我国南丁格尔奖获得者一般成因研究

[目的]总结我国南丁格尔奖获得者空间、年龄、学历学位、专业技术职称与学术职务的分布特征。[方法]采用文献分析法进行研究。[结果]我国南丁格尔奖获得者集中在人口密集、交通便利、文化底蕴深厚和经济发达的区域;年龄27岁～81岁,有年轻化和获奖人数逐年增多的趋势;中专学历占69.77%;58.14%获奖者拥有高级专业技术职称;60.47%担任过学会理事或秘书,均担任过管理职务。[结论]我国南丁格尔奖获得者具有较长的护理工作年限,具有所处时代层次较高的学历,具有高级专业技术职称,具有一定的护理学术或管理职务,工作地区具有人口密集、交通便利、文化底蕴深厚和经济繁荣的地理优势。     

我国南丁格尔奖获得者社会成因分析

[目的]探讨家庭、学校与工作环境对我国南丁格尔奖获得者的成因影响，挖掘其中重要影响因素，为培养优秀护理人才提供参考。[方法]采用文献分析法进行研究。[结果]我国南丁格尔奖获得者家庭环境大多贫困，家庭类型以教师、医生等知识分子家庭居多；就读学校大多为治学严谨、校规严明的教会创办学校；工作单位最多6个，最少1个，平均1．98个；获得者83．72％来自综合类医院（其中32．56％获奖时已退休），16．28％来自专科类医院。88．37％参加过重大突发事件的护理工作；获奖前工作年限最长61年，最短10年，平均39．49年。[结论]家庭潜移默化；学校治学严谨、校规严明；工作单位多为综合类医院；绝大多数历经特殊事件磨炼。     

我国南丁格尔奖获得者获奖前科技产出与社会影响关系研究

[目的]探讨我国南丁格尔奖获得者获奖前科技产出与社会影响关系。[方法]采用定性与定量相结合方法分析我国南丁格尔奖获得者获奖前科技产出与社会影响的关系。[结果]定量研究结果与定性研究结果不存在相关关系，相关系数为-0．2（P=0．198）。[结论]我国护理工作者之所以获得南丁格尔奖，主要取决于以护理学科体制化贡献为主的社会影响力。     

我国南丁格尔奖获得者获奖前科技产出分析

[目的]分析我国南丁格尔奖获得者获奖前科技产出情况，探讨影响获得者科技产出的因素。[方法]选取我国43位南丁格尔奖获得者获奖前科技产出资料，运用科学计量方法进行分析统计。[结果]我国南丁格尔奖获得者获奖前的科技产出数量和质量都偏低。[结论]南丁格尔奖遴选章程中科技产出权重不够以及我国的社会环境、护理学发展水平、护理人力资源配备均是影响获奖者获奖前科技产出的主要原因。     

我国南丁格尔奖获得者论文合作的社会网络分析

[目的]在前期对南丁格尔奖获得者论文合作作者关系研究的基础上,拟用社会网络分析方法对其论文进行社会网络分析,以期为我国护理学发展提供更多的参考依据。[方法]以68名南丁格尔奖获得者的姓名、工作单位为检索条件,在知网和万方数据库进行3次检索,运用社会网络分析方法对我国南丁格尔奖获得者论文合作的整体网络、网络密度及中心性进行分析。[结果]我国南丁格尔奖获得者的论文合作以机构内小团体合作为主;整体网络和各小团体网络密度均较低;南丁格尔奖获得者未处于论文合作网络核心地位。[结论]提示应注意南丁格尔奖评选标准的时代局限性,注重学术创新在护理学科带头人内在素质上的体现。     

南丁格尔奖获得者学术影响力的研究意义

介绍了南丁格尔、南丁格尔奖、南丁格尔奖获得者、获得者学术影响力的研究现状，以及研究南丁格尔奖获得者学术影响力对我国护理学科发展、护理学术水平提高和护理精英培养的积极意义？提出对南丁格尔奖获得者学术影响力的研究将促进我国护理学科的发展。     

我国南丁格尔奖获得者获奖前科技产出分析

[目的]分析我国南丁格尔奖获得者获奖前科技产出情况,探讨影响获得者科技产出的因素.[方法]选取我国43位南丁格尔奖获得者获奖前科技产出资料,运用科学计量方法进行分析统计.[结果]我国南丁格尔奖获得者获奖前的科技产出数量和质量都偏低.[结论]南丁格尔奖遴选章程中科技产出权重不够以及我国的社会环境、护理学发展水平、护理人力资源配备均是影响获奖者获奖前科技产出的主要原因.     

中国南丁格尔奖获得者的社会学特征分析

目的通过分析和研究我国南丁格尔奖章获得者的社会学特征，弘扬南丁格尔精神，为我国护理事业发展提供精神导向。方法 平面媒体与电子媒体相结合收集有关南丁格尔奖章获得者的性别、学历、护龄、获奖年龄、所在省份、所在单位和突出成绩等资料并对其甄别、梳理和统计。结果（1）从第29届（1983年）我国参加南丁格尔奖章评选工作，至今（第41届，2007年）有48名护理工作者获得南丁格尔奖章。（2）获奖者中，藏族2名，满族1名，汉族45名；女性47名，男性1名；获奖时年龄（59．13±11．62）岁，护龄（38．88±11．25）年。（3）获奖者中，原始学历本科者2名，中专者46名。（4）46名获奖者担任或曾担任过护理行政职务。（5）获奖者所在地区分布于我国24个省。结论（1）危难时刻是考验护理人员弘扬南丁格尔精神的试金石；（2）南丁格尔奖章将向年轻、普通临床一线护士倾斜；（3）未来将会有更多高学历者获奖；（4）我国南丁格尔奖章比较关注欠发达地区。     

我国南丁格尔奖获得者社会成因分析

[目的]探讨家庭、学校与工作环境对我国南丁格尔奖获得者的成因影响,挖掘其中重要影响因素,为培养优秀护理人才提供参考。[方法]采用文献分析法进行研究。[结果]我国南丁格尔奖获得者家庭环境大多贫困,家庭类型以教师、医生等知识分子家庭居多;就读学校大多为治学严谨、校规严明的教会创办学校;工作单位最多6个,最少1个,平均1.98个;获得者83.72%来自综合类医院(其中32.56%获奖时已退休),16.28%来自专科类医院。88.37%参加过重大突发事件的护理工作;获奖前工作年限最长61年,最短10年,平均39.49年。[结论]家庭潜移默化;学校治学严谨、校规严明;工作单位多为综合类医院;绝大多数历经特殊事件磨炼。     

上海市护理学会与护理前辈共庆5·12佳节

[本刊讯]为庆祝5·12国际护士节成立100周年,上海市护理学会学术工作委员会特邀请几十位资深护理专家相聚一堂,参加的护理专家中,有南丁格尔奖获得者与提名者,有年愈九旬的耄耋老人,也有还在指导临床、培养新人的顾问,大家共同畅想几十年护理生涯的峥嵘岁月,密切     

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.