恶性胸腔积液的综合治疗新进展

恶性胸腔积液(MPE)属恶性肿瘤进展期内的并发症,患者出现胸闷、进行性呼吸困难、胸痛及发热等不适症状。胸膜原发性肿瘤或恶性肿瘤侵犯胸膜进而产生恶性胸腔积液。恶性胸腔积液如不及时治疗,那么患者的生存期平均仅剩数月。因而提高患者恶性胸腔积液有效治疗能进一步提高病患的生活质量,进一步延长病患的生存期。本文根据当前的研究,综述了治疗恶性胸腔积液的疗法,特别是分子靶向治疗和基因治疗等近年来的新研究热点,总结了近年来出现的新药物及新治疗手段。     

胸腔热灌注化疗与胸腔灌注化疗治疗恶性胸腔积液的Meta分析

目的:系统评价胸腔热灌注化疗治疗恶性胸腔积液(MPE)的疗效及安全性。方法:计算机检索中外数据库,检索时间为建库之日至2020年9月1日,纳入胸腔热灌注化疗与灌注化疗治疗MPE的临床随机对照研究(RCT),再对本研究纳入的RCT进行方法学文献质量评价,使用Revman 5.0和Stata 14.0进行统计学分析。结果:...     

全面系统化护理在胸腔手术后胸腔闭式引流中的应用

目的研究全面系统化护理在胸腔手术后胸腔闭式引流中的应用效果。方法选取160例实施胸腔闭式引流术患者作为研究对象,随机分为两组各80例。对照组采用常规护理,观察组在常规护理基础上实施全面系统化护理,比较两组的护理效果。结果观察组的平均日引流量显著少于对照组(P <0.05),两组的引流时间比较无统计学差异(P>0.05)。观察组的术后并发症发生率为3.75%,显著低于对照组的12.50%(P <0.05)。观察组的护理满意度为93.75%,显著高于对照组的83.75%(P <0.05)。结论在胸腔手术后胸腔闭式引流中应用全面系统化护理,可明显减少日均引流量和胸腔术后并发症,提高患者满意度。     

改良胸腔积液引流术治疗胸腔积液36例

<正>改良胸腔积液引流术治疗各种原因的胸腔积液与常规穿刺治疗比较,具有操作简单,创伤小,不良反应小、并发症少、疗效好等优点。我院自2008年12月—2010年7月采用改良胸腔积液引流术治疗胸腔积液患者36例,疗效满意,现报道如下。     

98例小儿胸腔积液胸腔闭式引流术后的护理探讨

目的探讨胸腔积液患儿行胸腔闭式引流术后的护理。方法选取2012年2月至2013年3月收治于我院的98例胸腔积液患儿为研究对象,并随机将其分成观察组与对照组,每组各49例。对照组行胸腔闭式引流术后常规护理,观察组行强化护理,分析对比两组的护理效果。结果观察组患儿治疗依从性以及家长满意度均显著高于对照组,差异有统计学意义(P<0.05);观察组患儿术后并发症发生率显著低于对照组,差异有统计学意义(P<0.05)。结论胸腔积液患儿术后加强护理有助于病情康复,可减少并发症的发生,同时提高患儿家长对护理工作的满意度。     

心力衰竭伴胸腔积液45例临床分析

心力衰竭伴胸腔积液以前比较少见,近年多有增加趋势,文献少有报道。现将我们收集的45例分析讨论如下。1 临床资料本组45例中,男32例,女13例,年龄24岁～82岁,平均58.4岁。双侧积液10例(10/45,22.2％),单侧胸腔积液35例(35/45,78％),单侧发病多于双侧发病。单侧病人中,左侧6例(6/35,17.1％),右侧24     

ADA和Ca125法检测结核性胸腔积液患者的临床意义

近年来研究发现肿瘤相关抗原125(Ca125)和腺苷脱氨酶(ADA)在结核性胸腔积液患者的血清及胸水中往往升高.本文探讨检测ADA和Ca125在结核性胸腔积液患者中的临床意义.     

胸腔闭式引流治疗108例胸腔积液体会

1986年10月～1996年10月,作者用胸腔闭式引流的方法治疗由各种原因引起的胸腔积液108例,疗效显著。现报告如下。1 临床资料1.1 一般资料本组108例,男性70例,女性38例。年龄最小1岁,最大87岁,平均年龄45.5岁。其中1～14岁8例,～30岁46例,～45岁28例,～60岁16例,≥61岁10例。结核性感染60例;化脓性感染35例,其中脓气胸5例;癌性胸水13例,其中肺     

