目的 观察倒悬电动牵引下正骨手法结合体控电疗技术治疗腰椎间盘突出症的临床疗效.方法 选择 2019 年12 月～2021 年 12 月之间的厦门特勤疗养中心 86 例腰椎间盘突出症患者,随机数据分为两组各 43 例,治疗组采用电脑多功能自动倒悬式下肢牵引床系统(DKQ-V型)结合龙氏中医正骨手法加体控电疗技术综合治疗,对照组采用颈腰椎多功能电动牵引床JYZ-IIIA型结合传统的中医推拿按摩手法治疗.每天治疗 1～2 次,一个疗程 8～10 次,总共治疗 2 个疗程,疗程之间停休 2 d.结果 治疗组与对照组临床有效率分别为 100％和 88.37％,治疗组临床疗效明显优于对照组,差异有统计学意义(P＜0.05).结论 倒悬电动牵引结合龙氏中医正骨手法加体控电疗技术综合治疗对腰椎间盘突出症患者临床疗效显著.

目的:探析针灸治疗痛风性关节炎的临床疗效及血尿酸变化情况.方法:选取2019年8月-2020年8月在我院门诊、住院收集诊断明确的痛风性关节炎患者100例,根据随机数字表将患者随机分成对照组和研究组各50例,对照组采取常规西药治疗,研究组在常规西药治疗基础上,加用针灸疗法.监测研究组与对照组治疗前后超敏C反应蛋白及血尿酸水平,观察两组患者症状的改善状况并评定中医治疗疗效.结果:研究组治疗后超敏C反应蛋白及血尿酸水平显著下降;研究组总有效率为96.0％,对照组总有效率为72.0％,差异有统计学意义(P<0.05).结论:针灸在痛风性关节炎的治疗中能有效降低超敏C反应蛋白及血尿酸水平,对改善痛风性关节炎患者临床症状具有较理想的效果.

Objective:To investigate the correlation and its clinical significance between the ratio of non-high density lipoprotein cholesterol to high density lipoprotein cholesterol (non-HDL-C/HDL-C) and subclinical arteriosclerosis (SA) in officers and seamen of naval special duty.Methods:A total of 118 officers and seamen of naval special duty with SA admitted to Xiamen Special Services Recuperation Center of the Army from June 2015 to June 2018 were selected as SA group. According to the carotid intima-media thickness (C-IMT) and plaque occurrence, they were divided into two subgroups: 60 cases in thickening group and 58 cases in plaque group. And another 60 officers and seamen of naval special duty admitted in the sanatorium in the same period for resting were selected into control group as they were healthy after examination. Routine physical examination recordings were compared among those groups, including general clinical data (cardiovascular health behavioral factors score, C-IMT, and blood glucose) and recordings on lipid [triglyceride (TG), total cholesterol (TC), HDL-C, low density lipoprotein cholesterol (LDL-C), non-HDL-C, non-HDL-C/HDL-C ratio, and atherogenic index of plasma (AIP)]. C-IMT and AIP were analyzed by correlation and multiple linear regression, and carotid plaque occurrence was analyzed by binary logistic regression.Results:①Among the control group, the thickening group, and the plaque group, variance analysis showed that TG, TC, LDL-C, non-HDL-C, AIP, non-HDL-C/HDL-C, C-IMT increased in turn significantly, while HDL-C, exercise score, and healthy diet score decreased in turn significantly ( P<0.05 or P<0.01). ②Correlation analysis showed that there was a positive correlation of non-HDL-C/HDL-C with C-IMT and AIP, respectively ( P<0.01 or P<0.05). ③Regression analysis showed that non-HDL-C/HDL-C entered the regression model with C-IMT and AIP as dependent variables ( P<0.01), and did not enter the regression model with common carotid artery plaque as the dependent variable ( P>0.05). Conclusion:There is obvious abnormal lipid metabolism in officers and seamen of naval special duty with SA. Non-HDL-C/HDL-C is positively correlated with C-IMT and AIP, which is a risk factor of officers and seamen of naval special duty with SA and can be used as a good index for evaluating officers and seamen of naval special duty with SA. Among the officers and seamen of naval special duty, the control of lipid should be focused on.

目的 探讨非高密度脂蛋白胆固醇(non-HDL-C)与肥胖海勤官兵亚临床动脉粥样硬化的关系.方法 选取2015～2018年在陆军厦门特勤疗养中心参加检查的60例肥胖体质海勤官兵为肥胖组,60例同期疗养且正常体质的健康海勤官兵为健康对照组.检测并比较两组官兵年龄、身高、体重、收缩压、舒张压、吸烟、运动及饮食评分;三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FBG);颈动脉内中膜厚度(C-IMT);体质量指数(BMI),非高密度脂蛋白胆固醇(non-HDL-C),血浆致动脉硬化指数(ALP).对肥胖组各项血脂指标、年龄、BMI与C-IMT和AIP做相关性分析.结果 肥胖组TG、TC、LDL-C、non-HDL-C、AIP和C-IMT均显著高于健康对照组,而HDL-C、运动和饮食评分显著低于健康对照组,差异有统计学意义(P＜ 0.05).相关性分析显示,肥胖组AIP与TG、non-HDL-C呈正相关,与HDL-C呈负相关(r=0.514、0.312、-0.433,P＜0.05);C-IMT与年龄、BMI、TC、LDL-C、Non-HDL-C呈正相关(r=0.364、0.348、0.478、0.543、0.488,P＜0.05).结论 肥胖海勤官兵存在亚临床动脉粥样硬化病变,non-HDL-C是动脉粥样硬化的危险因素,可作为评价肥胖海勤官兵亚临床动脉粥样硬化的良好指标,在肥胖海勤官兵血脂控制中应重点关注.

