Effects of long working hours and the night shift on severe sleepiness among workers with 12‐hour shift systems for 5 to 7 consecutive days in the automobile factories of Korea

We investigated the effects of 12‐hour shift work for five to seven consecutive days and overtime on the prevalence of severe sleepiness in the automobile industry in Korea. [Correction added after online publication 28 Nov: Opening sentence of the summary has been rephrased for better clarity.] A total of 288 randomly selected male workers from two automobile factories were selected and investigated using questionnaires and sleep‐wake diaries in South Korea. The prevalence of severe sleepiness at work [i.e. Karolinska Sleepiness Scale (KSS) score of 7 or higher] was modeled using marginal logistic regression and included theoretical risk factors related to working hours and potential confounding factors related to socio‐economic status, work demands, and health behaviors. Factors related to working hours increased the risk for severe sleepiness at the end of the shift in the following order: the night shift [odds ratio (OR): 4.7; 95% confidence interval (CI): 3.6–6.0)], daily overtime (OR: 2.2; 95% CI: 1.7–2.9), weekly overtime (OR: 1.6; 95% CI: 1.0–2.6), and night overtime (OR: 1.6; 95% CI: 0.8–3.0). Long working hours and shift work had a significant interactive effect for severe sleepiness at work. Night shift workers who worked for 12 h or more a day were exposed to a risk of severe sleepiness that was 7.5 times greater than day shift workers who worked less than 11 h. Night shifts and long working hours were the main risk factors for severe sleepiness among automobile factory workers in Korea. Night shifts and long working hours have a high degree of interactive effects resulting in severe sleepiness at work, which highlight the need for immediate measures to address these characteristics among South Korean labor force patterns.     

红细胞体积分布宽度在贫血诊断中的临床意义

目的：探讨贫血患者红细胞体积分布宽度的变化及其临床意义。方法：应用sysmex F-820血细胞分析仪测定164例贫血患者红细胞体积分布宽度变异系（RDW-CV）。结果：MCV↓RDW↑缺铁性贫血、MCV↑RDW↑巨幼红细胞性贫血、MCV和RDW异常,急性再生障碍性贫血、MCV↑RDW,慢性再生障碍性贫血、MCV↑RDW↑溶血性贫血、MCV、RDW↑铁粒幼细胞性贫血、MCV↓RDW,单纯小细胞性贫血。结论：RDW指标的改变对贫血的分类及缺铁性贫血的诊断有较好的敏感性和特异性。     

门诊挂号排队现象的原因及对策

目的：提高挂号服务质量,以满足患者就诊需要,缩短患者挂号排队时间。方法：通过在门诊工作中实际观察、了解和对门诊患者进行满意度调查,发现挂号过程中存在的问题,对其进行分析并提出相应的对策。结果：缩短了患者排队挂号时间,提高了分诊准确率和挂号成功率,减少了门诊挂号投诉率。结论：挂号质量和工作效率的提高,有利于建立良好的医患关系,对于增强医院的核心竞争力起到了重要的作用。     

全脑血管造影术并发症的分析

目的回顾性分析单纯全脑血管造影术围操作期的并发症。方法2008年7月-2009年6月在首都医科大学宣武医院介入放射诊断治疗科单中心完成单纯全脑血管造影术2460例。其中男1608例,女852例,年龄为2～84岁,平均（60±3）岁。分析其术后并发症的发生情况。结果全脑血管造影术后共31例出现并发症,发生率为1．26％,其中局部并发症19例,发生率为0．78％,分别为皮下血肿9例,动脉夹层3例,血管开口狭窄2例,导管打折2例。神经系统并发症7例,发生率为0．29％,分别为血管痉挛3例,栓塞事件1例,其他（包括心慌、血压下降、恶心、呕吐等）3例。全身并发症共5例,发生率为0．20％,分别为对比剂过敏反应2例,对比剂肾病2例,鱼精蛋白过敏1例。经合理处理后,全脑血管造影术后并发症患者均未出现严重后遗症。结论在规范操作的基础上,单纯全脑血管造影术是安全的,并发症较低。同时随着造影设备的不断改进,术前术中准备充分,操作耐心细致,可进一步减少其并发症。     

氟化钠涂膜在预防正畸牙脱矿的应用

目的了解氟化物涂膜在防龋及防治、减少和预防牙釉质脱矿方面的效果。方法选择68例错颌畸形患者,用小毛刷将氟化钠涂膜在托槽周围牙面上均匀地涂布,以后每三个月均匀涂布1次,病例追踪观察1年。结果涂布氟化钠涂膜后患者脱矿率25％。结论氟化钠涂膜在预防正畸牙釉质脱矿方面有良好效果。     

