目的   系统评价护士的护理伦理敏感性现状及影响因素，为针对性干预提供参考。方法   检索国内外相关数据库，检索时限为2024年7月护士的护理伦理敏感性现状及影响因素的相关文献。由两名分析人员独立筛选文献、提取资料、质量评价后采用Stata 15.0和RevMan 5.3软件进行meta分析。结果   纳入16篇文献，包括4 961例研究对象。Meta分析结果显示，护士的护理伦理敏感性处于中等偏高水平，总分为［OR=67.29，95%CI（53.24，81.34）］分。年龄［OR=2.78，95%CI（1.45，5.33），P=0.002］、工作年限［OR=3.55，95%CI（1.35，9.33），P=0.001］、伦理知识教育［OR=14.60，95%CI（4.24，50.32），P＜0.001］、共情能力［OR=1.35，95%CI（1.01，1.80），P＜0.001］、工作场所氛围［OR=1.85，95%CI（0.42，4.51），P＜0.001］、工作嵌入量［OR=3.60，95%CI（0.40，32.84），P=0.001］是护士护理伦理敏感性的主要影响因素。结论   当前证据表明，护士的护理伦理敏感性处于中等偏高水平，影响因素较多，管理者需结合人群特征实施干预，以提高护士护理伦理敏感性水平。

   Objective  To systematically evaluate the current status of nurses’  ethical  sensitivity in  nursing  and influencing factors that influence it，in order to inform targeted interventions．Methods  Domestic and international databases were searched to collect literature related to the current status of nurses’ ethical sensitivity in nursing and the factors influencing it from the year of construction to July 2024．Meta-analysis was performed by two analysts independently screening the literature，extracting information，and quality evaluation using Stata 15.0 and RevMan 5.3 software．Results  Sixteen papers including 4 961 study subjects were included．Meta-analysis results showed that nurses had moderately high level of ethical sensitivity in nursing with a total score of 67.29（95%CI［53.24，81.34］）．Age（OR=2.78，95%CI［1.45，5.33］，P=0.002），years of experience（OR=3.55，95%CI［1.35，9.33］，P=0.001），education on ethical knowledge（OR=14.60，95%CI［4.24，50.32］，P＜0.001），and empathic ability（OR=1.35，95%CI［1.01，1.80］，P＜0.001），workplace atmosphere（OR=1.85，95%CI［0.42，4.51］，P＜0.001），and the amount of job embeddedness（OR=3.60，95%CI［0.40，32.84］，P=0.001） were the main influences on nurses’ ethical sensitivity in nursing．Conclusions  The previous evidence suggests that nurses have moderately high levels of nursing ethical sensitivity，with a high number of influencing factors，and managers need to give interventions that incorporate the characteristics of the population in order to increase the level of nursing ethical sensitivity among nurses．

目的 分析人脑胶质瘤组织中O6—甲基鸟嘌呤—DNA甲基转移酶(MGMT)、DNA拓扑异构酶Ⅱ(TopoⅡ)基因的表达情况及其对化疗敏感性的影响。方法 收集医院2012年4月—2018年6月期间进行开颅手术切除的新鲜人脑胶质瘤标本80例和同期经颅脑手术治疗的脑外伤或脑出血内减压切除的正常脑组织30例。采用免疫组化法检测两种标本中MGMT和TopoⅡ基因表达情况,并通过脑胶质瘤U251和U87细胞培养、体外药物(替莫唑胺)干预、Transwell体外侵袭实验分析其对化疗敏感性的影响。结果 胶质瘤标本、正常脑组织MGMT和TopoⅡ基因表达程度分布比较差异均有统计学意义(P＜0.05),且二者MGMT基因阳性表达率分别为63.75%、3.33%,TopoⅡ基因阳性表达率分别为55.00%、0.00%,差异有统计学意义(P＜0.05)。MGMT、TopoⅡ基因均在细胞核显示为阳性染色。体外药物干预的实验组、未进行药物干预的阴性对照组干预前U251、U87细胞穿膜细胞计数比较无统计学意义(P＞0.05),但干预后实验组U251、U87细胞穿膜细胞计数高于阴性对照组(P＜0.05),干预后实验组U251、U87细胞有更强的侵袭力。结论 MGMT和TopoⅡ基因在人脑胶质瘤标本中阳性表达率高,且可能参与促进脑胶质瘤细胞侵袭,影响肿瘤化疗敏感性。