医学继续教育是医务人员提高专业技术水平的重要手段,如何提供便捷的继续教育方式是目前关注的重点.文章通过对医院外出学习管理系统近四年数据的调研,分析医院外出学习差异化,得出继续教育资源分配不均的结论.分享了继续教育管理的经验,并对当前外出学习管理模式提出优化建议.

Objective To have a preliminary analysis of the out learning of medical staff in the hospital,in order to improve the continuing education level of medical staff in the whole hospital and propose some reasonable suggestions.Methods Extract the data of out learning management system from 2014 to 2016 and analyze the differences.Results There were big differences in the out learning situation, and continuing education resources were unevenly distributed. Conclusion The out learning management mode needs to be optimized.

目的 观察体控电疗配合推拿治疗腰椎间盘突出症(LDH)的临床疗效.方法 选取2016年9月 ～2018年4月解放军陆军厦门特勤疗养中心收治的128例腰椎间盘突出症患者,采用随机数表法分为观察组和对照组各64例.观察组采用体控电疗配合推拿治疗,而对照组采用腰椎牵引配合推拿治疗.采用VAS疼痛评分,SF-MPQ各项评分和Oswestry功能指数评价两组患者的治疗效果.结果 观察组总有效率和治愈率分别为95.3％和57.8％,对照组分别为79.7％和37.5％,观察组总有效率、治愈率均高于对照组,差异有统计学意义(P<0.05).治疗后两组VAS、SF-MPQ、Oswestry功能评分与治疗前比较明显改善,且观察组优于对照组,差异具有统计学意义(P<0.05).结论 体控电疗配合推拿治疗腰椎间盘突出症能明显减轻患者疼痛和改善功能障碍.

As an important part of the military medical organization, the military sanatorium had its shortcomings like the big gap of service, unitary pattern, backward idea, and weak force.To adapt to the urgent situation of high-tech warfare in the future, sanitoriums should focus on the battlefield, pay attention to the reserve of talents, enhance combined services, promote quality and connotation so as to construct new military sanatorium service mode.

我军为确保在现代战争中“打得赢”,主要聚焦能打仗、打胜仗,近似实战的演训已在规模、强度、课题作业向纵深发展.现代科技在实战中的广泛应用,加剧了官兵对战争负性心理反应.为确保官兵身心健康,圆满完成实战演训任务,心理疏导工作已受到极度重视.近年来,对部队实战演训现状进行的调查统计,发现部分部队在实战演训中心理疏导工作存在着一些问题.现就实战演训中心理疏导的需求现状及对策报告如下.

随着国家医疗体制改革的不断推进,疗养院运行模式也在不断更新,以期更好地适应新的医疗环境,做好医疗保障服务. 国内各家疗养院都在探讨新的疗养模式,其中以健康管理模式、专病疗养模式等较多,本院将临床路径应用于疗养路径得到了良好的效果[1].

目的 探讨沙疗联合中医推拿治疗腰部软组织损伤的疗效.方法 选取2015年3月~2016年9月来本院疗养的腰部软组织损伤特勤疗养员125例,采用单盲随机法分为推拿联合沙疗组(沙疗组)和推拿联合电脑中频治疗组(电脑中频治疗组).采用VAS、Fairbank JC评分对2组治疗前、治疗第3、7、14天评价并比较分析.结果 结果分析显示,沙疗组治疗3、7、14 d与治疗前比较差异有统计学意义(P<0.05);电脑中频治疗组治疗7、14 d与治疗前比较差异有统计学意义(P<0.05).治疗7、14 d后,沙疗组与电脑中频治疗组比较差异有统计意义(P<0.05).结论 沙疗联合中医推拿按摩能够有效缓解慢性腰部软组织损伤疼痛,且效果明显优于电脑中频治疗.

Objective To develop a new type of muhifunctional inflatable medicine chest to execute medical service at special conditions.Methods The chest was made of Hypalon rubber,and composed of multi facets of air cells.Each air cell was divided into several independent columns to enhance the stability and anti-leakage performance of the chest.Results The chest realized the function of medicine storage,and the air cell could be used for rescue when applied separately and used as floating stretcher when collectively.The problems of the original medicine chest were solved in withdrawal,volume,transportation and etc.Conclusion The chest gains advantages in compactness,closure,moisture resistance,floating,stability,reliability,practicability,safety,anti shock and multi function,and thus is worthy promoting in emergency rescue and field training.

