宁夏三级甲等医院男护士职业认同感的调查研究

目的 调查宁夏三级甲等医院男护士职业认同感的水平,比较在职男、女护士职业认同感的差异,为男护士的培养与管理提供一定的指导和参考依据.方法 采用自行设计的调查问卷,对银川市三甲医院246名男、女护士进行调查.结果 护士职业认同感总分为(58.46±10.84),其中,职业认同感良好者111例(45.1%),职业认同感不良者135例(54.9%).男、女护士在职业认同感总分、职业认同感价值观及提高职业认同感积极程度方面差异具有统计学意义(P<0.05).结论 女护士职业认同感总分、职业认同感价值观、提高职业认同感积极性优于男护士,应在男护士培养与管理方面多加关注,采取有效措施,加强支持力度,提高资金支持,以提高男护士职业认同感.     

男护士职业认同与职业获益的相关性研究

目的调查男护士职业认同和影响职业获益的相关因素,从而更加有效地管理男护士,并通过增进其职业认同和职业获益来激发工作热情、提高工作效率。方法 采用便利抽样法抽取2017年1—6月上海市和广州市132名从事临床护理工作1年以上的男护士进行问卷调查,调查内容包括男护士的年龄、科室、学历、编制等一般资料;职业认同评价量表评分;职业获益量表评分。结果 132名男护士的职业认同总分为(111.41±18.87)分,职业获益的总分为(100.73±19.11)分,两者均处于中等偏上水平。学历、年龄和科室对男护士的职业认同和职业获益感的影响不明显(均P>0.05);在不同编制的男护士中,是否有编制对其职业认同和职业获益感的影响因素比较明显,有编制的职业认同和职业获益优于无编制者,两者相比差异有统计学意义(t=5.229,P=0.031;t=6.852,P=0.010);男护士的职业认知评价、社会支持、职业社交技巧、职业挫折应对和职业自我反思的评分与职业认同相关因素呈正相关(P<0.05)。结论 男护士的职业认同感和职业获益与临床护理人员对工作的投入和对护理的情感关系密切,若处理不好相关的影响因素,则会造成护士的离职倾向与职业倦怠。     

大型三甲医院ICU护士职业认同现状调查分析

目的 了解ICU护士职业认同现状,探讨影响职业认同感的相关性因素.方法 采用分层抽样法,选取2015年1-6月福建省福州市3家大型三级甲等医院166名ICU护士进行问卷调查.调查问卷内容包含一般资料问卷、职业认同评定量表.采用SPSS 11.5对资料进行录入与分析.结果 护士职业认同感总分为(105.75±14.57)分,各维度得分分别为:职业认知评价(27.02±5.34)分、职业社会支持(21.69±3.79)分、职业挫折应对(20.52± 3.30)分、职业自我反思(11.56±1.91)分、职业社交技能(18.06±3.41)分.不同年龄、学历、职称、婚姻状况、收入、夜班频率及工作年限的ICU护士在职业认知评价的得分差异有统计学意义(P＜0.05),不同年龄、学历及工作年限的ICU护士在职业社会支持的得分差异有统计学意义(P＜0.05),不同年龄及婚姻状况的ICU护士在职业挫折应对的得分差异有统计学意义(P＜0.05),不同夜班频率的ICU护士在职业社交技能得分差异有统计学意义(P＜0.05),不同工作年限的ICU护士在职业自我反思得分差异有统计学意义(P＜0.05).结论 ICU护士职业认同感处于中等水平.护理管理者应重视影响ICU职业认同感的相关因素,制订有针对性的支持策略,提高护士的职业认同水平,以巩固护士团队和提高工作绩效.     

