自攻型正畸微种植体即刻负载的组织学研究

目的探讨自攻型微螺旋种植体即刻负载持续水平力的可行性及周围骨组织的反应。方法28枚自攻型钛合金微螺旋种植体置于2只犬上下颌骨颊侧的牙根间区。20枚种植体即刻负载约2N持续水平力9周,作为实验组;8枚没有负载的作为对照组。光学和荧光光学显微镜检查不脱钙的种植体周围组织的组织切片。结果所有种植体有良好的初期稳定性。4周时,实验组下颌双尖牙区1枚微型种植体2级松动,下颌磨牙区1枚折断。组织学分析显示,2组微型种植体与周围组织呈骨性结合,实验组骨生长和再生更活跃。结论自攻微螺旋种植体适用于上颌骨及下颌骨骨皮质较薄区作为正畸支抗源。     

Evolution of a Systematic Approach to Smoking Cessation in Ontario’s Regional Cancer Centres

Smoking cessation after a cancer diagnosis can significantly improve a person’s prognosis, treatment efficacy and safety, and quality of life. In 2012, Cancer Care Ontario (now part of Ontario Health) introduced a Framework for Smoking Cessation, to be implemented for new ambulatory cancer patients at the province’s 14 Regional Cancer Centres (RCCs). Over time, the program has evolved to become more efficient, use data for robust performance management, and broaden its focus to include new patient populations and additional data collection. In 2017, the framework was revised from a 5As to a 3As brief intervention model, along with an opt-out approach to referrals. The revised model was based on emerging evidence, feedback from stakeholders, and an interim program evaluation. Results showed an initial increase in referrals to cessation services. Two indicators (tobacco use screening and acceptance of a referral) are routinely monitored as part of Ontario Health’s system-wide performance management approach, which has been identified as a key driver of change among RCCs. Due to the COVID-19 pandemic, many RCCs reported a decrease in these indicators. RCCs that were able to maintain a high level of smoking cessation activities during the pandemic offer valuable lessons, including the opportunity to swiftly leverage virtual care. Future directions for the program include capturing data on cessation outcomes and expanding the intervention to new populations. A focus on system recovery from COVID-19 will be paramount. Smoking cessation must remain a core element of high-quality cancer care, so that patients achieve the best possible health benefits from their treatments.     

国家基本药物政策实效弱化的后果分析与强化推行的对策探讨

目的:探讨推行国家基本药物政策的方法与途径,以实现其制约与导向功能。方法:回顾我国国家基本药物政策推行的背景,分析其推行过程中存在的问题及实效弱化的深层次原因,提出我国今后全面推行该政策的措施与对策。结果与结论:探索、分析和解决国家基本药物政策推行实效问题是迫在眉睫的一个重大课题。大力推行该政策是治理、解决药价高和看病难、看病贵及不合理用药等问题的有效途径之一。     

静脉用药集中调配中心信息管理软件设计及实践

目的建立适合静脉用药集中调配中心工作的信息系统。方法利用Powerbuilder 9．0开发工具在现有医院信息系统（HIS）的基础上增加PIVAS模块,并使之与临床工作站对接。结果PIVAS模块运行稳定,实现了医嘱的审核、发药、收费、快速统计查询、分类打印等功能。结论信息技术可显著提高PIVAS的工作效率,提升药学服务质量和水平。     

沉浸式教学结合闭环式考核在呼吸内科实习教学中的应用研究

目的 探讨沉浸式教学结合闭环式考核在呼吸内科实习教学中的应用效果。方法 选取2021年8月至2023年8月到呼吸内科实习的140名学生作为研究对象,按进科先后顺序分为对照组和观察组,每组70人。对照组采用传统教学,观察组采用沉浸式教学结合闭环式考核。实习结束后对两组学生的理论、临床诊疗和操作技能、共情能力、教学效果进行比较评价。结果 观察组学生理论、临床诊疗和操作技能考核成绩均明显高于对照组,差异有统计学意义（P<0.001）。观察组学生共情量表得分高于对照组,差异有统计学意义[（73.83±6.71）分 vs. （61.08±6.32）分;t=15.60,P<0.001]。观察组学生在学习兴趣、自主学习能力、对疾病的综合分析能力、临床思维能力、独立发现分析及解决问题的能力、团队协作能力6个方面的认可率高于对照组,组间比较差异有统计学意义（P<0.05）。结论 沉浸式教学结合闭环式考核有利于提高呼吸内科学生的理论和实践水平,提升学生的共情能力和综合分析能力,有助于改善临床教学效果。     

学习科学视域下医学院校ESP课程体系的生态构建

医学院校研究生的ESP课程（English for specific purpose）兼具自然及社会双重属性,注重专业应用型语言的学习及实践,构建具备职业、社会境脉特征的英语教学生态体系是探索医学院校高水平医学生英语语言应用能力的有效途径。本文基于设计的实施研究理念,设计与构建了情景仿真式课程模式,实施了任务型语言教学,完成了混合式关联课堂体系模式的探讨与融合性教师角色的分析。在课堂实践基础上,将创新课程理念与ESP课程生态体系构建有机结合,进一步指导学习科学视域下课程的设计与实施,验证了ESP课程体系生态构建的可行性。     

