应用型本科高校医学生健康素养水平及影响因素分析

目的了解应用型本科高校医学生的健康素养水平现况及其影响因素,为进一步开展针对医学专业人才的健康促进工作提供依据。方法于2022年9—12月采用分层随机抽样法在某应用型本科高校抽取部分医学生,用一般资料调查问卷、健康素养问卷进行调查。结果应用型本科高校医学生的总体健康素养水平为41.72%,健康基本知识和理念、健康生活方式与行为、健康技能这3个方面的素养水平分别为51.87%、33.11%、44.11%。慢性病防治、传染病防治、基本医疗、健康信息、科学健康观、安全与急救这6类健康问题的素养水平分别为:23.64%、44.78%、56.75%、60.29%、70.53%、74.64%。多因素Logistic回归分析显示,年级、是否独生子女以及专业是应用型本科高校医学生健康素养水平的影响因素(P<0.05)。结论应用型本科高校医学生具有较高的健康素养水平,但慢性病防治素养以及健康生活方式与行为素养有待提升,应重点关注低年级和非独生子女学生的健康素养水平。

SBAR标准化床边交班在急诊重症病房中的应用

目的分析SBAR标准化床边交班在急诊重症病房中的应用效果。方法于2018年2—7月对急诊重症病房18名护士实行SBAR标准化床边交班培训,分别在SBAR标准化床边交班实行前和实行6个月后调查护士对病情掌握情况及护士交接班评估量表评分情况。结果实行SBAR标准化床边交班后,责任护士对患者病情掌握情况评分与实行前相比,差异具有统计学意义(P <0.05)。护士交接班评估量表中促进有效沟通、确保高效沟通、有利于识别患者病情变化、有利于预防患者的安全隐患、交接班中团队协作良好,这五个条目均分高于实行前,差异具有统计学意义(P <0.05)。结论实行SBAR标准化床边交班后,规范了危重患者床边交接流程,提高了责任护士对患者病情的掌握程度,增进了护士有效沟通,从而保证交接班信息的全面准确性,有利于提高团队协作能力和护理质量,保障患者安全。

二胎早产儿的喂养方式及营养状况分析

目的回顾性分析二胎政策后二胎早产儿的喂养方式和营养状况,为相关政策的制定提供依据。方法统计2017年1月1日—6月30日于厦门市某三级甲等综合医院进行系统的产前检查并住院分娩的1 075例二胎儿,对其26例早产儿的喂养方式和生后42 d营养状况进行分析。结果 1 075例二胎儿中有26例早产儿,占分娩总数的2.42%;1 075例二胎儿喂养方式中,纯母乳喂养708例,配方奶喂养62例,混合喂养305例;以纯母乳喂养为主。在26例早产儿中,消瘦19例,轻度贫血3例,中度贫血1例。结论二胎早产儿的喂养方式与营养状况密切相关,护理人员可根据情况加强针对性的健康管理。

砭石穴位按摩预防后路腰椎椎间融合术后便秘的效果观察

[目的]探讨砭石按摩对后路腰椎椎间融合术后便秘的早期预防效果。[方法]将93例病人随机分为手指按摩组、砭石按摩组和对照组各31例。对照组给予骨科术后常规护理,手指按摩组在对照组基础上予手指按摩支沟、中脘、天枢、气海、足三里,砭石按摩组在对照组的基础上予砭棒的砭尖按摩支沟、中脘、天枢、气海、足三里,手指按摩组和砭石按摩组从术前1 d起每日均予按摩2次,每次每穴按摩3 min,全程21 min,持续按摩8 d。比较3组病人术后首次肛门排气、排便时间的差异。在术前、术后第3天和术后第6天比较3组病人的便秘症状总积分。[结果]手指按摩组和砭石按摩组术后首次肛门排气时间均早于对照组,差异均有统计学意义(P<0.05),但手指按摩组与砭石按摩组术后首次肛门排气时间差异无统计学意义(P<0.05),砭石按摩组术后首次肛门排便时间早于手指按摩组和对照组,手指按摩组与对照组、砭石按摩组与对照组、手指按摩组与砭石按摩组术后首次肛门排便时间差异均有统计学意义(P<0.05)。术前、术后第3天、术后第6天3组病人的便秘症状总积分比较,时间效应差异、组间效应差异、交互效应差异均有统计学意义(P<0.05)。[结论]砭石穴位按摩和手指穴位按摩均可使后路腰椎椎间融合术后病人的首次肛门排气时间提前,砭石穴位按摩可使病人术后首次肛门排便时间提前,改善便秘症状总积分,预防后路腰椎椎间融合术后便秘。

