西藏亚东地区蜱类调查报告

于１９９２年５－７月在西藏亚东地区进行了蜱类调查，采用在灌丛挥摆或拖拉布旗及牛体检查，获蜱３属５种，其中阿坝革蜱为西藏新记录蜱种；对蜱在不同生境的分布、牛体寄生情况及卵形硬蜱的季节消长作了分析。     

The effect of music therapy sessions on compassion fatigue and team building of professional hospice caregivers

The purpose of this study was to evaluate the effects of music therapy on compassion fatigue and team building of professional hospice workers. Participants were nurses, social workers, and chaplains and were employed for at least one year in hospice care. Seventeen participants engaged in one of two experimental music therapy groups. Experimental group 1 utilized an ecological music therapy approach with an open, free form without structure and encouraged participation in the live music experiences of instrumental improvisation as well as toning and chanting. Experimental group 2 utilized a didactic music therapy approach with a structured format wherein interventions were planned and facilitated by the music therapist a priori. Such interventions included guided meditation with live music, lyric analyses, and music and movement. To measure compassion fatigue, the Compassion Fatigue Scale (CFS) was used as a pre- and post-test measure in each group. To measure team building, the Team Building Questionnaire (TBQ) was used as a pre-and post-test measure in each group. Statistical analyses indicated a significant improvement in team building in both groups but no significant differences with regard to compassion fatigue. Further research studying the effects of music therapy on compassion fatigue and team building of professional hospice caregivers is recommended.     

结直肠肿瘤多学科协作诊治模式的团队文化建设(一)

目的探讨在结直肠肿瘤多学科协作(MDT)诊治模式中进行团队文化建设的策略。方法通过对传统志愿者概念的理解以及传统团队文化的价值探讨,结合结直肠肿瘤MDT模式对团队文化的实际需求,合理定位结直肠肿瘤MDT的团队文化和核心思想。结果确定志愿者团队和志愿者文化的建设是结直肠肿瘤MDT团队文化的核心。分析志愿者团队的特点和运作策略并指出了维护志愿者文化的方法。结论随着志愿者团队的扩大及参与类型的增加,结直肠肿瘤MDT团队文化将体现出更多的社会性和广度,也是未来发展的重要思路和方向。在与组织构架、人员构架相辅相成的整体中,根据实际情况不断调整和完善团队文化将是MDT一项长期工作。     

Analysis of verbal communication during teaching in the operating room and the potentials for surgical training

BACKGROUND: Verbal communication in the operating room during surgical procedures affects team performance, reflects individual skills, and is related to the complexity of the operation process. During the procedural training of surgeons (residents), feedback and guidance is given through verbal communication. A classification method based on structural analysis of the contents was developed to analyze verbal communication. This study aimed to evaluate whether a classification method for the contents of verbal communication in the operating room could provide insight into the teaching processes. METHODS: Eight laparoscopic cholecystectomies were videotaped. Two entire cholecystectomies and the dissection phase of six additional procedures were analyzed by categorization of the communication in terms of type (4 categories: commanding, explaining, questioning, and miscellaneous) and content (9 categories: operation method, location, direction, instrument handling, visualization, anatomy and pathology, general, private, undefinable). The operation was divided into six phases: start, dissection, clipping, separating, control, closing. RESULTS: Classification of the communication during two entire procedures showed that each phase of the operation was dominated by different kinds of communication. A high percentage of explaining anatomy and pathology was found throughout the whole procedure except for the control and closing phases. In the dissection phases, 60% of verbal communication concerned explaining. These explaining communication events were divided as follows: 27% operation method, 19% anatomy and pathology, 25% location (positioning of the instrument-tissue interaction), 15% direction (direction of tissue manipulation), 11% instrument handling, and 3% other nonclassified instructions. CONCLUSION: The proposed classification method is feasible for analyzing verbal communication during surgical procedures. Communication content objectively reflects the interaction between surgeon and resident. This information can potentially be used to specify training needs, and may contribute to the evaluation of different training methods.     

