基于CiteSpace的我国造血干细胞移植护理相关文献的可视化分析

目的分析我国造血干细胞移植护理研究文献,探讨造血干细胞移植护理的发展趋势、研究热点,为造血干细胞移植临床护理工作及相关研究提供借鉴和参考。方法在中国知网数据库(CNKI)于1995-2018年收录的文献中,以主题词造血干细胞移植护理进行检索,应用可视化分析软件CiteSpace进行文献计量学分析。结果共检索出622篇文献,发文量总体上呈现增加的趋势,发文量最多的机构是苏州大学附属第一医院血液科,高频关键词为护理、造血干细胞移植、异基因造血干细胞移植、自体造血干细胞移植等,突现词为自体造血干细胞移植、患者、层流室等。结论造血干细胞移植护理日益受到护理研究人员的关注,但发文机构及作者之间缺乏合作与交流;口腔黏膜炎相关护理研究是造血干细胞移植未来的发展趋势和研究热店。     

保护动机理论在乳腺癌患者功能锻炼中的应用

目的探讨保护动机理论(protection motivation theory,PMT)在乳腺癌患者功能锻炼中的应用效果。方法采用便利抽样法,选取2018年1—12月在郑州大学附属肿瘤医院(河南省肿瘤医院)接受乳腺癌改良根治术的110例乳腺癌患者作为研究对象,将2018年1—6月住院的55例患者作为对照组,将2018年7—12月住院的55例患者作为试验组。对照组于患者出院前采用常规功能锻炼指导,试验组采用PMT进行干预。采用乳腺癌术后患者院外功能锻炼依从性量表、DASH简式评分表、SAS比较两组的干预效果。结果对照组共获得完整资料50份,试验组共获得完整资料52份。干预后试验组患者的身体锻炼依从性、主动寻求建议依从性得分高于对照组,差异有统计学意义(P<0.05)。干预后试验组患者的上肢功能障碍得分低于对照组,差异有统计学意义(P<0.05)。干预后试验组患者的焦虑得分低于对照组,差异有统计学意义(P<0.05)。结论依据PMT制订的干预措施能够提高乳腺癌患者功能锻炼的依从性,改善患者的上肢功能,降低患者的焦虑状态。     

基于职业感知的低年资护士同理心训练效果研究

目的探讨基于职业感知的同理心训练对低年资护士临床沟通能力、职业获益感和自我效能感的影响。方法采用类实验研究方法,于2018年3—9月,以自愿报名的方式招募河南省肿瘤医院自我效能低下的67名低年资护士作为研究对象,将其分为5组,每组12~15名,分别进行5周共5次面对面的以职业感知为主要内容的同理心训练。采用护士临床沟通能力量表、护士职业获益感量表和一般自我效能感量表于训练前和训练后评价干预效果。采用SPSS 22.0软件进行统计分析。结果训练过程中3名护士退出,最终64名护士完成训练。训练后,64名护士的临床沟通能力总均分为(3.75±0.66)分,职业获益感总均分为(4.65±0.40)分,一般自我效能感总均分为(2.53±0.20)分,均高于训练前,差异均有统计学意义(t值分别为5.058、7.911、25.979;P<0.01)。结论基于职业感知的同理心训练能够提高低年资护士的临床沟通能力,提升其职业获益感水平和自我效能,该干预方案或可进一步在护士人群中得到拓展和应用。     

Dose issues in antiepileptic therapy

Antiepileptic drug (AED) therapy is complex, with numerous traditional drugs and more than 10 second-generation drugs being approved since the mid-1990s. The burden of epilepsy is compounded by the adverse effects of these drugs, which comprise a variety of manifestations, the most devastating of which is their association with physical and cognitive foetal malformations in babies exposed to these agents in utero. Many effects are dose-related – a clear understanding of these adverse effects is desirable to be able to adjust medications and medication regimens to suit individual patient needs and to try to prevent them, by a careful introduction, slow escalation, well-considered combination and possible pre-exposure testing of patients for their tolerance, to each proposed AED. The overall problem and the profiles of the main agents are outlined from the perspective of dose-related issues.     

Relevance of serum estradiol and estrogen receptor beta expression from a high-incidence area for esophageal squamous cell carcinoma in China

The striking 3-4:1 male predominance of esophageal squamous cell carcinoma (ESCC) has not yet been well explained. Our hypothesis is that the changes in level of estrogen and/or subtype of estrogen receptor (ER) may exert a protective factor in esophageal carcinogenesis and prognosis of ESCC. Radioimmunoassay (RIA) was used to determine the serum level of estradiol in healthy cohort from high-incidence area (HIA) and low-incidence area (LIA) for esophageal cancer as well as patients with ESCC from HIA in Henan, northern China. The ERβ expression profiling during the multi-stage progression of ESCC pathogenesis was evaluated by immunohistochemistry (IHC). Both males and females from HIA had significant decreases of serum estradiol in high-risk subjects predisposing for ESCC compared to healthy counterparts from LIA (P < 0.01). Furthermore, patients with ESCC from HIA developed the lowest level of estradiol (P < 0.01). ERβ expressed in precursor lesions of ESCC and changed quantitatively and qualitatively with disease progression during the multi-stages process of esophageal carcinogenesis. High frequency of ERβ expression was correlated with less aggressive potential of clinical behavior (P = 0.012, 0.015 for lymph node metastasis and tumor stage, respectively). This study indicates that lower serum level of estradiol may represent higher predisposition for development of ESCC, and ERβ expression and/or nuclear location may predict better outcome for patients with ESCC. The present results provide clues to explain the striking gender difference for ESCC, which warrants further investigations on potential applications of estrogen or analogs in prevention of ESCC.