临床护理综合性实验设计与实践

目的：探索知识、技能和能力综合训练的护理综合性实验（实训）的教学方法。方法：设计3种类型的综合性实验课,并进行试点教学。结果：使理论紧密联系临床实际,丰富了教学内涵,护生的护理综合能力在实践中得到明显提高。结论：综合性实验教学优化了高等护理教学方法。     

中西医结合治疗急性脑梗塞的疗效和其对促肾上腺激素及超氧化物歧化酶的影响

目的：探讨中西医结合治疗急性脑梗塞的疗效和其对促肾上腺激素（ＡＣＴＨ）和超氧化物歧化酶（ＳＯＤ）的影响。方法：对４５例急性脑梗塞患者行中西医结合〔紫外线照射充氧自血回输（ＵＢＩＯ）＋高压氧（ＨＢＯ）＋活血化瘀补肾中药〕治疗；３０例用ＵＢＩＯ＋ＨＢＯ治疗；３５例患者用复方丹参治疗作对照组。结果：中西医结合治疗急性脑梗塞治愈率及总有效率分别为４０．０％及９５．６％，复方丹参对照组分别为１４．３％及７１．４％，ＵＢＩＯ＋ＨＢＯ组分别为３３．３％和９０．０％。中西医结合治疗后ＡＣＴＨ及ＳＯＤ水平明显增高，与对照组比较差异有显著性，ＡＣＴＨ及ＳＯＤ变化趋势呈一致性。结论：中西医结合治疗使内分泌系统的垂体下丘脑肾上腺轴激素分泌作用增强，内环境ＳＯＤ对自由基清除力增高，疗效高。     

多学科团队管理模式在新生儿病房早产儿喂养中的应用效果

【摘要】目的：研究多学科团队管理模式在新生儿病房喂养中的应用效果。方法：选择2019年3月到2019年12月入住新生儿科病房的431例早产低出生体重儿作为对照组，2020年1月至2020年10月入住新生儿科病房的431例早产低出生体重儿作为观察组。其中对照组给予常规的新生儿喂养护理，观察组则成立多学科团队管理小组对新生儿实施病房喂养，统计两组住院期间纯母乳喂养率，达到全肠道喂养时间，住院天数，出院后坚持6个月纯母乳喂养率，出院后生长发育合格率，不良反应发生情况。结果：观察组住院期间纯母乳喂养率明显高于对照组，达到全肠道喂养时间和住院天数明显少于对照组，差异有统计学意义（P＜0.05）。随访6个月，观察组的纯母乳喂养率，生长发育合格率均明显高于对照组，差异有统计学意义（P＜0.05）。观察组不良反应总发生率低于对照组（P＜0.05）。结论：多学科团队管理模式能有效提高新生儿病房纯母乳喂养率，缩短新生儿达到全肠道喂养的时间，提升家长母乳喂养知识和意识，改善早产低出生生长发育结局，效果较好，值得推广。     

Investigating Characteristics of Quality Peer Mentors With Spinal Cord Injury

ObjectiveTo identify characteristics (1) of high- and low-quality spinal cord injury (SCI) peer mentors; (2) that should be used to match SCI peer mentors and mentees.DesignThe study was conducted in partnership with three Canadian provincial SCI organizations using an integrated knowledge translation approach. The Delphi exercise was completed in three rounds. In Round 1, people with SCI completed a thought-listing exercise to identify characteristics of high- and low-quality peer mentors and for matching. In Rounds 2 and 3, people with SCI and community organization staff rated characteristics from the previous round on an 11-point scale. After the final round, the remaining characteristics were thematically analyzed.SettingCommunity-based peer mentorship programs in three Canadian provinces.ParticipantsPeople with SCI and SCI community organization staff (Round 1, n=45; Round 2, n=27; Round 3, n=25).InterventionsNot applicable.Main Outcome MeasuresConsensus-based list of characteristics.ResultsParticipants reached consensus on 215 characteristics of quality peer mentors and 11 characteristics for peer mentor-mentee matching (ICC=0.96). A consensus-based characterization of high- and low-quality peer mentorship was created and included six overarching themes: competencies, personality characteristics, emotional state, mentor outlook, reason for mentoring, and role model.ConclusionA consensus-based characterization of quality peer mentorship was co-developed with input from over 50 members of the SCI community. Findings highlight that peers have both interpersonal and intrapersonal characteristics that contribute to quality mentorship. The findings highlighted the importance of matching mentors on lived experience and shared interests. Findings will inform future research and SCI peer mentorship programs.     