人TAT-Survivin融合蛋白原核表达载体的构建

目的:构建人TAT-Survivin融合蛋白原核表达载体。方法:以人胸腺细胞瘤cDNA为模板,采用RT-PCR扩增survivin基因成熟蛋白编码的全部序列,克隆入原核表达载体pET28a(+)中,经限制性内切酶双酶切及DNA序列分析鉴定目的基因。结果:PCR扩增的特异性片段长度为462bp,以此构建的重组质粒pET28a-TAT-survivin,经HindIII和BamHI双酶切后显示5.9kb和462bp左右的两条片段,测序结果与Genbank中的人survivin基因cDNA(Genbank序列号)序列一致。证明人survivin已成功克隆到了原核细胞表达载体pET28a(+)中。结论:成功构建了pET28a-TAT-survivin重组原核表达载体。     

丙泊酚联合氯诺昔康用于人工流产镇痛的临床研究

目的:研究丙泊酚联合氯诺昔康用于人工流产术的临床安全性与镇痛的效果.方法:120例孕妇,ASA Ⅰ-Ⅱ级,年龄18-35岁,随机分成3组,比较丙泊酚联合氯诺昔康镇痛的效果及手术中血压、脉搏、SpO2.结果:丙泊酚联合氯诺昔康和丙泊酚联合芬太尼镇痛的效果明显优于单纯丙泊酚组.结论:丙泊酚联合氯诺昔康用于人工流产镇痛是安全、有效、便捷的方法.     

The "Continuum of Care" for Older Adults: Design and Evaluation of an Educational Series

Geriatricians work within a continuum of health services designed to meet the diverse care needs of older adults. They must develop expertise in these care models and be able to guide safe and efficient transitions. This article describes a 9-week educational series designed to review the evidence base and practical aspects of implementing key services that span the continuum of care for older adults. The sessions in the series covered geriatric assessment, ambulatory care, acute hospital, house call, hospital-at-home, Program of All-Inclusive Care for the Elderly, assisted living, inpatient consultation, rehabilitation, nursing home, chronic hospital, and palliative care and hospice. To assess the educational effect of these sessions, evaluations were collected at the end of each session, including one "summative evaluation" after the completion of the entire 9-week series. The vast majority (97%) of survey responses evaluating individual sessions were positive (scores of 4 or 5 on a 5-point Likert scale), and 89% of responses on the summative evaluation were in that range. This educational series efficiently provides a sequential "tour" of health services for older adults, allowing learners to appreciate the continuum of geriatric care models and relationships between services. Feedback from attendees suggests that this format increases knowledge of health services along the continuum of care for older adults and does so in an efficient manner for learners at different levels of training.     

电化学发光免疫测定法检测抗环瓜氨酸肽抗体的方法比较

目的:比较电化学发光免疫测定(ECLIA)法与酶联免疫吸附试验(ELISA)法检测抗环瓜氨酸肽(抗CCP)抗体的价值。方法:采用ECLIA法和ELISA法分别检测192例类风湿关节炎(RA)患者、56例其他风湿性疾病患者及100名健康对照者血清中的抗CCP抗体,观察ECLIA法检测抗CCP抗体的精密度、回收率、诊断灵敏度、诊断特异度,并分析ECLIA法与ELISA法间的相关性。结果:ECLIA法检测抗CCP抗体的批内、批间变异系数分别为0.9%~1.8%、1.7%~2.4%,明显低于ELISA法(5.8%~8.6%,6.7%~9.8%)(P<0.01)。ECLIA法检测抗CCP抗体的回收率为96.7%~98.6%,灵敏度和特异度分别为72.9%、98.7%,与ELISA法检测结果的一致率达96.7%。结论:ECLIA法检测抗CCP抗体的精密度较高,且对RA诊断的灵敏度、特异度与ELISA法具有较好的一致性。     

预执行某特殊军事任务武警战士MMPI人格测验分析

目的 了解和探讨准备参加某特殊军事任务武警战士个性特征和心理卫生状况,为今后执行类似任务选取人员提供依据.方法 采用自编一般人口学资料调查表、中国版明尼苏达多项个性测查表(MMPI)对534名准备执行此任务的武警战士进行整群抽样、现况研究,问卷测量由心理医生统一组织,战士自行独立填写,所有人员同时完成.结果 全体战士各量表得分与全国常模差异有统计学意义(P＜0.001),各量表T分平均值均低于65分,个别战士少数分量表T分值大于70分;以人口资料学各变量为分类变量做方差分析和两独立样本t检验,发现既往执行任务不同的战士,在L、F、K、Hs、Pd、Pt、Sc、Ma等量表得分差异有统计学意义(P＜0.05),其他量表得分差异无统计学意义.结论 执行此次特殊任务的武警战士整体个性发育比较完善,部分量表得分优于常模,既往执行任务对部分量表得分有影响,任务执行中的心理干预很有必要.