护理教育发展的促进策略分析

随着近年来社会经济与医疗器械水平的发展,人们对健康的要求已经不仅是局限于以往的"不生病",而是转而追求更高程度的健康水平。因此,我国相关教育部门开始注重护理教育的时代性改革,并将工作重心由治病转移一部分到护理工作上来,加强护理人员的专业素质培养,促进全面健康社会战略目标的早日实现。由此可知,优化改革护理教育工作是促进护理工作改革的重中之重,也是当前教育部门针对护理教育进行有效改革的具体落实点。本文主要结合当前时代特点对我国护理教育的发展状况进行分析与探讨,总结出教育过程中存在的问题与不足,并就其提出针对性建议,旨在推动当前护理水平的提升,促进护理行业能够更好的满足人民群众的健康需求,以此推进我国护理事业的发展。     

The 5-year incidence of male breast cancer in Southwest of China from 2007 to 2011

Objective： Male breast cancer is a rare disease with an incidence of about 1% of breast cancers in USA, but relatively lack of the information of male breast cancer in China, especially in Southwest of China, led us to study its incidence trends. Methods： Chongqing is one of the biggest and the most important areas that is located in Southwest of China. There are around 31.4 million people who live in approximate 82 402.95 km2 area of Chongqing. Data about breast cancer patients registered in the Center for Disease Prevention and Control of Chongqing （China） were statistically collected from 187 hospi- tals, about 58 hospitals in city and 129 hospitals in country, and over 6.2 million people were studied every year. It was tried to represent all the people in villages and cities in Chongqing, China. Results： The incidence of male breast cancer in Southwest of China ranged from 0.34/100 000 to 1,45/100 000 between 2007 and 2011, while the incidence of female breast cancer ranged from 15.40/100000 to 21.66/100000 at the same time. The rate of male breast cancer to female breast cancer ranged from 0.02：1 to 0.07：1, male breast cancer accounted for 1.96% to 6.5% （with the mean value of 2.9%） of breast cancers in Southwest of China from 2007 to 2010. Conclusion： In Southwest of China male breast cancer accounts for about 2.9% of breast cancers which is higher than that in United States. It is important for policy makers and health manager to seriously consider breast cancer in future plan in Southwest of China.     

微量动态浊度法检测细菌内毒素方法的建立与验证

目的 建立使用微量动态浊度法检测细菌内毒素的方法，并进行验证。方法 采用动态浊度法鲎试剂，每孔样品和鲎试剂加样量25 μL，检测波长405 nm，预设OD值0.03，使用半孔酶标板检测，并经过4个实验室协作验证方法的准确度、重现性、线性和范围、耐用性以及重组新型冠状病毒疫苗、重组新型冠状病毒疫苗(5型腺病毒载体)、重组乙型肝炎疫苗、麻腮风联合减毒疫苗、双价肾综合征出血热灭活疫苗、四价流感病毒裂解疫苗共计6种疫苗的品种适用性。结果 高、中、低3个剂量组在4个实验室的共计24次试验总平均回收率分别为100.8%，150.0%，125.3%，RSD值分别为5.3%，11.0%，20.7%；标准曲线在0.01~10 EU·mL^-1内相关系数平均值为0.990，耐用度考察2个来源的鲎试剂对检测的影响符合规定；6个品种的共计18批样品的干扰试验回收率均在50%~200%，干扰试验符合规定。结论 建立了使用微量动态浊度法检测细菌内毒素的方法，该方法具有良好的准确度、重现性、线性和范围、耐用性，并且在6种生物制品中具有良好的品种适用性。该方法可用于常规样品的细菌内毒素检测。     

Osteoconductive effectiveness of bone graft derived from antler cancellous bone: an experimental study in the rabbit mandible defect model

The purpose of this study was to evaluate the properties of a novel inorganic xenogenic bone substitute, calcinated antler cancellous bone (CACB). Physicochemical properties of CACB including surface morphology, phase composition, chemical bond structure, Ca/P ratio and porosity were characterized by scanning electron microscopy, X-ray diffraction spectroscopy, Fourier-transform infrared spectroscopy, inductively coupled plasma-atomic emission spectroscopy and nitrogen adsorption analysis, and were found to closely resemble calcinated human cancellous bone. The bone defect repair efficacy of CACB was evaluated in comparison with commercially available bone substitutes (Bio-Oss^®) within rabbit mandible defects. The gross observation, micro-CT and histology analysis data demonstrated that CACB was efficacious for bone regeneration, and was comparable with Bio-Oss^® bone substitute in inducing neovascularization and osteogenesis within the mandible defects. CACB can therefore serve as a safe, renewable, and sustainable source of bone graft material, but without the ethical issues pertaining to animal welfare.     

