体验式教学在《基础护理学》实验教学中的应用研究

目的：探索体验式教学在《护理学基础》实验教学中的应用效果。方法选定我校2011级护理本科生为研究对象，在《基础护理学》实验教学中采用体验式教学方法，通过对研究对象体验感想的分析，探索体验式教学的应用效果。结果认为体验式教学非常利于提高学生积极性和主动性、学习兴趣、护理知识理解、技能操作、为进入临床打下基础、人文关怀能力、团队精神、组织能力、沟通交流能力、解决问题能力具有明显的效果。结论将体验式教学应用于《基础护理学》实验教学当中有利于提高护理专业学生的实践工作能力，增强了学生学习的主动性和积极性，并能显著提高护理专业综合素养。     

Fractional Factorial Design Study on the Performance of GAC-Enhanced Electrocoagulation Process Involved in Color Removal from Dye Solutions

The aim of this study was to determine the effects of main factors and interactions on the color removal performance from dye solutions using the electrocoagulation process enhanced by adsorption on Granular Activated Carbon (GAC). In this study, a mathematical approach was conducted using a two-level fractional factorial design (FFD) for a given dye solution. Three textile dyes: Acid Blue 74, Basic Red 1, and Reactive Black 5 were used. Experimental factors used and their respective levels were: current density (2.73 or 27.32 A/m²), initial pH of aqueous dye solution (3 or 9), electrocoagulation time (20 or 180 min), GAC dose (0.1 or 0.5 g/L), support electrolyte (2 or 50 mM), initial dye concentration (0.05 or 0.25 g/L) and current type (Direct Current—DC or Alternative Pulsed Current—APC). GAC-enhanced electrocoagulation performance was analyzed statistically in terms of removal efficiency, electrical energy, and electrode material consumptions, using modeling polynomial equations. The statistical significance of GAC dose level on the performance of GAC enhanced electrocoagulation and the experimental conditions that favor the process operation of electrocoagulation in APC regime were determined. The local optimal experimental conditions were established using a multi-objective desirability function method.     

目标性培训在消毒供应中心培训中的应用

目的 探讨目标性培训方法在消毒供应中心岗位人员器械培训中的应用效果。方法 本研究为随机对照试验。选取2021年4月至7月在揭阳市人民医院消毒供应中心从事手术组工作的 20名 33～45岁女性岗位人员作为培训对象，采用随机数字表法将其分为对照组和观察组，各 10名。 对照组应用传统的培训方法，观察组应用目标性培训方法。培训后比较两组人员操作技能考核成绩、 培训满意度、负责清洗包装腹腔镜基础器械包的清洗质量和包装质量合格率。符合正态分布的计量资料采用均数±标准差（xˉ ± s）表示，组间比较采用独立样本t检验；计数资料采用例数或率（%）表示， 组间比较采用卡方检验；P＜0.05为差异有统计学意义。结果 观察组考核成绩、培训满意度及其负责清洗包装的腹腔镜基础器械包清洗质量、包装质量合格率明显高于对照组［（90.2±6.1）分比（77.0± 7.5）分、（90.0±6.0）分比（72.1±9.8）分、487（97.4%）比453（90.6%）、492（98.4%）比472（94.4%）］，差异有统计学意义（均P＜0.05）。结论 在消毒供应中心岗位人员器械培训时应用目标性培训方法，可有效提高岗位人员考核成绩及培训满意度及其负责清洗包装的腹腔镜基础器械包清洗质量、包装质量合 格率，保障患者安全。     

Correlation between symptoms and course duration of upper aerodigestive tract cancer at early and advanced stages

There still are many clinical and biological aspects of the natural history of cancer of the upper aerodigestive tract to be unveiled; which in Brazil is a direct consequence of the failure of systematic prevention and early diagnosis campaigns.ObjectiveTo analyze the signs and symptoms presented by patients with the disease at initial and advanced stages. Other variables such as disease duration, general and nutritional status were considered.MethodA historical cohort study with a cross-section involving 895 subjects with cancer of the upper aerodigestive tract.ResultsClinical findings were not statistically correlated with disease progression, nor with the disease in early stages, but it showed rapid disease development.ConclusionThe results suggest a disease of insidious onset in the early stages and fast course afterwards. The long disease duration - greater than three months, was associated with worsening in general and nutritional states of patients.     

