Evaluation on the effect of standardized training of intravenous therapy nursing technology for community nurses / 中国实用护理杂志

Objective:To provide basis for carrying out standardized training courses of intravenous therapy nursing technology for community nurses and improving the level of intravenous therapy for community nurses.Methods:This was a quasi experimental study. From May to July 2020, 260 nurses from 20 community health service institutions in Dalian were investigated with the convenient sampling method and self-designed evaluation scale for venous treatment nursing skills of community nurses and were given standardized training. The changes of venous treatment nursing skills of community nurses before and after training were compared.Results:The scores of theoretical knowledge, skill operation, complication nursing and health education of the intravenous therapy nursing skill evaluation scale for community nurses after training were (15.32 ± 1.67), (18.26 ± 2.46), (19.32 ± 1.57) and (16.33 ± 1.02) points, which were higher than (10.23 ± 2.43), (12.35 ± 3.42), (14.36 ± 2.48) and (12.31 ± 1.47) points before training. The difference was statistically significant ( t values were 1.32-2.46, all P<0.05). After the training, the total score of the evaluation scale of community nurses' intravenous treatment nursing skills was (77.41 ± 1.21)points, which was higher than that before the training (55.38 ± 1.35) points, with a statistically significant difference ( t=2.38, P<0.05). Conclusions:Higher medical institutions should construct venous treatment training group, strengthen the training of community nurses on intravenous therapy, improve the quality of community intravenous therapy services, and promote the better functioning of community health service institutions.

Progress of research on evaluation indicators and standards about high-speed train comfort / 中华劳动卫生职业病杂志

The rapid development of high-speed railway in China has proposed higher requests for the comfort level of high-speed trains. However, there is no internationally unified evaluation criterion for high-speed train comfort currently, which therefore substantially affects the comparability and standardization of research results for high-speed train comfort. This paper systematically reviews the research literature about evaluation indicators and standards related to high-speed train comfort, and finds that there is currently no unified definition, evaluation indicators, as well as evaluation criterion for high-speed train comfort. Most current evaluation criteria are based on a single indicator. Some indicators are simultaneously developed by different apartments and differ between each other, and there is no comprehensive indicator or criteria for high-speed train comfort, restricting the comparison of high-speed train comfort across regions. It is recommended that the administrative department of high-speed railroad in China should organize experts to establish a unified definition of high-speed train comfort, comprehensive evaluation indicators and relevant judgment criteria for high-speed train comfort, in face of the rapid development and globalization of high-speed trains.

Monitoring and analysis of secondary water supply quality of passenger train in a certain district / 公共卫生与预防医学

Objectives To investigate the sanitary condition of the secondary water supply for passenger trains in the administration area, to evaluate the influencing factors of the secondary water supply system for passenger trains, and to put forward suggestions for improving the water quality of the secondary water supply for passenger trains. Methods The water quality of secondary water supply of 48 trains of 24 pairs of CRH type passenger trains and 160 trains of 10 pairs of type 22 passenger trains and 30 pairs of type 25 passenger trains in Lanzhou Railway Bureau in 2019 was analyzed and compared. Results The qualification rate of 208 samples tested was 73.08%. The qualification rate of secondary water supply quality of type 22 and 25 passenger trains was 62.50% and 66.67%, respectively, and the difference was not statistically significant（χ2=0.23 ，P＞0.05）. The qualification rate of secondary water supply of CRH passenger train was 97.92%, which was statistically significantly different compared with that of type 22 and 25 passenger trains（χ2=18.40, 18.15, P2=0.056, 0.054, 0.056, 0.22, 0, and 0.22, P>0.05). The total number of bacterial colonies, total coliform, turbidity and iron in the secondary water supply of type 22 and 25 passenger trains did not meet the standard, while only one water sample for the secondary water supply of CRH passenger trains did not meet the standard. Conclusion The quality of secondary water supply of CRH passenger train is obviously better than that of type 22 and 25 passenger trains. Changing the position of defecation port and water injection pipe of type 22 and 25 passenger trains, selecting non direct train defecation collection system, or adding appropriate amount of chlorine disinfectant into the water supply hose can significantly improve the qualification rate of bacteriological indexes of secondary water supply of passenger trains.

