国外护患关系研究热点分析北大核心

[目的]探讨国外护患关系研究现状及热点领域。[方法]检索美国国立图书馆PubMed数据库收录的近10年的护患关系文献,提取主要主题词等信息,运用文献计量学方法、书目信息共现分析系统(BICOMB)和图形聚类软件(gCluto)进行计量分析、高频主题词词篇共现分析、聚类可视化分析,结合文献评阅分析护患关系研究现状及研究热点。[结果]共检索到文献3 857篇,排名前10位的期刊(其中有7种护理期刊)刊文量1 083篇(28.08%),截取高频主题词44个,聚类分析为7类,2006年—2015年护患关系研究的主要研究对象集中在产妇、肿瘤病人、老年人及重症病病人这4类人群,护患沟通、病人满意度、灵性照顾、同理心是护患关系研究中的热点。[结论]国外护患关系研究在护理领域内受到重视,发文的质量和水平较高,护患关系研究处于稳定发展的成熟期。     

国外护患关系研究热点分析

[目的]探讨国外护患关系研究现状及热点领域。[方法]检索美国国立图书馆PubMed数据库收录的近10年的护患关系文献,提取主要主题词等信息,运用文献计量学方法、书目信息共现分析系统(BICOMB)和图形聚类软件(gCluto)进行计量分析、高频主题词词篇共现分析、聚类可视化分析,结合文献评阅分析护患关系研究现状及研究热点。[结果]共检索到文献3 857篇,排名前10位的期刊(其中有7种护理期刊)刊文量1 083篇(28.08%),截取高频主题词44个,聚类分析为7类,2006年—2015年护患关系研究的主要研究对象集中在产妇、肿瘤病人、老年人及重症病病人这4类人群,护患沟通、病人满意度、灵性照顾、同理心是护患关系研究中的热点。[结论]国外护患关系研究在护理领域内受到重视,发文的质量和水平较高,护患关系研究处于稳定发展的成熟期。     

基于PubMed数据库的护理人员职业召唤研究现状的共词聚类分析

目的分析PubMed数据库中近10年护理人员职业召唤研究现状与趋势,为今后我国进行该领域的研究提供参考。方法检索PubMed数据库中近10年(2010年1月—2020年2月)发表护士职业召唤相关文献,运用Bicomb2.0对发表年代、作者、期刊、国家和主题词进行统计分析;利用SPSS25.0软件对高频主题词-副主题词进行聚类分析。结果共纳入81篇文献,2010年—2014年总发文量25篇,2015年—2020年总发文量56篇,发文量最多为美国,共41篇。截取高频主题词-副主题词27个,占总频次的33.86%。共词聚类总结出护理人员职业召唤研究的4个热点,包括职业召唤来源、职业召唤测量、职业召唤相关关系和职业召唤影响因素。结论职业召唤在护理领域应用不多,但文章刊载量总体呈上升趋势。研究热点集中于探讨职业召唤相关关系和职业召唤影响因素,目前我国护士职业召唤研究仍在探索初期,在护理领域该方面的研究较少。     

