影像系本科生对X射线辐射防护认知状况的调查分析

目的 了解医学影像系本科生对X射线辐射防护知识的认知水平,为辐射防护课程设置提供参考依据,促进临床放射检查规范化、合理化、最优化,将X射线损害降到最低。方法 采用现场无记名问卷的调查方式,对165名湖北医药学院2011级影像系本科生进行调查。结果 影像系本科生对辐射防护知识关注程度不高,对辐射防护知识掌握不全面,缺少辐射知识教育的正规途径。结论 医学院校应重视影像生的辐射防护知识教育,积极开展相关辐射课程,提高影像生辐射知识水平,为今后的医疗工作和灾害救援提供保障。     

中西医结合治疗慢性阻塞性肺病缓解期的临床观察

目的研究中西医结合在慢性阻塞性肺病(COPD)缓解期的临床疗效。方法对72例COPD缓解期患者随机分成2组,治疗组在基础治疗基础上结合中医治疗,对照组单纯西医治疗,观察2组疗效,并进行临床对比分析。结果中西医结合治疗组显效率高于西医治疗对照组,且差异有统计学意义(P<0.05)。结论COPD缓解期给予中医辨证结合西医基础治疗,既能更好地缓解患者症状,预防疾病急性发作,提高生活质量,且疗效肯定,又能减少西药药量与相关的副作用,有利于调节机体与药物平衡,临床上值得推广。     

Nicotine delivery efficiency of first- and second-generation e-cigarettes and its impact on relief of craving during the acute phase of use

Knowledge about the change in blood nicotine concentrations during the first five minutes (acute phase) of e-cigarette vaping is important to determine whether the used product has a dependence potential or may be an efficient nicotine replacement product. To address this issue, we monitored blood nicotine levels during the acute phase in volunteers using disposable cigalikes (CLs) and a tank model (TM) and compared them with blood nicotine levels in subjects using a tobacco cigarette (TC). In parallel, heart rate changes were continually measured and withdrawal symptoms and craving were assessed with the Questionnaire on Smoking Urges before and immediately after the vaping/smoking sessions. Additionally, at the end of each session negative health effects were rated on a visual analog scale.After five minutes of e-cigarette or TC use, the mean nicotine plasma concentrations were as follows: CLs, 5.5 ng/ml; TM, 9.3 ng/ml; TC, 17.1 ng/ml. Nicotine levels increased significantly faster in the first 4 min of consuming a TC than with the CLs and the TM. The highest rate of increase in nicotine concentration was found with the TC (6.8 ng/ml) and TM (2.3 ng/ml) between the 1st and 2nd minute, whereas the CLs showed comparatively small changes in the amount delivered over the five minutes. Withdrawal and craving for smoking decreased with the TM by the same amount as with the TC, even though less nicotine was delivered to the blood and considerably fewer side effects occurred. The heart rate of TM users was also markedly lower than that of the TC users.Unlike CLs, TM e-cigarettes represent an effective source of nicotine and might be used as an alternative nicotine replacement product to aid smoking cessation. However, nicotine plasma levels observed in TM users after short-time vaping have also the potential to produce and sustain nicotine addiction.     

再论药品不良反应救济的保险模式

目的:探索适合现状的药品不良反应损害救济模式.方法:阐述药品不良反应相关理论依据及当前探索中的ADR救济模式,分析ADR责任险构建的可行性.结果:提出保险形式构建ADR救济机制的具体措施.结论:建立ADR保险救济机制有利于解决当前ADR补偿问题,有利于构建和谐社会.     

浅析我国救援医学教育现状和改革方向

本文立足于救援医学教育现状,分析存在的问题,提出救援医学教学改革可从利用急诊医学教学资源、针对性培养师资队伍、引入全科医学教育、使用PBL教学方法、搭建国际交流平台等方面入手,为＂国际救援一体化＂培养人才。     

Progression after release of obstructive nephropathy

Progressive glomerular and tubulointerstitial fibrosis develop in 1-year-old rats even after relief (R) of unilateral ureteral obstruction (UUO) at 5 days of age. The present study investigated whether a progressive renal injury model of UUO could be achieved after reversal of UUO (RUUO) in adult instead of neonatal rats. The potential for α-tocopherol modulation of mRNA for the fibrogenic cytokine, transforming growth factor-β1 (TGFβ1), apoptosis (TUNEL assay), and the presence of the stress protein, heat shock protein-70 (HSP-70), was also studied in this post-obstructive model. Male Sprague-Dawley rats weighing 125–150 g were randomly assigned to groups of 4 animals each for durations of 7 or 14 days of α-tocopherol supplementation after RUUO. The groups included: (i) sham, regular chow; (ii) RUUO, regular chow; (iii) RUUO, contralateral nephrectomy (NX); and (iv) RUUO, NX plus α-tocopherol supplementation. We found a significant increase in the ratio of kidney weight/body weight in the RUUO+NX group at 14 days compared with the sham and RUUO groups. This rise in the RUUO+NX group was significantly reduced after 14 days of α-tocopherol administration. The elevated level of kidney TGFβ1 mRNA in the RUUO+NX group was only partially reduced at 7 days. But at 14 days this became significantly reduced with the continued α-tocopherol treatment. The HSP-70 staining and the apoptosis of the kidney showed results parallel to those of TGFβ mRNA at 14 days. To separate the effects of hypertrophy after unilateral NX from the RUUO studies, we carried out a second experiment in control animals subjected to NX, with and without α-tocopherol supplementation. Fourteen days after NX, the apoptosis and TGFβ1 mRNA showed no significant differences from the control animals. Our data suggest that a model of progressive renal injury in RUUO can be established in adult rats. After contralateral NX, the progressive injury is evidenced by the increase in the ratio of kidney weight/total body weight, the apoptotic counts, as well as fibrogenic cytokine TGFβ1 mRNA in the post- obstructed kidney. Finally, our data also support the concept that α-tocopherol is renal protective, as judged by TGFβ1 mRNA, apoptosis, and HSP-70 staining, even in the progressive disease process of the post-obstructed model. Received: 17 February 2000 / Revised: 21 September 2000 / Accepted: 21 September 2000     