胸腔镜联合胸腔闭式引流诊治结核性胸腔积液30例临床分析

目的对利用胸腔镜与胸腔闭式引流结合的方法对存在结核性胸腔积液的患者进行治疗的临床效果进行研究分析。方法抽取60例存在结核性胸腔积液的临床确诊患者病例,将其分为A、B两组,平均每组30例。分别采用反复胸部穿刺和胸腔镜与胸腔闭式引流联合的方法进行处理。结果 B组患者经过治疗后的体温恢复正常和胸水得到控制所需的时间明显短于A组;治疗过程中的实际胸水抽放量明显多于A组;并发症的发生率明显低于A组;出院时间明显早于A组。结论利用胸腔镜与胸腔闭式引流结合的方法对存在结核性胸腔积液的患者进行治疗的临床效果非常明显。     

胸腔灌洗对开胸术后胸腔感染的临床治疗研究

目的 探讨胸腔灌洗对开胸术后胸腔感染的临床效果,以期寻找最合适的方法,提高临床治疗水平。方法随机选取2010年4月-2013年4月70例开胸术后胸腔感染患者为研究对象,分成两组,对照组35例,予以传统的胸腔冲洗法,观察组35例,予以胸腔灌洗治疗,比较两组治疗后在临床效果、实验室检查等差异性,采用SPSS16.0进行软件分析。结果 对照组治愈率为25.71%、总有效率为74.29%,观察组治愈率为45.71%、总有效率为91.43%,两组比较差异有统计学意义(P<0.05);两组在体温恢复正常时间、住院时间、症状改善时间、肺不张恢复时间、肺部啰音消失时间、生活质量评分和实验室指标白细胞、C-反应蛋白、肿瘤坏死因子、白介素-6两组比较差异有统计学意义(P<0.05)。结论 胸腔灌洗治疗开胸术后胸腔感染临床效果显著,能缩短治疗时间,提高预后水平。     

临床型医院科研工作存在的问题和对策

非医科院校直属的临床型医院普遍存在着科研意识淡薄,科研水平滞后,科研团队缺如,科研制度缺乏等阻碍科研工作发展的问题。近年来,针对这些问题,山西省人民医院采取开展科研培训,完善科研设施,加强科研梯队建设,制定各项科研奖惩制度等措施,有力地促进了科研工作的开展和进步,使医务人员对科研工作的思想观念从根本上发生了改变,医院在各项科研工作中取得了切实的成绩。     

科技期刊出版中有关科研诚信问题的研究述评

【目的】 追踪科技期刊出版中有关科研诚信问题的研究发展情况,探寻科技期刊在科研诚信领域的研究主题与新兴研究内容,提出科技期刊在科研诚信领域的关注点与能动作用,推动科研诚信体系建设。【方法】 对Web of Science核心合集SCIE数据库中科技期刊科研诚信相关论文进行分析,从数字环境下学术不端检测、注册登记、存档、服务边界等方面归纳、总结科技期刊出版中有关科研诚信方面的相关研究。【结果】 科技期刊科研诚信研究呈现“意识觉醒—提出问题与探讨规范建设—建立统一标准—调研标准遵照执行程度/新兴问题出现”的发展路径。目前新兴研究主要集中在学术不端检测、登记环节审查、存档环节建设、“第三方服务”边界四个方面。【结论】 科研诚信研究与科学研究的发展相对应,随着科研新范式的发展和确立,“数字化”“数据化”“技术性”加入到科技期刊科研诚信研究体系中。科学研究的新技术与研究结果的新呈现,开放环境下科研成果在登记、评估、传播、存档环节中的科研诚信问题仍将是未来该领域讨论的焦点。     

Collaboration and co‐ownership in research: dynamics and dialogues between patient research partners and professional researchers in a research team

Background Different strategies by which patients can be involved in research include consultation, control and collaboration. This article focuses on collaboration within research teams and considers this with reference to a research project about setting a social–scientific agenda for health research from the perspectives of patients with a chronic kidney disease (CKD). Objective To examine the dynamics and dialogues in a collaboration between patient research partners and professional researchers. Design A responsive methodology was used in the research project. Two patient research partners participated in the research team. Twenty‐seven patients with CKD and parents of young children with CKD were interviewed, seven focus groups were organized and observations were held at a dialysis centre. Results During the collaboration, the research partners and professional researchers engaged in a mutual learning process in all stages of the project. The professional researchers gave the research partners a sense of ownership in the research process. The research partners could relate to the lives of patients by using their experiential knowledge. In the context of collaborative working, this helped shape an agenda for research. Conclusion and discussion The active involvement of patients as research partners can add value to a research strategy, especially when research partners and professional researchers engage in a dialogue that is open, inclusive and deliberative. Issues for discussion include the possibility of ‘over‐involvement’, the research profile and training of research partners and whether participation of patients is restricted to certain types of research.     

Faculty research skills development

This article presents a plan for faculty research skills development. Three categories of faculty research roles are described: researcher, researcher/teacher, teacher/research team member. A faculty member elects to be placed in one of the categories based on academic credentials, research expertise, and professional goals. At the departmental level, faculty share research ideas and receive mutual support through regularly scheduled biweekly faculty research meetings. Faculty research skills are cultivated via monthly seminars. Administrative support is furnished through a research management system designed to facilitate the process of initiating research projects and responding to external funding research opportunities in a timely manner. The research management component offers: seed money for pilot studies and small projects; funds for research assistants and consultants; focused information dissemination concerning funding sources; and clerical support systems for completing and submitting grant applications.     

