合理分配护理资源对护理质量的影响

目的:探讨责任制整体模式对护理人力资源开发及护理质量的影响。方法:经过调查研究,2010年7～12月将科室34张病床分为3组,每组分管11～12张床位,由责任护士负责11～12例病人的全部护理治疗工作,包括基础护理、专科护理、治疗、病情观察、护理记录、心理护理、健康教育等。与科室原有的功能制护理模式进行比较,展开问卷调查,将获得的资料进行统计分析。结果:责任制整体护理模式较原有护理模式在护理质量和病人家属满意度上有明显提高(P<0.01)。结论:责任制整体护理模式更能发挥护士能动性,科学合理的提高护理工作质量与效率,提高病人家属满意度。     

观察压力支持通气模式对重症监护患者睡眠质量的影响

目的:观察压力支持通气模式(Pressure Support Ventilation,PSV)对重症监护患者睡眠质量的影响.方法:选取2017年1月至2017年8月德州市陵城区人民医院重症监护病房(ICU)收治的重症治疗患者60例作为研究对象,按照随机数字表法分为观察组和对照组,每组30例.对照组患者给予低剂量镇静加气...     

教师标准化病人在护生临床见习中的应用

目的探讨教师标准化病人(TSP)教学模式用于护生临床见习的效果。方法选取2010年进入我院内外科进行护理临床见习的大专及以上学历的护生62人,将其随机分为观察组与对照组各31人。对照组采用常规教学方法,即讲解-示教-练习的教学模式。观察组采用常规教学方法+TSP的教学模式。见习结束后对两组护生操作考核成绩与理论考核成绩进行比较并征求观察组对培训方式的效果评价。结果观察组护生理论考试的病例分析成绩和操作考试的沟通技能成绩显著优于对照组(均P<0.01);除提高临床护理技能、促进知识掌握与理解外,观察组对TSP教学的认可度显著优于对照组(均P<0.01)。结论 TSP教学法应用于护理临床见习教学中,有助于提高教学效果,提高护生病例分析能力和沟通能力。     

失效模式与效应分析用于预防化疗药物外渗

目的规范静脉化疗操作流程,降低化疗药物外渗发生率。方法将200例确诊为血液系统肿瘤拟行化疗患者随机分为观察组(102例)和对照组(98例),对照组按照常规进行化疗药物的治疗操作;观察组采用失效模式与效应分析(FMEA)的方法,即确定降低化疗药物外渗的主题,组建团队,制定流程,分析失效模式的原因,实施改进。结果两组化疗药物外渗发生率比较,差异有统计学意义(P<0.01)。结论 FMEA应用于化疗患者,能显著降低药物外渗发生的风险,保障患者安全。     

Binding modes of thioflavin T molecules to prion Peptide assemblies identified by using scanning tunneling microscopy

The widely used method to monitor the aggregation process of amyloid peptide is thioflavin T (ThT) assay, while the detailed molecular mechanism is still not clear. In this work, we report here the direct identification of the binding modes of ThT molecules with the prion peptide GNNQQNY by using scanning tunneling microscopy (STM). The assembly structures of GNNQQNY were first observed by STM on a graphite surface, and the introduction of ThT molecules to the surface facilitated the STM observations of the adsorption conformations of ThT with peptide strands. ThT molecules are apt to adsorb on the peptide assembly with β-sheet structure and oriented parallel with the peptide strands adopting four different binding modes. This effort could benefit the understanding of the mechanisms of the interactions between labeling species or inhibitory ligands and amyloid peptides, which is keenly needed for developing diagnostic and therapeutic approaches.     

爆破模式在农村硬核白内障防盲手术中的应用

目的:探讨爆破模式超声乳化吸除术在农村硬核白内障防盲手术中的应用价值。方法:将162例162眼硬核(Ⅳ～V级核)白内障患者随机分为爆破超声乳化吸除术组和小切口白内障囊外摘除术(small incision cataract extraction,SICE)组。记录两组患者术后视力及视力恢复时间、角膜散光以及手术并发症的发生情况,同时记录爆破模式超声乳化术中的实际超声能量和超声时间。结果:两组患者术后视力均有提高,但相比差异有统计学意义(P<0.05),且SICE组视力恢复显著慢于爆破模式组(P<0.01)。术后角膜散光SICE组明显高于爆破模式组(P<0.05)。爆破模式组术中实际超声能量为(16.2±5.4)%、超声时间为(42.8±6.1)s。手术并发症主要是角膜水肿和后囊膜破裂,SICE组角膜水肿69眼、后囊破裂6眼,而爆破模式组角膜水肿12眼、无后囊膜破裂。结论:爆破模式超声乳化吸除术治疗农村防盲中的硬核白内障,可显著改善术后视力,缩短恢复时间,可以用较低的超声能量和时间,减少术后早期角膜水肿,降低手术并发症发生率,值得推广使用。     

