基于SPOC的翻转课堂模式在医学生院前创伤急救能力培养中的应用

目的 探讨基于小规模限制性在线课程(SPOC)的翻转课堂模式在急诊科医学生院前创伤急救能力培养中的应用效果。方法 选取嘉兴学院医学院临床医学专业2019级106名学生,随机分为实验组和对照组进行创伤急救教学,对照组采用传统教学授课模式,实验组采用基于SPOC的翻转课堂模式,授课结束后比较两组学生的综合成绩,并通过问卷调查学生对课程过程性评价及满意度。结果 实验组学生的技能考核成绩和综合成绩均高于对照组学生,差异均有统计学意义(t分别=12.85、10.61,P均<0.05),两组理论成绩比较,差异无统计学意义(t=-0.17,P>0.05)。与对照组比较,实验组学生的过程性评价中创伤救治课前准备度提高、学习兴趣增加、创伤包扎水平提升、课程参与度提高,课程中同学贡献度增加,差异均有统计学意义(t分别=11.38、10.37、10.46、10.04、19.27,P均<0.05)。实验组对于学习效率提升度、对课程理解程度、理论知识掌握度、临床技能掌握度及课程中教师表现五个方面评价的满意度评分均高于对照组,差异均有统计学意义(t分别=5.96、6.15、5.61、13.30、5.18,P均<0.05)。结论 基于SPOC的翻转课堂模式能提升医学生院前创伤急救实践技能,有助于提高创伤救治思维能力、提升包扎水平、增加学习兴趣、提高课程参与度。

中药处方犬粮的安全性评价及其对犬创伤恢复能力的影响

[目的]评价中药处方犬粮的安全性及其对犬创伤恢复能力的影响。[方法]选取1龄中华田园犬8只,随机分为试验组和对照组,每组4只、雌雄各半。预试1周后,对照组饲喂普通犬粮、试验组饲喂中药处方犬粮4周,于试验开始前和结束后测定体重并采血,分析体重和血液指标的变化。对试验犬进行腹壁切开术,观察各组犬创口愈合情况。[结果]中药处方犬粮能极显著提高犬体重和增加犬血液中红细胞、白细胞、中性粒细胞、淋巴细胞数目(P<0.01),显著增加血红蛋白和单核细胞数目(P<0.05)。试验前后,试验组犬碱性磷酸酶含量显著增加(P<0.01),其他血液生化指标变化不显著(P>0.05)。剖腹伤口愈合时间试验组显著短于对照组(P<0.05)。[结论]该处方犬粮可安全用于宠物临床,对创口愈合具有一定的促进作用。

新形势下非现役文职护士战创伤救护能力在职培养模式调查分析

非现役文职护士是按照规定的编制聘用到军队工作,履行现役军官(文职干部)同类岗位相应职责的非现役人员[1]。随着部队改革的进一步深入,文职人员在部队中所占比例不断增大,所肩负的任务也日益增多。就文职护士而言,不仅要保障后勤医疗工作,而且参与重大作战任务也越来越多,如何适应新形势下作战部队后勤医疗保障需要,目前尚未形成一个统一的培训模式。为进一步提高非现役文职护士战创伤救护能力,探讨适合新形势下部队卫勤保障需要的培养模式,现将相关调查情况汇报如下。

谈声乐教师应具备的基本能力

声乐教学是一门综合艺术,既要培养学生获得科学的发声方法,又要处理好歌曲作品,还要以某种乐器伴奏作为教学的辅助手段。因此,作为一名声乐教师,只有具备了多方面的知识、修养和能力,才能培养出更多更好的声乐人才。

