The effectiveness of humanoid diagram teaching strategy on care capacity and retention in novice nurses

AimTo examine the effectiveness of a Humanoid Diagram Teaching Strategy (HDTS) on care capabilities and retention of novice nurses.BackgroundGuiding novice nurses in clinical practice is a matter of concern and the use of diagrams in assisting the learning process and to promote learning efficiency has been acknowledged.DesignThis is a quasi-experimental study with asynchronous repeated measurements for the experimental and control groups.MethodsThe study was conducted in a medical centre in southern Taiwan with 24 novice nurses. The intervention, Humanoid Diagrams Teaching Strategy, contained three parts: the head and neck; trunk; and limbs. The HDTS was applied three time weekly. Each session lasted approximately 30 min and the training lasted 4 weeks. The effectiveness of HDTS was measured using Mini-CEX, CbD and retention rates in the 3rd and 6th months of novice nurses’ experience.ResultsAfter the HDTS, although increases in mini-CEX and CbD scores in the experimental group were greater than the control group, these differences were not statistically significant after considering the time interaction. But the 3rd month and 6th month novice nurses’ retention rates were statistically significantly different by comparing the differences under the time interaction effects in both groups.ConclusionsThe Humanoid Diagram Teaching Strategy is an effective tool for preceptors to use in assisting novice nurses in learning, improving their nursing care knowledge and technical skills and to increase their retention rate.     

1,8-桉叶油素自微乳给药系统的制备及质量评价和细胞摄取研究

目的优化1,8-桉叶油素(1,8-cineole,1,8-Cin)自微乳给药系统(1,8-cineole self-microemulsion drug delivery system,1,8-Cin-SMEDDS)处方,对其进行表征并进行细胞摄取考察。方法通过绘制伪三元相图,确定1,8-Cin-SMEDDS有效自乳化区域,进行初步处方筛选。以粒径和载药量为指标,采用星点设计-效应面法对1,8-Cin-SMEDDS处方进行优化并验证。荧光显微镜观察高糖损伤的人脐静脉内皮细胞(HUVEC)对1,8-Cin-SMEDDS的摄取情况。结果 1,8-Cin-SMEDDS的最佳处方是大豆油(7.5%)与1,8-Cin(22.5%)为混合油相,HS15(56%)为乳化剂,乙醇(14%)为助乳化剂,滴加纯水至8m L得半透明略带蓝色乳光液体。透射电镜观察其外观呈球形液滴,激光粒度Zeta电位测定仪测得平均粒径为(131.68±1.44)nm,Zeta电位为(-10.03±1.63)m V;HPLC法测得包封率为(99.890±0.012)%,载药量为(224.750±0.028)mg/g。HUVEC细胞摄取实验结果表明,细胞对1,8-Cin-SMEDDS的摄取高于游离1,8-Cin。结论 1,8-Cin-SMEDDS制备方法简便,重复性好,所得1,8-Cin-SMEDDS外观良好,包封率高,理化性质稳定,且能促进细胞摄取。     

A Computational Geometry Generation Method for Creating 3D Printed Composites and Porous Structures

A computational method for generating porous materials and composite structures was developed and implemented. The method is based on using 3D Voronoi cells to partition a defined space into segments. The topology of the segments can be controlled by controlling the Voronoi cell set. The geometries can be realized by additive manufacturing methods, and materials can be assigned to each segment. The geometries are generated and processed virtually. The macroscopic mechanical properties of the resulting structures can be tuned by controlling microstructural features. The method is implemented in generating porous and composite structures using polymer filaments i.e., polylactic acid (PLA), thermoplastic polyurethane (TPU) and nylon. The geometries are realized using commercially available double nozzle fusion deposition modelling (FDM) equipment. The compressive properties of the generated porous and composite configurations are tested quasi statically. The structures are either porous of a single material or composites of two materials that are geometrically intertwined. The method is used to produce and explore promising material combinations that could otherwise be difficult to mix. It is potentially applicable with a variety of additive manufacturing methods, size scales, and materials for a range of potential applications.     