基于WOS的大量输血研究的科学计量学分析

目的从web of science核心合集收录的文献中了解大量输血的研究趋势、现状特征及研究热点。方法登录http://www. webofknowledge. com/,选择web of science核心合集数据库,以"massive transfusion"为主题检索1999—2019年的相关文献,精炼文献类型为Article和Review,采用文献计量学方法以及利用VOSviewer(version1. 6. 10)可视化分析软件,对检索得到、涉及"大量输血"的相关数据(关键词、作者、机构、国家/地区、参考文献等)做合著关系分析(Co-authorship)、共现分析(Co-occurrence)、引文分析(Citation)和共引分析(Co-citation),并构建相关可视化分析网络。结果 1999—2019年共检索到"大量输血"文献1 647篇,总被引频次43 593次,发文量由15增加到166篇,年均增长率12. 77%。年被引频次由1增加到5 385次,年均增长率53. 52%,平均引用次数26. 47次/篇,h指数94;发文量排名前4位的国家是美国890篇(43. 91%)、单篇文献平均被引频次35. 23,德国161篇(7. 94%)、单篇文献平均被引频次31. 75,英国121篇(5. 97%)、单篇文献平均被引频次36. 71和加拿大109篇(5. 38%)、单篇文献平均被引频次42. 12,中国以37篇(1. 83%)排名第10、单篇文献平均被引频次17. 24;排名前20研究机构17所为大学(85%),3所为军方研究机构,其中19所来自美国(95%),发文量最高的前2个机构是美国德克萨斯大学系统(UNIVERSITY OF TEXAS SYSTEM)和德克萨斯大学休斯敦健康科学中心(UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER HOUSTON),共计发文量289篇(17. 5%),其次是加州大学系统(UNIVERSITY OF CALIFORNIA SYSTEM)发文量93篇(5. 6%)和美国国防部(UNITED STATES DEPARTMENT OF DEFENSE)发文量74篇(4. 5%);中国学者发文量排名前3的是DANG QL、XU CX和YANG JC,均为7篇,皆来自陕西省人民医院; 261个大量输血高频关键词形成4个聚类(研究)热点:1)患者血液管理; 2)创伤患者早期凝血障碍以及控制性复苏; 3)凝血障碍以及凝血功能检测,4)血浆比例的应用与预后的关系。识别出以"纤维蛋白原(fibrinogen)产后出血(postpartum hemorrhage)和休克指数(shock index)"为代表的共26个前沿热点关键词。结论从web of science核心合集检索大量输血文献进行文献计量学分析,可从1个较长时间范围认清大量输血的研究主题和动态并了解大量输血的研究现状和热点,为研究人员开展大量输血相关临床和科研工作提供参考。     

基于PubMed数据库的近10年消毒学文献计量分析

摘要 目的 了解国际消毒学研究现状与热点领域,为消毒学研究与学科发展提供参考。方法 计算机检索2006-2015年PubMed收录消毒学相关文献,提取主题词等信息,运用文献计量学方法、书目信息共现分析系统(BICOMB)、图形聚类工具包(gCluto)进行文献计量分析。结果 共检出发表的有关消毒学论文4 468篇,相关高频主题词70个,共词聚类分析发现高频主题词聚类为7个类别,发文量居前3位的国家分别是美国、英国和荷兰,中国位列第6位。研究热点包括光照消毒、食品消毒、生物膜消毒、消毒副产物、医院感染控制中消毒和医疗器械消毒和酸性氧化电位水等。结论 通过对消毒学领域的文献计量学分析,可了解消毒学研究方向及其发展现状,供消毒学研究参考。     

国际输血协会《非感染性输血不良反应监测标准》之解读

正国际输血协会血液安全监测工作委员会(Working Partyon Haemovigilance,International Society of Blood Transfusion)于2011年公布了《非感染性输血不良反应监测标准》[1](以下简称《监测标准》)。《监测标准》以欧洲血液安全监测网络和其他血液安全监测系统使用的以及已公开发表文献给出的"输血不良反应"的定义为编制基础,经ISBT血液安全监测工作委员会(2006年9月2日开普敦会议)评审通过后,已在国际血液安全监测网络(International HaemovigilanceNetwork)应用。现将其主要内容解读如下。     

英文现刊输血医学文献题录汉译选辑

血液输注、骨髓及干细胞移植 输血与免疫系统 Transfusion 1995,35(11):879 输血医学的教育与旁听 Vox Sang 1996,70(1):1 人为接种细菌的全血在2～24℃保存8～24小时后所制备的成份血中的细菌水平 Transfusion 1995,35(11):911 床边输血中发生的错误:一种监护和预防发生错误的系统应用2年的情况分析 Vox Sang 1996,70(1):16 施行再次冠状血管侧支循环侈植病人的用血:多变量分析 Transfusion 1995,35(10):850 输血相关性移植物抗宿主病及其预防 Blood Rev 1995,9(4):251 对易受损害的血液制品中少量白细胞的检测的近期情况     

2002年循证医学研究热点的文献计量分析

目的分析2002年国外循证医学研究热点,为我国开展循证医学研究与实践提供借鉴.方法检索MEDLINE数据库中收录的2002年"Evidence-based medicine"论文;遵循文献计量学原理、利用作者所在系编制的文献计量分析软件确定循证医学研究高频主题词;对高频主题词进行同篇聚类分析、并描绘聚类关系图.结果共检出循证医学研究论文545篇;相关主题词1 554个;高频主题词35个,其中包括循证医学、循证医学标准、方法及教育、实践指南及其标准、决策等;聚类分析显示高频主题词主要聚于循证实践指南及其推广、循证医学方法学等9个类别.结论2002年循证医学研究热点主要包括实践指南及其推广、循证医学方法学、医学伦理、循证临床决策及其应用等,可为我国的循证医学研究提供参考.     

