多种措施并举,加强学风建设

多种措施并举,加强学风建设,包括以师德师风促学风建设、健全教育管理制度、构建具有自身特色的学生工作机制、建立行之有效的激励机制、实施本科生导师制和学导制、丰富教育形式、严肃考风考纪、积极开展课外科技文化活动等,获效显著:学生学习风气良好,自觉遵守校规校纪;学习气氛浓厚,学习成绩提高;涌现出了一大批先进集体和先进个人;优秀大学生先进群体引起社会各界强烈反响;创新与实践能力得到提升.     

佛山市城区集体儿童健康状况调查分析

目的了解佛山市城区集体儿童健康状况,以制定干预措施。方法采用随机整群抽样的方法,抽取本市城区共15间幼儿园,并对各间园所的儿童体检的资料数据进行整理和分析。结果佛山市集体儿童缺点总检出率为71.40%。其中私营幼儿园儿童缺点患病率明显高于事业单位的幼儿园(P<0.05),有显著性差异。儿童骨矿物质测定缺钙的检出率为13.73%。男女儿童无性别差异。结论今后继续加强对幼儿园的管理工作,私营的幼儿园管理工作是我们今后管理工作的重点,做好防治工作,降低患病率,增强儿童的身心健康。     

Identifying the special needs of children with Type 1 diabetes in the school setting. An overview of parents' perceptions.

AIMS: The aims of this observational study were to identify the special needs of children with Type 1 diabetes in schools from the parents' point of view and the difficulties experienced with full integration, and to define a series of interventions which may improve the situation. METHODS: Parents of children aged 3-18 years with Type 1 diabetes were eligible. Those who agreed to participate completed a self-reporting questionnaire which determined the effects of the disease on children, parents and school personnel, and addressed aspects including children's integration, glycaemic control, insulin administration, meals, sports, trips and attitudes of teachers and school colleagues to their disease. RESULTS: A total of 499 questionnaires were completed and validated. Median age of children was 11.5 years (95% CI 7.8-15.2). Only 34% of parents believed that teachers could recognize the symptoms of a mild hypoglycaemic episode. Seventeen per cent of parents experienced problems at their schools when they informed staff about their children's disease, 5% were finally not accepted and 8% were forced to change school. In some cases, they had to modify glucose monitoring (9%) and treatment administration (16%) because of a lack of cooperation from the school. CONCLUSIONS: Training sessions on Type 1 diabetes, an increase in the number of nurses, better availability of resources from diabetic associations to schools and improved communication between school personnel and parents were identified as key factors that may improve the full integration of the diabetic child in this setting.     

艾司洛尔控制开颅手术苏醒期脑过度灌注的效果

目的 通过监测脑血流速度、颈静脉球部血氧饱和度(SjvO2)、血压、心率(HR)和不良反应发生率等,综合评价艾司洛尔用于控制开颅手术苏醒期患者脑过度灌注的效果.方法 选择择期在全身麻醉下行开颅肿瘤切除术的患者,随机分为艾司洛尔组(E组,20例)和对照组(C组,20例).E组患者从拔管即刻起给予艾司洛尔0.6 mg·kg1·h-1静脉持续滴注15 min C组患者从拔管即刻起给予0.9%氯化钠溶液静脉持续滴注.分别监测两组患者术前、术后拔管即刻及拔管后15、30、45、60 min时的大脑中动脉平均血流速度(MCAVm)、SivO2平均动脉压(MAP)及HR,并记录不良反应发生例数.结果 E组术后15和30 min的MCA Vm、sjvO2及HR均显著低于C组(P值均<0.01),术后15 Min的MAP显著低于C组(P<0.05).无一例患者发生与艾司洛尔相关的药物不良反应.结论 艾司洛尔是控制术后脑过度灌注的理想药物.     