含功能性油的水飞蓟宾超饱和自纳米乳的制备与体外评价

目的制备含功能性油的水飞蓟宾超饱和自纳米乳(SLB-S-SNEDDS),并对其进行表征及体外评价研究,以提高难溶性药物水飞蓟宾的生物利用度。方法铁氢化钾还原力与1,1-二苯基-2-苦肼基(DPPH)自由基清除实验筛选功能性油脂;伪三元相图考察乳化剂乳化能力;测定粒径、多分散指数(PDI)、Zeta电位等考察混合油相比例与载药量;相容性与溶出度实验筛选促过饱和物质并考察其质量浓度;从外观、粒径分布、自乳化效率、形态学等方面表征SLB-S-SNEDDS,并进行溶出度、抗氧化能力、细胞毒性等体外评价。结果所得SLB-S-SNEDDS处方为(1)小麦胚芽油/Capryol 90-Cremophor ELP-Transcutol HP与(2)沙棘籽油/Capryol 90-Cremophor ELP-Transcutol HP,1 g基质(包含0.043 g小麦胚芽油或沙棘籽油、0.387 g Capryol 90、0.380 g Cremophor ELP、0.190 g Transcutol HP),水飞蓟宾的添加量为各组分平衡溶解度之和的20%,Soluplus的添加量为上述总质量的0.1%。小麦胚芽油、沙棘籽油体系分别为淡黄色、亮黄色透明状均一液体,2种体系自乳化分散后均呈近球形白色扁平乳滴,粒径约为50 nm,乳化时间均为65 s。与药物原料及SLB-SNEDDS相比,SLB-S-SNEDDS中水飞蓟宾的累积溶出率8h内均维持在85%～110%,表明该体系能够显著提高药物的溶出度。SLB-S-SNEDDS与铁氰化钾反应后的吸光度(A值0.452～0.782,0.488～0.765)以及DPPH自由基清除率(39.09%～96.02%,30.54%～89.20%)均高于相应质量浓度下水飞蓟宾原料的A值与清除率(0.411～0.760,22.89%～63.21%),表明2种处方体系均能提高水飞蓟宾的抗氧化能力。细胞毒性实验结果显示,在5、10μmol/L药物浓度下,水飞蓟宾原料组、水飞蓟宾S-SNEDDS组及其相应的空白S-SNEDDS组细胞生存率均90%,说明SLB-S-SNEDDS及其所用辅料对人克隆结肠腺癌细胞(Caco-2)毒性较小、安全性较好。结论制备的含功能性油SLB-S-SNEDDS在提高水飞蓟宾累积溶出率的同时,增强了其抗氧化能力,为将超饱和自纳米乳(S-SNEDDS)用于改善难溶性药物水溶性及其生物活性提供有益参考。     

基于薄荷油为油相的红花提取物自微乳凝胶递送系统制备研究

目的制备以薄荷油(Menthaha plocalyx oil,MPO)为油相的红花提取物(Carthamus tinctorius extract,CTE)自微乳凝胶递送系统(CTE-SMEDDS-BGs)。方法以MPO为油相,CTE为水相,采用伪三元相图法优选载药自微乳处方,采用单因素法筛选凝胶工艺与处方,并对其外观性状、黏度和pH值进行评价。结果所得CTE-SMEDDS-BGs最佳处方工艺:F68为乳化剂,无水乙醇为助乳化剂,乳化剂与助乳化剂比例(Km)为1∶1,乳化剂和助乳化剂总量(TS)与MPO的比例为8∶2,卡波姆2%,甘油6%,CTE5m L。处方量自微乳加入溶胀后的凝胶基质,三乙胺调节pH值至6.0即得CTE-SMEDDS-BGs;其外观为黄色半透明、黏稠度适中、均匀细腻、不油腻,易涂展的胶状凝胶,黏度为4.98×10~4m Pa·s(RSD为1.53%),pH为6.04(RSD为0.44%)。结论制得的薄荷油为油相的CTE-SMEDDS-BGs,制备简便,方法稳定,符合凝胶局部外用制剂要求。     

