国内外药物相互作用信息研究现状分析与思考

本文通过对国内外药物相互作用信息研究现状的分析,提出了整合国内外相互作用信息资源,构建药物相互作用专业数据库的思路,以达到充分利用这些研究信息有效指导临床合理用药的目的。     

内科学临床实习教学改革的回顾与思考

内科学临床实习教学是帮助医学生将课堂上学到的医学理论知识运用于临床实践的教学途径,是培养高素质医学人才的关键环节。广州医学院第二附属医院内科学教研室从加强学生临床技能培训,强化临床教学查房制度,建立有效的临床实践教学工作监督机制,构建科学有效的临床基本技能考核体系等方面进行临床教学改革,取得了满意的教学效果。     

Reflection on a patient's airway management during a ward-based resuscitation

BACKGROUND: The bag-valve-mask (BVM) system is a common adjunct used during adult resuscitation to ventilate the lungs and deliver oxygen to patients in cardiopulmonary arrest. Gastric inflation, regurgitation and aspiration are well-documented complications of BVM ventilation, which can have serious consequences for patients. AIM: The aim of this paper is to review the cause of gastric inflation, regurgitation and aspiration during BVM ventilation and to consider techniques that have been suggested to reduce these problems. METHOD: Using a reflective model, the author revisits an actual cardiac arrest, and within a structured framework considers the event itself, the context of the event and looks at ways in which practice could be improved in future. RESULTS: It is clear from the evidence that a reduction in peak airway pressure can reduce the risk of gastric inflation, regurgitation and aspiration. A review of the available research strongly suggests that in expert hands, the most effective means of reducing peak airway pressure is by reducing tidal volume by using a smaller bag. CONCLUSION: Although the evidence, as presented, for a reduction in bag size is convincing, there appears to be a problem that less regular users do not appear to be able to produce effective tidal volumes when using a smaller bag. If a reduced bag size is standardized, further research using a diverse group of health care workers with the BVM is required before a clear policy can be achieved. It is likely that training and practice will be shown to be important for nursing staff expected to use the smaller BVM.     

Teaching and learning professional behavior in practice

This paper is the fourth article in a series on Professionalism and provides an overview of current methods used for teaching and learning about professionalism. The questions “whether” and “how” professionalism can be placed in the formal medical school curricula are addressed, and the informal learning related to professionalism reviewed.     

Profession and professionalisation in medical radiation science as an emergent profession

PurposeDeregulation, reduced operating costs, new ways of organising the professional workforce, increasing competition within the healthcare sector and increasing consumer expectations are factors that challenge any health profession. This paper, which forms part of the first author's doctoral study on continuing professional development in medical radiation science, details the journey of medical radiation science as a profession in Australia. Specifically, the paper examines the challenges confronting practitioners in their struggle to be recognised as a profession in its own right.FindingsThe challenges facing medical radiation science practitioners included low professional self-esteem and apathy, which adversely affects their willingness and ability to continue learning and to assume increasing work responsibilities which are essential attributes of a health professional. Low self-esteem and apathy are also preventing practitioners from venturing beyond their comfort zone of daily workplace practices. This ultimately impacts on their ability to advance clinical practice in response to a constantly changing health care system.ConclusionDespite the current difficulties confronting the profession, it is possible for practitioners to assume a more proactive role in moving the profession forward. As part of the solution to improving practitioners’ low self-esteem and to rekindling their enthusiasm for the profession, the authors propose that continuing professional development programs should go beyond simply assisting practitioners in advancing clinical competence. They should also aim to empower practitioners to develop their reflective skills. Reflection is now widely promoted in healthcare professions as one of the means of enhancing clinical practice and improving healthcare delivery. To this end, educational designers should incorporate reflection into professional development programs as both a learning goal and a strategy. Helping practitioners to become more reflective provides an effective way to address the major challenges that are currently confronting the medical radiation science profession.     

创新高等医学院校大学生社会实践活动的思考

高等医学院校大学生社会实践活动的社会化趋势日益明显，实践活动本身更加凸现知识化、专业化，社会实践活动的育人功能已经得到社会的基本认同，但在服务内容、服务形式以及实践效果等方面仍然存在一些问题。高等医学院校应当积极借鉴国外大学生社会实践活动的经验，寻求社会力量的全面支持，改进社会实践的运作方式，不断丰富医学生社会实践的内容，积极探索和建立社会实践与专业学习相结合、与择业就业相结合、与创新创业相结合的管理体制，培养大学生的劳动观念和职业道德，激励和引导大学生自觉参加社会实践，促进大学生成长成才。     

关于医学院建立临床技能培训中心的思考

随着各种新型模拟训练器材、设备的飞速发展，医学生临床技能训练的手段和方法将从本质上得到改变，医学生的临床技能将得到大幅度的提高，我们从临床技能中心建设的必要性和迫切性进行分析，进而探讨临床技能培训中心建立的运营模式以及管理方法，并对大型综合性教学医院建立临床技能培训中心进行了进一步的深入思考：     

反射式红外光谱组织血氧计传感器设计

描述了一种可用于全身体表各部位监测组织血氧状态的反射式光电传感器的设计,并应用此传感器分别进行了脑血氧和肌血氧状态的测量,获得有意义的实验结果,证实设计的合理性和可行性。     

Peripheral vascular permeability following a thermal injury to the airway

Effects of thermal injury to the airway on the vascular permeability in the region of head and neck, were studied in the canine models. The thermal airway injury was produced by an inhalation of a gas burners flame through the metallic tracheostomy cannula. The changes in vascular permeability were evaluated by calculating the reflection coefficient, which was obtained by the protein washdown technique into lymph. The reflection coefficient after the flame inhalation did not show any increases, while it increased significantly after a histamine infusion into the carotic artery. We concluded, that the vascular permeability in the unburned area does not increase at least in the first 3hr after a thermal injury to the airway.(Okamoto K, Noguchi H, Akashi M, et al.: Peripheral vascular permeability following a thermal injury to the airway. J Anesth 5: 79–87, 1991)     

在体和离体兔组织射频介电特性的测量

作者制作了同轴线传感器，根据同轴传输线反射原理，建立起计算机控制的生物组织介电测量系统，在６０～３０００ＭＨｚ频率范围对兔器官组织进行了有效在体和离体介电测量，５０只兔器官组织的统计分析结果表明，不同兔器官组织之间介电参数的最大差异可达３０．４％，在体和离体测量得出介电常数之间未见显著性差异，但电导率有频率依赖性的显著差异，因此将人体的离体介电参数延用到实际活体场合时，必须慎重。