膝骨性关节炎病人的砭石循经穴位按摩效果观察

[目的]探讨砭石循经穴位按摩在膝骨性关节炎病人中的应用效果。[方法]将60例膝骨性关节炎病人随机分为对照组与观察组,每组各30例。对照组予口服盐酸氨基葡萄糖胶囊和电脑中频治疗,观察组在对照组的基础上予砭石循经穴位按摩每天1次,7 d为1个疗程,共干预2个疗程。于1个疗程和2个疗程之后,比较两组西安大略和麦克玛斯特大学骨关节炎指数(WOMAC)和视觉模拟评分法(VAS),于2个疗程后比较两组关节炎生活质量测量量表简化量表(AIMS2?SF)中文版修改的量表评分。[结果]干预后两组WOMAC、VAS和AIMS2?SF评分分别与同组干预前比较,差异均具有统计学意义(P<0.05);干预后观察组WOMAC评分和VAS评分低于对照组(P<0.05),AIMS2?SF评分高于对照组(P<0.05)。[结论]砭石循经穴位按摩可以缓解膝骨性关节炎的疼痛症状,改善关节功能及生活质量。

护理迷你临床演练评估量表在急诊科护生护理技能教学中的应用

目的探讨护理迷你临床演练评估量表(nursing-mini-clinical evaluation exercise,Nursing-Mini-CEX)在急诊科护生护理技能教学中的应用效果。方法选取2018年9月至2019年8月在本院急诊科实习的护生72人,共12个实习批次,每批次6人,实习前应用SPSS 21.0软件将12个实习批次分别随机分配一个数字,将随机数进行排序,前6位对应的批次为对照组,后6位对应的批次为观察组。对照组采用传统护理带教方法;观察组在对照组基础上结合Nursing-MiniCEX进行操作技能的教学,两组护生急诊科实习时间均为4周。于实习第4周对两组护生操作进行考核和测评其人文关怀能力。结果观察组护生操作考核成绩(90.56±1.75)分高于对照组(85.39±3.51)分,差异有统计学意义(t=7.911,P<0.001)。观察组护生人文关怀能力总分(175.72±15.47)分高于对照组(168.08±13.83)分,差异有统计学意义(t=2.209,P=0.030)。结论将Nursing-Mini-CEX应用于急诊科护生护理技能教学中有助于提高护生的操作技能水平和人文关怀能力。

二孩政策后初产与二产产妇的母婴结局分析

目的回顾分析二孩政策后初产与二产产妇的母婴结局情况。方法选取2017年1—6月在厦门大学附属第一医院住院分娩的2 276例产妇,根据产次分为初产组1 008例及二产组1 268例,回顾分析两组产妇的分娩方式、妊娠合并症及并发症、早产儿、低出生体质量儿、巨大儿、畸形儿的发生率。结果二产组剖宫产率高于初产组,巨大儿、瘢痕子宫、B族链球菌感染、妊娠期糖尿病、产后出血的发生率高于初产组,差异均具有统计学意义(P <0.05)。初产组胎膜早破的发生率高于二产组,差异具有统计学意义(P <0.05)。两组产妇妊娠期高血压疾病、妊娠合并贫血、妊娠合并甲状腺疾病、羊水量异常、前置胎盘、早产儿、低出生体质量儿、畸形儿比较,差异均无统计学意义(P> 0.05)。结论实施二孩政策后,二产产妇明显增多,妊娠合并症及并发症增加,巨大儿发生率高,有必要加强对二产孕产妇的围产期健康管理,以减少不良母婴结局的发生,保证母亲及婴儿平安健康。

发展学生“证据推理与模型认知”素养的教学实践——以“燃烧与灭火”为例

分析了以往“燃烧与灭火”教学中发展学生“证据推理与模型认知”核心素养的现状。介绍“燃烧与灭火”一节教学中围绕取火有“术”、驭火有“方”、防火有“法”三大板块展开的五大实验探究活动。阐释发展学生“证据推理与模型认知”化学学科核心素养的具体教学实施过程。

