自然分娩孕产妇人文关怀护理实践文献计量学分析

目的了解我国自然分娩孕产妇人文关怀护理实践的现状及存在问题,为今后自然分娩人文关怀护理实践及相关研究提供参考。方法采用文献分析法,从文献的时间、作者、机构地区、基金等的分布特点、研究类型等方面进行系统分析;阅读文献,收集文献中的详细内容信息,从自然分娩孕产妇人文关怀护理实践的医院、所采取的研究设计、人文关怀护理的具体措施及实施效果评价指标等方面分析目前自然分娩孕产妇人文护理临床实践的现状及问题。结果共检索筛选出文献147篇,从2001年开始且文献发表呈递增趋势;研究对象为拟经阴道分娩的孕产妇,人文护理措施中30%以上的文献突出了营造人文环境、分娩及产后相关知识指导、心理支持、助产士一对一全程陪伴分娩、仔细观察病情及产程进展,及时告知孕产妇及家属产程进展情况、沟通及提供无痛分娩和分娩减痛措施及护理的重要性;评价指标以分娩结局最多(44.22%)。结论对自然分娩孕产妇实施人文关怀护理实践,以产妇为中心的理念日益受到重视,人文关怀护理的内涵不尽相同,目前国内缺乏指导产科护士及助产士对自然分娩孕产妇实施人文护理的具体可行的实践标准以及评价标准。     

5种核心期刊刊载人文关怀护理研究的文献分析

目的了解我国人文关怀护理的研究现状及存在的问题,为促进今后的研究提供参考。方法以"人文关怀"或"人文关怀护理"或"人文护理"或"人性化护理"为主题检索5种护理核心期刊关于人文关怀护理的相关文献并进行分析。结果共检索符合标准的文献382篇,其中临床护理所占比例最大,共197篇,护理理论最少,共14篇。结论人文关怀护理已经引起护理研究者的重视,但仍然存在护士对人文关怀理论认识不足,人文关怀护理教育落后及其研究不足等问题,护理管理者需予以政策引导和支持,以提高我国护理人文关怀水平。     

2000-2010年我国护理继续教育研究的文献计量学分析

目的了解我国护理继续教育的研究现状并进行分析,为进一步的研究提供参考。方法以中国知网《中国期刊全文数据库(CNKI)》、维普资讯《中文科技期刊全文数据库(CSTJ)》为数据来源,运用文献计量学方法对检索结果进行分析。结果检索出文献共计381篇;文献年度变化基本呈稳定状态;文献广泛分布于183种期刊,排名前12位的期刊载文占文献总量的39.11%;发文量排名前10位的省份发文225篇,占文献总量的59.06%;以第一作者发文2篇以上的著者共发文14篇,占总发文量的3.67%;文献的合作度为2.04,合著率为57.74%;有基金资助的文献12篇,占所有文献的3.15%;文献的研究内容主要以临床实践的经验介绍和现状及问题分析为主,分别占文献总量的29.66%、28.61%。结论我国护理继续教育研究的文献年发文量稳定,期刊分布合理,地域分布广泛,核心作者未形成,文献合作度和合著率低,资金资助少,研究的内容局限,研究者需在研究的广度和深度上进一步加强。     

我国护理硕士专业学位研究生培养的文献计量分析

目的了解我国护理硕士专业学位(MNS)研究生培养的现状和趋势,为相关研究提供参考。方法采用文献计量学方法,以中国知网、维普、万方数据库中主题词为"护理"和"专业学位"的文献为研究对象,对各数据库收录开始至2015年9月我国大陆正式发表的MNS研究生培养文献进行检索,利用EndNote文献管理软件和Excel进行统计分析。结果共纳入文献122篇,分别发表于36种期刊,以《中华护理教育》载文量最多;第一作者来自21个省市,其中重庆、北京、河南、山东4个省/市发文量较多;发文量最多研究机构为第三军医大学护理学院;研究内容涉及12个方面。结论目前我国MNS研究生培养处于探索阶段,其研究范围、地域、机构分布不均匀,内容较广泛,今后还需继续加强MNS研究生培养的研究,以适应护理发展的需要。     