前庭器官超微结构研究及结构图构建

目的通过扫描电镜观察小鼠椭圆囊、球囊、壶腹超微结构,研究分析并据此构建前庭器官新的结构示意图。方法选取3个年龄段小白鼠各10只,分别是年轻组≤2个月、中年组2~12个月、老龄组>12个月。分离出椭圆囊、球囊、壶腹,采用扫描电镜技术样品制备方法制备样品,应用扫描电镜进行样品观察。结果扫描电镜下可以得到:①椭圆囊斑及球囊斑不同层面图片:表面为堆积并相互黏附的"表面耳石",表面耳石下是无结构胶状质;底层表面耳石深入到无结构胶质层里;无结构胶质层下面是毛细胞纤毛及"纤毛间耳石"层,不同纤毛束之间均有纤毛间耳石存在,立于支持细胞表面,表面平坦;蜂窝状胶质物质联接无结构胶质层、纤毛间耳石及毛细胞纤毛。②壶腹超微结构的图片:嵴帽是无结构的胶状质与壶腹外侧壁紧贴,但较易分离,嵴帽和壶腹外侧壁之间有纤细的晶状体物质,在壶腹嵴两侧壁上也有纤细晶体物质(壶腹嵴表面耳石);不同的毛细胞纤毛之间有耳石结构的存在(壶腹嵴纤毛间耳石)。结论通过对前庭器官扫描电镜的观察,发现了椭圆、球囊斑及壶腹的新结构成分,由此构建出新的前庭器官超微结构示意图。     

500例老年科病区药学服务的帕累托图分析

目的： 回顾分析老年科病区药学服务记录，找出需要重点关注的内容，以便优化药学服务模式。方法： 收集2018年5月-2019年7月的老年科药学服务记录，采用Excel软件绘制帕累托图，对各类药学服务内容类别和所涉及的药品类别进行统计，以区分出构成老年病区药学服务内容和药品类型的主要因素、次要因素及一般因素。结果： 帕累托图分析结果显示，用法用量指导与干预、用药依从指导、药物选择指导构成药学服务内容的主要因素；心血管系统药物、血液及造血系统药物、主要作用于中枢神经系统药物、抗感染药物、激素及其有关药物构成药物类别的主要因素。结论： 采用帕累托图进行统计和分析，可迅速直观地了解临床药师服务的重点内容及重点关注的药物，为多重用药管理切入点的选择提供数据参考，使药师更好地在老年综合评估团队中发挥作用。     

立体心电图对冠心病心肌缺血的诊断价值

目的 以冠状动脉造影结果作为金标准,对比分析常规12导联心电图(ECG)、向量心电图(VCG)、立体心电图(SECG)等检查对诊断冠心病心肌缺血的敏感性,评价SECG在冠心病心肌缺血诊断中的价值.方法 选择156例行冠脉造影(CAG)的患者,其中冠心病组103例,非冠心病组53例,分析其于同一心电工作站所做的ECG、VCG、SECG资料,观察比较这三种方法的检出结果.结果 SECG在诊断冠心病心肌缺血方面,检出率高于VCG、ECG,差异有统计学意义(P<0.05);SECG在诊断冠心病心肌缺血方面的灵敏度、特异度、正确指数、诊断符合率均高于VCG、ECG;SECG在诊断冠心病冠脉多支病变上与ECG、VCG无差异,在一支病变及两支病变上与ECG相比差异有统计学意义(P<0.05),检出率较ECG明显增高,而与VCG相比差异无统计学意义(P>0.05);SECG在诊断冠心病Ⅱ～Ⅲ级狭窄组中检出率较ECG明显增高(P<0.05),但与VCG相比差异无统计学意义;在完全闭塞组中,虽然SECG检出率较VCG、ECG高,但结果差异无统计学意义(P>0.05).结论SECG在诊断冠心病心肌缺血有一定的诊断价值,且优于VCG、ECG.