医联体模式下糖尿病视网膜病变筛查模式探索

目的探究在医联体内进行糖尿病视网膜病变筛查模式的方法。方法纳入2019年1—12月重庆医科大学附属大学城医院与所属医联体单位明确诊断糖尿病的患者1980例为研究对象。对患者进行糖尿病视网膜病变相关眼科检查及问卷调查,评价患者生活方式及糖尿病视网膜病变发生情况。进而讨论在目前医联体模式下为患者提供健康教育、疾病预防、诊断、治疗、康复、护理等连续医疗服务的管理模式。结果按照纳入标准和排除标准,最终符合要求的患者763例。对这些患者进行资料统计,发现男女比例差异无统计学意义(P>0.05);身体质量指数(body mass index,BMI)检查超重患者比例较高,空腹血糖>7.0 mmol/L的患者占比68.68%,15.33%的患者出现糖尿病视网膜病变。糖尿病视网膜病变患者中,出现严重糖尿病视网膜病变患者为11.27%。结论构建和实施医联体模式下糖尿病视网膜病变筛查预防模式,能有效促进患者糖尿病视网膜病变预防和治疗,防止严重并发症的发生。

中央国术馆馆刊及其社会功能

对中央国术馆馆刊及其社会功能进行分析。中央国术馆在武术意识转变、传承传播、训练教学、理论研究、思想延承等方面做出了积极探索,其创办的《中央国术馆汇刊》《中央国术旬刊》《国术周刊》3种刊物,为近代武术发展注入了新能量:强有力地推动了尚武思潮,为武术走上竞赛道路扫除主观障碍,促进武术技术的整合、传承和扩散,诱发尚武者从科学和人文社会学科学理的角度认识武术。

Dryland Expansion in Northern China from 1948 to 2008

This study examines the expansion of drylands and regional climate change in northern China by analyzing the variations in aridity index （AI）, surface air temperature （SAT）, precipitation and potential evapotranspiration （PET） from 1948 to 2008. It is found that the drylands of northern China have expanded remarkably in the last 61 years. The area of drylands of the last 15 years （1994--2008） is 0.65 × 106 km2 （12%） larger than that in the period 1948-62. The boundary of drylands has extended eastward over Northeast China by about 2 °of longitude and by about 1° of latitude to the south along the middle- to-lower reaches of the Yellow River. A zonal band of expansion of semi-arid regions has occurred, stretching from western Heilongjiang Province to southern Gansu Province, while shifts to the east of semi-arid regions in dry subhumid regions have also occurred. Results show that the aridity trend of drylands in northern China is highly correlated with the long-term trend of precipitation and PET, and the expansion of semi-arid regions plays a dominant role in the areal extent of drylands, which is nearly 10 times larger than that in arid and subhumid regions.

Comparison of Dryland Climate Change in Observations and CMIP5 Simulations

A comparison of observations with 20 climate model simulations from the Coupled Model Intercomparison Project, Phase 5 （CMIP5） revealed that observed dryland expansion amounted to 2.61 × 10^6 km^2 during the 58 years from 1948 to 2005, which was four times higher than that in the simulations （0.55 × 10^6 km^2）. Dryland expansion was accompanied by a decline in aridity index （AI） （drying trend） as a result of decreased precipitation and increased potential evapotranspiration across all dryland subtype areas in the observations, especially in the semi-arid and dry subhumid regions. However, the CMIP5 multi-model ensemble （MME） average performed poorly with regard to the decreasing trends of AI and precipitation. By analyzing the factors controlling AI, we found that the overall bias of AI in the simulations, compared with observations, was largely due to limitations in the simulation of precipitation. The simulated precipitation over global drylands was substantially overestimated compared with observations across all subtype areas, and the spatial distribution of precipitation in the MME was largely inconsistent in the African Sahel, East Asia, and eastern Australia, where the semi-arid and dry subhumid regions were mainly located.

创伤控制骨科理念用于严重多发伤的效果观察

目的探讨创伤控制骨科理念用于严重多发伤的效果。方法选择义乌市中心医院2016年3月至2018年3月收治的急诊严重多发伤患者74例,采用随机数字表法分为对照组37例、观察组37例。对照组采用一次性确定手术治疗;观察组采用在创伤控制骨科理念下急诊严重多发伤的救治措施。比较两组体温恢复时间、凝血酶原(PT)恢复时间、休克纠正时间、并发症发生情况及治疗效果。结果观察组体温恢复时间、PT恢复时间、休克纠正时间分别为(6.73±3.29)h、(5.18±1.89)h、(5.84±3.14)h,均短于对照组的(9.85±1.62)h、(9.86±2.41)h、(8.45±0.87)h,差异均有统计学意义(t=5.175、9.295、4.873,均P<0.05)。观察组并发症发生率为8.11%(3/37),低于对照组的32.43%(12/37),差异有统计学意义(χ^2=6.773,P<0.05)。观察组治愈率为97.30%(36/37),高于对照组的91.89%(34/37),但差异无统计学意义(P>0.05)。结论创伤控制骨科理念下急诊严重多发伤的救治效果明显,是一种有效、可行的方法。