目的 探讨个性化干预策略对退休老干部睡眠质量的影响.方法 对50例睡眠障碍的老年人进行个性化干预,并对干预前和干预后1个月睡眠质量采用匹兹堡睡眠质量指数(PSQI)进行评价比较.结果 50名受试者在接受个性化干预策略后1个月PSQI总分及各因子评分均较干预前降低,差异均具有统计学意义(P＜0.05).结论 个性化干预策略依从性好,可以明显改善老年人的睡眠质量.

加强继续教育是促进军队疗养院建设发展、提升疗养质量的重要途径。本文对军队某疗养院继续教育现状进行了系统的SWOT分析，找出其优势、劣势、机会和挑战，在此基础上提出可持续发展的综合策略。

快速上浮脱险法是目前发达国家普遍使用的潜艇单人自动脱险方法，具有加压速度快、水下暴露时间短、脱险深度大及操作简单等特点，是艇员进行水下脱险自救的一种先进方法［1］。现将30 m 快速上浮脱险医学保障体会报道如下。

目的 观察鼓浪屿疗养因子对肿瘤患者造血功能及免疫功能的影响.方法 选择来院进行为期15 d疗养的恶性肿瘤患者56例,于疗养前后分别测定血常规、T淋巴细胞亚群(CD4+、CD8+、CD4+/CD8+)水平.结果 经过短期综合海滨疗养,患者外周血白细胞计数和血红蛋白均高于疗养前(P＜0.05);CD4+和CD4+/CD8+水平均高于疗养前,CD8+水平低于疗养前(P＜0.05).结论 鼓浪屿综合疗养能够改善肿瘤患者的造血功能及免疫功能.

Objective To develop a field medical electromobile for special environment at peacetime. Methods YK8112 Yika electromobile was adopted, with the chassis retained and the electromobile divided into a driver cabin and a medical compartment. The medical compartment was composed of a casualty area, medical staff area and a treatment area,equipped with first-aid respirator, defibrillator-monitor and etc. Results The electromobile had the maximal velocity of45 km/h, and could be deployed in special environment. Conclusion The electromobile can be used for military and civilian medical support in special environment.

目的：探索提高疗案质量的方式方法。方法就2012年下半年606份归档疗案暴露出的问题进行原因分析，制定整改措施，如建立健全管理网络，健全规章制度与考评办法，不断强化疗案书写培训，设计应用疗案终末质控管理Excel表等。结果通过近一年的整改，本院的电子疗案书写质量明显提高，质量管理逐步走上严格、规范、合理的轨道，且已形成常态管理机制，取得了较好的成效。结论管理者的重视起到决定性作用，立足现有条件积极想办法解决问题，能有效提高疗案质量。

OBJECTIVE:To detect the role of surviving (SVV) in the protective effect of resveratrol against hypoxia/reperfusion injury (H/RI) of cardiac microvascular endothelial cells (CMECs).METHODS:CMECs isolated from the hearts of adult rats were exposed to hypoxia (94% N₂, 5% CO₂, 1% O₂) for 2 h followed by 4 h reoxygenation (95% O₂, 5% CO₂). The cell proliferation of CMECs was measured by MTT assay and Transwell method was used to detect migration ability of CMEC, PI-AnnexinV double staining and flow cytometry technique were employed to observe the apoptotic rate of CMECs. The SVV protein expression was detected with Western blot method.RESULTS:Compared to control group, the proliferation (0.19 ± 0.03 vs. 0.42 ± 0.07, P < 0.01) and migration ((28 ± 2)/5HPF vs. (50 ± 3)/5 HPF, P < 0.01) abilities were impaired and the apoptosis index ((19.7 ± 0.8)% vs. (5.4 ± 0.3)%, (P < 0.05) of CMEC was increased after H/RI. The proliferation (0.36 ± 0.07 vs. 0.19 ± 0.03, P < 0.05) and migration ((55 ± 3)/5HPF vs. (28 ± 2)/5HPF, P < 0.05) abilities of CMEC were significantly improved while the apoptosis index ((9.6 ± 0.7)% vs. (19.7 ± 0.8)%, P < 0.05) was significantly decreased in H/RI+resveratrol group compared to H/RI group.SVV protein expression was also upregulated in H/RI+resveratrol group compared to H/RI group (P < 0.05). To further ascertain the role of SVV in the protective effects of resveratrol, PI3K specific inhibitor LY294002 was added to H/RI+resveratrol group, the proliferation (0.25 ± 0.05 vs. 0.36 ± 0.07, P < 0.05) and migration ((34 ± 3)/5HPF vs. (55 ± 3)/5HPF, P < 0.05) abilities were significantly decreased, the apoptosis index ((16.2 ± 0.6)% vs. (9.6 ± 0.7)%, P < 0.05) was increased and the protein expression of SVV was downregulated (P < 0.05) in LY294002+H/RI+resveratrol group compared to H/RI+resveratrol group.CONCLUSION:Resveratrol could significantly reduce H/RI induced apoptosis and attenuate H/RI induced cardiac microvascular endothelial cells dysfunction through up-regulating PI3K/Akt/SVV pathways.

本文总结了笔者所在疗养院加强科研创新和科研经费管理的具体举措,为加强科研管理、学科建设和人才培养等方面提供有益参考。