目的探讨学生标准化病人(student as standardized patient,SSP)在麻醉专业住院医师规范化培训(简称“住培”)教学查房中应用的可行性。方法选择2020年8月—2022年8月安庆市立医院麻醉科住培医师60名,分为研究组和对照组各30名,研究组...目的探讨学生标准化病人(student as standardized patient,SSP)在麻醉专业住院医师规范化培训(简称“住培”)教学查房中应用的可行性。方法选择2020年8月—2022年8月安庆市立医院麻醉科住培医师60名,分为研究组和对照组各30名,研究组采用将SSP引入教学查房的教学模式;对照组采用传统示教模式,两组完成教学查房3个月后采用迷你临床演练评量(mini-clinical evaluation exercise,Mini-CEX)及住培医师满意度调查总结评价教学查房效果。结果研究组问诊能力、查体能力、临床诊断、人文关怀、组织效能、沟通能力以及整体表现评分均高于对照组,差异有统计学意义(P<0.001),研究组满意度高于对照组,差异有统计学意义(P<0.05)。结论麻醉科专业住培教学查房实施过程中引入SSP,调动了住培医师的学习积极性,全面提高了住培医师综合能力与职业素养,可提高麻醉专业住院医师规范化培训教学质量和内涵。展开更多
Based on the data from a special project titled China's Offshore Marine Integrated Investigation and Evaluation as well as Regional Ocean Modeling Systems(ROMS)diagnostic numerical model,we studied the influence o...Based on the data from a special project titled China's Offshore Marine Integrated Investigation and Evaluation as well as Regional Ocean Modeling Systems(ROMS)diagnostic numerical model,we studied the influence of high wind processes on the circulation and water exchange between the Bohai and Yellow Seas(BYS)in winter.The results show that the vertical structure of the Yellow Sea Warm Current(YSWC)is relatively uniform under condition of high winds,showing obvious barotropic features.However,this flow is not a stable mean flow,showing strong paroxysmal and reciprocating characteristics.A comparison of the changes in sea level suggests that the intensity of the northwards upwind flow is consistent with the abnormal fluctuations in the sea level.It indicates that the upwind flow is closely related to the water exchange between the BYS.The impact of high wind processes on the water exchange between the BYS is enormous.It can make the flux through the Bohai Strait,as well as that through the mouth of each constituent bay(i.e.,Liaodong Bay,Bohai Bay,and Laizhou Bay)far greater than usual,resulting in a significant increase in the water exchange rate.The exchange capacity,which is about 8%of the total volume of the Bohai Sea,can be completed in a few days.Therefore,the water exchange of the Bohai Sea may be completed by only a few occasional high wind processes in winter.展开更多
On the basis of the conductivity temperature depth(CTD)observation data off the coast of the Philippines(7.5°–18°N,130°E–the east coast of the Philippines)in the fall of 2005,the water mass distributi...On the basis of the conductivity temperature depth(CTD)observation data off the coast of the Philippines(7.5°–18°N,130°E–the east coast of the Philippines)in the fall of 2005,the water mass distribution,geostrophic flow field,and heat budget are examined.Four water masses are present:the North Pacific Tropical Surface Water,the North Pacific Sub-surface Water,the North Pacific Intermediate Water,and the Antarctic Intermediate Water(AAIW).The previous three corresponded with the North Equatorial Current(NEC),the Kuroshio Current(KC),and the Mindanao Current(MC),respectively.AAIW is the source of the Mindanao Undercurrent.The mass transport of NEC,KC,and MC is 58.7,15,and 27.95Sv,respectively(relative to 1500db).NEC can be balanced by the transport across the whole transect 18°N(31.81 Sv)and 7.5°N(26.11 Sv)but not simply by KC and MC.Direct calculation is used to study the heat flux.In sum,1.45PW heat is transported outwards the observed region,which is much more than that released from the ocean to the air at the surface(0.05PW).The net heat lost decreased the water temperature by 0.75℃each month on average,and the trend agreed well with the SST change.Vertically,the heat transported by the currents is mainly completed in the upper 500 m.展开更多
目的评价静脉输注右美托咪定对甲状腺手术患者术后恢复质量的影响。方法选取2020年8月-2021年4月我院择期行甲状腺手术患者80例,按照随机数字表法分为右美托咪定组(D组)和对照组(C组),每组40例。D组于麻醉诱导前静脉输注右美托咪定负荷...目的评价静脉输注右美托咪定对甲状腺手术患者术后恢复质量的影响。方法选取2020年8月-2021年4月我院择期行甲状腺手术患者80例,按照随机数字表法分为右美托咪定组(D组)和对照组(C组),每组40例。D组于麻醉诱导前静脉输注右美托咪定负荷量1μg/kg,时间为10 min,继以0.4μg/(kg·h)的速度持续输注至手术结束前30 min;C组则输注等容量生理盐水。比较两组手术时间、麻醉时间、瑞芬太尼用量、QoR-15评分、VAS评分、术后镇痛补救和恶心呕吐发生情况。结果两组手术时间和麻醉时间比较,差异无统计学意义(P>0.05);D组瑞芬太尼用量少于C组,差异有统计学意义(P<0.05);D组术后第1天身体舒适度、情绪状态、疼痛和QoR-15总评分均高于C组,差异有统计学意义(P<0.05),两组心理支持和身体独立性评分比较,差异无统计学意义(P>0.05);D组术后2、4、8、12 h VAS评分低于C组,差异有统计学意义(P<0.05);两组术后24 h VAS评分比较,差异无统计学意义(P>0.05);D组术后第1次需要镇痛补救的时间长于C组,需要镇痛补救的人数、术后曲马多总用量以及恶心呕吐发生率低于C组,差异有统计学意义(P<0.05)。结论静脉输注右美托咪定可以改善甲状腺手术患者的术后恢复质量,提供良好的术后镇痛,降低术后恶心呕吐发生率。展开更多