横向联合:血液中心学科建设的有效途径

输血是现代临床医学抢救危重患者的主要手段之一.输血方法虽然发轫于中世纪,但直到1900年Landstin发现ABO血型后方进入安全输血时代;至20世纪80年代,国外才形成了一门新学科,始称输血学(Transfusionology)或输血医学(Transfusion Medicine)[1].到了20世纪90年代后期,我国各省、市、自治区都已先后建立起(或健全)了省级血液中心,在地市一级都建立起了中心血站,相应的是各级、各类临床医院也建立了输血科(或血库),至此,1个庞大的血液采集、加工、质检、临床应用的网络在我国成型[2].     

2006—2015年PubMed数据库收录老年人尿失禁文献分析

目的了解老年人尿失禁研究文献的分布规律和研究热点。方法以美国国立图书馆的Pub Med数据库为文献信息来源,对2006—2015年收录的老年人尿失禁相关文献的年代分布、国家、发文语种、期刊分布和作者情况等进行统计分析,并对高频主题词进行聚类分析。结果共检索到老年人尿失禁相关文献3449篇,其中美国作者发文最多,为1313篇,占38.07%,中国位居第10位;研究文献以英语为主,汉语文献数量位居第5位;期刊分布则以《The Journal of Urology》发表老年人尿失禁文献最多,中文期刊均未进入核心区期刊;在发文量≥7篇的22名作者中,中国作者仅朱兰(北京协和医院妇产科)一位,列第4位。高频主题词聚类分析结果显示,老年人尿失禁文献的主要研究方向集中于尿失禁的外科手术治疗方法、病理生理学机制、流行病学研究、对尿失禁患者的护理、尿失禁的药物治疗方法 5个方面。结论尿失禁的手术治疗和药物治疗方法、病理生理学机制、护理和流行病学研究是近几年老年人尿失禁研究的热点,应引起国内外该领域临床和科研人员的重点关注。     

安宁疗护研究热点的共词聚类分析

目的 分析安宁疗护研究热点,了解该领域研究现状及发展趋势。方法 以“hospice care”为主题词,采用主题检索方法对PuMed数据库中2008-2018年发表的安宁疗护相关文献进行主题检索,运用Bicomb、SPSS 24.0 软件对其进行共词聚类分析。 结果 共检索到相关文献2 968篇,截取高频关键词41个,通过共词聚类分析总结出 2008-2018年安宁疗护相关文献年发表数量虽然出现几次波动,但总体来说仍处于较高水平且趋于稳定,其中美国的相关研究论文最多,总结安宁疗护研究的共词聚类可归纳为6个热点:①安宁疗护中心标准;②安宁疗护开展现状;③安宁疗护护理实践;④安宁疗护与心理学;⑤安宁疗护的管理;⑥经济学与伦理。结论 本研究总结了安宁疗护的研究热点及其文献分布,可为今后安宁疗护的研究发展提供参考依据。     

Transfusion trigger – how precise are we? Intraoperative blood transfusion practices in a tertiary centre in Nigeria

