杭州市3所小学风疹暴发和应急接种效果调查

对１９９６年杭州市３所小学的风疹暴发，和应急接种冻干风疹减毒活疫苗的效果进行了调查。结果显示：病儿风疹ＩｇＭ抗体检出率与采血时间密切相关，以出疹后５～２８天检出率最高（９７７３％）；风疹血凝抑制（ＨＩ）抗体临界滴度，显性感染为１∶１６，隐性感染为１∶２５６；抗体阴性的未接种疫苗者，经过风疹暴发，显性和隐性感染率分别辊为１３７９％、４４８３％，显性与隐性感染之比为１∶３６２５；暴发前抗体阳性率４０％，暴发后升至８８２４％，提示人群风疹抗体阳性率＞９０％可阻断风疹传播。抗体阴性者接种风疹疫苗后抗体全阳转，几何平均滴度倒数（ＧＭＲＴ）为２１８６９。风疹罹患率接种组和未种组分别为５８３％、２７６１％，疫苗保护率为７８８８％。     

急腹症术后继发甲亢危象的抢救护理

本文报告了６例急腹症术后继发甲亢危象的抢救及护理措施。主要有保持气道通畅，及时准确使用抗甲状腺制剂药物，降温，防止并发症发生。体会到早期发现病情变化是抢救成功的基础，正确有效的抢救措施是抢救成功的关键，良好的心理护理和疾病指导是护理这类病人成功的重要内容之一。     

从两则实例看合理运用紧急避险理论

北京协和医院在防治传染性非典型肺炎的工作中遇到的两则实例(急需应用尚未完成药品审批手续的新药,疑似“非典”病人死亡后因家属拒绝签字火化而无法处理尸体),使医院面临两种合法利益不能同时得到保护的困难局面。为解决问题,有必要引入法学上的紧急避险理论。从法律构成要件和制度价值的角度分析,紧急避险理论应在“非典”防治实践中做积极的合理的应用。     

Consent to Sterilization section of the Medicaid-Title XIX form: is it understandable?

INTRODUCTION: We sought to assess readability and comprehension characteristics of the Consent to Sterilization section of the Medicaid-Title XIX form (Title XIX-SCF) in order to determine if it was likely providing informed consent to the Medicaid population. MATERIALS AND METHODS: The current Title XIX-SCF was evaluated using the Readability and Processability Form (RPF). The RPF, designed to assess the format of informed consent documents, assigns points to each of 20 areas of comprehension analysis according to established scoring criteria. Finally, a modified Title XIX-SCF was developed and evaluated using the RPF. RESULTS: The overall RPF score for the current Title XIX-SCF was in the "poor" range (total=37), while the Fry reading level was at the ninth grade. The modified Title XIX-SCF scored in the "excellent" range (total=92), while the Fry reading level was at the sixth grade. CONCLUSIONS: The readability and comprehension demands of the current Title XIX-SCF exceed recommended guidelines for patient education and informed consent materials. The current Title XIX-SCF should be revised to ensure that women understand, desire and consent to permanent sterilization.     

急诊经皮冠状动脉介入治疗急性心肌梗死死亡因素分析

目的分析急性心肌梗死患者行急诊经皮冠状动脉介入治疗(PCI)手术中及住院期间死亡原因。方法1999年3月至2005年6月行急诊PCI治疗的急性心肌梗死患者623例,死亡27例,回顾性分析其死亡原因及临床特征。结果死亡27例,病死率4．3%,年龄51～91岁,(69±18)岁。三支病变16例．二支病变10例．单支病变1例。合并陈旧心肌梗死10例,糖尿病9例．高血压病19例,肾功能损害4例,陈旧性脑梗死6例。死亡原因：心源性休克9例,无复流6例,心脏破裂2例,急性血栓形成2例,急性左心功能衰竭2例,急性肾功能衰竭2例,颅内出血2例,穿刺处出血致休克1例,急性心包填塞1例。结论急性心肌梗死急诊介入治疗死亡原因有多种,心源性休克、无复流为主要死亡原因。高龄、多支病变、合并糖尿病、陈旧性心肌梗死等可能为死亡的预测因子。     

Predictors of reading comprehension ability in primary school-aged children who have pragmatic language impairment

