护理人员发表论文的现状分析

[目的]对北京大学深圳医院护理科研课题、已发表的护理论文情况进行对比分析.[方法]对北京大学深圳医院2002年-2007年护理人员发表论文的类型、护理人员的学历、职称、年龄分布等情况进行回顾分析.[结果]北京大学深圳医院护理人员7年来共发表论文302篇,科研论文仅占8.9%;初级职称护理人员发表论文占1.0%;中专学历发表论文占1.7%;35岁以下护理人员发表论文占9.9%.[结论]在护理继续教育中增加护理科研课程设置、在临床护理中开展循证护理、加强低职称护事人员的培训是提高护理人员科研能力的必要途径.     

护理人员开展护理科研状况调查分析与思考

对《中华护理》、《实用护理杂志》、《护士进修杂志》1994年－1999年气刊论文情况进行统计分析,结果表明：五种杂志共刊出论文10563篇,其中科研课题论文89篇,内容以专科护理为主,占35．99％,由多到少,主要分布在军队、江苏、广东、山东等地区,所属系统以军队院校及军队医院最多,不同单位合作课题仅占16．85％,在1056篇文章中有统计学分析的文章2410篇,占22．82％。提示：护理人员科研水平亟待提高,因此,应强化护理人员的科研意识,提高护理人员的科研能力。     

从《中华护理杂志》论文的表达形式分析护理科研论文撰写中存在的问题

[目的]通过对《中华护理杂志》发表论文的表达形式分析,了解护理科研论文撰写中存在的问题。[方法]从《中华护理杂志》2008年全年刊出的487篇论文中筛选出符合条件的论文151篇,评判其在研究对象的选择、研究设计、统计学处理等方面18项内容的表达形式的缺陷。[结果]研究对象有诊断标准者占83.4%,有纳入和排除标准者占21.2%;有样本含量计算依据者占6.1%;符合随机对照试验设计者占23.4%,合理应用盲法者占13.2%;完全符合统计学处理要求者占27.2%。高级和初级职称作者或研究生以上学历者论文表达水平较高、科研能力较强。[结论]护理科研论文表达形式存在一定的问题,有待提高护理人员的科研能力和论文写作水平。     

我院护理人员科研活动现状及其认知情况的调查

目的了解我院护理人员开展护理科研的现状及其认知情况,为制订护理科研管理对策提供依据。方法采用自行设计的调查问卷,了解近5年我院护理人员科研活动现状及其认知情况和影响护理人员进行科研活动的因素。结果近5年,我院193名护理人员以第1作者发表了202篇论文,人均发表论文1.05篇。以工龄>20年、年龄>40岁、本科及以上学历和高级职称的护理人员发表的论文和从事的科研活动所占的比例较大。本科及以上学历和高级职称护理人员其护理科研的认知程度较高和动力较强。阻碍护理人员参与护理科研活动的主要因素是自身科研能力、试验条件、缺少护理科研导师指导与信息资源。结论护理人员的科研能力有待进一步提高。应根据护理人员现有的科研能力状况进行分层和有计划地培养,制订长效激励和奖励机制,改善科研环境,提升护理人员整体科研能力。     

6种护理期刊近10年护理管理研究方法载文分析

[目的]分析《中华护理杂志》《中国护理管理》《护理管理杂志》《护理学报》《中华护理教育》《护理研究》6种护理期刊近10年护理管理科研论文,以了解护理管理领域的研究方法进展.[方法]采用文献计量学方法对护理管理科研论文进行分析.[结果]10年来6种护理期刊共刊出管理类科研论文1498篇,其中科研设计以调查性研究为主,占77.37％.研究对象以护理人员为主,为1055篇;抽样方法以非概率抽样为主,占70.90％;统计方法以描述性统计使用最多,占58.36％.[结论]护理管理科研论文的数量和质量有待提高,建议设立护理专项基金,加强护理管理人员的科研意识和科研水平培训.     

本院护理人员论文发表情况的调查分析

目的了解中医院护理人员护理论文发表的现状,分析存在的问题并寻求对策。方法对本院2008~2012年护理人员发表护理论文的期刊级别及作者学历、职称、工龄、年龄等情况进行回顾性分析。结果本院2008~2012年发表护理论文在数量呈上升趋势,护理论文内容以中医护理技术所占比例最大(29.12%),药械监控方面的护理论文较少。发表在不同期刊级别的作者年龄、职称、工龄及学历比较,差异具有统计学意义(均P0.05)。结论护理人员撰写论文的意识、能力需要培训和提高。实施激励政策,调动护理人员科研积极性,对提高护理人员科研意识和水平具有积极的意义。     

实验动物在护理研究中的应用

为了解实验动物学在护理研究中的应用现状,利用《中国生物医学文献光盘数据库》检索“动物AND护理”论文38篇,从论文发表年代、作者地域分布,第一作者发文数,期刊分布,论文质量,所应用的动物种类等方面进行统计和分析。结果显示：38篇论文中1997年－2000年4a间发文33篇,占86．84％,而且有逐年增加趋势;从地域分布来看,军队和医学院校单位发文量较高,在《中华护理杂志》发文17篇,占44．74％。38篇论文质量较高,使用的动物种类及品种品系符合要求,提示,为提高护理科研的数量和质量,护理人员有必要学习和提高实验动物学的知识。     

运用目标管理提升医院护理科研管理的效果

目的通过对医院护理论文发表数量与质量的分析，探讨目标管理提升护理科研管理的效果。方法采用回顾性研究的方法，对某综合医院826名护理人员在2008--2010年期间发表于统计源期刊的论文数量及质量进行分析。结果发表护理论文数量呈逐年上升趋势，3年共发表论文397篇，护士参与论文书写的人员由73人上升至120人，人均发表论文数量由（1．34±0．583）篇增长至（1．36±0．708）篇；论著性文章由2008年78．57％增长至2010年85．42％，差异具有统计学意义（x2=125．582，P〈0.05）。结论有效的目标管理可促进护理科研水平的提高。     

急救护理科研现状的调查分析与对策

为了解急救护理科研的现状，对北京市急救中心及所属急救分站的150名护理人员进行问卷调查，并对1997年－2000年287篇护理论文进行评估分析,结果58．00％的护士有搞护理科研的愿望，而参加过护理科研的仅点4．00％，发表过科研论文的只有2．00％，52．66％护士缺乏科研选题及设计能力，38．00％护士缺乏论文撰写及统计学知识。287篇护理论文中，上刊率仅3．14％。建议主管部门加强护理科研的组织管理，改善科研基础条件，从提高护理人员的整体素质出发，制定相应的激励机制，加快急救护理科研的开展。     

护理类期刊基金资助课题论文刊出分析

为了解我国护理科研的现状,探讨护理领域各分支的科研状况,对护理类重点期刊《中华护理杂志》,《护士进修杂志》,《护理研究》,《实用护理杂志》1999年－2001年刊载的基金资助课题论文进行统计分析。结果：1999年－2001年共刊载基金论文120篇,占总论文数的2．2％,国家级资助论文占10．0％,且以实验研究论文为主（63．3％）,学科分布涉及各个专业,且与护理学科的发展方向相一致,提出护理管理者应加大力度扶持护理科研,提高护理人员的科研水平,争取国家级资助课题。     

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.     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.