亚专业分区形势下新型急诊医学住培教学模式的应用研究

目的 探讨亚专业分区形势下新型急诊医学住培教学模式的应用及教学效果。方法 30名急诊专业住培生随机分成两组,每组15人。试验组采取亚专业分区模式教学,对照组接受传统带教;采用SPSS 26.0进行t检验和卡方检验,对比分析两组学员在人口学变量、培训考核成绩、教学反馈等方面的差异。结果 两组学员在年龄、性别、学历、临床工作年限等人口学变量上差异无统计学意义;两组学员在重庆市结业考核成绩上差异无统计学意义（P>0.05）,但在结业考核前科内模拟理论考试成绩差异有统计学意义[（81.20±2.83） vs. （89.73±3.01）,P<0.001];教学反馈调查结果显示,两组对独立值班的信心和教学满意度都较高,差异无统计学意义（P>0.05）,但试验组对急诊亚专业发展的认同度高于对照组,同时在科研和自身发展方向定位上也优于对照组。结论 亚专业分区形势下新型急诊住培教学模式更利于急诊医学的长远发展,建议在急诊住培教学中进一步推广验证。     

基于成分含量和生态因子的浙贝母品质区划研究

[目的]进行浙贝母药材的品质区划研究,指导浙贝母的合理栽培。[方法]通过实地走访调查和采样,收集浙贝母药材样品和分布信息。基于浙贝母中贝母素甲、贝母素乙的含量,以及生态环境因子和空间分布数据,利用高效液相色谱-蒸发光散射检测法(high performance liquid chromatographyevaporative light scattering detection,HPLC-ELSD)、Arc地理信息系统(Arc Geographic Information System,ArcGIS)的空间计算功能、最大信息熵模型、统计产品与服务解决方案(Statistical Product and Service Solutions,SPSS)软件的统计分析方法,进行浙贝母质量适宜性等级区划。[结果]通过回归分析,可以得到浙贝母适合种植参数;利用最大信息熵模型,得到浙贝母的空间分布概率区划图和浙贝母素甲与浙贝母素乙的含量空间分布图。不同产地所产浙贝母中生物碱含量差别较大,其中贝母素甲和贝母素乙总含量最高达0.26%,最低为0.06%。贝母素甲含量较高的浙贝母分布区集中在浙江省中东部,贝母素乙含量较高的浙贝母分布区集中在浙江省东部和浙江、江苏两省交界处。[结论]该研究结果与生产实践的经验相吻合,浙江省东部及北部和江苏省东部为高品质浙贝母的适合种植区域,该结果为浙贝母的规范化种植和引种提供科学依据。     

新疆精河县草原生态保护奖补政策实施的效果分析

新疆精河县草场植被类型复杂多样,全县冬夏冷热悬殊、干燥少雨,草原生态极其脆弱。近年来,由于人为和自然的因素,草原退化较严重,自2011年起,国家和自治区不断地加大对草原生态保护的补奖力度。本文从草原禁牧、草畜平衡政策实施及生态补偿资金发放情况等方面着手,通过项目实施前后在草场生产力、牲畜存栏数、生态和社会效益及牧民收入等方面的数据对比,对新疆精河县草原生态保护奖补政策实施情况及实施效果进行评估,对项目运行过程中存在的问题进行分析,并提出了相应对策。     

Community Control of Alcohol and Drug Risk Environments: The California Experience

This article describes California community (city, county) uses of local powers and resources to prevent alcohol and other drug (AOD) problems by managing AOD risk environments in retail, public, and social domains. The article presents a promising framework used in several counties dedicated to community environment approaches to prevention. A case example of its application is provided. The framework has developed locally since the mid 1980s through AOD prevention demonstration grant research, policy advocacy, and state support for local initiatives. Data for this article come from the author's experience observing and consulting with California cities and counties over 25 years.     

Adaptive management of the Great Barrier Reef: A globally significant demonstration of the benefits of networks of marine reserves

The Great Barrier Reef (GBR) provides a globally significant demonstration of the effectiveness of large-scale networks of marine reserves in contributing to integrated, adaptive management. Comprehensive review of available evidence shows major, rapid benefits of no-take areas for targeted fish and sharks, in both reef and nonreef habitats, with potential benefits for fisheries as well as biodiversity conservation. Large, mobile species like sharks benefit less than smaller, site-attached fish. Critically, reserves also appear to benefit overall ecosystem health and resilience: outbreaks of coral-eating, crown-of-thorns starfish appear less frequent on no-take reefs, which consequently have higher abundance of coral, the very foundation of reef ecosystems. Effective marine reserves require regular review of compliance: fish abundances in no-entry zones suggest that even no-take zones may be significantly depleted due to poaching. Spatial analyses comparing zoning with seabed biodiversity or dugong distributions illustrate significant benefits from application of best-practice conservation principles in data-poor situations. Increases in the marine reserve network in 2004 affected fishers, but preliminary economic analysis suggests considerable net benefits, in terms of protecting environmental and tourism values. Relative to the revenue generated by reef tourism, current expenditure on protection is minor. Recent implementation of an Outlook Report provides regular, formal review of environmental condition and management and links to policy responses, key aspects of adaptive management. Given the major threat posed by climate change, the expanded network of marine reserves provides a critical and cost-effective contribution to enhancing the resilience of the Great Barrier Reef.     

