全国肿瘤医院患者服务中心模式的探索与推广

针对肿瘤患者及家属的特点,成立肿瘤医院患者服务中心,组建志愿者团队,在就诊的各环节开展医疗专业及志愿服务.用专业知识和爱心奉献为患者提供医院医疗诊治外的服务,帮助人们科学有效就诊、正确认识肿瘤、树立信心、提高生活质量,推动肿瘤疾病由“单一治疗”转向“全人关怀”.随着对患者服务中心项目的探索和研究,以点带面,可以进一步构建出全国肿瘤医院患者服务中心网络,使更多的患者及家属受益,具有重要推广意义.     

Characterization of peripheral blood progenitor cells (PBPC) mobilized by filgrastim (rHuG-CSF) in normal volunteers: dose–effect relationship for filgrastim with the character of mobilized PBPC

Filgrastim (rHuG-CSF)-mobilized peripheral blood progenitor cells (PBPC) in healthy Japanese volunteers were characterized in detail using two clonal cell culture systems and double-colour flow cytometry to detect multilineage colony-forming cells and subsets of CD34⁺ cells. The kinetics of PBPC during the administration of filgrastim was studied, and possible differences in the character of progenitor cells relative to given doses of filgrastim were investigated. Filgrastim was administered subcutaneously to normal volunteers for 7 d at doses of 100, 200 or 400 μg/m² (10 per cohort). Treatment with 100 or 200 μg/m² filgrastim was well tolerated; however, the 400 μg/m² dose level was not completed because of bone pain and myalgia. The treatment strikingly mobilized various types of progenitor cells, including highly proliferative megakaryocytic colony-forming cells. The number of progenitor cells peaked on days 5 and 6. The fold increase of circulating progenitor cells from the baseline value in the volunteers treated with 200 μg/m² filgrastim was more pronounced than in those treated with 100 μg/m². Treatment with 200 μg/m² also released the less mature progenitor cells (i.e. mixed colony-forming cells, CD34⁺/33^? cells, and CD34⁺/HLA-DR^? cells) into circulation better than the 100 μg/m² dose. These results suggest that daily subcutaneous injection with 200 μg/m² filgrastim for 5 d will effectively mobilize, both qualitatively and quantitatively, PBPC in healthy donors.     

县级医院志愿者管理工作实践与探索

面对县级医院学生志愿者服务时限短、其他社会志愿者招募难度大、缺乏专职管理人员等不足,医院在如何提高志愿者招募效果、组织管理效率等方面做了一些探索,逐步建立“志愿服务在医院”的长效机制,形成志愿服务常态化、规范化。     

The global vet nurse

Travelling – something some people only dream of one day doing. Work commitments being one of the major hold backs for most, it is easy to forget that this industry we work in has a worldwide need and our skills are completely transferable in almost every country.

This short article aims to inspire and advise other veterinary nurses and student veterinary nurses on the options available to work, or volunteer abroad and how and where to do it.     

Leukapheresis for the extraction of monocytes and various lymphocyte subpopulations from peripheral blood: product quality and prediction of the yield using different harvest procedures

BACKGROUND AND OBJECTIVES: Leukapheresis of non-mobilized healthy donors is performed to harvest monocytes and lymphocyte subpopulations for use in various therapeutic regimens. In this methodological study, we compared two different leukapheresis programs, using equivalent volumes of processed blood over similar processing periods, to determine the influence of the procedures on the donor peripheral blood count and to establish the procedure that yields the highest quality product. MATERIALS AND METHODS: The target variables obtained in 41 healthy blood donors who underwent short-term leukapheresis (80-105 min) were retrospectively compared. Twenty-one volunteers were processed on a COBE Spectra machine at the MNC setting and 20 volunteers were processed at the AutoPBSC setting. Data were collected on pre- and postleukapheresis samples and on the product. RESULTS: AutoPBSC and MNC procedures resulted in a decrease of haemoglobin (5-7%), platelets (17-20%), monocytes (22%) and lymphocytes (23-27%), but not of granulocytes in peripheral blood. Both procedures produced nearly identical leucocyte and lymphocyte yields. AutoPBSC products contained a greater number of granulocytes, monocytes and red cells, but fewer platelets. The preleukapheresis values correlated with the yields for monocytes, T-helper and T-suppressor cells, B-lymphocytes and natural killer cells, but not for granulocytes or platelets. CONCLUSIONS: Leukapheresis is a safe and efficient procedure for collecting large numbers of peripheral blood monocytes and different lymphocyte populations from non-mobilized donors. The two programs yield comparable leucocyte harvests. Based on our results, yields can be predicted from the peripheral cell counts.     

