南山区与某社区常住人口6年恶性肿瘤发病调查

目的：了解某社区常住人口恶性肿瘤平均年发病率是否高于周边人群，重点是白血病平均年发病率。方法：采用回顾性调查法及个案调查表收集该社区1998年6月～2004年9月常住人口中的确诊恶性肿瘤病人22例，将该社区恶性肿瘤平均年发病率与南山区在该时段恶性肿瘤平均的发病率进行比较。结果：1998年6月～2004年9月南山区常住人口恶性肿瘤平均年发病66．1／10万，某社区常住人口恶性肿瘤平均年发病率29．9／10万，两地差异有统计学意义（F=0．0001，P〈0．05）；南山区常住人口白血病平均年发病率2．79／10万，某社区常住人口白血病平均年发病率4．07／10万，两者无统计学意义差异（F=0．467，P〉0．05）。结论：该社区常住人口恶性肿瘤及白血病平均年发病水平低于南山区全区水平。     

南通市居民健康知识水平现状及对策

为全面了解和准确掌握南通市各行各业、中小学校健康知识的知晓情况,对创建国家卫生城市健康教育工作进行效果评估。调查显示,南通市11个片区健康知识的总知晓率居民为93.42%,学生为91.08%。要真正提高全体市民的健康教育水平,下一步必须采取三大对策,即:形成“抓反复、反复抓”的常态机制;加大健康教育投入;教育部门加强全市学生的健康知识普及工作,对卫生部门列入学校卫生的指标加以考核。只有这样,南通市的健康教育工作才能跃上新台阶。     

An inexpensive ex-vivo porcine laparoscopic Nissen fundoplication training model.

BACKGROUND: We recently implemented the use of an ex-vivo porcine model to teach residents the fundamentals of performing a laparoscopic Nissen fundoplication. METHODS: Residents were trained using intact porcine esophagus, stomach, and spleen placed in a standard video-trainer. They were later asked to complete a survey containing a course evaluation. RESULTS: Sixteen residents (R1-R4) completed the survey. They agreed that (1) the exercise was a valuable use of their limited time, (2) repeating the exercise will be of additional benefit, (3) it will improve their ability to perform or assist in an actual case in the OR, and (4) the surgical principles learned using the model will transfer to other laparoscopic cases. Significant subjective improvements were reported in resident comfort level in assisting in or performing a laparoscopic Nissen fundoplication. CONCLUSIONS: The use of an inexpensive ex-vivo porcine training model increases resident comfort level in performing a Nissen fundoplication in the operating room.     

神经外科重症监护病房住院医师规范化培训教育的思考

重症神经外科是神经外科住院医师规范化培训的难点和重点之一。通过对重庆医科大学附属第一医院神经外科重症监护病房的住院医师进行以急救技能培训、理论与实践相辅相成的多模态病例分析、神经影像学及电生理知识的拓展、手术操作及围手术期管理的专科知识培训、定期病例讨论等方式构成的系统性、规范化的培训,他们的临床思维更加地成熟,对神经外科重症监护病人管理方法的掌握时间明显地缩短,参与临床实践的主动性也较前明显地增加,对神经外科患者围手术期管理的方法有了更深刻的认识,有效地提升了神经外科重症监护室的带教成效。     

A Cross-Sectional,Correlational Study Comparing Individual Characteristics of Younger and Older Nursing Home Residents using Western Canadian Resident Assessment Instrument–Minimum Data Set (RAI-MDS) 2.0

ObjectiveTo compare characteristics of nursing home (NH) residents by age categories in Western Canada.DesignA cross-sectional, correlational analysis of secondary data.Setting and Participants89,231 residents living in Western Canada NHs in the provinces of Alberta, Manitoba, and British Columbia in 2016 and 2017.MethodsResident characteristics (age, sex, marital status, body mass index, medical diagnoses, cognitive function, physical function, depressive symptoms) came from the Resident Assessment Instrument–Minimum Data Set 2.0 and were analyzed using chi-square, analysis of variance, and post hoc pairwise tests. Human developmental stage age categories were used to create 5 age groups: 18-34, 35-50, 51-64, 65-80, and 81 years and older.ResultsThe demographics, medical diagnoses, cognitive function, and physical function characteristics of NH residents among 5 age groups differed considerably (all P < .001). Residents aged 18-34 years were predominately male, never married, with a higher incidence of paralysis and traumatic brain injury. Residents aged 35-50 years had a higher incidence of stroke and multiple sclerosis, and residents aged 51-64 years mainly were morbidly obese and more prone to depression. Residents aged 65-80 years were predominately married and more prone to diabetes, and residents aged 81 years and older were predominately widowed, with a higher incidence of dementia compared with others.Conclusions and ImplicationsFindings describe the uniqueness of younger NH age groups and indicate that the youngest NH residents often have the severe disability and a modest support system (as defined by partnered status) compared to older residents in NHs. Future studies must analyze longitudinal data that track the growth of, and changes in, residents’ health and functional status.     

认真抓好临床住院医师规范化培训

当今医疗服务市场的竞争,实质上是医学专业人才的竞争,如何将一名刚步出校门的医学生尽快地培养成为高水平的临床专业人才一直是摆在医院管理者和医学教育工作者面前的重要课题,而临床住院医师规范化培训正是培养高水平医学人才的重要手段。本文总结了我院1993年以来实施住院医师规范化培训收到的较好效果,并从培训方法、培训内容、管理制度、考核办法等方面进行了阐述,旨在交流经验、提高管理水平。     

社区卫生服务对居民健康和医院效益的影响

社区卫生服务是社会进步的一个标志。建立以医院为依托 ,以社区居委会为纽带的社区卫生服务站 ,明确社区卫生服务的目标 ,发挥社区卫生服务的作用 ,满足社区居民对医疗服务的需求 ,及时为居民提供医疗保健卫生服务 ,不仅方便了群众 ,提高了居民的生活质量 ,而且医院通过社区卫生服务 ,综合利用医院的技术、设备、人力资源 ,提升了医院的形象 ,开拓了医院的医疗市场 ,是提高医院效益的途径之一。     

广州市东山区居民二次供水水池卫生学现状

目的了解广州市东山区居民二次供水水池卫生学现状,为进一步研究二次供水水池保洁时间提供部分依据。方法对112个居民二次供水水池进行问卷调查,同时进行水质检测和评价。结果33%水池盖配有锁,池盖口、溢水口、透气口安装防虫防尘网率分别为35.3%、33.9%和32.1%,办理卫生许可证率为0%,水池水质合格率为64.3%。结论居民二次供水水池卫生管理不规范,有必要制订相应的地方性生活饮用水卫生管理规范。     

流动人口与常住人口低出生体重儿原因分析

目的:了解和探讨流动人口与常住人口低出生体重儿产生原因和孕期保健现状。方法:对该院1999~2003年出生的低出生体重儿的情况进行回顾性分析。结果:共对11 473例婴儿进行调查,发现低出生体重儿491例,其中流动人口低出生体重儿发生率11.78%,常住人口低出生体重儿发生率1.47%,两者经2χ检验差异显著。流动人口中低出生体重儿产生的原因主要是:妊娠后期的体力劳动引起早产占67.39%,孕期营养不良引起足月低出生体重儿(足月小于低龄儿)占66.25%,孕期保健覆盖率19.1%。结论:制定有效的政策,加强流动人口的管理,做好孕期保健宣传,增强整个人群的孕期保健意识,防止和降低低出生体重儿的发生。