2013—2023年国内外慢性阻塞性肺疾病患者自我管理研究热点的共词聚类分析

目的分析国内外慢性阻塞性肺疾病(COPD)患者自我管理研究的热点。方法检索中国知网、Web of Science数据库中有关COPD患者自我管理的相关文献, 检索时限为2013年1月1日—2023年6月30日。采用CiteSpace 5.8软件进行关键词聚类分析。结果检索共获得中文文献641篇, 英文文献1 192篇。国内COPD患者自我管理研究热点主要聚焦于健康教育、延续护理、康复护理等;国外COPD患者自我管理研究热点主要聚焦于移动健康、远程医疗等。结论本文分析了国内外有关COPD患者自我管理的研究热点, 为未来COPD患者自我管理相关研究提供参考。     

国内6种核心期刊近5年慢性阻塞性肺疾病患者护理的文献定量分析

目的回顾发表在国内6种核心期刊的慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者护理相关文献,探讨护理人员在COPD护理领域的研究现状及存在问题。方法 2017年3月,以"COPD"、"慢阻肺"、"慢性阻塞性肺疾病"和"护理"为关键词检索中国期刊全文数据库、中文科技期刊数据库、万方数据库。应用文献分析法对相关文献从期刊、时间分布、地域范围、研究类型、研究内容等方面进行描述性分析。结果 2011-2016年期间,6种核心期刊发表COPD护理相关文献共287篇,其中《护理研究》、《中国实用护理杂志》、《解放军护理杂志》发文量较多。287篇文献来自我国共28个省、直辖市和自治区,文章地域分布具有一定的广泛性。研究内容注重于患者的生活质量、延续护理和肺疾病康复;研究类型以实验研究类文章较多。研究类型中,实验性研究类文献为179篇(62.4%);其次为调查性研究类文献,共51篇(17.8%);综述类文献38篇(13.2%);质性研究类文献16篇(5.5%)。实验性研究类文献的研究内容主要为生活质量、延续护理等,而调查类文献的研究内容主要有患者自我管理相关影响因素分析、患者自我感受负担等。结论 COPD护理的研究热点集中于提高患者生活质量,无创正压通气应用亦日渐广泛。护理人员需重视患者的延续护理、重视肺康复锻炼的多样化。     

基于Web of Science和中国知网的肺康复研究可视化分析

目的分析国内外肺康复研究的相关文献, 了解其研究热点及发展趋势, 为今后开展肺康复研究提供参考和依据。方法检索2015年1月至2022年2月发表在Web of Science和中国知网数据库的肺康复相关文献, 运用文献计量学方法和CiteSpace软件, 将年发文量、作者、研究机构、高频关键词等内容进行可视化分析。结果年度发文量从2015年开始均呈较明显的上升趋势, 其中2019—2020年中文文献篇数高于英文文献。英文文献发文数量最多的作者为MARTIJN A SPRUIT65篇, 各机构和学者间合作密切, 形成了合作网络;中文发文量最多的作者为车国卫13篇, 高产机构和作者间合作较为缺乏, 相对分散。国外主要研究机构为高校, 发文量第一的机构为荷兰马斯特里赫特大学85篇, 国内研究机构以医院为主, 累计发文量最高的是四川大学华西医院胸外科14篇。通过关键词共现和聚类与时间线视图分析得出该领域的研究热点为不同慢性呼吸疾病患者的肺康复、肺康复对慢性阻塞性肺疾病患者肺功能和生命质量的影响、肺康复的干预方法, 预测未来趋势为肺康复在肺癌治疗中的临床应用价值。结论目前肺康复研究处于稳定发展期...     

