Objective: This study aimed to demonstrate and promote the skill of critical emancipatory reflection through reflecting on a nursing practice-based ethical issue about nurses' paternalistic decision-making for pat...Objective: This study aimed to demonstrate and promote the skill of critical emancipatory reflection through reflecting on a nursing practice-based ethical issue about nurses' paternalistic decision-making for patients. Meanwhile, critical awareness will be developed and the underlying issues of paternalism in nursing decision-making will be analyzed. Then, by applying the procedure, improvement in nursing decision-making practice will be expected.Methods: Taylor's model of emancipatory reflection with four steps, including construction, deconstruction, confrontation, and reconstruction, is utilized to guide the author's reflection.Results: Guided by the socialization theory, the author's personal and professional socialization is seen to be associated with the formation of the value of paternalism. The theory of reflexivity is applied to unearth the related issues, including deeper personal value,work environment, as well as historical and cultural contexts. Moreover, the power derived from policy, work relationship, and nursing administration, which could induce paternalism in the author's nursing decision-making practice, was critically debated using the hegemony theory. Finally, new insights into paternalism will be achieved, which enable change in terms of how to facilitate patients' autonomous decision-making.Conclusions: The process of refection makes it clear that respecting patients' right and performing patient-centered caring are the bases to change the paternalism existing in the nursing decision-making practice currently. The reconstruction step assists the author in terms of how to value the patients' autonomy and balance patients' safety and choice, rather than being overprotective; carry out risk assessment, and search for strong evidence to counterbalance the positive and negative aspects of risk-taking; communicate with patients appropriately in a manner that they can comprehend; spend more time to explore patients' preference and choice; make every effort to elevate the patients' decision-making capacity; implement patient-centered care and shared decision-making in nursing practice; consult with other colleagues and obtain the required support when limitations or challenges exist; try to justify and avoid hidden paternalism behind policy or guidelines; deal with the power in hand well and fairly; and also positively face the powers that constrain the author.展开更多
The 21th century is a "quality century". Facing the s evere challenge about quality, all the developed industry countries attach impor tance to the research and education about quality project. With the deep...The 21th century is a "quality century". Facing the s evere challenge about quality, all the developed industry countries attach impor tance to the research and education about quality project. With the deepening of the reform of China and it’s joining to WTO, many industries and enterprises wi ll be confronted with severe challenge while being offered the opportunity to wa lk up to the world. The arrival of knowledge economy and web time has provided t he space for the innovation on enterprise management. It has also provided new m ethod and model for enterprise management, that is online management based on th e internet. The online management use an enterprise model including the goal of the enterprise and the scheme to carry out it to represent the whole operational of all the work. The online management is constructed on the integration of exp ert system, database, software and other technical models. How to scientifically manage the entire system of product, precisely master the condition of quantity and quality and analyze the rules of the change of produc t quality in order to carry out the overall control of quality, guarantee the go od condition of product as well as improve product quality and prolong it’s se rvice life was discussed in this thesis. Based on the above research the thesis also discussed how to develop the study on product quality information and const ruct it’s decision making support system. The concrete measures to improve peopl e’s concept of quality are also raised. Based on the type analysis, scientific management of product quality information should start from dynamic information of quality, instruction information as we ll as the information about the use, maintain, management and conservation of pr oduct, and induce them and further propose a design scheme of feedback system on product quality information, and then set up the blueprint of the information s ystem of product quality. This thesis included 7 chapters:1.the type of quality information;2.the content of quality information;3.the construction of the se nsitive web for transfering information, and collecting and transfering quality information rapidly and effectively;4.the way and procedure to transfer informa tion;5.the construction of quality information library for all phases; 6.the d isposal of quality information;7.the decision making support system of the mana gement of quality information;8.attach importance to three key factors on impro ving quality concept.展开更多