Objective To analyze the expression of O6-methylguanine-DNA methyltransferase (MGMT) and DNA topoisomerase II (Topo II) genes in human brain gliomas and its influence on the chemosensitivity. Methods A total of 80 fresh human brain glioma specimens resected by craniotomy and 30 normal brain tissues resected by craniocerebral operation for traumatic brain injury or decompression for cerebral hemorrhage during the period from April 2012 to June 2017 were collected. The expression of MGMT and Topo II genes in the two kinds of specimens was detected by immunohistochemical method, and the influence on chemosensitivity was analyzed through brain glioma U251 and U87 cell culture, in vitro drug (temozolomide) intervention and Transwell invasion in vitro. Results There was a significant difference in the expression of MGMT and Topo II genes in glioma specimens and normal brain tissues (P<0.05). The positive expression rates of MGMT gene in the two kinds of specimens were 63.75% and 3.33% respectively while the positive expression rates of Topo II gene were 55.00% and 0.00%, respectively (P<0.05). Both of MGMT and Topo II genes were displayed in the nucleus as positive staining. There was no significant difference in transmembrane cell count of U251 and U87 cells between the experimental group given drug intervention in vitro and negative control group without drug intervention before the intervention (P>0.05). However, the transmembrane cell count of U251 and U87 cells in the experimental group after intervention was higher than that in the negative control group (P<0.05). After intervetion, U251 and U87 cells were with stronger invasiveness in the experimental group. Conclusion The positive expression rates of MGMT and Topo II genes are high in human brain glioma specimens. They may be involved in promoting glioma cell invasion, affecting tumor chemosensitivity.

目的 研究BAG-1基因与乳腺癌他莫昔芬(TAM)治疗敏感性的相关性。方法 以58例乳腺癌患者为观察组,50例乳腺良性肿瘤患者为对照组。予以观察组患者TAM治疗,检测并统计2组患者肿瘤组织BAG-1基因的阳性率;并根据检测结果将观察组患者分为BAG-1阳性组与阴性组,对比分析观察组BAG-1阳性者与阴性者的临床预后及血清肿瘤标志物水平,包括癌胚抗原(CEA)、糖类抗原153(CA153)。结果 观察组BAG-1基因阳性率为74.14%,对照组为12%,2组比较, P＜0.05。观察组BAG-1阳性组患者临床缓解率为46.51%,阴性组为66.67%,2组比较,P＜0.05;BAG-1阳性组患者临床控制率为67.44%,阴性组为86.67%,2组比较,P＜0.05。观察组BAG-1阳性组患者平均OS为(1.55±0.86)a,PFS为(1.02±0.31)a,阴性组依次为(2.76±0.95)a、(2.06±0.82)a,2组比较,差异均有统计学意义(P＜0.05)。治疗后,观察组BAG-1阴性组患者血清CEA、CA153指标值均低于对照组(P＜0.05)。结论 BAG-1基因与乳腺癌TAM治疗敏感性密切相关,BAG-1阳性者行TAM治疗的临床效果及预后均较阴性者差。

Objective To study the correlation between BAG-1 gene and the sensitivity of tamoxifen (TAM) in breast cancer. Methods 58 cases of breast cancer patients as the observation group, 50 cases of benign breast cancer patients as the control group.The positive rate of BAG-1 gene in two groups of patients was detected and statistically analyzed by TAM. The patients in the observation group were divided into BAG-1 positive group and negative group according to the test results, and the positive rate of BAG- (CEA), carbohydrate antigens 153 (CA153) and carcinoembryonic antigen (CEA). Results The positive rate of BAG-1 gene was 74.14% in the observation group and 12% in the control group, P<0.05. The clinical response rate of BAG-1 positive group was 46.51% and negative group was 66.67%, P<0.05; The clinical control rate of BAG-1 positive group was 67.44%, negative group was 86.67%. Compared 2 groups , it was P<0.05. The mean OS was (1.55±0.86) years, PFS was(1.02±0.31) years in the BAG-1 positive group and (2.76±0.95) years in the negative group and (2.06±0.82) years in the negative group, (P<0.05). After treatment, the serum CEA and CA153 values in the negative group of BAG-1 were lower than those in the control group (P<0.05). Conclusion BAG-1 gene and breast cancer TAM treatment sensitivity is closely related to BAG-1 positive TAM treatment of clinical efficacy and prognosis were worse than negative.

目的 探讨不同年份CLSI文件中头孢吡肟折点变化对肠杆菌科细菌药敏结果的影响,辅助临床合理调整用药。方法 应用2013年(S23)与2014年(S24)CLSI文件中的头孢吡肟折点回顾性分析我院2014年肠杆菌科细菌的药敏变化情况。结果 与S23折点相比,肠杆菌科细菌中大肠埃希菌、肺炎克雷伯菌对头孢吡肟的耐药率分别上升了2.6%、2.8%,耐药率差异有统计学意义(P<0.05);产ESBLs大肠埃希菌、产ESBLs肺炎克雷伯菌以及非产ESBLs肺炎克雷伯菌对头孢吡肟的耐药率分别上升了3.8%、2.4%、2.0%,耐药率差异有统计学意义(P<0.05); 对于其它肠杆菌科细菌如非产ESBLs大肠埃希菌、阴沟肠杆菌等对头孢吡肟的耐药率变化无差异(P>0.05)。与S23相比,在S24中头孢吡肟MIC值分布在4 μg/mL、8 μg/mL、16 μg/mL时对细菌的药敏变化最为显著。结论 依照S24折点,肠杆菌科细菌对头孢吡肟的耐药率有不同程度的升高;尤其对产ESBLs菌株耐药率影响更大;临床应结合实验室报告合理调整用药。

