护士绩效考核内容指标设定与效果

通过对实施护士绩效考核的认识,指出了具体的护士绩效考核量化指标的设定,论述了实行护士绩效考核的体会.     

根源性分析结合质量环管理法循环对预防护理安全隐患的作用

目的:探讨应用根源性分析(RCA)结合质量环管理法(PDCA)预防护理安全隐患的效果。方法:2012年实行PDCA循环管理法,2013年在PDCA基础上实行RCA,提出改进措施或修改流程,建立完善的预防及处理评估流程。结果:横向观察,2013年与2012年相比护理安全隐患上报例数增加,护理差错发生例数减少,且同一差错发生率降低;纵向观察,2013年较2012年护理差错有下降趋势。结论:RCA与PDCA管理法相结合,在持续护理质量改进的循环中分析确定根本原因,能够有效解决质量问题并且预防同类不良事件的发生,取得治标更治本的管理效应。     

高压氧治疗新生儿缺血缺氧性脑病的疗效观察

高压氧的主要作用机理是通过提高血氧含量及血氧分压,显著提高脑组织中氧分压和有效弥散半径,改善脑缺氧,逆转缺氧的病理生理过程,以恢复脑细胞正常的能量代谢,促进受损脑细胞修复.同时高压氧可明显改善病变区域的血氧供应,促进有氧分解,纠正酸中毒,减轻脑水肿,对神经组织的再生和侧枝循环的建立极为有利.     

论米非司酮的应用及其影响

米非司酮是一种孕激素拮抗剂,临床应用极为广泛,主要用于避孕和流产,以及治疗子宫肌瘤和妇科恶性肿瘤,同时还可治疗子宫内膜异位症及其它妇科疾病.它在作用显著的同时,但也有一定的副反应,因此提醒有关部门要谨慎管理,提醒患者要安全使用.     

Keishi‐bukuryo‐gan prevents the progression of atherosclerosis in cholesterol‐fed rabbit

In this study, we examined whether in vivo keishi‐bukuryo‐gan (a Kampo formulation) could prevent the progression of atherosclerosis in cholesterol‐fed rabbits, an animal model for hypercholesterolaemia. Sixteen male Japanese white rabbits (2 kg body weight) were divided into two groups. Group A (n = 8) was fed standard rabbit chow containing 1% cholesterol for 8 weeks. Group B (n = 8) was fed standard rabbit chow containing 1% cholesterol and 1% keishi‐bukuryo‐gan for 8 weeks. At the end of the experiment, average plasma concentrations of total‐cholesterol and IDL‐cholesterol were 2055.9 ± 201.8 mg/dL and 408.1 ± 62.6 mg/dL in group A and 1950.5 ± 126.3 mg/dL and 407.6 ± 56.6 mg/dL in group B, respectively. The percentage of the surface area of the total thoracic aorta with visible plaque was significantly reduced by keishi‐bukuryo‐gan administration; group A was 33.2% ± 5.3% and group B was 14.3% ± 2.9%. β ‐very low density lipoprotein (VLDL) and low density lipoprotein (LDL) isolated from cholesterol fed rabbits treated with keishi‐bukuryo‐gan (group B) were shown to be highly resistant to oxidative modification by cupric ion. Sera isolated from rabbits administered keishi‐bukuryo‐gan had reduced lipid peroxide formation compared with those from rabbits without keishi‐bukuryo‐gan. Thus, keishi‐bukuryo‐gan prevents the progression of atherosclerosis in cholesterol‐fed rabbits in vivo by limiting oxidative LDL modification. Copyright © 1999 John Wiley & Sons, Ltd.     

Pyruvate kinase M2 is highly correlated with the differentiation and the prognosis of esophageal squamous cell cancer

It's frequently stated that the pyruvate kinase M2 (PKM2) and Warburg effect are important for cancer development by accumulating more raw materials for macromolecule biosynthesis. However, the correlation between PKM2 and cancer is poorly reported. Here, we investigated the PKM2 expression in esophageal squamous cell cancer (ESCC). We observed that the expression of PKM2 was much higher in ESCC than in control normal tissue, and it is highly associated with many clinical features and prognosis. Specially, we found that the expression of PKM2 was closely related to the differentiation state of ESCC, and we further confirmed this discovery in vitro. As a result, out data indicated that PKM2 might be a useful indicator for determining the survival of patients with ESCC. Considering previous researches on the link among PKM2, Warburg effect, and differentiation, our study inferred the direct roles of PKM2 and Warburg effect in the differentiation of cancer cells rather than only providing synthetic intermediates for the promotion of cancer's progression.     