PurposeChildren who have pragmatic language impairment (CwPLI) have difficulties with the use of language in social contexts and show impairments in above-sentence level language tasks. Previous studies have found that typically developing children's reading comprehension (RC) is predicted by reading accuracy and spoken sentence level comprehension (SLC). This study explores the predictive ability of these factors and above-sentence level comprehension (ASLC) on RC skills in a group of CwPLI.MethodSixty nine primary school-aged CwPLI completed a measure of RC along with measures of reading accuracy, spoken SLC and both visual (pictorially presented) and spoken ASLC tasks.ResultsRegression analyses showed that reading accuracy was the strongest predictor of RC. Visual ASLC did not explain unique variance in RC on top of spoken SLC. In contrast, a measure of spoken ASLC explained unique variance in RC, independent from that explained by spoken SLC. A regression model with nonverbal intelligence, reading accuracy, spoken SLC and spoken ASLC as predictors explained 74.2% of the variance in RC.ConclusionsFindings suggest that spoken ASLC may measure additional factors that are important for RC success in CwPLI and should be included in routine assessments for language and literacy learning in this group.     

某校藏族学生健康素养调查

目的了解某校藏族学生健康素养现状,为健康教育开展提供依据。方法在{2009中国公民健康素养调查问卷》基础上自行设计问卷,抽取某校139名大学生进行调查。结果该校藏族学生健康素养知晓率为41．92％,健康基本知识与理念、健康生活方式与行为、基本技能素养知晓率分别为45．32％、29．08％和61．15％。结论该校藏族学生健康素养知晓率高于全国居民相应水平,但其自身健康生活方式与行为素养的知晓率低于其他项目,建议该校加强藏族学生健康素养教育,注重其生活方式与行为的培养。     

科学素养与人文精神融合培养的探索及做法——以宝鸡职业技术学院护理人才培养模式为例

首先阐述了科学素养与人文精神的理论基础及融合培养意义,其次着重分析了该院特色“1234”模式：围绕一个目标,打造过硬的融合型师资队伍;坚持双轨并举,形成独特的融合式培养模式;体现三种能力,建立融合型考核评价体系;突出四位一体教学特色,实施分年级分阶段融合教育途径.     

中毒事件中四种鼠药的快速检测

目的建立对四种鼠药的实验室应急检测方法,以应对突发公共卫生毒物中毒事件。方法采用气质联用法(GC/MS)测定毒鼠强、氟乙酰氨和高效液相色谱法(HPLC)测定敌鼠钠、溴敌隆,以鼠药标准和鼠药样品为对象,优化GC/MS和HPLC色谱、质谱条件,从而建立各鼠药的色谱图库和质谱图库。结果 GC/MS定性检测毒鼠强的特征离子和丰度比分别为212/240和2:1,氟乙酰胺的分别为44/77和1.5:1;敌鼠钠、溴敌隆以高效液相色谱双波长(285nm和260nm)检测,固体样品最低检测浓度为0.80 mg/kg,液体样品最低检测浓度为0.16 mg/L。结论研究方法对中毒事件中四种鼠药检测快速、结果可靠,适用于鼠药中毒实验室应急检测。     

Promoción de la lectura en etapas precoces desde atención primaria en una zona de exclusión social

IntroductionReading is a tool that stimulates brain activity, increasing its cognitive reserve and providing innumerable benefits such as the stimulation of empathy, concentration or language development. Promoting reading at a very early age helps develop reading skills correctly. However, social inequalities can result in this practice being carried out less in groups of low socioeconomic, social or cultural levels. The purpose of this study was to assess the outcomes of a promoting reading habits intervention in a primary health care center located in a social transformation district by talking to the parents, providing books to families and encouraging books to become a part of children's play preferences.Materials and methodsA non-random intervention study in which children born in 2015 and registered in a particular health center took part. A reading promotion intervention was carried out at the ages of 4, 6, 12 and 18 months and at 24 months their preference for reading activities was assessed in relation to other leisure activities.ResultsThree hundred forty-two subjects were included, 154 allocated in the intervention group and 188 in the control group. The children in the intervention group exhibited a greater preference for reading as a leisure activity as compared to those in the control group (reading ranked in last position of favourite activities in 18.8 vs. 33.9%; p=0.003). The variables found on multivariate analysis to have a greater influence on reading position in the ranking of favorite activities were not having participated in the intervention OR: 2.06 (1.19-3.58) and gipsy ethnicity, OR: 2.37 (1.38-4.09).ConclusionsResults reveal a slight improvement in the preference for reading as an activity in the children that took part in the literacy program.