中国护理学硕士研究生学位论文研究选题热点分析

目的 分析中国护理学硕士研究生学位论文研究选题的热点.方法 采用内容分析法对中国科学技术信息研究所在2007年1月1日前所收藏的254篇护理学硕士研究生学位论文进行分析.结果 学位论文研究选题的热点是临床护理研究占46%、护理教育研究占18%和护理管理研究占15%.结论 中国护理学硕士研究生学位论文的选题热点与目前护理所存在并需要解决的问题相一致.     

中国护理学博士研究生学位论文分析

目的系统分析我国护理学博士研究生学位论文的现状、研究热点及动态趋势。方法采用内容分析法对学位论文的研究内容、研究方法等进行分析;采用Bicomb 2.0书目共现分析软件和SPSS 22.0对纳入论文的研究热点及趋势进行文献计量分析。结果纳入的248篇护理学博士研究生学位论文中,研究领域以临床护理最为多见(52.02%),其次为社区护理(16.94%);研究设计类型以量性研究最为多见(75.40%),其次为混合研究设计(18.15%),且呈现上升趋势;超过半数的学位论文(64.86%)能够阐明其理论基础。研究热点涵盖了模型的构建与验证及量表相关研究、老年护理及慢性病管理、乳腺癌患者的护理、护理人力资源配置等领域。结论我国护理学博士研究生学位论文总体上呈现出主题广泛、贴近临床的特点,研究设计趋向科学化、多元化、复杂化发展,此为今后护理学博士研究生的培养提供方向和参考。同时,论文在格式、研究设计及内容方面尚存在需要进一步完善的地方;论文的研究结果有待进一步实证研究的支撑以指导具体的护理实践,更好地促进护理专业的发展。     

我国护理学硕士研究生学位论文研究设计的内容分析

[目的]描述我国护理学硕士研究生学位论文研究设计,并分析其发展趋势.[方法]采用内容分析法对254篇护理学硕士研究生学位论文的研究设计内容进行分析.[结果]学位论文研究性质主要是量性研究(99.2%),研究设计类型主要是非实验性研究(65.0%),研究对象主要是护理对象(52.8%),研究场所主要是医院(58.3%),抽样方法以便利抽样为主(59.8%),收集资料方法以问卷调查法(69.7%)居多,资料类型主要是计量资料和计数资料合用(79.1%),统计分析方法大多合用了统计描述和统计推断(93.3%).[结论]随着护理教育的发展和逐渐完善,护理学硕士研究生的研究内容更加深入,研究领域也在不断扩大,研究设计内容更加严谨,研究设计方法更加多样化.     

我国护理学硕士研究生学位论文研究设计的内容分析

[目的]描述我国护理学硕士研究生学位论文研究设计,并分析其发展趋势。[方法]采用内容分析法对254篇护理学硕士研究生学位论文的研究设计内容进行分析。[结果]学位论文研究性质主要是量性研究（99.2%）,研究设计类型主要是非实验性研究（65.0%）,研究对象主要是护理对象（52.8%）,研究场所主要是医院（58.3%）,抽样方法以便利抽样为主（59.8%）,收集资料方法以问卷调查法（69.7%）居多,资料类型主要是计量资料和计数资料合用（79.1%）,统计分析方法大多合用了统计描述和统计推断（93.3%）。[结论]随着护理教育的发展和逐渐完善,护理学硕士研究生的研究内容更加深入,研究领域也在不断扩大,研究设计内容更加严谨,研究设计方法更加多样化。     

我国护理教育方向研究生硕士学位论文分析

目的了解我国护理硕士研究生护理教育研究方向的发展、选题热点和动向,为护理研究生选题、护理教育的进一步完善提供参考。方法采用文献计量法,利用中国知网检索护理硕士研究生学位论文中有关护理教育的课题,并进行统计分析。结果护理教育硕士学位论文数量呈逐年增加的趋势,但占同年护理学位论文总数的比例增加不明显。研究内容以"学生"(38%)和"教学"(16.7%)居多;研究对象学历层次以本科(74.0%)、硕士研究生(15.4%)居多;研究性质以量性研究(89.6%)为主,近年来质性研究虽有增加,但数量仍较少;研究设计类型以非实验性研究(83.7%)为主;资料收集方法以问卷调查(57.1%)居多,其次是德尔斐法(19.0%)。结论护理教育方向硕士学位论文研究内容日趋丰富,研究设计形式更加多样,但质性研究、实验性研究仍然缺乏,还有待进一步发展。     

