Do weekly and fast-rotating shiftwork schedules differentially affect duration and quality of sleep?

 Characteristics of shiftwork schedules can have distinct impacts on workers’ sleep. This report presents comparisons of the effects of two different shiftwork schedules on duration and quality of the main sleep episodes in comparable worker populations at two different petrochemical plants. No significant differences were found for sleep duration in comparing the two plants. However, within each plant’s shift cycles, morning and night shifts showed shorter sleep durations than all other workdays and days off. Quality of sleep was perceived as lowest for night shifts of both plant schedules, and of lesser quality for weekly than for fast-rotating shifts. These results support recommendations for reducing the number of consecutive nights of shiftwork. However, before recommending any optimal shift schedule, interactions of sleep duration and quality with shift schedules need much further evaluation. Received: 18 December 1995/Accepted: 18 July 1996     

Psychosocial effects of vitiligo

A limited number of studies have paid attention to the psychosocial well-being of patients affected with vitiligo. We review the psychosocial effects of vitiligo, how patients deal with them and the psychiatric morbidity in vitiligo patients. Given the appreciable comorbidity, it is important to consider these observations in the management of patients, for example in patient-physician interaction but also in treatment strategies and evaluation of treatments. The effects of the psychological state on the disease itself together with the potential therapeutic implications are reviewed. Based on these data, we suggest how to further improve patient's management.     

实施责任护士竞聘制的做法与成效

目的 :营造良性竞争的机制和氛围 ,全面提高护理质量。方法 :通过资格认定、理论技术考试、民主测评及双项选择 ,由护理部聘任。结果 :较好地进行了人力资源的开发 ,竞聘上岗后的护士有责任感和使命感 ,工作积极主动 ,自觉地成为科室各项工作的带头人。加之岗位工资的兑现 ,更有利于护士长在科室开展工作 ,使科室各项护理工作质量显著提高。结论 :良性的竞争运行机制 ,使优秀护理人才脱颖而出 ,体现能级对应的原则 ,从而使护理质量不断提高。     

Closed suction drainage after orthopaedic surgery: evidence versus practice

Abstract Closed suction drainage systems are commonly used in orthopaedic surgery, particularly in joint arthroplasty. The rationale for the use of drains is a theoretical reduction of wound haematomas and infection. However the benefit of using drains after total hip or knee arthroplasty is controversial. Several reports have shown that the use of drains does not reduce infection and morbidity and is an unnecessary and potentially dangerous practice. In fact most studies highlighted that at best their use appears to make no difference to important clinical outcomes. Recently a metaanalysis raised the question about the usefulness of closed suction drainage again, concluding that it has no major benefits. The purpose of this study was to review the evidences available concerning the utility of closed suction drainage outlining that this practice is not supported by clinical evidence.     

再生医学技术在烧伤传统治疗无效病人中的应用(附38例报告)

目的：总结重度烧伤传统疗法无效改为再生医学(MEBT/MEB0)技术治疗变化规律和临床验．方法：将我科l995年5月至2002年5月收治的院外采用传统疗法无效改用MEBT/MEBO技术治疗的38例重度烧伤病人临床资料进行回顾性总结，病人一旦入院创面均改用MEBT/MEBO治疗，初始予以彻底清创，规范用药、规范操作，规范认识；全身实行系统综合治疗措施．以临床观察和病人感觉评价治疗效果。结果：本组38例全部治愈，末植皮自行愈合者21例．占55.26％．深Ⅲ度创面自愿要求植皮者17例，占44.74％。经随访多数无增生性瘢痕，部分愈后有局限性瘢癌，质软无残废。结论：重度烧伤经传统疗法久治不愈或疗效欠佳病人．病情复杂，并发症较多治疗难度也较大，再生医学可有效改善以上缺陷和病症．是重度烧伤病人传统治疗无效时的理想疗法。     

Stochastic models for geriatric in-patient behaviour

Departments of geriatric medicine engage in two distinct formsof clinical activity: acute/rehabilitative and long-stay care.These are organizationally distinct and have very differentresource needs. Current hospital planning models, however, assumethat patients all move through the system at the same rate,thereby ignoring this effect of inherent heterogeneity in patientbehaviour. The present paper describes the movement of patientsthrough geriatric hospitals by a two-stage continuous-time Markovmodel, where the stages represent acute/rehabilitative and long-staypatients respectively. Patients are initially admitted to thefirst stage, from which they may depart from the system, bydeath or discharge, or move into the second stage, from whichthey eventually depart by death or discharge (unlikely). Admissionsare modelled in two ways: either as replacements for departuresor as a Poisson stream. Expressions for the distribution andmovement of numbers of patients are derived and evaluated fordata from a number of hospitals. Such an approach has the advantage,over previous crude models, of taking into account differenttypes of patients and introducing variability, thus making itpossible to extract variances as well as means of numbers ofgeriatric patients requiring hospital care.     

Additive effects of earthworm extract with HpD-laser on the enhancement of reactive oxygen production and the inhibition of[~3H]—thymidine.uptake in mouse ascitic tumor cells

The effects of combined use of earthworm extract(912)and HpD-laser on the produc-tion of reactive oxygen and the biosynthesis of DNA in S_(180) tumor cells were studied throughchemiluminescence measurement and[~3H]-TdR incorporation assay.The results showed that as com-pared with the control,the intensity of chemiluminescence emitted by tumor cells treatedsimultaneously with 912 and HpD-laser was enhanced more than ten-folds,while that treated with912 or HpD-laser alone was increased only 2～4 folds.The[~3H]-TdR incorporation into tumorcells of the former group was inhibited upto 74.1%,and that of the latter groups decreased onlyby 42.2% and 40.0%,respectively.In accordance with these biochemical changes,the ultrastructuraldamage of tumor cells of the former,combinedly treated group appeared to be the most serious.This suggests an additive effect of 912 with HpD-laser on tumor cells.In addition,if free radicalscavengers,such as catalase and superoxide dismutase,were added to the reaction systembefore chemiluminescence assay,the luminescent enhancement effect mentioned above was dramaticallyalleviated,implying the presence of O_2~ and H_2O_2 in the system.Therefore,as to the toxic effecton tumor cells,912 and HpD-laser are not only additive in efficiency,but also similar in theunderlying mechanism of action.     

Epilepsy in Ancient India

The ancient Indian medical system, Ayurveda, meaning science of life, is the oldest system of medicine in the world. Epilepsy is defined as Apasmara: apa, meaning negation or loss of; smara, meaning recollection or consciousness. Aura was recognized and was called Apasmara Poorva Roopa. A large number of symptoms indicative of aura were listed. Worthy of mention are subjective sensation of sounds, sensation of darkness, feeling of delusion, and dream-like state. An actual attack of Apasmara includes falling down; shaking of the hands, legs, and body; rolling up of the eyes; grinding of the teeth; and foaming at the mouth. Four major types of epilepsy based on the disturbance of doshas (humors) that govern the physiological and physiochemical activities of the body are mentioned. Apasmara is considered a dangerous disease that is chronic and difficult to treat. Several causes are mentioned. Treatment included correcting the etiological factors and dietary regimen and avoiding dangerous places that may result in injuries.     

3—氯—4—氟苯胺的生产与研究概况

评述了3-氯-4-氟苯胺的实验室研究和工业生产现状,特别对氯化、硝化、氟化和还原等反应中间体的制备及其质量作了分析。