立体视锐度测定及其对机动车驾驶员的重要性

用立体视觉检查图对９２５０名机动车驾驶员的立体视锐度进行测定，其结果正常率９２．８％，异常率７．２１％，立体视锐度异常的机动车驾驶员事故发生率高于正常者。在引起立体视锐度异常的原因中，老视值得研究。     

汽车驾驶员心电多相频谱分析

对１１７例汽车司机应用ＨＢＤ－１心电多信息诊断仪进行心电多相频谱分析，其功率谱，传递相移，幅度直方图等五项指标总分阳性率明显高于对照组，随着驾车年限的增加，总分阳性率有升高趋势，心电频谱分析对２３０例冠心病病人阳性检出率８４．７８％。研究认为汽车司机是易发高血压，冠心病的危险人群，该方法在冠心病的环境流行病学研究中具有重要的临床，亚临床意义。     

职业驾驶员心理应激及其相关变量分析

目的 :了解职业驾驶员心理应激状况及相关因素 ,为减少事故的发生提供资料。方法 :采用LES、应对、成人内外控制、SSRS、EPQ、SCL -90等量表对 2 40名职业驾驶员进行测试。结果 :①驾驶员的主要应激源是工作学习问题、家庭有关问题 ;应对方式上 ,更趋向于积极应对 ;社会支持上 ,主观支持分明显高于客观支持分 ;在心理控制感上 ,明显趋于外控 ;EPQ得分与普通人群相比 ,E分较高 ,N分较低 ;SCL -90各因子分均值与全国常模相比 ,除躯体化、强迫、焦虑等项因子均值较高外 ,其他无显著差异。②事故组与安全组驾驶员在生活事件、相关变量、应激反应上 ,均存在显著差异。③行车事故与应激性生活事件呈正相关 (P <0 0 1)、与EPQ -N ,SCL -90诸因子呈负相关 (P <0 0 1)。结论 :生活事件引起的情绪应激 ,与驾驶操作、交通违章和事故发生有一定相关关系。     

On-Road Behavior in Older Drivers With Mild Cognitive Impairment

ObjectivesDementia increases the risk of unsafe driving, but this is less apparent in preclinical stages such as mild cognitive impairment (MCI). There is, however, limited detailed data on the patterns of driving errors associated with MCI. Here, we examined whether drivers with MCI exhibited different on-road error profiles compared with cognitively normal (CN) older drivers.DesignObservational.Setting and ParticipantsA total of 296 licensed older drivers [mean age 75.5 (SD = 6.2) years, 120 (40.5%) women] recruited from the community.MethodParticipants completed a health and driving history survey, a neuropsychological test battery, and an on-road driving assessment including driver-instructed and self-navigation components. Driving assessors were blind to participant cognitive status. Participants were categorized as safe or unsafe based on a validated on-road safety scale, and as having MCI based on International Working Group diagnostic criteria. Proportion of errors incurred as a function of error type and traffic context were compared across safe and unsafe MCI and CN drivers.ResultsCompared with safe CN drivers (n = 225), safe MCI drivers (n = 45) showed a similar pattern of errors in different traffic contexts. Compared with safe CN drivers, unsafe CN drivers (n = 17) were more likely to make errors in observation, speed control, lane position, and approach, and at stop/give-way signs, lane changes, and curved driving. Unsafe MCI drivers (n = 9) had additional difficulties at intersections, roundabouts, parking, straight driving, and under self-navigation conditions. A higher proportion of unsafe MCI drivers had multidomain subtype [n = 6 (67%)] than safe MCI drivers [n = 11 (25%)], odds ratio 6.2 (95% confidence interval, 1.4–29.6).Conclusion and ImplicationsAmong safe drivers, MCI and CN drivers exhibit similar on-road error profiles, suggesting driver restrictions based on MCI status alone are unwarranted. However, formal evaluation is recommended in such cases, as there is evidence drivers with multiple domains of cognitive impairment may require additional interventions to support safe driving.     

铁路机车司机神经行为功能状况研究

目的：研究铁路驾乘作业对铁路机车司机神经行为功能的影响情况。方法：采用随机整群抽样法,抽取机车司机２３８名,另选年龄、工龄等条件类同的车站工作人员１９０名,按照ＷＨＯ神经行为核心组合测试并分析比较行为功能。结果：与对照组相比,机车司机的反映情感状态的６项指标均受到显著或非常显著的不利影响。神经反应速度也受到了一定影响,表现在简单反应时中的最快及平均反应时间延长。另外,反映手的操作速度以及眼手协调功能的指标利手与非利手操作速度也较对照组明显下降,进一步分析可见,随着工龄或年龄的延长,上述指标受影响的程度呈逐渐增加的趋势。结论：神经行为核心测试组合在检测机车司机的亚临床职业损害方面是一项灵敏的指标     

基于“一动力三循环”管理模式的“3S”方法在临床研究生导师队伍建设中的应用

研究生教育是国家高水平教育的代表,也是医院发展的体现,在一定程度上可以看出医院的医疗、教学、科研、学术地位。研究生导师是高层次和高水平师资的主要代表,是一个医院提升自身教学实力、影响力、竞争力的关键。本文针对专科医院研究生导师队伍建设存在以下问题进行阐述:对外交流培训不足,师资队伍评价体系不科学,师资队伍结构不合理。基于“一动力三循环”管理模式,探索提出“3S”研究生导师队伍建设模式:加强对外交流与培训,建立科学的评价体系,建立结构合理的导师队伍,以优化研究生导师队伍建设为目标,打造一支业务能力专业、评价体系科学、师资结构合理的导师队伍,不断提升医院研究生导师队伍建设水平,是每个研究生培养单位的重要任务。同时概括了现阶段研究生导师队伍建设的成效和不足,并给予了反馈与意见。     

布地奈德联合沙丁胺醇氧驱动治疗喘憋性肺炎痰堵的临床护理观察

目的通过布地奈德混悬液联合硫酸沙丁胺醇溶液经氧驱动雾化吸入辅助治疗喘憋性肺炎，观察喘憋性肺炎痰堵患儿的临床护理疗效。方法80例喘憋肺炎患儿随机分为两组，观察组和对照组各40例，两组患儿均常规给予抗病毒、止咳化痰、吸氧、镇静等常规治疗与护理；观察组在此基础上给予布地奈德混悬液联合沙丁胺醇溶液氧驱动雾化吸入治疗，并进行仔细的临床观察，予以综合护理措施，观察临床护理效果。结果通过仔细观察和有针对性的护理，两组患儿有效率差异有显著意义（P〈0．05），未见不良反应和并发症。结论布地奈德混悬液联合沙丁胺醇溶液经氧驱动雾化吸入辅助治疗，结合临床观察和综合护理，可有效解除喘憋性肺炎患儿的痰堵，缓解临床症状，缩短病程，提高治愈率。     

Factors Associated with Drug Use Among Male Motorbike Taxi Drivers in Urban Vietnam

A cross-sectional study was conducted on a sample of 291 male motorbike taxi drivers (MMTDs) recruited through social mapping technique in Hanoi, Vietnam, for face-to-face interviews to examine factors associated with drug use among MMTDs using Information-Motivation-Behavioral skills (IMB) model. Among 291 MMTDs, 17.18% reported drug use sometime in their lives, 96% of whom were drug injectors. Being depressed, being originally borne in urban cities, currently residing in rural areas, having a longer time living apart from their wives/lovers, using alcohol, following Buddhism, and reporting lower motivation of HIV prevention predict significantly higher odds of uptaking drugs.