我院合同制护士推优转正制度的实施与效果

目的探讨合同制护士管理的方法及效果。方法成立推优审核组,建立推优标准,遵循推优转正程序和流程,对符合标准的合同制护士进行推优考核。结果合同制护士离职率降低,患者满意度提高,科室同行对合同制护士的评价明显提高。结论稳定了合同制护士队伍,提高了合同制护士队伍的综合素质,保障了医疗护理工作的安全,在满足服务对象多元化需求方面取得了良好效果。     

Risk assessment of the potential side effects of long–term creatine supplementation in team sport athletes

Summary Background Use of creatine has become widespread among sportsmen and women, although there are no conclusive evidences concerning possible health risks of long–term creatine supplementation. The aim of the study To investigate long–term effects of creatine monohydrate supplementation on clinical parameters related to health. Methods Eighteen professional basketball players of the first Spanish Basketball League participated in the present longitudinal study. The subjects were ingesting 5 g creatine monohydrate daily during three competition seasons. Blood was collected in the morning after an overnight fast, five times during each of the three official competition seasons of the first National Basketball League (September 1999–June 2000, September 2000–June 2001 and September 2001–June 2002) and the European League. Standard clinical examination was performed for 16 blood chemistries. Results The plasma concentrations of all clinical parameters did not alter significantly during the analyzed time frames of creatine supplementation. All of these parameters were, with the exception of creatinine and creatine kinase, within their respective clinical ranges at all time points. Conclusion Our data shows that low–dose supplementation with creatine monohydrate did not produce laboratory abnormalities for the majority of the parameters tested.     

Training and performance characteristics among Norwegian international rowers 1970-2001

This study quantified changes in training volume, organization, and physical capacity among Norwegian rowers winning international medals between 1970 and 2001. Twenty-eight athletes were identified (27 alive). Results of physiological testing and performance history were available for all athletes. Twenty-one of 27 athletes responded to a detailed questionnaire regarding their training during their internationally competitive years. Maximal oxygen uptake (VO2 max) increased 12% (6.5+/- 0.4 vs. 5.8+/-0.2 L min(-1)) from the 1970s to the 1990s. Similarly, 6-min ergometer rowing performance increased almost 10%. Three major changes in training characteristics were identified: (1) training at a low blood lactate (< 2 mM) increased from 30 to 50 h month(-1) and race pace and supra-maximal intensity training (approximately 8-14 mM lactate) decreased from 23 to approximately 7 h month(-1); (2) training volume increased by approximately 20%, from 924 to 1128 h yr(-1); (3) altitude training was used as a pre-competition peaking strategy, but it is now integrated into the winter preparation program as periodic 2-3-week altitude camps. The training organization trends are consistent with data collected on athletes from other sports, suggesting a "polarized" pattern of training organization where a high volume of low intensity training is balanced against regular application of training bouts utilizing 90%-95% of VO2 max.     

Role of psychological stress in cortisol recovery from exhaustive exercise among elite athletes

Life-event stress (LES) was used to classify elite athletes (n = 39) into high-and low-LES groups. A repeated measures analysis of variance revealed higher Cortisol concentration after a graded exercise test among the high-LES group relative to the low-LES group, which was maintained for up to 20 hr. Subsequent prospective analyses further indicated that high-LES athletes were more likely to be symptomatic than low-LES athletes and that elevated Cortisol level was positively correlated with symptomatology. To the extent that Cortisol is a marker of exercise recovery in competitive atbletes, our results suggest that chronic stress prolongs the recovery process, which may potentially widen a window of susceptibility for illness and injury among competitive athletes. This article was supported in part by the Division of Sport Science and Technology of the United States Olympic Training Center and by NIMH research training Grant MHI8917.     