Effect on implant drills and postoperative reactions for pre-extraction interradicular implant bed preparation during the COVID-19 pandemic and beyond

The aim of the present study was to observe the abrasion of implant drills and postoperative reactions for the preparation of the interradicular immediate implant bed during the COVID-19 pandemic and beyond.Thirty-two implant drills were included in four groups: blank, improved surgery, traditional surgery, and control. In the improved surgery group, a dental handpiece with a surgical bur was used to decoronate the first molar and create a hole in the middle of the retained root complex, followed by the pilot drilling protocol through the hole. The remaining root complex was separated using a surgical bur and then extracted. Subsequently, the implant bed was prepared. Implant drills were used in the traditional surgery group to complete the decoronation, hole creation, and implant-drilling processes. The tooth remained intact until the implant bed was prepared. The surface roughness of the pilot drill was observed and measured. Surgery time, postoperative reactions (swelling, pain, and trismus), and fear of coronavirus disease 2019 scale (FCV-19S) were measured and recorded, respectively.Statistical analysis revealed significant difference with surface roughness among blank group (0.41 ± 0.05 μm), improved surgery group (0.37 ± 0.06 μm), traditional surgery group (0.16 ± 0.06 μm), and control group (0.26 ± 0.04 μm) (P < .001). Significant differences were revealed with surgery time between improved surgery group (5.63 ± 1.77 min) and traditional surgery group (33.63 ± 2.13 min) (P < .001). Swelling, pain, and trismus (improved group: r ≥ 0.864, P ≤ .006; traditional group: r ≥ 0.741, P ≤ .035) were positively correlated with the FCV-19S.This study proved that a new pilot drill could only be used once in traditional surgery but could be used regularly in improved surgery. Improved surgery was more effective, efficient, and economical than the traditional surgery. The higher FCV-19S, the more severe swelling, pain, and trismus.     

开设医学生物化学综合性实验的探索

生物化学综合性实验涉及知识面广、实验技术多、时间长且环环相扣,具有一定的难度。为了保证综合性实验的顺利进行,河北医科大学生物化学与分子生物学教研室从教学准备和教学实施等方面采取如下措施：建专项实验室;教师课前集体备课和预实验;实验准备教师带教;运用多媒体教学手段;学生课前提交实验预习报告,以小组为单位完成实验等,从而达到开设综合性实验的预期目的。     

贵阳市云岩区疫苗接种妈妈课堂实施效果分析

目的分析疫苗接种“妈妈课堂”培训前后相关免疫规划知识知晓率,评价健康教育干预的效果,探索新的免疫规划健康教育模式。 方法对2014年7—12月在贵州省贵阳市云岩区47所预防接种门诊首次建卡儿童的家长进行疫苗接种“妈妈课堂”培训,通过4 420份问卷调查,分析比较培训前后免疫规划知识知晓率。结果培训前、后家长免疫规划知识总知晓率[培训前70.4%、培训后85.3%]及9个免疫规划知识相关问题知晓率的差异均有统计学意义(P 均<0.01);培训前除不同性别家长免疫规划知识知晓率差异无统计学意义(P>0.05)外,知晓率在不同居住属性[城郊结合部71.1%(17 309/24 342)、城中心区69.1%(9 662/13 981)]、不同户籍(流动71.5%、常住69.3%)、不同文化程度(小学69.6%,初中71.8%,高中70.9%,大专及以上70.0%)、对疫苗接种知识是否了解(了解72.9%,不了解69.1%)的家长中差异均有统计学意义(P均<0.05);培训后仅不同文化程度家长知晓率(小学80.8%,初中84.4%,高中86.1%,大专及以上86.1%)差异有统计学意义(P<0.01),其余不同居住属性、户籍、性别、对疫苗接种知识是否了解的家长知晓率差异均无统计学意义(P均>0.05)。结论疫苗接种“妈妈课堂”这种新型健康教育模式的实施,可以增加儿童家长对预防接种知识的认知,提高儿童家长预防接种的积极性、主动性。     

Epidemiology,aetiology and knowledge,attitudes, and practices relating to burn injuries in Palestine: A community‐level research

The aim of this study was to identify the epidemiology, aetiology as well as the knowledge, attitudes, and practices relating to burn injuries in Palestine. A mixed‐method approach was used. A survey was distributed to a total of 1500 households selected by randomised approach. The survey was standardised based on World Health Organisation''s guidelines for conducting community surveys on injury. Additionally, there were 12 focus group discussions and 10 key informant interviews to collect rich qualitative data. In the West Bank and Gaza, 1.5% of Palestinians had experienced serious burn injuries in the 12 months. The total sample of 1500 yields a margin of error (plus/minus) = 2.5% at a 95% level of confidence and a response distribution (P = 50%) with 3% non‐response rate. Of the 1500 households approached, 184 reported a total of 196 burn injuries, with 87.2% occurring inside the home: 69.4% were females and 39.3% were children. The main source of reported cause of burn was heat and flame (36%), electric current (31.6%), hot liquid (28.6%), and chemicals (2.7%). The most common first aid for burns was pouring water (74.7%). People in rural, refugee, and Bedouin settings had the highest incidence of burns. This study provides the burn prevalence rate, explanatory factors that contribute to the frequency of burns in Palestine. Making burn prevention a higher priority within the national policy is crucial.