本文结合核污染伤员医学洗消站的建设实际,分析洗消站的建设要点与注意事项.提出洗消站工作人员准备区、伤员检测分类区、普通伤员洗消区、重伤员急救洗消区和洗消检测评估区等分区的设立;指出洗消站的放射性污染检测设备、医疗急救器材、洗消器材、污物收集器材、防护器材和放射性救治药品等器材配备;对洗消站的排水系统、电源和墙面装饰等配套设施,以及运行洗消站所需要的方案制度、工作人员、培训演练和日常维护保养等技术保障措施等提出建设性意见.

Translational medicine,as an important form of research-based medicine,is key to research hospitals.Analysis in the paper holds that such hospitals should highlight top-level design in its medical system building,rely on characteristic and advantageous disciplines,target research outcome applications,take the pathway of overlapping and fusion,and the synergy mechanism as the guarantee. The paper introduced the efforts of the hospitals'experiences in innovative clinical practice of research during the development of the translational medicine system,in an organized,planned,targeted,and measurable manner.It is concluded that the innovative outcomes of the effort help elevate medical competence of the hospital as a whole.

Objective:To illustrate the sample library transformation experiment platform plays an important role in the basic laboratory and the clinic.Methods: Focus on the role of the sample library translational medicine experiment platform, and the establishment of our hospital’s translational medicine experiment platform to instruct.Results: The sample library transformation experiment platform is direct execution facility that they complete the conversion between basic laboratory and clinical.Conclusion: The sample library transformation experiment platform established a two-way conversion channel between basic laboratory and clinical.

Objective:To implement full medical equipment, dynamic management of business processes to achieve fine control, improve motivation equipment availability, utilization and mobilize members of the department, can help to raise the overall level of management departments. Methods: By induction of workflow, personnel grouping design, data analysis, the design of system establish medical engineering department daily working model and achieve establishment of process management personnel, materials, services. Results: The system designed to improve the authenticity and credibility of the department of business data, which improve the personnel, materials, information level business management and accelerate scientific management to provide reference. Conclusion: The system has the ability to reduce the labor intensity of transaction processing personnel, auxiliary department management, improve work efficiency, allowing minimal investment for maximum social and economic benefits.

Objective:To study the pharmacokinetics of hydrocodone tartrate tablets in human. Methods:We carried out single dose, parallel design study. Subjects were divided into three groups according to the dose of 5 mg, 10 mg, 15 mg (low, medium, high), and each group contained ten subjects. HPLC-MS/MS method was used for analysis of hydrocodone and its two metabolites (demethylation of hydrocodone and hydromorphone). WinNonlin 6.1 software was used to calculate the pharmacokinetic parameters. Results:Linearity was established in the range of 0.05–50.00μg·L-1 for hydrocodone and demethylation of hydrocodone, and 0.01–10.00μg·L-1 for hydromorphone. After the oral dose of hydrocodone tartrate tablets, Cmax, AUC0-t and AUC0-∞increased with the dose and showed a good linear relationship. There were no serious adverse events during the course of this study. Conclusion:HPLC-MS/MS is a sensitive and accurate method, which is suitable for the analysis of hydrocodone and its two metabolites (demethylation of hydrocodone and hydromorphone) in plasma and the pharmacokinetics study of hydrocodone tartrate tablets in human.

Objective To determine the mass concentration in human plasma hydromorphone by established HPLC -MS/MS method.Methods The treatment of plasma with solid-phase extraction, selec-tion Kromasil 100 -5 SIL, E97915 column with 95% acetonitrile -5 mmol· L-1 ammonium acetate as the mobile phase gradient elution with positive ion, multiple reaction monitoring mode mass concentration of the sample was measured.Results The plasma samples, hydromor-phone in good ( r >0.999 8 ) 0.05 -10.00 ng · mL-1 linear relation-ship, the minimum detectable concentration was 0.05 ng· mL-1.Blood samples day and inter-day RSD were less than 15%, the average recovery >70%, and stability were good.Conclusion The method is simple, rapid, sensitive and accurate, specific, kinetics in vivo pharma-cokinetics of hydromorphone apply.

我国高度重视核与辐射突发事件医学救援工作，建立了从国家到地方、军队的应急救援组织体系与应急预案，在这一领域积累了一定经验。随着时效救治概念的提出，基于时效观点的核与辐射医学应急救援原则、技术规范和标准操作流程尚需进一步探讨优化。

University of Washington Institute of Translational Health Sciences ( UW-ITHS ) was among the first group of the National Institutes of Health-Clinical and Translational Science Award ( NIH-CTSA) sponsored institutions .UW-ITHS is the only CTSA institution which has been covered the health science translational research activities within the five states , including the States of Washington, Alaska, Idaho, Wyoming and Montana.ITHS ′s mission is to promote health sciences including the entirely range of life science and health care , as well as the basic and clinical resear-ches at the both academic health centers and community-based environments .UW-ITHS′s mission is to provide the precision medicine based on its unique characterizations in advancing informatics tech -nologies, omic technologies and industrial design super-model (Boeing model).

