信息化平台支持下的计量管理研究

伴随着我国大中型医院不断扩充的发展规模,目前的计量管理模式已不能适应形势发展的需要,面临着新的挑战。分析现状,为建立＂医院管理系统＂作出准备。     

母婴同室新生儿护理模式探讨

目的 探讨母婴同室合适的新生儿护理模式。方法 选择2002年1～2月住院分娩的152人为对照组,采用护士以照顾者角色为主的传统护理模式;选择同年3月～4月住院分娩的158人为改良组,采用护士以教育者与照顾者角色兼顾的改良式护理模式。结果 改良组产妇及家属对护士的满意度、新生儿日常护理的掌握除尿布更换外,均明显高于对照组,P<0.05,热线电话回访率改良组低于对照组。结论 改良式新生儿护理模式优于传统护理模式。     

Real time observation of left ventricular aneurysm by B mode echocardiography.

This paper describes two cases of left ventricular aneurysm following myocardial infarction by real time B mode echocardiography with a mechanical sector scan. The most distinctive feature was the paradoxical movement of the aneurysmal wall; in systole, it moved posteriorly to form a bulge, whereas the remaining noinfarcted area was oriented toward the left ventricular cavity in contraction. The final diagnosis was verified by aneurysmectomy.     

基于光学表面成像与锥形束CT结合的综合引导模式在头颈部肿瘤精确放疗中的研究

目的 探讨光学表面成像（OSI）Catalyst^TM系统与锥形束CT（CBCT）相结合用于引导头颈部肿瘤精确放疗的临床价值。方法 82名患者均来自四川大学华西医院2015年2月至2018年1月收治的需要进行头颈部肿瘤放射治疗的患者,其中45名患者使用OSI-CBCT综合引导放射治疗,37名患者CBCT独立引导治疗。每组患者在治疗疗程中均获得208次有效分次治疗;对综合引导治疗组与独立引导治疗组CBCT所得到的摆位误差数据进行统计学分析。结果 独立引导组CBCT扫描得出的分次间摆位误差平移方向x、y、z和旋转方向rx、ry、rz的结果（均值±标准差）分别为（0.19±1.01）mm、（0.29±1.36）mm、（-0.05±1.23）mm,（-0.05±0.65）°、（0.18±0.83）°、（-0.12±0.59）°;综合引导组OSI-CBCT得出的分次间摆位误差的结果分别为（0±1） mm、（0.01±0.98） mm、（-0.4±1.08） mm,（-0.03±0.72）°、（-0.19±0.82）°、（-0.37±0.85）°。两系统的相关性系数分别为：0.17、0.07、0.03、0.1、-0.06、0.01。两系统进行配对样本t检验,结果分别为（0.19±1.3） mm,P<0.05;（0.28±1.62） mm, P<0.05;（0.35±1.62） mm, P<0.05;（-0.03±0.92）°, P>0.05;（0.37±1.2）°, P<0.05、（0.25±1.03）°, P<0.05。结论 OSI-CBCT系统综合引导模式在保证放疗精确性的同时可以减少CBCT扫描次数,能有效降低CBCT带来的额外辐射量,在头颈部肿瘤放疗中优于传统的单一的CBCT引导模式。     

简论我国当前医务社会工作的境地与如何开展医务社会工作

我国当前的医务社会工作正处于萌芽阶段,其理论基础、价值观、伦理观都未充实,亟待医务工作者、众多学科学者、政策制定者进行深入研究,并建立健全医务社会工作的各项制度,使此工作有据可依。其中还对医务社会工作的功能、职能和工作方式进行了叙述。     

产妇分娩方式的变化与新生儿转归的关系

目的探讨分娩方式变化及其与新生儿死亡率、重度窒息率的相关性。方法对我院近10年来产妇的分娩方式、剖宫产指征、新生儿结局进行回顾性分析,比较不同阶段阴道分娩率、剖宫产率、新生儿死亡率和新生儿重度窒息率间的差异。结果产妇的分娩方式呈现剖宫产率逐年增高、经阴分娩率逐年降低的趋势,而新生儿死亡率及重度窒息率未出现明显下降。剖宫产指征变化以社会因素所占比例逐年增高为主。结论提高剖宫产率不能显著降低新生儿死亡率及重度窒息率。     

在传承中超越 努力探索新时期中医人才培养新模式

首都医科大学附属北京中医医院是一所临床优势突出的大型综合中医院,名医荟萃,专科特色突出,形成了北京中医医院的服务品牌。近年来在工作中院党委发现随着名老中医的故去,医院原有的一些特色优势有弱化的趋势。2007年医院党委确定了由党委书记为第一责任人,组织实施"新名中医培养战略工程"。采用"团队带团队"的方式,发挥第一、二、三批全国老中医药专家学术经验继承工作的滚动效应,集中医院内可以利用的中医药资源,通过多种形式的培养方法,利用三年的时间,在教学相长的过程中打造一批具有中医临床特长的中青年名医队伍。新的人才培养模式有力地促进了我院中医人才队伍建设。本项目同时获得北京市委组织部、北京市人事局的资助。     

Preliminary evaluation of the human relevance of respiratory tumors observed in rodents exposed to naphthalene

Inhalation bioassays in mice and rats exposed to naphthalene (NA) show incidences of lung and nasal cancer, respectively. This paper describes a preliminary mode of action (MOA)/human relevance (HR) framework for NA. Species differences in both carcinogenic and cytotoxic responses between the rodent and human have been noted based on qualitative and quantitative differences in metabolism. Some occur at the initial oxidation of NA in the rat through CYP2F, versus CYP2A13 metabolism in the human respiratory system and which results in a difference in the specific naphthoquinone formed. Normally, subsequent reactive metabolites are then conjugated through glutathione, but high dose exposures, as in the rat bioassay, result in glutathione depletion, and the availability of 1,2-naphthoquinone for other conjugation. In the rat nose, it is proposed that a naphthoquinone imine is formed via a species and site-specific aryl amidase acting on an amino acid conjugate of the quinone. Such a quinone imine is believed to be the active agent in Alachlor and phenacetin, resulting in the same profile of respiratory tumors in the rat as NA. Based on the MOA and the limited epidemiological data indicating no human evidence of nasal or lung tumor risk, the carcinogenic response observed in rats does not appear relevant to the human.     

Reproducibility and robustness of metabolome analysis in rat plasma of 28-day repeated dose toxicity studies

BASF has developed a rat plasma metabolomics database (MetaMap^®Tox) containing the metabolome of more than 500 chemicals, agrochemicals and drugs, for which the toxicity is well known, derived from 28-day repeated dose toxicity studies in rats. The quality/reproducibility of data was assessed by comparing the metabolome of 16 reference compounds tested at least twice under identical experimental conditions at three time points (day 7, day 14 and day 28). Statistical correlation analysis showed that the repeated treatment induced very similar changes to the metabolome. For all repetitions the modes of action of the compounds were always correctly identified. Moreover, when compared against the metabolome of all compounds available in the MetaMap^®Tox database, the repetitions showed in most cases the highest degree of overall similarity with the metabolome of the original study. In addition, we also evaluated the robustness of our metabolomics technique, displayed by constancy of variability in control groups over time. Based on these results, it can be concluded, that metabolomics can reproducibly be applied during toxicological in vivo testing in rats under the conditions applied here.