Training intensity distribution on running time in amateur endurance runners: a scoping review / Distribución de intensidades de entrenamiento sobre el tiempo de carrera en corredores recreativos de resistencia: revisión de alcance

Problem: Intensity in endurance training is important for improving race time; its optimal handling in amateur runners has not been extensively studied. The polarized training intensity distribution (TID) model emerges as a possibility to reduce race time; however, effect of this model remains to be demonstrated compared to other TID models. Objective: The objective of this study is to explore the current state of the evidence and its the gaps, according to the effect of the polarized TID model on race time in amateur runners compared to other TID models. Method: A scoping review without date restrictions was carried out in PubMed, EBSCO, SciELO, LILACS, and Google Scholar. Randomized controlled studies, quasi-experimental studies, and case studies, which comprise polarized TID model in amateur runners on race time, were include. Results: Five studies evaluated the effect on running time using the polarized TID model compared to other models in amateur runners; four of them did not show differences between groups in the race times in two, five, and ten km. Only one study showed significant diferences in the race time at 21 km. Conclusions: The model with polarized TID did not show significant differences in race time compared to other models, except for a case report in which the polarized TID was higher by 21 km compared to the threshold TID: 1 hour. 20 min. 22 seconds and 1 hour. 26 min. 34s, respectively. The scarce evidence found, the heterogeneity in the distances in the evaluated race time, the distribution of zones in the same TID, the duration of the interventions, and the monitoring of the loads, are the main limitations found in the studies. The polarized TID could contribute to adherence, lower perception of effort, and injury prevention. However, this must be tested in future studies.

Problema: La intensidad en el entrenamiento de la resistencia es importante para mejorar el tiempo de carrera; su manipulación óptima en corredores recreativos no ha sido estudiada ampliamente. El modelo de distribución de intensidad del entrenamiento (DIE) polarizado emerge como posibilidad para reducir el tiempo de carrera. Sin embargo, falta demostrar su efecto comparado con otros modelos de DIE. Objetivo: Explorar el estado actual de la evidencia científica y sus vacíos respecto al efecto del modelo de DIE polarizado sobre el tiempo de carrera en corredores recreativos, en comparación con otros modelos de DIE. Método: Se realizó una revisión de alcance sin restricción de fechas en PubMed, EBSCO, SciELO, LILACS y Google Scholar. Se incluyeron estudios controlados aleatorios, estudios cuasiexperimentales y estudios de caso, que tuvieran como DIE el modelo polarizado en corredores recreativos sobre el tiempo de carrera. Resultados: Cinco estudios evaluaron el efecto en el tiempo de carrera usando el modelo de DIE polarizado comparado con otros modelos en corredores recreativos; cuatro de ellos no mostraron diferencias entre grupos en los tiempos de carrera en dos, cinco y diez km. Solo un estudio mostró diferencias significativas en el tiempo de carrera en 21 km. Conclusiones: El modelo con DIE polarizado no mostró diferencias significativas en el tiempo de carrera comparado con otros modelos, a excepción de un reporte de caso en el cual la DIE polarizado fue superior en 21 km comparado la DIE umbral: 1 hora. 20 min. 22 s y 1 hora. 26 min. 34 s, respectivamente. La escasa evidencia encontrada, la heterogeneidad en las distancias en el tiempo de carrera evaluado, la distribución de zonas en una misma DIE, la duración de las intervenciones y la monitorización de las cargas son las principales limitaciones encontradas en los estudios. La DIE polarizado podría contribuir a la adherencia, a una menor percepción del esfuerzo y a la prevención de lesiones. No obstante, esto debe ser probado en estudios futuros.

Prevalencia de bloqueo residual en la Unidad de Cuidados Postanestésicos del Hospital Metropolitano / Prevalence of residual blockade in the Postanesthetic Care Unit of the Hospital Metropolitano

RESUMEN El bloqueo residual se define como la debilidad muscular postoperatoria producida por un antagonismo incompleto de los relajantes neu-romusculares, siendo sus principales complicaciones las respiratorias. Actualmente, el mejor método de evaluación objetiva del bloqueo neuromuscular es el Tren de Cuatro (TOF). El objetivo de este estudio fue describir la prevalencia de bloqueo residual en la Unidad de Cuidados Postanestésicos (UCPA) en pacientes ASA I y ASA II sometidos a cirugía electiva y de emergencia bajo anestesia general en el Hospital Metropolitano. Se realizó un estudio observacional, descriptivo y prospectivo en 211 sujetos, donde mediante el TOF se deter-minó que la prevalencia de bloqueo residual en la UCPA fue del 8,5%, valor que se relacionó con la falta de monitorización de la función neuromuscular, determinando además que el empleo de fármacos que revierten el bloqueo neuromuscular no excluye la presencia de bloqueo residual. Se recomienda el uso rutinario de monitorización de la relajación neuromuscular para prevenir y diagnosticar el bloqueo residual, además de la administración de reversión farmacológica independientemente del tiempo quirúrgico.

ABSTRACT Residual blockade is defined as postoperative muscle weakness caused by incomplete antagonism of neuromuscular relaxants, its main complications being respiratory, currently the best method of objective evaluation of neuromuscular blockade is the Train of Four (TOF). The objective of this study was to describe the prevalence of residual block in the Post Anesthesia Care Unit (UCPA) in patients with ASA I and ASA II undergoing elective and emergency surgery under general anesthesia at the Metropolitan Hospital. An observational, descrip-tive and prospective study was conducted in 211 subjects, where it was determined that the prevalence of residual block in UCPA was 8.5% with TOF, a value that was related to the lack of monitoring of neuromuscular function, also determining that the use of drugs that reverse neuromuscular blockade does not exclude the presence of residual blockade. Routine use of neuromuscular relaxation monitoring is recommended to prevent and diagnose residual block, in addition to drug reversal administration regardless of surgical time.

Feasibility of Perioperative Diaphragmatic Ultrasound in Assessment of Residual Neuromuscular Blockade / 中国医学科学院学报

Objective To evaluate the relationship between diaphragmatic ultrasound and postoperative residual neuromuscular blockade(PRNB). Methods The patients undergoing non-thoracic and abdominal surgery under general anesthesia from August to October in 2019 were randomly enrolled from Peking Union Medical College Hospital.Diaphragmatic ultrasound was acquired pre-operation and post extubation.A 4-15 MHz probe was used to measure diaphragmatic thickness at the intersection point of 8-9 intercostal space with right anterior axillary line at the end of inspiration and expiration during quiet breathing and deep breathing(DB),and the diaphragmatic thickness fraction(DTF)was calculated.A 1-5 MHz probe was used to measure diaphragmatic excursion(DE)at the intersection point of right costal margin with midaxillary line during quiet breathing and DB.Train of four ratio(TOFr)was recorded for neuromuscular monitoring.TOFr,observer assessment of alertness and sedation score at extubation,Aldrete score at postanesthesia care unit,and postoperative pulmonary complication were recorded. Results The PRNB rate was 54.7%.The DTF-DB [31.3(21.1,45.0)vs.38.5(26.6,53.9),P=0.045] and DE-DB(2.9±1.4 vs.4.1±1.0,P<0.001)in PRNB group was lower than those in the group without PRNB.DTF-DB(r=0.351,P=0.002)and DE-DB(r=0.580,P<0.001)were correlated with TOFr. Conclusion Perioperative diaphragmatic ultrasound may be helpful for the diagnosis of PRNB.

Bioluminescence emissions from the Indian winter species of firefly Diaphanes sp.

Numerous studies have been carried out on different aspects of the light from summer-active fireflies. Characteristics of this light have led to very interesting conclusions on the chemiluminescence reaction as well as onthe nature of the light from live fireflies. Here we present a first report on bioluminescence emissions from anewly found winter-active Indian species of firefly Diaphanes sp. The steady-state emission spectrum from thisspecies comes out to be apparently similar to those from the other two Indian summer species, Luciolapraeusta and Asymmetricata circumdata: asymmetric in nature with a little bit of change in the position of thepeak wavelength and in the width of the full width at half maximum. An increase in temperature toapproximately 28C causes a red-shift in the peak wavelength, which probably indicates denaturation of theenzyme luciferase in the live, flashing condition. Emissions in the time domain reveal that the light is nevercompletely off – it decreases in intensity to a low value, sometimes very close to zero, and then increases – acharacteristic unheard-of till date. Flash durations are considerably longer than those from the two Indiansummer species; those become shorter at about 28C and increase to noticeably larger values at highertemperatures.