创伤救治体系管理模式的构建研究

目的探讨创伤救治体系管理模式的构建。方法将2019年11月—2020年5月构建创伤救治体系管理模式前救治78例创伤患者设为对照组,将2020年6—12月构建创伤救治体系管理模式后救治的82例创伤患者设为观察组。对比两组创伤救治团队成员综合能力、创伤救护时效、生命支持完成情况及满意度。结果与对照组相比,研究组学习能力、科研能力、工作态度、职业素质、专业实践能力、协调与应急能力、团队配合能力、综合处置能力更高,差异有统计学意义(P<0.05)。与对照组相比,研究组创伤救治团队到达时间、早期治疗处理时间、挂号、分诊时间、血液相关指标送检时间、首次CT检查时间更短,差异有统计学意义(P<0.05)。与对照组相比,研究组8 min高级生命救治完成率、手术到达时间完成率更高,差异有统计学意义(P<0.05)。与对照组满意度评分(30.81±3.06)分相比,研究组满意度评分(35.21±3.01)分更高,差异有统计学意义(P<0.05)。结论创伤救治体系管理模式可提供创伤救治团队成员综合能力、创伤救护时效、生命支持完成情况及满意度,具有可靠性、实用性及科学性,对临床创伤救治具有重要意义。

战创伤急救模拟训练的应用

目的探讨战创伤急救模拟训练在提高军队护理人员战创伤救治能力中的效果。方法选取2017年1月—2018年1月某部队医院战创伤学组护理人员48名,进行战创伤急救模拟训练,对培训前后护理人员的战救理论知识、战救技术、战救综合能力进行考核比较。结果培训后,护士的战救理论知识、战救技能、战创伤情境模拟救护案例得分等均有明显提高,培训前后比较差异有统计学意义﹙P<0.05﹚。结论战创伤急救模拟训练能够提高军队护理人员的战救理论知识、战救技术和特殊环境下战创伤综合救护能力,提高护理备战练兵活动的效果。

The Interweaving of Native Culture and Traditional Healing Practices in the Treatment of Trauma Lessons Learned

The premise of this abstract focuses on lessons learned as a clinician through the process of being invited into the homes, lives and stories of trauma and incredible resilience for native survivors of Indian residential schools. Through the process of unravelling stories of past trauma with a view to recovery/freedom from symptoms, meaningful therapy requires the weaving together of traditional beliefs and practices with trauma focused cognitive behavioral therapy approaches. Culturally, the relevant treatment respects traditional beliefs and focuses on their innate resiliency historically within their culture. As a clinician invited intimately through the therapeutic relationship into the lives of First Nations abuse survivors, the healing power of cultural identity was discovered along them. Similarly, the author＇s role as therapist was one of teachers, who guided them through the process of telling their stories to the peace and acceptance utilizing therapeutic techniques from an eclectic spectrum of therapeutic approaches. All the while, it should interweave their stories and native beliefs into the therapy journey. It was a process of co-creating healing through a mutual respect of the shared roles as guide, teacher, story teller and healer. Culturally, the relevant psychotherapy requires the weaving of two world views to create a basket of healing.

Reduced capacity of dendritic cells from trauma-hemorrhage mice in initiating delayed-type hypersensitivity to fluorescein isothiocyanate

Objective： To study the role of dendritic cells （DCs） in initiating delayed-type hypersensitivity （DTH） to fluores- cein isothiocyanate （FITC） after trauma-hemorrhage in mice. Methods： Inbred BALB/c mice （6-8 weeks old, male） were epicutaneously sensitized with FITC 12 hours, 1 day, 2 days, 4 days and 7 days after closed bilateral femur fractures combined with hemorrhage. And 5 days after sensitization, DTH was evaluated by ear swelling after a challenge of FITC. Draining lymph node cells were examined for the percentages of FITC-positive cells, cluster of differentiation （CD）11c positive cells and major histocom- patibility complex II （MHC II）-positive cells by means of flow cytometry. In vitro proliferative responses of syngeneic lymphocytes and in vivo passive transfer of DTH to naive recipients induced by isolated DCs from the draining lymph nodes were determined. Results： The time of DTH to FITC decreased more significantly in the mice with trauma-hemorrhage （12 hours to 4 days） than in the mice with sham injury. After sensitization, the relative percentages of FITC^＋ cells, FITC^＋/ CD 11c^＋ cells and FITC^＋/CD 11c^＋/MHC II^＋ cells from the draining lymph nodes were all significantly reduced following injury. And the capacity of DCs from the draining lymph nodes in stimulating proliferative responses of lymphocytes and transferring DTH to naive recipients were also inhibited after injury. Conclusions： Trauma-hemorrhage induces repressive DTH in mice, which may be attributed, at least partially, to the reduced trafficking of DCs into the draining lymph nodes and insufficient maturation during DC migration.