PTEN和VEGFPCNAbcl-2在胃癌组织中的表达及相关性研究

目的通过对PTEN和血管内皮生长因子(vascularendothelialgrowthfactor,VEGF)、增生细胞核抗原(proliferatingcellnuclearantigen,PCNA)、bcl-2在胃癌中表达的研究,结合临床病理特征,探讨PTEN和VEGF、PCNA、bcl-2的相关性。方法应用免疫组织化学S-P法检测68例胃癌组织及20名正常胃黏膜中PTEN、VEGF、PCNA和bcl-2的表达。结果胃癌组织中PTEN蛋白表达率为47%(33/68),显著低于正常胃黏膜的表达100%(20/20)(P<0.01),与组织分化程度呈正相关(P<0.01),与淋巴结转移呈负相关(P<0.05)。VEGF在胃癌中的表达率为75%(51/68),显著高于正常胃黏膜的表达10%(2/20)(P<0.01),与癌组织浸润深度呈正相关(P<0.01),与淋巴结转移也呈正相关(P<0.05),与组织分化程度无关。PCNA在胃癌中的表达率为74%(50/68),显著高于正常胃黏膜的表达20%(4/20),与癌组织浸润深度呈正相关(P<0.01),与淋巴结转移呈正相关(P<0.05),与组织分化程度呈负相关(P<0.05)。bcl-2在胃癌中的表达率为54%(37/68),显著高于正常胃黏膜的表达5%(1/20)(P<0.01),与癌组织浸润深度、淋巴结转移及组织分化程度无关。PTEN在胃癌中的表达与VEGF、PCNA呈负相关(P<0.01)。结论PTEN失活或蛋白表达降低与胃癌的组织分化程度及淋巴结转移密切相关,且与VEGF、PCNA呈显著负相?     

社会支持对慢性肾功能衰竭非透析患者心理状况的影响

目的通过对慢性肾功能衰竭非透析患者的抑郁状况以及社会支持情况的调查,了解社会支持对于患者抑郁状况的影响。方法本研究采用问卷调查法,对70例慢性肾功能衰竭非透析患者的社会支持和抑郁状况进行评估。结果慢性肾功能衰竭非透析患者抑郁发生率为54.3%,客观支持、支持利用度,社会支持总分的得分明显低于常模,差异有统计学意义(P<0.01),主观支持的得分与常模比较差异无统计学意义(P>0.05),社会支持总分及其各维度与抑郁情绪呈负相关(P<0.05)。结论慢性肾功能衰竭非透析患者抑郁发生率高,社会支持系统不足,改善患者的社会支持情况有利于降低抑郁的发生。     

老年阻塞性睡眠呼吸暂停综合征认知损害与应用茴拉西坦治疗疗效观察

目的探讨老年阻塞性睡眠呼吸暂停综合征(OSAS)患者的认知状况与其睡眠结构紊乱和低氧血症之间的关系。方法受试者分为OSAS组(46例)及对照组(45例),均进行多导睡眠图(PSG)、简易智能精神状态量表(MMSE)和事件相关电位(ERP)检测;OSAS组应用茴拉西坦治疗。结果 OSAS组Ⅲ+Ⅳ期和REM期睡眠时间、最低及平均血氧饱和度明显减少(P<0.05),醒觉次数及睡眠呼吸紊乱指数(AHI)明显增加(P<0.05);OSAS组MMSE总分显著低于对照组(P<0.05),且MMSE总分与AHI呈显著负相关(P<0.05),与夜间低氧血症呈显著正相关(P<0.05);OSAS组P300潜伏期显著长于对照组(P<0.05),P300潜伏期与MMSE总分呈显著负相关(P<0.05);OSAS组应用茴拉西坦治疗后,MMSE总分与治疗前相比有明显差异(P<0.05),OSAS组P300的潜伏期较治疗前有明显缩短(P<0.05),波幅较治疗前有所增高。结论老年OSAS患者存在认知功能损害,夜间低氧血症可能起重要作用,茴拉西坦治疗安全有效。     

健康管理中心护士工作压力源和心理资本对职业生涯状况的影响

目的 探讨健康管理中心护士工作压力源和心理资本对职业生涯状况的影响。方法 采用便利抽样法于2020年1～12月抽取沧州地区16所健康体检中心护士172例为研究对象,采用中国护士工作压力源量表(CNSS)、护士心理资本量表、职业生涯状况评价量表对其进行问卷调查,收集患者年龄、职称、护龄,文化程度、层级、工作性质、收入情况、婚姻状态等一般资料,分析其工作压力源、心理资本及其影响因素。结果 健康管理中心护士CNSS总分为(94.34±14.16)分,心理资本总分为(86.21±13.45)分,职业生涯状况总分为(79.64±11.32)分,Pearson线性相关分析显示,CNSS总分及各维度与职业生涯总分、职业满意度呈负相关(P<0.05),心理资本总分及各维度与职业生涯总分呈正相关(P<0.05),多因素Logistic回归分析结果显示,CNSS总分、工作压力源总分是健康管理中心护士职业生涯状况的主要变量(P<0.05)。结论 健康管理中心护士的职业生涯状况与多种因素有关,其中工作压力越大、心理健康水平越低的护士职业生涯状况越差,加强心理资本培养、缓解工作压力,有助于健康...     

