Improving Prenatal Diagnosis of Coarctation of the Aorta

Background

The purpose of the study was to evaluate the association between fetal echocardiographic measurements and the need for intervention (primary coarctation repair, staged coarctation repair, or catheter intervention) in prenatally diagnosed coarctation of the aorta.

郑州市三甲医院急诊科护士道德困境与职业倦怠的现状及相关性研究

目的 调查郑州市三甲医院急诊科护士的道德困境与职业倦怠的现状,并分析两者之间的相关性。方法 采用便利抽样法选取郑州市5所三甲医院的228名急诊科护士作为研究对象,采用一般资料调查表、中文版护士道德困境量表、护士职业倦怠量表对其进行问卷调查。结果 郑州市三甲医院急诊科护士道德困境总分为(49.41±13.35)分,职业倦怠总分为(63.51±17.25)分。单因素分析显示,不同学历、工作年限的急诊护士的道德困境得分比较,差异均有统计学意义(F=4.830,P=0.015; F=6.302,P=0.001);不同年龄急诊护士的职业倦怠得分比较,差异有统计学意义 (F=8.328,P=0.005),急诊科护士道德困境与职业倦怠呈正关性(r=0.412,P<0.05)。结论 郑州市三甲医院急诊科护士的道德困境与职业倦怠普遍存在,护士的道德困境与职业倦怠呈正相关。     

中华传统文化视角下疾病终末期患者尊严模型解析

目的:解析加拿大Chochinov疾病终末期患者尊严模型在中华文化情境下的适用性,并基于此对模型进行调适。方法:采用内容分析法,按照选定分析范围、抽取样本、确定分析单位和分析框架、资料分析四步完成。首先检索中、英文数据库中以中华文化背景下临终尊严为主题的文献,然后以尊严模型为框架对文献内容进行编码、归纳和分析。结果:尊严模型包含的多数主题符合我国临终患者的认知,如身体功能、医疗不确定性、死亡焦虑、隐私界限、照护要旨、他人负担、后事担忧等。但也出现了矛盾的主题,如忍受痛苦、自主性等,以及新的主题,包括家庭支持、病耻感和财务担忧。结论:加拿大版疾病终末期患者尊严模型并不完全符合中国文化,调适后的尊严模型更具我国文化特色,但仍需实证研究对模型进行验证。     

营养风险与腹膜后肿瘤患者住院时间的相关性研究

目的 探讨营养风险与腹膜后肿瘤患者住院时间的相关性。方法 采用回顾性研究，选取2012年1月至2018年12月四川大学华西医院血管外科新入院腹膜后肿瘤患者60例，采用营养风险筛查表评估患者营养风险，收集患者体质指数、围术期血红蛋白和白蛋白水平、住院天数、术后恶心呕吐发生情况、术后排气、排便时间和首次进食时间。采用单因素分析比较不同患者住院时间，采用多重线性逐步回归分析患者住院时间的影响因素。结果 纳入的60例腹膜后肿瘤患者中，40例患者（66.7%）术前存在营养风险，52例患者（86.7%）术后存在营养风险；单因素分析显示，患者术前、术后营养风险 （术前P<0.001，术后P=0.043）、术前白蛋白 （P=0.019）、术后血红蛋白 （P=0.019）、术后白蛋白（P=0.025） 水平以及术后恶心呕吐 （P=0.001） 均会影响患者的住院时间；患者住院时间与围术期营养风险筛查工具评分、术后首次进食时间、术后排气时间和排便时间具有相关性，且相关性强（r=0.759~0.770； P<0.01）；多因素分析显示术前营养风险是腹膜后肿瘤患者住院时间的重要预测因素（β=0.399）。结论 术前营养风险是腹膜后肿瘤患者住院时间的预测因子。     

Methaemoglobin formation in the koala and the possum

Measurements were made of glutathione (GSH) levels, catalase activity and the oxidant sensitivity of the erythrocytes from the koala (Phascolarctos cinereus) and the common brushtail possum (Trichosurus vulpecula). The oxidant sensitivity was tested by treating the haemolysates with either 0.55 him H₂O₂ or 1.4mm NaNO₂. The erythrocytes of the koala had greater levels of GSH and catalase and yet were found to be more susceptible to oxidation induced by both these oxidants.     

非孕期子宫肌瘤红色变性40例分析

目的 了解非孕期子宫肌瘤红色变性的临床特征。方法 本组回顾分析了1993年1月～2001年2月间住院手术治疗40例非孕期子宫肌瘤红色变性的临床病理特征。结果 非孕期子宫肌瘤红色变性发生率为2.3%。生育年龄多见，绝经后也可发生。有典型表现者2例，占5%，非典型下腹隐痛而无发热者7例，占17.5%，肌瘤结节局部压痛者12例，占30%，无任何症状者30例，占75%，白细胞升高占10例，25%。90%的红色变性肌瘤直径在5cm以上，77.5%为壁间肌瘤。68.6%有典型牛肉样改变，54.8%旋涡状结构存在。65%为单纯红色变性，余35%可合并其他类型变性。结论 非孕期子宫肌瘤红色变性临床过程缓和，症状不典型，易漏诊，不作为手术指征，但因子宫肌瘤往往较大，多需手术治疗。     

糖尿病患者腹部手术后消化道功能的观察

目的了解糖尿病患者腹部手术后消化道功能恢复情况,为临床进行有针对性的护理提供依据.方法对72例糖尿病患者腹部手术后消化道功能恢复情况进行观察,并随机抽取70例非糖尿病腹部手术患者作对照.结果在肠鸣音恢复及肛门排气时间、进流质饮食后食欲状况、恶心呕吐、腹胀发生情况5个方面进行比较,两组消化道功能恢复差异明显(P均＜0.01).结论糖尿病患者腹部手术后消化道功能恢复延迟,临床护理中应予重视.     

FDA’S Perspectives on Cardiovascular Devices

The Food and Drug Administration (FDA) decision process for approving or clearing medical devices is often determined by a review of robust clinical data and extensive preclinical testing of the device. The mission statement for the Center for Devices and Radiological Health (CDRH) is to review the information provided by manufacturers so that it can promote and protect the health of the public by ensuring the safety and effectiveness of medical devices deemed appropriate for human use (Food, Drug & Cosmetic Act, §903(b)(1, 2(C)), December 31, 2004; accessed December 17, 2008 ). For high-risk devices, such as ventricular assist devices (VADs), mechanical heart valves, stents, cardiac resynchronization therapy (CRT) devices, pacemakers, and defibrillators, the determination is based on FDA’s review of extensive preclinical bench and animal testing followed by use of the device in a clinical trial in humans. These clinical trials allow the manufacturer to evaluate a device in the intended use population. FDA reviews the data from the clinical trial to determine if the device performed as predicted and the clinical benefits outweigh the risks. This article reviews the regulatory framework for different marketing applications related to cardiovascular devices and describes the process of obtaining approval to study a cardiovascular device in a U.S. clinical trial.     

A reaction route graph analysis of the electrochemical hydrogen oxidation and evolution reactions

The reaction route (RR) graph approach recently developed by us for complex, non-linear kinetic mechanisms is applied to the hydrogen oxidation and evolution reactions. A corresponding RR graph is constructed and translated into an equivalent electrical circuit network by associating each elementary step with a characteristic resistance for the steady-state case and considering the overall reaction as a power source. It is further shown that the steady-state kinetics of the reaction can be investigated employing the conventional methods of the electrical network theory. Using a set of rate constants for the hydrogen evolution reaction (her) in alkaline solutions from the literature, the dominant RRs are identified and simplified mechanisms and kinetics derived.