summary .  To determine how well anaesthetists in Nigeria determine the need for transfusion based solely on physiological variables and estimated blood loss. To determine the incidence of inappropriate blood transfusion. Anaesthetists in our hospital determine when to transfuse patients based solely on clinical acumen. This may result in inappropriate transfusion especially in this subregion where blood donors are scarce and risk of transmission of infection high. All surgical patients requiring blood transfusion were prospectively studied over 3 months. Transfusion was based solely on the discretion of the attending anaesthetist. Haemoglobin (Hb) concentration was measured prior to transfusion and 24 h postoperatively. Appropriate transfusion was defined as blood transfusion at Hb < 8 g dL⁻¹ or 10 g dL⁻¹ in the elderly and those with medical comorbidities. The trigger for transfusion was documented as well as estimated blood loss. Thirty-four patients were studied. The mean pretransfusion Hb was 8·09 ± 2·45 g dL⁻¹ (range 4·6–14·2). Twenty-one patients (61·8%) had appropriate blood transfusion. The commonest transfusion triggers were clinical pallor (82·4%), excessive blood loss (76·4%), delayed capillary refill (55·9%) and severe hypotension (50%). The use of near patient monitoring devices might further improve blood transfusion practice in this setting where donor blood is scarce.     

基于PubMed数据库的人工智能在护理领域的研究热点分析

目的 分析人工智能在护理领域的研究现状与热点。 方法 检索在PubMed数据库中收录的有关人工智能的相关护理文献,检索时间为: 建库至2019年8月31日,应用书目共现分析系统(BICOMB 2.0)软件,对文献年代、发表期刊等数据进行计量学分析。采用SPSS 21.0 统计软件将词篇矩阵进行聚类分析,生成研究热点。 结果 共纳入227篇文献,提取出29个英文高频主题词,总结出了3个研究热点:护理信息化建设及其对护理人员的改变;护理决策支持系统的应用;与机器人相关的专科护理的发展。 结论 人工智能正处于快速发展时期,研究范围涉及体系构建、临床护理及居家等多个方面,且更加于注重临床应用。     

Assessing the national productivity in subspecialty critical care medicine journals: A bibliometric analysis

Purpose

In recent years, significant growth has been seen in the subspecialty critical care medicine. However, the national productivity to the subspecialty critical care medicine remains unknown. We therefore intended to reveal the national contribution in the subspecialty critical care medicine journals.

Materials and Methods

Articles published in 20 highly cited journals in subspecialty critical care medicine from 2006 to 2010 were retrieved from Web of Science and PubMed. The number of total articles and randomized, controlled trials, the per capita numbers, total impact factors (IFs), and citations were tabulated to assess the contribution of different countries.

Results

A total number of 17 667 articles were published in the 20 journals from 2006 to 2010 worldwide. North America, West Europe, and East Asia were the most productive regions. High-income countries published 89.68% of the total articles. The United States published the most number of articles in 2006 to 2010 (6659/17 667, or 37.69%), followed by United Kingdom, Germany, France, and Australia. Besides, the United States also had the most number of randomized, controlled trials (260), the highest total impact factors (27 206.55), and the highest total citations (84 170). When normalized to population size, Australia had the highest number of articles per million population, followed by Netherlands, Switzerland, Austria, and Belgium.

Conclusion

The United States is the most productive country in the subspecialty critical care medicine. When normalized to population size, Australia and some European countries might be more productive.     

医院临床用血现状调查分析

目的 了解医院临床用血合理性情况。方法 随机抽取本院2006～2008年有输血治疗的病历700份,其中外科病历500份,内科病历200份。依据《临床输血技术规范》中“手术及创伤输血指南”和“内科输血指南”对病例输血合理性进行分析评估。结果 700例病例中,合理用血占44％,部分合理用血占40％,不合理用血占16％。内科合理输血比例显著高于外科（χ^2=91．827,P〈0．01）。结论 不合理用血现象在医院中普遍存在,外科占有较大比例。     

高校医学检验技术专业开设输血检验辅修专业的探索

输血医学已经发展成1门独立的专业学科,但大多数血站机构检验科工作人员、医院输血科和检验科(血库)医技人员的输血专业背景只是在医学院校学习时接受过少量的输血检验相关知识的教育,难以胜任输血医学学科发展的需求;因此培养输血检验专业人员是1项非常紧迫而重要的任务。在借鉴检验医学院和大连市血液中心拥有共同开办血液检验专业方向经验的基础上,我们在医学检验技术专业中设立了输血检验辅修专业,优选对输血感兴趣、学有余力的学生学习输血医学(检验)专业知识,确保其在有限的时间内尽量掌握更多的输血检验的相关理论和技术。由于在输血检验教学模式、教学方法作了配套改革和探索,使辅修输血检验专业的学生未来就业多了1个选项并可以更好地适应血站、医院的输血检验工作之需。     

