ICU护士医疗设备报警疲劳现状及影响因素调查

目的了解三级医院ICU护士医疗设备报警疲劳现状及影响因素。方法便利抽取长沙市11所三级医院ICU护士326名,采用临床报警疲劳量表、心理弹性量表与护理工作环境量表进行调查。结果 ICU护士医疗设备报警疲劳总分为(17.04±5.97)分,多元逐步回归结果显示,护士的健康状况、对护理工作的态度、心理弹性及护理工作环境满意度是医疗设备报警疲劳的重要影响因素(P0.05,P0.01)。结论ICU护士医疗设备报警疲劳处于中等偏低水平。护理管理者应进行合理的护理人力调控,改善ICU护士的健康状况、心理弹性现状,提供良好的护理工作环境,从而改善医疗设备报警疲劳。     

ICU护士报警疲劳的影响因素研究

目的 调查ICU护士报警疲劳状况,分析其影响因素,为临床制定相关报警疲劳干预策略提供参考。方法 采用便利抽样法选取贵州省3所三级甲等医院的252名ICU护士作为调查对象,使用一般资料调查表、ICU护士报警疲劳量表、护士同情心负荷量表进行问卷调查。结果 ICU护士报警疲劳总分为(25.52±5.57)分,同情心疲乏得分为(19.90±5.75)分,工作倦怠得分为(20.22±3.28)分。同情心疲乏及工作倦怠均与ICU护士报警疲劳呈显著正相关(均P＜0.05)。多元逐步回归分析显示,对护理工作的喜爱程度、设置报警参数的频率、职称、同情心疲乏和工作倦怠是ICU护士报警疲劳的影响因素(均P＜0.05),共解释43.1%的总变异。结论 护理管理者应高度重视ICU护士同情心疲乏及工作倦怠情况,合理安排人力资源,积极进行医疗仪器设备报警相关培训,提高护士对护理工作的满意度、适当设置报警参数以降低ICU护士报警疲劳水平。     

ICU护士处理医疗设备报警影响因素的质性研究

目的 了解ICU护士处理医疗设备报警的影响因素，为实施有效的报警管理策略提供临床依据。 方法 采用半结构式访谈方法，收集13名ICU护士处理医疗设备报警的工作感受，运用内容分析法对访谈资料进行现象学研究。 结果 ICU护士床旁处理设备报警的影响因素包含4个主题，即患者病情危重程度、报警管理经验、报警疲劳、报警优先级别。 结论 ICU护士处理医疗设备报警涉及多方面的因素，管理者应建立完善的医疗设备报警管理体系，加强相关培训，促进团队合作，从而提升ICU护士报警管理胜任力，保障患者安全。     

河南省三级医院麻醉科护士岗位胜任力现状及影响因素分析

目的调查分析麻醉科护士的岗位胜任力水平及影响因素,为麻醉护理队伍规范化建设提供参考。方法采用自行设计的麻醉科护士岗位胜任力调查表对河南省62所三级医院的205名麻醉科护士进行调查。结果麻醉科护士岗位胜任力总分为19～120(83.29±19.39)分;回归分析显示,麻醉护理工作年限及学历为麻醉科护士岗位胜任力的影响因素(均P0.01)。结论河南省三级医院麻醉科护士的岗位胜任力总体水平偏低,其中低年资、低学历者更甚。医院管理者应根据岗位胜任力薄弱因素制订针对性的培养计划,以提升麻醉科护士岗位胜任力,促进麻醉护理专业持续发展。     

麻醉科护士职业认同现状及其影响因素分析

目的 了解麻醉科护士职业认同现状，并分析其影响因素。方法 采用一般资料调查表、护士心理资本问卷和护士职业认同评定量表对311名麻醉科护士进行调查，对麻醉科护士职业认同的影响因素进行回归分析。结果 麻醉科护士职业认同感总分为（82.57±13.17）分，心理资本总分为（78.16±14.58）分。麻醉科护士职业认同与心理资本呈正相关（P<0.05）。多元线性回归分析结果显示，心理资本、工作满意度和是否参与患者转运是麻醉科护士职业认同的影响因素（均P<0.05）。结论 麻醉科护士职业认同处于中等水平，护理管理者应积极引导护士，提升其心理资本水平，并通过优化工作内容和增强护士满意度等措施，提高麻醉科护士的职业认同。     

