重大活动“三防”医学现场救援准备的做法与思考

目的总结重大活动＂三防＂医学现场救援准备工作经验,提出今后＂三防＂医学现场救援准备需要加强的工作内容。方法结合担负的上海上合组织首脑峰会、北京中非论坛、博鳌亚洲论坛年会和北京奥运会＂三防＂医学现场救援任务实践,从组织、方案、技术、物资等4个方面,对重大活动＂三防＂医学现场救援准备的主要内容和方法进行探讨。结果在重大活动＂三防＂医学现场救援准备方面仍存在体系不健全、机制不完善、装备落后等问题,建议从国家宏观准备角度出发不断加强建设,提高重大活动＂三防＂医学现场救援能力。结论构建国家＂三防＂医学救援体系,建立军地协同联动机制,是做好重大活动＂三防＂医学现场救援准备的关键。     

化学事故应急救援的准备与实施

1化学事故应急救援的准备化学事故应急救援准备工作,主要做好组织机构、人员、装备三落实,并制定切实可行的工作制度,使救援的各项工作达到规范化管理。1.1组织机构在化学事故应急救援中,组织机构设置及其主要职责如下。     

核应急和放射应急医学准备与响应

核应急和放射应急医学准备与响应是核和放射应急工作的重要组成部分。卫生部负责全国核应急和放射应急医学救援的组织协调工作,组织建立了国家核应急和放射应急医学救援体系,组织开展了一系列有关核和放射应急医学救援的技术准备工作。概要阐述了近年来卫生部门在核应急和放射应急医学救援准备与响应方面开展的工作。     

海上核辐射事件的卫生救援准备

海上核辐射事件特点是辐射污染重、外部救援难、处置困难大,而且需要专用装备才能进行救援。应急卫生救援开始前的准备工作包括全面研判事故动态、减员预计、伤情评估等事故相关信息,协调各方救援力量之间的指挥关系,确定卫生救援的要点原则等。     

玉树地震灾害紧急医疗救援的难点与对策

2010年4月14日青海省玉树县发生7.1级地震,国家地震灾害紧急救援队奔赴玉树开展医疗救援.此次救援面临前期准备时间短、医疗救援任务重、高原寒冷缺氧易引发各种疾患、急性高原病高发等救援难点.救援队快速采取充分的前期准备工作、科学合理的医疗救援流程、积极稳妥应对急性高原病、加强救援队员自身防护等措施以确保完成救援任务.     

核与辐射突发事件医学应急现场救援流程研究及探讨

目的：探讨实施迅速、有效的核与辐射突发事件医学应急现场救援,为我国核与辐射突发事件医学应急准备与响应提供参考。方法：根据国内外有关法律、法规和标准,以及本课题组多年来参与核与辐射突发事件医学应急准备与响应相关工作的经验和研究,进行救援工作的探讨。结果：介绍了核与辐射突发事件现场救援的原则、目的以及流程等。结论：针对核与辐射突发事件提出进一步加强核与辐射突发事件医学应急现场救援的相关建议。     

基于抗震救灾医疗救援的军队医院应急准备

以汶川地区“5·12”特大地震救援实践为引导，探讨抗震救灾医疗救援应急准备的特点和规律，指出有哥对性的做好应急准备是出色完成抗震救灾医疗救援任务的前提，应以提高救援效能为目标，以坚持统筹兼顾为原则，扎实推进抗震救灾医疗救援的各项准备工作，确保随时处于优良的应急准备状态，做到一声令下，迅即行动，准确施救、高效保障。     

疫情防控常态化形势下某三甲医院护士灾害准备度调查△

目的：通过调查,了解新冠肺炎疫情防控常态化形势下济南市某三甲医院临床一线护士灾害准备度及影响因素。方法：选取济南市某三甲医院的323名临床一线护士作为研究对象,采用一般资料调查表和中文版灾害准备度评估量表进行调查。结果：323名护士灾害准备度总得分为（213.52±39.23）分,处于中等偏上水平,学历、工作科室、是否有身边同事参与过新冠肺炎疫情救援、是否参加过灾害救援或相关培训、抗疫救灾心理意愿是护士灾害准备度的影响因素（均P < 0.05）。结论：济南市某三甲医院的临床一线护士灾害准备度处于中等偏上水平,学历水平高、在重症监护室或急诊科工作、职称较高、有身边同事参与过新冠肺炎疫情救援、参加过灾害救援或相关培训、正在参加抗疫救灾的护士灾害准备度较好。     

非军人护士应急医疗救援中的培训

目的 探讨军队医院非军人护士应急医疗救援培训的护理组织与管理.方法 配备合理的人力资源,明确应急医疗救援工作职责,制定科学的轮训制度,通过训练及严格的组织管理,做好应急医疗救援的准备工作.结果 非军人护士的考核成绩由75.26分升至85.23分;提高应急医疗队的快速反应能力,准备阶段的时间由25分钟缩短至15分钟,提高工作效率.结论 科学高效的组织管理是圆满完成应急医疗救援任务的关键.     

