In order to improve the general level of emergency specialist training. The author compares the difference between the training and management of emergency specialist in the developed countries and our country. First introduced the British and American emergency specialist training system,from the regulatory access,objectives,process,evaluation,qualification are very perfect. The training of China's emergency physicians are analyzed: one is the higher education system of different lengths,the content is not the same,the uneven quality of teaching,the basic education of medical emergency is weak,two is to implement the emergency medicine residency training standard is not enough,lack of awareness of education after graduation,from personnel evaluation and training,education and degree specialist training docking is not good,have affected the quality of the training of physicians in hospital. There is still a big gap between the training of emergency doctors in our country compared with the developed countries. Therefore,we need to further improve the system,management methods and training content and details. State health planning commission to overcome difficulties in the introduction of a series of specialist training management approach,and achieved some results. As emergency specialist training needs to be strengthened in five aspects.

目的 为检验自主研发的心肺脑复苏计时器在复苏过程中的性能,模拟心肺脑复苏现场,通过对照实验,探讨心肺脑复苏计时器相比传统回忆计时法在提高Utstein登记模式数据采集的实用性和优越性.方法 熟悉Utstein复苏登记模式,掌握登记的时间点;模拟心肺脑复苏现场并记录过程,由工作人员专门计时采集标准时间,30名参加模拟复苏的人员分别采用计时器计时和通过人脑回忆计时两种方法 采集Utstein各操作点的时间信息,并与标准时间相比较,得出各自的误差值,分析各组的误差值和相关影响因素.结果 回忆组误差为(21.5±22.7)s,计时器组误差为(3.36±4.28)s,两组比较差异有统计学意义(P<0.05);回忆组的误差值随操作时间延长而增大,相关系数为0.538,计时器组也存在类似趋势,相关系数为0.286,Z检验的结果 表明,两者差异有统计学意义(Z=2.41,P<0.05);回忆组的误差值随着操作项目的 增多而增大,相关系数为0.523,计时器组也存在类似趋势,相关系数为0.218,Z检验的结果 表明,两者差异有统计学意义(Z=2.59,P<0.05).结论 相比回忆的方法,心肺脑复苏计时器能减少在数据采集过程中因回忆产生的误差,并能减小因为操作时间延长和操作项目增多导致的误差.

OBJECTIVE:To investigate the protective effect of reactive oxygen species (ROS) scavenger, N-acetyl-L-cysteine (NAC), against H9c2 cardiomyocytes from injuries induced by chemical hypoxia.METHODS:H9c2 cells were treated with cobalt chloride (CoCl2), a chemical hypoxia-mimetic agent, to establish the chemical hypoxia-induced cardiomyocyte injury model. NAC was added into the cell medium 60 min prior to CoCl2 exposure. The cell viability was evaluated using cell counter kit (CCK-8), and the intercellular ROS level was measured by 2', 7'- dichlorfluorescein-diacetate (DCFH-DA) staining and photofluorography. Mitochondrial membrane potential (MMP) of the cells was observed by Rhodamine123 (Rh123) staining and photofluorography, and the ratio of GSSG/ (GSSG+GSH) was calculated according to detection results of the GSSG kit.RESULTS:Exposure of H9c2 cardiomyocytes to 600 micromol/L CoCl2 for 36 h resulted in significantly reduced cell viability. Pretreatment with NAC at the concentrations ranging from 500 to 2000 micromol/L 60 min before CoCl2 exposure dose-dependently inhibited CoCl2-induced H9c2 cell injuries, and obviously increased the cell viability. NAC at 2000 micromol/L obviously inhibited the oxidative stress induced by CoCl2, decreased the ratio of GSSG/(GSSG+GSH), increased ROS level, and antagonized CoCl2-induced inhibition on MMP.CONCLUSION:NAC offers obvious protective effect on H9c2 cardiomyocytes against injuries induced by chemical hypoxia by decreasing in the ratio of GSSG/(GSSG+GSH) and ROS level and ameliorating MMP.

现代心肺复苏术(cardiopulmonary resuscitation,CPR)虽历经四十多年的发展,但复苏成功率和心脏骤停病人的预后仍然令人失望.因此,人们一直在探索CPR的新疗法.近年来,随着对心脏骤停病因学和复苏过程中病理生理学的认识,溶栓疗法逐渐引起人们的重视.我们现将这一疗法的应用现状综述如下.