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Do medical students studying in the United Kingdom have an adequate factual knowledge of basic life support?

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World Journal of Emergency Medicine 2019年第2期10卷 75-80页

作者： Robert D.Willmore Damjan Veljanoski Feray Ozdes Bethan stephens James Mooney seamus G.Crumley Arpan Doshi Philippa Davies shreya Badhrinarayanan Emily Day Kristian Tattam April Wilson Nathan Crang Lorna Green Craig A.Mounsey Howell Fu Joseph Williams Michelle s.D'souza Dhanya sebastian Liam A.Mcgiveron Matthew G.Percy James Cohen Imogen J.John Alice Lethbridge Imogen Watkins Omar Amin Mubasher A.Qamar John Gerrard Hanrahan Emily Cramond-Wong Barts Health NHs Trust Barts & the London Medical school Queen Mary University of London Norwich Medical school University of East Anglia Lancaster Medical school Lancaster University school of Medicine Dentistry and Biomedical Sciences Queen's University Belfast Faculty of Medicine University of St Andrews Faculty of Medicine Dentistry and Health University of Sheffi eld Brighton and sussex University Hospitals NHs Trust st george's University of London University of Liverpool school of Medicine University of Exeter medical school Faculty of Medicine University of Southampton Medical sciences Division University of Oxford University of Edinburgh Medical school Faculty of Medicine University of Warwick University College London Medical school Cardiff University school of Medicine College of Medical and Dental sciences University of Birmingham College of Medical Veterinary and Life Sciences University of Glasgow Guys Kings and St Thomas School of Medicine King’s College London Faculty of Life sciences & Medicine King's College London Faculty of Health sciences at the University of Nottingham

BACKGROUND: Healthcare professionals have a duty to maintain basic life support(BLs) skills. This study aims to evaluate medical students' factual knowledge of BLs and the training they ***: A cross-sectional, closed-response questionnaire was distributed to the fi rst-and fourth-year students studying at institutions in the United Kingdom. The paper questionnaire sought to quantify respondent's previous BLs training, factual knowledge of the BLs algorithm using five multiple choice questions(MCQs), and valuate their desire for further BLs training. students received 1 point for each correctly identifi ed answer to the 5 MCQ'***: A total of 3,732 complete responses were received from 21 medical schools. Eighty percent(n=2,999) of students completed a BLs course as part of their undergraduate medical studies. There was a signifi cant difference(Pstudents selecting the correct answer in all the MCQ's compared to the fi rst-year students except in identifyingthe correct depth of compressions required during CPR(P=0.095). Overall 10.3%(95% CI 9.9% to 10.7%) of respondents correctly identified the answer to 5 MCQ's on BLs: 9% of the first-year students(n=194) and 12% of the fourth-year students(n=190). On an institutional level the proportion of students answering all MCQ's correctly ranged from 2% to 54% at different universities. Eighty-one percent of students(n=3,031) wished for more BLs training in their ***: Factual knowledge of BLs is poor among medical students in the UK. There is a disparity in standards of knowledge across institutions and respondents indicating that they would like more training.

关键词： Emergency Medicine Basic life support Medical education Resuscitation

与核素测量清除率比较,使用MDRD评估肾小球滤过率的显著差异

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国际医学放射学杂志 2011年第6期 611-612页

作者： A.J. Craig A. Britten s.D. Heenan A.G. Irwin 蔡兆熙 Department of Medical Physics St. George's Hospital Knightsbridge Wing Blackshaw Road Tooting London SW17 0QT UK

目的比较采用MDRD(Modification of Diet inRenal Disease equation)方程的佑计肾小球滤过率(eGFR)和核素肾小球滤过率(rGFR)在放射学检查对比剂运用前评估肾功能的差异。方法回顾性分析混合配对人群516例的rGFR研究并计算eGFR,分析Blan... 详细信息

目的比较采用MDRD(Modification of Diet inRenal Disease equation)方程的佑计肾小球滤过率(eGFR)和核素肾小球滤过率(rGFR)在放射学检查对比剂运用前评估肾功能的差异。方法回顾性分析混合配对人群516例的rGFR研究并计算eGFR,分析Bland-Altman回归和效益,

