循证实践实施氛围量表的汉化及信效度检验

目的 引进、汉化循证实践实施氛围量表，并检验中文版量表的信效度，为我国护理人员循证实践实施氛围感知的评估提供测量工具。方法 采用Brislin翻译模型，通过翻译、回译和文化调适，形成中文版循证实践实施氛围量表。采用方便抽样法抽取1所三甲医院的297名护士进行调查，评价量表信效度。结果 中文版量表包括对循证实践的关注、对循证实践的教育支持、对循证实践的认可、对循证实践的奖励、循证实践的人员选拔以及选拔人员的开放性6个维度共18个条目。量表18个条目的决断值（CR）为19.884～32.438，各条目与总分的相关系数（r）为0.776～0.883（均P<0.01）。平均内容效度指数（S-CVI/Ave）为0.926。验证性因子分析结果显示，模型各项指标均达到标准，模型拟合较好。总量表Cronbach′s α系数为0.975，重测信度为0.983，折半信度为0.935。结论 中文版循证实践实施氛围量表在国内护士群体中具有较好的信效度，可以用于测评护士对循证实践实施氛围的感知。     

基于precede-proceed模式的护士职业性腰背痛预防行为量表的汉化及信效度评价

目的 汉化英文版护士职业性腰背痛预防行为量表(occupational low back pain prevention behaviours of nurse, OLBPPBN)并进行信效度检验。方法 通过翻译、专家咨询和预调查，形成初始汉化版护士职业性腰背痛预防行为量表，采用整群抽样法抽取陕西省某三甲医院346名护士进行调查，后进行项目分析，信效度检验，形成最终量表。结果 最终形成的护士职业性腰背痛预防行为量表，共包含30个条目、6个维度，与源量表一致。总量表项目分析显示良好，Cronbach’s α系数为0.904,重测信度为0.910;内容效度指数为0.971,条目水平内容效度指数为0.714～1.000;探索性因子累积方差贡献率为68.422%;验证性因子显示各指标达标。结论 中文版OLBPPBN信效度良好，可以用来测量护士职业性腰背痛预防行为水平。     

抗凝治疗量表用于心脏机械瓣膜置换术后患者的信效度检验

目的 引进和翻译抗凝治疗量表,将中文版量表应用于心脏机械瓣膜置换术后出院患者,并对其进行信效度检验.方法 将英文版抗凝治疗量表进行汉化,形成中文版.应用中文版量表对心脏机械瓣膜置换术后患者进行调查,计算分析量表信度和效度.结果 量表提取3个公因子,共16个条目,累积方差贡献率为56.375％;重测信度为0.929,Cronbach's α系数0.870.结论 中文版抗凝治疗量表具有较好的信效度,可用于评价我国心脏机械瓣膜置换术后出院患者长期抗凝治疗的抗凝满意度.     

护理管理者毒性领导行为量表的汉化及信效度检验

目的 对护理管理者毒性领导行为(Toxic Leadership Behaviors of Nurse Managers, ToxBH-NM)量表进行汉化并检验信效度。方法 遵循Brislin模型对原量表进行翻译、回译、跨文化调适和预调查后，形成中文版ToxBH-NM量表。采用便利抽样法，对贵州省501名护士进行问卷调查，评价量表的信效度。结果 中文版ToxBH-NM量表共30个条目，探索性因子分析提取4个公因子，累计方差贡献率为65.200%;验证性因子分析显示模型适配指标：χ²/df=1.639、RMSEA=0.036、CFI=0.974、TLI=0.972、IFI=0.974。量表水平的平均内容效度指数为0.946,与辱虐管理问卷得分的相关系数为0.669。Cronbach′s α系数为0.951,折半信度为0.831,重测信度为0.959。结论 中文版ToxBH-NM量表具有良好的信效度，适用于我国文化背景下的护理管理者毒性领导行为测量。     