状态空间模型在流行性腮腺炎防控评价中的应用

目的 分析2012年和2014年流行性腮腺炎（腮腺炎）流行特征，探讨山东省2剂次含腮腺炎成分疫苗（MuCV）接种的预防效果。方法 在一定模型假定基础上，结合相关文献设置合理参数，构建状态空间模型，利用迭代滤波对模型进行参数估计。结果 2012年和2014年托幼及学生人群基础再生数（R₀）分别为4.49（95%CI：4.30~4.67）和2.50（95%CI：2.38~2.61）。结论 状态空间模型能够很好地描述腮腺炎传播过程；山东省实行2剂MuCV能够有效降低腮腺炎在人群中的传播；托幼和学生是实现腮腺炎进一步控制的重要人群，应进一步提高2剂次MuCV接种率。     

The role of postural instability/gait difficulty and fear of falling in predicting falls in non-demented older adults

IntroductionPostural instability/gait difficulty (PIGD) and fear of falling (FoF) frequently co-exist, but their individual predictive values for falls have not been compared in aging. This study aims to determine both independent and combined effect of PIGD and FoF to falls in older adults without dementia.MethodsPIGD and other extrapyramidal signs were systematically assessed in 449 community-dwelling participants without Parkinson’s disease (76.48 ± 6.61 ys; 56.8% female) enrolled in this longitudinal cohort study. Presence of FoF was measured by a single-item question (Do you have a FoF?) and self-confidence by the Activities-specific Balance Confidence scale (ABC scale).ResultsOne hundred sixty-nine participants (38%) had an incident fall over a mean follow-up of 20.1 ± 12.2 months. PIGD was present in 32% and FoF in 23% of the participants. Both PIGD (adjusted hazard ratio (aHR): 2.28; p = 0.016) and self-confidence (aHR: 0.99; p = 0.040) predicted falls when entered simultaneously in the Cox model. However, presence of FoF (aHR: 1.99; p = 0.021) and self-confidence (aHR: 0.98; p = 0.006) predicted falls only in individuals with PIGD.ConclusionsPIGD and FoF were associated with future falls in older adults without dementia but FoF was a fall’s predictor only in individuals with PIGD.     

Increased Basic Fibroblast Growth Factor (bFGF) Accumulation and Distinct Patterns of Localization in Isoproterenol-Induced Cardiomyocyte Injury

Basic FGF is a multifunctional protein which promotes regeneration in several tissues. To investigate involvement in cardiac injury-repair, bFGF accumulation and localization was examined in hearts of rats injected with a single high dose of isoproterenol. The bFGF content of cardiac extracts was analyzed at 6 and 24 hours as well as 1, 4, and 6 weeks by western blotting of heparin-sepharose-bound fractions. The 18 kilodalton bFGF species showed an approximately 2-fold increase in extracts from treated animals compared to non-treated controls. A transient rise in a 21–23 kilodalton bFGF species was seen at 24 hours after treatment. An induction of bFGF mRNA was also observed in treated animals. To localize bFGF in vivo, immunofluorescent labelling with specific antibodies was used at 4–24 hours and 1–4 weeks after treatment. Simultaneous labelling for the cytoskeletal proteins vinculin or vimentin was employed to identify viable myocytes or non-muscle interstitial cells, respectively. Necrotic myocytes, identified by loss of vinculin, displayed a pronounced increase in cytoplasmic anti-bFGF staining compared to adjacent normal myocytes. This increase occurred prior to and may play a role in promoting mobile cell migration and proliferation in areas of necrosis. Viable cardiomyocytes adjacent to fibrotic regions displayed strong pericellular anti-bFGF staining and, occasionally, were also stained by anti-vimentin antibodies, suggesting reexpression of an embryonic phenotype and thus an attempt for regeneration. These data showing increased accumulation and distinct patterns of localization of bFGF in the hearts of isoproterenol-treated animals suggest that this growth factor plays a role in short-term as well as long term response of the myocardium to injury.     

Fatal disseminated Trichosporon asahii fungemia in a child with acute lymphoblastic leukemia and a morbilliform eruption

Trichosporonosis is a rare, life‐threatening, opportunistic fungal infection that affects immunocompromised individuals with neutropenia, particularly those with underlying hematologic malignancies. We present the case of a 10‐year‐old boy with acute lymphoblastic leukemia who developed a diffuse, morbilliform eruption in the setting of fever and pancytopenia. He was found to have Trichosporon asahii fungemia with widespread visceral dissemination, and his condition rapidly deteriorated despite treatment. It is important to consider trichosporonosis in the evaluation of a critically ill individual with neutropena and a rash, because the initial cutaneous presentation may appear benign and delayed therapy results in death.     

情景模拟教学法在低年资护士基础生命支持培训中的应用

目的探讨情景模拟教学法对急诊科低年资护士基础生命支持培训的实践效果和应用体会。方法应用情景模拟教学法对我科24名N0、N1级护理人员进行理论和操作培训,培训结束后予以考核。并对培训前后急诊临床教学质量及各级医护人员的满意度进行评价。结果自实行情景模拟教学法培训以来,护理人员的心肺复苏考核成绩较前有较大提升(P0.01);各级医护人员的满意度均有所提高,受训护士自身满意度与情景模拟教学培训前比较,差异有统计学意义(P0.05)。结论情景模拟教学因材施教,效果显著,增进了急诊科教学效果,提高了急诊教学满意度。