定性研究及其数据分析简介

定性研究作为现代流行病学调查分析研究的两大方法体系之一正在得到广泛的应用,但我国流行病学界仍然存在“定性研究只是定量研究的补充”等片面认识现象,定性研究数据分析软件方面的应用就更少。我国极少的定性研究理论尚还不能对定性研究做出明确而具有实际操作性的指导。本文就定性研究的产生和发展、定义、用途和特点、常用的技术方法以及CDCEZ-Text等定性分析软件逐一简介。     

“两癌”研究现状及热点探究--基于CiteSpace可视化分析

目的对我国"两癌"已有研究成果进行文本挖掘及分析,探究研究现状及研究热点,为进一步研究提供依据。方法以1995-2019年CNKI中的281篇"两癌"的相关文献为样本,运用CiteSpace,对研究作者和机构进行分析以找出研究力量;对关键词频次、关键词聚类进行分析以总结研究热点;对关键词膨胀词进行分析以理清研究趋势和前沿。结果 "两癌"的研究作者及机构集中于我国东部城乡,西部地区研究缺乏,研究方法多为定量分析,研究热点集中于"农村妇女","两癌筛查"逐渐成为研究前沿。结论有关部门需加强对西部地区"两癌"的关注,积极引入定量与定性相结合的研究方法,进行大范围、多元化、多合作的研究。     

Epidemiological research in Brazil

The current epidemiological research in Brazil is described. Secondary data sources were consulted, such as the year 2000 database of the Brazilian Directory of Research Groups and the National Board of Scientific and Technological Development (CNPq). The criterion to identify a group as a research one relies on the existence of at least one research line in the field of epidemiology, as defined by the group leader. After identifying the defined universe of epidemiological research, which included 176 groups and 320 different research lines, the following issues were presented and discussed: the relationships between research financing and health research, focusing on CAPES (Coordination Center for the Advance of University Professionals) graduation programs, public health research and epidemiological research, geographic and institutional distribution and outreach of the current epidemiological research, the researchers and students directly participating in epidemiological research, research topics and patterns of disseminating research findings; the journals where papers in its fullness were published; the financial support of the epidemiological research focusing on the 23 officially recognized graduate programs in public health field.     

Aufgabenverständnis und Entwicklungsstand der Versorgungsforschung

Given the fact that health services research has become increasingly popular in Germany during the last 5 years this article focuses on the status quo of this research field in a multinational comparison. An overview of the health services research situation in the USA, UK, Australia and Germany is given by considering development status, definition and future challenges. This overview shows that health services research is by now regarded as an essential field in these countries. Despite clear distinctions in research tradition and research infrastructure there are cross-national themes and challenges regarding research questions and organisation of research. The common challenges of the future are probably the enhancement of research capacities, the further development of adequate research methods and the question of translating research results into practice. All countries concur that the cooperation between stakeholders of the health services research field needs to be strengthened.     

Niqivut Silalu Asijjipalliajuq: Building a Community-Led Food Sovereignty and Climate Change Research Program in Nunavut,Canada

The history of health research in Inuit communities in Canada recounts unethical and colonizing research practices. Recent decades have witnessed profound changes that have advanced ethical and community-driven research, yet much work remains. Inuit have called for research reform in Inuit Nunangat, most recently creating the National Inuit Strategy on Research (NISR) as a framework to support this work. The present study details the process undertaken to create a research program guided by the NISR to address food security, nutrition, and climate change in Inuit Nunangat. Four main elements were identified as critical to supporting the development of a meaningful and authentic community-led program of research: developing Inuit-identified research questions that are relevant and important to Inuit communities; identifying Inuit expertise to answer these questions; re-envisioning and innovating research methodologies that are meaningful to Inuit and reflect Inuit knowledge and societal values; and identifying approaches to mobilizing knowledge that can be applied to support food security and climate change adaptation. We also identify considerations for funding agencies to support the meaningful development of Inuit-led research proposals, including aligning funding with community priorities, reconsidering who the researchers are, and investing in community infrastructure. Our critical reflection on the research program development process provides insight into community-led research that can support Inuit self-determination in research, enhance local ethical conduct of research, privilege Inuit knowledge systems, and align Inuit-identified research priorities with research funding opportunities in health research. While we focus on Inuit-led research in Nunavut, Canada, these insights may be of interest more broadly to Indigenous health research.     

定性研究方法在预防医学研究中的应用

定性研究作为社会学调查分析研究的两大方法之一,具有省时省力,研究设计方法灵活,可获取许多定量研究得不到的信息等优点,所以在现代预防医学研究中,定性研究越来越受到重视.本文主要介绍了定性研究的几种常用研究方法,包括观察法、访谈法、专题小组讨论、文献分析等,以及各种方法的适用范围和不足之处.