低热硅酸盐水泥应用于高寒地区混凝土坝的性能研究

为了改善高寒地区混凝土坝体内部因水化热引起的坝体开裂问题,以低热水泥为研究对象,对几种不同水泥的水化放热、绝热温升、胶砂力学性能、混凝土抗裂性能等进行了对比研究。结果表明:低热水泥可有效降低混凝土的水化放热,减小绝热温升,控制早期温度裂缝;C_(2) S反应较慢,使得低热水泥的早期力学强度远低于中热水泥,但C_(2) S较C3 S可生成更多的C-S-H,使得低热水泥后期强度大幅度提高;低热硅酸盐水泥中CH含量较低,可增加混凝土界面过渡区的致密性,使得低热水泥混凝土长龄期的劈裂强度、极限拉伸值、抗拉强度均高于中热水泥混凝土,抗裂性能显著优于中热水泥。

国内外医学生健康素养的研究进展

查阅国内外医学生健康素养相关的研究文献,从国内外医学生健康素养的研究现状、测评工具、影响因素进行综述总结,提出对医学生健康素养研究的展望,以期为后续开展医学生健康素养的相关研究提供参考依据。

Integrated UV-based photo microreactor-distillation technology toward process intensification of continuous ultra-high-purity electronic-grade silicon tetrachloride manufacture

Ultra-high-purity silicon tetrachloride(SiCl4)is demanded as an electronic-grade chemical to meet the stringent requirements of the rapidly developing semiconductor industry.The high requirement for ultra-high-purity SiCl4 has created the need for a high-efficient process for reducing energy consumption as well as satisfying product quality.In this paper,a mass of production technology of ultra-high-purity SiCl4 was successfully developed through chlorination reaction in the ultraviolet(UV)-based photo microreactor coupled with the distillation process.The influences of key operational parameters,including temperature,pressure,UV wavelength and light intensity on the product quality,especially for hydrogen-containing impurities,were quantified by the infrared transmittance of Fourier transform infrared spectroscopy(FT-IR)at 2185 cm^-1and 2160 cm^-1indicating that chara cteristic vib rational modes of Si-H bonds,as well as the operating conditions of distillation were also investigated as key factors for metal impurities removing.The advanced intensification of SiCl4 manufactured by the integration of photo microreactor and distillation achieves the products with superior specifications higher than the standard commercial products.

High-pressure-induced phase transition in cinchomeronic acid polycrystalline form-I

Diamond anvil cells combined with Raman spectroscopy and angle-dispersive x-ray diffraction(ADXRD) were used to investigate the compression behavior of cinchomeronic acid(C_7H_5NO_4, CA), a hydrogen-bonded polymorphs. The compression of form-I at approximately 6.5 GPa caused an irreversible phase transition that produced the new polymorph form-III. Lattice and internal modes in the Raman spectra were analyzed to determine the modifications in the local environment of CA form-I molecules. The form-III was indexed and refined to a low-symmetry triclinic structure with space group P1. The mechanism for the phase transition involved the reconstructions in the hydrogen-bonded networks in CA form-I.

Optimal Operation of Electric Vehicles and Distributed Generation Resources in Smart Grid Considering Load Management

Technology advancement and the global tendency to use renewable energy in distributed generation units in the distribution network have been proposed as sources of energy supply.Despite the complexity of their protection,as well as the operation of distributed generation resources in the distribution network,factors such as improving reliability,increasing production capacity of the distribution network,stabilizing the voltage of the distribution network,reducing peak clipping losses,as well as economic and environmental considerations,have expanded the influence of distributed generation(DG)resources in the distribution network.The location of DG sources and their capacity are the key factors in the effectiveness of distributed generation in the voltage stability of distribution systems.Nowadays,along with the scattered production sources of electric vehicles with the ability to connect to the network,due to having an energy storage system,they are known as valuable resources that can provide various services to the power system.These vehicles can empower the grid or be used as a storage supply source when parked and connected to the grid.This paper introduces and studies a two-stage planning framework for the concurrent management of many electric vehicles and distributed generation resources with private ownership.In the first stage,the aim is to increase the profit of electric vehicles and distributed generation sources;finally,the purpose is to reduce operating costs.The proposed scheduling framework is tested on a distribution network connected to bus 5 of the RBTS sample network.Besides distributed generation sources and electric vehicles,we integrate time-consistent load management into the system.Due to distributed generation sources such as photovoltaic systems and wind turbines and the studied design in the modeling,we use the Taguchi TOAT algorithm to generate and reduce the scenario to ensure the uncertainty in renewable energy.MATLAB software is used to solve the problem and select the optimal answer.

