高年资专科护士自我超越驱动力的质性研究

目的 了解高年资专科护士自我超越的促进因素。方法 对15名高年资专科护士就自我超越的动力因素进行深入访谈,对访谈资料采用内容分析法进行归纳和提炼。结果 归纳出2个主题和9个副主题,包括内在驱动力（思维结构改变、个性特征、目标导向、反馈寻求行为、反思与自我激励）和外在驱动力（团队支持、领导授权、外源性压力和社会认可）。结论 促进高年资专科护士自我超越的因素是多方面的,建议护理管理者采取相应措施,重视发挥专科护士的内在动力,优化外力支持环境,以促进专科护理队伍建设。     

伊立替康不良反应与患者个体差异相关性的研究进展

伊立替康是治疗胃肠道肿瘤和小细胞肺癌的常用化疗药物,其最常见的不良反应为迟发性腹泻和中性粒细胞减少。不良反应的发生与遗传因素和非遗传因素有关。遗传因素涉及羧酸酯酶、肝脏尿苷二磷酸葡萄糖醛酸转移酶1A和细胞色素P4503A4等多种酶与转运体的基因多态性。患者的年龄、吸烟、合并用药等非遗传因素也可影响机体对伊立替康的敏感性和药物在体内的代谢过程。针对不同基因型患者制定伊立替康的个体化治疗方案,有助于提高临床疗效并降低不良反应发生率。     

运用纽曼健康系统模式提高脑卒中合并高血压患者自我管理能力的成效

目的 探讨纽曼健康系统模式对老年脑卒中及高血压患者护理干预的方法及效果.方法 随机选取90例老年脑卒中高血压患者分为对照组和观察组各45例,对照组采取脑卒中常规护理;观察组在常规护理的基础上采用纽曼健康系统模式对患者进行三级预防护理,比较干预前后两组患者不良生活习惯、高血压控制情况和相关知识掌握情况.结果 观察组中不良生活习惯的患者例数明显少于对照组,血压控制情况明显优于对照组,对相关知识掌握情况明显优于对照组,两组比较差异有统计学意义（P＜0.05）.结论 将纽曼健康系统模式理论运用于老年脑卒中合并高血压患者,可提高患者对疾病相关知识的认知度,改变不良生活习惯,控制病情的发展,减少脑卒中高血压疾病的复发.     

Balloon pulmonary angioplasty vs. pulmonary endarterectomy in patients with chronic thromboembolic pulmonary hypertension: a systematic review and meta-analysis

Heart Failure Reviews - Although balloon pulmonary angioplasty (BPA) and pulmonary endarterectomy (PEA) are effective in chronic thromboembolic pulmonary hypertension (CTEPH), the comparison of...     

Bamboo leaf-based carbon dots for efficient tumor imaging and therapy

In this study, carbon dots synthesized from bamboo leaf cellulose were used simultaneously as a staining agent and for doxorubicin delivery to target cancer cells. Owing to their nontoxic properties, the production of carbon dots from bamboo leaves is a green approach involving optimized application of bamboo tree waste. For multifunctional applications, the carbon dots were modified with 4-carboxybenzylboronic acid and doxorubicin to improve target specificity and drug delivery to HeLa tumor cells. The resulting modified carbon dots were characterized using different analytical techniques, which showed that they were biocompatible, nontoxic, and highly stable over a wide range of pH values and at high ionic strengths. Furthermore, in vitro confocal microscopy studies demonstrated their blue fluorescence and cellular pathway for entering HeLa cells via folate receptor-mediated endocytosis. Cell viability data and flow cytometry results also confirmed the selective uptake of the carbon dots by HeLa cells, which significantly enhanced cell cytotoxicity.

In this study, carbon dots synthesized from bamboo leaf cellulose were used simultaneously as a staining agent and for doxorubicin delivery to target cancer cells.     

3M透明敷料贴用于经股动脉穿刺全脑血管造影术的效果观察

目的探讨3M透明敷料贴用于预防经股动脉穿刺全脑血管造影术患者穿刺并发症的效果。方法回顾性分析200例经股动脉穿刺全脑血管造影术患者的临床资料。其中对照组为2012年2月至2013年2月未使用透明敷料贴患者80例,观察组为2013年3月至2014年2月使用3M^TMTegaderm^TM透明敷料贴固定动脉鞘患者120例。分析患者出现动脉鞘管折断、造影管折断、股动脉痉挛、穿刺处淤斑以及皮下血肿等并发症情况,评估使用3M透明敷料贴固定动脉鞘的可行性及有效性。结果观察组动脉鞘管折断、造影管折断、股动脉痉挛、穿刺处淤斑以及皮下血肿总并发症发生率明显低于对照组[5．8％（7／120）比26．2％（21／80）],差异有统计学意义（P〈0．05）。结论3M透明敷料贴价格低廉,安全性好,应用于固定股动脉穿刺鞘管可以有效减少股动脉穿刺相关并发症的发生,且操作方法简单,值得广泛推广使用。     

