某院47名护士长高危药物外渗相关态度技能认知调查分析

目的了解护士长对高危药物外渗态度技能知识掌握情况,为加强高危药物的风险管理提供依据,促进护理持续质量改进.方法采用自制高危药物外渗相关态度技能知识调查问卷对暨南大学附属第一医院47名护士长进行调查评定,调查内容包括高危药物外渗相关态度、技能和知识3个维度,采用SPSS 16.0统计软件进行系统描述分析.结果关于高危药物外渗态度、技能、知识的平均正确率分别为99%、75%、23%;加权后总体平均正确率为70%.不同年龄、学历、职称、工作年限的护士长问卷总体平均正确率差异均无统计学意义(P>0.05).结论护士长在高危药物外渗态度方面掌握较好,在技能和知识方面存在欠缺.作为风险管理者和质量控制者,护士长应同时重视处理高危药物外渗技能和知识方面的提高.     

新护士带教方法的再探讨

目的探讨一种在新护士带教中既节省时间又全面系统的带教方法。方法便利抽样法选择2008年5月至2011年lO月在保定市第二中心医院妇产科轮转的新护士60名为研究对象。按随机数字表法将其分为观察组和对照组,每组30名。观察组新护士接受多个老师的带教,对照组新护士按一对一带教。带教3个月后,两组新护士进行综合考评并比较带教效果。结果观察组新护士在操作技术、疾病宣教、护理查房、表格书写、口头提问等方面均优于对照组,差异均有统计学意义（均P〈O．05）。结论多个老师的带教较一对一带教能使新护士在更短时间内全面、系统地掌握护理知识及治疗方法。     

RESEARCH BASIC TO MEDICAL EDUCATION: Pimping: Perspectives of 4th Year Medical Students

Background: A well-known phenomenon among U.S. medical students known as pimping, or the pedagogical device of questioning students in the clinical setting, receives virtually no attention in medical literature. Purpose: Identifying 4th-year medical students' relevant knowledge and attitudes about pimping may help educators understand the range of beliefs about pimping and the role it plays in the socialization process into the medical community. Methods: Over a 2-month period, 11 fourth-year medical students at a Midwest medical school were asked 6 open-ended questions focusing on pimping as understood and experienced in the clinical setting. Investigators individually analyzed the interview data using qualitative methods to characterize students' experiences and recurring ideas and concepts. Results: All students noted the hierarchical nature of pimping, viewing it as a tool for attendings or residents to assess students' levels of knowledge. Although some students experienced malignant pimping, humiliated by incessant questioning or questions inappropriate to their level of training, all the students in the sample were positive about pimping and its effectiveness as a pedagogical tool. Investigators found that location within the clinical setting determines how students define and understand the motives for pimping. Conclusions: Understanding how students define and experience the pimping phenomenon prepares medical educators to scrutinize pimping as a pedagogical tool and to provide the most effective and encouraging environment for students.     

Expert Knowledge in Palliative Care on the World Wide Web: Palliativedrugs.Org

ABSTRACT.?

In my last Internet-related article, I speculated that social networking would be the coming wave in the effort to share knowledge among experts in various disciplines. At the time I did not know that a palliative care site on the World Wide Web (WWW), palliativedrugs.com, already provided the infrastructure for sharing expert knowledge in the field. The Web site is an excellent traditional formulary but it is primarily devoted to “unlicensed” (“off-label”) use of medications in palliative care, something we in the specialty often do with little to support our interventions except shared knowledge and experience. There is nothing fancy about this Web site. In a good way, its format is a throwback to Web sites of the 1990s. In only the loosest sense can one describe it as “multimedia.” Yet, it provides the perfect forum for expert knowledge and is a “must see” resource. Its existing content is voluminous and reliable, filtered and reviewed by renowned clinicians and educators in the field. Although its origin and structure were not specifically designed for social or professional networking, the Web site's format makes it a natural way for practitioners around the world to contribute to an ever-growing body of expertise in palliative care.     

乳腺癌中微血管密度及bFGF表达的意义

 目的 研究肿瘤中微血管密度(MVD)和肿瘤碱性成纤维生长因子(bFGF)的表达水平在乳腺癌中的临床意义.方法 对32例手术切除的乳腺癌标本进行连续切片,分别做HE染色,F-Ⅷ相关抗原和bFGF免疫组织化学染色,根据Weidner法进行MVD的测定.结果 32例中,bFGF阳性者18例,表达率为56.3%,阳性表达者MVD记数为41.55±14.44,肿瘤直径大于5 cm时,肿瘤微血管密度明显增高.结论 bFGF在肿瘤血管形成和肿瘤生长中起重要作用,而肿瘤微血管密度可以做为评定乳腺癌预后的一项重要指标.     

创伤后应激障碍早期脑脊液MBP、ET1变化与边缘系超微结构改变

借助犬双后肢低、高速投射物致伤模型，采用酶联免疫吸附试验及放免分析，动态监测脑脊液（CSF）髓鞘碱性蛋白（MBP）、内皮素－1（ET1）的含量变化，并同期观察了边缘系超微结构改变。结果显示，伤后8h CSF－MBP及CSF－ET1含量均明显增高（P＜0．01）；同期超微结构观察显示，高速组下丘脑、海马神经元变性，神经纤维受损。提示严重致伤后应激障碍早期边缘系下丘脑、海马结构选择性受损，可能是创伤后应激障碍早期重要的神经病理学基础之一；而CSF－MBP与CSF－ET1检测可较特异、敏感地反映严重致伤后中枢神经系统应激受损。     

Business knowledge in surgeons

BACKGROUND: Surgeons and residents in training receive little, if any, formal education in the economic side of clinical practice during medical school or residency. As medical professionals face shrinking reimbursement, loss of control over health care decisions, and limited resources, surgical specialties must reevaluate the need to teach their members business survival skills. Before designing business related-teaching modules, educators must know the exact gaps in knowledge that exist among surgeons. METHODS: This article reports a survey of 133 surgeons in the Midwest who were asked to rate their knowledge base in 11 business topics relevant to the practice of medicine. RESULTS: The survey showed that the average surgeon perceives himself or herself to be poorly equipped to understand basic financial accounting principles, financial markets, economics of health care, tools for evaluating purchases, marketing, budgets, antitrust and fraud and abuse regulations, and risk and return on investments. CONCLUSIONS: Armed with this data, teaching faculty, health care systems, and medical specialty societies should design business education seminars to better position surgical specialists and trainees to communicate with insurers, hospital administrators, health care organizations, and their own personal financial advisors.     

急性坏死性胰腺炎大鼠脑脊液髓磷脂碱性蛋白水平变化的初步研究

目的:研究急性坏死性胰腺炎(ANP)大鼠24h内脑脊液髓磷脂碱性蛋白(MBP)水平的动态变化。方法:应用5%和1%的牛磺胆酸钠分别诱导ANP和急性水肿性胰腺炎(AEP)大鼠模型,同时设立假手术对照组。分别于模型诱发后3、6、9、12及24h,经大鼠小脑延髓池抽取脑脊液。以酶联免疫吸附(ELISA)法测定标本中的MBP含量。结果:诱发ANP后3h,脑脊液MBP水平明显高于AEP组和假手术组(P<0.01);6h和9h时仍维持于较高水平(P<0.05),12h开始缓慢降低。而AEP组和假手术组的MBP水平无明显变化,在24h内维持于较低水平。结论:ANP大鼠早期时脑脊液MBP水平已异常升高,提示脑组织髓鞘结构已有损害。检测脑脊液MBP水平变化对临床胰腺炎病人并发脑功能障碍的诊断和预后评估具有重要意义。