工余塑造量表的汉化及在护士群体中的信效度分析

目的 汉化工余塑造量表，并检验该量表在护士群体中应用的信效度。 方法 采用Brislin翻译模式对量表进行翻译和回译，通过专家函询和预调查对量表进行文化调适。便利选取来自山东省4所三级医院的1 235名护士进行问卷调查，评价量表的信度、效度。 结果 中文版工余塑造量表共9个条目，量表的内容效度为0.940；提取1个公因子，条目的因子载荷为0.762～0.916，累积方差贡献率为76.409%；单因子模型拟合度良好（χ2/df=1.814，NFI=0.909，IFI=0.913，TLI=0.888，CFI=0.913，RMSEA=0.067）。量表的Cronbach′s α系数为0.953，折半信度为0.923，重测信度为0.825。 结论 中文版工余塑造量表具有良好的信度、效度，适用于在中国文化背景下调查护士群体的工余行为状况。     

类风湿关节炎患者自我护理行为量表的汉化及信效度检测

目的 汉化类风湿关节炎患者自我护理行为量表（RA-SCBS）并检验其信效度。方法 对类风湿关节炎患者自我护理行为量表进行翻译、回译及文化调适,形成中文版量表;采用该量表对兰州市450例类风湿关节炎患者进行调查,检验其信效度。结果 探索性因子分析共提取6个公因子（运动管理、药物管理、压力管理、营养/关节保护、日常生活管理、疼痛管理 ）,累积方差贡献率为62.280%;验证性因子分析显示模型适配度良好。中文版量表总的CVI=0.910,各条目CVI0.805~1.000;总的Cronbach′s α系数为0.844,重测信度为 0.854。结论 中文版类风湿关节炎患者自我护理行为量表具有较好的信效度,可作为我国类风湿关节炎患者自我护理行为的评估工具。     

护士悲伤状态量表的汉化及信效度检验

目的 汉化护士悲伤状态量表(Grief State Scale for Nurses, GSSN)并在临床护士中检验信效度。方法 获得原量表作者的授权，严格按照Brislin模型对护士悲伤状态量表进行翻译、回译，通过文化调适后形成中文版护士悲伤状态量表。2022年12月采用便利抽样法选取湖州市2所三级甲等医院221名临床护士行正式调查，在调查2周后从中随机抽取30名护士再次填写量表，评价中文版护士悲伤状态量表的信效度。结果 中文版护士悲伤状态量表的Cronbach′s α系数为0.813,4个维度的Cronbach′s α系数分别为0.729、0.855、0.846、0.929;重测信度为0.915。总量表的平均内容效度指数为0.980,条目水平内容效度指数为0.833～1.000。探索性因子分析共提取出4个公因子，累积方差贡献率74.232%。结论 中文版护士悲伤状态量表具有良好的信效度，适用于测量护士职业悲伤水平。     

基于护士视角的护患关系量表开发与信效度检验

目的基于护士视角编制护患关系量表,并检验其信效度。方法以人性照护理论为理论基础,通过文献回顾、参考国内外相关量表,根据护士访谈结果,结合中国国情及专家访谈形成初始量表,预调查472名护士及正式调查379名护士对量表进行信效度检验,并请10名专家验证量表的内容效度。结果护患关系量表包含护患信任和以患者为中心的护理2个因子,共9个条目。量表各项指标值均达到拟合度标准,有较好的结构效度;量表水平的内容效度指数(S-CVI)为0.900;量表总体Cronbach′s α系数为0.873,护患信任和以患者为中心的护理2个因子的Cronbach′s α系数分别为0.900、0.883。结论开发的护患关系量表具有较好的信效度,可用于护士视角的护患关系测量。     

