中国药物依赖自愿戒毒机构的医院文化与医学伦理建设

药物依赖自愿戒毒机构的医院文化和医学伦理建设直接关系到其职能的实施和宗旨的贯彻.以现代生命伦理学和社会伦理学为内涵的医学伦理学是指导现代药物依赖临床医疗机构文化建设的重要基础之一;其对构建具有中国特色的医院文化和禁毒工作意义重大.     

从颅脑外伤救治中存在的问题谈区域创伤中心建设的重点

目的 结合目前国内在颅脑外伤救治中存在的问题探讨区域创伤中心建设的重点内容及关注点。方法 收集2015年8月至2017年7月泰州市人民医院收治的颅脑外伤急诊手术病例共171例。根据患者入院时GCS评分（Glasgow Coma Scale）分为4组。术后根据其出院时的GCS评分对其预后进行评价,分为死亡,4～5分,6～8分,9～12分,13～15分5个类别。结果 共有171例患者纳入本研究中,按照入院GCS评分分为4组（3～5分,6～8分,9～12分,13～15分）,其病死率分别是48.15%,20.59%,4.76%,8.57%。在3～5分组中入院1 h内手术的组内死亡率与1～2 h及大于2 h相比（17.95%,38.96%,43.59%）差异有统计学意义（P<0.05）,在6～8分组入院1 h内手术的组内死亡率与1～2 h及大于2 h相比（0,42.86%,57.14%）差异有统计学意义（P<0.05）,另外两组（9～12分,13～15分）死亡率组间比较差异无统计学意义（P>0.05）。针对上述数据,结合国内及国际颅脑创伤救治现状分析,目前颅脑外伤救治中存在院前...     

Community organization factors affecting veteran participation in adaptive sports

Objective: This study aims to describe United States military veteran participation in adaptive sports and to assess the demographic make-up and organizational characteristics of existing adaptive sports programs.Design: Prospective, cross-sectional survey.Setting: Community organizations with adaptive sports programs.Participants: 85 adaptive sports programs.Interventions: Nine question survey.Outcome Measures: Demographic data and sports offered by adaptive sports programs in the United States.Results: The survey response rate was 70%. The median number of total participants in an organization was 75 and the median number of veterans was 50. 76% of organizations had some degree of affiliation with a VAMC. Organizations affiliated with a VAMC are more likely to be rehabilitation centers, whereas community organizations with no VAMC affiliation are most commonly independent organizations with no rehabilitation component. Individuals of all ages participate in adaptive sports, with increasing participation associated with increasing age. Golf was the sport offered most commonly by adaptive sports programs in this survey. Low-contact sports were offered more often than high-contact sports, and the majority of programs offered adaptive sports year-round.Conclusions: Our results suggest that U.S. Military veterans represent a large proportion of the individuals participating in adaptive sports. Further research specifically focusing on factors veterans find desirable when considering participating in adaptive sports is indicated to identify programs that should be promoted, developed, and funded to increase veteran participation in adaptive sports.     

Safety and usefulness of emergency maternal transport using helicopter

AIM: Japan has a shortage of tertiary medical care facilities for maternal and fetal medicine. Establishment of efficient medical transport systems is needed for pregnant women and fetuses with severe complications. Maternal transport by helicopters is expected to shorten transportation time to advanced facilities, although its feasibility has not yet been evaluated. The aim of the present study was to investigate the status of maternal helicopter transport, and conditions of the pregnant patients and children transferred by helicopter to Kameda Medical Center (KMC). METHODS: Between August 2005 and July 2006, 26 pregnant women were transported by helicopters to KMC. RESULTS: The median net flight time was 24 min (range 15-29 min), and the median of estimation of ground transportation time was 125 min (range 90-180 min). The causes for transfers were preterm labor in eight, preterm premature rupture of the membrane in five, cervical incompetence in five, pre-eclampsia in three and other medical reasons in five. Five of the 26 patients were discharged with restored stability of pregnancy. The remaining 21 patients underwent delivery at KMC. The median gestational age was 26 weeks (range 22-33 weeks) at the time of transfer and 31 weeks (range 22-37 weeks) at delivery. Four of 26 neonates who were born at KMC died after birth due to severe premature or congenital anomaly. Seventeen of the remaining 22 neonates, including 10 twins, received treatment in the neonatal intensive care unit. All of the 22 neonates and all the mothers were discharged in good condition. No patients developed any complications requiring treatment during flights. CONCLUSION: Helicopter transfer is feasible for pregnant patients with severe complications.     

