3D-CPA、HR-HPV及TCT联合检测对高级别宫颈上皮内瘤变及早期宫颈癌的诊断价值

目的:探讨经阴道三维彩色血管能量成像(3D-CPA)技术、高危型人乳头瘤病毒(HR-HPV)及液基细胞学(TCT)联合检测对高级别宫颈上皮内瘤变(CIN)及早期宫颈癌的诊断价值.方法:选取2012年6月～ 2014年12月在该院宫颈门诊就诊的患者为研究对象,分别接受3D-CPA、HR-HPV及TCT检查,以上3项指标任一阳性者行阴道镜下活检,病理诊断为金标准.选取慢性宫颈炎52例、低级别CIN 50例、高级别CIN 80例、早期宫颈癌(Ⅰa-Ⅱa)35例进行分析.评价3种筛查方法单独或联合筛查共5种方案的灵敏度、特异度、诊断符合率及约登指数.结果:早期宫颈癌组血管形成指数(VI)大于高级别CIN组及低级别CIN组,差异均有统计学意义(P＜0.01);3组血管形态及分级比较,差异均有统计学意义(P＜0.05);3种筛查方法单独筛查发现:灵敏度最高为HPV(89.70％),特异度最高为VI(80.77％),诊断符合率最高为HPV(85.25％).HPV+TCT与HPV+TCT+VI联合筛查发现:灵敏度和特异度最高均为三者联合筛查,灵敏度为96.36％,特异度为75％,诊断符合率为91.24％,约登指数最高为0.715.HPV16/18阳性患者宫颈癌组占94.29％,高级别CIN组占55.00％,低级别CIN组占21.57％.结论:3D-CPA、HR-HPV及TCT联合检测可提高宫颈病变筛查的灵敏度及准确度,应加强对HPV16/18阳性患者的筛查.     

我国护理期刊学术影响力排名分析

[目的]分析我国护理期刊学术影响力排名,综合评价我国21种护理学统计源期刊学术影响力。[方法]以2014年版《中国科技期刊引证报告》(扩刊版)中21种护理期刊为研究对象,以总被引频次、影响因子、他引总引比、高被引论文数、来源文献量、平均引文数、地区分布数、Web下载量共8项指标为依据,赋予各项指标不同的权重,运用归一化加权法综合评价21种护理期刊的学术影响力。[结果]2014年21种护理学统计源期刊与全国6 345种科技期刊6项评价指标比较显示,总被引频次、影响因子、他引总引比、来源文献量、地区分布数5项评价指标均显著高于科技期刊平均水平,但平均引文数显著低于我国科技期刊的平均水平;运用多指标归一化加权法得出21种护理学统计源期刊的综合值,排名前5位的依次为《中华护理杂志》《护理研究》《中国实用护理杂志》《护士进修杂志》和《护理学杂志》;将本研究护理核心期刊排名情况与《中国科技期刊引证报告》进行比较,部分期刊在2个评价体系中排名有不同程度的上升或下降,存在综合值排名与影响因子排名分离的现象。[结论]我国护理期刊整体影响力较科技期刊平均水平高,但护理科研论文质量较其他科技期刊存在较大差距;运用多指标数据归一化加权法综合评价我国21种护理学统计源期刊的学术影响力,能作出全面、科学、准确的评价,真实反映护理期刊的影响力,能够为护理学术期刊自身发展及提高期刊影响力提供改进方向。     

Power wheelchair driving challenges in the community: a users’ perspective

Purpose: There is limited information on the difficulties individuals experience in manoeuvring their power wheelchairs during daily activities. The aim of this study was to describe the nature and context of power wheelchair driving challenges from the perspective of the user. Methods: A qualitative design using semi-structured interviews with power wheelchair users. Qualitative content analysis was used to identify themes. Results: Twelve experienced power wheelchair users were interviewed. Findings revealed that power wheelchair driving difficulties were related to the accomplishment of activities of daily living, and the influence of environmental context. Four key themes emerged: (1) difficulties accessing and using public buildings-facilities, (2) outdoor mobility, (3) problems in performing specific wheelchair mobility tasks/manoeuvres and (4) barriers and circumstances that are temporary, unforeseen or specific to a particular context. Conclusion: This qualitative study furthers our understanding of the driving difficulties powered wheelchair (PW) users experience during daily activities. This knowledge will assist clinicians and researchers in two areas: in choosing assessment measures that are ecologically valid for power wheelchair users; and, in identifying and refining the content of training programs specific to the use of power wheelchairs.

• Implications for Rehabilitation

• A better understanding of the everyday challenges individuals experience in driving their power wheelchair will assist clinicians and researchers in:

• Choosing assessment measures and identifying training programs for this population.

• Refining the content of power wheelchair training programs.

     

Fully Implantable Deep Brain Stimulation System with Wireless Power Transmission for Long-term Use in Rodent Models of Parkinson's Disease

ObjectiveThe purpose of this study to develop new deep-brain stimulation system for long-term use in animals, in order to develop a variety of neural prostheses.MethodsOur system has two distinguished features, which are the fully implanted system having wearable wireless power transfer and ability to change the parameter of stimulus parameter. It is useful for obtaining a variety of data from a long-term experiment.ResultsTo validate our system, we performed pre-clinical test in Parkinson''s disease-rat models for 4 weeks. Through the in vivo test, we observed the possibility of not only long-term implantation and stability, but also free movement of animals. We confirmed that the electrical stimulation neither caused any side effect nor damaged the electrodes.ConclusionWe proved possibility of our system to conduct the long-term pre-clinical test in variety of parameter, which is available for development of neural prostheses.     

