成人护理专科教育护理学基础课堂教学设计的探讨

本文以“健康与疾病”为例，介绍了成人护理专科的护理学基础课堂教学设计。主要包括学生的情况分析、授课计划的制定、教学方法的选择、课程内容的优化、教学媒体和教学案例的运用等。同时，提出了调动学生的学习积极性、学生终身学习意识教育及医德教育等问题，从而使学生既能真正获得有用知识，又尽可能地通过考试取得学历文凭。     

Characteristics of Acute Asthma Patients Attended Frequently Compared with Those Attended Only Occasionally in an Emergency Department

Asthma patients that depend on emergency department (ED) services are generally considered to have extremely poor disease control and prognosis. It is important to identify characteristics related to poor disease control and frequent visits to the ED to apply appropriate clinical management. This study comprised a cross-sectional survey of consecutive patients with asthma exacerbation (age ≥12 years) presenting at the adult ED of a large, tertiary care, university-affiliated hospital over a 2-month period. The frequent visitors (FV) were defined by ≥3 visits to the ED in the preceding year, and the occasional visitors (OV) by ≤2 visits. Eighty-six patients (61 females and 25 males) were included in the study (mean age 38 ± 18 years). Of these patients, 51.2% were FV and 48.8% were OV. Sixty-nine percent had annual income lower than A$3000 and 66.3% had ≤8 years of the formal education. Only 18.6% had used inhaled corticosteroids, 79.1% identified the asthma attack severity, 70.9% increased or initiated inhaled β-agonist, 20.9% increased or initiated steroid therapy, and 55.8% had an asthma action plan for attack. The number of hospital admissions in past year (OR 4.3, P = .02), use of home nebulizer (OR 3.6, P = .05) and the lack of a written asthma action plan (OR 3.3, P = .03) were independently associated with frequent visits to the ED. We conclude that a substantial proportion of the patients that visit the ED are FV. These patients are more likely to have hospital admission in the past year, to use a home nebulizer, and to lack a written asthma action plan. They should be considered the most important target for asthma education.     

老年人自发性气胸的临床分析

目的探讨老年人自发性气胸的诊断及治疗,以提高老年人自发性气胸的诊治水平。方法回顾性分析我科1996年2月3日～2006年2月23日我科89例老年人自发性气胸的诊治经过。结果老年人自发性气胸的临床症状易被原发病掩盖,其临床特点有:(1)临床表现多不典型,症状以紫绀、气急多见,无明显胸痛;(2)以继发性气胸为多;(3)老年自发性气胸并发症、伴发病多;(4)肺复张时间长,负压吸引效果差;(5)交通型和张力型在老年自发性气胸当中较为多见;(6)易误诊;(7)由于基础疾病存在,肺功能差,发生气胸后易出现肺部感染、呼吸衰竭等并发症,死亡率高。结论老年人各器官储备功能差,肺功能差,同时多并存基础疾病,老年人自发性气胸后易出现肺部感染、呼吸衰竭等并发症,死亡率高,早期诊断和积极合理的治疗是降低老年人自发性气胸病死率的关键。     

三联药物治疗未破裂异位妊娠的临床研究

目的 :观察甲氨蝶呤(Methotrexate,MTX)、米非司酮(Mifepristron,Ru486)及中药三联用药治疗未破裂型异位妊娠的临床疗效。方法 :对171例未破裂型异位妊娠病人 ,按药物治疗方法不同分为两组进行对照研究 :A组使用MTX注射 +Ru486口服 +中药联合治疗。B组单独使用MTX注射治疗。测定法定期测定两组病人血HCG值以监测血HCG下降情况 ,测量异位妊娠包块三径线值以监测病灶包块缩小情况 ,同时观察临床症状持续时间、副反应发生率及总有效率。结果 :血HCG下降及病灶包块缩小A组较B组明显 ,差异有显著性(p<0 05,p<0 01);临床症状持续时间A组较B组短 ,差异有显著性(p<0 05);副反应发生率两组间无显著差异(p>0 05);A、B两组的总有效率分别为 :95 74%和71 43% ,A组较B组高 ,差异有显著性(p<0 05)。结论 :三联使用甲氨蝶呤、米非司酮及活血化瘀消包块杀胚的中药既有很强的杀胚功能 ,又能消除病灶包块 ,保留生育功能。三联药物联合治疗未破裂异位妊娠具有疗效肯定、安全     

