本科护理学专业学生专业认知情况调查

目的了解本科护理学专业学生对护理学专业的认知情况,总结护理学专业学生情感领域教育的现状并发现存在的问题,为改进教学方式和课程设置提供理论依据。方法采用自设问卷调查北京大学护理学院2002级～2005级本科护理学专业学生在入学初期及入学1年后对护理学专业的认知情况,包括对护理学专业的一般认知及对护士工作内容的认知,同时调查护理学专业学生获取有关护理学专业信息的途径。结果相对入学初期,入学1年后的学生对护理学专业的一般认知及护士工作内容的认知程度均有显著提高（P〈0．05）,入学1年后学生对护理学专业的信息来源主要是教师的介绍及对护理学课程的学习。结论经过1年的学习,学生对护理学专业的认知程度显著提高,提示护理教育工作者应当从多方面对新入学的护理学专业学生加强专业情感教育。     

混合研究视角下不同年级本科护生专业认知现状调查

目的 调查不同年级本科护生专业认知现状及影响因素。方法 采用量性和质性研究相结合的方法,选取某本科院校328名护理专业学生作为研究对象发放调查问卷,通过目的抽样法抽取12名本科护生进行半结构化访谈,收集并分析资料。结果 不同年级本科护生专业认知存在一定差异,各年级专业认同感均有待提高。访谈发现本科护生入校前对护理专业存有单一刻板印象,入校后专业认同感明显增强,不同年级护生专业认知的影响因素有专业入学教育、专业课程、临床见习、实习环境。结论 不同年级本科护生的专业认知主要受现阶段学习重心的影响。学校可通过渐进式专业认知教育有针对性地满足不同年级、不同阶段护生的专业认知需求,从而增强护生的专业认同感。     

哈尔滨医科大学护理学专业课程设置的研究与实践

通过问卷调查方式以哈尔滨医科大学两所附属医院的临床护士、护理专业教师和本科护理学专业四年级学生为主要调查对象,对哈尔滨医科大学本科四年制护理学专业现行课程计划设置的合理性进行了调查和研究,为护理学专业课程改革提供参考意见。     

早期临床实践对五年制护理学专业学生认识护士角色影响的研究

探讨早期临床实践在促进五年制护理学专业学生对护士角色的认知与认同的影响。采用自设问卷和学生临床见习日记的形式,调查五年制护理学专业一年级学生在“护理学专业现状与护士角色”课程授课前后对护士角色的认知与认同情况。结果表明,“护理学专业现状与护士角色”课程授课前学生对于护士角色的认知和认同相对不足;“护理学专业现状与护士角色”课程授课后学生对于护士角色的认知和认同普遍增强（P〈0、01）;97．14％的学生认为该课程有助于更好地认识护士角色;92．85％的学生认为该课程有助于更好地认识护理学专业。研究结果提示,“护理学专业现状与护士角色”课程的设置在提高学生对护士角色的认知和认同方面产生了很好的效果,对学生更好地认识护士角色和护理学专业产生了积极的影响;教学中应当注重对护理学专业学生有关护士“研究者”角色的教育。     

护理学专业学生对专业喜爱程度和职业意向的调查分析

为了了解护理学专业学生对专业喜爱程度及其毕业就业意向,为护理学专业教育改革和发展提供参考,本研究对中山大学2007级～2010级护理学专业200名本科学生进行了问卷调查,对调查结果进行统计分析.调查结果表明,各年级学生对专业的喜爱程度不同,差异有统计学意义;各年级学生对专业的了解情况不同,差异有统计学意义,随着学生就读年级的增高,学生对专业的喜爱及了解程度有所趋势;有很大一部分学生并非自愿选择本专业;有39.5％的学生表示毕业后会从事护理工作,各年级学生选择毕业后从事护理工作的人数不同,差异有统计学意义,年级越高,愿意从事护理工作的比例越高.学校应当对护理学专业报考者有一定的要求,如要有对该专业的基本了解和喜爱、要有较好的文化素质,学校还要对学生进行一定的前期教育.     

本科护理学专业学生学习适应行为与学校环境因素认可度的相关研究

目的 了解本科护理学专业学生学习适应行为与学校环境因素认可度之间的相关关系.方法 采用自设问卷对北京、天津3所高等院校中一年级~四年级五年制本科护理学专业491名学生进行了有关调查.结果 本科护理学专业学生对同伴因素和教学因素的认可度较好,对综合因素、课程因素的认可度相对较差;学校环境因素认可度中总体评价、教师因素、同伴因素三方面的认可度对学生学习适应行为有直接影响.结论 通过提高学生对于教师因素、同伴因素的认可度可以促进学生良好学习适应行为的产生.提示护理教育者应当充分考虑学生的需求,进一步改善学校环境因素中的教师因素和同伴因素,以提高学生良好的学习适应行为.     

我校不同年级护理本科学生择业意向的比较分析

目的：通过对我校不同年级护理本科学生职业价值现的调查研究,把握我校护理本科生职业价值观的特点,为开展针对性的科学职业价值观教育和做好就业指导工作提供参考依据.方法：采用调查问卷方法抽取我校2009～2012级本科护理学专业200名学生进行调查,利用统计学分析结果.结果：不同年级本科护生在就业意愿、就业考虑因素等方面存在较大差异,高年级护生在就业方面更加现实并具有针对性.结论：根据不同年级护生实际情况开展择业观教育,提高低年级护生的专业认同感,正确认识护理职业发展前景,做好职业生涯规划.     

本科教学工作水平评估对我校学生焦虑心理影响的调查分析

目的调查本科教学工作水平评估对我校学生焦虑心理的影响。方法根据整群抽样原则,按各专业人数比例随机抽取1 000名在校生,采用焦虑自评量表(SAS)进行问卷调查。结果所有学生中有焦虑症状者占11.7%;不同年级和专业学生焦虑状况有显著性差异。结论我校学生在本科教学工作水平评估过程中出现一定的焦虑心理,应按不同年级和专业有针对性地开展相关教育,引导和缓解学生焦虑心理。     

实习阶段本科护生心理健康状况调查分析

目的了解实习阶段本科护生的心理健康状况,为护理学专业临床带教工作提供参考。方法采用问卷调查法,对正在实习的46名五年制护理学本科生进行心理健康状况调查。结果本科护生实习期间总体心理健康状况较好,但就个体的健康因子分值来看,有11%左右的护生处于亚健康状态。护生心理健康与应激水平呈高度正相关。结论实习阶段本科护生心理健康状况较好,应激可以对护生的心理健康产生影响。     

基于问题学习在眼科护理学教学中的应用评价

目的在眼科护理学教学中采用基于问题教学法,并评价此方法的教学效果。方法研究对象为护理学专业四年级本科生,2001级采用基于问题教学法,2002级采用传统教学法。课程结束后运用DREEM量表和相同闭卷试题成绩评价教学效果。结果基于问题教学组学生DREEM量表的总分明显高于传统教学组,且基于问题教学组学生应用知识解决问题的得分显著高于传统教学组。结论基于问题教学法适用于本科护理学专业学生的眼科护理学教学。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.