基于CBM我国护理胜任力研究的文献计量学分析

目的探索我国护理胜任力的研究现状和发展趋势,为护理胜任力的进一步研究和发展提供理论指导和参考。方法对中国生物医学文献数据库在2013年12月之前收录的护理胜任力相关的文献进行检索,采用NoteExpress2.8和Excel2007建立数据库对文献的年份变化、地区分布、机构分布、合作撰文情况、期刊分布、基金资助情况、关键词、研究类型、研究领域等进行计量学分析。结果共检索出护理胜任力相关文献331篇;第一作者来自全国30个省市自治区,211个机构,机构合作率为28.70%,作者合著率85.50%;331篇文献发表在国内85种期刊,其中135篇文献获得省市等单位的108项基金资助,占文献总量的40.79%;共有关键词462个,最高频关键词"核心能力"出现187次;文献研究热点集中在基于胜任力的教学和培训、理论构建和胜任力及其影响因素的调查研究。结论我国护理胜任力研究文献数量呈逐年递增趋势,已经形成发文数量较多的机构群、作者群和核心期刊群。后续研究应该着重研究领域的扩展并加强跨地域、跨机构合作。     

基于Web of Science数据库对骨质疏松近十年文献计量分析

背景:在全球迈向老年化社会的今天,骨质疏松已成为威胁人类健康、严重影响老年人生活质量的主要疾病之一,骨质疏松症也是医学研究热点之一。目的:初步分析骨质疏松症的研究现状及最新进展,为该领域预防、临床和科学研究提供一定参考。方法:采用Web of Science数据库(简称WoS数据库)核心合集中子库SCI-EXPANDED(SCIE)为研究对象,根据引文分析法统计2009年至2018年近十年间以骨质疏松为主题相关文献,分析WoS数据库核心合集收录骨质疏松领域研究文献状况,包括文献发表出版年、机构、来源出版物、国家地区、研究方向、作者、基金资助等分布情况。结果:通过WoS数据库观察到骨质疏松领域近十年间国内外发表论文共40436篇,相关文献发表在117个国家的2946种期刊中,高产作者中英国的Cooper C发文量最多,与英国的Kanis JA及比利时的Boonen S为重要核心领军人物;科研机构均是大学研究机构,《国际骨质疏松杂志》、《骨与矿物研究杂志》、《骨骼》等业内期刊收录文献最多;研究方向中内分泌代谢与骨质疏松有相当密切关系;基金资助机构主要在国家基金机构或世界百强生物药企;高被引论文多发表在知名度很高的主流及顶尖期刊。结论:近十年我国骨质疏松类论文在该数据库发文量迅猛增长,位居第二位,但被引频次、篇均被引频次和h指数并不高,在论文研究深度与高产作者等方面还存在一定距离,说明总体研究实力还需进一步加强,有较大提升空间。     

国内外电烧伤研究现状与热点的可视化分析

目的分析国内外发表的电烧伤相关文献, 探讨电烧伤研究的热点与前沿。方法采用文献计量学方法。分别检索中国知网、万方数据库、维普数据库及Web of Science数据库核心合集中2013年1月1日—2022年12月31日发表的与电烧伤相关的中英文文献, 采用CiteSpace6.2.R2软件进行分析。分别统计中英文文献的发文量、发文作者、国家与机构, 对关键词进行共现分析并在此基础上进行突现情况分析和聚类分析, 将关键词按时间排序得到聚类时间线图, 探讨电烧伤领域研究现状和热点的演变过程。结果在Web of Science数据库核心合集中检索出398篇英文文献;在中国知网、万方数据库、维普数据库检索并查重后得到523篇中文文献。2013—2022年, 电烧伤领域英文文献发文量呈稳步上升趋势, 中文文献发文量呈下降并趋于平稳趋势。中文文献中共302位作者以第1作者发表电烧伤相关文章, 发文量≥3篇的核心作者共有17位;英文文献中共320位作者以第1作者发表电烧伤相关文章。共有65个国家进行电烧伤相关研究, 美国是与其他国家合作最多、发文量最多的国家。国内外共512家机构发表电烧伤相关文章,...     