National intercomparisons of I radioactivity measurements in nuclear medicine centres in India

National intercomparisons of activity measurements of ¹³¹I, a radioisotope widely used for diagnosis and therapy of thyroid related ailments, were initiated in 1979 as a quality assurance program, towards improving radiation safety procedures and related dosimetry in Nuclear Medicine Centres (NMCs) in India. Oral administration of a known quantity of radioiodine to patients requires accurate radioactivity measurements to be performed on a well-calibrated isotope calibrators. Under or over estimation of the activity due to a faulty or uncalibrated isotope calibrator could provide misleading results. Calibration of isotope calibrators and the traceablity of subsequent measurements to the national standards laboratory is one of the essential basic radiation safety requirement of the IAEA. In view of the stringent quality assurance requirements for activity measurements imposed by Atomic Energy Regulatory Board, a National Intercomparison Program was initiated and to date ten such intercomparison programs have been conducted by the Radiation Safety Systems Division, of the Bhabha Atomic Research Centre. This program has benefited the participants by making their measurements traceable to the National Primary Standards. Over the years there has been a marked increase in the number of NMCs participating in the intercomparison programs. As a result, the number of institution showing large deviation from the correct value has decreased considerably over the years. This program thus, has enabled participating NMCs to check their isotope calibrators so as to ensure proper delivery of radiation dose to the patients and hence to optimise patient exposure.     

中西医联合治疗单纯疱疹性角膜炎的疗效观察

目的 :探讨单纯疱疹性角膜炎是中西医联合用药的治疗方法。方法 :本组 10 0例 ( 10 6只眼 )单纯疱疹性角膜炎患者应用抗病毒药物联合清热解毒中药的疗效观察。结果 :本组病例治疗后总有效率 82 .0 8%。结论 :中西医联合治疗措施是我们对单纯疱疹性角膜炎治疗的一项新的探讨。     

多站点综合性毕业考试的改革与实践

我校改革临床医学专业毕业考试模式与方法，在临床实习过程中组织多站点综合性考试，采用闭卷笔试方法考核临床理论知识，占70％；采用实践操作与现场口试方法考核临床技能及相关知识，占20％；采用开卷笔试方法考核医疗文书书写，占10％。实践证明，此项改革能促进医学生端正实习态度，调动实习的积极性与主动性，引导医学生在实习中重视理论学习与临床实践的密切结合，促进临床教学质量的提高。     

深化医学教学改革为社区培养实用型医学人才的实践

为适应医学模式的转变，实现“人人享有卫生保健“的全球战略目标，培养和建设一支满足社区卫生服务急需的实用型医学人才。文章介绍了我院在深化医学教学改革过程中，采用多种综合性措施强化在校临床医学专业本科生的全科医学知识教育，为其将来从事社区卫生服务奠定基础。为满足当前我国社区卫生服务工作对实用型医学人才的急需，对于主要面向基层培养高级医学人才的地方性普通高等医学院校，应对在校学生提前有机地增加和融入社区全科医学知识教育，这有利于强化和巩固医学生的社区卫生服务观念和综合素质。     

一种具有高信噪比的脉搏波光电传感器的研制

目的：探讨研制一种生理信号光电传感器。方法：利用光电传感器检测通过指端毛细血管后的光强度的变化，将光信号转换成电信号，再经过电信号1/V转换、放大、滤波处理。结果：获得了清晰稳定的指端容积脉搏波。结论：高信噪比的光电传感器可用作于临床监测和生理信号分析处理系统。