中药热熨敷在我国临床护理应用的文献计量学研究

目的从文献计量学角度分析中药热熨敷在我国临床护理应用现状,为临床应用和后续研究提供参考。方法计算机检索中国学术期刊全文数据库(CNKI)、万方数据库2000年至2017年所收录的中药热熨敷临床护理应用文献,对其年度发文量分布、第一作者地域分布、第一作者机构分布、期刊分布、合著被引、基金资助情况、相关疾病系统分布进行统计分析。结果共纳入文献500篇,年度发文量总体呈上升趋势;期刊分布及第一作者地域分布广泛;第一作者机构以中医院为主(75.40%);合著率65.40%,合作度2.628,被引频次10次的文献479篇(95.80%);基金资助论文105篇(21.00%);相关疾病系统分布以运动系统(38.40%)、消化系统(30.60%)为主。结论近年来中药热熨敷在临床护理应用已取得快速发展,但仍存在各地区发展不平衡、学术影响力低等问题,护理科研工作者应加强与其他学科的合作,提高创新意识以提升热熨敷在临床护理应用研究质量。     

中药湿敷法临床护理应用的文献计量分析

目的基于文献计量学分析我国中药湿敷法的临床护理应用现状,总结规律,为临床应用和科学研究提供经验和借鉴。方法计算机检索中国学术期刊全文数据库(CNKI)2000-2014年间发表的有关中药湿敷法临床护理应用的文献,对其年份、作者、作者单位、被引频次、合著率、基金资助及疾病分布情况进行统计分析。结果共纳入文献386篇,分别发表在160种期刊上,文献数量总体呈上升趋势;第一作者来自我国22个省、4个直辖市、4个自治区;研究机构以综合性医院为主;文献被引频次在10次以上的有33篇,最高被引频次为54次;但是文献合著率及总体被引频次较低,科研基金资助少。结论中药湿敷法这一中医护理技术日益受到人们的重视,但是相关研究还需拓宽深度和广度,相关人员之间的交流和联系需加强,科研基金的投入也需加大。     

拔罐法临床护理应用的文献计量学分析

目的对拔罐法临床护理应用状况进行文献计量学分析。方法计算机检索2000年1月至2014年12月正式发表于中国学术期刊全文数据库的拔罐法临床护理应用的文献,利用Excel 2007软件建立数据库,对其每年发文量、地区、机构、被引、合著率、基金资助情况、高被引期刊分布、相关疾病系统分布进行统计分析。结果共纳入文献180篇,其中期刊论文179篇,硕士论文1篇。2000~2008年相关文献的数量变化相对较稳定,2009年以后呈相对较快速的增长趋势;其第一作者分布于21个省、4个直辖市以及4个自治区,发文量排名前五的省份共发文90篇,占50%;研究机构类型中中医院所占比例最大,为53.33%;文献的合著率为60.6%,合作度为2.2;被引频次10的文献167篇,占总文献的92.78%;由基金资助的文献2篇,占总文献1.11%;高被引文献分布于24种杂志,总被引频次为326次,均被引频次为9.31次;相关的疾病系统分布以皮肤及皮下组织、运动系统、神经系统和呼吸系统为主,分别占30.6%、23.9%、16.1%、15.0%。结论拔罐法临床护理应用的文献发文量总体呈上升趋势,地域分布广泛,文献合著率、合作度及被引频次较低,基金资助少,护理人员在该研究的创新性以及深度和广度上有待进一步加强。     

基于护理核心期刊的系统评价文献计量学分析

目的从文献计量学角度把握2016版《中国科技期刊引证报告(核心版)》中系统评价总体情况和发展趋势,为后续研究提供参考。方法计算机检索中国知网、万方数据库建库至2017年9月所收录发表在2016版《中国科技期刊引证报告(核心板)》护理核心期刊上的系统评价文献,对其年度分布、地域分布、机构分布、期刊分布、合著撰文及被引、基金资助、研究方向及相关主题分布等情况进行统计分析。结果共纳入文献603篇,年度发文量总体呈上升趋势;地域分布广泛;研究机构以医学院校为主(47.60%);合著率96.19%,合作度3.92,被引频次10次的文献475篇(78.77%);获基金资助论文197篇(32.67%);研究领域分布广泛,主要集中在糖尿病、压疮、医务人员职业暴露、高仿真模拟人等主题。结论近年来系统评价在护理科研中的应用取得快速发展,但各地区、领域发展不平衡,学术影响力低,护理科研工作者应加强与其他学科的合作,提高创新意识和循证意识以促进循证护理的良性发展。     