BACKGROUND Alzheimer’s disease(AD)is a serious disease causing human dementia and social problems.The quality of life and prognosis of AD patients have attracted much attention.The role of chronic immune inflammation...BACKGROUND Alzheimer’s disease(AD)is a serious disease causing human dementia and social problems.The quality of life and prognosis of AD patients have attracted much attention.The role of chronic immune inflammation in the pathogenesis of AD is becoming more and more important.AIM To study the relationship among cognitive dysfunction,abnormal cellular immune function,neuroimaging results and poor prognostic factors in patients.METHODS A retrospective analysis of 62 hospitalized patients clinical diagnosed with AD who were admitted to our hospital from November 2015 to November 2020.Collect cognitive dysfunction performance characteristics,laboratory test data and neuroimaging data from medical records within 24 h of admission,including Mini Mental State Examination Scale score,drawing clock test,blood T lymphocyte subsets,and neutrophils and lymphocyte ratio(NLR),disturbance of consciousness,extrapyramidal symptoms,electroencephalogram(EEG)and head nucleus magnetic spectroscopy(MRS)and other data.Multivariate logistic regression analysis was used to determine independent prog-nostic factors.the modified Rankin scale(mRS)was used to determine whether the prognosis was good.The correlation between drug treatment and prognostic mRS score was tested by the rank sum test.RESULTS Univariate analysis showed that abnormal cellular immune function,extrapyramidal symptoms,obvious disturbance of consciousness,abnormal EEG,increased NLR,abnormal MRS,and complicated pneumonia were related to the poor prognosis of AD patients.Multivariate logistic regression analysis showed that the decrease in the proportion of T lym-phocytes in the blood after abnormal cellular immune function(odd ratio:2.078,95%confidence interval:1.156-3.986,P<0.05)was an independent risk factor for predicting the poor prognosis of AD.The number of days of donepezil treatment to improve cognitive function was negatively correlated with mRS score(r=0.578,P<0.05).CONCLUSION The decrease in the proportion of T lymphocytes may have predictive value for the poor prognosis of AD.It is recommended that the proportion of T lymphocytes<55%is used as the cut-off threshold for predicting the poor prog-nosis of AD.The early and continuous drug treatment is associated with a good prognosis.展开更多
Milk fat globule membrane(MFGM),which contains abundant glycoproteins and phospholipids,exerts beneficial effects on intestinal health and immunomodulation.The aim of this study was to evaluate the protective effects ...Milk fat globule membrane(MFGM),which contains abundant glycoproteins and phospholipids,exerts beneficial effects on intestinal health and immunomodulation.The aim of this study was to evaluate the protective effects and possible underlying mechanisms of MFGM on cow’s milk allergy(CMA)in aβ-lactoglobulin(BLG)-induced allergic mice model.MFGM was supplemented to allergic mice induced by BLG at a dose of 400 mg/kg body weight.Results demonstrated that MFGM alleviated food allergy symptoms,decreased serum levels of lipopolysaccharide,pro-inflammatory cytokines,immunoglobulin(Ig)E,Ig G1,and Th2 cytokines including interleukin(IL)-4,while increased serum levels of Th1 cytokines including interferon-γand regulatory T cells(Tregs)cytokines including IL-10 and transforming growth factor-β.MFGM modulated gut microbiota and enhanced intestinal barrier of BLG-allergic mice,as evidenced by decreased relative abundance of Desulfobacterota,Rikenellaceae,Lachnospiraceae,and Desulfovibrionaceae,while increased relative abundance of Bacteroidetes,Lactobacillaceae and Muribaculaceae,and enhanced expressions of tight junction proteins including Occludin,Claudin-1 and zonula occludens-1.Furthermore,MFGM increased fecal short-chain fatty acids(SCFAs)levels,which elevated G protein-coupled receptor(GPR)43 and GPR109A expressions.The increased expressions of GPR43 and GPR109A induced CD103+dendritic cells accumulation and promoted Tregs differentiation in mesenteric lymph node to a certain extent.In summary,MFGM alleviated CMA in a BLG-induced allergic mice model through enhancing intestinal barrier and promoting Tregs differentiation,which may be correlated with SCFAs-mediated activation of GPRs.These findings suggest that MFGM may be useful as a promising functional ingredient against CMA.展开更多