关键词：肾小球滤过率 51Cr-EDTA 钆血浆清除率 MDRD

Fluid balance concepts in medicine:Principles and practice

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World Journal of Nephrology 2018年第1期7卷 1-28页

作者： Maria-Eleni Roumelioti Robert H Glew Zeid J Khitan Helbert Rondon-Berrios Christos P Argyropoulos Deepak Malhotra Dominic s Raj Emmanuel I Agaba Mark Rohrscheib Glen H Murata Joseph I shapiro Antonios H Tzamaloukas Division of Nephrology Department of MedicineUniversity of New Mexico School of MedicineAlbuquerqueNM 87131United States Department of surgery University of New Mexico School of MedicineAlbuquerqueNM 87131United States Division of Nephrology Department of MedicineJoan Edwards School of MedicineMarshall UniversityHuntingtonWV 25701United States Division of Renal and Electrolyte Department of MedicineUniversity of Pittsburgh School of MedicinePittsburghPA 15260United States Division of Nephrology Department of MedicineUniversity of Toledo School of MedicineToledoOH 43614-5809United States Division of Renal Disease and Hypertension Department of MedicineGeorge Washington UniversityWashingtonDC 20037United States Division of Nephology Department of MedicineJos University Medical CenterJosPlateau State 930001Nigeria Research service Raymond G Murphy VA Medical Center and University of New Mexico School of MedicineAlbuquerqueNM 87108United States 不详

The regulation of body fluid balance is a key concern in health and disease and comprises three concepts. The first concept pertains to the relationship between total body water(TBW) and total effective solute and is expressed in terms of the tonicity of the body fluids. Disturbances in tonicity are the main factor responsible for changes in cell volume, which can critically affect brain cell function and survival. solutes distributed almost exclusively in the extracellular compartment(mainly sodium salts) and in the intracellular compartment(mainly potassium salts) contribute to tonicity, while solutes distributed in TBW have no effect on tonicity. The second body fluid balance concept relates to the regulation and measurement of abnormalities of sodium salt balance and extracellular volume. Estimation of extracellular volume is more complex and error prone than measurement of TBW. A key function of extracellular volume, which is defined as the effective arterial blood volume(EABV), is to ensure adequate perfusion of cells and organs. Other factors, including cardiac output, total and regional capacity of both arteries and veins, starling forces in the capillaries, and gravity also affect the EABV. Collectively, these factors interact closely with extracellular volume and some of them undergo substantial changes in certain acute and chronic severe illnesses. Their changes result not only in extracellular volume expansion, but in the need for a larger extracellular volume compared with that of healthy individuals. Assessing extracellular volume in severe illness is challenging because the estimates of this volume by commonly used methods are prone to large errors in many illnesses. In addition, the optimal extracellular volume may vary from illness to illness, is only partially based on volume measurements by traditional methods, and has not been determined for each illness. Further research is needed to determine optimal extracellular volume levels in several illne

关键词： Body fluids Body water Extracellular volume Hypertonicity Hypotonicity Congestive heart failure Hepatic cirrhosis sepsis Nephrotic syndrome

Observatory science with eXTP

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science China(Physics,Mechanics & Astronomy) 2019年第2期62卷 97-138页