新医改环境下公立医院物价管理面临的困惑及“解惑”之道

建国以来,公立医院医疗服务消耗主要由政府财政投入、医疗服务收入和药品加成收入进行补偿.自2009年我国启动新一轮的医疗体制改革至今已有5年,但医疗费用问题和医院服务仍未得到人民群众的满意认可.而医院物价工作的管理者处于医院和患者之间一个十分“尴尬”的位置,也面临着诸多困惑.从“困惑”形成的原因及如何“解惑”,进而发挥物价管理在医院日常经营中“正能量”作用进行了探讨.     

松香局部应用对牙本质小管封闭效果的实验研究

目的 观察天然松脂局部应用对牙本质小管的封闭效果以及其浓度效应,为其单独防治牙本质过敏提供实验依据。方法 制备牙本质块80个,采用随机数字表法随为8组,每组10个,酸蚀30 s,分别用无水乙醇,氟涂膜,10%,20%,30%,40%,50%和60%松香乙醇溶液涂布牙本质,场发射扫描电镜观察牙本质表面及剖面的显微形貌,并测量牙本质小管开口面积(ADTO)、牙本质小管开口相对面积(PADTO)和树脂突长度(LTD)。结果 各松香乙醇组ADTO,PADTO均显著低于乙醇组(P＜0.05)。30%,40%,50%和60%松香乙醇组ADTO,PADTO与氟涂膜组差异无统计学意义(P＞0.05),均显著低于10%和20%松香乙醇组(P＜0.05)。扫描电镜见乙醇组牙本质表面牙本质小管完全开放,管壁较疏松;氟保护漆组牙本质小管完全封闭,未见明显树脂突形成;松香乙醇组牙本质小管呈不同程度封闭,剖面可见长度不等的树脂突形成。结论 松香乙醇溶液局部应用可快速封闭开放的牙本质小管,形成树脂突,且50%松香溶液即可达到较好即刻封堵效果。松香可通过封堵开放的牙本质小管防治牙本质过敏。     

Computational study on natural compounds inhibitor of c-Myc

To screen and identify ideal leading compounds from a drug library (ZINC15 database) with potential inhibition effect against c-Myc to contribute to medication design and development.A series of computer-aided virtual screening techniques were performed to identify potential inhibitors of c-Myc. LibDock from the software Discovery Studio was used to do a structure-based screening after ADME (absorption, distribution, metabolism, excretion) and toxicity prediction. Molecular docking was utilized to show the binding affinity and potential mechanism between ligands and c-Myc. Stability of the ligand-receptor complex was analyzed by molecular dynamic simulation at the end of the research.Compounds with more interactive energy which are confirmed to be the potential inhibitors for c-Myc were identified from the ZINC15 databases. Additionally, those compounds are also anticipated with fewer ames mutagenicity, rodent carcinogenicity, nondevelopmental toxic potential, and tolerant with cytochrome p450 2D6(CYP2D6). Dynamic simulation analysis also revealed that the very compounds had more favorable potential energy compared with 10058-F4(ZINC12406714). Furthermore, we prove that those compounds are stable and can exist in natural conditions.This study demonstrates that the compounds are potential therapeutic inhibitors for c-Myc. These compounds are safe and stable for drug candidates and may play a critical role in c-Myc inhibitor development.     

CTGF对破骨前体细胞RAW264.7增殖及碳酸酐酶Ⅱ分化的影响

目的研究结缔组织生长因子(CTGF)对体外培养的破骨细胞前体细胞RAW264.7增殖及对核因子Kappa B配体受体(RANKL)诱导体外培养的破骨细胞前体细胞RAW264.7分化为成熟多核破骨细胞的影响。方法使用200 ng/mLCTGF干预培养的破骨细胞前体细胞RAW264.7,采用3H-TdR掺入法检测RAW264.7细胞增殖率;使用200 ng/mL CTGF与RANKL单独或共同处理RAW264.7细胞,抗酒石酸酸性磷酸酶(TRAP)染色观察TRAP阳性多核细胞,Western blot检测碳酐酶Ⅱ蛋白的表达。结果 CTGF可显著促进RAW264.7细胞增殖;200 ng/mLCTGF与RANKL共同处理RAW264.7细胞可促进RAW264.7细胞分化为成熟多核破骨细胞;200 ng/mL CTGF与RANKL共同处理RAW264.7细胞可促进RAW264.7细胞碳酐酶Ⅱ蛋白的表达。结论 CTGF促进体外培养的破骨细胞前体细胞RAW264.7增殖,促进RANKL诱导的破骨细胞前体细胞RAW264.7分化为成熟多核破骨细胞。