血液透析患者家庭照顾者生活质量量表汉化及信效度检验

目的 汉化血液透析患者家庭照顾者生活质量量表,检验其信效度。 方法 采用Brislin模式将英文版血液透析患者家庭照顾者生活质量量表翻译成中文,采用中文版量表对738名血液透析患者家庭照顾者进行调查,检验量表信效度。 结果 中文版量表各条目水平的内容效度指数为0.848～1.000,量表水平的内容效度指数为0.935,探索性因子分析提取5个公因子,共35个条目,累积方差贡献率为64.172%。验证性因子分析的模型适配度良好。总量表Cronbach′s α系数为0.831,5个公因子的Cronbach′s α系数为0.694～0.821,重测信度为0.886。中文版量表总分与ZBI照顾者负担量表总分相关系数为-0.821（P＜0.05）。 结论 中文版血液透析患者家庭照顾者生活质量量表具有较好的信效度,适用于我国血液透析患者家庭照顾者生活质量测量。     

护理教育欺凌行为量表的汉化及信效度检验

目的汉化护理教育欺凌行为量表并评价其在中国护生中的信效度。方法经Brislin模式翻译和文化调适形成中文版,对552名护生进行调查检验量表的信效度。结果中文版共18个条目,探索性因子分析提取4个公因子,累积方差贡献率为73.244%;验证性因子分析拟合较好(CFI=0.916,IFI=0.918,RMSEA=0.071);量表内容效度为0.972,各条目内容效度为0.833~1.000;总量表Cronbach′sα系数0.921,折半信度0.956,重测信度0.955。结论中文版护理教育欺凌行为量表具有良好的信效度,适用于测量护生在护理教育中遭受的欺凌行为。     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

A Teaspoon Pump for Pumping Blood with High Hydraulic Efficiency and Low Hemolysis Potential

Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.     

A comparison of the inhibitory effects of four volatile anaesthetics on the metabolism of chlorzoxazone, a substrate for CYP2E1, in rabbits

Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Tissue perfusion in relation to cardiac output during continuous positive-pressure ventilation and administration of propranolol or verapamil

Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H₂O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg⁻¹ followed by 0.15 mg · kg⁻¹ · h⁻¹, n=8) or verapamil (0.1 mg · kg⁻¹ followed by 0.3 mg · kg⁻¹ · h⁻¹, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.     

Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts

Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Synergistic interaction between the effects of propofol and midazolam with fentanyl on phrenic nerve activity in rabbits

Background: It has been shown that the depressive effects of both propofol and midazolam on consciousness are synergistic with opioids, but the nature of their interactions on other physiological systems, e. g. respiration, has not been fully investigated. The present study examined the effect of propofol and midazolam alone and in combination with fentanyl on phrenic nerve activity (PNA) and whether such interactions are additive or synergistic. Methods: PNA was recorded in 27 anaesthetised and artificially ventilated rabbits. In three groups, propofol, fentanyl and midazolam were administered intravenously in incremental doses to construct dose-response curves for the depressant effects of each one on PNA. In another two groups, the effect of pretreatment with either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. on the effects of propofol and fentanyl respectively on PNA were studied. Results: Propofol and fentanyl caused a dose-dependent depression of PNA with complete abolition at the highest total doses of 16 mg · kg^?1 i. v. and 32 μg · kg^?1 i. v., respectively. In contrast, midazolam in incremental doses to a total of 0.8 mg · kg^?1 reduced mean PNA by 63%, but approximately 12% of PNA remained at a total dose as high as 6.4 mg · kg^?1. The mean ED₅₀s, calculated from dose-response curves, were 5.4 mg · kg^?1, 3.9 μg · kg^?1 and 0.4 mg · kg^?1 for propofol, fentanyl and midazolam, respectively. Initial doses of either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. acted synergistically with subsequent doses of either propofol or fentanyl to abolish PNA at total doses of 8 mg · kg^?1 and 8 μg · kg^?1, respectively. Conclusion: Fentanyl has a synergistic interaction with both propofol and midazolam on PNA and hence potentially on respiration.     

Influence of dopexamine hydrochloride on haemodynamics and regulators of circulation in patients undergoing major abdominal surgery

Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg^?1 · min^?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min^?1 · m^?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO₂I) and oxygen consumption index (VO₂I) were also significantly increased in the dopexamine group (DO₂I: from 416±91 to 717±110 ml/m² · m²; VO₂I: from 98±25 to 157±22 ml/m² · m²), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow.