Scientific and technological innovation plays an important role in hospital development.The process of Scientific and technological innovation in hospital is a Complex Adaptability System made up of the interactions of multi-agents in research team and also the interactions between agents and their environmental conditions.After analyzing the CAS characteristics of hospital scientific and technological innovation system,the paper put forward the management strategies for research team.For example,set up hospital scientific and technological innovation system based CAS theory,explore new research management model,construct open scientific and technological innovation platform,and optimize collaborative mechanism.

随着国家医药卫生体制改革的不断深入，以及军队医疗保障和多样化军事保障任务的不断加重，军队医院发展面临着前所未有的挑战和机遇。在新形势下，如何形成竞争和发展优势，是军队医院管理面临重大现实任务。成本问题贯穿于医院管理全过程和各个环节，是医院管理的核心问题。成本问题解决不了，医院的效益就没有保障，竞争力和保障力也会变得低下。因此，深化成本管理是军队医院适应“市场”和“战场”需要的重要举措，对新形势下军队医院的发展具有重要意义。现报道如下。

转化医学近几年在国内外得到了快速发展,对海军部队的医疗保健提出了更高的要求.作者简要介绍转化医学概况、军队转化医学和海军部队卫勤保障对转化医学的需求,论述转化医学推动研究型医院建设、医学研究平台建设和科研成果向部队转化,总结近几年转化医学在海军部队的实践,通过加强军民融合,促进新技术在海上医疗救治中的转化医学应用,保障人民群众和海军官兵的健康,推进军队卫生事业的创新发展.

Objective To investigate the effects of central tyrosine on the dopamine content and its turnover rate in rats with psychological stress.Methods Forty SD rats were randomly divided into 5 groups:the control group,the psychological stress group,and 3-dose tyrosine intervention groups( fed with tyrosine with doses of 250 mg/kg,500 mg/kg and 1000 mg/kg respectively),each consisting of 8 rats.The psychological stress model was developed with the Communication Box.Contents of dopamine (DA) and dihydroxy-phenyl acetic acid (DOPAC) in the mesoprefrontal cortex (mPFC),nucleus accumbens (Nac) and ventral tegmental area(VTA) were determined by HPLC-ECD.Results The content of DA declined and that of DOPAC/DA increased significantly in mPFC,Nac and VTA area in the animals of psychological stress treatment group [ (0.08 ± 0.05 )、( 1.88 ± 0.27 )、( 1.01 ± 0.26 ) μg/g ]( P ＜ 0.05 ),when a comparison was made with the animals of the control group[(0.36 ± 0.15 )、(3.47 ± 0.52 )、( 1.35 ± 0.31 ) μg/g ].As compared with those of the psychological stress treatment group,the content of DA increased significantly in mPFC,Nac and VTA area (P ＜ 0.05 ) and DOPAC/DA declined significantly in mPFC and VTA area (P ＜ 0.05 ) in the 500 mg/kg and 1 000 mg/kg tyrosine intervention groups( P ＜0.05 ).Conclusions The content of DA could be depressed and the turnover rate of DA could be increased by psychological stress in the mPFC,Nac and VTA area,while tyrosine intervention could increase the content of DA and depress the turnover rate of DA in rats with psychological stress.

<正>老年人在心理、生理等方面均处于逐渐衰老与退化状态,免疫功能降低,所以是各种疾病的易感群体[1]。高龄患者往往同时患有多种慢性疾病,因而长期使用药物不可避免。但由于其缺乏相关医学知识,用药往往不够合理。所以,该类人群更应在保健医师的正确指导下合理用药,这样不仅有利于其健康与长寿,也可在一定程度上减少药物的滥用和浪费。

