Design and application analysis of public health emergency training based on instructional system design model / 中华医学教育探索杂志

Objective:In order to improve the staff's ability to deal with public health emergencies, a third-class hospital in Beijing has made efforts to improve the emergency response ability of all staff members to achieve zero infection, and to carry out vocational training and assessment of all staff.Methods:The instructional system design (ISD) model system is used to design the training course. The online learning, electronic examination paper assessment and on-site training of people in the hospital were analyzed by Excel and SPSS 22.0.Results:After training, the average scores of trainees increased from 84 points to 100 points, and the average answering time was shortened from 308 s to 179 s. There were differences in the assessment scores before and after training for personnel with different professional titles, and there were differences in the assessment scores before and after training for personnel between different departments.Conclusion:In case of public health emergency, it is necessary to train and assess the whole staff. The application of ISD model is helpful to make training plan quickly. The application of online learning assessment is the first effective way of emergency training.

Alarmins act both an immune and a disease alert / 中国免疫学杂志

Alarmins known as danger associated molecular patterns(DAMPs) are released into the extracellular endogenous bi-ological mediate by white blood cells and epithelial cells when body in a state of tissue injury and inflammation or physiological stress. Immunological and adaptive immune responses are activated and strengthened by chemotaxis and activation of antigen presenting cells(APC). They are closely associated with the disease development and outcome,and have important guiding significance for clinical diagnosis and treatment.

Clinical observation on electroacupuncture and Chinese drug for treatment of oligospermia and asthenospermia of the male infertility patient / 中国针灸

<p><b>OBJECTIVE</b>To compare therapeutic effects of acupuncture and Chinese drug on oligospermia and asthenospermia in the male infertility.</p><p><b>METHODS</b>Two hundred and thirty-one cases were divided into 3 groups. The electroacupuncture group (n = 71) were treated with acupuncture at Qihai (CV 6), Guanyuan (CV 4), Zhongji (CV 3), etc., the Chinese drug group (n = 82) with oral administration of Chinese drug Wuzi Yanzong Pill and the acupuncture plus medication group (n = 78) with both electroacupuncture and oral administration of the Chinese drug. Changes of semen routine examination and the acrosome enzyme activity were observed before and after treatment in the 3 groups.</p><p><b>RESULTS</b>The effective rate was 67.6% in the electroacupuncture group, 68.3% in the Chinese drug group and 84.6% in the acupuncture plus medication group, the acupuncture plus medication group being significantly better than both the electroacupuncture and the Chinese drug group (P < 0.05); after treatment, the semen density, vitality and the acrosome enzyme activity were increased in the 3 groups, with more obvious increase in the acupuncture plus medication group.</p><p><b>CONCLUSION</b>Both electroacupuncture and Chinese drug Wuzi Yanzong Pill can improve the semen quality, increase the pregnancy rate in the patient of male interfile with oligospermia and asthenospermia, and the effect of the combined treatment of acupuncture and Chinese drug is the best.</p>

Clinical analysis of patients with actue renal failure at high altitude / 中华急诊医学杂志

Objective To analyze the etiologies,clinical characteristics and prognostic factors of patients with acute renal failure(ARF)admitted to the hospital at high altitude.Method This retrospective study included clinical data of patients with acute renal failure in the General Hospital of Tibet Military Command from May 2001 to April,2006.Results There were 85 male patients and 63 female patients with mean age(42.4?18.1)years old.Among 148 patients with acquired ARF,52.7% was iatrogenic or nosoeomal origin, demonstrating a trend of increasing.The ARF included pre-renal(n=48,32.4%),renal parenchymal(n= 90,60.8%)and post-renal(n=10,6.8%)in origin.Acute high altitude sickness(n=20)was the major causes of pre-renal ARF.Renal parenchymal ARF could be classified into glomerular vascular lesions(n=24), acute tubular necrosis(n=53),acute interstitial nephritides(n=12),and contusion of unitesticle(n=1).of 90 cases of renal parenchymal ARF,39 patients(43.3%)were induced by medicines.Lithiasis was the major causes of post-renal ARF.The mortality of ARF in our study was 42.6%.The mortality of patients contracted ARF in hospital was much higher than that of patients community ARF in community(55.1 vs 23.6%;P=0.01). There was no significant differences of the mortality between the patients with and without dialysis treatment. Univariate analysis showed that prognosis was correlated with age,the presence of hematuria and oliguria or anuria Hb,and the number of organ system failures.The logistic regression showed that age,Hb and the number of organ system dysfunction were the predictors of mortality.Conlusions The major causes of ARF at high altitude were acute high altitude sickness and the use of medicines with nephrotoxicity.The morbility and mortality of nosocomisl ARF increased significantly.Prevention of MODS is a key management to decrease mortality in severe ARF.

Outcome of the kidney transplant recipients with chronic hepatitis B virus / 中南大学学报(医学版)

OBJECTIVE@#To investigate the outcome of the kidney transplant recipients with different grades and stages of chronic hepatitis B virus after receiving renal transplantation for 3 years.@*METHODS@#Thirty nine cases of kidney transplant recipients with hepatitis B virus and 20 cases of kidney transplant recipients (control group) between August 2000 and February 2002 were studied. Before the transplantation, the patients were divided into 4 groups: the mild hepatitis group (Group A, n = 8), the middle hepatitis group (Group B, n = 6), the severe hepatitis group (Group C, n =5) according to pathological diagnosis by percutaneous liver biopsy, and the control group (Group D). During the 3 year follow-up, the serum creatinine, alanine aminotransferase, g-Glutamyl transferase (GGT), total bilirubin, direct bilirubin, prothrombin time, cyclosporine trough concentration, urinary protein excretion, the HBV markers, HBV-DNA, albumin (A), globulin (G), the hepatic fibrosis markers and Child-Pugh score were studied at intervals. All patients received ultrasound examination every year. Two patients received repeated liver biopsy at the end of the follow-up in the hepatitis groups.@*RESULTS@#The outcome of Group A and Group D was fine. In Group B, GGT level was significantly elevated (P < 0.05) sixth months after the operation, the Child-Pugh score of 2 patients were B, the liver pathohistological changes in another 2 patients were in severe stage in the endpoint. In Group C, GGT values had higher base-line (P <0.01) during the follow-up. Albumin were lower and globulin were higher than normal at the beginning of the 24th month. At the end of the follow-up, the Child-Pugh scores of all patients were B or C (B = 3, C = 2), 4 patients had end-stage cirrhosis, one died of hepatic cancer and the survival rate was 40% in Group C.@*CONCLUSION@#The outcome of the 3 groups is different. The pathohistological diagnosis by liver biopsy is important for patient selection receiving renal transplantation.