Family-centered Care for Sick Newborns: A Thumbnail View

Family-centered care (FCC) for sick newborns is emerging as a paradigmatic shift in the practice of facility-based newborn care. It seeks to transforming a provider-centered model into a client-centered one and thus build a new therapeutic alliance. FCC is the cornerstone of continuum of care, imparting caregiving competencies to parents/caregivers both within institutions as well as after the discharge. This has potential gains for the newborn, family members, and facility-level staff. The initial model piloted in tertiary-care settings is now undergoing translation at five sites across the country; the outcomes are keenly awaited.     

Determination of needed radiographic room capacity to serve an emergency department

This study describes a method for determining the number of radiographic rooms devoted to emergency radiology that would be required to keep mean patient waiting time at a desired level. A desired mean waiting time for patients must be determined. In our setting, a mean waiting time of 8 minutes resulted in few complaints. The waiting time then sets the required utilization rate of available capacity. Daily and hourly volume and variability in volume of examinations were measured over a 3-month period. This represents the demand. The needed number of rooms is determined by comparing demand with effective available capacity for different numbers of rooms. To maintain an 8-minute mean waiting time, 50% utilization of capacity is required. Mean demand on Sundays is 176 examinations. Five rooms are required, since this gives a 180-examination effective capacity. Using waiting time as the primary decision criterion for making capacity decisions in emergency radiology has several advantages: the method is easy to use, volume variability is taken into account, and the focus is on service to patients.     

Quantitative displacement of blood acid base equilibrium in acutely water depleted dogs

Summary Dogs were water depleted 2% of their body weight by the intraperitoneal injection of a hyperosmotic solution of saline and glucose (550 mOsm/l). During a 3-h experiment these water-depleted (WD) animals showed a significant decrease in blood pH, base excess (BE) and plasma bicarbonate (Bic_p) and an increase in both hematocrit (Ht) and blood buffer capacity (BBC). These changes were quantitatively time-dependent. The rate change of pH, BE, and Bic_p were –0.072 units h^–1, –4.7 mEq/l h^–1, and 2.9 mEq/l h^–1, respectively. As control dogs showed no significant time-dependent changes in their blood acid-base status, the observed modifications in the experimental dogs were ascribed to water depletion. Increased endogenous acid production related to tissue hypoxia is suggested to be the mechanism that could explain the increased fixed acid accumulation observed in the water-depleted animals.     

评“McCall观察方法”——对一种色谱系统分配效果观察方法的商榷

本文通过理论分析和文献数据的分析,对McCall提出的色谱系统分配效果的观察方法提出了不同的看法,认为McCall方法中的所谓logK并不是常数。McCall的方法无论在理论上和实践上都是不妥的。     

我国女性性工作者领域社会组织参与艾滋病防治项目管理能力建设需求研究

目的 了解为女性性工作者（FSW）提供艾滋病防治服务的社会组织项目管理能力建设需求。方法 向2017-2018年参与国家艾滋病防治基金项目的社会组织负责人开展问卷调查及访谈,结合基金项目管理信息系统相关数据,利用Excel 2016软件和SPSS 25.0软件整理分析社会组织的分布与基金获得情况,以及社会组织对项目管理能力的需求。结果 2017-2018年参与执行基金FSW项目的社会组织共184个,完成问卷调查的社会组织156个,主要集中在西部地区（44.0%,81/184）,以四川省、广西壮族自治区和云南省居多;东部地区获得的基金支持最多;社会组织对项目数据收集及分析利用的需求最高,占68.6%（107/156）,其次是项目风险分析应对及质控,占64.1%（100/156）;社会组织负责人学历对项目计划管理和项目财务管理能力建设需求的差异有统计学意义（χ²=5.78,P=0.016;χ²=8.99,P=0.003）。结论 当前我国FSW领域的社会组织数量和基金获得比例的分布,与异性性传播的艾滋病疫情分布不一致。仍需继续鼓励、引导扶持社会组织的发展资金;结合社会组织对能力建设的需求针对性的制定项目能力建设计划。     