我国输精管缺如研究趋势及文献计量分析

目的探索国内关于输精管缺如研究的发展趋势及文献计量分析。方法应用CiteSpace对CNKI和Web of Science(WoS)数据库中所有输精管缺如相关文献进行文献计量分析,绘制科学知识图谱并分析输精管缺如研究领域的发展概况。结果检索到CNKI文献总数158篇,发文量最高的核心作者是周惠耕,共形成多个独立且分散的研究团队;研究成果最多的机构是宁波市妇女儿童医院与南京医科大学第一附属医院;“先天性双侧输精管缺如”、“基因突变”、“男性不育”等是高频关键词,关键词共现分析得到15个聚类标签。在WoS数据库中检索到55篇文献,发文量从1993年至今呈现逐渐增加趋势,每项文献平均引用次数15.69次。发文量最高的核心作者是Chan Hsiao Chang、阮晔纯、许文明团队,其次为李宏军团队和张炎团队。当前围绕囊性纤维化跨膜传导调节因子(CFTR)基因突变与输精管缺如关系而进行的染色体与基因水平的研究是热点方向。结论我国输精管缺如研究的数量和热度稳步发展;研究机构较多,但欠缺合作;研究维度从研究初期的临床病例报道发展为现在的基因与染色体水平;我国在该领域的研究在国际上得到广泛认可。     

黄褐斑相关文献计量及可视化分析

目的：基于Web of Science核心合集数据库收录的文献,通过文献计量方法分析黄褐斑的研究现状及未来发展趋势。方法：检索2005年-2022年Web of Science数据库核心合集中收录的黄褐斑相关文献,运用文献计量学方法,使用VOSviewer和CiteSpace软件进行可视化分析,将结果以可视化形式呈现。结果：共检索到1 276篇黄褐斑相关文献,其中论著1 067篇,综述209篇。这些文献来自63个国家的1 662个机构的4 853名作者,发表在278种期刊上。美国在出版物总数、总被引频次和H指数方面排名第一,发文量最多的机构是埃及知识库,刊文量最多的期刊是Journal of Cosmetic Dermatology,发文量最多的作者是Helio Miot。目前该领域的研究热点主要集中在药物治疗及防晒等方面。结论：应用VOSviewer和CiteSpace软件进行可视化分析,可客观反映出2005年-2022年黄褐斑文献数量变化及分布情况。关键词涉及黑色素生成、对苯二酚、氨甲环酸、CO₂激光、Nd∶YAG激光等,黄褐斑的研究热点已从其机制研究及外用药...     

2000至2004年《中华骨科杂志》载文被引分析

目的从文献引证的角度了解《中华骨科杂志》的学术水平和期刊质量。方法以《中华骨科杂志》2000至2004年共60期刊载的论文和被引用的论文为研究对象。依据中国生物医学期刊引文数据库(ChineseMedicalCitationIndex,CMCI),采用文献计量学方法对载文被CMCI来源期刊引用的情况进行统计分析及评价。主要文献计量学统计指标为各年度发文被引比例、单篇论文平均被引次数、单篇论文被引情况、作者发文被引情况、被引论文的地区分布、高被引作者机构、被引论文年代分布、主要引用期刊和自引率。结果《中华骨科杂志》2000至2004年发表论文1184篇,被CMCI来源期刊引用了749篇(4213次),被引率分别为76.43%、75.20%、71.49%、57.46%和30.19%,平均被引率为63.26%,单篇论文被引次数分别为7.86、6.54、5.48、2.98和1.78次,平均被引次数为5.62次,单篇被引最高次数为68次。被引作者群的地域分布30个省(自治区)、直辖市和特区。北京、上海和天津在骨科学研究领域居于国内前列。CMCI来源期刊中有461种期刊引用《中华骨科杂志》。《中华骨科杂志》自引191条,自引率为0.045。结论《中华骨科杂志》所载文献质量较高,是我国骨科学研究领域最重要的信息源之一,也是我国医学领域的主要核心期刊。     

Semen analysis and fertility prognosis in andrological patients

Semen analyses of 529 men who consulted our department due to infertility problems, were related to the time period prior to conception, with factors adversely affecting the fertility of the female partner taken into consideration. The statistical method used was Cox's proportional-hazard model of regression. Untransformed, logarithmically transformed and dichotomized semen analysis variables were included in the calculations. The relationship between the following parameters and the probability of conception was examined: sperm count, sperm motility, progressive sperm motility, morphology and sperm motility remaining 24 h after ejaculation. All variables co-varied with the probability of conception; however, the exact type of relationship could not be determined by regression analyses. Cox's model assumes an exponential relationship. Our data suggest that this assumption is not suitable for fertility investigations. Using conventionally defined limiting values for normal and pathological semen quality, statistical analysis yielded significant differences in fertility between both categories for all of the variables considered; in the stepwise regression analysis, however, it could be shown that progressive motility and morphology alone were sufficient to discriminate between normal and pathological semen quality. The results are interpreted as indicating that, as a result of semen analysis, it is possible to predict the individual probability of conception if the exact shape of the relationship can be determined, which, up to now, has not been accomplished.     