基金Supported by the National Natural Science Foundation of China(Nos.41506034,41676004,41376001,41430963)the Basic Scientific Fund for National Public Research Institutes of China(No.GY0213G02)+1 种基金the National Program on Global Change and Air-Sea Interaction(No.GASIGEOGE-03)the National Key Research and Development Program(No.2016YFA0600900)
文摘Based on the data from a special project titled China's Offshore Marine Integrated Investigation and Evaluation as well as Regional Ocean Modeling Systems(ROMS)diagnostic numerical model,we studied the influence of high wind processes on the circulation and water exchange between the Bohai and Yellow Seas(BYS)in winter.The results show that the vertical structure of the Yellow Sea Warm Current(YSWC)is relatively uniform under condition of high winds,showing obvious barotropic features.However,this flow is not a stable mean flow,showing strong paroxysmal and reciprocating characteristics.A comparison of the changes in sea level suggests that the intensity of the northwards upwind flow is consistent with the abnormal fluctuations in the sea level.It indicates that the upwind flow is closely related to the water exchange between the BYS.The impact of high wind processes on the water exchange between the BYS is enormous.It can make the flux through the Bohai Strait,as well as that through the mouth of each constituent bay(i.e.,Liaodong Bay,Bohai Bay,and Laizhou Bay)far greater than usual,resulting in a significant increase in the water exchange rate.The exchange capacity,which is about 8%of the total volume of the Bohai Sea,can be completed in a few days.Therefore,the water exchange of the Bohai Sea may be completed by only a few occasional high wind processes in winter.
基金supported by the National Natural Science Foundation of China (Nos. 41676004, 41506034, 41376001, 41376038, 41806123, 41430963)the Basic Scientific Fund for National Public Research Institutes of China (No. GY0213G02)+1 种基金the National Major Scientific Research Program (No. 2015CB954300)the National Science and Technology Major Project (No. 2016ZX05057015)
文摘On the basis of the conductivity temperature depth(CTD)observation data off the coast of the Philippines(7.5°–18°N,130°E–the east coast of the Philippines)in the fall of 2005,the water mass distribution,geostrophic flow field,and heat budget are examined.Four water masses are present:the North Pacific Tropical Surface Water,the North Pacific Sub-surface Water,the North Pacific Intermediate Water,and the Antarctic Intermediate Water(AAIW).The previous three corresponded with the North Equatorial Current(NEC),the Kuroshio Current(KC),and the Mindanao Current(MC),respectively.AAIW is the source of the Mindanao Undercurrent.The mass transport of NEC,KC,and MC is 58.7,15,and 27.95Sv,respectively(relative to 1500db).NEC can be balanced by the transport across the whole transect 18°N(31.81 Sv)and 7.5°N(26.11 Sv)but not simply by KC and MC.Direct calculation is used to study the heat flux.In sum,1.45PW heat is transported outwards the observed region,which is much more than that released from the ocean to the air at the surface(0.05PW).The net heat lost decreased the water temperature by 0.75℃each month on average,and the trend agreed well with the SST change.Vertically,the heat transported by the currents is mainly completed in the upper 500 m.
文摘目的评价静脉输注右美托咪定对甲状腺手术患者术后恢复质量的影响。方法选取2020年8月-2021年4月我院择期行甲状腺手术患者80例,按照随机数字表法分为右美托咪定组(D组)和对照组(C组),每组40例。D组于麻醉诱导前静脉输注右美托咪定负荷量1μg/kg,时间为10 min,继以0.4μg/(kg·h)的速度持续输注至手术结束前30 min;C组则输注等容量生理盐水。比较两组手术时间、麻醉时间、瑞芬太尼用量、QoR-15评分、VAS评分、术后镇痛补救和恶心呕吐发生情况。结果两组手术时间和麻醉时间比较,差异无统计学意义(P>0.05);D组瑞芬太尼用量少于C组,差异有统计学意义(P<0.05);D组术后第1天身体舒适度、情绪状态、疼痛和QoR-15总评分均高于C组,差异有统计学意义(P<0.05),两组心理支持和身体独立性评分比较,差异无统计学意义(P>0.05);D组术后2、4、8、12 h VAS评分低于C组,差异有统计学意义(P<0.05);两组术后24 h VAS评分比较,差异无统计学意义(P>0.05);D组术后第1次需要镇痛补救的时间长于C组,需要镇痛补救的人数、术后曲马多总用量以及恶心呕吐发生率低于C组,差异有统计学意义(P<0.05)。结论静脉输注右美托咪定可以改善甲状腺手术患者的术后恢复质量,提供良好的术后镇痛,降低术后恶心呕吐发生率。