应对方式对临床护士反刍思维与工作压力的影响

目的:选取蚌埠市3所三级甲等医院护士为研究对象，探讨应对方式在反刍思维与工作压力中的中介作用。方法:采用线上问卷调查的方法，使用一般资料调查表、护士工作压力源量表、简易应对方式问卷(SCSQ)、反刍思维量表(RRS)对蚌埠市3所三级甲等医院的532名护士进行问卷调查，最终回收500份有效问卷。结果:临床护士反刍思维、积极应对方式、消极应对方式及工作压力量表平均得分分别为(42.87±9.65)分、(35.56±7.29)分、(18.72±4.25)分、(64.41±19.68)分。护士反刍思维总分与工作压力总分呈正相关(r=0.482,P<0.01),与应对方式中积极应对维度得分呈负相关(r=-0.206,P<0.01),与消极应对维度得分呈正相关(r=0.413,P<0.01);工作压力总分与积极应对维度得分呈负相关(r=-0.204,P<0.01),与消极应对方式维度得分呈正相关(r=0.271,P<0.01)。反刍思维能直接作用于护士工作压力(β=0.431,P<0.01),也可通过积极应对方式和消极应对方式作用于工作压力(β=0.031、0....     

肺癌化疗患者癌因性疲乏发生情况及与社会支持的相关性研究

目的 探讨肺癌化疗患者癌因性疲乏(cancer-related fatigue,CRF)的发生情况,并分析其与社会支持的相关性.方法 选择2015年6月-2016年6月确诊的肺癌并进行化疗的144例,对其临床资料进行回顾性分析,分析CRF的发生情况,应用社会支持评定量表(SRSS)评估其社会支持情况,分析其与社会支持的相关性.结果 本组中CRF的发生率为79.17％,Piper疲乏量表(piper fatigue scale,PFS)各维度得分由高到低依次为行为、感觉、认知、情感.SRSS的主观支持、客观支持、对社会支持利用度和社会支持总分均低于国内常模(P＜0.01).CRF患者PFS各维度均与SRSS的主观支持、对社会支持的利用度和社会支持总分呈负相关,而情感维度与客观支持呈负相关(P＜0.05,P＜0.01).结论 肺癌化疗患者CRF发生率较高,且社会支持度较低,应加强CRF患者的社会支持,以提高临床治疗效果,延长生存期,提高生活质量.     

河北省三甲医院低年资护士心理状态与人文关怀能力相关性研究

目的 调查河北省三级甲等医院低年资护士的心理状态与实施护理人文关怀能力之间的关系。方法 采用整群抽样的方法，选取河北省4所三级甲等医院临床低年资护理人员，选用人文关怀能力量表、情绪智力量表和职业倦怠量表进行综合测评，共回收有效问卷249份，有效回收率为83.56%。结果 临床低年资护士人文关怀能力总分(193.60±23.32)分高于国内常模(191.04±19.49)分、低于国外常模(211.58±20.52)分。河北省三甲医院临床低年资护士的情绪智力总均分与江苏常模接近，低年资护士感知他人情绪均分、运用情绪均分高于江苏常模(均P<0.01),感知情绪均分低于江苏常模(P<0.01)。低年资护士职业怠倦与M式常模比较，低年资护士职业怠倦情绪枯竭、去人格化维度得分高于M式常模(P<0.05),个人成就感维度高于M式常模(P<0.01)。低年资护士的人文关怀能力总分与情绪智力总分呈正相关(P<0.001);与情绪智力各维度(情绪知觉、自我情绪管理、他人情绪管理、情绪利用)得分也呈正相关(P<0.01、P<0.05、P<0.001、P<...     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg x kg(-1)) or i.p. (50 mg x kg(-1)) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) 1 x h(-1) x kg(-1) in the male rat and 10.6 (95% CI: 7.5, 15.0) 1 x h(-1) x kg(-1) in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was approximately 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p < 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p < 0.001) in plasma obtained from the male (8.8 +/- 2.0%) compared with the female rat (11.7 +/- 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Hyperkalaemia in patients in hospital