Computer‐aided sperm analysis,the new key player in routine sperm assessment

For sperm analysis, important inter‐laboratory variations have been observed in manual analyses. In this study, a computer‐aided sperm analysis (CASA) system was assessed versus manual technique, and specific software modifications were operated to fit the David's classification already used in the laboratory. Four parameters were studied (concentration, motility, vitality and morphology), and at least 30 semen samples from 30 different patients have been tested. Manual and automated analyses were compared using a least‐squares regression line analysis, Student's t test, Bland–Altman plots and Passing–Bablok regressions. Repeatability was also assessed, and coefficients of variation (CV) were calculated. Both manual and automated methods gave similar results for sperm concentration (n = 150), motility (n = 30), vitality (n = 90) and morphology (n = 90). Repeatability always showed a decrease in the CV with automated analysis; for example in normal range of sperm values, CV for manual and CASA analyses were, respectively, 9.0% versus 4.4% for sperm concentration, 5.2% versus 4.1% for motility, 7.3% versus 4.2% for vitality and 11.4% versus 4.1% for morphology. All parameters were comparable between automated and manual analysis, and repeatability measures confirm the more reliable values of the SCA compared to those of manual analysis.     

Die Aussagekraft retro- und prospektiver Datenerfassung

Zusammenfassung Die retrospektive Analyse eines Kollektivs 88 operativ behandelter Bronchialcarcinompatienten ergab gravierende Mängel in der Dokumentation. So war bei 15 % der Grund der Klinikeinweisung nicht bekannt, bei 74 % der Patienten keine exakte Raucheranamnese zu erheben. Nur bei 59 % war eine retrospektive TNM-Klassifizierung möglich. Bei 67 % der Patienten war bekannt, ob eine Strahlentherapie, bei 16 % ob eine Cytostaticatherapie postoperativ adjuvant durchgeführt worden war. Von 20 noch lebenden Patienten des retrospektiv erfaßten Zeitraumes erschienen nur 13 zu Nachuntersuchungen. Eine prospektive Datenerfassung von 44 Bronchialcarcinompatienten erbrachte im Gegensatz dazu eine mindestens 95 %ige Aussage über die erfaßten Parameter.

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Validity of retro- and prospective data analysis

Summary Retrospective chart analysis of 88 operated patients with bronchial carcinoma showed grave deficiencies. In 15 % the reason for admission to hospital was not available and the exact smoking habits of 74 % were not known. Retrospective TNM-classification was possible in only 59 %. It was known in 67 % whether a radiotherapy and in 17 % whether a cytostatic therapy was additionally performed. Only 13 of the 20 surviving patients participated in the follow-up. In contrast with these figures, a prospective collection of data (44 patients) has an effectiveness of 95 % or more for all parameters.

     

高转换型骨质疏松模型的生化特点

应用摘除卵巢的方法。建立大鼠高转换型骨质疏松模型。本模型有以下生化特征；血清骨钙素水平明显升高；血浆酸性磷酸酶活性增强：全尿钙、全尿羟脯氨酸和肌酐含量增高。提示血浆酸性磷酸酶活力可以作为此模型动物骨吸收的特异指标，血清骨钙素水平可用于评价骨转换率。用总尿钙和总尿羟脯氨酸指标评价骨量丢失，其敏感性高于尿钙/肌酐、羟脯氨酸/肌酐。     

The cost-effectiveness of increasing kidney transplantation and home-based dialysis

Background:   Renal replacement therapy (RRT) consumes sizable proportions of health budgets internationally, but there is considerable variability in choice of RRT modality among and within countries with major implications for health outcomes and costs. We aimed to quantify these implications for increasing kidney transplantation and improving the rate of home-based dialysis.
Methods:   A multiple cohort Markov model was used to assess costs and health outcomes of RRT for new end-stage kidney disease (ESKD) patients in Australia for 2005–2010, using a health-care funder perspective. Patient characteristics and current practice patterns were based on the ANZDATA Registry. Two proposed changes were modelled: (i) increasing kidney transplants by between 10% and 50% by 2010; and (ii) increasing home haemodialysis (HD) and peritoneal dialysis (PD) to the highest rates observed among Australian centres. We assessed costs (Australian dollars), survival and quality-adjusted survival, and cost-effectiveness.
Results:   The number of new ESKD patients in 2010 was estimated to be 2700, with annual RRT costs of about $A700 million; cumulative costs (2005–2010) were $A5 billion. Increasing transplants by 10–50% saves between $A5.8 and $A26.2 million, and increases quality-adjusted life years (QALYs) by 130–658 QALYs. Switching new patients from hospital HD to (i) home HD saves $A46.6 million by 2010; or (ii) PD saves $A122.1 million.
Conclusions:   These clinical practice changes reduce costs, improve patient quality of life and, in the case of transplantation, increase survival. Planning for RRT services should incorporate efforts to maximize rates of transplantation and to encourage home-based over hospital-based dialysis to optimize cost-effectiveness in RRT service delivery.     