中鼻道及其周围结构的解剖学观测

目的　探讨临床上经上颌窦口进入上颌窦诊疗的途径。方法　在 40例成人尸体颅矢状切面上 ,对中鼻道、半月裂孔、上颌窦口及其周围结构进行解剖学观测及上颌窦口的探针插入试验。结果　中鼻道、半月裂孔的长度分别为5 6.3 6± 2 .5 8mm、2 1.46± 1.79mm ;40例中 ,2 8侧 (70 .0 0 % )的上颌窦口位于半月裂孔的中 1/3部 ;12侧 (3 0 .0 0 % )的上颌窦口位于半月裂孔的后 1/3部。上颌窦口的形态不一。上颌窦口的前后径为 3 .14± 0 .47mm。上颌窦口距鼻腔底部、鼻小柱的距离分别为 3 0 .41± 2 .85mm、49.5 2± 2 .3 7mm。鼻小柱到上颌窦口与到鼻腔基底面连线的夹角为 40 .2± 3 .7°。 3 7侧 (92 .5 0 % )的上颌窦口能用直径≤ 2 .5mm的探针穿过。结论　经上颌窦自然开口行上颌窦口穿刺是安全、简便和有效的一种诊治方法。     

Cerebral perfusion during human liver transplantation

Summary. During transplantation of the liver cerebral perfusion was monitored by transcranial Doppler determined middle cerebral artery mean flow velocity (V_mean) and pulsatility index (PI) in six fulminant hepatic failure patients and 11 patients with chronic liver disease. In both groups of patients V_mean, PI and central haemodynamic variables were recorded during (1) the last preanhepatic hour; (2) the anhepatic phase; (3) the first 15 min of reperfusion; and (4) for the following 45 min of reperfusion. No significant differences were detected between the two groups of patients with respect to changes of variables with time. The V_mean (40±13 cm s^-1 [mean±SD]), thoracic electrical impedance (TI) (30±7 Ohm), heart rate (97±19 beats min^-1), mean arterial pressure (84±9 mmHg) and arterial carbon dioxide tension (PaCO₂, 4.5±0.4 kPa) remained stable in the anhepatic phase, while cardiac output (CO, 7.6±2.7 to 5.4±1.41 min^-1), stroke volume (SV, 79±26 to 56±15 ml) and PI (1.2±0.3 to 0.9±0.2) decreased (P<0.05). During reperfusion, CO (9.9±4.01 min^-1), SV (105±40 ml), Pa_CO2 (5.5±0.6 kPa), Vmean (57±17 cm s^-1) and PI (1.2±0.2) became elevated. Taken together, during the anhepatic phase of the liver transplantation a maintained central blood volume as indicated by the constant TI served for a stable blood pressure and in turn cerebral perfusion, whereas revascularization of the graft increased cerebral perfusion concomitant with an elevated carbon dioxide tension.     

阻断大脑中动脉建立大鼠局灶性脑梗塞模型的观察

通过经颅阻断大鼠大脑中动脉制成局灶性脑缺血动物模型。大脑中动脉阻塞后大鼠均出现各种神经病学征象。氯化三苯基四氮唑染色发现梗塞区位于皮质及基底节。光镜和电镜观察大脑中动脉阻塞后脑组织的病理改变,发现梗塞区不同程度的细胞和间质变性坏死。结果表明该模型是比较理想的局灶性脑缺血模型.     

Medical education for minorities at a US medical school

The University of Washington School of Medicine (UWSM) has initiated new efforts to build a regional minority applicant pool and to expand its educational programmes to accommodate students from disadvantaged backgrounds. Specific interventions include: establishment of medical career planner position to coordinate region-wide outreach; pre-entry education; and support activities once enrolled. This study describes specific services and presents sociodemographic and performance data on 56 minority and 280 majority students entering the UWSM between 1981 and 1985. Economic status and educational background of minority students were significantly below that of majority students, several flexible academic policies enabled most students to achieve mastery in courses and to progress through the curriculum. The educational data base utilized in this study, and those at other institutions, can assume important roles in the identification of problem areas in the education of disadvantaged students and in evaluation of the interventions attempted.     

Choosing a career in general practice: the influence of medical schools

Summary. This paper reviews the literature on career choice to investigate the undergraduate influences on the preference of Australian graduates for a career in general practice. Although isolation of influencing factors is difficult, admission criteria and undergraduate curricula may influence career preference. As the institutional environment of medical schools is weighted towards scientific research and specialized medicine, medical students may be socialized into choosing non-generalist careers. Medical schools should consider broadening selection criteria and curriculum exposure to produce graduates with a broad range of career interests.