Human tissue biobanks have an increasingly important role in transforming medical study designs and is critical for application of a wide range of new technologies(-”omics”)to the discovery of molecular patterns of disease and for imple-mentation of novel biomarkers into clinical trials.Although pathologists has patient care as their primary mission in their nor-mal practice of pathology,they do play a vital but often underrecognized role in the operation of these tissue banks.Besides making sure that the timing of all operations is consistent with both the requirements of clinical diagnosis and the optimal pres-ervation of biological products,pathologists are needed to characterize tissues for research,to conduct quality assurance pro-grams,to assist with resource allocation decisions,and to serve an educational role for investigators using the tissues.This article describes these key principles and a set of practice gross pathology guidelines focused on the decision for tissue banking at the time specimens are macroscopically evaluated,where pathologist involvement is crucial to biobank management.In conclu-sion,pathologists play a critical role in helping biobank users understand the principles of specimen evaluation(histologic and structural composition of tissues,and their limitations)so as to optimize the scientific benefit of the tissues.We believe that ap-preciation of these principles will facilitate the partnership between surgical pathologists and biobank directors,enhance the val-ue of research on non renewable resources of biological samples,and at the same time,optimize the operational standardiza-tion of biological sample collection procedures in clinical pathology.

Objective:To achieve the quality of hospital medical equipment, measurement and control of document management standardization and automation. Methods: By systematic analysis and other methods to summarize, analyze the current measurement and quality control of document workflow hospital and execution methods. Results:The combination of measurement and quality of work in the hospital document management features, preparing management system software. Conclusion: Through the establishment of document management system, improve the document management system, standardize and automate measurement and quality control of medical equipment, reduce maintenance costs and ensure the normal operation of medical equipment.

Objective: To develop the risk assessment of medical equipment for lifecycle management designed for the training of medical equipment and use of technical basis, thereby improve their security performance. For standardization of medical treatment device management, improve the level of modern medical equipment management. Methods:In the event of the establishment of medical equipment management system established on the basis of risk assessment models and decision support mechanism to protect the operating status of the device. Result: The system implements the life cycle management and risk assessment process medical devices. Conclusion:It can be widely used in evaluating the effectiveness of medical devices, and its application to improve the quality of medical care is important.

目的 分析含铂方案对人类表皮生长因子受体(human epidermal growth factor receptor-2,HER-2)阴性蒽环和紫杉类治疗失败的晚期乳癌患者的疗效,并对比不同含铂方案的疗效与不良反应.方法 选择2005-04-01-2013-05-31就诊于解放军第307医院乳腺肿瘤科的186例晚期乳癌患者,均为蒽环和紫杉治疗失败,接受吉西他滨联合顺铂(gemcitabine-cisplatin,GP)治疗76例,长春瑞滨联合顺铂(vinorelbine-cisplatin,NP)治疗110例.GP方案:吉西他滨(1 000 mg/m2),静脉滴入,d1、d8;顺铂(75 mg/m2),静脉滴入,d1～d3.NP方案:长春瑞滨(25 mg/m2),静脉滴入,d1、d8;顺铂用法两组相同.治疗每3周为1个周期.结果 舍铂方案总有效率为29.6％(55/186),中位无进展生存时间为5个月,95％CI:4.2～5.8个月,其中一线治疗和单器官受累者中疗效更佳.GP方案组和NP方案组的客观有效率分别为26.3％(20/76)和31.8％(35/110),x2=0.653,P=0.419;临床获益率分别为36.8％(28/76)和41.8％(46/110),x2 =0.465,P=0.495;中位无进展生存时间分别为5个月(95％CI:3.8～6.2个月)和6个月(95％CI:5.0～6.9个月),P=0,797,差异均无统计学意义.两组不良反应相似,其中3～4级主要为血液学毒性,非血液学毒性中1～2级呕吐发生率较高.结论 在HER-2阴性蒽环和紫杉类治疗均失败的晚期乳腺癌患者中含铂方案疗效确切,不良反应可耐受.GP和NP两方案疗效相当,均可作为HER-2阴性乳腺癌患者的有效解救治疗方案.