护士对心电监护仪报警的认知现状及影响因素分析

目的 调查护士对心电监护仪报警的认知现状，并分析影响因素，为改善心电监护仪报警现状提供参考。方法 采用便利抽样方法，于2018年11月选取武汉市某三级甲等医院护士381名，使用一般资料调查表和心电监护仪报警认知问卷进行调查。结果 护士对心电监护仪报警的知识得分为(6.39±0.96)分；多元线性回归分析结果表明，工作年限、参加心电监护仪报警相关知识培训、心电监护仪报警不良事件分析会议对知识得分的影响有统计学意义（P<0.05，P<0.01）。护士对心电监护仪报警的态度得分为(28.59±2.12)分；多元线性回归分析结果表明，科室和参加心电监护仪报警相关知识培训对态度得分的影响有统计学意义（P<0.05，P<0.01）。结论 护士对心电监护仪报警知识掌握程度整体良好，态度较积极。建议护理管理者应加强对低年资和综合ICU护士的培训，并开展多种形式的培训，以提高培训效果。     

低年资护士职业性腰背痛预防行为及影响因素研究

目的 调查低年资护士职业性腰背痛预防行为现状，分析其影响因素，为针对性干预提供参考。方法 对446名低年资护士采用一般资料调查问卷、护士预防职业性腰背痛量表、离职意愿量表及职业疲劳耗竭恢复量表进行调查。结果 低年资护士职业性腰背痛预防行为总分(92.31±17.11)分。多元线性回归分析显示，离职意愿、职业疲劳耗竭恢复(急性疲劳、慢性疲劳、班次间恢复)、学历为低年资护士职业性腰背痛预防行为的影响因素(均P<0.05)。结论 低年资护士职业性腰背痛预防行为处于中等水平，护理管理者应针对影响因素采取有效干预措施，提高低年资护士职业性腰背痛防护水平。     

精神病医院护士情绪劳动与疲劳的相关性研究

目的探讨精神病医院护士情绪劳动与疲劳的关系。方法采用情绪劳动量表中文版和疲劳量表对368名精神病医院护士进行问卷调查。结果精神病医院护士的情绪劳动量表总分及表面表现、深层表现和自然表现维度得分分别为9.16±2.31、3.55±0.81、3.19±0.76、2.42±0.74;工作年限正向预测情绪劳动及其表面表现、深层表现(P<0.05,P<0.01);夜班数负向预测自然表现(P<0.05)。疲劳总分为6.72±3.48,躯体疲劳和脑力疲劳维度得分分别为4.83±2.12、1.89±1.69;疲劳总分受独生子女的负面影响(P<0.01),夜班数对疲劳有正向影响(P<0.05);表面表现、深层表现与疲劳呈正相关(P<0.01)。结论精神病医院护士情绪劳动中的表面表现和深层表现较强,与疲劳具有密切的关系。精神病医院应高度重视护士的情绪劳动,并采取措施提高护士的自然表现,降低其疲劳程度。     

护士二胎妊娠相关焦虑及其影响因素分析

目的了解护士二胎妊娠期焦虑情绪的发生状况并分析影响因素。方法采用妊娠相关焦虑量表、中国护士工作压力源量表、疲劳量表,随机抽取长沙市5所三级综合医院的163名妊娠二胎的在职护士进行调查。结果 163名护士二胎妊娠相关焦虑发生率为39.9%;单因素分析显示,晚夜班频率、担忧小孩教育、经济压力、无暇照顾长子女、夫妻关系、家庭支持度不同的护士,其焦虑发生率比较差异有统计学意义(P0.05,P0.01);焦虑组护士工作压力源量表总分、患者护理、管理及人际关系分值、疲劳量表总分、躯体疲劳及脑力疲劳分均高于无焦虑组(P0.05,P0.01);多因素Logistic回归分析结果显示,经济压力、无暇照顾长子女、夫妻关系、患者护理以及脑力疲劳对二胎妊娠护士焦虑情绪有重要影响。结论二胎妊娠护士存在焦虑情绪,且受多种因素影响,医疗单位应给予必要的心理支持和健康指导,确保母婴健康以及医疗安全。     

