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International Journal of Nursing Sciences 2018年第2期5卷 121-125页

作者： Brenda A.Wands department of nurse anesthesia Virginia Commonwealth UniversityVirginiaUnited States

Objective:The aim of this study was to examine the relationship between moral distress that may affect patient safety,and the clinical practice model,assessing ethical decision-making skills of certified registered nurse anesthetists(CRNAs).Methods:A survey using the Ethical Stress Scale(ESS)and the Ethical Assessment Skills Survey(EASS)was conducted with 134 ***:Results indicated no significant effect of practice model on level of moral distress or perceived ethical assessment skill knowledge[Wilks's lambda=0.952,F(6,256)=1.068,P=0.382,n^(2)=0.02].A statistically significant positive correlation existed between importance and skill(r=0.275,P=0.001).CRNAs felt skilled to manage the actions or activities they deemed ***:CRNAs who perceived a higher skill level in addressing ethical issues experienced lower levels of moral *** indicate content-specific curricula for the CRNAs need to be evaluated for ethical decision-making skill assessment content.

关键词： Advance practice nurse Certified registered nurse anesthetist Moral distress

Advancing the quality of care and nursing practice through emancipatory reflection

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Frontiers of Nursing 2019年第1期6卷 1-4页

作者： Hong-Jing Yu Dong-Lan Ling Jia-Le Hu department of Nursing Administration The Second Affiliated Hospital of Guangzhou Medical University department of Urologic Surgery The Second Affiliated Hospital of Guangzhou Medical University department of nurse anesthesia Virginia Commonwealth University

Reflection is a fundamental skill of health-care professionals and plays an important role in ensuring the quality of care in health-care practice. It is believed that undertaking reflection in practice can help nurses develop an awareness of a sense of personal power and agency, cultivate their critical thinking ability and help them promote their professional development. However, reflection has not been introduced widely as a nursing curriculum in China, and literature shows that some clinical nurses lack critical thinking skills and critical reflective practice skills by reason of not receiving systematic education on reflection when they were at nursing ***, we present a series of seven articles focused on prevalent and interesting practice-based events to reflect on in this special issue. The main aim is to disseminate reflective methodology and techniques and present examples of reflective writing for *** is expected that these articles will help to lead Chinese nurses to adopt critical emancipatory reflective processes to bring about transformative actions.

关键词： Smyth’s framework critical emancipatory reflection quality of care nursing practice

Effects of apoptosis on liver aging

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World Journal of Clinical Cases 2019年第6期7卷 691-704页

作者： Shao-Jie Hu Sha-Sha Jiang Jin Zhang Dan Luo Bo Yu Liang-Yan Yang Hua-Hua Zhong Mei-Wen Yang Li-Yu Liu Fen-Fang Hong Shu-Long Yang department of Physiology College of MedicineNanchang University department of nurse Nanchang University Hospital Experimental Teaching Center Nanchang University

As an irreversible and perennial process,aging is accompanied by functional and morphological declines in organs. Generally,aging liver exhibits a decline in volume and hepatic blood flow. Even with a preeminent regenerative capacity to restore its functions after liver cell loss,its biosynthesis and metabolism abilities decline,and these are difficult to restore to previous standards. Apoptosis is a programmed death process via intrinsic and extrinsic pathways,in which Bcl-2 family proteins and apoptosis-related genes,such as p21 and p53,are *** inflicts both favorable and adverse influences on liver *** eliminates transformed abnormal cells but promotes age-related liver diseases,such as nonalcoholic fatty liver disease,liver fibrosis,cirrhosis,and liver cancer. We summarize the roles of apoptosis in liver aging and age-related liver diseases.

关键词： Apoptosis Liver aging Oxidative stress Caloric restriction Cirrhosis

Balloon dilator controls massive bleeding during endoscopic ultrasound-guided drainage for pancreatic pseudocyst:A case report and review of literature

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World Journal of Clinical Cases 2018年第11期6卷 459-465页

作者： Bao-Hua Wang Li-Ting Xie Qi-Yu Zhao Hua-Jie Ying Tian-An Jiang department of Ultrasound The First Affiliated HospitalCollege of MedicineZhejiang University department of nurse The First Affiliated HospitalCollege of MedicineZhejiang University

Pancreatic pseudocyst(PPC), a common sequela of acute or chronic pancreatitis, was defined by the revised Atlanta classification as "a collection." Endoscopic ultrasound(EUS)-guided drainage is often considered a standard first-line therapy for patients with symptomatic PPC. This effective approach exhibits 90%-100% technical success and 85%-98% clinical success. Bleeding is a deadly adverse event associated with EUS-guided drainage procedures, and the bleeding rate ranges from 3% to 14%. Hemostasis involves conservative treatment, endoscopy, interventional radiology-guided embolization and surgery. However, few studies have reported on EUSguided drainage with massive, multiple hemorrhages related to severe pancreatogenic portal hypertension(PPH). Thus, the aim of this case report was to present a case using a balloon dilator to achieve successful hemostasis for PPH-related massive bleeding in EUSguided drainage of PPC. To our knowledge, this method has not been previously reported.

