加强高等护理实验中心建设的思考

随着高等护理专业在全国各医学院校的普遍设置及新时期对护理实验教学的新要求，加强高等护理实验中心的建设显得尤为重要和紧迫。笔者提出高等护理实验中心建设的基本思路和发展目标，并提出护理实验建设的主要任务及建设的保障措施，以更好地强化护理实验中心的各项功能，有效地为护理教学服务。     

The ethics of organ donation,donation after circulatory determination of death,and xenotransplantation from an Islamic perspective

Donation after circulatory determination of death (DCDD) and xenotransplantation are advanced as possible solutions to the growing gap between the number of individuals in need of organ transplantation and the pool of donors. Investigating how various publics, including religious leaders, might view these “therapies” is essential for broad public and professional support and will be needed in order to make these solutions viable. This study, therefore, presents normative Islamic bioethical perspectives on donation after circulatory determination of death and xenotransplantation. First, we will discuss foundational Islamic ethico‐legal debates regarding organ donation. These debates can be grouped into three broad positions, those who consider organ donation categorically impermissible as a violation of human dignity (?urma and karāma ), those who agree that organ donation is impermissible in principle, but allow it conditionally on the basis of dire necessity (?arūra ), and those who permit organ donation based on notions of public interest (ma?la?a ). Next, we will reflect upon the additional ethical dimensions DCDD and xenotransplantation add to these debates. We contend that the condition of minimal harm to the donor and the definition of death need to be accounted for within Islamic perspectives on DCDD. Xenotransplantation, on the other hand, highlights concerns about using pigs for therapeutic purposes. We conclude by commenting on additional questions that remain to be addressed in the Islamic bioethical debate over these practices and with recommendations for further research.     

Research progress on hypoxia/reoxygenation model of nerve cells in vitro; [神经细胞缺氧／复氧体外模型的研究进展]北大核心CSCD

缺血性脑卒中是世界人口第二大死亡原因和第三大致残原因,发病率在全球范围内逐年增加。缺血性脑卒中经过血液再通治疗后会引起缺血/再灌注损伤,而缺血/再灌注损伤的机制目前仍不是十分明确,因此,构建具有其特性的临床前模型十分必要。鉴于动物模型研究的复杂性和体外脑切片培养的局限性,体外细胞模型成为了简化而有价值的工具。该文对目前常用的神经细胞以及缺血/再灌注体外模型的构建方法、构建原理及相关研究进展进行阐述,以期为合理选择缺氧/复氧细胞模型进行脑缺血/再灌注的基础研究与药物筛选提供参考和依据。     

原发性胸骨肿瘤的临床诊治进展

临床上激素受体（HR）阳性乳腺癌患者治疗方案的制定通常基于病理学的各项指标。然而,一些临床特征相似的患者在接受相同的治疗后,疗效和预后有很大差异,这提示经典的临床病理学特点可能不足以用来制定乳腺癌综合治疗策略。该文研究早期浸润性乳腺癌中HR阳性、人表皮生长因子受体2（HER2）阴性的人群,对3种常见的基因检测手段21基因复发评分（OncotypeDX）、70基因（MammaPrint）和PAM50（Prosigna）的临床有效性和实用性进行系统的综述。3种检测方式均能区分预后差异,可用于HR+、HER2-、淋巴结未受累的早期乳腺癌患者的全身治疗指导,MammaPrint还可用于1～3枚淋巴结受累的患者。Prosigna具有长期预后能力,或可用于筛选能从延长内分泌治疗中获益的人群。     

Association of hospital construction with the development of healthcare associated environmental mold infections (HAEMI) in pediatric patients with leukemia

Background

Healthcare associated mold infections (HAEMI) increase morbidity and mortality in children with leukemia. Excavation adjacent to Children's Medical Center Dallas (CMCD) April 2006–February 2007 provided an opportunity to determine if excavation adjacent to a hospital building is associated with increased risk of developing HAEMI in children receiving intensive chemotherapy for acute leukemia.

Methods

Children who began receiving intensive chemotherapy for acute leukemia at CMCD from 2004 to 2008 were identified (n = 275). Exposures to the CMCD campus during intensive chemotherapy and duration of neutropenia per exposure were recorded. Proven, probable, or possible invasive fungal disease (IFD) was classified using EORTC/MSG guidelines. Institutional guidelines categorized mold infections as definite or possible HAEMI. A bivariate time‐to‐event model compared the association of excavation with HAEMI and yeast infections, controlling for neutropenia.