Objective:To investigate the mechanism of TAT-tCNTF on human umbilical vein endothelial cells (HUVECs) injured by cytochalasin D (CD). Methods:After HUVECs were treated with CD and TAT-tCNTF, cell viability was determined by CCK-8. The structural changes of F-actin stained by rhodamine labeled ghost cyclic peptide were observed through the lfuorescence microscope. Concentrations of intracellular free calcium by Fluo 4-AM loading were detected through the lfuorescence microscope and lfow cytometry. Western blot was used to detect the expression of F-actin protein. Results:CD (10μmol·L-1) reduced the cell viability of HUVECs (P< 0.000 1), while TAT-tCNTF (10 μg·mL-1 ) significantly increased the cell viability of HUVECs (P=0.003). F-actin with CD was fractured and reduced, while it was improved after subsequent treatment with TAT-tCNTF. TAT-tCNTF alleviated the calcium overload caused by CD. Flow cytometry showed mean lfuorescence intensity (MFI) of Ca2+in CD group was stronger than that in control group, the MFI of Ca2+in (CD+TAT-tCNTF) group was lower than that in CD group. Western blot showed the expression of F-actin protein had almost no change among all groups. Conclusion:TAT-tCNTF ameliorated the cell injury caused by CD. The mechanism was associated with maintaining actin cytoskeleton and alleviating the calcium overload.

目的:研究脉冲电磁场对糖尿病大鼠足底血流灌注量的影响.方法:成年SD大鼠随机分为3组(8只/组):正常组(正常成年非糖尿病大鼠)、模型组(糖尿病大鼠,不施加脉冲电磁场照射)以及实验组(糖尿病大鼠,施加脉冲电磁场辐照8 h/d,6周),以足底血流灌注量为检测指标对各组糖尿病大鼠的微循环进行评估.结果:经过6周的脉冲电磁场照射,发现脉冲电磁场能够显著抑制糖尿病引起的大鼠足底血流灌注量的降低.结论:脉冲电磁场照射能够缓解糖尿病导致的大鼠足底血流灌注量的下降,并且脉冲电磁场对相关疾病导致的微循环障碍可能有积极的治疗作用,但其确切机理还有待更多的实验来加以研究证实.

核化生灾害是指由放射性物质、有毒化学物质、病原体或生物毒素等造成人员伤亡、财产损失和生态破坏的现象.核化生灾害医学现场救援主要是由核化生医学救援队对受伤人员与公众的现场应急医学处置.结合作者单位长期从事的核化生现场医学救援保障工作实践,本文重点阐述了核化生医学救援队的人员组成与分工、现场救援所需物资与装备,以及救援队现场救治流程与布局展开.希望此文能为突发特殊灾害医学应急救援保障工作提供有益的借鉴.

Objective: To design a support system for combat materials of medical such as equipment, supplies and medicines, which aims to avoid materials, confusing accounts and improve the level of modernization of the management of war material. Methods: The design is based on J2EE architecture and Oracle11i platform, computing terminal within the LAN can be achieved by JDBC, JSP, JavaMail, data access, scalable and easy to maintain. Results: This system is to achieve combat readiness of medical supplies materials coding, classification, routine maintenance, emergency bags combination function, and intelligent management ofemergency supplies. Conclusion: This system has a small investment, high efficiency, modern management tools for the management of medical supplies of the army combat readiness, lower unit response time for emergency medical treatment to fight for the precious time.

本文从门诊信息系统改造的目标和适应医保政策要求的实现等方面,就军队医院门诊系统适应医保需要改造的相关问题进行了探讨.

In the Evaluation of hospital,the assessment of medical records is a significant item to reflect the management of a hospital as well as its medical treatment quality,which runs throughout the process of hospital evaluation.According to the relevant rules and evaluation features related to medical records assessment in the "Evaluation Standard of Three-level Hospital",we put forward some improvement measures to solve the problems and defects existing in medical records quality and monitoring,thus promote the continuous improvment of medical records.

分析了传统PACS硬件平台的不足,提出了适用于大型医院新一代信息系统、高可用PACS系统的技术要求,设计实现了一个基于双机实时应用集群和虚拟化技术的高可用性PACS硬件平台.实际应用表明,该技术平台具有管理自动化程度高、故障恢复迅速、异地容灾、报表数据实时查询等技术优势,可满足大型医院新一代PACS系统建设的需求.

[目的]:设计实现适合大型医院的高可用、高可靠医院核心信息系统数据的备份恢复平台,保证医院核心信息系统的数据安全和业务连续性.[方法]:在综合分析该领域新技术的基础上,针对307医院实际情况和不同业务系统需求特性确定具体技术方案,利用Oracle RMAN进行数据库备份并通过TSM备份服务器完成到物理磁带库的离线备份,设计消息平台做备份的可靠性验证;使用虚拟化技术实现数据恢复及业务接管,同时利用Oracle Data Guard实现容错；制定针对不同业务系统的数据备份和恢复方案.[结果]:在307医院建立了一体化的HIS、PACS、LIS等核心系统数据备份恢复平台,并已上线运行,可以很好地满足实际应用需求.该方案可为其他大型医院建立类似平台提供设计参考.