作者： Jean J.M.in 't Zand Enrico Bozzo JinLu Qu Xiang-Dong Li Lorenzo Amati Yang Chen Immacolata Donnarumma Victor Doroshenko stephen A.Drake Margarita Hernanz Peter A.Jenke Thomas J.Maccarone simin Mahmoodifar Domitilla de Martino Alessandra De Rosa Elena M.Rossi Antonia Rowlinson Gloria sala Giulia stratta Thomas M.Tauris Joern Wilms XueFeng Wu Ping Zhou Iván Agudo Diego Altamirano Jean-Luc Atteia Nils A.andersson M.Cristina Baglio David R.Ballantyne Altan Baykal Ehud Behar Tomaso Belloni sudip Bhattacharyya stefano Bianchi Anna Bilous Pere Blay Joao Braga sφren Brandt Edward F.Brown Niccolo Bucciantini Luciano Burderi Edward M.Cackett Riccardo Campana sergio Campana Piergiorgio Casella Yuri Cavecchi Frank Chambers Liang Chen Yu-Peng Chen Jér?me Chenevez Maria Chernyakova ChiChuan Jin Riccardo Ciolfi Elisa Costantini Andrew Cumming Antonino D'Aì Zi-Gao Dai Filippo D'Ammando Massimiliano De Pasquale Nathalie Degenaar Melania Del santo Valerio D'Elia Tiziana Di salvo Gerry Doyle Maurizio Falanga XiLong Fan Robert D.Ferdman Marco Feroci Federico Fraschetti Duncan K.Galloway Angelo F.Gambino Poshak Gandhi MingYu Ge Bruce Gendre Ramandeep Gill Diego G?tz Christian Gouiffès Paola Grandi Jonathan Granot Manuel Güdel Alexander Heger Craig O.Heinke Jeroen Homan Rosario Iaria Kazushi Iwasawa Luca Izzo Long Ji Peter G.Jonker Jordi José Jelle s.Kaastra Emrah Kalemci Oleg Kargaltsev Nobuyuki Kawai Laurens Keek stefanie Komossa Ingo Kreykenbohm Lucien Kuiper Devaky Kunneriath Gang Li En-Wei Liang Manuel Linares Francesco Longo FangJun Lu Alexander A.Lutovinov Denys Malyshev Julien Malzac Antonios Manousakis Ian McHardy Missagh Mehdipour YunPeng Men Mariano Méndez Roberto P.Mignani Romana Mikusincova M.Coleman Miller Giovanni Miniutti Christian Motch Joonas Nättilä Emanuele Nardini Torsten Neubert Paul T.O'Brien Mauro Orlandini Julian P.Osborne Luigi Pacciani stéphane Paltani Maurizio Paolillo Iossif E.Papadakis Biswajit Paul Alberto Pellizzoni Uria Peretz Miguel A.Pérez Torres Emanuele Perinati Chanda Prescod-Weinstein Pablo Reig sRON Netherlands Institute for space Research Department of Astronomy University of Geneva Key Laboratory for Particle Astrophysics Institute of High Energy PhysicsChinese Academy of Sciences school of Astronomy and space science Nanjing University INAF-IAsF Bologna AsI Via del Politecnico snc INAF-Istituto di Astrofisica e Planetologie spaziali Institut für Astronomie und Astrophysik Tübingen Universit?t Tübingen NAsA Goddard space Flight Center ICREA&Institute of space sciences(IEEC-CsIC) Campus UABCarrer de Can Magrans CsPAR SPA University of Alabama in Huntsville Department of Physics Texas Tech University INAF Osservatorio Astronomico di Capodimonte Leiden Observatory Leiden University Anton Pannekoek Institute University of Amsterdam AsTRON Netherlands Institute for Radio Astronomy Universitat Politecnica de Catalunya(UPC-IEEC) Universitádegli studi di Urbino‘Carlo Bo’ Max-Planck-Institut für Radioastronomie Dr.Karl-Remeis-sternwarte and Erlangen Centre for Astroparticle Physics(ECAP) Friedrich Alexander Universit?t Erlangen-Nurnberg Purple Mountain Observatory Chinese Academy of Sciences Instituto de Astrofysíca de Andalucia-CsIC Department of Physics and Astronomy University of Southampton IRAP Universitéde ToulouseCNRSUPSCNES Mathematical sciences and sTAG Research Centre University of Southampton New York University Abu Dhabi Center for Relativistic Astrophysics School of PhysicsGeorgia Institute of Technology Physics Department Middle East Technical University Department of Physics Technion-Israel Institute of Technology INAF Osservatorio Astronomico di Brera Tata Institute of Fundamental Research Dipartimento di Matematica e Fisica Universitàdegli Studi Roma Tre Instituto de Astrofísica de Canarias Instituto Nacional de Pesquisas Espaciais-INPE National space Institute Technical University of Denmark(DTU Space) Department of Physics and Astronomy Michigan State University INAF Osservatorio Astrofisico di Arcetri Dipartimento di Fisica Universitádegli Studi di Cagliari Department of Physics and A