品管圈在COPD患者肺康复功能锻炼指导中的应用

目的探讨品管圈在提高慢性阻塞性肺疾病(COPD)患者肺康复功能锻炼依从性中的应用效果。方法抽样选取2014年8月~2015年8月在本院呼吸科行肺康复训练指导的COPD患者197例,按照入院时间先后分为对照组和观察组。对照组患者行常规肺康复训练指导护理,观察组患者实施品管圈活动干预的肺康复训练指导护理,通过同一评定标准评价两组患者功能锻炼的依从率。结果实施品管圈活动干预的COPD患者肺康复功能锻炼依从率从41.00%提升至81.44%,患者满意度有明显提高,差异有统计学意义(P0.05)。结论品管圈活动的开展有利于提高COPD患者肺康复功能锻炼的依从性,从而提高患者满意度。     

慢性阻塞性肺疾病患者自我管理与生活质量相关性分析

目的:探讨慢性阻塞性肺疾病(COPD)患者自我管理和生活质量之间的关系.方法:采用描述性相关性研究,用COPD自我管理量表、COPD生活质量量表对 169例 COPD患者进行问卷调查.结果:COPD患者自我管理总分和生活质量总分分别为(154.75±16.15)分、(90.69±19.44)分,二者存在中度负相关(r=-0.663,P＜0.01);自我效能可以解释生活质量总变异的48.00%.结论:护理人员应积极开展COPD患者的自我管理健康教育,从而提高其自我效能、自我管理水平及生活质量.     

慢性阻塞性肺疾病稳定期患者肺康复治疗的临床研究

<正>慢性阻塞性肺疾病(COPD)是一种较常见的慢性呼吸系统疾病,具有很高的发病率和死亡率~([1])。相关研究~([2])显示,COPD稳定期患者接受有效的肺康复治疗,可以显著增强其运动功能,减轻其呼吸困难程度,提高其生命健康和生活质量。本研究探讨肺康复治疗对COPD稳定期患者的临床效果,现报告如下。     

基于Citespace的慢性阻塞性肺疾病肺康复的研究热点与趋势分析

目的:分析国内慢性阻塞性肺疾病肺康复的作者、机构合作情况,挖掘研究热点与前沿,为今后慢性阻塞性肺疾病肺康复研究提供借鉴和参考.方法:选取中国知网(CNKI)收录的有关慢性阻塞性肺疾病肺康复的论文,借助信息可视化软件Citespace-5.1.R6分析其作者、机构和关键词.结果:共纳入有效文献1611篇,年度发文量总体呈上升趋势;发文量最多的作者是陈锦秀,发表10篇文献;发文最多的研究机构是上海市浦东新区人民医院,共发表60篇文献,机构间最大的合作网络是以南华大学护理学院为中心,由湖南省肿瘤医院、湖南省人民医院、长沙市中心医院等组成;研究热点是肺功能、生活质量、稳定期、肺康复训练,研究前沿是康复护理、肺康复护理.结论:慢性阻塞性肺疾病肺康复研究目前处于快速发展时期,但核心作者群与机构不够广泛,研究质量不高,未来需加强跨区域、跨院校的合作交流,开展多中心、大样本、高质量的研究,为研究人员提供借鉴.     

功能锻炼配合营养疗法治疗稳定期慢性阻塞性肺疾病的疗效观察

慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）已成为呼吸系统疾病中引起人类死亡的第4位病因，而且发病率逐年上升。对稳定期COPD患者进行康复治疗，已成为提高COPD患者运动耐量，改善其生存质量的重要措施。本研究对21例稳定期COPD患者在药物治疗的基础上给予功能锻炼配合营养疗法，并与常规药物治疗组进行比较，现报道如下：     