Objective To investigate the change of the break point of the CLSI in different years on the drug sensitivity of Enterobacteriaceae bacteria. This is valuable for rational use of antibiotics. Methods To retrospective analyze 2014 Enterobacteriaceae bacteria susceptibility variation by CLSI file cefepime breakpoint of 2013(S23) and 2014(S24). Results Compared with breakpoint of S23, E. coli and Klebsiella pneumonia, cefepime resistant rate rose by 2.6% and 2.8% respectively, and the resistance difference was statistically significant (P<0.05); ESBLs-producing E. coli, ESBLs-producing Klebsiella pneumoniae and ESBLs non-producing Klebsiella pneumoniae toword cefepime resistant rate rose by 3.8%, 2.4% and 2.0% respectively, and the resistance difference was statistically significant (P<0.05); For other Enterobacteriaceae bacteria, such as ESBLs non-producing E. coli and Enterobacter cloacae with cefepime in drug resistance rate had no significant difference (P>0.05). Compared with S23, variety in drug susceptibility of bacteria was most significant in S24, during cefepime MIC of 4 μg/mL, 8 μg/mL, 16 μg/mL. Conclusion According to the S24 breakpoint, the drug resistance rates of the bacteria in the intestines of the bacteria is increasing, especially in ESBLs strain; antibiotics use should be following laboratory results.

目的 研究进展性脑梗塞与超敏 C-反应蛋白(hs-CRP)、纤维蛋白原(FIB)、血清胱抑素C(CysC)的相关性。方法 选择82例脑梗塞患者作为观察组,根据患者临床表现分为进展性脑梗塞组和非进展性脑梗塞组,另选择70例非脑血管病患者作为对照组;分别检测血清hs-CRP和FIB、CysC水平。结果 观察组患者血清hs-CRP和FIB、CysC含量较对照组升高(P<0.01);进展性脑梗塞组血清hs-CRP和FIB、CysC含量高于非进展性脑梗塞组(P<0.05)。经Spearman 相关分析发现,进展性脑梗塞组的血清hs-CRP、FIB、CysC水平与美国国立卫生研究院卒中量表(NIHSS)评定的神经功能缺损评分呈正相关。结论 血清hs-CRP、FIB、CysC水平检测有助于进展性脑梗塞患者的早期诊断,对预后有评估作用。

目的 对经皮冠状动脉介入(PCI)治疗术前高敏C反应蛋白(hs-CRP)水平进行测定,探究其与患者术后发生造影剂肾病相关性。方法 选取2011年4月—2013年5月在我院进行PCI手术疗的患者120例为实验对象。根据术前hs-CRP值分为3组:A组(hs-CRP<1 mg/L,n=56),B组(hs-CRP 1～3 mg/L,n=40)和C组(hs-CRP>3 mg/L,n=24)。观察各组术后造影剂肾病的发生情况以及探究其两者之间的相关性。结果 A、B、C组患者术后CIN的发生率分别为8.93%、22.5%和50.0%,经过统计学比较,差异有统计学意义(P<0.05)。患者术前hs-CRP水平年龄在75岁以上、男性、糖尿病、贫血、水化治疗均与CIN显著独立相关。C组MACE发生率均高于A组、B组(P<0.05)。结论 接受PCI手术治疗的患者,其术前hs-CRP水平与其术后CIN的发生具有一定的相关性,患者术前hs-CRP水平越高,术后更可能发生CIN,hs-CRP的水平可作为辅助CIN诊断的指标。

       目的   探析子宫输卵管超声造影（D-HyCoSy）配合宫腔水造影对不孕症患者宫腔粘连（IUA）诊断灵敏度、特异度情况。方法   选取2021年1月—2023年2月南华大学附属长沙中心医院的110例不孕症者为研究对象，均予以宫腔水造影、D-HyCoSy，以宫腔镜病理结果为金标准，分析不同诊断方法应用的效果。结果   在110例不孕症患者中，经宫腔镜病理检查发现，宫腔粘连患者占比47.27%（52/110）。D-HyCoSy的诊断准确率为76.36%、宫腔水造影的为79.09%，均低于联合诊断的93.63%（P＜0.05）。D-HyCoSy的诊断灵敏度为73.08%，宫腔水造影的为80.77%，均低于联合诊断的94.23%，差异具有统计学意义（P＜0.05）。D-HyCoSy的诊断特异度为79.31%，宫腔水造影的为77.59%，与联合诊断的93.10%相比，差异无统计学意义（P＞0.05）。结论   对于不孕症患者，予以宫腔水造影联合D-HyCoSy诊断，其诊断效能高于单一诊断检查率，能更准确地判定宫腔粘连，效能高。