无国界医生在救援中备灾的重要性

无国界医生致力于应对天灾和战祸所引起的人道医疗危机。灾后实时爆发的人道医疗危机包括急性的外科创伤问题和基础医疗系统的破坏导致疫症发生。本文介绍了无国界医生的救援经验以及专业的备灾体系。     

Looking for resilience: Understanding the longitudinal trajectories of responses to stress

Taking advantage of two large, population-based, and longitudinal datasets collected after the 1999 floods in Mexico (n = 561) and the September 11, 2001 terrorist attacks in New York (n = 1267), we examined the notion that resilience may be best understood and measured as one member of a set of trajectories that may follow exposure to trauma or severe stress. We hypothesized that resistance, resilience, recovery, relapsing/remitting, delayed dysfunction, and chronic dysfunction trajectories were all possible in the aftermath of major disasters. Semi-parametric group-based modeling yielded the strongest evidence for resistance (no or mild and stable symptoms), resilience (initially moderate or severe symptoms followed by a sharp decrease), recovery (initially moderate or severe symptoms followed by a gradual decrease), and chronic dysfunction (moderate or severe and stable symptoms), as these trajectories were prevalent in both samples. Neither Mexico nor New York showed a relapsing/remitting trajectory, and only New York showed a delayed dysfunction trajectory. Understanding patterns of psychological distress over time may present opportunities for interventions that aim to increase resilience, and decrease more adverse trajectories, after mass traumatic events.     

地震救援中现场截肢的探讨

目的探讨地震救援中现场截肢手术适应证、手术方法及伦理问题。方法映秀镇地震救援中现场截肢2例共3个肢体，采用局部麻醉，截肢平面靠近压迫物。术后补充等张盐水，补液速度1．5L／h，静脉滴注5％碳酸氢钠溶液150mL。口服头孢克肟胶囊，400mg顿服。结果截肢后2例患者均未出现严重并发症，次日送后方医院行二次截肢。结论灾难救援中现场截肢必须综合考虑，严格掌握适应证，必要的截肢可以挽救伤员生命。     

The “Scandinavian Star” ferry disaster 1990 -a challenge to forensic odontology

Summary With 158 victims, the fire on board the Scandinavian Star was one of the world's worst ferry disasters. A team of identification experts, including dentists, were employed to secure evidence for identification and to remove the victims from the ferry. Four parallel teams, each with 2 dentists, examined and autopsied the victims at the Institute of Forensic Medicine, University of Oslo. Using the INTERPOL Disaster Victim Identification forms and aided by computers, all victims were identified within 17 days. Dental identity could be established in 107 cases (68%).     

中药汤剂在舟曲特大泥石流灾后防疫保健中的应用

目的:了解灾区人群感冒、腹泻的发病状况及对中药汤剂的态度、效果等。方法:采用自制调查问卷、对灾区中药发放及对感冒、腹泻发病情况进行数据统计等方法。结果:8月12日至8月19日腹泻病人和感冒病人呈高发病趋势,从8月20日开始至9月11日随着中药发放人数的增加,发病呈现稳定的下降趋势。调查问卷显示:2113人在"8.8"灾后有36.2%的人得过腹泻,有48.7%的人得过感冒,8.0%的人得过皮肤病,7.8%的人得过抑郁失眠,还有4.3%的人得过其他病;有97.5%的人每天至少喝1次中药汤剂;65.1%的人对中药在灾后防疫中大量应用持非常欢迎的态度,有32.3%的人持积极配合的态度,只有2.6%的人持无所谓的态度;有89.7%的人认为中药对感冒和腹泻绝对有预防作用,只有10.3%的人认为说不上有还是没有;有76.7%的人认为今后的疾病防疫中中医中药应该广泛应用,23.3%的人认为应配合其他措施应用。结论:中药汤剂可降低感冒、腹泻的发病率,在舟曲灾后受到广泛欢迎,在今后的疾病防疫中,应该广泛推广应用。     

Exchanging information: current United Kingdom developments in the infrastructure to support post-mortem imaging

Through joint working across the Home Office, Ministry of Justice and Department of Health the United Kingdom (UK) has developed a single programme of research and development in the field of less invasive autopsy, forensic and mass fatality imaging. By supporting research and development within these fields the UK has developed an outline for a national core training programme in this field along with the development of the National Forensic Image Management System (FiMag). This symposium paper is a brief overview of this development.     

6σ理论在国际灾难救援分诊中的应用研究

目的 探讨六西格玛理论在国际灾难救援中提高护理分诊人员每日分诊量的作用.方法 将2010年8月、2010年9月前往巴基斯坦参加抗洪救灾的两批护理人员分别作为对照组和观察组.第一批人员（对照组）应用传统的分诊流程,第二批人员（观察组）应用6σ理论指导下的分诊流程进行分诊,比较两批人员的每日分诊量、分诊效率.结果 观察组每日平均分诊量为723人,明显高于对照组（649人,P＜0.05）,观察组平均每日分诊率较对照组提高10.2%.结论 6σ理论在国际灾难救援中的应用可提高护理分诊量,适用于国际灾害救援.