Profile of Cleft Lip and Cleft Palate at a Public Hospital in Southern India

Objective: To analyze the pattern of cleft lip and cleft palate cases and their operativemanagement at a tertiary-care hospital. Methods: Data of all patients (<18 year) with cleft lipand cleft palate operated between 2011 and 2016 were extracted from the records andanalyzed. Results: The final analysis included1643 cases (60.9% males). Mean (SD) age atthe time of surgery was 8.9 (10.17) years. Left-sided cleft clip was more common. Completehard palate type of cleft palate on left was present in 787 (47.90%). Primary Cleft Palaterepair was most common procedure (492, 29.9% children, followed by primary lip noseunilateral in 458 (27.9%) and lip nose revision in 298 (21.1%). Conclusion: Data on age atpresentation and procedures used for correction of cleft lip and cleft palate are presented.

Investigation and analysis of intentions and demands of nurses in a cancer hospital to study and train abroad / 中华医院管理杂志

Objective To learn the intention and demand of nurses of cancer hospitals to train abroad, so as to promote international exchange and management of nursing work. Methods Investigation was carried out by self-designed questionnaires among the nurses at the cancer hospital.The questionnaire covered the basic information of the nurses, the intention and demand of studying abroad, and information of those who have completed study abroad. The differences among different age groups were compared by descriptive statistics and χ2 test. Results Of the 700 people surveyed, 71.7% (502/700) of the nurses expect to study and train abroad.Their main purpose was to learn new nursing skills, new knowledge and nursing supervision methods.Nurses expect to study and train abroad for updating their concepts, promoting nursing skills, improving their command of a foreign language, and enhancing knowledge update ability. 54.9% (384/700)of the respondents were found with concerns for studying abroad.67.4% (33/49) of the respondents had the assessments after returning home. And 69.4% (34/49) of the respondents had more opportunities after their return. Conclusions It is important for nurses to study and train abroad.To this end, a gradient and hierarchical platform should be developed for nurses to go abroad for study under an institutionalized framework. It is also necessary to build an international communication platform and to establish a long-term evaluation and assessment mechanism.

Comparison of Different Dosages of Rocuronium on Abdominal Wound Closure / 昆明医科大学学报

Objective To evaluate the effects of different dosages of rocuronium on abdominal wound closure under general anesthesia.Methods Ninety ASA class I or II patients scheduled for elective abdominal surgery under general anesthesia were randomized into three groups with 30 cases each.Each group received rocuronium 1 time of ED95 (0.3 mg/kg),0.5 time of ED95 (0.15 mg/kg),0.2 time of ED95 (0.06 mg/kg) respectively when closing the abdominal wall.TOF recovered to 25%, 75%, 90%, time of eye-opening on command, time of head-lift for more than 5 seconds,extubation time, the rate of upper airways obstruction after extubation and the satisfaction score for the muscle relaxation to general surgeons were recorded.Results TOF values had no significantly different among the three groups before abdominal wound closure (P＞0.05).Compared with group A and group B,time of TOF in group C was significangtly increased after administration of rocuronium (P＜0.05) . Time of TOF recovery to 25%, 75%, 90%in group C were significangtly decreased (P＜0.01).Compared with group A and group B, time of eye-opening on command ,head-lift for more than 5 seconds and extubation time were significantly shorter in group C.There were 8,4,0 patients undwent upper airways obstruction among each group respectively after extubation (P＜0.05).The satisfaction score for muscle relaxation among three groups had no significant difference.Conclusion An additional administration of 0.2 time of ED95 (0.06 mg/kg) rocuronium before abdominal wound closure in abdominal surgery can achieve satisfactory muscle relaxation for surgeons.

Change of occupational stress from 1996 to 2012 among train engine drivers / 中华预防医学杂志

Objective@#To analyze the change of level of occupational stress between 1996 and 2012 among train engine drivers.@*Methods@#the cross-section investigation was conducted by using cluster sampling method, subjects included 1 116 and 1 002 passenger train engine drivers and freight train engine drivers respectively in 1996 and in 2012;occupational stressors, strains, personalities, buffering factors and individual factors were investigated by using Occupational Stress Instruments. Unconditional logistic regression analyses were performed to estimate the associations between job stressors, personalities, buffering factors and individual factors and strains. Multivariate OR(95%CI) were derived from the logistic regression models.@*Results@#From 1996 to 2012, for the passenger train engine drivers the scores of role ambiguity (17.67±5.30 vs.14.11±4.66) increased 25.32%, mental load (10.41±3.56 vs. 16.29±2.08) and physical environment (3.61±2.18 vs. 7.03±1.65) scores decreased 36.10% and 48.64% respectively, sleep disorders (18.04±9.20 vs. 13.35±4.00) and negative affectivity (2.76±1.86 vs. 2.14±1.86) scores increased 33.14% and 28.97% respectively, the differences were statistical significant (P<0.001) . For the freight train engine drivers the scores of sleep disorders (20.33±8.17 vs. 12.47±4.12) and negative affectivity (2.95±1.70 vs. 1.87±1.81) scores increased 57.75% and 60.03% respectively, positive affectivity (2.17±1.60 vs. 2.91±1.50) score decreased 25.43%, the differences were statistical significant (P<0.001) . In general, scores varies in factors related to occupational stress among freight train engine drivers were larger than those among passenger train engine drivers. The risk factor of job dissatisfaction among passenger train drivers in 1996 was insufficient superior support (OR=3.77, 95%CI: 2.23-6.37) , the risk factors in 2012 were insufficient superior support (OR=3.35, 95%CI:1.56-7.17) , poor physical environment (OR=3.61, 95%CI: 1.91-6.80), and fewer positive affectivity (OR=3.47, 95%CI: 1.75-6.82). The risk factor of job dissatisfaction among freight train drivers in 1996 and in 2012 were insufficient superior support (OR (95%CI) were 3.11 (2.31-4.19), 2.59 (1.84-3.65) , respectively).@*Conclusion@#The level of occupational stress among train engine drivers in 2012 was larger than that in 1996, the level of occupational stress among freight train drivers was larger than passenger train drivers, the interventions aimed at reducing occupational stress in the Chinese train engine drivers should take into account promotion for design of job organization and contents and organization management style.

Application of "Dual-mentor System" in the standardized residency training in cardiovascular internal medicine / 中华医学教育探索杂志

Objective To explore the application effect of the dual-mentor system in the standardized training in cardiovascular internal medicine. Methods 40 physicians received from January to December in 2016 and 40 from January to December in 2017 were selected as the control group and the observation group respectively. The control group was administrated with the traditional training mode, while the obser-vation group was administrated with the dual-mentor training model, namely a theoretical mentor and a skill mentor. The training was carried out in accordance with the training plan formulated by the teaching group. The training effect was investigated by questionnaire survey and compared with that of the traditional train-ing mode. Results Under the dual-mentor system, the physicians acquired more theoretical knowledge and clinical skills and their ability of doctor-patient communication was improved significantly. The complete mastery rate of the theoretical knowledge and clinical skills in the observation group was 42.5％ and 35.0％respectively, significantly greater than that in the control group (15.0％ and 12.5％, respectively, P<0.05). The ability of doctor-patient communication improved more significantly in the observation group than in the control group (92.5％ vs. 77.5％, P<0.05), and the satisfaction with the teachers and the training arrangement was higher in the observation group than in the control group (82.5％ vs. 60.0％, 82.5％ vs. 52.5％, P<0.05). Conclusions The dual-mentor system has a definite effect on the standardized residency training of cardio-vascular internal medicine, The dual-mentor system facilitates the mastery of professional knowledge and skills in residents, improves the ability of doctor-patient communication, and increases residents' satisfaction with the mentors and the training program, thereby worthy of widespread promotion and application.

Measurement and performance analysis of functional neural network / 生物医学工程学杂志

The measurement of network is one of the important researches in resolving neuronal population information processing mechanism using complex network theory. For the quantitative measurement problem of functional neural network, the relation between the measure indexes, i.e. the clustering coefficient, the global efficiency, the characteristic path length and the transitivity, and the network topology was analyzed. Then, the spike-based functional neural network was established and the simulation results showed that the measured network could represent the original neural connections among neurons. On the basis of the former work, the coding of functional neural network in nidopallium caudolaterale (NCL) about pigeon's motion behaviors was studied. We found that the NCL functional neural network effectively encoded the motion behaviors of the pigeon, and there were significant differences in four indexes among the left-turning, the forward and the right-turning. Overall, the establishment method of spike-based functional neural network is available and it is an effective tool to parse the brain information processing mechanism.