我国护理学硕士研究生学位论文引文分析

目的:描述我国护理学硕士研究生学位论文引文情况,反映学位论文的学术水平及研究生对文献信息吸收利用能力。方法:对中国科学技术信息研究所在2006年11月1日前所收藏的254篇护理学硕士研究生学位论文按时序采用引文分析法进行分析。结果:学位论文平均引文量为65.81条,并有逐年上升趋势;引文类型中期刊引文率为81.02%,是学位论文的第一文献来源,其次是图书、网络文献、学位论文和会议论文等;引文语种以英文为主,占53.34%,其次是中文,占46.66%,再次是日文等其他语种,仅占0.18%;学位论文的平均普赖斯指数为41.67%;学位论文中有12.20%著录不规范,但有逐年下降的趋势。结论:我国护理学硕士研究生学位论文的学术水平较高,研究生对文献信息具有很强的吸收和利用能力。     

国内外护理学博士学位论文分析研究现状

主要对国内外护理学博士研究生学位论文分析研究现状及趋势进行综述,内容包括选题分析、研究方法分析、理论基础分析、研究对象及场所分析研究等方面,以期为我国护理学博士研究引领方向,同时也为我国博士研究生学位论文质量的提高提供一定的参考与借鉴。     

国内外护理学博士学位论文分析研究现状

主要对国内外护理学博士研究生学位论文分析研究现状及趋势进行综述,内容包括选题分析、研究方法分析、理论基础分析、研究对象及场所分析研究等方面,以期为我国护理学博士研究引领方向,同时也为我国博士研究生学位论文质量的提高提供-定的参考与借鉴.     

基于聚类分析探讨护理学硕士研究生学位论文选题热点

目的了解护理学硕士研究生学位论文选题现状与发展趋势,指出当前选题存在的问题,为提高研究生选题质量提供参考。方法在中国知网硕博士学位论文数据库获取2013-2017年的护理硕士研究生学位论文全文。将学位论文中的关键词导入书目共现分析系统(bibliographic items co-occurrence matrix builder,Bicomb),得到高频关键词,形成关键词词篇矩阵,使用图形聚类工具包gCLUTO1.0对高频关键词进行聚类分析。结果获取护理学硕士研究生学位论文共3752篇,其中:学术学位论文3504篇,获得高频关键词23个,选题热点可概括为研究方法相关的应用与分析、慢性病生活质量相关研究、心理社会特点与疾病管理研究3个主题;专业学位论文248篇,得到高频关键词22个,选题热点概括为研究方法相关的应用与分析研究、临床实践相关研究、心理社会特点与疾病管理研究3个主题。结论护理学硕士研究生学位论文选题与社会需求相协调,学术学位与专业学位研究生选题既有统一性又有差异性,且体现了专业学位特色;但存在选题热点比较局限,与其他学科交叉不够深入的问题。护理学硕士研究生培养单位及导师在指导硕士研究生选题时应注意克服局限性。     

我国护理学博士研究生教育现状分析

目的 了解我国护理学博士研究生教育现状,为加速与规范护理学博士研究生培养提供参考.方法 采用便利抽样法.对8所院校护理学博士研究生教育情况进行调查.结果 5所院校已开展护理学博士研究生招生培养工作;各院校护理学博士研究生的培养目标与研究方向具有较多共同点;学制多为全日制3年,以哲学博士(PhD)为主;各院校对护理博士课程设置仍具有较大自主性,在护理专业核心课程设置方面尚缺乏统一标准;博士学历的护理师资占8所院校博士学历教师总数的75%,各院校师资力量结构不均衡.结论 应使博士教育与高级临床护理实践紧密结合;探索联合培养模式,实现教育资源共享;设置护理专业核心课程与教育质量评价体系;组建护理学博士研究生导师队伍.     

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.