美国海军陆战队作为美军的精锐战斗部队,需要随时履行国家赋予的职责,遂行各种军事或非军事任务.陆战队卫勤保障的成功与否直接关系到其战斗力的发挥.现将美国海军陆战队卫勤保障有关情况简要介绍如下. 1 陆战队基本编制及任务 美国海军陆战队的主力部队是其下辖的远征军,每支远征军下辖3个师,是世界各国军队编制人数最多的地面作战师.其卫勤保障部队归属远征军后勤支援部队管辖,后勤支援部队的自身人数一般在3万人左右,其保障的战斗部队人数为5000～2万人.通常情况下,卫勤保障力量一般要在领受任务的6～48 h部署完毕,海军陆战队海上预制部队的部署时间为5～14天,最长应在30天内完成部署.后勤支援部队的主要任务是为战斗部队提供各种物资支援、装备维修及医疗救助,其目的是维护和提高作战部队的战斗力.

美海军两艘医院船平战时根据不同任务要求,始终处在不同战备状态当任务变化时,尤其是战时,医院船将由减负荷运行的训练战备状态,进入满负荷运行的完全战备状态.医院船只有经过一个为期5天的应急启用程序,才能执行海上医疗救护任务.现将有关情况介绍如下.

医院船作为一个海上流动医院,在使用和管理中,必须严格遵守相关法律法规.在战时,参与海上医疗救护的医院船应当在有关国际法的框架内,在规定的时间、允许的海域实施对伤病员的医疗救护,否则,医院船将不受法律保护,甚至可能会遭到敌方的袭击或误击.目前,医院船的使用和管理主要受<日内瓦公约>和<改善海上武装部队伤者病者及遇船难者境遇之日内瓦公约>这两个公约的保护.

非战争军事行动是美军于1993年在冷战结束后提出的概念,它是为达到某种政治目的而开展的军事行动,其内容包括国家援助、安全援助、人道主义援助、抢险救灾、反恐、缉毒、武装护送、联合演习等.美海军医院船除战时为陆上和海上伤病员提供机动、灵活、快速的医疗救护之外,还有一项重要使命,即平时为各种自然灾害等突发事件提供人道主义救援.现将有关情况介绍如下.

医院船的医疗救护能力,取决于其医务人员的配置和医疗设施的配备.美海军两艘医院船在其5级医疗阶梯中执行第3级医疗阶梯的救治任务.现将有关情况介绍如下. 1 医院船医疗设施 美海军医院船共有8层,最上层甲板为直升机起降平台.污染消除舱设在上甲板,以方便核化生伤员上船后先期进行彻底的洗消.上甲板以下为主甲板.主甲板分别设有伤员接收分类区、复苏室、手术区、病房、化验室、放射科和药房等7个主要功能区域.

聚维酮碘(PVP-I)是碘与1-乙烯基-2-吡咯烷酮均聚物的络合物,是碘伏的一种.PVP-I是一种优秀的皮肤消毒剂,已被2000年版中国药典收录.PVP-I具有许多优良的特性,其克服了游离碘难溶于水、不稳定、对皮肤刺激性大、着色不易褪色等缺点,保留了碘的良好杀菌性能;碘伏扩展了碘的使用范围,在国内外医院消毒中得到广泛的应用.

Objective To establish the noise-susceptible guinea pig models.Methods One hundred and three male healthy guinea pigs were exposed to 110 dBA narrow-band noise for 3 hours.The distortion product otoacoustic emission(DPOAE) and auditory brainstem response of all guinea pigs were detected before and after the noise exposure.The morphological changes were observed under scanning electron microscope.By using percentile methods,the 90% re-ference value of all guinea pigs was determined,through which noise susceptible and unsusceptible guinea pigs were distinguished.Finally,a comparison was made between the two groups for their difference in the auditory function and cochlear morphological structure.Results Percentile algorithm showed that the 90% reference value of guinea pigs' mean value of left and right temporary threshold shift after the noise exposure was within a range of 18.2 dB to 31.7 dB.The number of noise-susceptible and unsusceptible guinea pigs was measured to be 7 and 22 respectively.It could be seen that the DPOAE amplitude of susceptible group was smaller than that of the unsusceptible group at distortion frequency of 1 409 Hz and 2 000 Hz(P0.05).The mean value of the left and right temporary threshold shift for the susceptible group was greater than that of the unsusceptible group(P0.05).Lesion to the cochlea of the susceptible group was more serious than that of the unsusceptible group,with its chief manifestations in the structure of the third circle and the fourth circle.Conclusions The noise susceptible guinea pig models were established successfully.