Deconvolution-based partial volume correction in Raclopride-PET and Monte Carlo comparison to MR-based method

In this work, we evaluated three iterative deconvolution algorithms and compared their performance to partial volume (PV) correction based on structural imaging in brain positron emission tomography (PET) using a database of Monte Carlo-simulated images. We limited our interest to quantitative radioligand PET imaging, particularly to (11)C-Raclopride and striatal imaging. The studied deconvolution methods included Richardson-Lucy, reblurred Van Cittert, and reblurred Van Cittert with the total variation regularization. We studied the bias and variance of the regional estimates of binding potential (BP) values and the accuracy of regional TACs as a function of the applied image processing. The resolution/noise tradeoff in parametric BP images was addressed as well. The regional BP values and TACs obtained by deconvolution were almost as accurate than those by structural imaging-based PV correction (GTM method) when the ideal volumes of interests (VOIs) were used to extract TACs from the images. For deconvolution methods, the ideal VOIs were slightly eroded from the exact anatomical VOI to limit the bias due to tissue fraction effect which is not corrected for by deconvolution-based methods. For the GTM method, the ideal VOIs were the exact anatomical VOIs. The BP values and TACs by deconvolution were less affected by segmentation and registration errors than those with the GTM-based PV correction. The BP estimates and TACs with deconvolution-based PV correction were more accurate than BPs and TACs derived without PV correction. The parametric images obtained by the deconvolution-based PV correction showed considerably improved resolution with only slightly increased noise level compared to the case with no PV correction. The reblurred Van Cittert method was the best of the studied deconvolution methods. We conclude that the deconvolution is an interesting alternative to structural imaging-based PV correction as it leads to quantification results of similar accuracy, and it is less prone to registration and segmentation errors than structural imaging-based PV correction. Moreover, PV-corrected parametric images can be readily computed based on deconvolved dynamic images.     

Chronology of the push pull effect on nonhuman primates—shift of the arterial pressure threshold

Fighter pilots are frequently exposed to high Gz acceleration which may induce in-flight loss of consciousness (G-LOC). One factor reducing tolerance to accelerations is a previous exposure to negative accelerations. This phenomenon, which happens during the first few seconds after the onset of the positive plateau, is called the push pull effect. Our goal was to validate a non human primate model in order to study push pull physiological mechanisms and possible changes in arterial pressure, which may occur after the first ten seconds of the positive acceleration plateau. Eight rhesus monkeys were centrifuged in profile runs, including positive Gz accelerations (+1.4, +2 and +3 Gz) with or without previous negative Gz acceleration (–2 and –3 Gz vs. +1.4 Gz). Heart rate, blood pressure and esophageal pressure were recorded during the entire centrifugation run. Results showed that the push pull effect was observed in the non human primate model. Moreover, the reduced tolerance to acceleration lingered longer than that during the first ten seconds after exposure to +Gz acceleration. It was found that, after the fourteenth second, mean blood arterial pressure stabilizes at a lower value, when the positive acceleration is preceded by a negative acceleration (15.8 kPa for –1 Gz and 15.5 for –2 Gz vs. 16.9 for 1.4 Gz). The chronology of the push pull effect seems to involve two periods. One has a short time span. The other one has a longer time span and could be induced by shift of pressure threshold, coming from exposure to previous negative acceleration.     

大学生性别空间刻板印象的行为效应

目的考察男女大学生性别空间刻板印象的行为效应。方法采用E-prime测验程序对76名大学生完成空间旋转任务的反应时进行测量。结果①大学生性别空间刻板印象行为效应的性别主效应显著(F=13.096,P<0.05);②大学生性别空间刻板印象行为效应的刻板印象激活主效应显著(F=4.653,P<0.05);③大学生性别空间刻板印象行为效应的性别与刻板印象激活的交互作用显著(F=8.353,P<0.05),简单效应检验发现,女性比男性更容易产生刻板印象行为效应。结论性别与刻板印象激活影响大学生性别空间刻板印象行为效应,并且女性空间旋转任务的消极刻板印象高于男性。