关键词： Endoscopic ultrasound guided Bleeding Pancreatic pseudocyst Balloon compression Novel hemostasis

COVID-19 pandemic and nurse teaching:Our experience

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World Journal of Clinical Cases 2022年第8期10卷 2657-2659页

作者： Juan Carlos Molina Ruiz Jose Luis Guerrero Orriach Maria Luisa Bravo Arcas Angela Montilla Sans RocioEscano Gonzalez department of anesthesia Hu Virgen De La VictoriaMalaga 29006Spain

In this letter to the editor,we would like to show in our hospital how our nurse team manage formation during coronavirus disease 2019 pandemic.

关键词： COVID-19 anesthesia Critical care nurses First wave Training

Consensus on the health education of home-based negative pressure wound therapy for patients with chronic wounds:a modified Delphi study

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Burns & Trauma 2021年第1期9卷 12-21页

作者： Yao Huang Beiqian Mao Jiale Hu Bing Xu Pengwen Ni Lili Hou Ting Xie Wound Healing Center at Emergency department Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai 200011China Shanghai Jiao Tong University School of Nursing Shanghai 200025China department of nurse anesthesia Virginia Commonwealth UniversityVirginia 23298USA Nursing department Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai 200011China

Background:The study aimed to develop consensus on the components of health education of home-based negative pressure wound therapy(NPWT)for patients with chronic ***:A Delphi method was used to achieve consensus on the components of health education and 75%agreement and coefficient of variation(CV)<0.25 were used as *** experts were recruited purposefully to finish this ***:Two rounds of consultation were *** was achieved on 36 of the 42 *** final agreed list of statements represented three domains:health education before carrying out home-based NPWT,health education for the treatment day of NPWT at hospital and health education for NPWT at ***:This study was the first attempt to develop consensus on the comprehensive components of health education of home-based NPWT for patients with chronic *** to the established framework and components of health education,wound professionals can safely and effectively implement health education of home-based NPWT for patients with chronic wounds and improve their self-care ability and treatment experience at home.

关键词： Wound healing Negative pressure wound therapy Home care services Delphi study Chronic wound Self-care

Sleep disorders in Alzheimer’s disease:the predictive roles and potential mechanisms

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Neural Regeneration Research 2021年第10期16卷 1965-1972页

作者： Huang Kuang Yu-Ge Zhu Zhi-Feng Zhou Mei-Wen Yang Fen-Fang Hong Shu-Long Yang department of Physiology College of MedicineNanchang UniversityNanchangJiangxi ProvinceChina department of nurse Nanchang University HospitalNanchangJiangxi ProvinceChina department of Experimental Teaching Center Nanchang UniversityNanchangJiangxi ProvinceChina

Sleep disorders are common in patients with Alzheimer’s disease,and can even occur in patients with amnestic mild cognitive impairment,which appears before Alzheimer’s *** disorders further impair cognitive function and accelerate the accumulation of amyloid-βand tau in patients with Alzheimer’s *** present,sleep disorders are considered as a risk factor for,and may be a predictor of,Alzheimer’s disease *** that sleep disorders are encountered in other types of dementia and psychiatric conditions,sleep-related biomarkers to predict Alzheimer’s disease need to have high specificity and ***,we summarize the major Alzheimer’s disease-specific sleep changes,including abnormal non-rapid eye movement sleep,sleep fragmentation,and sleep-disordered breathing,and describe their ability to predict the onset of Alzheimer’s disease at its earliest *** the mechanisms underlying these sleep changes is also crucial if we are to clarify the role of sleep in Alzheimer’s *** paper therefore explores some potential mechanisms that may contribute to sleep disorders,including dysregulation of the orexinergic,glutamatergic,andγ-aminobutyric acid systems and the circadian rhythm,together with amyloid-β*** review could provide a theoretical basis for the development of drugs to treat Alzheimer’s disease based on sleep disorders in future work.

关键词： Alzheimer’s disease amyloid-βaccumulation circadian rhythm GABAergic system glutamatergic system non-rapid eye movement sleep orexinergic system sleep disorders sleep fragmentation sleep-disordered breathing

EXPERIMENTAL　STUDY　ON　ANTITUMOR　EFFECT　OF　MONOCLONAL　ANTI－IDIOTYPIC　ANTIBODY－DNR　CONJUGATE　TO　LEUKEMIA

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Chinese Journal of Cancer Research 1995年第1期7卷 20-23页

作者：王晓林曹熙芳朱慧芬苏娜张悦沈关心 department of Immunology Research Center of Experimental Medicine Tongji Medical University Wuhan nurse School of the First Teaching Hospital Hubei Medical University China

In this experiment,the Dcxtran-T40(Dex-T40) served as intermidiate carrier,conjugated SM6 monoclonal antiidiotypic antibody(anti-Id-McAb) against B lymphocytic leukemia cells and chemotherapeutical drug daunorubicin(DNR) to form SM6:Dex: DNR *** activity of anti-Id-McAb and DNR of the immunoconjugate and their extent of the substitution were measured,and the autitumor activity of SM6:hex:DNR was assayed in *** results demonstrateil that using Dex-T40 to prepare immunoconjugate could get a higher extent of substitution of McAb and DNR and maintain the activity of McAb and drug *** results of cytotoxic assay in vitro suggested that the immunoconjugate SM6:Dex:DNR possess a specific cytotoxic effett to target tumor cells.

