我国护理学硕士学术学位研究生课程设置调查

目的了解当前我国护理学硕士学术学位研究生课程设置,拟为教育主管部门和护理院校优化课程设置提供参考。方法采用问卷调查法,调查了国内66所护理学硕士学术学位研究生培养院校的课程设置情况。结果护理学硕士学术学位研究生课程类型以公共必修课、专业必修课和选修课为主;66所院校平均设有23.44门课程,护理专业类课程资源不足;课程主要包括思想政治教育、医学专业知识、护理基础理论、研究方法等。院校间学分要求有所差异,64所院校平均总学分为32.07分。结论我国护理学硕士学术学位研究生课程体系逐渐完善,但存在院校间学分要求差异较大,护理专业课程开设不足等问题。各院校需结合自身情况,从调整学分要求、加强护理专业课程建设、减少医学专业课程等方面优化护理学硕士学术学位研究生课程设置;教育主管部门应帮助各院校更加科学地设置护理专业核心课程。     

新生儿重症监护室护士经历道德困扰体验的现象学研究

目的了解新生儿重症监护室护士经历道德困扰的心理体验及应对方式。方法采用现象学研究方法,对14名新生儿重症监护室护士进行一对一的半结构式访谈,访谈内容根据Colaizzi的资料分析方法进行整理、提炼主题。结果新生儿重症监护室护士经历道德困扰的心理体验包括:失落与气愤、伤心与难过、无力与受挫、麻木与淡漠;应对方式包括:被动接受、心理弹性、寻求措施。结论由于照护对象的特殊性,新生儿重症监护室护士产生道德困扰的情境较为复杂,易给护士带来消极情绪,但却很少受到管理者重视。今后应进一步探究减轻护士道德困扰的干预方法,以合理利用人力资源,提高护理质量。     

A Review of Machine Learning Techniques for Keratoconus Detection and Refractive Surgery Screening

ABSTRACT

Various machine learning techniques have been developed for keratoconus detection and refractive surgery screening. These techniques utilize inputs from a range of corneal imaging devices and are built with automated decision trees, support vector machines, and various types of neural networks. In general, these techniques demonstrate very good differentiation of normal and keratoconic eyes, as well as good differentiation of normal and form fruste keratoconus. However, it is difficult to directly compare these studies, as keratoconus represents a wide spectrum of disease. More importantly, no public dataset exists for research purposes. Despite these challenges, machine learning in keratoconus detection and refractive surgery screening is a burgeoning field of study, with significant potential for continued advancement as imaging devices and techniques become more sophisticated.     

Immunohistochemical features of carcinoma ex pleomorphic adenoma and pleomorphic adenoma in the lacrimal gland

AIM: To investigate C-myc, Ki-67, pan-cytokeratin, and vimentin immunohistochemical features of carcinoma ex pleomorphic adenoma (Ca-ex-PA) and pleomorphic adenoma (PA) in the lacrimal gland in order to find some clues in the differential diagnosis between them. METHODS: We reviewed microscopic slides and clinical records of 64 cases of PA and 15 cases of Ca-ex-PA in the lacrimal gland. Immunohistochemical antibodies for C-myc, Ki-67, pan-cytokeratin, and vimentin were employed. RESULTS: Median age of PA was 43.2y (from 21 to 75). The 35 patients (54.7%) were male and 29 patients (45.3%) were female. For the PAs, the average positivity of C-myc was 4.6%; the average proliferation index of Ki-67 was 3.2%; pan-cytokeratin was positive in ductal cells, and vimentin was positive in myoepithelial cells. Median age of Ca-ex-PA was 54.3y (from 26 to 76). There were 7 male patients (46.7%) and 8 female patients (53.3%). Among 15 Ca-ex-PAs, there were 6 myoepithelial carcinomas, 4 adenocarcinomas, 3 epithelial-myoepithelial carcinomas, and 2 squamous cell carcinomas. For the Ca-ex-PAs, the average positivity of C-myc was 36.4%; the average proliferation index of Ki-67 was 29.2%; pan-cytokeratin was positive in all cases, and vimentin was positive in myoepithelial carcinomas. CONCLUSION: PA has a lower positivity of C-myc and Ki-67, while Ca-ex-PA had a higher positivity of these two biomarkers. These four biomarkers as a set could provide valuable clues in the differential diagnosis between Ca-ex-PA and PA. Our results indicate that the activation of C-myc could play an important role in the pathogenesis of Ca-ex-PA and PA.