厂矿化学事故前医疗急救准备工作刍议

厂矿化学事故前医疗急救准备工作刍议江西省南昌造漆厂（３３００１３）邹志华化工企业是化学事故多发部门，作为厂矿医院及卫生所，如何在化学事故发生前积极做好医疗急救准备工作尤为重要，其有效与否是应急救援成败的关键。现就厂矿化学事故应急救援医疗急救的准备作一...     

Clinical problems in the antibiotic treatment of gonorrhoea

After briefly reviewing the history of penicillin therapy in gonorrhoea, the author shows that the number of cures effected with the repository penicillins, although originally very high, has diminished considerably in recent years, despite a general tendency to increase the dosage. The reduced efficacy of PAM and benzathine penicillin is demonstrated by an exposition of the current results obtained with these two preparations in the treatment of gonorrhoea patients in London. Some of the difficulties involved in distinguishing between treatment failures and reinfections are discussed.     

The social and economic effects of manic depressive illness and of its treatment in lithium clinics

Advising about the employment of those who have had manic depressive episodes requires Occupational Health Physicians to obtain, with consent, an objective account of previous episodes and to appreciate the enormous range of manic and depressive manifestations. Familiarity is needed with the likely effects of treatment of episodes and the benefits and problems of prophylaxis--not just in general but in individual cases, for example, where driving is required. This article summarizes research into the effects of lithium preparations on the course of the illness, thyroid and renal function and the risk of suicide. The author found that changing from treatment of episodes to continuous prophylaxis benefited employment and personal relationships without causing body weight problems. Many patients do well in life if supported by an experienced professional team, with 61% requiring no further admissions once on lithium, and with an 86% reduction in admissions achieved in our local clinic.     

不同营养制剂的选择对急性脑卒中患者的影响

目的：探讨急性脑卒中患者采用短肽型肠内营养制剂逐步过渡到含膳食纤维的整蛋白型肠内营养制剂的＂序贯营养支持＂疗法是否比单纯采用整蛋白型肠内营养制剂的＂常规营养支持＂疗法更有利于患者营养状况的改善。方法：将105例急性脑卒中伴吞咽障碍的患者随机分为研究组和对照组,研究组（采用＂序贯营养支持＂疗法）54例,对照组（采用＂常规营养支持＂疗法）51例。观察两组患者入院第1、7、14、21、28天时腹胀（与文章里的指标不同）、腹泻等消化道症状发生情况及营养状态（要写出指标）。结果：研究组入院第7、14天时的消化道症状发生率明显低于对照组,营养评定指标显著高于对照组;入院第21、28天时两组差异无统计学意义。结论：急性患者采用短肽型肠内营养制剂逐步过渡到含膳食纤维的整蛋白型肠内营养制剂的＂序贯营养支持＂疗法比单纯采用整蛋白型肠内营养制剂的＂常规营养支持＂疗法更有利于患者病后第1-2周时营养状况的改善。     

Modifications of the catalytic and binding subunits of pertussis toxin by formaldehyde: effects on toxicity and immunogenicity

A panel of pertussis toxin (PT) preparations with varying levels of residual toxicity was prepared by treatment of native PT with formaldehyde (0-1.00% (w/v)) with the purpose of investigating the effects of residual toxicity on immunogenicity. The catalytically inactive mutant PT (PT-9K/129G) was used for comparison. Results from in vitro ADP-ribosyl transferase and Chinese hamster ovary (CHO)-cell toxicity assays demonstrated a formaldehyde-dependent reduction in PT toxicity, and implied that both A and B domain functions of PT were modified. The in vivo histamine sensitisation and leukocyte proliferation tests suggested that the formaldehyde-treated native PT preparations were subject to reversion to toxicity. Reversion was confirmed by in vitro toxicity assays, which demonstrated recovery of A and B domain functions. The presence of high molecular weight aggregated and cross-linked species of PT in these preparations did not appear to be detrimental to the production of a neutralising antibody response. IgG responses to native and non-catalytic mutant PT suggested that low levels of residual activity in the native PT enhanced the antibody response, while higher levels of activity inhibited the response. Using the non-catalytic mutant PT showed that formaldehyde-induced changes were not detrimental to the magnitude of the PT-specific antibody response but did reduce the PT-specific neutralising activity. In conclusion, the residual toxicity of PT preparations following formaldehyde treatment may play an important role in the immune response to pertussis vaccine, potentially altering the quality, class and magnitude of the antibodies produced to PT.     

