三级综合医院护理质量敏感性指标的构建

目的构建三级综合医院护理质量敏感性指标,为医院护理质量评价提供相关依据。方法通过证据总结与半结构式访谈法对护理质量敏感性指标进行初步设计,通过德尔菲法进行专家函询确定最终护理质量敏感性指标。结果最终构建的护理质量敏感性指标包含一级指标3个,二级指标20个。3轮专家函询积极系数为94.12%~100.00%,权威系数为0.84,变异系数为0.00~0.22,协调系数为0.09~0.24(均P0.01)。结论通过循证、半结构式访谈及德尔菲法构建的护理质量敏感性指标具有科学性、严谨性,对护理管理及临床护理工作具有一定的指导意义。     

动脉顺应性评价降压疗效的临床意义

目的 探讨动脉顺应性评价降压疗效的临床意义。方法 受试者均为男性，分为正常对照组72例；高血压控制和未控制组各35例，使用美国产HDI－DO－2020动脉测试仪同步记录血压和动脉顺应性（大动脉弹性C1，小动脉弹性C2）。结果 高血压未控制组：收缩压（SBP），舒张压(DBP），平均动脉压（MAP）和脉压（PP）均明显高于正常对照组和高血压控制组（P均＜0．01）；而对照组和高血压控制组之间无统计学差异（P＞0．05）。高血压未控制组的C1和C2顺应性明显降低，与对照组和高血压控制组比较有统计学差异（P均＜0．01）；同样后两组之间无学差异（P＞0．05）。结论 动脉面应性可作为评价降低疗效的敏感指标。     

免疫评分系统在结直肠癌中应用的研究进展

结直肠癌是常见的消化系统恶性肿瘤,发病率和死亡率呈逐年上升趋势。TNM分期系统是目前国际上最为通用的肿瘤分期系统,但其分期标准仅基于肿瘤细胞本身特征,未能纳入患者整体免疫情况,在对患者预后的指导中逐渐显露不足。因此,在量化分析肿瘤微环境中免疫细胞的基础上,提出了免疫评分系统。近年多项研究证实,免疫评分系统能够更精准地评估结直肠癌患者的临床预后,且效果优于TNM分期。此外,免疫评分系统在辅助放化疗、评估免疫治疗疗效等方面也发挥重要作用,可进一步优化TNM分期系统及风险分层,有利于制定肿瘤患者的个体化治疗方案。本文就免疫评分系统在结直肠癌患者预后及疗效评估方面的研究进展进行综述。     

脑钠肽对早发急性心肌梗死患者近期预后的影响

目的探讨血浆脑钠肽(BNP)浓度对早发急性心肌梗死(AMI)患者近期预后的预测价值。方法检测90例AMI患者(男<55岁,女<65岁)入院时的血浆BNP和肌钙蛋白T(TnT)浓度,记录患者住院和平均随访6个月期间的心血管事件(心血管意外死亡、心力衰竭、再发心绞痛或再发心肌梗死),分析BNP与TnT的相关性及BNP对近期预后的预测价值。结果早发AMI患者平均BNP浓度高于对照组[(238.74±131.59)pgmlvs.(38.70±23.81)pgml,P<0.01]。早发AMI组BNP与TnT成正相关(r=0.805,P<0.01)。早发AMI患者心血管意外死亡再发心绞痛再发心肌梗死事件组BNP与无此事件组相比较,差异无显著性(P>0.05);发生心力衰竭或复合心血管事件组BNP高于未发生组[(337.75±66.05)pgmlvs.(229.08±132.61)pgml,P<0.05;(304.05±134.94)pgmlvs.(214.37±120.86)pgml,P<0.01]。多变量回归分析,BNP是预测早发AMI患者近期心血管事件的有效指标(RR:1.831,95%CI1.086～3.514,P=0.016)。结论血浆BNP可以反映早发AMI患者心肌坏死的程度和预测近期预后。     

A general protocol for creating high-throughput screening assays for reaction yield and enantiomeric excess applied to hydrobenzoin

A general approach to high-throughput screening of enantiomeric excess (ee) and concentration was developed by using indicator displacement assays (IDAs), and the protocol was then applied to the vicinal diol hydrobenzoin. The method involves the sequential utilization of what we define herein as screening, training, and analysis plates. Several enantioselective boronic acid-based receptors were screened by using 96-well plates, both for their ability to discriminate the enantiomers of hydrobenzoin and to find their optimal pairing with indicators resulting in the largest optical responses. The best receptor/indicator combination was then used to train an artificial neural network to determine concentration and ee. To prove the practicality of the developed protocol, analysis plates were created containing true unknown samples of hydrobenzoin generated by established Sharpless asymmetric dihydroxylation reactions, and the best ligand was correctly identified.     