Results

There were 7,454 CMCD exposures, 1,007 (13.5%) during excavation. Of 50 cases of IFD, 31 were HAEMI. By time‐to‐event analysis exposure to the CMCD campus during the excavation period was significantly associated with HAEMI (HR = 2.8, P = 0.01) but not yeast infections (HR = 0.75, P = 0.75). Neutropenia was significantly associated with both HAEMI and yeast infections (P < 0.001). Voriconazole prophylaxis did not prevent HAEMI in 42% of the 14 patients with AML who had been receiving this agent.

Conclusion

This study is the first to demonstrate an association between exposure to hospital construction that includes excavation and HAEMI in pediatric oncology patients. Since neutropenic patients need protection from aerosolized fungal spores during visits to expanding medical centers, preventive strategies with adherence monitoring need additional study. Pediatr Blood Cancer 2014;61:276–280. © 2013 Wiley Periodicals, Inc.     

民族医药古籍保护性研究意义及现状

各民族医药在发展历史进程中,均通过文献、典籍、碑刻、口耳相传等形式起到了传播、传承、发展的重要作用。但经过几百年甚至几千年的传承,有遗失,有破损,有传承人断代致家传秘籍不能传承的危境等等,为此,需要开展藏医药古籍的保护性整理研究工作。课题组在全国范围内开展藏医药古籍文献的普查、收集、整理,经过5年多的努力,课题组首次以出版名录的形式对藏医药古籍文献进行文化产权的保护,首次以藏文、汉文、英文和藏文拉丁文转写作为国际规范和标准及成果进行推广,首次以信息化平台建设的形式对藏医药古籍文献进行永久性数字化保存、保护及传播,并以发明专利、著作权登记等形式对藏医药古籍文献进行知识产权的保护。     

中医药治疗高血压文献信息服务系统的敏捷构建研究

中国高血压人数逐年增加,中医药在高血压的治疗上具有明显的优势,丰富的高血压相关中医药文献资源对高血压的治疗有着重要的参考和指导作用。基于敏捷构建思想和MVC 架构,以数据需求驱动系统功能需求,能够高效率、高质量地完成中医药治疗高血压文献信息服务系统的建设工作,所提供的高血压相关文献信息服务对中医药治疗高血压的科研和临床都有着重要的促进作用。     

The current state of the center for the creation and dissemination of new Japanese nursing science: The 21st century Center of Excellence at Chiba University School of Nursing

Aim: The Center of Excellence for the Creation and Dissemination of a New Japanese Nursing Science at Chiba University School of Nursing is now in its third year of operation. This center aims to develop nursing science that is appropriate for Japanese culture and to internationally disseminate the importance of culturally based care. Our project seeks to systematically transform the art of nursing practise into a nursing science. Method: To date, multiple frameworks have been created through the qualitative meta‐synthesis of research on effective nursing care. To create a nursing science, these frameworks derived from meta‐synthesis must be verified and internalized in nursing practise. Results: After three years of research, the following findings are emerging: professional care relationships in nursing practise in Japan are characterized by the bidirectional process between the nurse and the client, in which both gradually undergo a transformation in order to establish a collaborative, therapeutic relationship; Japanese nurses emphasize the importance of understanding adolescent clients’ subjective understanding of their own life with self‐care, as well as social support; and the priority for community health nurses in Japan is to create support systems in the community, regardless of whether the intended client is an individual, a family, a specific group, or the community as a whole. Conclusions: Our future efforts will focus on verifying our findings through interdisciplinary and international comparative research and by integrating various frameworks in order to create a new Japanese nursing science.     

Russian Nursing Education Reform Project: New Nurses for a New Russia

Purpose: To describe a 2-year nursing exchange project, 1992–1994, designed to access Russian nursing education and to make recommendations for change.
Results: Nursing education in Russia is at a level similar to vocational schools in the United States and is closely linked to medicine. Russian nurrse educators were assisted in developing a philosophy of nursing, developing definitions for nursing, and incorporating process into practice.
Conclusions: The Russian government and Russian nurse educators are committed to improving the equality of health care and nursing. This exchange toward a process-based baccalaureate model.