人性化管理在骨科护理管理中的应用

通过将人性化管理理念应用在骨科护理管理中,在管理的过程中重视人的因素,达到激励护士进取、赋予护士价值感、成就感,增强团队的凝聚力的目的,从而促进护理工作质量的全面提高。     

以团队为基础学习在预防医学教学中的应用

目的探讨以团队为基础学习（TBL）的教学方法在预防医学教学中的应用。方法采用整群抽样方法选取80名2010级护理专业学生,随机分为TBL教学组和传统教学组,通过调查问卷和课堂测试评价两组的教学效果。结果TBL教学组学生的学习态度、学习效果、学习能力评分有明显的提高,均优于传统教学组（P〈0．05）。TBL教学组和传统教学组的理论考试成绩分别为（87．60±3．10）和（72．90±4．68）分,两组之间差异有统计学意义（P〈0．05）。结论TBL教学方法优于传统教学,能够提高学生的学习兴趣,加深理论知识的理解和记忆．促进团队精神和实践能力的培养．提高了学生的学习成绩。     

中国医疗队在佛得角开展妇产科手术的临床疗效分析

目的研究中国援非医疗队在佛得角首都医院（Hospital Agostinho-neto,HAN）采取中国术式与佛得角本国术式治疗妇产科疾病的临床疗效,为在HAN建立中国病房（计划生育专业）提供临床实践依据。方法将HAN门诊100例自愿要求终止妊娠患者,随机分为实验组（A组）与对照组（B组）,每组50例,A组由中国医生采取负压吸引术治疗,B组由佛得角医生采用子宫刮匙术治疗;另选取该院需行输卵管结扎患者60例,分为实验组（A1组）与对照组（B1组）,每组30例,A1组由中国医生行腹腔镜下输卵管结扎术治疗,B1组由佛得角医生行传统输卵管结扎术治疗;分别观察两种疾病在两种不同术式治疗下手术时间、术中出血、术后疼痛等情况。结果两种疾病的实验组在手术时间、术中出血、术后疼痛等方面与对照组比较具有明显优势,差异有统计学意义（P〈0.05）。结论中国援非医疗队在HAN开展妇产科手术具有明显优势,探索建立援HAN中国病房（计划生育专业病区）,对发挥中国援非医疗队优势、促进我国援非医疗工作具有重要意义。     

护患合作型质量控制小组活动在提高头面颈部烧伤患者功能锻炼依从性中的作用

为提高头面颈部烧伤患者功能锻炼的依从性,开展护患合作型质量控制小组活动,收集头面颈部烧伤患者不能按计划进行功能锻炼的原因并进行分析,设定目标,制订及实施对策,包括:①加强新护士的培训考核.②加强功能锻炼健康教育.③完善宣教资料及物品.④建立家庭支持系统.⑤制订个性化康复计划.⑥制订健康教育路径.结果显示,实施1年后,头面颈部烧伤患者对功能锻炼的依从性明显优于活动前:对功能锻炼完全依从的患者由活动前的35.5％提高至活动后的60.3％ (P＜0.05),对功能锻炼部分依从的患者由活动前的45.0％下降至活动后的32.3％(P＜0.05),对功能锻炼不依从的患者由活动前的19.5％下降至活动后的7.4％(P＜0.05);活动前患者对功能锻炼的满意度为80％,活动后达到预期目标值90％.采用护患合作型质量控制小组活动对开展头面颈部烧伤患者功能锻炼的方法进行持续质量改进,有利于提高患者功能锻炼依从性及患者对功能锻炼的满意度,体现了优质护理服务的内涵.     

团体心理治疗对改善精神分裂症患者阴性症状的疗效观察

目的:探讨团体心理治疗对改善精神分裂症患者阴性症状及其生活质量的疗效。方法:将120例慢性精神分裂症患者随机分为观察组和对照组各60例。两组都服用抗精神病药物,观察组同时辅以团体心理治疗,3个月为1个疗程,并于治疗前、后采用阴性症状量表及生活质量综合评定问卷分别对两组进行测定。结果:观察组在治疗后阴性症状评定量表评分明显降低,而生活质量综合评定问卷多项评分明显提高,两组比较有统计学差异。结论:团体心理治疗明显提高了患者的社会适应能力及生活自理能力,增强了对外界的关心与兴趣,提高了治疗的信心。     

Implications médicolégales de l’implantation transcathéter de la valve aortique (TAVI)

Compassionally reserved for inoperable patients in 2002, Transcatheter Aortic Valve Implantation has now a place almost equivalent to surgical valve replacement. The pioneering teams first succeeded in demonstrating a benefit on the mortality of extremely serious patients, while managing a learning curve that seemed unreachable without a strong partnership with cardiac surgeons. This win/win challenge enabled cardiologists to surpass the limits they did not dare to brave (management of large arterial approach, annular rupture and tamponade) and surgeons to appropriate the endovascular's culture. The technological contribution, the maturity of the teams and the expansion to less severe populations have reduced the perioperative mortality of TAVI to less than 3%. At this stage, it seemed interesting to take stock of forensic developments around this technique. After a review of the studies and the healthcare requirements, we reported and analyzed the claims received from one of the leaders of the medical insurance in France. From this feedback, attempts will be made to identify ways of improving the prevention and subsequent treatment of complications, which will undoubtedly limit the risk of subsequent complaints.