论文被引频次学科领域百分位在创建期刊百分位数指标中的应用

【目的】 探讨基于InCites数据库中论文被引频次百分位创建期刊百分位数指标的方法,比较不同百分位数指标的期刊评价效果。【方法】 以2018年版JCR中多学科交叉科学期刊及其2017—2018年发表的论文为研究对象,根据InCites数据库中论文被引频次学科领域百分位(Percentile in Subject Area,PSA)创建期刊百分位数指标(Journal Indicator of Percentage Rank,JIPR),包括JIPR4、JIPR6、JIPR8、JIPR10、JIPR100和平均PSA(aPSA),比较不同JIPR对多学科交叉科学期刊的评价效果。【结果】 68种期刊的JIPR4呈偏态分布,其他JIPR呈正态分布,多数指标之间呈高度相关,不同等级JIPR之间相关度更高;影响因子与aPSA排序位次变化较大的期刊多是发表综述文献较多、单篇高被引论文对影响因子贡献较大的期刊。【结论】 与影响因子相比,多数JIPR有明显优势,其中aPSA可能是最理想的期刊评价指标。     

Turning back from the brink: Detecting an impending regime shift in time to avert it

Ecological regime shifts are large, abrupt, long-lasting changes in ecosystems that often have considerable impacts on human economies and societies. Avoiding unintentional regime shifts is widely regarded as desirable, but prediction of ecological regime shifts is notoriously difficult. Recent research indicates that changes in ecological time series (e.g., increased variability and autocorrelation) could potentially serve as early warning indicators of impending shifts. A critical question, however, is whether such indicators provide sufficient warning to adapt management to avert regime shifts. We examine this question using a fisheries model, with regime shifts driven by angling (amenable to rapid reduction) or shoreline development (only gradual restoration is possible). The model represents key features of a broad class of ecological regime shifts. We find that if drivers can only be manipulated gradually management action is needed substantially before a regime shift to avert it; if drivers can be rapidly altered aversive action may be delayed until a shift is underway. Large increases in the indicators only occur once a regime shift is initiated, often too late for management to avert a shift. To improve usefulness in averting regime shifts, we suggest that research focus on defining critical indicator levels rather than detecting change in the indicators. Ideally, critical indicator levels should be related to switches in ecosystem attractors; we present a new spectral density ratio indicator to this end. Averting ecological regime shifts is also dependent on developing policy processes that enable society to respond more rapidly to information about impending regime shifts.     

供应室消毒指示带粘贴架的制作

随着供应室新规范的出台，每家医院都在取消无菌包的包扎绳，但无菌包的名称必须写在消毒指示带上。为了节省时间，每天必须预先将带有无菌包名称的消毒指示带写好，粘贴于架子上，便于操作时取用方便。为此，我科自行设计制作了消毒指示带粘贴架，通过使用效果良好，现介绍如下。     

纳米铁粉对小鼠血糖和血脂的影响

[目的]探讨纳米铁粉对小鼠血糖、血脂的影响。[方法]分别以5g/kg剂量微米粒径铁粉(Micro-Fe)或纳米粒径铁粉(Nano-Fe)给小鼠1次经口灌胃,14d后处死;测定肝、肾脏器系数、血糖(Glu)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)的变化。[结果]Micro-Fe和Nano-Fe染毒小鼠肝脏系数明显高于对照组相(P﹤0.05)。与对照组相比,Nano-Fe染毒小鼠血清Glu明显降低(P﹤0.05);Micro-Fe组血清TG比control组有明显升高(P﹤0.05),Nano-Fe组血清TG比control组有升高趋势,但差异无统计学意义(P﹥0.05)。Control、Micro-Fe和Nano-Fe染毒组3组小鼠血清TC、LDL-C和HDL-C水平间差异无统计学意义(P﹥0.05)。[结论]大剂量Nano-Fe经口染毒可使血清Glu降低,对TC、TG、HDL-C和LDL-C无明显影响。     

大学生预防艾滋病知识与能力评价指标体系的开发研究

目的 开发大学生艾滋病预防知识与能力评价指标。方法 采用改良的Delphi法,选择艾滋病预防控制、健康教育、大学生教育与管理领域的专家40人进行咨询。结果 专家平均年龄48.5±10.33岁,全部具有副高或副处以上职称、职务,大部分工作20年以上;咨询意见回收率分别达到95.0%、82.5%和72.5%,专家权威系数达到0.8264,采用专家选择率、均数、满分率、变异系数作为标准进行指标筛选后,确定一级指标7项,二级指标92项。一级指标协调系数在0.16～0.4之间,权重系数在0.2909～0.3151之间。结论 专家积极可靠,指标筛选过程比较规范,指标比较全面、可靠,可用于实践进一步检验与完善。