护理硕士研究生职业期望的定性研究

职业期望又称职业意向,是个体对职业的渴望和向往,是个体对待职业的一种态度和信念。护理研究生作为一个特殊群体,其职业期望具有自身特征,是护理研究生将自身的兴趣、能力、价值观等主观因素与社会需要、就业机会不断协调的过程[1]。护理硕士研究生如何平衡自我价值的实现与满足社会需求,树立合理的职业期望;学校如何指导研究生对职业角色正确定位,进行职业生涯规划,理性择业;用人单位如何充分发挥护理研究生的专业优势,缓解临床高层次护理人员短缺等问题都亟需得到重视。本研究通过深入访谈法,探讨护理研究生的职业需求,为引导其树立合理的职业期望、具备良好的职业适应提供参考依据。     

研究生学历护士从事临床工作的职业体验及职业需要的研究

[目的]探讨硕士研究生学历护士（以下简称研究生护士）在临床工作中的职业体验和职业需要,为职业发展管理提供参考依据。[方法]采用质性研究方法中的现象学研究法,对9名研究生护士进行半结构式深度访谈,将获得的资料进行分析、整理并提炼出主题。[结果]职业体验为研究生护士在临床工作中感到价值感缺失,时间感紧迫,临床实践无优势;职业需要体现在职业发展需要和职业管理需要两个方面。[结论]研究生护士应努力提高自身的综合能力;护理管理者应为其职业发展提供相应的支持,实现高层次护理人才的合理使用。     

临床医学硕士研究生培养质量的实证研究

目的 了解临床医学硕士研究生培养质量的现状,并分析存在的问题.方法 采用分层整群随机抽样的方法,在上海交通大学2006-2009年毕业的622名临床医学硕士研究生中,按照就业主要聚集地区和分布单位,抽取在上海地区26家医院就业的415名研究生,由医院的人事主管或科室领导对临床医学硕士研究生培养质量(包括职业价值观、专业能力、职业发展能力、身心素质和科研能力5个方面)进行评判,并与毕业生的自我评价结果作配对比较.结果 用人单位对临床医学硕士研究生培养质量评价较低的依次是批判性思维能力(21.62％)、创新能力(36.0％)和相关学科知识(36.04％);用人单位对研究生培养质量的评价与毕业生的自我评价比较,差异有统计学意义(P＜0.05);用人单位注重毕业生职业价值观的培养,毕业生注重专业技能的训练;用人单位对是否为独生子女、居住地、本科毕业院校的毕业生质量评价比较有统计学差异(P＜0.05).实证因子分析得出4个公因子,分别是专业知识和专业技能、可迁移能力、科研能力和职业价值观.结论用人单位认为临床医学硕士研究生的创新能力不足、相关学科知识薄弱.用人单位和毕业生对临床医学研究生培养质量的预期目标存在差异,是否为独生子女、城乡差异、本科毕业院校等因素对研究生培养质量存在影响.评价临床医学硕士研究生的培养质量,可从专业知识和专业技能、可迁移能力、科研能力和职业价值观4个方面展开.     

医学研究生就业价值取向现状及引导研究

以福建医科大学和福建中医药大学的医学研究生为研究对象,采用问卷调查的方法,按照“个体—集体”“物质—精神”两个维度,结合“成就实现”“社会促进”“家庭维护”“地位追求”四因子结构,分析医学研究生就业价值取向现状以及性别、专业、培养类型、政治面貌等因素的影响,提出从职业的深层认知教育、实习阶段的价值观养成教育、职业就业教育的系统化建设等方面加强医学研究生就业价值观引导的建议。     

疫情时期新入学临床医学专业学位研究生职业认同情况及对策研究

目的：了解新型冠状病毒肺炎疫情背景下,新入学临床医学专业学位研究生职业认同情况,探讨其影响因素并提出对策。方法：采用调查问卷对2020年新入学的医学专业研究生职业认同情况进行调查并统计分析。结果：职业认同的得分为(3.75±0.54)。讨论：新入学医学专业研究生职业认同整体水平较高,但职业认知较低。硕士职业认同得分高于博士。有学生干部经历的医学生职业认同得分高于未当过学生干部的医学生。选择我院原因为认同学校/医院核心价值观、科室/导师水平的医学生职业认同得分更高。职业认同得分更高的医学生,疫情期间心理状况更加稳定。对策：构建和谐行医环境,提高医务人员待遇。加强医学生职业素养教育,做好职业生涯规划。树立正确职业价值观,重视医学生德行教育。提升医学生自主学习能力,提供针对性心理疏导。     

青年医务人员职业精神调查研究

本研究运用问卷量表调查了江苏省9家大型综合性公立医院青年医务人员在职业价值观?工作压力和组织承诺三个方面的行为特点和行为取向,分析了江苏省公立医院青年医务人员的职业精神现状及影响因素,提出加强青年医务人员职业精神培养的对策,引导青年医务人员树立适应时代需要的核心价值观体系?     

医务人员职业价值观与工作满意度的关系研究

职业价值观是从业者的择业意愿及对所从事职业价值与意义的内心信念与总体看法。医务人员的职业价值观包含从业意愿、薪酬水平、职业意义、社会评价等四个方面。理论分析与实证研究都表明：职业价值观对于工作满意度有着正向的显著作用。因此,对于医务人员而言,进行职业生涯管理,加强医德修养,提高薪酬水平,提升社会形象,有助于提高工作满意度。     

长春市某三甲医院护士职业价值观与工作倦怠相关性研究

目的:探讨三甲医院护士职业价值观与工作倦怠的相关性。方法:对184名某三甲医院护士采用一般资料调查表、护士职业价值观量表和工作倦怠问卷进行调查。结果:工作倦怠得分为49.83±12.70分,职业价值观与工作倦怠呈负相关关系(=-0.193,=0.009)。其影响因素包括职称、年龄、工作年限、用工性质、工作满意度、月收入等。结论:三甲医院护士职业价值观与工作倦怠呈负相关关系,职业价值观中立偏积极,工作倦怠检出率高。     

浅谈护士职业价值观对护理质量的影响

目的:了解护士职业价值观现状,探讨护士职业价值观对护理质量的影响。方法:对159名护理人员进行调查,采用职业价值观量表进行评价。结果:护士对职业价值观的认同维度较高(4.33),对工作满意度各维度的评价为中等水平(2.97),对职业稳定性的维度评分为中等水平(2.68)。结论:分析护士职业价值观的因素和现状,从护士工作环境、生活背景、护理水平和道德等方面提高护士职业价值观,提高对护理工作的认可,从而提高护理质量。     

妇产科90后护士的角色认知与职业价值观的相关性

目的:分析90后妇产科护士的角色认知与职业价值观的相关性。方法:选取2012年6月-2015年6月三年期间内在本院妇产科入职的82名"90"后护士行横断面调查,对个人状况、护士职业价值观及角色认知进行量化评定,根据对护士角色认知得分情况分为及格组与不及格两组,并对角色认知与职业价值观行Logistic回归分析。结果:及格组护士职业价值观得分(照顾提供,信任,责任、自由及安全,行动主义四项维度)以及总分均明显高于不及格组(P0.05)。及格组在保持所从事专业临床工作能力、保持患者与医护人员的信任以及拒绝参与违背伦理的工作等六项护士职业价值观得分均明显高于不及格组(P0.05)。经Logistic回归分析,照顾提供,行动主义,信任,责任、自由、安全四个方面均是影响职业价值的直接因素(P0.05)。结论:"90"后护士角色认知程度是影响护士职业价值的直接相关因素,护士角色认知程度越深,其职业价值观越积极。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.