舰艇官兵心肺复苏认知水平调查及混合式培训效果评价

以海军某部140名官兵为研究对象，采用心肺复苏认知水平调查问卷了解官兵对海水溺水后心跳骤停伤员进行心肺复苏救治的认知水平，分别采用单纯理论授课以及“理论授课+课后考核+智能心肺复苏模型操作”相结合的混合式培训模式进行培训，利用心肺复苏授课情况调查问卷及溺水伤员心肺复苏技术操作考核评分表进行授课情况分析及评价，旨在了解舰艇官兵对海水溺水后心跳骤停伤员进行心肺复苏救治的认知水平，并评估不同教学模式在心肺复苏培训中的效果。     

社区居民连动模式培训对心肺复苏普及效果的影响

目的:观察社区居民连动模式培训对心肺复苏普及效果。方法:2016年5月至2017年5月随机选取本社区120例居民为本次实验研究对象,按照培训方式不同将所有居民均分为实验组与对照组,对照组60例居民给予常规培训方式宣传心肺复苏,实验组60例居民给予社区居民连动模式培训宣传心肺复苏,比较两组居民心肺复苏普及效果。结果:实验组居民心肺复苏相关基础知识得分以及心肺复苏技能操作得分明显与培训前相比提升明显,实验组居民心肺复苏培训后其心肺复苏相关基础知识得分以及心肺复苏技能操作得分明显优于对照组,两组居民各项数据差异具有统计学意义(P0.O5)。结论:采用社区居民连动模式培训宣传心肺复苏可有效提高居民对心肺复苏相关基础知识的了解,并提升个体居民心肺复苏临床操作技能。     

乡镇医师心肺复苏知识和技能培训的调查分析

目的了解乡镇医师对心肺复苏知识和技能的掌握情况、培训现状,探讨提高乡镇医师心肺复苏知识、技能的对策。方法采取自行设计的调查表,对232名乡镇医师在CPR培训前后进行调查。结果乡镇医师心肺复苏知识和技能的合格率低,对CPR专题培训需求率高(92.4%),通过CPR专题培训,被调查人员在培训后对心肺复苏知识及技能的知晓率显著提高(P0.001)。结论乡镇医师心肺复苏知识和技能普遍缺乏。应加强基层医院医务工作者心肺复苏知识及技能的培训,建立一个CPR规范化培训及考核的模式是必要的。     

各种急救培训模式在医院心肺复苏培训中的应用评价

参考我国近10年的急诊心肺复苏培训方法,结合本院实际运行情况研究发现,多种培训模式并存,以导师授课模式、视频指导自学模式、模拟急救场景模式为主的急救培训模式,各有优缺点.更新教学理念,创新教学方法,优化传统心肺复苏培训模式是提高教学效果的关键.     

2015版心肺复苏及AHA心血管急救课程模式在基层医院的应用研究

目的 探讨2015版心肺复苏及AHA(American heart association,美国心脏协会)心血管急救课程模式在基层医院的推广应用价值。方法 将2017年1～6月丽水市5家县级医院的128例规培医护人员纳入研究,按随机数表法分成研究组与对照组,各64例。对照组医护人员接受常规操作示教、个人联系联合培训,研究组在常规培训基础上开展2015版心肺复苏及AHA心血管急救课程模式培训。观察两组医护人员心肺复苏相关理论知识、技能考核成绩及心肺复苏操作合格率。结果 培训后3个月两组医护人员心肺复苏的理论知识考核评分增高,研究组高于对照组,差异有统计学意义(P0.05);相较于培训前,培训后3个月两组医护人员心肺复苏的实践技能考核评分均增高,研究组高于对照组,差异有统计学意义(P0.05);培训后3个月,两组医护人员的心肺复苏操作合格率均增加,且研究组心肺复苏操作合格率为93.75%(60/64),高于对照组的76.56%(49/64),差异有统计学意义(P0.05)。结论 2015版心肺复苏及AHA心血管急救课程模式在基层医院的推广应用价值高,能使基层医院医护人员进一步掌握心肺复苏理论知识及实践技能,提高基层医院的医护人员心肺复苏操作合格率。     

浅析纳络酮在心肺脑复苏中的应用

心肺复苏经过几个世纪的发展,日趋完善,成功率明显提高,但如何提高脑复苏的成功率仍然是困扰临床医师的重大课题.近年来,广大国内外学者应用纳络酮救治心肺脑复苏做出了大量研究,并取得巨大成果.我们对这类患者在施以常规救治的基础上,及早足量持续的加用纳络酮,对心肺脑复苏成功率及延长存活时间效果满意.     

纳洛酮对心搏骤停患者氧化应激反应及心肺复苏的影响研究

目的 探讨纳洛酮对心搏骤停患者心肺脑复苏过程中氧化应激反应及心肺复苏效果的影响.方法 选择心肺复苏抢救的心搏骤停急救患者68例,随机将患者分为观察组和对照组,每组各34例.患者均采取心肺复苏救治,使用血管活性药物及细胞活性药物,观察组患者在复苏过程中加用纳洛酮静脉应用,观察两组患者心肺复苏时间、心肺复苏成功率及24 h...     

基层医务人员徒手心肺复苏培训效果研究

目的:了解基层医务人员徒手心肺复苏理论知识和操作技能掌握情况提高基层医务人员徒手心肺复苏水平.方法:依据2005年华国际心肺复苏与心血管急救指南>对扬中市部分基层医务人员进行培训,将参与培训的293名基层医务人员随机分为培训前组(先考核后培训)和培训后组(先培训后考核),考核包括理论知识和技能操作.结果:我市基层医务人员徒手心肺复苏水平较差,培训前、后两组理论知识及操作技能考核成绩差异显著(P＜0.001),具有统计学意义.结论:培训能显著提高基层医务人员徒手心肺复苏水平,提高复苏成功率.     

冠心病患者主要照顾人员情景模拟心肺复苏培训效果观察

目的 探讨冠心病患者主要照顾人员实施情景模拟心肺复苏培训的可行性和效果.方法 由心血管内科医生和护士组成心肺复苏情景模拟教学组,将120名冠心病患者主要照顾人员随机分成2组,观察组(60例)和对照组(60例).观察组采取情景模拟教学法进行理论知识和现场情景模拟讲解示教,操作培训;对照组按照传统的模式进行心肺复苏理论与操作培训.2组培训后现场考核.结果 观察组心肺复苏理论知识、操作水平和满意度均显著高于对照组(P<0.01).结论 冠心病患者主要照顾人员实施情景模拟心肺复苏培训切实可行,可显著提高患者家属的急救水平,为冠心病患者的抢救提供宝贵时间,值得向社会推广.     

对特殊岗位职工开展以心肺复苏技术为主的急救普及培训的探讨

目的探讨对特殊岗位职工开展以心肺复苏技术为主的急救普及培训模式、方法及内容。方法2006年2~5月采用分期培训的方法培训特殊岗位职工579人。培训内容包括以心肺复苏技术为主的基本急救知识和技能。制定特殊岗位职工急救培训标准、考核标准。培训时间为16学时。培训结束后进行考核和技能比赛。结果理论考试合格率为98%,徒手心肺复苏操作考核合格率为99%,培训满意度为99%。结论以心肺复苏技术为主的急救培训模式可使学员掌握基本的自救互救知识和关键的初级救生术,提高了他们遇到灾害、意外事故和危重患者时的应急能力。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.