A survey of all laboratory blood specimens with a plasma potassium concentration greater than or equal to 5.5 mmol/L was conducted over a three month period. Of 331 specimens with hyperkalaemia, 71 were excluded because the specimens was haemolysed, old or contaminated. The laboratory served a population of 348,561 and during this time measured the plasma potassium on 25,016 occasions. Sixty-six outpatients and 20 neonates were not evaluated. The survey was undertaken on 86 of 102 inpatients (46 males), 48 of whom were over 66 years of age. Fifty-seven patients were admitted under a medical service and 29 under a surgical service. Fifty-nine had a single episode of hyperkalaemia. Thirty-two underwent a surgical procedure. The commonest contributing factor was impaired renal function which was present in 71 (83%) patients. Although a definitive causative role for drugs could be identified in only five patients, in 52 (60%) patients drugs were a contributing factor (potassium supplements 24, ACE inhibitors 16, nonsteroidal antiinflammatory drugs 12). Thirty-five of the 86 (41%) patients died during their hospital admission. Nineteen of the 35 deaths occurred within three days of the hyperkalaemia being recorded. A normal plasma potassium was eventually documented in 50 of the 86 patients. Of the remaining 36 patients, 25 (69%) subsequently died. In general the treatment of patients with hyperkalaemia focused on identifying and treating the underlying cause. Hyperkalaemia must always be considered seriously and regard given to the overall clinical status of the patient, with particular attention to drug therapy, renal and cardiac function, acid base status and the possibility of sepsis.     

Changes in angiopoietin expression in glomeruli involved in glomerulosclerosis in rats with daunorubicin-induced nephrosis

AIM: To study the potential pathological role of endogenous angiopoietins in daunorubicin-induced progressive glomerulosclerosis in rats. METHODS: Seventy male Wistar rats were allocated randomly into a daunorubicin group (DRB; n=40) or a control group (n=30). The rats in the DRB group were injected with DRB (15 mg/kg), in their tails. Subsequently, at intervals of 1, 2, 4, 6, 8, and 12 weeks, 5 male Wistar rats in each group were chosen randomly for 24 h urinary protein quantitative measurements (24 h UPQM), and determination of plasma tumor necrosis factor alpha (TNF-alpha), angiopoietin-1 (Ang1), and angiopoietin-2 (Ang2) levels. Kidney sections were examined by electron microscopy, Periodic Acid Schiff (PAS) staining, immunohistochemical staining and in situ hybridization histochemistry. RESULTS: As glomerulosclerosis progressed in the DRB group, expression of Ang1 mRNA and protein in glomeruli decreased and expression of TNF-alpha protein, Ang2 mRNA and protein in glomeruli increased. Expression of Ang1 mRNA and protein in glomeruli were negatively correlated with 24 h UPQM, Fn protein expression, and mean area of extracellular matrix (MAECM). In comparison, expression of Ang2 mRNA and protein in glomeruli were positively correlated with 24 h UPQM, Fn protein expression and MAECM; furthermore, there was a positive correlation between plasma Ang2 and 24 h UPQM. Plasma TNF-alpha and expression of TNF-alpha in glomeruli were positively correlated with expression of Ang2 mRNA and protein in glomeruli. There was a negative correlation between Ang1 protein expression and Ang2 protein expression in glomeruli. CONCLUSION: During DRB-induced glomerulosclerosis, podocyte injury led to a shift in the balance of Ang1 and Ang2 in glomeruli. Increased TNF-alpha in plasma and glomeruli may upregulate Ang2 expression in glomeruli. Elevated Ang2 in both plasma and glomeruli may mediate protein permeability through the glomerular filtration barrier. Moreover, local expression of Ang2 may facilitate the progress of glomerulosclerosis by upregulating a component expression of extracellular matrix.