采用SWOT法对高职医药营销专业就业形势分析

据高职医药营销专业就业难的现状,采用SWOT分析法对该专业存在的优势、劣势、机会和威胁进行深入客观的分析。以便权衡利弊,帮助毕业生克服就业过程中的不足,协助学校审视自身存在的劣势,为高职医药营销专业就业形势改善提供参考。     

新形式下儿童医院发展战略研究

随着我国市场经济体系的逐步建立,医疗卫生体制不断完善,在新的时代背景下,面对新的时代问题,如何解决医疗卫生问题,如何加强国有医院的现代化管理,提高自身综合实力便成为卫生研究的重点。以重庆医科大学附属儿童医院为例,通过内外部环境分析,运用战略管理理论分析建立医院发展战略,并提出了战略实施支撑体系。     

Young athletes after ACL reconstruction with asymmetric quadriceps strength at the time of return-to-sport clearance demonstrate drop-landing asymmetries two years later

BackgroundQuadriceps strength asymmetry at the time of return-to-sport (RTS) after anterior cruciate ligament reconstruction (ACLR) contributes to altered landing mechanics. However, the impact of RTS quadriceps strength on longitudinal alterations in landing mechanics, a risk factor for poor knee joint health over time, is not understood. The purpose of this study was to test the hypothesis that young athletes with quadriceps strength asymmetry at the time of RTS clearance after ACLR would demonstrate asymmetric landing mechanics 2 years later compared to those without quadriceps strength asymmetry.MethodsWe followed 57 young athletes (age at RTS = 17.6 ± 3.0 years; 77% females) with primary, unilateral ACLR for 2 years following RTS clearance. At RTS, we measured isometric quadriceps strength bilaterally and calculated limb-symmetry indices [LSI = (involved/uninvolved)×100%]. Using RTS quadriceps LSI, we divided participants into High-Quadriceps (HQ; LSI ≥ 90%) and Low-Quadriceps (LQ; LSI < 85%) groups. Two years later, we assessed landing mechanics during a drop-vertical jump (DVJ) task using three-dimensional motion analysis. We compared involved/uninvolved limb values and LSI between the HQ and LQ groups using Mann-Whitney U tests.ResultsThe LQ group (n = 26) demonstrated greater asymmetry (lower LSI) during landing at 2 years post-RTS for knee flexion excursion (p = 0.016) and peak vertical ground reaction force (p = 0.006) compared to the HQ group (n = 28). There were no group differences in uninvolved or involved limb values for all variables (all p > 0.093).ConclusionYoung athletes after ACLR with quadriceps strength asymmetry at the time of RTS favored the uninvolved limb during DVJ landing 2 years later. These landing asymmetries may relate to long-term knee joint health after ACLR.     

基于BiSSkiT理论的强化咽喉上升电子生物反馈训练联合表面肌电生物反馈对脑卒中恢复期患者吞咽障碍的影响

目的 观察基于力量和技能训练生物反馈（BiSSkiT）理论的强化咽喉上升电子生物反馈训练联合表面肌电生物反馈对脑卒中恢复期患者吞咽障碍的影响。 方法 选取脑卒中恢复期吞咽障碍患者60例，采用随机数字表法将其分为生物反馈组、咽喉上升组和联合组，每组患者20例。3组患者均给予常规吞咽功能训练，生物反馈组在此基础上增加表面肌电生物反馈训练（每日1次，每次20 min），咽喉上升组在常规吞咽功能训练的基础上增加基于BiSSkiT理论的咽喉上升强化训练器的训练（每日1次，每次20 min），联合组则在吞咽功能训练的基础上增加表面肌电生物反馈训练和基于BiSSkiT理论的咽喉上升强化训练仪的训练。于治疗前和治疗4周后（治疗后）对3组患者进行X光荧光透视检查（VFSS）检查，并采用VFSS量表、吞咽功能评定量表（SSA）、吞咽功能障碍预后和严重程度量表（DOSS）评估3组患者的吞咽功能。 结果 治疗后，3组患者的VFSS评分、SSA评分和DOSS评分较组内治疗前均显著改善（P＜0.05）。治疗后，联合组患者的VFSS评分、SSA评分和DOSS评分分别为（5.85±0.88）分、（35.45±1.90）分和（4.1±1.10）分，均显著优于生物反馈组和咽喉上升组治疗后（P＜0.05），而咽喉上升组的VFSS评分、SSA评分和DOSS评分亦均显著优于生物反馈组治疗后，差异均有统计学意义（P＜0.05）。 结论 基于BiSSkiT理论的强化咽喉上升电子生物反馈训练联合表面肌电生物反馈可显著改善脑卒中恢复期患者的吞咽功能。     

Pre-cementation treatment of glass-ceramics with vacuum impregnated resin coatings