Recognition of medication information from discharge summaries using ensembles of classifiers

ABSTRACT: BACKGROUND: Extraction of clinical information such as medications or problems from clinical text is an important task of clinical natural language processing (NLP). Rule-based methods are often used in clinical NLP systems because they are easy to adapt and customize. Recently, supervised machine learning methods have proven to be effective in clinical NLP as well. However, combining different classifiers to further improve the performance of clinical entity recognition systems has not been investigated extensively. Combining classifiers into an ensemble classifier presents both challenges and opportunities to improve performance in such NLP tasks. METHODS: We investigated ensemble classifiers that used different voting strategies to combine outputs from three individual classifiers: a rule-based system, a support vector machine (SVM) based system, and a conditional random field (CRF) based system. Three voting methods were proposed and evaluated using the annotated data sets from the 2009 i2b2 NLP challenge: simple majority, local SVM-based voting, and local CRF-based voting. RESULTS: Evaluation on 268 manually annotated discharge summaries from the i2b2 challenge showed that the local CRF-based voting method achieved the best F-score of 90.84% (94.11% Precision, 87.81% Recall) for 10-fold cross-validation. We then compared our systems with the first-ranked system in the challenge by using the same training and test sets. Our system based on majority voting achieved a better F-score of 89.65% (93.91% Precision, 85.76% Recall) than the previously reported F-score of 89.19% (93.78% Precision, 85.03% Recall) by the first-ranked system in the challenge. CONCLUSIONS: Our experimental results using the 2009 i2b2 challenge datasets showed that ensemble classifiers that combine individual classifiers into a voting system could achieve better performance than a single classifier in recognizing medication information from clinical text. It suggests that simple strategies that can be easily implemented such as majority voting could have the potential to significantly improve clinical entity recognition.     

Variants in CXADR and F2RL1 are associated with blood pressure and obesity in African-Americans in regions identified through admixture mapping

OBJECTIVE:: Genetic variants in 296 genes in regions identified through admixture mapping of hypertension, BMI, and lipids were assessed for association with hypertension, blood pressure (BP), BMI, and high-density lipoprotein cholesterol (HDL-C). METHODS:: This study identified coding SNPs identified from HapMap2 data that were located in genes on chromosomes 5, 6, 8, and 21, wherein ancestry association evidence for hypertension, BMI, or HDL-C was identified in previous admixture mapping studies. Genotyping was performed in 1733 unrelated African-Americans from the National Heart, Lung and Blood Institute's Family Blood Pressure Project, and gene-based association analyses were conducted for hypertension, SBP, DBP, BMI, and HDL-C. A gene score based on the number of minor alleles of each SNP in a gene was created and used for gene-based regression analyses, adjusting for age, age, sex, local marker ancestry, and BMI, as applicable. An individual's African ancestry estimated from 2507 ancestry-informative markers was also adjusted for to eliminate any confounding due to population stratification. RESULTS:: CXADR (rs437470) on chromosome 21 was associated with SBP and DBP with or without adjusting for local ancestry (P?相似文献   

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糖皮质激素是临床上皮肤科医生处方最多的外用药物之一,自20世纪50年代问世以来,糖皮质激素极大改善了皮肤病的治疗效果,被誉为皮肤科药物治疗学的"里程碑"。但随着新型外用糖皮质激素不断问世和广泛应用,其在治疗疾病的同时不可避免带来了更多副反应。与抗生素一样,外用糖皮质激素是目前临床上滥用最为严重的药物之一。由于儿童生理和皮肤组织结构特点,外用糖皮     

hBMP-2基因修饰自体BMSCs移植促进兔下颌骨牵张成骨新骨形成的X线分析

目的:探讨hBMP-2基因修饰自体BMSCs移植对兔下颌骨牵张成骨新骨形成的促进作用。方法:取新西兰白兔36只随机分为3组,每组12只。建立牵张成骨动物模型,在固定期第2天,实验组于牵张间隙注射200μl的BMP-2基因修饰的自体BMSCs(2×105个细胞)悬液;对照组注射200μl的自体BMSCs(2×105个细胞)悬液;空白组注射200μl生理盐水。分别于固定2、6周摄X线片观察骨质愈合、改建情况。结果:通过X线观察并经过灰度值统计软件分析,在固定期2周及6周实验组牵张区骨密度明显高于对照组和空白组(P0.01)。结论:BMP-2基因修饰的自体BMSCs移植能有效促进兔下颌骨牵张成骨新骨形成。     

Outcome predictors of cirrhotic patients with spontaneous bacterial empyema

Background: Spontaneous bacterial empyema (SBE) is a complication of cirrhotic patients in which a pre‐existing pleural effusion becomes infected. This retrospective study was designed to investigate the bacteriology and outcome predictors of SBE in cirrhotic patients. Methods: Medical records of cirrhotic patients treated in a tertiary care university hospital from December 2004 to December 2008 were retrospectively reviewed. Results: Of 3390 cirrhotic patients seen during the study period, 81 cases of SBE were diagnosed. The incidence of SBE was 2.4% (81/3390) in cirrhotic patients and 16% (81/508) in patients with cirrhosis with hydrothorax. There were 46 monomicrobial infections found in 46 SBE patients. Aerobic Gram‐negative organisms were the predominant pathogens (n=29, 63%), and Escherichia coli (n=9, 20%) was the most frequently isolated sole pathogen. The mortality rate of SBE was 38% (31/81). Univariate analysis showed that Child–Pugh score, model for end‐stage liver disease (MELD)–Na score, concomitant bacteraemia, concomitant spontaneous bacterial peritonitis, initial intensive care unit (ICU) admission and initial antibiotic treatment failure were predictors of poor outcomes. Multivariate regression analysis demonstrated that the independent factors related to a poor outcome were initial ICU admission [odds ratio (OR): 4.318; 95% confidence interval 1CI) 1.09–17.03; P=0.037], MELD–Na score (OR: 1.267; 95% CI 1.08–1.49; P=0.004) and initial antibiotic treatment failure (OR: 13.10; 95% CI 2.60–66.03). Conclusion: Spontaneous bacterial empyema in cirrhotic patients is a high mortality complication. The independent factors related to poor outcome are high MELD–Na score, initial ICU admission and initial antibiotic treatment failure. High MELD–Na score may be a useful mortality predictor of SBE in cirrhotic patients.