安宁疗护女性护士正念自我照护对专业生活 品质的影响：有调节的中介效应

目的 对安宁疗护女性护士的专业生活品质现状进行调查,依据医疗保健专业健康模型,探讨正念自我照护与专业生活品质的关系,以期引导安宁疗护女性护士用积极有效的方式应对同情疲劳,提高专业生活品质。方法 采用方便抽样法选取山西省10所安宁疗护试点医院内300名女性护士,使用简化版正念自我照护量表、简式弹性量表、专业生活品质量表、简版心理健康连续体量表进行问卷调查。结果 安宁疗护女性护士专业生活品质量表中同情满意度维度为(33.84±7.15)分,同情疲劳维度为(51.22±10.36)分;正念自我照护与同情满意度呈正相关(r=0.635,P<0.05),与同情疲劳呈负相关(r=-0.320,P<0.05)。心理弹性在正念自我照护与同情满意度间起部分中介作用,在正念自我照护与同情疲劳间起完全中介作用(P<0.05)。正念自我照护与心理弹性之间受到情绪幸福感的调节(P<0.05)。结论 多数安宁疗护女性护士专业生活品质处于中高度水平,心理弹性在正念自我照护和专业生活品质之间起中介作用,情绪幸福感在正念自我照护与心理弹性间起调节作用。护理管理者应重视正念自我照护在安宁疗护女性护士职业健康中的积极作用,提高其自我同情能力和应对同情疲劳的能力,以保障安宁疗护队伍的稳定发展。     

2015年乳腺癌辅助化疗进展

【摘要】〓乳腺癌是危害我国女性健康的头号杀手,尽管近年来辅助化疗的研究进展突飞猛进,但临床中仍有不少问题未能明确,如辅助化疗的合适人群、化疗的开始时间、蒽环及紫杉类的地位和用法、强化维持治疗的作用、疗效及预后的生物标志物等。本文结合乳腺癌辅助化疗在临床上的常见问题和2015年各大乳腺癌会议阐述乳腺癌辅助化疗的最新进展。     

Alterations in T-Cell Subset Frequency in Peripheral Blood in Obesity

Background: Obesity affects the regulation of immune and inflammatory responses. This study characterizes differences in peripheral blood lymphocyte phenotype in obese humans. Methods: Frequencies of lymphocyte subsets among peripheral blood mononuclear cells were compared between 10 obese (BMI ≥35) and 10 lean subjects, as determined by antibodies directed against cluster differentiation (CD) markers. Results: Obese patients demonstrated an increased frequency of CD3+CD4+ T-cells (mean difference 12%, P=0.004), a decreased frequency of CD3+CD8+ T-cells (mean difference 9.4%, P=0.016) and an increased frequency of CD3+CD8+CD95+ T-cells (mean difference 13.3%, P=0.032). No other differences among T-cell or monocyte subsets were noted. Conclusions: Obesity is associated with alterations in frequencies of peripheral CD4+ and CD8+ T-cells and aberrations in the expression of CD95 among CD8+ T-cells. These data suggest both CD4+ and CD8+ T-cell compartments, as well as the regulation of CD95 expression on CD8+ T-cells, as targets for further study into obesity's effects on the immune system.     

西宁地区烧伤病人动脉血气分析观察

对高海拔地区的27例烧伤病人动脉血气变化进行了分析和观察。结果证明:无论是存活病人还是死亡病人伤后均存在有低氧血症问题。并且在死亡病人和烧伤合并吸入性损伤病人其低氧血症的发生早于单纯烧伤病人。提示:吸入性损伤病人应立即行气管切开术以保障氧气供给,单纯烧伤病人可常规吸氧以维持正常血 PaO_2,ARDS 均发生在合并吸入性损伤的病人,高频喷射通气技术对纠正低氧血症有一定效果。     

Controversies in Fistula in Ano

Managing a complex fistula in ano can be a daunting task for most surgeons; largely due to the two major dreaded complications—recurrence & fecal incontinence. It is important to understand the anatomy of the anal sphincters & the aetiopathological process of the disease to provide better patient care. There are quite a few controversies associated with fistula in ano & its management, which compound the difficulty in treating fistula in ano. This article attempts to clear some of those major controversies.     