Estimation of the effect-site equilibration rate constant using the time-to-peak effect of muscle relaxants measured by train-of-four stimulation during general anesthesia induction / 대한마취과학회지

BACKGROUND: The concept of the effect-site concentration of anesthetic agents is important. The effect compartment model can be explained using the concepts of effect-site concentration and effect-site equilibration rate constant (k e0). This study confirms that the time-to-peak effect (tpe ) can be measured easily in clinical practice by applying a priming dose and train-of-four (TOF) during general anesthesia induction, and k e0 can be calculated from the tpe of the four muscle relaxants that are commonly used in general anesthesia. METHODS: Eighty patients who received general anesthesia were divided into the succinylcholine, rocuronium, atracurium, or vecuronium groups. Priming doses of muscle relaxants were administered. The effects of muscle relaxants were quantified by recording the twitch response of the adductor pollicis muscle after stimulating the ulnar nerve. The tpe was measured at the lowest TOF value. k e0 was calculated from the measured tpe . RESULTS: The k e0 values of the succinylcholine, rocuronium, atracurium, and vecuronium groups were 0.076 (0.030)/min, 0.228 (0.122)/min, 0.062 (0.011)/min, and 0.077 (0.019)/min, respectively. CONCLUSIONS: It is possible to estimate k e0 from the tpe of muscle relaxants using a priming dose and TOF during general anesthesia induction.

Self-esteem and Occupational Stress Relationship Analysis of 1413 Train Drivers in a Railway Bureau / 中华劳动卫生职业病杂志

Objective@#To investigate self-esteem status of train drivers. @*Methods@#By using cluster sampling method, a cross-sectional study was conducted in 1 413 train drivers (including passenger train drivers 301, freight train drivers683, passenger shunting train drivers350, and high speed train drivers79) from a railway bureau. The occupational stressors, strains, self-esteem and personalities were measured using occupational stress instruments and effort-reward imbalance questionnaire. @*Results@#The level of self-esteem is medium ofthe train drivers. Sself-esteem scores among different among different job category (job title) , marry status, age, length of service groups were statistical significance (P<0.01) . Differences of self-esteem among different educational level, exercise, smoking and drinking groups weren’t statistical significance (P>0.05) . Correlation analysis revealed that self-esteem score was related positively to job satisfaction (r=0.300) , reward (r=0.842) , working stability (r=0.243) , promotion opportunities (r=0.493) , positive affectivity (r=0.216) , responsibility for human beings (r=0.112) and responsibility for things scores (r=0.108) (P<0.01) , negatively to sleep quality (r=-0.103) , social support (r=-0.212) , role conflict (r=-0.007) , role ambiguity (r=-0.169) , physiological needs (r=-0.115) , daily stress (r=-0.150) , negative affectivity (r=-0.252) , depressive symptoms scores (r=-0.215) (P<0.01) . Nonparametric test found that train drivers of group with low self-esteem score reported higher scores for physiological need, role conflict, role ambiguity, social sleep quality, depressive symptoms, negative affectivity, social support and daily stress scores than the medium and higher groups (P<0.01 or<0.05) . But reword, job satisfaction, positive affectivity, copping stratgy, working stability and promotion opportunities scores were lower than the group of medium and higher groups (P<0.01) . Inter-group conflict scores were insignificance (P>0.05) . Multivariate logistic regression analysis revealed that low low self-esteem for drivers occured the risk of job dissatisfaction about 1.5 times as high as that of drivers with higher self-esteem (OR=1.476) @*Conclusion@#Different types of locomotive drivers get different level of self-esteem. Self-esteem was affected by occupational stress largely.

Informatization module requirement analysis and system framework design for train hospital in 350 km/h speed Chinese standard EMU / 医疗卫生装备

Objective To analyze informatization module requirements and to design system framework for manufacturing train hospital in 350 km/h speed Chinese standard EMU. Methods Using 350 km/h speed Chinese standard EMU as the design platform and medical experience in hospital and health informazation in warship as design foundation data, the informatization system requirements of hardware and software were discussed to figure out the rational framework design of hospital in train. Results The informatization system of the train hospital was divided into two components for external and internal communication. The external communication component consisted of telemedicine subsystem based on KU satellite communications, train dispatching subsystem based on train dispatching private network and military command subsystem based on special communication bands, and the internal communication component was made up of the hospital information subsystem, internal office subsystem, video supervision subsystem etc. Conclusion The framework design of the informatization system of the train hospital takes considerations on the compatability with military and civilian uses as well as the requirements for information exchange between information functional systems, which lays a foundation for the manufacture of the train hospital based on the EMU.