SARIMA模型在苏州市细菌性痢疾发病预测中的应用

目的 探讨季节性差分自回归求和滑动平均(seasonal auto-regressive integrated moving average, SARIMA)模型在苏州市细菌性痢疾月发病数预测中的应用。 方法 利用R i386 3.2.3软件对2005年1月－2018年4月苏州市细菌性痢疾月发病数据构建SARIMA模型,对2018年5－7月份细菌性痢疾的月发病人数进行预测,验证预测效果。 结果 建立了SARIMA(0,l,2)×(0,1,1)₁₂模型,Ljung-Box检验结果为Q=19.494,P=0.244,模型拟合效果良好,与2018年5－7月实际发病人数比较,实际值均在预测值95%可信区间内,相对误差的平均值为-0.147。 结论 SARIMA(0,l,2)×(0,1,1)₁₂模型可以对苏州市细菌性痢疾月发病人数进行较好的预测。     

2004－2016年珠海市道路交通伤害时间序列分析

目的 建立珠海市道路交通伤害(road traffic injuries,RTIs)发生的时间序列模型,了解RTIs的时间变化规律。方法 对2004－2016年珠海市3家哨点监测医院RTIs病例发生时间进行描述性分析。以2004－2015年RTIs按发生年、月份建立自回归移动平均混合模型(ARIMA),以2016年资料进行验证;同时按RTIs发生星期、时点(24 h)建立ARIMA模型进行时间序列分析。结果 2004－2016年共监测到70 813例RTIs。1－2月份 RTIs较少,7月达高峰;星期一、六和日RTIs发生数量较多;18－21点RTIs呈现最高峰,7－9点、0－2点分别呈现次高峰。构建得到RTIs发生人数按年、月份的ARIMA(0,1,1)模型(Ljung-Box检验Q=16.586,P=0.413),预测2016年RTIs人数,预测值与实际观测结果较相符;随着预测时间延长,CI范围扩大。对RTIs发生星期及时点序列分析建模为ARIMA(1,0,0)(Ljung-Box检验Q=13.283,P=0.652),观测值与拟合值基本相符。结论 2004－2016年珠海市RTIs流行状态具有一定时间变化规律,ARIMA模型适合进行RTIs发生时间趋势拟合并进行短期预测分析。     

Probabilistic hazard assessment for skin sensitization potency by dose–response modeling using feature elimination instead of quantitative structure–activity relationships

Supervised learning methods promise to improve integrated testing strategies (ITS), but must be adjusted to handle high dimensionality and dose–response data. ITS approaches are currently fueled by the increasing mechanistic understanding of adverse outcome pathways (AOP) and the development of tests reflecting these mechanisms. Simple approaches to combine skin sensitization data sets, such as weight of evidence, fail due to problems in information redundancy and high dimensionality. The problem is further amplified when potency information (dose/response) of hazards would be estimated. Skin sensitization currently serves as the foster child for AOP and ITS development, as legislative pressures combined with a very good mechanistic understanding of contact dermatitis have led to test development and relatively large high‐quality data sets. We curated such a data set and combined a recursive variable selection algorithm to evaluate the information available through in silico, in chemico and in vitro assays. Chemical similarity alone could not cluster chemicals' potency, and in vitro models consistently ranked high in recursive feature elimination. This allows reducing the number of tests included in an ITS. Next, we analyzed with a hidden Markov model that takes advantage of an intrinsic inter‐relationship among the local lymph node assay classes, i.e. the monotonous connection between local lymph node assay and dose. The dose‐informed random forest/hidden Markov model was superior to the dose‐naive random forest model on all data sets. Although balanced accuracy improvement may seem small, this obscures the actual improvement in misclassifications as the dose‐informed hidden Markov model strongly reduced " false‐negatives" (i.e. extreme sensitizers as non‐sensitizer) on all data sets. Copyright © 2015 John Wiley & Sons, Ltd.     

肝豆汤合驱铜疗法对肝豆状核变性患者生活质量影响的前瞻性研究

目的 观察肝豆汤合驱铜疗法对Wilson病(Wilson's disease,WD)患者生活质量的影响.方法 共纳入135例WD患者,在二巯基丙磺酸钠强力驱铜治疗及青霉胺和二巯基丁二酸维持驱铜治疗的基础上,口服肝豆片.治疗前及治疗1年后分别采用WHO生活质量简表评价患者的生活质量,并观察总体疗效.结果 与治疗前比较,135例WD患者治疗后WHO生活质量简表的生理领域、心理领域、社会领域、环境领域得分均显著提高(P＜0.01).135例WD患者中,临床痊愈5例,显效33例,有效88例,无效7例,恶化2例,无死亡病例,总有效率达93.3％.结论 肝豆汤口服合驱铜治疗可以明显改善WD患者的生活质量.