β-半乳糖苷酶在体内外成骨细胞中的表达

目的 研究β—半乳糖苷酶(β—gal)在成骨细胞中的表达状况，为阐明MorquioB综合征的发病机制提供依据。方法 裸鼠各器官和骨组织标本行X-gal染色检测。抽取羊和人骨髓行骨髓基质细胞(BMSCs)培养，分为4组：I：Adv-hBMP-2转染组；Ⅱ：Adv—β—gal转染组；Ⅲ：未转染组；Ⅳ：地塞米松诱导组。分别行X-gal染色和RT-PCR检测β—gal的表达。结果 裸鼠骺板两侧、骨膜内面及松质骨的成骨细胞和破骨细胞可见多量β—gal的表达。未转染BMSCs组有少量β—gal的表达，其他3组细胞的β—gal表达增高。结论成骨细胞和破骨细胞可表达多量β—gal，该两种细胞的β—gal缺乏可能是MorquioB综合征骨骼异常的直接原因。     

Smoking-Attributable mortality in Spain in 2016

IntroductionSmoking-attributable mortality (SAM) is a valuable indicator that can be used to characterize the course and health burden of the smoking epidemic. The aim of this paper was to estimate SAM in Spain in 2016 in the population aged 35 and over, using the best available evidence.MethodsA smoking prevalence-dependent analysis based on the estimation of population-attributable fractions was performed. Smoking prevalence (never, former, and current smokers) was calculated from a combination of the Spanish Health Survey (2016) and the European Health Survey (2014); the relative risk of death among current and former smokers was taken from the follow-up of various cohorts; and mortality rates were obtained from National Center for Statistics data. SAM estimates are presented globally, and by sex, age groups, and major disease categories: cancer, cardiometabolic diseases and respiratory diseases.ResultsIn 2016, 56,124 deaths were attributed to tobacco consumption, 84% in men (47,000), and 50% in the population aged over 74 (27,795). Overall, 50% of SAM was due to cancer (28,281), 65% of which was lung cancer. One in 4 attributable deaths (13,849) occurred before the age of 65.ConclusionsOne in 7 deaths in Spain in 2016 were attributable to smoking. This estimation of SAM clearly highlights the great impact of smoking on mortality in Spain, mainly due to lung cancer and chronic obstructive pulmonary disease.     

MicroRNAs in hepatic pathophysiology in diabetes

MicroRNAs(miRNAs or miRs) are small approximately 22 nucleotide RNA species that are believed to regulate diverse metabolic and physiological processes.In the recent past,several reports have surfaced that demonstrate the role of miRNAs in various biological processes and numerous disease states.For a disease as complex as diabetes,the emergence of miRNAs as key regulators leading to the disease phenotype has added a novel dimension to the area of diabetes research.On the other hand,the liver,a metabolic hub,contributes in a major way towards maintaining normal glucose levels in the body as it can both stimulate and inhibit hepatic glucose output.This equilibrium is frequently disturbed in diabetes and hence,the liver assumes special significance considering the correlation between altered hepatic physiology and diabetes.While the understanding of the mechanisms behind this altered hepatic behavior is not yet completely understood,recent reports on the status and role of miRNAs in the diabetic liver have further added to the complexities of the knowledge of hepatic pathophysiology in diabetes.Here,we bring together the various miRNAs that play a role in the altered hepatic behavior during diabetes.     

Fluid-phase transcytosis in the primate epididymis in vitro and in vivo

Ligated tubules from the corpus epididymidis of men and monkeys were incubated in medium containing horseradish peroxidase (HRP) as a marker for fluid-phase endocytosis. HRP was localized by light and electron microscopy after 0, 15, 30 and 60 min of incubation. Movement between the cells was prevented by tight junctions, but bypass of this barrier was apparently achieved by an intracellular vesicular mechanism leading to a time-dependent appearance of HRP in the lumen. Uptake of HRP into basal cells and capture by the lysosomal apparatus of principal cells were also observed. HRP-filled vesicles also appeared in the basal, mid and apical cytoplasm of epithelial cells in the caput 1 h after injection of the tracer into the epididymal circulation of the monkey, suggesting that this pathway also operates in vivo.