影响手工制备浓缩血小板数量因素的探讨

目的：探讨手工制备浓缩血小板的影响因素,提高手工浓缩血小板的质量。方法：2008年1～12月随机选择献血者且献血前72h内未服用过阿司匹林类药物,采集顺畅;采用两种形状的血袋及两种规格的血液,通过不同的离心条件及同一分离手法制备手工浓缩血小板。结果：按＂白膜法1＂制备浓缩血小板收集效果好;400ml全血制备浓缩血小板含量高。结论：手工制备浓缩血小板的数量除献血者本身因素外,离心条件、血液规格及血袋的形状对收集血小板均有影响。     

护理本科生心理健康及干预方法的研究进展

综述了心理健康概念和护理本科生的心理健康现状,以及目前对护生心理健康干预的研究进展,分析了影响护理本科生心理健康的因素,指出了素质教育体系下推进护理本科生心理健康教育工作,培养高质量护理人才的意义。     

应变及应变率的速度向量成像定量分析诊断猪心肌挫伤

目的探讨应变（strain,ε）、应变率（strain rate,SR）的速度向量成像（velocity vector imaging,VVI）定量分析对猪心肌挫伤（myocardial contusion,MC）的早期诊断价值。方法建立8只猪MC模型。分别于撞击前及撞击后0.5、2、4、8h,采集左室二尖瓣、乳头肌、心尖水平短轴切面VVI动态图像,利用VVI脱机分析软件获得左室短轴各节段径向峰值ε、SR。结果撞击后MC节段左室径向峰值ε及SR测值低于撞击前（P〈0.05）,损伤节段的径向峰值ε及SR测值低于非损伤节段（P〈0.05）。结论 VVI技术能够定量评价MC后室壁运动异常,为MC早期诊断提供了新方法。     

The impact of a single seizure on health status and health care utilization

PURPOSE: To assess the health status of patients after a single seizure. METHODS: We compared single-seizure patients (SS) with patients who had well-controlled epilepsy (WC), and uncomplicated hypertension (HT). Patients were adults screened from emergency and outpatient units of two urban teaching hospitals using predefined criteria. The 83 patients (SS, 30; WC, 29; HT, 24) were interviewed by phone about functional status (SF-36), comorbid illness, cause of illness, number of visits to health providers, and drug side effects. RESULTS: No significant differences were found among groups for health status, SF-36 domain, or occurrence of drug side effects. SS patients had significantly lower scores on vitality (p < 0.03) and a trend toward lower role physical function (p < 0.07) compared with age-adjusted population norms. SS reported more visits to health providers than WC or HT, and the number of visits remained high at interview 1 year later. Patient knowledge of the "reason" for the seizure was not associated with health status or number of visits. CONCLUSIONS: Health status of patients within 1 year of a single seizure is similar to that of patients with well-controlled epilepsy or hypertension, but SS patients have greater health care utilization.     

国际期刊撤销论文引证特征及其自身净化效果分析

【目的】分析Web of Science（WoS）数据库近十年撤销论文的引证特征,探究撤销行为对学术界的净化效果。【方法】分析撤销论文数量、被引频次等信息和期刊影响因子（impact factor,IF）的相关性,撤销时滞与论文被引频次的相关性;计算高被引撤销论文对IF的贡献率;评价撤销时滞对撤销前、后被引频次的影响。【结果】76种期刊（撤销论文数量≥5篇）IF和撤销论文数量、总被引频次、撤销后被引频次、篇均被引频次相关（均为P<0.05）。撤销时滞和撤销论文总被引频次相关（P=0.000）。随撤销时滞延长,撤销前被引频次逐渐增大。高被引撤销论文对期刊IF的贡献率为0.00%~2.00%。【结论】高IF期刊发表的、撤销时滞长的撤销论文对学术界的负影响较大;肯定期刊进行自我净化效果的同时,建议科研管理部门、期刊编辑和科研人员等加强对撤销论文及其不良影响的关注。     

2003～2007年科学引文索引扩展版药理学和药剂学领域高影响因子期刊论文分析

目的:为药学科研工作者提供科学引文索引扩展版药理学和药剂学领域高影响因子期刊论文的相关信息。方法:根据美国科学信息研究所发布的2007期刊引证报告网络版筛选出药理学和药剂学领域影响因子排名前10位的期刊,在科学引文索引扩展版中套录2003～2007年10种期刊发表的全部论文,利用论文分析软件Thomson Data Analyzer对套录的论文从多角度进行分析。结果与结论:10种期刊在2003～2007年发文量稳定;论文类型以Review和Meeting Abstract为主;发文量排名前10的国家和机构集中在欧美发达国家;研究热点集中在癌症、心血管疾病、白血病、艾滋病等领域,研究已深入到分子生物学水平。鉴于此,我国药学科研工作者在发表专业文章时可选择高影响力期刊,提高论文影响力。     