Radiology and Social Media: Are Private Practice Radiology Groups More Social Than Academic Radiology Departments?

PurposeThis study assesses the prevalence of use of the most commonly used social media sites among private radiology groups (PRGs) and academic radiology departments (ARDs).MethodsThe 50 largest PRGs and the 50 ARDs with the highest level of funding from the National Institutes of Health were assessed for presence of a radiology-specific social media account on Facebook, Twitter, Instagram, Pinterest, YouTube, and LinkedIn. Measures of organizational activity and end-user activity were collected, including the number of posts and followers, as appropriate; between-group comparisons were performed.ResultsPRGs adopted Facebook 12 months earlier (P = .02) and Twitter 18 months earlier (P = .02) than did ARDs. A total of 76% of PRGs maintained ≥1 account on the social media sites included in the study, compared with 28% of ARDs (P < .0001). The prevalence of having an account on the social media sites for PRGs was: Facebook, 66%; LinkedIn, 56%; Twitter, 42%; YouTube, 20%; Pinterest, 4%; and Instagram, 2%. The prevalence of radiology-specific social media accounts for ARDs was: Facebook, 18%; LinkedIn, 0%; Twitter, 24%; YouTube, 6%; Pinterest, 0%; and Instagram, 0%. There was no significant difference between ARDs and PRGs in measures of end-user or organizational activity on Facebook or Twitter.ConclusionsUse of social media in health care is emerging as mainstream, with PRGs being early adopters of Facebook and Twitter in comparison with ARDs. Competitive environments and institutional policies may be strong factors that influence how social media is used by radiologists at the group and department levels.     

学院型医院建设

学院型医院建设是现阶段我国部分大学附属医院的发展目标。本文介绍了学院型医院的定义、内涵、特征以及建设意义和发展现状;同时提出在学院型医院建设过程中应正确处理好理论研究与实践、附属医院与大学、科研教学与医疗、重点学科与非重点学科之间的关系。     

护理学生学业复原力与自我控制的相关性研究

目的 了解护理专业学生学业复原力及自我控制的现状,探讨两者之间的相关性,为解决护理专业学生心理和行为问题提供了理论依据,以提高护理学生的学业复原力与自制力水平。 方法 采用学业复原力量表和自我控制量表通过网络调查和现场派发形式对广州市4所高校的286名护理专业本科学生进行调查。 结果 护理专业学生学业复原力得分为(47.65±8.45)分,自我控制总分为(58.33±9.68)分,两者呈正相关,工作或学习表现及抵制诱惑是学业复原力的影响因素(F=40.735,R2=0.224)。 结论 护理专业学生的学业复原力和自我控制水平均处于中等水平,应针对具体因素提高学业复原力和自我控制水平,改善护生的心理健康状态。     

津沽推拿流派学术概要

发源于天津地区的津沽推拿流派,具有历史悠久、底蕴深厚、风格独特、学术特点突出等特点。作为全国具有代表性的推拿流派,津沽推拿流派已有百余年发展历史,现已形成津沽伤科推拿、津沽脏腑推拿、津沽小儿推拿3大稳定的学术分支。津沽推拿流派注重理论传承,强调道术结合,又具有典型的手法特点。津沽推拿流派对近代推拿的发展贡献突出,目前该流派的传承推广应用工作成绩卓著,引起了推拿学界的广泛关注。     

Preparation and Study of Sulfonated Co-Polynaphthoyleneimide Proton-Exchange Membrane for a H2/Air Fuel Cell

The sulfonated polynaphthoyleneimide polymer (co-PNIS70/30) was prepared by copolymerization of 4,4′-diaminodiphenyl ether-2,2′-disulfonic acid (ODAS) and 4,4’-methylenebisanthranilic acid (MDAC) with ODAS/MDAC molar ratio 0.7/0.3. High molecular weight co-PNIS_70/30 polymers were synthesized either in phenol or in DMSO by catalytic polyheterocyclization in the presence of benzoic acid and triethylamine. The titration reveals the ion-exchange capacity of the polymer equal to 2.13 meq/g. The membrane films were prepared by casting polymer solution. Conductivities of the polymer films were determined using both in- and through-plane geometries and reached ~96 and ~60 mS/cm, respectively. The anisotropy of the conductivity is ascribed to high hydration of the surface layer compared to the bulk. SFG NMR diffusometry shows that, in the temperature range from 213 to 353 K, the ¹H self-diffusion coefficient of the co-PNIS_70/30 membrane is about one third of the diffusion coefficient of Nafion^® at the same humidity. However, temperature dependences of proton conductivities of Nafion^® and of co-PNIS_70/30 membranes are nearly identical. Membrane–electrode assemblies (MEAs) based on co-PNIS_70/30 were fabricated by different procedures. The optimal MEAs with co-PNIS_70/30 membranes are characterized by maximum output power of ~370 mW/cm² at 80 °C. It allows considering sulfonated co-PNIS_70/30 polynaphthoyleneimides membrane attractive for practical applications.