人类脑神经元电偶极子模拟方法的研究

目的：通过对脑神经元电偶极子模拟方法的研究探索脑神经的空间耦合形式及相邻脑神经元的电磁耦合与人类大脑活动的关系。方法：本文对脑神经电偶极子的形成物理学原理进行了深入的探讨,创建了脑神经垂直电偶极子数理模型,用实验的方法对偶极子进行了模拟同时采用MATLAB对该模型进行了偶极子电势分布与耦合的仿真实验。结果与结论：仿真实验的结果与实际电偶极子的电势分布的理论相吻合。该数理模型对于研究脑神经在人脑外部空间的电势分布和耦合形式、研究EEG、ERP及ECoG有一定的应用价值,同时通过对大脑皮层的电势分布与耦合的表现可以对大脑的物理形态进行研究。     

Psychosocial mediators and moderators of the effect of peer‐victimization upon depressive symptomatology

Background: Intervention strategies and developmental models of stress have been criticized for failing to integrate social psychological variables. This study investigates both self‐referential cognitive mediators (perceived threat and control) and a social psychological moderator (ethnic/religious identity) of the effect of peer‐victimization upon depressive symptomatology. Methods: Self‐report questionnaires were completed by 924 students (46% female), aged 8 to 12 years. Experiences of discriminatory and non‐discriminatory peer‐victimization, threat and control appraisals, depressive symptoms, and strength of main identity were assessed. Results: Perceived threat partially mediated the effect of peer‐victimization (regardless of whether it was discriminatory or not) on depressive symptoms. Perceived control partially mediated the effect of non‐discriminatory peer‐victimization on depressive symptoms. Strength of ethnic/religious identity buffered the effect of peer‐victimization on depressive symptoms. Victimization perceived to be discriminatory in nature was more strongly associated with depressive symptoms than non‐discriminatory victimization. Conclusions: Findings support calls for a greater emphasis to be placed on social psychological variables in explaining depressive symptomatology. For clinical, counseling and intervention purposes, it is important to examine whether victims perceive peer‐victimization as discriminatory and whether their own strength of identity affects symptomatology.     

Initial fixation strength of a new hybrid technique for femoral ACL graft fixation: the bone wedge technique

Background Aperture fixation with interference screws matching the diameter of the tunnel is associated with the risk of graft laceration and graft rotation. Hypothesis A hybrid fixation technique (extracortical and aperture fixation) with undersized interference screw placed behind a bone wedge provides a higher fixation strength as aperture fixation with a screw alone matching the size of the tunnel. Study design Experimental laboratory study. Methods We evaluated the initial fixation strength (single cycle and cyclic loading tests) of hybrid and interference screw aperture fixation using different sized interference screws in porcine knees. Results Analysis of yield load, maximum load and stiffness in the single cycle loading test showed no statistically significant differences for hybrid fixation with a 1 mm undersized screw and aperture fixation with a screw matching the size of the tunnel. The use of an undersized screw alone resulted in low fixation strength. Conclusion The initial fixation strength of the hybrid technique with undersized screws is comparable to that of interference screw fixation matching the size. Clinical relevance The new “bone wedge fixation” is an alternative for ACL graft fixation without the risk of graft laceration and graft rotation.     

As time goes by: temporal constraints on emotional activation of inferior medial prefrontal cortex

To investigate the influence of stimulus duration on emotional processing, we measured changes of regional cerebral blood flow (rCBF) in 14 healthy subjects who viewed neutral or emotional images presented for 3 or 6 s. Presentation for 3 s reproduced the previous result of higher rCBF in inferior medial prefrontal cortex (IMPC) during neutral than emotional stimulation. Six-second presentation reverted this relationship, with activity in IMPC being higher during emotional stimulation. Prolonged stimulus presentation attenuated the rise of rCBF associated with emotions in left parietal cortex and cerebellar hemisphere. We speculate that the different rCBF during neutral and emotional stimulation for 6 s is a consequence of attention divided between the emotional stimuli and their associations. Thus, prefrontal activity rises when a cognitive task accompanies emotional stimulation because several cognitive processes compete for attention. The IMPC may serve the mechanism of attention underlying the concept of a default mode of brain function, selecting among competitive inputs from multiple brain regions rather than just processing emotions. The results emphasize the importance of implicit cognitive processing during emotional activation, however, unintended.