维吾尔族慢性阻塞性肺疾病患者生活质量现状及影响因素的研究

目的探讨喀什地区维吾尔族慢性阻塞性肺疾病(COPD)患者生活质量现状及影响因素。方法采用方便抽样,选取2017年10月-2018年1月在喀什地区某三级甲等医院就诊的203名维吾尔族COPD患者,运用维语版一般情况问卷、COPD患者疾病认知问卷和COPD患者自我管理量表以及慢性阻塞性肺疾病评估测试表(CAT)量表对符合纳入标准的研究对象进行调查。结果维吾尔族COPD患者疾病认知水平一般,平均水平为(22.68±4.67)分,自我管理总分的平均水平为(153.58±18.30)分。多元回归分析显示:过去1年因COPD住院的次数、自我管理(症状管理、自我效能维度)、文化程度4个变量进入了以生活质量水平为因变量的回归方程(R2=0.185,F=10.177,P=0.000)。结论维吾尔族COPD患者生活质量水平亟待提高,患者住院次数是影响维吾尔族COPD患者生活质量的重要因素,自我管理及文化程度是影响COPD患者生活质量水平的次要因素。     

肺康复治疗在慢性阻塞性肺疾病治疗中的作用

肺康复是在全面的评估后给予患者的个体化综合干预治疗,包括但不仅限于运动训练、健康教育、行为改变,旨在改善慢性呼吸系统疾病患者的生理和心理状态,促进患者形成长期的有益健康的行为习惯[1]。2006年《慢性阻塞性肺疾病全球倡议》（GOLD）首次将慢性阻塞性肺疾病（chronic obstructive pulmonary disease,COPD）重新定义为可以预防和可以治疗的疾病,并将肺康复作为COPD患者稳定期非药物治疗的重要手段[2],     

Effects of Three Treatment Modes on Plasma Lipids and Lipoproteins in Uraemic Patients

Plasma lipids, chemical composition of various lipoprotein fractions, apolipoprotein B concentrations and apolipoprotein E phenotypes were studied in 12 uraemic patients on conservative treatment (CT), in 16 patients on haemodialysis (HD) and in 18 patients on continuous ambulatory peritoneal dialysis treatment (CAPD). Plasma total cholesterol and triglyceride concentrations were increased in the CAPD patients in comparison to the HD patients and the control subjects. Moreover, the CAPD patients had higher LDL cholesterol concentration than the CT and HD patients. The HDL cholesterol concentration was lower in the HD and CAPD patients than in the control subjects. The chemical composition of lipoproteins in all fractions of the CT and HD patients and in VLDL, IDL and LDL fractions of the CAPD patients differed from those of the control subjects. The main differences were the increased proportion of triglycerides in VLDL and LDL fractions of all the patient groups and in HDL fraction of the CT and HD patients in comparison to the control subjects. Moreover, the proportion of cholesterol was increased in VLDL and IDL fractions of the CT and the CAPD patients and decreased in HDL fraction of the CT and HD patients compared to the control subjects. In conclusion, in addition to the alterations in the lipoprotein concentrations in uraemic patients there are also marked changes in the chemical composition of the lipoprotein particles that may further contribute to the accelerated atherosclerosis among uraemic patients. The abnormalities are particularly prevalent in CAPD patients.     

Tackling drug and alcohol misuse in Brazil: priorities and challenges for nurses

AIMS: To provide an overview of the extent of drug and alcohol misuse in Brazil and the policies and approaches in tackling substance misuse. An examination of the challenges facing the nursing profession in working with substance misusers is presented. BACKGROUND: Alcohol, cocaine, and cannabis are the most commonly misused psychoactive substances in Brazil. One of the biggest public health problems is the interface between the misuse of psychoactive substances and HIV prevalence and other sexually transmitted diseases. Findings from a recent study suggest that undergraduate nurses in Brazil are not adequately prepared in the care and management of substance misuse problems. The nursing profession in Brazil faces numerous challenges in the development of professional competence of nurses in this field. CONCLUSION: A strategy proposed is the creation of regional centres in Brazil to study the integration of substance use and misuse in the nursing undergraduate curriculum and the giving of specific support in teaching and research to nurse teachers. Nurses have a key role to play in the early recognition, assessment, prevention, and treatment of substance misuse.     