Biomechanical gait features associated with hip osteoarthritis: Towards a better definition of clinical hallmarks

Critical appraisal of the literature highlights that the discriminative power of gait‐related features in patients with hip osteoarthritis (OA) has not been fully explored. We aimed to reduce the number of gait‐related features and define the most discriminative ones comparing the three‐dimensional gait analysis of 20 patients with hip osteoarthritis (OA) with those of 17 healthy peers. First, principal component analysis was used to reduce the high‐dimensional gait data into a reduced set of interpretable variables for further analysis, including tests for group differences. These differences were indicative for the selection of the top 10 variables to be included into linear discriminant analysis models (LDA). Our findings demonstrated the successful data reduction of hip osteoarthritic‐related gait features with a high discriminatory power. The combination of the top variables into LDA models clearly separated groups, with a maximum misclassification error rate of 19%, estimated by cross‐validation. Decreased hip/knee extension, hip flexion and internal rotation moment were gait features with the highest discriminatory power. This study listed the most clinically relevant gait features characteristics of hip OA. Moreover, it will help clinicians and physiotherapists understand the movement pathomechanics related to hip OA useful in the management and design of rehabilitation intervention. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 33:1498–1507, 2015.     

Cost-utility analysis in orthopaedic trauma; what pays? A systematic review

BackgroundAs healthcare systems come under ever-increasing pressure to provide more care with fewer resources, emphasis is being placed on value-based systems that maximise quality and minimize cost. The aim of this study was to determine which interventions in fracture care have been demonstrated to be cost effective.MethodsA systemic review of cost-utility studies on the management of fractures from 1976 to 2015 was carried out using a search of the Cost-Effectiveness Analysis Registry, National Health Service Economic Evaluation Database (NHS EED) and MEDLINE.Results20 studies were included with 15 (75%) studies assessing interventions in lower limb trauma and 8 (25%) studies assessing interventions in upper limb trauma. 50% of studies used a decision tree model and 50% used collected data alongside a randomised clinical trial. Interventions which were shown to be cost effective in lower limb trauma were total hip replacement in displaced femoral neck fractures, the SHS in stable (A1 and A2) fractures and IM nailing for unstable (A3) fractures, salvage treatment for grade IIIB and IIIC open tibial fractures and operative treatment of ankle and calcaneal fractures. For systems-based strategies, there is evidence demonstrating cost effectiveness to treating hip fractures in high volume centres and to having resources in place to facilitate fractures being treated within 48 h of injury. In upper limb trauma there was evidence showing operative treatment of displaced proximal humerus fractures to be neither clinically nor cost effective. There was evidence supporting the operative treatment of non-displaced scaphoid fractures. Overall the quality of the studies was poor with only 50% (10) of studies able to make a treatment recommendation. Reasons for this included poor quality primary source data and poor reporting methodological practices.ConclusionCertain aspects of fracture management have been shown to be cost effective. However, there is a paucity of evidence in this area and further research is required so that value-based interventions are chosen by healthcare providers engaged in orthopaedic trauma care.     

应用Photoshop对侧面相测量进行软组织侧貌分析的可行性研究

目的：通过对侧面像和头颅定位片进行测量，探寻一种更为简单实用的软组织测量辅助分析方法。方法：选择正畸门诊病例40名，应用Photoshop软件对其侧面像进行定点测量，将所得数值与通过常规头影测量所得数值进行对比研究。结果：两种方法所得的全面凸角、面凸角和Z角之间不存在统计学的差别，而两组的鼻唇角则存在统计学差别；不同方法评价上下唇基角所得出的数值高度相关。结论：应用Photoshop对侧面相测量进行软组织侧貌分析表现出了良好的可行性。