关键词： Immunoconjugate Anti-Id-McAb Cytotoxic assay.

Recurrent perimesencephalic nonaneurysmal subarachnoid hemorrhage within a short period of time: A case report

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World Journal of Clinical Cases 2021年第14期9卷 3356-3364页

作者： Juan Li Xiang Fang Fu-Chao Yu Bin Du Operating Room nurse Jinan Central Hospital Affiliated to Shandong First Medical UniversityJinan 250000Shandong ProvinceChina Operating Room nurse Jinan Central Hospital Affiliated to Shandong UniversityJinan 250000Shandong ProvinceChina department of Neurosurgery Jinan Central Hospital Affiliated to Shandong First Medical UniversityJinan 250000Shandong ProvinceChina department of Neurosurgery Jinan Central Hospital Affiliated to Shandong UniversityJinan 250000Shandong ProvinceChina

BACKGROUND Spontaneous subarachnoid hemorrhage(SAH)is primarily caused by a ruptured intracranial *** nonaneurysmal SAH(PNSAH)accounts for approximately 5%of all spontaneous *** displays favorable *** risk of hemorrhage recurrence is *** report a case of PNSAH recurrence,occurring within a short time after the initial episode in a patient not receiving antithrombotic or antiplatelet *** SUMMARY A 66-year-old male,without any history of recent trauma or antithrombotic/antiplatelet medication,suffered two similar episodes of sudden onset of severe headache,nausea,and vomiting.A plain head computed tomography(CT)scan showed subarachnoid blood confined to the anterior part of the *** count and coagulation function were *** was diagnosed by repeated head CT,magnetic resonance imaging,and cerebral angiography,none of which revealed the source of *** patient was discharged without focal neurological *** 6-mo follow-up,the patient had experienced no sudden onset of severe headache and presented favorable clinical *** have reported a few patients with recurrent PNSAH,originating frequently from venous hemorrhage and conventionally associated with venous *** recurs within a short time following the initial onset of symptoms,although the possibility of re-hemorrhage is extremely *** PNSAH recurrence should arouse vigilance;however,the definite source of idiopathic SAH in this case report deserves further attention.

关键词： Negative angiography Perimesencephalic nonaneurysmal subarachnoid hemorrhage Recurrence Computed tomography Prognosis Case report

One year experience with computer-assisted propofol sedation for colonoscopy

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World Journal of Gastroenterology 2017年第16期23卷 2964-2971页

作者： Otto S Lin Danielle La Selva Richard A Kozarek Deborah Tombs Wade Weigel Ryan Beecher Johannes Koch Susan Mc Cormick Michael Chiorean Fred Drennan Michael Gluck Nanda Venu Michael Larsen Andrew Ross Digestive Disease Institute Virginia Mason Medical CenterSeattleWA 98101United States department of anesthesia Virginia Mason Medical CenterSeattleWA 98101United States

AIM To report our one-year experience with computer assisted propofol sedation(CAPS) for colonoscopy as the first United States Medical Center to adopt CAPS technology for routine clinical *** Between September 2014 and August 2015, 2677 patients underwent elective outpatient colonoscopy with CAPS at our center. All colonoscopies were performed by 1 of 17 gastroenterologists certified in the use of the CAPS system, with the assistance of a specially trained nurse. Procedural success rates, polyp detection rates, procedure times and recovery times were recorded and compared against corresponding historical measuresfrom 2286 colonoscopies done with midazolam and fentanyl from September 2013 to August 2014. Adverse events in the CAPS group were *** The mean age of the CAPS cohort was 59.9 years(48.7% male); 31.3% were ASA?Ⅰ, 67.3% ASA Ⅱ and 1.4% ASA Ⅲ. 45.1% of the colonoscopies were for screening, 31.5% for surveillance, and 23.4% for symptoms. The mean propofol dose administered was 250.7 mg(range 16-1470 mg), with a mean fentanyl dose of 34.1 mcg(0-100 mcg). The colonoscopy completion and polyp detection rates were similar to that of historical measures. Recovery times were markedly shorter(31 min vs 45.6 min, P < 0.001). In CAPS patients, there were 20(0.7%) cases of mild desaturation(< 90%) treated with a chin lift and reduction or temporary discontinuation of the propofol infusion, 21(0.8%) cases of asymptomatic hypotension(< 90 systolic blood pressure) treated with a reduction in the propofol rate, 4(0.1%) cases of marked agitation or discomfort due to undersedation, and 2 cases of pronounced transient desaturation requiring brief(< 1 min) mask ventilation. There were no sedation-related serious adverse events such as emergent intubation, unanticipated hospitalization or permanent injury. CONCLUSION CAPS appears to be a safe, effective and efficient means of providing moderate sedation for colonoscopy in relatively healthy patients. Recovery

关键词： Colonoscopy Propofol Sedation Colon cancer screening anesthesia