聚维酮碘(Povidone Iodine, PVP-I)是碘和1-乙烯基-2-吡咯烷酮均聚物的络合物,属碘伏的一种.目前聚维酮碘作为一种优良的皮肤黏膜消毒剂和外用药已被许多国家药典收录,我国2000年版药典也将其收录.

Objective To study the effect of distortion product otoacoustic emission (DPOAE) on guinea pigs exposed to narrow band noise of different intensity. Methods Sixty healthy male guinea pigs were randomly divided into 3 groups: the 105 dBA group, the 110 dBA group and the 115 dBA group. The duration of exposure for all the groups was 3 hours and noise spectrum was narrow - band, with a mid - frequency of 4 000Hz and band-width of 1000 Hz. Two days before and 15 minutes after noise exposure, DPOAE of guinea pigs was measured by means of Smart OAE Hearing Test System. Results With increased intensity in noise exposure, DPOAE amplitude and throughput of guinea pigs at all the distortion frequencies showed a decreased tendency. For the 105 dBA group and the 110 dBA group at the distortion frequency of 1 409 Hz, and for the 105 dBA group and the 115 dBA group at frequencies of 499 Hz,704 Hz,1 003 Hz, and 1 409 Hz, the difference in DPOAE amplitude and throughput after exposure all had statistically significance (P<0.05). Conclusions Following exposure to 4 000Hz narrow band noise, DPOAE began to change at high frequencies and heating damage extended from higher frequency to lower frequencies as noise level increased.

米非司酮配伍米索前列醇最初只用于妊娠49天内的早孕引产,随着米非司酮的普遍应用,其应用指征日渐广泛.既往妊娠10～15周采用钳刮术技术难度高、损伤大、并发症多,而米非司酮配伍米索前列醇用于终止10～15周妊娠,是一种安全、简便、有效的方法.

美海军舰队医院为一标准化、模块化和集装箱式的野战医院,是一个主要在海外部署的医疗机构.舰队医院在各种局部战争、非战争军事行动等应急情况下,可前置或预置在世界各地.与医院船一样,其在美海军战场医疗救护行动中执行第3级医疗阶梯的救治任务.

2008年5月12日汶川地震发生30h后,海军总医院抗震救灾第一医疗队抵达灾区绵阳。截止7月4日,抢救重伤员37人次,开展各类手术125台次,诊治灾民12025人次,先后4次向重庆、昆明、广州、德阳等地远距离转运伤员583名。从战伤救治的角度看,我们经历了全部三级救治过程。在最初的紧急救治基本结束后,对其中的体会和经验进行小结。

北大西洋公约组织(NATO)是目前世界上最大的多国军事联盟,1949年在华盛顿成立.历经半个多世纪的发展,现已由原先的12个缔约国增至26个,势力遍及北美和欧洲大部分地区.现将北大西洋公约组织卫勤保障情况介绍如下.

Objective:To optimize the formulation of iodine tablets.Methods:The formulations of the tablets were composed of a certain proportion of citromalic acid,NaHCO3 and polyglycol 4000(PEG4000).And the formulations were evaluated by the appearance,dissolution and effervescence.Results:The tablets prepared were fine in appearance and disintegrated within 10min.Conclusion:The quality of the tablets was mostly related to the amount of supplementary material.

世界各国历来对军队战时的心理应激,即战斗应激反应(CSR)极为重视,以美英为主的发达国家在19世纪就开展了CSR研究.