Transfusion recipient epidemiology and outcomes research: possibilities for the future

The National Heart, Lung, and Blood Institute (NHLBI) supports major research programs related to the field of transfusion medicine, which encompass blood banking, the practice of transfusion medicine itself, and cellular therapies. Specific programmatic elements have included 1) the Transfusion Medicine/Hemostasis Clinical Trials Network (TMH CTN) charged with conducting clinical trials in transfusion medicine and hemostasis; 2) the Retrovirus Epidemiology Donor Study-II (REDS-II), which includes domestic and international efforts dedicated to blood donor safety and blood availability issues; 3) the Specialized Centers of Clinically Oriented Research (SCCOR) in Transfusion Biology and Medicine that include two major projects, the Biologic and Immunologic Aspects of Transfusion Medicine Program and the Transfusion and Lung Injury Program, and 4) the Transfusion Therapy Trial for Functional Outcomes in Cardiovascular Patients Undergoing Surgical Hip Fracture Repair (FOCUS), a Phase III clinical trial that has as its major goal to determine whether a more aggressive transfusion strategy in surgery patients with cardiovascular disease (or risk factors) is associated with improved functional recovery and decreased risk of adverse postoperative outcomes. Notably, none of these programs supports epidemiologic and clinical outcomes research focused on transfusion recipients. Thus, on October 31, 2007, a Working Group on Transfusion Recipient Epidemiology and Outcomes Research was convened by the NHLBI. This group was asked to discuss the current status of the field, identify critical research needs, and make recommendations to the NHLBI program staff.     

Would doctors dream of electric blood bankers? Large language model-based artificial intelligence performs well in many aspects of transfusion medicine

Background

Large language models (LLMs) excel at answering knowledge-based questions. Many aspects of blood banking and transfusion medicine involve no direct patient care and require only knowledge and judgment. We hypothesized that public LLMs could perform such tasks with accuracy and precision.

Study Design and Methods

We presented three sets of tasks to three publicly-available LLMs (Bard, GPT-3.5, and GPT-4). The first was to review short case presentations and then decide if a red blood cell transfusion was indicated. The second task was to answer a set of consultation questions common in clinical transfusion practice. The third task was to take a multiple-choice test experimentally validated to assess internal medicine postgraduate knowledge of transfusion practice (the BEST-TEST).

Results

In the first task, the area under the receiver operating characteristic curve for correct transfusion decisions was 0.65, 0.90, and 0.92, respectively for Bard, GPT-3.5 and GPT-4. All three models had a modest rate of acceptable responses to the consultation questions. Average scores on the BEST-TEST were 55%, 40%, and 87%, respectively.

Conclusion

When presented with transfusion medicine tasks in natural language, publicly available LLMs demonstrated a range of ability, but GPT-4 consistently scored very well in all tasks. Research is needed to assess the utility of LLMs in transfusion medicine practice. Transfusion Medicine physicians should consider their role alongside such technologies, and how they might be used for the benefit and safety of patients.     

Blood transfusion at the time of the First World War – practice and promise at the birth of transfusion medicine

The centenary of the start of the First World War has stirred considerable interest in the political, social, military and human factors of the time and how they interacted to produce and sustain the material and human destruction in the 4 years of the war and beyond. Medical practice may appear distant and static and perhaps seems to have been somewhat ineffectual in the face of so much trauma and in the light of the enormous advances in medicine and surgery over the last century. However, this is an illusion of time and of course medical, surgical and psychiatric knowledge and procedures were developing rapidly at the time and the war years accelerated implementation of many important advances. Transfusion practice lay at the heart of resuscitation, and although direct transfusion from donor to recipient was still used, Geoffrey Keynes from Britain, Oswald Robertson from America and his namesake Lawrence Bruce Robertson from Canada, developed methods for indirect transfusion from donor to recipient by storing blood in bottles and also blood‐banking that laid the foundation of modern transfusion medicine. This review explores the historical setting behind the development of blood transfusion up to the start of the First World War and on how they progressed during the war and afterwards. A fresh look may renew interest in how a novel medical speciality responded to the needs of war and of post‐war society.