护士职业价值观现状分析及对护理职业教育的启示

目的:通过对中职护理专业学生及在职护士的职业价值观问卷调查分析,旨在为学校的护理教育及医院的护理管理提供依据。方法:采用护士职业价值观量表对护理专业二年级学生、三年级学生以及在职护士进行调查。结果:职业价值观的总得分及4个维度得分,在三组之间均存在显著差异(P<0.05)。结论:护士职业价值观教育贯穿整个护理专业教育过程,需要学校与医院的紧密合作,通过多途径渗透职业价值观教育,以实现"学会做事"与"学会做人"的同构共生。     

医学新生心理健康状况调查

目的 评价宁夏医学院新生的心理健康状况,为学生心理健康教育提供科学依据.方法 采用心理自评量表（SCL-90）对宁夏医学院2004级1509名新生进行测试.结果 心理问题前三位依次为强迫、人际关系敏感、抑郁;研究生、本科生、大专生、中专生各因子分的比较差异均有统计学意义,各因子均分总体趋势由低到高依次是研究生-本科生-中专生-大专生;除躯体化因子外,医学新生各因子分高于全国常模（P＜0.01）;农村学生的各因子分高于城市学生（P＜0.01）,除敌对因子差异无统计学意义外,其余因子间的差异均有统计学意义（P＜0.01）.女生的各因子分高于男生,总均分、躯体化、抑郁、焦虑、恐怖因子分的差异有统计学意义（P＜0.01）.除敌对因子外,非独生子女的各因子分高于独生子女,总均分、强迫、敌对、人际关系、抑郁因子间的差异有统计学意义.父母离异和父母非离异学生各因子分差异无统计学意义;汉族学生和少数民族学生各因子分差异无统计学意义.结论 2004级医学新生自评症状较多,不同教育层次新生具有不同的心理特点,应建立科学的心理健康教育体系,采取有效措施,使新生度过心理问题高发阶段.     

护理学专业毕业生就业岗位满意度调查分析

目的 了解护理学专业本、专科毕业生就业岗位满意度及用人单位对毕业生的满意度.方法 采用自制的调查问卷方式对我院2010届、2011届护理学专业本、专科毕业生的就业岗位满意度及其用人单位对毕业生的满意度进行调查.结果 护理学专业毕业生就业岗位满意度普遍较高,其中就业成功率和就业环境满意度最高,职业成就感及医院对护理行业的重视满意度最低.本、专科毕业生比较,其中就业成功率、用人方式、职业成就感、工作岗位满意度及改行意愿差异有统计学意义(P＜0.05).各用人单位对我院毕业生的敬业精神与工作态度、专业能力、沟通能力、个人约束力及我院毕业生总体评价满意度均较高.结论 我院护理学专业毕业生的就业满意度和用人单位满意度均较高,但学校需要加强对学生的职业角色培养,医院需进一步加强对护理行业的重视以提升护士的职业成就感,稳定护理队伍,促进护理事业的发展.     

不同教育层次护生社区护理就业意愿比较

目的：调查不同教育层次护生社区护理就业意愿,为社区护理教育和护生就业指导提出建议。方法采用分层整群抽样方法选取不同教育层次护生共220人,采用“不同护生社区护理就业意向调查问卷”进行调查,对结果进行统计分析。结果护生社区护理就业意愿普遍较低,不同教育层次护生比较差异有显著统计学意义（P＜0.01）,高职本科生社区护理就业意愿分别与普通本科生、专升本科生和专科生比较差异均有显著统计学意义（ P＜0.01）。结论有针对性的加强护生社区护理专业教育和就业指导,护生才能形成强烈的社区护理就业意愿和积极的就业动机。     