Geomorphologic Structure, Characteristics and Processes in the Cangshan Mountains: Explanations for the Formation and Development of the Dali Glaciation

The area around Cangshan Mountain, located on the southeastern fringes of the Tibetan Plateau, is a key region in terms of revealing the processes involved in the uplifting of the Tibetan Plateau, plus its environmental effects. Based on systemic field and laboratory work, this study uncovers the step-like geomorphologic structure, characteristics and processes revealed in the Cangshan Mountain area, to argue for the formation and development of the Quaternary glaciation there. The results indicate that there were two paleo-glaciations in the area, which were the early and late Dali Glaciations, and that these occurred during the time periods 5.76 × 104 aBP and 1.6 × 104 aBP respectively, being the southernmost paleo-glaciations to have taken place in China. Two step-like paleo-planation surfaces were formed vertically at the mountain (that is, at the summit of Cangshan, which is 3800 to 4000 m above sea level (a.s.l) in height;and at the paleo-glacial and peri-glacial active zones: 3700 to 3900 m a.s.l. in height). Meanwhile three widespread erosion surfaces can be identified at about 2900 to 3500 m, 3000 to 3100 m and 2450 to 2550 m a.s.l. in height;three fluvial fans developed on the landform at about 2250 to 2200 m, 2200 to 2150 m and 2150 to 2100 m a.s.l. in height respectively, and lacustrine relief developed surrounding the Erhai Lake.

三氯氢硅精馏节能技术研究进展

概括了多晶硅生产中三氯氢硅节能精馏提纯技术的研究现状。介绍了多效精馏、热泵精馏、反应精馏、热耦合精馏、以及复合工艺在三氯氢硅精馏节能降耗方面的应用技术。并讨论了三氯氢硅精馏节能技术的发展趋势,指出采用多种精馏节能综合应用是我国多晶硅生产中三氯氢硅精馏提纯的方向。

高中“化学反应与电能”跨学科项目式教学——探究原电池电动势的影响因素

以“探究原电池电动势的影响因素”为项目学习主题,以探讨化学电源的应用、探究原电池的工作原理、测量原电池的电动势、搭建高电动势原电池等4个任务为关键项目任务,呈现高中“化学反应与电能”跨学科项目式教学设计思路和教学实践过程。

桃红四物汤颗粒通过改善线粒体功能障碍和氨基酸代谢紊乱缓解鱼藤酮诱导的SH-SY5Y细胞毒性作用

帕金森氏病(PD)是一种进行性神经系统疾病,以震颤和运动缓慢为特征。线粒体功能障碍和氨基酸代谢是PD疾病的重要机制。前期工作证实SH-SY5Y细胞中氨基酸含量的变化早于细胞活力的变化。本研究旨在探讨桃红四物配方颗粒(THSWDG)是否能够减轻鱼藤酮诱导的SH-SY5Y细胞毒性,是否能够改善鱼藤酮诱导线粒体功能障碍及氨基酸代谢紊乱。用MTT法分析细胞存活率;JC-1染色法测定线粒体膜电位;高效液相色谱法测定SH-SY5Y细胞中氨基酸的含量。采用主成分分析法分析氨基酸含量的变化趋势;使用生物信息学工具进一步阐明其潜在机制。研究表明,SH-SY5Y细胞氨基酸含量的变化早于细胞活性的变化。THSWDG能显著提高细胞存活率,改善鱼藤酮对线粒体膜电位的影响和氨基酸的异常代谢。生物信息分析结果表明,THSWDG的作用涉及9个生物学过程,包括5个与PD疾病相关的氨基酸代谢调节过程和4个与氧化损伤相关的生物学过程。细胞氨基酸过程是一种常见的调节氨基酸代谢和氧化损伤的生物过程。提示THSWDG通过改善线粒体功能障碍和氨基酸代谢紊乱对鱼藤酮诱导的SH-SY5Y细胞损伤发挥保护作用。

In situ observations of tungsten speciation and partitioning behavior during fluid exsolution from granitic melt