Notch基因在支气管哮喘模型小鼠肺中的表达

目的:对支气管哮喘模型小鼠肺组织及肺T细胞中4种Notch基因表达的特征进行研究,探讨Notch信号在支气管哮喘发病中的作用。方法:制作哮喘小鼠模型,制备肺组织石蜡切片进行病理学检查;从肺组织中分离T细胞,利用RT-PCR半定量技术,测定小鼠肺组织及肺T细胞中4种NotchmRNA的表达量,并与对照组比较。结果:两组小鼠肺组织中4种Notch基因均有表达。哮喘模型组Notch1、Notch2表达较对照组增加(P0.05);Notch4表达组间比较无差异。Notch1、Notch2在肺T细胞中的表达与肺组织中的一致(P<0.05);Notch3、Notch4在T细胞中的表达组间比较无差异。结论:Notch1、2信号在支气管哮喘的发病机制中可能发挥一定作用。     

Practices for caring in nursing: Brazilian research groups

ERDMANN A.L., DE ANDRADE S.R., FERREIRA DE MELLO A.L., KLOCK P., DO NASCIMENTO K.C., SANTOS KOERICH M. & STEIN BACKES D. (2011) Practices for caring in nursing: Brazilian research groups. International Nursing Review 58 , 379–385 Background: The present study considers the production of knowledge and the interactions in the environment of research and their relationships in the system of caring in nursing and health. Aim: To elaborate a theoretical model of the organization of the practices used for caring, based on the experiences made by the research groups of administration and management in nursing, in Brazil. Methods: The study is based on grounded theory. Twelve leaders of research groups, working as professors in public universities in the south and the south‐east of Brazil, distributed in sample groups, were interviewed. Findings: The core phenomenon ‘research groups of administration and management in nursing: arrangements and interactions in the system of caring in nursing’ was derived from the categories: conceptual bases and contexts of the research groups; experiencing interactions in the research groups; functionality of the research groups; and outputs of the research groups. The research groups are integrated in the system of caring in nursing. Conclusions: The activities of the Brazilian administration and management in nursing research groups are process oriented and in a process of constant renovation, socially relevant, operate in a complex scenario and contribute to the advancement of the organizations of the system of caring in nursing through strengthening the connection among academia, service and community.     

Cisplatin‐ and dietary ascorbic acid‐mediated changes in the mitochondria of Dalton’s lymphoma‐bearing mice

Cisplatin treatment caused a significant increase in the life span of ascites Dalton’s lymphoma (DL) Tumor‐bearing (TB) mice. However, as compared to cisplatin (CP) alone, combination treatment with ascorbic acid plus CP resulted in better therapeutic efficacy against murine DL. Cisplatin treatment of TB mice resulted in the appearance of thickened and irregular arrangement of mitochondrial cristae in the liver, kidney and DL tumor cells. Combination treatment of the hosts with ascorbic acid and CP lessened deformities in the mitochondria of liver and kidney, while in tumor cells, this increased the formation of vacuoles and disruption in mitochondrial cristae. Cisplatin treatment decreased the succinate dehydrogenase (SDH) activity in the mitochondria of kidney and DL cells and combination treatment caused further decrease in SDH activity in kidney and DL cells during 24–48 h of treatment. After CP treatment, the protein content in the mitochondria of these tissues decreased, and during combination treatment, it showed significant improvement. Mitochondrial lipid peroxidation (LPO) increased in these tissues after CP treatment. However, combination treatment significantly decreased mitochondrial LPO in liver and kidney but increased in DL cells. This increase in mitochondrial LPO in DL cells and decrease in liver and kidney could play an important role in the antitumor activity of combination treatment and at the same time reduce CP‐induced toxicity in the host. However, further study may be desirable to explore some aspects of the mechanism(s) involved in these changes in mitochondria.     