一站式便民服务中心在县级公立综合性医院的应用实践与研究

目的：探讨县级公立综合性医院构建一站式便民服务中心的效果。方法：在县级公立综合性医院构建一站式便民服务中心,对其效果采用调查问卷法分析,就突出问题开展访谈,并采用描述性统计及定量、定性分析。结果：该中心能够显著降低患者就诊询问次数和就诊路程,但总就诊时间无明显缩短。结论：在县级公立综合性医院构建一站式便民服务中心可以有效提高门诊办公效率,方便病员就诊,提高病员的满意度,在操作上是可行的,也是有效的。     

大规模白内障复明手术中同时行胬肉切除联合球结膜瓣转移手术的应用

目的:探讨大规模白内障复明手术中对合并翼状胬肉的患者同时施行胬肉切除联合球结膜瓣转移术的安全性和有效性。方法:对36例老年性白内障合并翼状胬肉的患者,使用前房维持器行小切口非超声乳化白内障摘除联合人工晶状体植入术,并行胬肉切除联合球结膜瓣移植,术后随访30～90(平均43.5)d。观察术后单纯球镜矫正视力、并发症、角膜愈合、角膜缘新生血管及球结膜是否有薄层胬肉样组织增生。结果:34例视力>0.3。角膜创面3～5d愈合,无1例胬肉复发,无新生血管生长及瘢痕组织增生现象。结论:防盲手术中对合并翼状胬肉的患者同时施行胬肉切除联合球结膜瓣转移术是安全和有效的。     

Implications of Crop Rotation and Fungicide on Fusarium and Mycotoxin Spectra in Manitoba Barley, 2017–2019

Fusarium head blight (FHB) is one of the most important diseases of barley in Manitoba province (western Canada), and other major barley producing regions of the world. Little is known about the Fusarium species and mycotoxin spectra associated with FHB of barley in Manitoba. Hence, barley grain samples were collected from 149 commercial fields from 2017 to 2019, along with information on respective cropping history, and analyzed with respect to Fusarium species spectra, abundance, chemotype composition, and mycotoxin profiles. Fusarium poae was the predominant Fusarium species associated with FHB of barley in Manitoba, followed by F. graminearum, and F. sporotrichioides; F. equiseti and F. avenaceum were also detected but at low levels. F. poae strains with the nivalenol (NIV) chemotype and F. graminearum strains with 3-acetyl deoxynivalenol (3-ADON) and 15-acetyl deoxynivalenol (15-ADON) chemotypes were commonly detected in the barley grain samples. Nivalenol (597.7, 219.1, and 412.4 µg kg⁻¹) and deoxynivalenol (DON) (264.7, 56.7, and 65.3 µg kg⁻¹) were the two most prevalent mycotoxins contaminating Manitoba barley in 2017, 2018 and 2019, respectively. A substantially higher DON content was detected in grain samples from barley fields with cereals as a preceding crop compared to canola and flax. Furthermore, F. poae proved less sensitive to four triazole fungicides (metconazole, prothioconazole+tebuconazole, tebuconazole, and prothioconazole) than F. graminearum. Findings from this research will assist barley producers with improved understanding of FHB threat levels and optimizing practices for the best management of FHB in barley.     

医患关系的改善与社区卫生服务的发展

医患关系是影响社区卫生服务中心发展的关键因素之一。目前 ,我国社区卫生服务中心的医患关系虽较以往有较大的改善 ,但仍处于人际关系较低的合作水平。从多方面、深层次建立平等互利的新型医患关系 ,不仅是为了满足广大患者日益增长的健康需要 ,同时也是适应新医学模式发展和加快社区卫生服务中心发展的需要。本文认为应从转变传统的经营观念、改善服务态度、建立标准化的服务等六方面去改善当前的医患关系     

Effects of tooth rotation on neighboring teeth and periodontal tissues

In the present experiment,we investigate the effects of orthodontic tooth rotation onneighboring teeth and periodontal tissues.The second maxillary incisors of 16 randomly selecteddogs were subjected to rotation at a magnitude of 100 grams and a moment of 550 g·mm in a du-ration of 3 to 56 days.Then sections were prepared for histological examination.The findings re-vealed that,due to tooth rotation,neighboring teeth were drifted and rotated(82%),and therewere disarrangement and hyalinization of the periodontal ligament(88%),remodeling of the pe-riodontium(86%)and root resorption(32%)were also observed.These results demonstratethat tooth rotation may exert marked effects on neighboring teeth and periodontal tissues,whichmay be of important clinical significance.     

A study of the rotation rate of single-rooted teeth in dogs

Sixteen one-year-old dogs were used in our experiment.We rotated the maxillary secondincisors of the dogs,applying a force of 100g and a moment of 550g·mm.The duration of theexperiment varied from 72h to 8 weeks.Activation was performed once every 2 weeks and the impressions were taken in order to measure the angles of rotation.The results of our experiment showthat the rotation rate of single-rooted tooth in dogs is 3.04/week.The graph shows the form ofgradual stairs.This paper introduces a new specialized experimental apparatus for tooth rotation.The angles of rotation are measured geometrically.