不同麻醉方法对结直肠癌根治术患者应激免疫反应的影响分析

目的：分析不同麻醉方法的运用对结直肠癌根治术患者应激免疫反应的影响。方法：选取120例结直肠癌根治术患者,依照入院顺序随机均分为四组,分别予以丙泊酚静脉全麻复合硬膜外（PRO＋EPI）、七氟烷吸入全麻复合硬膜外（SEV＋EPI）、丙泊酚静脉全麻（PRO）、七氟烷吸入全麻（SEV）处理;对照四组各阶段白细胞内丙酮酸激酶（PK）、葡萄糖6-磷酸脱氢酶（G-6PD）活性变化。结果：PRO组各阶段的白细胞PK活性、G-6PD活性对比均无明显变化（P〉0.05）。除PRO组之外的三组T3、T4期白细胞PK活性均明显高于T1期、G-6PD活性均明显低于T1期;PRO＋EPI组、SEV＋EPI组T4期白细胞PK活性明显低于T3期、G-6PD活性明显高于T3期,差异均有统计学意义（P〈0.05）。结论：吸入全麻复合硬膜外（SEV＋EPI）、静脉全麻复合硬膜外（PRO＋EPI）两种麻醉方式下患者直肠癌根治术过程中会出现白细胞代谢增强现象,但术后24 h内白细胞代谢逐渐回落,表明此两种麻醉方式不会对应激免疫反应产生过大刺激;单纯静脉全麻（PRO）中2项指标调控效果不明显,表明麻醉对白细胞代谢刺激较大而得不到调控,应激免疫反应影响最大。     

营养治疗对妊娠期糖尿病孕妇的影响初探

目的：探讨营养治疗对妊娠期糖尿病孕妇的影响。方法：48例妊娠期糖尿病孕妇,随机分为观察组（营养治疗＋胰岛素治疗）24例和对照组（胰岛素治疗）24例,对两组疗效进行对比分析。结果：观察组孕妇在血糖的改善与对照组比较无显统计学意义（P〉0.05）;观察组并发症发生率为12.5％,对照组并发症发生率为16.7％,两组并发症发生率差异有统计学意义（P〈0.05）。结论：对采用胰岛素治疗加营养治疗的妊娠期糖尿病,与常规单纯胰岛素治疗对比,临床疗效显著,且并发症少,安全可靠,为妊娠期糖尿病治疗的首选方法之一。     

医保支付制度改革对医院管理的影响与对策研究

从医疗费用、医保基金风险、现行支付制度的困境分析我国医疗保险支付制度改革的必要性和迫切性,以医疗服务提供方的角度,探讨支付制度改革对医院管理的积极和消极影响,并从医疗质量、临床路径、成本管理、信息化管理、谈判机制等5方面提出应对策略和建议.     

Encouraging maternal health service utilization: an evaluation of the Bangladesh voucher program

With the ultimate goal of reducing maternal and neonatal mortality, many countries have recently adopted innovative financing mechanisms to encourage the use of professional maternal health services. The current study evaluates one such initiative - a pilot voucher program in Bangladesh. The program provides poor women with cash incentives and free access to antenatal, delivery, and postnatal care, as well as cash incentives for providers to offer these services. We conducted a household survey of 2208 women who delivered in the 6 months before the survey (conducted in 2009) in 16 intervention and 16 matched comparison sub-districts. Probit and linear regressions are used to analyze the effects of residing in voucher sub-districts on the use of professional maternal health services and associated out-of-pocket expenditures. Using information on birth history, we conducted sensitivity analyses employing difference-in-differences methods, comparing women's reported births before and after the program's initiation in the intervention and comparison sub-districts. We found that the program significantly increased the use of antenatal, delivery, and postnatal care with qualified providers. Compared to women in matched comparison sub-districts, women in intervention areas had a 46.4 percentage point higher probability of using a qualified provider and 13.6 percentage point higher probability of institutional delivery. They also paid approximately Taka 640 (US$ 9.43) less for maternal health services, equivalent to 64% of the sample's average monthly household expenditure per capita. No significant effect of vouchers was found on the rate of Cesarean section. Our findings therefore support voucher program expansion targeting the economically disadvantaged to improve the use of priority health services. The Bangladesh voucher program is a useful example for other developing countries interested in improving maternal health service utilization.