In this White Paper we present the potential of the enhanced X-ray Timing and Polarimetry(eXTP) mission for studies related to Observatory science targets. These include flaring stars, supernova remnants, accreting white dwarfs, low and high mass X-ray binaries, radio quiet and radio loud active galactic nuclei, tidal disruption events, and gamma-ray bursts. eXTP will be excellently suited to study one common aspect of these objects: their often transient nature. Developed by an international Consortium led by the Institute of High Energy Physics of the Chinese Academy of science, the eXTP mission is expected to be launched in the mid 2020s.

关键词： space research in struments nuclear astrophysics flare stars accretion and accretion disks mass loss and stellar winds cataclysmic binaries X-ray binaries supernova remnants active galactic nuclei X-ray bursts gamma-ray bursts gravitational waves

食物特异性IgG4抗体指导的限制性饮食可改善肠易激综合征症状和直肠顺应性

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世界核心医学期刊文摘（胃肠病学分册） 2005年第12期1卷 51-52页

作者： Zar s. Mincher L. Benson M.J. Kumar D. 郝筱倩 Department of Gastrointestinal surgery St. George' s Hospital Medical SchoolCranmer Terrace London SW17 0QT United Kingdom Dr.

Objective. Dietary modification improves symptoms in irritable bowel syndrome (IBs). Identification of offending foods by dietary elimination/re- challenge is cumbersome. IgG4 antibodies to common food antigens are elevated in IBs. The aim of this article was to evaluate the effect of exclusion diet based on IgG4 titres on IBs symptoms and rectal sensitivity and compliance. Material and methods. The study comprised 25 patients with IBs (3M, 22 F,mean age 43 years,Rome II criteria). IgG4 titres to 16 foods (milk, eggs, cheese, wheat, rice, potatoes, chicken, beef, pork, lamb, soya bean, fish, shrimps, yeast, tomatoes and peanuts) were measured. Foods with titres >250 μ g/l were excluded for 6 months. symptom severity was assessed with a previously validated questionnaire at baseline, at 3 months and at 6 months. Rectal compliance and sensitivity were measured in 12 patients at baseline and at 6 months. Results. IgG4 antibodies to milk, eggs, wheat, beef, pork and lamb were commonly elevated. significant improvement was reported in pain severity (p severity (p = 0.001), satisfaction with bowel habits (p = 0.004) and effect of IBs on life in general (p = 0.008) at 3 months. symptom improvement was maintained at 6 months. Rectal compliance was significantly increased (p = 0.011) at 6 months but the thresholds for urge to defecate/discomfort were unchanged. Conclusions. Food- specific IgG4 antibody- guided exclusion diet improves symptoms in IBs and is associated with an improvement in rectal compliance.

关键词：肠易激综合征 IgG 抗体滴度特异性顺应性罗马Ⅱ标准证实有效食物构成评价根据排便习惯

培哚普利降压治疗可降低心房纤颤及以前有卒中或短暂缺血性发作患者大血管事件的发生

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世界核心医学期刊文摘（神经病学分册） 2006年第3期2卷 44-45页

作者： Arima H. Hart R.G. Colman s. J. Chalmers 牛亚利 PROGREss Collaborative Group c/o The George Institute for International Health University of Sydney Missenden Road Sydney NSW 2050 Australia