远程护理发展现状的文献计量学分析

[目的]基于文献计量学分析我国远程护理发展现状以及存在的不足,为今后远程护理的研究提供借鉴。[方法]通过检索中国知网数据库、万方数据库以及中文科技期刊数据库关于远程护理的文献,利用文献计量学方法对文献主题分布、发表年度、发文地区、作者情况、研究机构、期刊分布、引用和被引情况以及基金资助情况进行分析。[结果]共纳入263篇文献,通过分析获知我国远程护理理论研究相对较多,实践性研究偏少;发达地区研究较多,欠发达地区研究较少;合作趋势强,但机构合作欠缺;基金资助少,无专业期刊,文献质量不高。[结论]远程护理发展已进入发展阶段,应该拓展该领域的研究广度和深度,理论与实践共同发展,加强学科间合作,加大科研基金投入,以此推动护理的发展。     

穴位贴敷应用于高血压护理的文献计量学分析

目的分析穴位贴敷在高血压护理中的应用,为临床应用和科学研究提供借鉴。方法检索2007年1月至2016年12月中国学术期刊网络出版总库(CNKI)和万方数据库有关穴位贴敷应用于高血压护理的文献,利用NoteExpress软件去重,Excel软件建立数据库并对年发文量、第一作者所在地区和机构、来源期刊、基金资助情况、文献被引情况以及研究内容进行统计分析。结果共纳入101篇文献,其中期刊论文93篇、学位论文8篇。2007-2010年年发文量较少,2011年开始发文量逐年上升;文献第一作者来自我国17个省、3个自治区和3个直辖市,湖北省、山东省、浙江省居前三位;发文单位以中医院为主;发文量前9位的期刊中,中医类期刊5种,护理类期刊仅1种;基金资助论文较少,仅占6.93%;101篇文献均篇论文被引次数较低;穴位贴敷的药物选择较多的是吴茱萸、天麻、川穹等,穴位选择上采用较多为涌泉穴、神阙穴等,主要评价指标为血压控制情况的占78.22%。结论穴位贴敷应用于高血压护理的研究自2011年之后呈快速发展态势,但论文的学术影响力还比较低。     

知识图谱在我国护理领域中应用的文献计量学分析

目的分析知识图谱在我国护理领域中的应用现状,为护理信息化的研究提供参考。方法通过中国知网和万方数据知识服务平台检索2005年1月1日至2019年10月31日知识图谱应用于护理领域中的相关文献,对其年度发文量、第一作者所在地域及期刊分布、合作撰文及被引等情况进行文献计量学分析。结果纳入文献168篇,年发文量呈显著上升趋势;第一作者分布于我国25个省区市,分布于60种期刊;作者合作度1.79,合著率77.4%;研究机构以医学院校为主(45.2%);文献被引频次及基金资助率较低;知识图谱可视化应用最多的方法为共现分析,应用最多的工具为CiteSpace。结论知识图谱作为文献计量学的方法之一,越来越受到护理研究者的关注,但存在起步晚、相关文献数量少、第一作者地域分布不平衡、基金支持力度低、学术影响力低等问题,研究者应加强机构间的合作,扩大研究范围,同时注重提高创新性,加强知识图谱在护理领域的应用力度。     