Social support and occupational stress relationship analysis of 1 413 train drivers in a railway bureau / 中华预防医学杂志

Objective@#To investigate the social support status of train drivers.@*Methods@#Using cluster sampling, a cross-sectional study was conducted in 1 413 male train drivers (including 301 passenger train drivers, 683 freight train drivers, 85 guest scheduling train drivers, 265 cargo adjustable drivers, and 79 high-speed train drivers) from a railway bureau depot. The survey included individual factors, social support, occupational stressors, strains, personalities, and coping strategy using occupational stress instruments and effort-reward imbalance questionnaire. We compared the difference in social support scores between different drivers, who were divided according to job type and age. Additionally, the correlation between social support score and job strain-related factors was analyzed. The influence of depressive symptoms and job satisfaction were analyzed using a non-conditional logistic multivariate model.@*Results@#The overall average age P50 (P25,P75) of 1 413 train drivers was 33.92 (27.83,43.58) years. The overall average length of service 12.25 (5.25,22.75) years. A significant difference in social support scores was observed according to job type (H=23.23, P<0.001). The specific scores were passenger driver(27 (23,32)), freight train driver (26 (22,30)), guest scheduling driver (27 (24,30)), cargo adjustable driver (26 (22,31)), and high-speed train driver (30 (26,36)) (P50(P25,P75)). Additionally, social support scores among different age groups were significantly different (H=6.64, P=0.036). The specific scores were ≤30 years (26 (22,31)), 30-40 years (27 (23,33)), and >40 years (27 (22,31)). Correlation analysis revealed that the social support score was negatively associated with job satisfaction (r=-0.43), reward (r=-0.22), working stability (r=-0.23), promotion opportunities (r=-0.12), positive affectivity (r=-0.31), esteem (r=-0.21), and self-esteem (r=-0.20) scores (P<0.001). The social support score was positively associated with sleep disorders (r=0.33), external effort (r=0.21), pay within (r=0.12), role conflict (r=0.20), conflict between groups (r=0.17), conflict in groups (r=0.06), responsibility for the others (r=0.06), responsibility for things (r=0.08), physiological needs (r=0.39), psychological needs (r=0.19), daily stress (r=0.29), negative affectivity (r=0.23), and depressive symptoms (r=0.44) scores (P<0.05). Multivariate logistic regression analysis revealed social support had a great influence on depressive symptoms and low job satisfaction. Compared with high social support, low social support resulted in depressive symptoms (OR=4.12, 95% CI:3.19-5.33) and low job satisfaction (OR=2.18, 95%CI:1.65-2.88).@*Conclusion@#Train drivers obtained various levels of social support. Social support greatly affected occupational stress. High social support was related to reduction in the occurrence of occupational stress, depressive symptoms, and low job satisfaction. Social support is related to mental health of train drivers.

Sleep quality and occupational stress relationship analysis of 1413 train drivers in a railway bureau / 中华劳动卫生职业病杂志