Background and Purpose -Patients with atrial fibrillation have a high risk of stroke and other vascular events even if anticoagulated. The primary objective here is to determine whether routine blood pressure-lowering provides additional protection for this high-risk patient group. Methods -This study was a subsidiary analysis of the Perindopril Protection Against Recurrent stroke study (PROGREss)-a randomized, placebocontrolled trial that established the beneficial effects of blood pressure-lowering in a heterogeneous group of patients with cerebrovascular disease. A total of 6105 patients were randomly assigned to either active treatment (2 to 4 mg perindopril for all participants plus 2.0 to 2.5 mg i ndapamide for those without an indication for or a contraindication to a diuretic) or matching placebo(s). Outcomes are total major vascular events, causespecific vascular outcomes, and death from any cause. Results -There were 476 patient s with atrial fibrillation at baseline, of whom 51%were taking anticoagulants. In these patients, active treatment lowered mean blood pressure by 7.3/3.4 mm Hg and was associated with a 38%(95%confidence interval [CI], 6 to 59) reduction in major vascular eve nt s and 34%(95%CI, -13 to 61) reduction in stroke. The benefits of blood pressu re-lowering in patients with atrial fibrillation were achieved irrespective of the use of anticoagulant therapy (P homogeneity=0.8) or the presence of hyperten sion (P homogeneity=0.4). Conclusions -For most patients with atrial fibrillati on, routine blood pressurelowering is likely to provide protection against major vascular events additional to that conferred by anticoagulation.

关键词：心房纤颤培哚普利吲达帕胺全因死亡预后指标患者群体安慰剂对照卒中发生率脑血管疾病辅助

美国医院护理职业生涯专业贡献规划图的介绍及启示

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护理学杂志 2021年第2期36卷 98-100页

作者：成磊 Mia Waldron Janice JMason Pamela sHinds 复旦大学护理学院上海200032 Children′s National Hospital george Washington University

介绍美国医院护理职业生涯专业贡献规划图的定义、产生背景、绘制步骤及实际应用。专业贡献规划图通过帮助护士主动定义工作的意义并采取积极的行动方案,从而实现自身期待的对专业的贡献。提出其对我国护士职业生涯发展规划的启示包括... 详细信息

介绍美国医院护理职业生涯专业贡献规划图的定义、产生背景、绘制步骤及实际应用。专业贡献规划图通过帮助护士主动定义工作的意义并采取积极的行动方案,从而实现自身期待的对专业的贡献。提出其对我国护士职业生涯发展规划的启示包括提升护士个体的主动性,鼓励团队成员间的互动和包容,加强系统层面的引领和支持。

关键词：护士职业生涯发展专业贡献规划图职业规划

science:研究鉴定出导致脑细胞死亡的罪魁祸首

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现代生物医学进展 2017年第4期17卷 I0001-I0001页

作者： Yingfei Wang Ran An george K Umanah Hyejin Park Kalyani Nambiar stephen M Eacker BongWoo Kim Lei Bao Maged M Harraz Calvin Chang Rong Chen Jennifer E Wang TaeIn Kam Jun seop Jeong Zhi Xie stewart Neifert Jiang Qian shaida A Andrabi seth Blackshaw Heng Zhu Hongjun song GuoLi Ming Valina L Dawson Ted M Dawson Neuroregeneration and stem Cell Programs Institute for Cell Engineering Johns Hopkins University School of Medicine Baltimore MD 21205 USA. tdawson@jhmi.edu vdawson1@jhmi.edu yingfei.wang@utsouthwestern.edu. Department of Neurology Johns Hopkins University School of Medicine Baltimore MD 21205 USA. Department of Pathology University of Texas Southwestern Medical Center Dallas TX 75390 USA. Department of Neurology and Neurotherapeutics University of Texas Southwestern Medical Center Dallas TX 75390 USA. Neuroregeneration and stem Cell Programs Institute for Cell Engineering Johns Hopkins University School of Medicine Baltimore MD 21205 USA. Department of Neurology of Huashan Hospital State Key Laboratory of Medical Neurobiology Fudan University Shanghai 200032 China. Adrienne Helis Malvin Medical Research Foundation New Orleans LA 70130-2685 USA. solomon H. snyder Department of Neuroscience Johns Hopkins University School of Medicine Baltimore MD 21205 USA. Department of Pharmacology and Molecular sciences Johns Hopkins University School of Medicine Baltimore MD 21205 USA. Center for High-Throughput Biology Johns Hopkins University School of Medicine Baltimore MD 21205 USA. Department of Ophthalmology Johns Hopkins University School of Medicine Baltimore MD 21205 USA. Department of Physiology Johns Hopkins University School of Medicine Baltimore MD 21205 USA.

