have the same UVA, but different UVB components (5 between 284 and 320 nm, 19 W m m 2, and 5 between 293 and 320 nm, 13 W m m 2) . CGL1 cells were irradiated with 466 J m m 2 with 5 > 284 nm and 1582 J m m 2 with 5 > 293 nm. These doses were approximately equilethal. The endpoints examined were oncogenic transformation, and centromere-positive and -negative micronucleus frequencies in the directly irradiated cells and in transtheir progeny. Results : At equilethal doses, the oncogenic transformation frequency in the directly irradiated cells was greater by a factor of at least 7 for 5 > 284 nm irradiation compared with 5 > 293 nm. The micronucleus induction frequency was also significantly higher with the 5 > 284 spectrum. Consistent with our previous findings, no delayed micronucleus formation was found in the progeny of cells exposed to 5 > 293 nm, while a threefold elevation above controls was seen in the progeny of cells exposed to 5 > 284 nm irradiation. This was also the case for formation of micronuclei with a centromere. Conclusions : It was found that: (1) for equilethal doses the 5 > 284 nm spectrum was more biologically effective than the 5 > 293 nm spectrum for induction of oncogenic transformation and micronucleus formation; and (2) the higher effectiveness of the 5 > 284 nm spectrum found at equilethal doses for delayed effects in the progeny of irradiated cells resembles that found for transformation. The results suggest that the UVB action spectrum for cell killing is different from that of some delayed effects, and from that of transformation.     

Orem自护模式在高血压病中的应用

目的探讨Orem自护模式对高血压患者临床护理疗效的影响。方法对105例高血压门诊患者随机分为实验组（n=53）和对照组（n=52）,对照组接受常规药物治疗和健康教育,实验组在对照组的基础上给予Orem自护模式进行干预,在受试前、受试后6个月分别进行降压疗效评价、自我管理能力评定和护理满意度调查。结果两组患者收缩压和舒张压均较受试前明显下降,但实验组较对照组下降更显著（P值均小于0．01）;两组患者在合理膳食、适度运动、遵医用药和血压监控四个自我管理能力达标例数明显高于受试前,但实验组明显优于对照组（P〈0．01）;实验组护理满意度高于对照组（P〈0．01）。结论Orem自护模式能提高高血压病患者的自我管理能力,协助降压,提升了护理满意度。Orem自护模式优于传统健康教育。     

星状神经节阻滞联合直线偏光近红外线照射治疗突发性耳聋的疗效观察

目的　观察在传统方法治疗的基础上 ,使用星状神经节阻滞 (SGB)联合直线偏光近红外线治疗仪 (S L)照射治疗突发性耳聋的效果。方法　选择我院耳鼻喉科确诊的突发性耳聋患者84例 ,均为单耳发病 ,每例在治疗前后进行纯音测听 ,按照听力损失程度配对随机分为两组 :对照组4 2例 ,采用传统方法治疗 ;观察组 4 2例 ,除接受传统方法治疗外 ,患侧每 3天接受一次SGB ,间歇期每日进行S L照射 ,1 2d为一疗程。疗效标准以中华耳鼻咽喉科学会制定的《突发性聋诊断依据和疗效分级》标准判定。结果　两组病人治疗前平均听阈相近 ,治疗后的平均听阈均有明显改善。观察组听阈下降更为显著 ,总有效率明显高于对照组 (P <0 0 5 )。结论　在传统方法治疗的基础上再联合应用SGB和S L照射 ,可提高突发性耳聋的治疗效果     

某三甲教学医院手术病人手术部位感染危险因素及人工网络模型探讨

目的 统计某医院外科病人手术部位感染发生率,找出导致术后感染的相关因素,对外科病人发生术后感染的机率进行科学预测。方法 研究对象选取2012—2015年某三甲教学医院术后病人,发生275例手术部位感染的病人为病例组,另按照1∶1比例选取术后无感染266例病人为对照组,进行病例回顾性调查研究,统计检出致病菌和手术感染部位情况,探讨手术部位感染综合因素,结合术后感染统计分析数据构建人工网络模型。结果 手术部位感染率0.35％。多因素分析结果表明,手术部位感染的独立危险因素分别是手术类型、是否有原发疾病、切口类别、ASA病情分级、病人年龄、手术时长、手术例次(OR=11.043,9.587,2.136,1.818,1.299, 1.293,1.041,P<0.05)。最终确定网络模型运行结果如下,平均误差为0.040%,网络错分率 0.038% ;通过曲线下面积(ROC)大于0.9。结论 部位感染危险因素前三位是手术类型、是否患有原发疾病、切口类别。人工网络模型针对手术部位感染危险度的预测结果较理想,建立与其相关预报信息平台系统,为临床院感管控决策提供指导依据。     