ObjectiveThe study aimed to investigate the effectiveness of a vacuum impregnation process to eliminate the porosity at the ceramic-resin interface to optimize the reinforcement of a glass-ceramic by resin cementation.Methods100 leucite glass-ceramic disks (1.0 ± 0.1 mm thickness) were air-abraded, etched with 9.6 % HF acid, and silanated. Specimens were randomly allocated to 5 groups (n = 20). Group A received no further treatment (uncoated control). Groups B and D were resin-coated under atmospheric pressure, whereas groups C and E were resin-coated using vacuum impregnation. The polymerized resin-coating surfaces of specimens in groups B and C were polished to achieve a resin thickness of 100 ± 10 µm, while in groups D and E no resin-coating modification was performed prior to bi-axial flexure strength (BFS) determination. Optical microscopy was undertaken on the fracture fragments to identify the failure mode and origin. Comparisons of BFS group means were made by a one-way analysis of variance (ANOVA) and post-hoc Tukey test at α = 0.05.ResultsAll resin-coated sample groups (B–E) showed a statistically significant increase in mean BFS compared with the uncoated control (p < 0.01). There was a significant difference in BFS between the ambient and vacuum impregnated unpolished groups (D and E) (p < 0.01), with the greatest strengthening achieved using a vacuum impregnation technique.SignificanceResults highlight the opportunity to further develop processes to apply thin conformal resin coatings, applied as a pre-cementation step to strengthen dental glass-ceramics.     

Factors contributing to racial differences in gait mechanics differ by sex

BackgroundRacial differences in gait mechanics have been recently reported, but we don’t know what factors may drive differences in gait and whether these factors are innate or modifiable. The answers to those questions will inform both basic research and clinical interventions and outcomes.Research questionDo anthropometric, strength, and health status measures explain racial differences in gait between African Americans (AA) and white Americans (WA)?MethodsVenous blood samples, anthropometric measures, lower extremity strength, and an assessment of health status were collected from 92 participants (18–30 years old) as part of an Institutional Review Board-approved study. 3D motion capture and force plate data were recorded during 7 walking trials at set regular (1.35 m/s) and fast (1.6 m/s) speeds. Racial differences in gait were identified at both speeds. Correlations between anthropometric, strength, and health status independent variables and outcome measures were computed after stratifying data by sex. Stepwise linear regression models evaluated whether the inclusion of anthropometric, strength, and health status independent variables explained racial effects.ResultsIn males, no racial differences in gait were explained by independent variables. Q-angle and ankle dorsiflexion strength accounted for racial differences in self-selected walking speed in females. Racial differences in ankle plantarflexion angle were explained by ankle plantarflexion strength differences.SignificanceFactors that explain racial differences in gait in females were both innate and modifiable. These data make clear that it is important to include racially diverse normative gait databases in research studies. These results also identify potential intervention targets aimed at reducing racial health disparities.     

Differential strength decline in patients with osteoarthritis of the knee: revision of a hypothesis

A quadriceps-to-hamstring isometric peak torque ratio (Q/H ratio) of approximately 2.0 is considered necessary for appropriate knee biomechanics. Lower ratios may affectthe function of persons with osteoarthritis (OA) and the progression of the disease. This study examined theisometric Q/H ratio in subjects with and without OA of the knee and explored the effect of age, pain, and joint enlargement on the ratio. Twenty-one pairs of subjects (OA, control) were matched on age (X = 62.6 years; SD = 13.9), gender (F = 17, M = 4), and leg dominance (Dominant = 10, Nondominant = 11). Isometric quadriceps and hamstring peak torque, knee pain, and joint enlargement were measured. Paired t-tests demonstrated that the OA group had significantly lower quadriceps peak torque than the control group but did not have significantly lower hamstring peak torque or gravity-corrected isometric Q/H ratio. Age correlated with the ratio in subjects without OA (p = −0.46; P = 0.03) but not in subjects with OA. Pain was not significantly correlated with the ratio in either group. Joint enlargement correlated with the ratio in the OA group (p = −0.45; P = 0.03). The gravity-corrected isometric Q/H ratio appears to decrease with age in subjects without OA. In subjects with OA, the Q/H ratio appears not to change with disease, pain, or age. Joint enlargement may decrease the ratio and merits further study.     

Layer characteristics in strength-gradient multilayered yttria-stabilized zirconia

ObjectivesTo investigate crystallography, translucency, phase content, microstructure and flexural strength of two commercial strength-gradient multilayered dental zirconia grades.MethodsTwo zirconia grades, i.e., KATANA Zirconia YML (Kuraray Noritake; referred to as “YML”; composed of four layers: enamel, body 1–3) and IPS e.max ZirCAD Prime (Ivoclar Vivadent; referred to as “Prime”; composed of three layers: enamel, transition, body) were investigated. Fully sintered square-shaped zirconia specimens from each layer were prepared. Microstructure, chemical composition, translucency parameter and zirconia-phase composition of each layer were characterized. Four-point and biaxial flexural strength of each layer was measured using fully sintered bar- and square-shaped specimens. Square-shaped samples were used to measure strength across the layers.ResultsFor both multilayer zirconia grades, the ‘enamel’ layer contains a higher amount of c-ZrO₂, which resulted in higher translucency but lower flexural strength than the ‘body’ layers. The characteristic 4-point flexural strength of the YML ‘body 2′ (923 MPa) and ‘body 3′ (911 MPa) layers, and of the Prime ‘body’ (989 MPa) layer were comparable and higher than for the YML ‘enamel’ (634 MPa), Prime ‘transition’ (693 MPa) and ‘enamel’ (535 MPa) layers. The biaxial strength of specimens sectioned across the layers was in-between that of the ‘enamel’ and ‘body’ layers for both YML and Prime, implying the interfaces did not form a weak link.SignificanceThe difference in yttria content affects the phase composition and mechanical properties of each layer of the multi-layer zirconia. The strength-gradient approach allowed to integrate monoliths with irreconcilable properties.