尽管存在不同的触发物，相同的一连串分子事件似乎导致中风、脑损伤和甚至阿尔茨海默病等神经退行性疾病中的脑细胞死亡。如今，在一项新的研究中。来自美国约翰霍普金斯大学的研究人员说，他们精确地发现一种位于这一连串事件末端的蛋... 详细信息

尽管存在不同的触发物，相同的一连串分子事件似乎导致中风、脑损伤和甚至阿尔茨海默病等神经退行性疾病中的脑细胞死亡。如今，在一项新的研究中。来自美国约翰霍普金斯大学的研究人员说，他们精确地发现一种位于这一连串事件末端的蛋白。即一种通过切割细胞的DNA给予致命性打击的蛋白。他们说，这一发现潜在地为开发预防、阻止或削弱这一过程的药物打开新的大门。相关研究结果发表在science期刊上。

关键词：细胞死亡脑损伤神经退行性疾病鉴定阿尔茨海默病分子事件研究人员致命性

EFNs急性卒中神经影像学指南EFNs特别工作组的报道

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国际脑血管病杂志 2007年第8期15卷 566-576页

作者： J.C. Masdeu P. Irimia s. Asenbaum J. Bogousslavsky M. Brainin H. Chabriat K. Herholz H.s. Markus E. Martínez-Vila K. Niederkorn P.D. schellinger R.J. seitz 林曰增（译） From the Department of Neurology and Neurosurgery Uniuersity of Navarra Pamplona Spain Department of Neurology Medical University of Vienna Vienna Austria Department of Neurology Centre Hospitalier Universitaire Vaudois Lausanne Switzerland Department of Neurology Donauklinikum and Donau-Universitat Maria Gugging Austria Department of Neurology I.zriboisiere Hospital University of Paris Paris Frame Wolfson Molecular Imaging Centre University of Manchester Manchester Department of Neurology and Clinical Neuroscience St George＇s Hospital Medical School London UK Department of Neurology Karl Franzens University Graz Austria Department of Neurology University Clinic at Heidelberg Genmany arid Department of Neurology University Hosnital Düsseldorf Düsseldorf Germary 南军区青岛第一疗养院放射科青岛266071

神经影像学技术对于卒中的评价是必需的。在发达国家，卒中是死亡和神经功能缺损的前几位原因之一。可供使用的影像学技术的多样性增加了临床医师决策的复杂性。我们全面回顾了1965-2005年的英文文献并对相关出版物进行了严格评价。专... 详细信息

神经影像学技术对于卒中的评价是必需的。在发达国家，卒中是死亡和神经功能缺损的前几位原因之一。可供使用的影像学技术的多样性增加了临床医师决策的复杂性。我们全面回顾了1965-2005年的英文文献并对相关出版物进行了严格评价。专家组成员检查和修改了初稿，然后按照欧洲神经病学学会联盟（EFNs）标准，对分层推荐意见达成共识。CT平扫是卒中患者初步评价的一种固定的影像学检查。然而，MRI对于显示梗死或缺血区较CT更为敏感，而且还能显示急性和慢性脑出血。灌注和弥散MRI和磁共振血管成像（MRA）对缺血性卒中的急性期评价非常有用。对于脑动脉瘤的筛查以及脑静脉血栓形成和动脉夹层分离的诊断，MRI和MRA是推荐的影像学技术。对于颅外血管的无创性检查，MRA不如超声检查轻便且价格更加昂贵，但它对颈动脉狭窄的敏感性和特异性更高。经颅多普勒对于监测溶栓治疗后的动脉再灌注、诊断颅内血管狭窄和右向左分流以及监测蛛网膜下腔出血后的血管痉挛非常有用。目前，单光子发射体层摄影和正电子发射体层摄影在急性卒中患者评价中的作用非常有限。

关键词：计算机体层摄影 CT血管造影磁共振成像磁共振血管造影灌注卒中超声