三种脑部炎症病变脑脊液铁蛋白、脑脊液白蛋白/血清白蛋白比值和免疫球蛋白的变化及意义

目的　探讨结核性脑膜炎、病毒性脑膜炎、急性播散性脑脊髓炎脊液铁蛋白、脑脊液白蛋白 /血清白蛋白比值及脊液免疫球蛋白的变化及诊断意义。方法　检测结核性脑膜炎 31例、病毒性脑膜炎 32例、急性播散性脑脊髓炎 30例患者的脑脊液铁蛋白、脑脊液白蛋白 /血清白蛋白比值及脊液免疫球蛋白的变化 ,并与 30例正常者作对照。结果　方差分析显示结核性脑膜炎、病毒性脑膜炎、急性播散性脑脊髓炎及对照组脑脊液铁蛋白、脑脊液白蛋白 /血清白蛋白比值差异均有统计学意义 (P <0 .0 0 0 1) ,3组脑部疾病间的铁蛋白、脑脊液白蛋白 /血清白蛋白比值差异均有统计学意义 (P均 <0 .0 5 )。方差分析结核性脑膜炎、病毒性脑膜炎及急性播散性脑脊髓炎脑脊液IgA、IgM、IgG变化差异有统计学意义 (P <0 .0 0 0 1) ,结核性脑膜炎组脑脊液IgA、IgM较急性播散性脑脊髓炎及病毒性脑膜炎显著升高(P <0 .0 5 ) ,急性播散性脑脊髓炎IgG较结核性脑膜炎及病毒性脑膜炎显著升高 (P <0 .0 5 )。结论　结核性脑膜炎、病毒性脑膜炎、急性播散性脑脊髓炎脊液铁蛋白、脑脊液白蛋白 /血清白蛋白比值和脊液免疫球蛋白的变化和差异 ,可作为诊断和鉴别诊断的参考指标。     

针刺对过敏性哮喘大鼠肺肠组织SP-AmRNA表达的影响

目的探讨针刺对过敏性哮喘(哮喘)大鼠肺肠组织表面蛋白A(SP-A)mRNA表达的影响。方法将40只SD大鼠随机分为空白组、哮喘模型组、针刺肺组、针刺肠组、针刺肺肠组,每组各8只。除空白组外,余4组采用腹腔注射卵蛋白致敏,2周后尾静脉注射卵蛋白激发哮喘发作进行造模。空白组、哮喘模型组不针刺,针刺肺组针刺尺泽、孔最、列缺、肺俞穴,针刺肠组针刺曲池、合谷、天枢、上巨虚穴,针刺肺肠组针刺孔最、列缺、曲池、天枢穴。检测并比较各组大鼠针刺后肺肠等组织中SP-A mRNA的表达。结果哮喘模型组肺、大肠及小肠组织中SP-A mRNA的表达均较空白组高(P0.01);针刺肺组、针刺肠组、针刺肺肠组的肺、大肠及针刺肺肠组小肠组织中SP-A mRNA的表达均较哮喘模型组高(P0.05);针刺肺组、针刺肠组的小肠组织中SP-A mRNA的表达与哮喘模型组比较无明显差异(P均0.05)。结论哮喘大鼠肺肠组织SP-A mRNA表达均发生异常,其中肺与大肠生物学相关性最为密切。     

The expression of cyclooxygenase-1 and -2 in proliferative endometrium and endometrial adenocarcinoma