基于人工脉冲神经网络的门诊静脉采血智能预约平台设计

基于人工脉冲神经网络建立新型门诊静脉采血智能预约平台。在数据源整合处理模块中,基于脉冲神经网络设计局部递归的人工脉冲神经网络,实现多类型预约数据源的整合处理。在序列特征挖掘模块中,利用多层双向LSTM网络建立PDCA模型,提取门诊静脉采血预约数据的形态特征和语义特征,通过多层双向LSTM网络融合序列特征实体信息。在预约模块中,门诊静脉采血智能预约主要通过自助设备与互联网来完成,通过JavaScrip编写自助设备与互联网页面的门诊静脉采血预约程序。平台数据库由多种数据表构成,具体包括医生信息表、预约时间点分配表等。平台性能测试结果显示,设计平台的数据库每秒查询率更高,最高可达到54239次,信息抽取准确率最高为98.60%。     

知名专家团队层级转诊预约系统设计与实现

以首都医科大学附属北京同仁医院为例,分析转诊需求,制定转诊规则与流程,设计包含知名专家团队成员维护、转诊权限维护、预约号源配置等功能的知名专家团队层级转诊预约系统,分析存在的不足并提出改进建议,指出该系统有助于完善就诊流程,提高医疗效率。     

扶正益气中药对优秀赛艇运动员力竭运动后T淋巴细胞亚群的影响及机理初探

目的:观察以黄芪、灵芝提取物为主要成分的扶正益气中药对优秀赛艇运动员大强度力竭运动后淋巴细胞亚群的影响,并从细胞凋亡的角度探讨该中药对免疫功能的作用机制。方法:16名国家健将级赛艇运动员,随机分为对照组和实验组。各组每天早、晚各一次服用扶正益气中药(实验组)或安慰剂(对照组),每次15g,连续服用30天。30天后,两组运动员在划船测功仪上以80%最大强度运动至力竭。观察运动前后两组T淋巴细胞亚群浓度、CD4+/CD8+比值、T淋巴细胞亚群细胞凋亡及CD95蛋白表达的变化。结果:(1)对照组运动后24h,CD4+、CD8+浓度及CD4+/CD8+比值较运动前无显著差异。运动后1.5h,该组CD4+、CD8+细胞凋亡率及CD95蛋白表达率也无显著变化。(2)实验组运动后24h,CD4+浓度、CD4+/CD8+比值显著升高(P<0.05)。运动后1.5h该组CD4+细胞凋亡水平明显降低(P<0.05),运动前后该组CD4+、CD8+淋巴细胞CD95蛋白表达无显著变化。结论:扶正益气中药对大强度力竭运动后,优秀赛艇运动员的CD4+/CD8+比值具有显著的升高作用,其作用机理可能为:扶正益气中药很可能通过能降低运动后CD4+细胞凋亡水平,进而提高CD4+细胞浓度,达到改善CD4+/CD8+比值、增强机体细胞免疫功能的作用。     

Maximal oxygen uptake as a predictor of performance ability in women and men elite cross-country skiers

Maximal oxygen uptake (O_2max) was measured in 51 females and males classified as either world-class, medium-class or less successful elite skiers. The O_2max in the male world-class skiers was significantly higher (mean 85.6 ml·kg⁻¹·min⁻¹ or 355 ml·min⁻¹ kg⁻²³) than in the other elite skiers. World-class and medium-class female skiers had identical mean O_2max expressed in ml·kg⁻¹·min⁻¹ (70.7 and 70.6, respectively), but the values differed significantly when the unit ml·min⁻¹kg^−2/3 was used (274 and 264, respectively). O_2max expressed as ml·min⁻¹·kg^−2/3 reflects differences in performance capability among elite skiers better than the unit ml·kg⁻¹·min⁻¹.     

外伤性脾损伤23例保留原脾手术治疗体会

目的:探讨脾外伤脾破裂时保留脾脏的手术治疗效果。方法:2000年1月至2005年12月对脾破裂中的23例患者,采用以脾动脉结扎加修补术的方法保留脾脏。结果:23例均治愈,术后无1例死亡。2例随访2个月~5年,经彩色多普勒及CT扫描检查,均无脾萎缩发生。无1例出现血小板骤升及易感染情况,脾脏的功能正常。结论:脾脏在血液及免疫方面的功能对于儿童及青少年尤为重要。当脾脏破裂时决定是否切脾应当慎重。本组采用的保脾手术方法安全,对防止脾切除后可能发生的并发症有一定的意义。