单侧唇裂继发畸形的美学修复

目的 探讨单侧唇裂继发畸形与I期手术方式选择的关系,以及进行唇裂继发畸形美学修复的策略.方法 选择单侧继发唇裂120例,根据I期采用的不同术式进行分组,对唇裂畸形进行观察和分析,采用个体化设计,进行美学修复.对采用Millard、Tennison、矩形瓣及上三角瓣法的单侧唇裂继发畸形修复后,观察上唇人中窝形念、瘢痕、唇峰形态的恢复.结果 显示原采用Millard方法、上三角瓣方法优于Tennison方法和矩形瓣方法.Ⅱ期修复术后效果满意.结论 单侧唇裂I期采用的手术方式对继发畸形的程度和修复有显著影响.     

犬双肺序贯性移植的研究

目的探讨犬双肺序贯性移植时供肺的采取及受体移植手术技巧。方法犬16条,体重差异<5%的随机配对作为供受体进行双肺序贯移植实验共8次,移植右肺钳夹左房时采用了‘v’钳夹技术,并检测左肺及右肺术后0.5、1、2 h各进行血气分析、肺水含量及电镜下超微结构,了解术后肺功能。结果移植右肺时采取的‘v’型钳夹术良好地解决了钳夹左房时因回心血量受阻而引起的心功能不全。术后检测结果表明移植后肺功能良好。结论掌握了犬双肺序贯性移植的全过程,"V"形双阻断钳夹左心房技术提高了犬肺移植的成功率。     

四年制中专涉外护理教育模式探讨

目的：构建以能力为本的涉外护理教学体系，培养适应医学模式转变和护理学科发展的涉外护理人才，方法：以涉外护理四年制中专学生为对象进行课程设置，教学方法和实践教学的改革。结果：涉外护理班英语，医学基础知识，护理学基础课程及综合能力测试成绩均优于普通护理班（P＜0．05或P＜0．01），结论：涉外护理教育模式有利于护生能力的培养及综合素质的提高。     

整形外科临床教学模式浅析

随着整形美容外科专业在我国的蓬勃发展,国内不同等级的医疗机构对经过正规培训的整形美容外科医生的需求逐年在增加。为了提高教学效果,针对整形外科不同层次的学生,我们采用了多种形式、有针对性的教学模式,并取得了一定的效果。本文分别从教学查房、手术带教、读书报告、技能培训、学术交流、专题讲座等多个层面浅析了整形外科临床教学模式。     

Initial fixation strength of a new hybrid technique for femoral ACL graft fixation: the bone wedge technique

Background Aperture fixation with interference screws matching the diameter of the tunnel is associated with the risk of graft laceration and graft rotation. Hypothesis A hybrid fixation technique (extracortical and aperture fixation) with undersized interference screw placed behind a bone wedge provides a higher fixation strength as aperture fixation with a screw alone matching the size of the tunnel. Study design Experimental laboratory study. Methods We evaluated the initial fixation strength (single cycle and cyclic loading tests) of hybrid and interference screw aperture fixation using different sized interference screws in porcine knees. Results Analysis of yield load, maximum load and stiffness in the single cycle loading test showed no statistically significant differences for hybrid fixation with a 1 mm undersized screw and aperture fixation with a screw matching the size of the tunnel. The use of an undersized screw alone resulted in low fixation strength. Conclusion The initial fixation strength of the hybrid technique with undersized screws is comparable to that of interference screw fixation matching the size. Clinical relevance The new “bone wedge fixation” is an alternative for ACL graft fixation without the risk of graft laceration and graft rotation.