Objective@#To investigate sleep quality status of train drivers.@*Methods@#By using cluster sampling method, a cross-sectional study was conducted in 1413 train drivers (including passenger train drivers 301, freight train drivers 683, passenger shunting train drivers 350, and high speed train drivers 79) from a railway bureau. The occupational stressors, strains, personalities and sleep quality were measured using occupational stress instruments and effort-reward imbalance questionnaire.@*Results@#The train drivers of poor sleep quality was 48.34%. Sleep quality scores among different among different job category (job title) , exercise, smoking and drinking were statistical significance (P<0.01) . Differences of sleep quality among different educational level, marry status, age, length of service groups weren’t statistical significance (P>0.05) .@*Correlation@#analysis revealed that sleep quality score was related negatively to job satisfaction, reward, working stability, promotion opportunities, positive affectivity, esteem and self-esteem scores (r: -0.454, -0.207, -0.329,-0.170, -0.291, -0.103, -0.139, P<0.01 or P<0.05) , positively to social support, effort, role conflict, conflict between groups, conflict in groups, responsibility for person, responsibility for thing, psychological needs, physiological needs, daily stress, negative affectivity, depressive symptoms scores (r: 0.338, 0.524, 0.226, 0.094, 0.182, 0.210, 0.247, 0.190, 0.615, 0.550, 0.345, 0.570, P<0.01) . Nonparametric test found that train drivers of group with high sleep quality score reported higher scores for physiological need, psychological need, effort, role conflict, conflict between groups, social support, daily stress, depressive symptoms, responsibility for person, responsibility for thing, negative affectivity and coping scores than the group of lower sleep quality score (P<0.01) . But reword, job satisfaction, positive affectivity, self-esteem working stability and Promotion opportunities scores were lower than the group of lower sleep quality score (P<0.01) . Multivariate logistic regression analysis revealed the risk for more physiological needs, more effort, more depressive symptoms and more daily stress for drivers occured the risk of poor sleep quality were more than two times as high as that of drivers with less physiological needs, less effort, less depressive symptoms and less daily stress (OR=2.905~2.005) . Conclusions Different types of locomotive drivers get different level of sleep quality. Sleep quality was affected by occupational stress largely. Reducing the occupational stress may contribute to improve the sleep quality of train drivers.

Influencing factors for job satisfaction in train drivers in a railway bureau: an analysis of 1413 cases / 中华劳动卫生职业病杂志

Objective@#To investigate the influencing factors for job satisfaction in train drivers.@*Methods@#In March 2012, cluster sampling was used to conduct a cross-sectional survey in 1413 male train drivers (including 301 passenger train drivers, 683 freight train drivers, 350 passenger shunting train drivers, and 79 high-speed train drivers) from a locomotive depot of a railway bureau. The occupational stress instruments, job content questionnaire, and effort-reward imbalance questionnaire were used to analyze job satisfaction, occupational stress factors, stress reaction, individual characteristics, coping strategies, and social support.@*Results@#There were significant differences in job satisfaction score between the drivers with different posts, working years, ages, smoking status, and drinking status (P<0.01). The correlation analysis revealed that job satisfaction score was positively correlated with reward, working stability, promotion opportunity, positive emotion, social support, self-esteem, and coping strategy scores (P<0.01) and negatively correlated with sleep disorders, effort, role conflict, intergroup conflict, responsibility for persons, responsibility for things, psychological needs, physiological needs, daily stress, negative emotion, and depressive symptom scores (P< 0.01). The analysis of variance showed that compared with the moderate and low job satisfaction groups, the high job satisfaction group had significantly higher reward, positive emotion, promotion opportunity, and role ambiguity scores (P<0.01) , as well as significantly lower scores of responsibility for persons and responsibility for things (P<0.01). Compared with the moderate and high job satisfaction groups the low job satisfaction group had significantly higher scores of psychological needs, effort, role conflict, sleep disorders, daily stress, depressive symptom, negative emotion, drug use, intragroup conflict, and social support (P<0.01) , and the moderate job satisfaction group had a significantly higher score of self-esteem than the other two groups (P<0.05). The logistic regression analysis showed that the risk of job dissatisfaction in the drivers with low so-cial support and high daily stress was more than 2 times that in those with high social support and low daily stress (OR=2.176 and 2.171) , and sleep disorders, effort, depressive symptom, low self-esteem, and role conflict were risk factors for job dissatisfaction (OR=1.48-1.625).@*Conclusion@#Occupational stress, stress re-sponse, emotion, individual characteristics, and social support have great influence on job satisfaction. Im-proving social support, increasing positive emotion, and reducing occupational stress are main measures for increasing job satisfaction in train drivers.

What anesthesiologists ask to know and should know about the neuromuscular monitoring: an updated review

The increase in mortality and morbidity associated with the use of muscle relaxants, is associated with a lack of clinical pharmacological knowledge of the drugs, and a lack of understanding the risk of postoperative residual curarization. This is due to the absence of standards for neuromuscular monitoring. Clinicians experienced in neuromuscular monitoring and using muscle relaxants in the clinic may have some queries regarding the monitoring: Why should neuromuscular monitoring be done? Are clinical tests really not effective? Why is it not good when I actually perform neuromuscular monitoring? Would using sugammadex not require neuromuscular monitoring? This review answers most of the questions that many clinicians have, and also forwards the knowledge required of clinicians.