Macromorphology and histology of intramuscular hemorrhages in cases of drowning

In a prospective autopsy series of 39 cases of fatal drowning, the detailed dissection of the skeletal muscles of the neck, anterior / posterior trunk and the upper extremities in layers revealed intramuscular hemorrhages of different size and shape in 20 cases (51.3 %). Light microscopy examination showed a premortal (vital/agonal) type of muscular alteration in 7 (50 %) out of 14 macroscopical hemorrhage-positive cases. These hemorrhages and histological muscle alterations are attributed to agonal convulsions, hypercontraction and overexertion of the affected muscle groups. As long as no cutaneous or subcutaneous hematomas above the hemorrhages can be found, these autopsy findings (with special reference to histology) can serve as an additional criterion concerning the differentiation of drowning and another cause of death. Received: 31 July 1998 / Received in revised form: 31 August 1998     

Time-dependent RNA synthesis in different skin layers after wounding. Experimental investigations in vital and postmortem biopsies

Summary Incision wounds were made on the outer ear of rats and two biopsies were taken for examination after different survival times. In each case a biopsy was made of vital tissue and a second of postmortem tissue after refrigeration for 24 h. The biopsies were exposed to a solution containing the RNA precursor³H-cytidine for 1 h, washed and fixed in formalin. Sections 5 m thick were then autoradiographically prepared and automatically evaluated using Quantimet 920. The intravital specimens showed a significant increase in³H-cytidine incorporation in the basal cell layer after survival times of 10–24 h. No increase was seen in the stratum corneum, corium or cartilage tissue. The investigated distance from the wound margin did not have any significant bearing on the results. The³H-cytidine incorporation rate in postmortem tissue was practically identical with that of vital tissue, but no increase was observed in the rate of RNA synthesis in the basal cells as a function of the age of the wound. It may therefore be assumed that this method provides no additional information as to the age of wounds in postmortem examination.Dedicated to Professor O. Pribilla on the occasion of his 70th birthday     

下咽癌淋巴引流的活体显像研究

目的：探讨下咽癌颈淋巴结转移时肿瘤区域引流淋巴结的活体显像方法，从肿瘤活体淋巴引流的角度观察下咽癌前哨淋巴结和颈淋巴结转移的方式，为颈淋巴结清扫术提供指导信息。方法：在表面麻醉和喉内镜引导下，用特制的注射针将^99mTc标记的人球蛋白注入20例下咽癌的肿瘤部位，在注射后不同时间采用SPECT扫描观察放射性核素通过淋巴扩散的过程及其在引流淋巴结内的浓集，以明确前哨淋巴结的位置和肿瘤颈淋巴结引流过程。同时对颈淋巴清扫标本进行病理检查。结果：20例肿瘤引流淋巴结均获得满意活体显像，显像的淋巴结最大3．5cm，最小1．0cm；12例梨状窝癌的颈部引流淋巴结位于肿瘤侧，其余8例中线结构的肿瘤颈部引流淋巴结均具有明显的优势偏向，即单侧颈部引流现象，没有出现双侧对称引流的病例。20例肿瘤引流淋巴结主要分布在Ⅱ、Ⅲ、Ⅳ区，未发现Ⅰ区和Ⅴ区显像的淋巴结。术后病理证实20例中有16例发现病理阳性淋巴结，且均位于引流优势侧，未出现对侧和双侧颈淋巴结转移的病例。结论：无论是中线结构或偏中线结构的下咽部癌肿，其向颈部的淋巴引流具有明显的优势偏向特点，术前进行引流淋巴结的活体显像对预测肿瘤转移部位和有目的地进行择区性颈淋巴结清扫术具有重要意义。     

湖南省学生1995年和2000年肺活量抽样调查分析

目的了解湖南省学生呼吸功能发育状况,探讨其变化趋势.方法于1995年和2000年在湖南省的长沙市、常德市、衡阳市和湘西自治州采用整群分层抽样和统一调查、检测方法,对学生体质健康状况调查,采用U检验对调查资料按年度、年龄、性别和城乡比较分析.结果从肺活量(ml)和肺活量指数(ml/kg)进行统计分析的结果显示,总体水平低于全国平均水平,1995年未达到全国平均水平的城乡男女年龄组有36个,2000年则增至38个;2000年与1995年进行肺活量指数比较,城乡男女共有33个年龄组下降;另外还呈现出城市高于农村,男生大于女生的特点.结论湖南省学生肺活量在全国处较低水平,且城乡男女多数年龄组呈现下降趋势,并有较明显的城乡差异和性别差异.