BACKGROUND. The activity of cyclooxygenase-2 (COX-2) is increased in inflammation and in several cancer types. We investigated the expression of COX-2, cyclooxygenase-1 (COX-1), nitric oxide synthase-2 (NOS-2) and nitric oxide synthase-3 (NOS-3) in normal proliferative and secretory human endometrium, and in endometrial adenocarcinoma. METHODS. Human endometrium was collected at hysterectomy. Seven samples were in proliferative and 11 samples in secretory stage. Twelve specimens from endometrial carcinoma were collected, as well. Immunohistochemistry was used to investigate the expression of COX-1, COX-2, NOS-2 and NOS-3. RESULTS. COX-2 immunostaining was detected in most specimens of normal proliferative glandular epithelium (86%) and of endometrial carcinomas (92%). COX-2 staining was often detected in cancer cells on the border areas of the tumour and on the areas of invasive growth. Staining for COX-2 was seen in proliferative glands usually only in the basal layer of the endometrium. NOS-2 was usually absent or negligible in proliferative endometrial glands and also in the cancer cells of endometrial adenocarcinomas. No staining for either COX-2 or NOS-2 was seen in specimens of secretory glandular epithelium. The expression of the constitutive COX-1 and NOS-3 was negligible or weak in the glandular epithelium of proliferative and secretory endometrium and in endometrial cancer cells. CONCLUSIONS. The expression of the inducible COX-2 but not of COX-1 is stimulated in the glandular epithelium of proliferative endometrium and in the cancer cells of human endometrial adenocarcinoma, in particular in those in the borders of carcinoma and spreading into lymphatic vessels.     

急慢性应激对大鼠中枢神经肽Y腺苷酸环化酶表达的影响

目的 探讨急、慢性应激对大鼠行为及不同脑区神经肽Y、腺苷酸环化酶表达的影响.方法 将30只雄性SD大鼠随机分为急性应激组、慢性应激组和正常对照组,每组10只,用强迫游泳和空瓶刺激分别制作急性和慢性应激模型,采用开野实验箱观察各组大鼠进入中央格次数、停留时间、外周格子数、修饰次数、粪便粒数;采用免疫组织化学方法检测各组大鼠神经肽Y、腺苷酸环化酶在前额叶皮质,海马CA3区,纹状体的表达水平,并进行相关分析.结果 开野实验箱中观察各组大鼠行为学指标显示,三组进入中央格次数、停留时间、外周格子数及修饰次数比较均有显著性差异(F=2.31、2.76、4.20、4.37,P<0.01～0.05).神经肽Y表达水平急、慢性应激组在前额叶皮质、纹状体均显著高于正常对照组(F=7.37、4.60,P<0.01),在海马CA3区慢性应激组表达水平显著高于正常对照组(P<0.05),而急性应激组无显著性变化.腺苷酸环化酶在慢性应激组大鼠的前额叶皮质,海马CA3,纹状体的表达水平显著低于正常对照组(P<0.05),而急性应激组大鼠在纹状体表达有所增加(P<0.05).急性应激组大鼠前额叶皮质,纹状体腺苷酸环化酶的表达和该组大鼠在开野实验箱中的停留时间,修饰次数成显著正相关(r=0.944、0.944、0.868、0.783).结论 强迫游泳和空瓶应激可诱导大鼠情绪障碍,神经肽Y、腺苷酸环化酶与情绪有关,前额叶皮质、纹状体腺苷酸环化酶的表达在急性应激状态的生理改变中有重要作用.     

不同阶段心理干预对层流病房患者的影响

目的:通过对入住层流病房患者在不同时期恐惧、焦虑、睡眠等心理状况分析并开展针对性的心理干预,以达到早日康复的目的。方法:对27例入住层流病房患者分别于入住前、入住后3 d和出层流病房前应用自制恐惧自评量表、焦虑自评量表、睡眠自评量表评估患者心理状况并针对性进行心理干预。结果:恐惧量表评分中,患者出层流病房前评分明显低于入住层流病房前、入住层流病房后3 d,同时入住层流病房后3日低于入住层流病房前。焦虑量表评分中,患者于出层流病房前评分明显低于入住层流病房前、入住层流病房后3 d,但入住层流病房前与入住层流病房后3 d之间无明显统计学差异。睡眠量表评分,患者入住层流病房后3 d评分明显高于入住层流病房前及出层流病房前,存在统计学差异,而入住层流病房前评分高于出层流病房前,存在统计学差异。结论:不同时期层流病房患者有不同的心理特征及心理变化,开展针对性心理干预是促进康复的重要手段之一。