新医改视域下医学生社区志愿服务长效机制研究

医学生拥有潜在的人力资源优势,开展医学生社区志愿服务是完善社区医疗卫生体系建设,提高医学生广泛参加社会实践,增强职业道德素质、专业知识水平和操作能力的重要举措。针对医学生志愿服务存在目的性不明确、专业性不强、缺乏系统培训和资金匮乏等问题,实现医学院校与社区卫生服务机构结对服务,构建新时期医学生社区志愿服务的长效机制。     

某公立医院青年志愿者工作的调查与分析

青年志愿者是医院服务的重要载体,是建立和谐医患关系的中坚力量。激励青年认真学习志愿者精神,培养健康的心理,对医院开展志愿者服务、和谐医患关系具有非常重要意义。采用随机采样方法,对535名医院青年志愿者进行问卷调查和访谈,分析了医院青年志愿者具备的思想政治水平、对某些问题的不同认知及可能遇到的来自多方面的压力;并对缓解志愿者的压力及提高对不同问题的认知能力提出了可行的建议。     

基于健康人急性骨筋膜室综合征模型的超声监测价值研究

目的:探讨超声在急性骨筋膜室综合征模型早期无创监测中的应用价值,为进一步的临床应用提供参考。方法:为前瞻性自身对照研究。通过袖带加压法建立小腿急性骨筋膜室综合征的健康志愿者模型,随机数字法确定一侧小腿为实验组,袖带依次给予0、20、30、40、50、60、70、80 mmHg (1 mmHg=0.133 kPa)压力,对照组的小腿袖带不加压。实验组每个压力水平持续5 min,期间应用超声测量双侧腘动脉、腘静脉及足背动脉的血流频谱及血管结构指标。采用重复测量方差分析和多变量方差分析进行统计分析。结果:研究共纳入25名健康志愿者,双侧小腿围和胫前筋膜室厚度的差异无统计学意义（ P=0.314、0.678）,小腿袖带加压期间心率及血压稳定（ P=0.235、0.358）。实验组腘动脉收缩期最大血流速、最小血流速均随袖带压力的增大而增加,从加压30 mmHg起实验组腘动脉最大血流速明显高于对照组[(73±19) cm/s vs (59±14) cm/s, P=0.023)],从加压20 mmHg起实验组腘动脉最小血流速显著高于对照组[(-28±8) cm/s vs (-22±6) cm/s, P=0.012)]。随着压力的增加,实验组腘动脉舒张期反向血流比增加（ P<0.001）,加压20 mmHg时即显著大于对照组[(0.42±0.14）cm/s vs (0.30±0.12) cm/s, P=0.009)]。实验组足背动脉正向血流比随压力增加而减小（ P=0.024）。 结论:在健康人急性骨筋膜室综合征模型中,随着筋膜室压力的增加,近端动脉的收缩期最大血流速、舒张期反向血流比例明显增加,远端动脉的收缩期正向血流比例明显减少,提示超声可用于急性骨筋膜室综合征的早期监测,值得进一步的临床研究。     

Can volunteer counsellors help prevent psychological trauma? A preliminary communication on volunteers skill using the ‘Orienting Approach’ to Trauma Counselling

The capacity of 73 volunteer telephone counsellors to administer a brief and early intervention for secondary trauma was assessed. The counsellors participated in a 1‐day training programme in the ‘Orienting Approach’ to Trauma Counselling (Phipps & Byrne, 2003). Volunteer counsellors showed significant improvements in both knowledge and skills from pre‐ to post‐training. The potential benefits of this intervention to the community and professional health services are discussed. Copyright © 2006 John Wiley & Sons, Ltd.