中医护理技术缓解妊娠期恶心呕吐的文献计量学分析

目的:对中医护理技术缓解妊娠期恶心呕吐的文献进行可视化分析,探讨关于妊娠期恶心呕吐的临床研究热点和未来发展趋势,为妊娠恶心呕吐的临床治疗提供参考意见。方法:检索中国知网(CNKI)自建库至2020年12月31日在我国公开发表的临床研究文献,对发表时间、第一作者所在地区、来源期刊、基金资助、被引情况和关键词等研究内容进行文献计量学分析。结果:检索获得相关文献415篇,包括10篇学位论文,6篇会议论文;中医护理技术缓解妊娠期恶心呕吐相关研究最早发表于1962年,发文总体呈上升趋势;广东省发文51篇,数量最多;文章共发表在168种杂志,临床研究得到36项科研项目基金资助。目前的研究热点集中在穴位贴敷、穴位注射等的临床疗效观察及中医护理辨证施护。结论:妊娠期恶心呕吐日益受到人们重视,我国临床多注重中医护理技术缓解病人症状的临床效果,辨证施护和人文关怀是今后临床研究重点。     

健身气功八段锦临床应用研究的文献计量学分析

目的对我国八段锦临床应用研究相关文献进行文献计量学分析,了解八段锦临床应用研究的现状及存在的问题。方法计算机检索中国知网建库至2017年12月关于八段锦临床应用研究的文献,利用NoteExpress软件去重,Excel软件建立数据库,对其每年发文量、地区、机构、期刊分布、被引情况、基金资助情况、研究内容及研究领域进行统计分析。结果共纳入文献176篇,其中期刊论文147篇、学位论文29篇。检索到最早的八段锦临床应用研究文献发表于2007年,2008-2013年增长缓慢,2014年后快速增长;第一作者分布于18个省、4个直辖市以及1个自治区;中医药大学和中医/中西医结合医院的作者发表的文献数量占61.9%;发表文献数量3篇的期刊共7种,占期刊文献总数约22.4%,核心期刊收录文献数量较少;文献平均被引频次为8.6次;受各级科研基金资助文献75篇(占51.0%);相关的疾病系统分布以肌肉骨骼结缔组织疾病、内分泌疾病、循环系统疾病、精神疾病、呼吸系统疾病为主,分别占20.5%、17.0%、16.5%、13.1%、12.5%。结论八段锦临床应用研究的文献发文量呈逐年上升趋势,地域分布广泛,临床应用和科研工作越来越受到重视,研究态势良好,但仍存在一些不足需要进一步解决和探讨。     

数据挖掘在国内护理领域应用的文献计量学分析

目的 分析数据挖掘在护理领域的应用现状,为开展护理学相关研究提供参考.方法 计算机检索中国期刊全文数据库和万方数据库自建库以来至2019年12月31日所收录的有关数据挖掘应用于护理领域的文献,采用文献计量学方法对文献年度和地区及期刊分布、作者情况、合著率及数据挖掘技术分布情况等进行分析.结果 共纳入351篇文献,文献年度发文量总体呈上升态势;发文量排名前5的省市为北京、江苏、上海、山东和湖北;文献分布于103种期刊,有基金支持的文献仅105篇(29.91％);文献第一作者所属机构类型以医学院校为主(47.01％);作者总人数811人,文献合作度2.31;使用的数据挖掘技术有聚类分析、主成分分析、决策树、关联规则、遗传算法等,其中使用最多的是聚类分析和主成分分析,分别占40.46％、37.32％.结论 数据挖掘在护理领域的研究正在逐渐深入,但存在研究覆盖面尚不宽广、基金资助尚显不足、文献合作度及被引频次低等问题,应加强护理人员信息化技术的教育和培训,以推进数据挖掘在护理学中的研究,从而提高护理研究的质量.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

Clinical Pharmacokinetics of Morphine

Morphine, the most widely used mu-opioid analgesic for acute and chronic pain, is the standard against which new analgesics are measured. A thorough understanding of the pharmacokinetics of morphine is required in order to safely and effectively use this analgesic in a wide variety of patients with different levels of organ function. A MEDLINE search was conducted to identify literature published between 1966 and January 2002 relevant to the pharmacokinetics of morphine. These publications were reviewed and the literature summarized regarding unique and clinically important elements of morphine disposition relative to its parenteral administration (including intravenous, intramuscular, subcutaneous, epidural and intrathecal administration), absorption profile (immediate release, controlled release, and sublingual/buccal, and rectal administration), distribution, and its metabolism/ excretion. Special populations, including infants, elderly, and those with renal/liver failure, have a unique morphine pharmacokinetic profile that must be taken into account in order to maximize analgesic efficacy and reduce the risk of adverse events.