地震后跨省跨地域公共卫生应急救援行动的实践和体会

2008年5月12日四川省发生了汶川大地震,导致了人员大量伤亡和财产损失,并成为最严重的突发公共危机事件.广东省卫生厅于第一时间派出医疗和卫生防疫队奔赴灾区参加抗震救灾行动.在灾情最为严重的平武县南坝镇,广东省卫生防疫队在当地指挥部的组织领导下,开展快速评估,确定了灾区面临的主要传染病和食物中毒的威胁,提出公共卫生需求和计划优先的现场干预措施,明确了3个重点场所:灾民集中安置区、救援人员集中生活区、可能掩埋人或动物的废墟,以及6个关键环节:生活饮用水供水点、集中供餐点、垃圾堆放点、临时厕所点、人畜尸体掩埋点、家畜动物圈养点,按照"把握重点,控制关键环节"的工作策略,开展了环境卫生控制、饮用水卫生控制、饮食卫生控制、人畜粪便处理、人畜尸体处理、病媒控制、疾病监测、健康教育与心理干预、当地医疗机构(点)的卫生防疫工作指导、入村入户开展卫生防疫等10个方面的控制工作,使灾区环境卫生得到明显改善,病媒孳生地得到控制,病媒密度显著下降,未发现食物中毒和传染性疾病的流行和暴发,实现了灾后无大疫的阶段性目标.     

国家地震灾害紧急救援队汶川地震救援期间队员受伤情况分析

目的 调查国家地震灾害紧急救援队汶川地震救援期间队员受伤情况以分析总结救灾人员如何在救治伤病员的同时有效保护自己. 方法 对2008年5月12日至5月29日救援队的187名队员中就诊的队员进行详细登记,病种统计采用国际疾病分类法. 结果 医疗队共诊治伤病员268人次,居前三位的病种是:皮肤病和皮下组织疾病占35.4%,肌肉骨骼结缔组织病占26.9%,呼吸系统疾病占13.4%.其中搜救队员受伤总人次最多,为244人次,占91.0%. 结论 充分的医疗准备工作,搭建固定医疗点、心理疏导卫生防疫是做好自身医疗保障的重要保证.     

发达国家及我国台湾地区药品不良反应损害救济制度的介绍及思考

摘 要我国除预防接种异常反应补偿机制外,在药品不良反应损害救济制度方面尚为空白,由此引起的社会矛盾日益凸显。本文通过对德国、瑞典、美国、日本及我国台湾地区几个国家具有代表性的药品不良反应损害救济制度进行具体分析,思考我国药品不良反应损害救济存在的问题及制度的构建。     

抗震救灾官兵生活质量和心理健康状况及影响因素研究

目的了解抗震救灾官兵生活质量和心理健康状况及影响因素。方法采用随机整群抽样法,应用WHOQOL-BREF和SCL-90量表,对驻昆明某部280名抗震救灾官兵和330名非抗震救灾官兵进行问卷调查。结果（1）抗震救灾官兵生活质量的生理、心理、社会及环境各领域百分制得分分别为（58．65＋15．02）分、（56．88±14．66）分、（63．01±17．92）分、（50．73±15．16）分。除社会领域外,其余三个领域与非抗震救灾官兵之间的差异有统计学意义（P〈0．01或P〈0．05）。（2）在SCL-90评分中,除躯体化因子分外,抗震救灾官兵在其余各因子分均高于非抗震救灾官兵,且在强迫、抑郁、焦虑、恐怖、偏执和总均分两组之间的差异有统计学意义（P〈0．01）。（3）民族、籍贯、学历、职别、婚姻状况和是否为独生子女对抗震救灾官兵生活质量和SCL-90评分有不同程度的影响和相关性（P〈0．01或P〈0．05）。结论抗震救灾官兵生活质量和心理健康水平均比非抗震救灾官兵差,其影响因素主要有民族、籍贯、学历、职别、婚姻状况和是否为独生子女等。