Issues surrounding the use of herbal therapies for AIDS in endemic regions

Herbal preparations are rampantly used in the treatment of AIDS in endemic regions. Despite beneficial effects from the use of some plant preparations, the issues that still have to be addressed comprise the interaction between herbal preparations and antiretrovirals, lack of conclusive clinical trials of widely used plants, and ethical issues surrounding the practices of traditional healers. The burden presented by AIDS requires an urgent need for closer collaboration among scientists, medical practitioners and traditional systems of medicine to evaluate promising herbal preparations rigorously, and develop policies and guidelines for the judicious use of herbs with proven clinical benefit.     

小汤山医院SARS诊疗质量管理与实时控制

介绍在应急状态下小汤山医院建立的以科室为质量管理主体、视信息质量为医疗质量同等地位、抓教育培训为质量管理具体措施和用先进技术为质量管理关键手段的SARS诊疗质量管理模式。阐述了SARS诊疗质量保证要素，即人员素质、医院信息系统功能以及组织管理。并对SARS诊疗质量实时控制实施方案以及纠正的主要问题进行讨论。     

“5．12”大地震伤员收容的紧急组织与救治

本文结合批量收治四川地震灾区伤员的管理实践，提出了六个确保的总要求，按照“集中收治、分区管理，集体把关、专科负责，综合救治、突出重点”的工作思路，探讨了畅通安全快速的绿色抢救通道、健全伤员救治的质量保障机制、确保伤员救治成功率减少、伤残率的做法措施，并简述了地震伤员的伤情特点和医疗救治的一般原则。     

伤病员空运后送护理与医学准备

通过分析空运情况下对伤病员影响的主要因素,提出了伤病员空运后送前医学准备的主要要求:维持伤病员生命体征的稳定;减少机上医疗护理操作;处置伤病员使其符合航空环境要求。指出伤病员空运后送前医学准备的主要内容包括:对伤病员进行分类,确定其空运后送的顺序;对伤病员进行更换敷料、包扎固定等一般性处置;针对不同的伤类、伤部和伤势进行特殊处置等。     

Comparison of efficacy, cycle control, and tolerability of two low-dose oral contraceptives in a multicenter clinical study

This study compares the contraceptive reliability, cycle control, and tolerability of two oral contraceptive preparations containing 20 micrograms of ethinyl estradiol combined with either 75 micrograms of gestodene (EE/GSD) or 150 micrograms of desogestrel (EE/DSG). Women received the trial preparations daily for 21 days, followed by a 7-day pill-free interval. Contraceptive efficacy, cycle control, and tolerability were evaluated over a period of 12 cycles. Efficacy data of 14,700 treatment cycles (EE/GSD: 7299; EE/DSG: 7401) were obtained from 1476 women (EE/GSD, n = 740; EE/DSG, n = 736). Both preparations provided effective contraception and good cycle control with a similarly low incidence of both spotting and breakthrough bleeding. The spotting rates in both treatment groups decreased from 35.1% (EE/GSD) and 37.5% (EE/DSG) in the first treatment cycle to approximately 10% in the fourth treatment cycle. The spotting incidence as percent of the total number of cycles was 12.7% for EE/GSD and 14.3% for EE/DSG. The breakthrough bleeding incidence was 5.2% of all cycles for EE/GSD and 6.0% of all cycles for EE/DSG. For 84.7% of the cycles in the gestodene group and for 82.5% of the cycles in the desogestrel group, neither spotting nor breakthrough bleeding were recorded. Overall, the spotting and breakthrough bleeding incidence tended to be lower with EE/GSD than with EE/DSG. However, the difference was not statistically significant. Amenorrhea was recorded in 2.7% of the cycles with EE/GSD and in 2.9% with EE/DSG. Both preparations were well tolerated and showed a similar pattern of adverse events. More than 83% of the women in both groups either did not gain weight or lost more than 2 kg. Both preparations had a beneficial effect on dysmenorrhea. Both regimens provided reliable contraception and good cycle control. The incidence of adverse events was relatively low and both preparations were well tolerated.     

Management and development of the dangerous preparation archive

In the year 2000 an archive of dangerous preparations was created at the National Health Institute (Istituto Superiore di Sanità), following a principle included in the Directive 88/379/EEC on dangerous preparations, subsequently modified by the Directive 1999/45/EC, concerning the creation of a data bank on dangerous preparations in each European country. The information stored in the archive is useful for purposes of health consumer's and workers protection and prevention, and particularly in case of acute poisonings. The archive is fully informatised, therefore the companies can send the information using the web and the authorized Poison Centres can find the information on the archive using the web. In each Member State different procedures are in place to comply with the 1999/45/EC Directive; therefore an international coordination could be useful in order to create an European network of national data-banks on dangerous preparations.