我国出版经纪产业发展急需创造的三大条件

出版经纪人是图书市场中的“润滑剂”和“催化剂”，一方面他们沟通国内出版市场及发行市场，其对图书操作的熟练和对市场的灵敏度将最大限度地整合图书资源，另一方面，在国际版权贸易中也扮演着代理人和中介人的重要角色。目前在我国出版界，出版经纪人还并不活跃。笔者认为：要使我国最终形成出版经纪产业，急需从创造法律条件、社会条件、自身条件三个方面入手。     

基于云服务平台的健康教育在门诊结肠镜检查患者肠道准备中的应用效果郭琦1, 王萍2上海徐汇区中心医院,上海 200031；2.复旦大学附属中山医院,上海 200032)

目的 探讨基于云服务平台的健康教育对门诊结肠镜检查患者肠道准备依从性及肠道准备质量的影响。方法 选择2018年5月-2019年7月门诊预约行结肠镜检查患者800例为研究对象,随机分为观察组400例、对照组400例。两组均给予相同的结肠镜检查肠道准备健康教育内容,对照组采用发放健康手册、口头介绍等常规健康教育形式,观察组采用基于云服务平台的健康教育,比较两组结肠镜检查患者肠道准备依从性、肠道准备质量、不良反应等指标。结果 观察组结肠镜检查患者饮食管理、服药管理、肠道运动、并发症预防依从性高于对照组[(98.50% vs 95.75%)、(95.25% vs 90.50%)、(96.00% vs 91.00%)、(93.75% vs 88.50%](x2=5.417, 6.819, 8.2257, 6.816, P<0.05)。右侧结肠、横结肠、左侧结肠、总体液体积聚量、渥太华肠道准备评分量表(OBPS)评分低于对照组[(0.96±0.45 vs 1.22±0.52)、(.16±0.42 vs 1.32±0.48)、(0.68±0.12 vs 0.75±0.18)、(0.42±0.18 vs 0.46±0.22)、(3.22±0.78 vs 3.75±0.82)](t=7.562, 5.017, 6.472, 2.814, 9.366, P<0.05, P<0.01)。腹胀、腹痛发生率低于对照组[(19.50% vs 28.50%)、(3.25% vs 8.25%)](x2=8.882, 7.181, P<0.05)。结论 基于云服务平台的健康教育有助于促进结肠镜检查患者肠道准备依从行为的养成,对于提高肠道准备质量、预防不良反应事件的发生,有着积极的应用价值。     

医学影像传输及储存系统数据库中应用云计算的设计

目的:在医学影像传输及储存系统(PACS)中,数据库是其整个系统的主要组成部分。数据库文件结构的建立是编制程序的基础,也是维护工作的依据。为满足患者对医疗技术水平的要求,研究出不必对现有医疗设备进行升级换代或购买新软件,而是设计一个"私有云",在"云"内进行数据处理和数据储存,实现对图像储存及图像的后处理。方法:将现有的PACS系统与医疗设备及用户端的PC使用"云计算"技术将其对接,使数据储存和数据运算等工作在云内进行。结果:"云"内储存的存储空间得到了极大的提升,且单独工作站瘫痪时不会引起数据丢失;因"云"内计算采用了分布式和并行式计算,大大提高了运算能力。结论:PACS数据库中应用"云计算"能有效的提高数据存储和数据处理方面的能力。     

Mapping social processes at work in nursing knowledge development

In this paper, we suggest a blueprint for combining bibliometrics and critical analysis as a way to review published scientific works in nursing. This new approach is neither a systematic review nor meta‐analysis. Instead, it is a way for researchers and clinicians to understand how and why current nursing knowledge developed as it did. Our approach will enable consumers and producers of nursing knowledge to recognize and take into account the social processes involved in the development, evaluation, and utilization of new nursing knowledge. We offer a rationale and a strategy for examining the socially‐sanctioned actions by which nurse scientists signal to readers the boundaries of their thinking about a problem, the roots of their ideas, and the significance of their work. These actions – based on social processes of authority, credibility, and prestige – have bearing on the careers of nurse scientists and on the ways the knowledge they create enters into the everyday world of nurse clinicians and determines their actions at the bedside, as well as their opportunities for advancement.     

Publication of clinical trials: accountability and accessibility

Publication of findings from clinical trials is a necessary step in the research continuum, to provide a record of the work done, convey information to the community, and support translation of research into clinical practice. Systematic reviews of randomized controlled trials are now widely regarded as the highest level of evidence in determining the effect of an intervention on an outcome. They largely depend on internationally accessible, published reports of all trials undertaken. Investigators and their institutions or organizations have responsibility for reporting their clinical trials accurately and completely, including disclosure of potential conflicts of interest. To ensure evidence-based health care, issues relating to accessibility and accountability of clinical trial results require immediate action.     

云技术在医院信息化管理中的应用

以浙江湖州九八医院为例,介绍云技术在医院信息化管理中的应用。阐述信息化建设现状及存在的问题,从需求分析、总体设计等方面具体说明云平台规划与实施情况,分析应用成效并提出后续建设计划。     

Doing agoraphobia(s): a material-discursive understanding of diseased bodies

Abstract This paper draws on a reading of selected English‐language case reports of agoraphobia that are representative of the medical literature written between 1871 and 1930. This reading demonstrates how agoraphobic bodies were materialised through a mutual engagement between practices associated with diagnosing agoraphobia, specifically the writing and publishing of case histories, and the reiteration of normative cultural categories implicit within them. Locating the discussion in the specific case of agoraphobia, the paper analyses the concept of disease, not only in terms of its social construction, but also in terms of its materialisation, thereby illuminating the socio‐cultural process of embodiment as one that unfolds in and through (disease) categories. Seeking to transcend current theoretical debates that demand a choice either between a material or a discursive explanation of medical phenomena, the body is thereby conceptualised beyond Foucault's subject‐object as an intra‐action between the material and the discursive, whilst retaining his key insights into the power relations inherent in the clinical gaze.