The economics of land‐use regulation in the presence of an externality: a dynamic approach

Land‐use restrictions are frequently applied to separate non‐polluting from polluting activities. In contrast to the existing literature, we simultaneously incorporate spatial and intertemporal aspects of the problem and endogenously determine the border of the zones. Intensity‐orientated instruments alone, such as a spatially differentiated tax on inputs or outputs, are not able to support the socially optimal outcome and need to be complemented by instruments that affect choices at the extensive margin such as positive or negative land‐use taxes or land zoning. The necessary changes required to transform a spatially optimal, yet static, environmental policy into an intertemporally and spatially optimal environmental policy are presented and discussed. Copyright © 2006 John Wiley & Sons, Ltd.     

腰1椎体应力的有限元分析及分区

【摘要】 目的：利用有限元分析法研究在不同等级载荷及不同运动状态下腰1（L1）椎体皮质骨及松质骨的应力分布情况，并建立应力分区。方法：选取1例志愿者行胸腰段CT平扫，获取CT原始数据以DICOM导入Mimics、Geomagic、SoliderWorks、HyperMesh、Abaqus等有限元软件，构建正常胸腰段椎体（T11～L2）模型，在T11椎体上缘均匀施加力学载荷，将在载荷500N、弯矩7.5N·m下产生的所有运动状态称为α组，载荷600N、弯矩7.5N·m下产生的所有运动状态称为β组，载荷700N、弯矩7.5N·m下产生的所有运动状态称为γ组。选取L1椎体，从矢状面观正中分割分为上下两部分，上半部分标记为A区，下半部分标记为B区；从椎体正中央至椎体边缘呈同心圆均匀划分6段，上下各构成三维圆弧柱形6部分，从外缘到中央依次标记为1、2、3、4、5、6区，构成A1、A2、A3、A4、A5、A6、B1、B2、B3、B4、B5、B6区域共12部分；分别在α、β、γ三组中均匀采集上述12区域内皮质骨及松质骨应力数据，对皮质骨及松质骨相邻区域内应力值进行两两配对t检验，将差异具有统计学意义的两相邻区域独立成区，将差异无统计学意义的两相邻区域进行合并成区，得到最终应力分区。结果：在α组中，A1区域皮质骨和松质骨的平均应力与A2区域比较差异均具有统计学意义；A2区域与A3区域比较差异无统计学意义；A3区域与A4区域比较差异具有统计学意义；A4区域、A5区域、A6区域三者之间两两比较差异均无统计学意义；B区域规律同A区域。在β组中，皮质骨中A区域及B区域应力均满足α组中统计学意义规律，松质骨中A4区域与A5区域、B4区域与B5区域两两比较差异具有统计学意义，其规律与α组一致。在γ组中，皮质骨及松质骨A4区域与A5区域、B4区域与B5区域应力两两比较差异具有统计学意义，其余与α组规律相同。根据统计学规律，将L1椎体分为A1（AⅠ）、A23（AⅡ）、A456（AⅢ）、B1（BⅠ）、B23（BⅡ）、B456（BⅢ）六个区域，其中AⅡ区域应力分布最为集中，称之为核心应力区，AⅠ、BⅠ、BⅡ应力分布次之，称之为主要应力区，AⅢ、BⅢ应力分布最少，称之为次要应力区。结论：L1椎体应力分布较为固定且呈现一定规律性，其中核心应力区、主要应力区和次要应力区承受应力依次减弱，有助于临床骨折类型预判和评估。     

石柱参（人参）产地适宜性研究

目的：分析石柱参在中国的适生区域，为人工种植适宜区筛选提供科学依据。方法：以辽宁省宽甸县石柱参分布区最适宜生长环境因子为依据，利用中药材产地适宜性分析地理信息系统（TCMGIS），区划石柱参在全国的适宜产地。结果：相似度为95％～100％的适宜面积15943．93km^2，辽宁占96．44％，吉林占3．56％；相似度为90％～95％的适宜面积20070．83km^2，主要分布在辽宁，占73．88％，吉林和秦岭中东部地区也有一定份额。结论：研究结果覆盖了石柱参现代分布区，预测了石柱参潜在适宜分布区；验证了TCMGIS系统应用于石柱参适生地分析的科学性和准确性；对于规划人参种植区域，保护优良品种，把人参生产规划在真正的适宜产地区域具有重要的参考意义。