Most economically important tungsten(W)deposits are of magmatic-hydrothermal origin.The species and partitioning of W during fluid exsolution,considered to be the controlling factors for the formation of ore deposits,are thus of great significance to investigate.However,this issue has not been well addressed mainly due to the significant difference in reported partition coefficients(e.g.,from strongly incompatible to strongly compatible)between fluid and melt(D_(W)^(fluid/melt)).Here,we used an in situ Raman spectroscopic approach to describe the W speciation,and to quantitatively determine the Dfluid/melt of individual and total W species in granite melts and coexisting Na2WO4 solutions at elevated temperatures(T;700–800C)and pressures(P;0.35–1.08 GPa).Results show that WO_(4)^(2-)and HWO4are predominant W species,and the fractions of these two species are similar in melt and coexisting fluid.The partitioning behaviors of WO_(4)^(2-)and HWO4are comparable,exhibiting strong enrichment in the fluid.The total DW fluid/melt ranges from 8.6 to 37.1.Specifically,DW fluid/melt decreases with rising T–P,indicating that shallow exsolution favors enrichment of W in evolved fluids.Furthermore,Rayleigh fractionation modeling based on the obtained D_(W)^(fluid/melt)data was used to describe the fluid exsolution processes.Our results strongly support that fluid exsolution can serve as an important mechanism to generate W-rich oreforming fluids.This study also indicates that in situ approach can be used to further investigate the geochemical behavior of ore-forming elements during the magmatic-hydrothermal transition,especially for rare metals associated with granite and pegmatite.

Functionalization of in vivo tissue-engineered living biotubes enhance patency and endothelization without the requirement of systemic anticoagulant administration

Vascular regeneration and patency maintenance,without anticoagulant administration,represent key developmental trends to enhance small-diameter vascular grafts(SDVG)performance.In vivo engineered autologous biotubes have emerged as SDVG candidates with pro-regenerative properties.However,mechanical failure coupled with thrombus formation hinder translational prospects of biotubes as SDVGs.Previously fabricated poly(ε-caprolactone)skeleton-reinforced biotubes(PBs)circumvented mechanical issues and achieved vascular regeneration,but orally administered anticoagulants were required.Here,highly efficient and biocompatible functional modifications were introduced to living cells on PB lumens.The 1,2-dimyristoyl-sn-glycero-3-phosphoethanolamine-N-methoxy(DMPE)-PEG-conjugated anti-coagulant bivalirudin(DPB)and DMPE-PEG-conjugated endothelial progenitor cell(EPC)-binding TPS-peptide(DPT)modifications possessed functionality conducive to promoting vascular graft patency.Co-modification of DPB and DPT swiftly attained luminal saturation without influencing cell viability.DPB repellent of non-specific proteins,DPB inhibition of thrombus formation,and DPB protection against functional masking of DPT’s EPC-capture by blood components,which promoted patency and rapid endothelialization in rat and canine artery implantation models without anticoagulant administration.This strategy offers a safe,facile,and fast technical approach to convey additional functionalization to living cells within tissue-engineered constructs.

非药物戒烟干预对肺癌筛查高危人群戒烟效果的网状Meta分析

目的采用网状Meta分析评价不同非药物戒烟干预措施对肺癌筛查高危人群戒烟的疗效。方法对Pubmed、Medline(Ovid)、PsycINFO、中文期刊网全文数据库(CNKI)、万方数据库、维普数据库进行检索,检索期限均从2010年01月至2020年09月公开发表的随机对照临床试验。按照纳排标准对检索文献进行筛选,并进行质量评价和提取数据,采用Stata 14.0软件进行统计分析。结果共纳入文献28篇,共纳入34640例高危人群,涉及的干预措施包括5R简短戒烟干预、认知行为疗法、AWARD模式戒烟干预、动机性访谈、网络干预、电话干预、激励机制+电话干预、网络+电话干预、常规治疗和空白对照。网状Meta分析结果显示:在随访6个月的7 d点戒烟率指标上,根据累积曲线下面积(the surface under the cumulative ranking curve,SUCRA)得分排名依次为5R简短戒烟干预(0.88)、认知行为疗法(0.85)、AWARD模式戒烟干预(0.80)、激励机制+电话干预(0.73)、动机性访谈(0.53)、网络+电话干预(0.40)、网络干预(0.37)、电话干预(0.31)、常规治疗(0.13)和空白组(0.03)。在随访12个月的7 d点戒烟率指标上,排名依次为5R简短戒烟干预(0.94)、AWARD模式戒烟干预(0.81)、动机性访谈(0.51)、网络干预(0.40)、电话干预(0.19)和常规治疗(0.14)。结论现有证据表明,无论随访时间长短,5R简短戒烟干预方法对肺癌筛查高危人群戒烟的疗效最好。