兰州地区在读护理本科生职业价值观现状调查及培养建议

目的了解兰州地区护理本科生职业价值观现状,分析存在问题,为护理教育者引导护理本科生树立正确专业价值观提供依据及建议。方法采用一般情况调查表及护士职业价值观量表对兰州地区238名护理本科生进行调查。结果护理本科生职业价值观评分为（3．68±0．41）,各维度得分由高到低分别是信任（3．98±0．59）、责任自由安全（3．73±0．50）、照顾提供（3．73±0．45）、行动主义（3．53±0．48）。结论护理本科生具有中立偏积极的护理职业价值观,但尚需培养和强化其护士角色,加强职业价值观教育。引导其热爱护理专业。     

新冠疫情爆发前后护理本科生职业认同感的差异及影响因素研究

目的：比较新冠疫情爆发前后护理本科生职业认同感的差异，分析其影响因素。方法：采用横断面调查，应用整群抽样法选取全国3所高校775名护理本科生，在线填写调查问卷。结果：疫情爆发后护理本科生职业认同感显著高于疫情爆发前(P<0.05),选择护理专业的原因是影响职业认同感的主要因素。结论：疫情爆发后护理本科生职业认同感显著提高，护理教育者应引导学生正确认识护理专业，媒体应加大宣传以提升大众对护理专业的理解和支持。     

护理本科生职业价值观与自主学习能力的相关性研究

目的：了解护理本科生职业价值观和自主学习能力现状,探讨职业价值观与自主学习能力之间的关系。方法：采用护士职业价值观量表和护理学生自主学习能力量表,对国内6所医学院校的1247名护理本科生进行调查。结果：本科护生职业价值观总分为(93.45±15.48)分,自主学习能力总分为(66.96±11.14)分,职业价值观与自主学习能力呈显著正相关。结论：本科护生职业价值观和自主学习能力处于中等水平,护理教育者应重视职业价值观教育在提高护生自主学习能力中的作用。     

护理专业大学生对护士职业认可度的调查

目的了解护理本科学生对护理职业的认可现状及其影响因素,为加强护理职业教育及政府决策提供参考依据。方法对郑州大学护理专业2008级、2009级、2010级三个不同年级300名在读本科生进行自设问卷调查。结果调查显示平均34.11%的护生不喜欢护理工作,护生的工作负荷、薪酬、发展前途、社会地位是影响护生职业认可度的重要因素。结论护理本科生对护士职业的了解及认可度偏低,需通过多种形式的护理职业教育,加强政府与社会支持来改善护理专业本科大学生对护士职业的认可度。     

护理本科生早期接触临床实践教学效果评价

目的 为提高护理本科生对专业知识的学习兴趣,稳定专业思想,培养积极的职业情感和职业素养,从实践教学中总结出适合护理本科生教育的早期接触临床的教学模式.方法 采用自行设计的问卷对昆明医科大学已接受过早期临床教育的护理本科生212人作为实验组,以海源学院405人未接受过早期接触临床的护理本科生作为对照组,进行问卷调查.结果 实验组和对照组对护理相关知识的认知比较,差异有统计学意义(P＜0.05).结论 护理本科生早期接触临床实践是非常有必要的,但在临床带教过程中应加强护理本科生与患者沟通能力的培养以及加深护理本科生对危重病人抢救程序的了解.     

大学生择业效能感、职业兴趣与专业承诺的关系

目的 探讨大学生择业效能感、职业兴趣与专业承诺的关系.方法 使用择业效能感、职业兴趣与专业承诺量表对568名大学生进行测查.结果 择业效能感与专业承诺呈显著正相关(r=0.47,P＜0.01),不同择业效能感水平在专业承诺上差异有显著性(F(2.565)=60.48,P＜0.01);在6种职业兴趣类型中,研究型职业兴趣与专业承诺的相关最高(r=0.31,P＜0.01);路径分析发现,择业效能感对专业承诺有直接影响(B=0.58,P＜0.01),同时研究型职业兴趣部分中介择业效能感对专业承诺的影响(B=0.05,P＜0.01).结论 大学生的专业承诺主要受择业效能感、研究型职业兴趣的影响,可以从这些方面着手提高大学生的专业承诺.     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.