针对目前ON-OFF控制策略在PLZT驱动器光致应变位移的闭环伺服控制系统中的缺点,提出了一种基于T-S模糊模型的PLZT驱动器应变位移的动态模型及预测控制方法。首先,建立了PLZT驱动器光致应变位移的T-S模糊模型,该模型利用基于减法聚类的模...针对目前ON-OFF控制策略在PLZT驱动器光致应变位移的闭环伺服控制系统中的缺点,提出了一种基于T-S模糊模型的PLZT驱动器应变位移的动态模型及预测控制方法。首先,建立了PLZT驱动器光致应变位移的T-S模糊模型,该模型利用基于减法聚类的模糊C均值聚类算法进行前件辨识,并利用奇异值分解(singular value decomposition, SVD)算法进行后件辨识,所建立模型的有效性通过拟合度仿真加以验证。随后,在所建立的T-S模糊模型的基础上结合预测控制方法对PLZT驱动器的光致应变位移进行闭环控制,并对该算法进行仿真验证。仿真结果显示,在PLZT驱动器微位移的控制中,该文控制算法减小了基于ON-OFF控制策略下的抖振,且具有更好的控制效果。展开更多
文摘Objective: This study aimed to demonstrate and promote the skill of critical emancipatory reflection through reflecting on a nursing practice-based ethical issue about nurses' paternalistic decision-making for patients. Meanwhile, critical awareness will be developed and the underlying issues of paternalism in nursing decision-making will be analyzed. Then, by applying the procedure, improvement in nursing decision-making practice will be expected.Methods: Taylor's model of emancipatory reflection with four steps, including construction, deconstruction, confrontation, and reconstruction, is utilized to guide the author's reflection.Results: Guided by the socialization theory, the author's personal and professional socialization is seen to be associated with the formation of the value of paternalism. The theory of reflexivity is applied to unearth the related issues, including deeper personal value,work environment, as well as historical and cultural contexts. Moreover, the power derived from policy, work relationship, and nursing administration, which could induce paternalism in the author's nursing decision-making practice, was critically debated using the hegemony theory. Finally, new insights into paternalism will be achieved, which enable change in terms of how to facilitate patients' autonomous decision-making.Conclusions: The process of refection makes it clear that respecting patients' right and performing patient-centered caring are the bases to change the paternalism existing in the nursing decision-making practice currently. The reconstruction step assists the author in terms of how to value the patients' autonomy and balance patients' safety and choice, rather than being overprotective; carry out risk assessment, and search for strong evidence to counterbalance the positive and negative aspects of risk-taking; communicate with patients appropriately in a manner that they can comprehend; spend more time to explore patients' preference and choice; make every effort to elevate the patients' decision-making capacity; implement patient-centered care and shared decision-making in nursing practice; consult with other colleagues and obtain the required support when limitations or challenges exist; try to justify and avoid hidden paternalism behind policy or guidelines; deal with the power in hand well and fairly; and also positively face the powers that constrain the author.
文摘The 21th century is a "quality century". Facing the s evere challenge about quality, all the developed industry countries attach impor tance to the research and education about quality project. With the deepening of the reform of China and it’s joining to WTO, many industries and enterprises wi ll be confronted with severe challenge while being offered the opportunity to wa lk up to the world. The arrival of knowledge economy and web time has provided t he space for the innovation on enterprise management. It has also provided new m ethod and model for enterprise management, that is online management based on th e internet. The online management use an enterprise model including the goal of the enterprise and the scheme to carry out it to represent the whole operational of all the work. The online management is constructed on the integration of exp ert system, database, software and other technical models. How to scientifically manage the entire system of product, precisely master the condition of quantity and quality and analyze the rules of the change of produc t quality in order to carry out the overall control of quality, guarantee the go od condition of product as well as improve product quality and prolong it’s se rvice life was discussed in this thesis. Based on the above research the thesis also discussed how to develop the study on product quality information and const ruct it’s decision making support system. The concrete measures to improve peopl e’s concept of quality are also raised. Based on the type analysis, scientific management of product quality information should start from dynamic information of quality, instruction information as we ll as the information about the use, maintain, management and conservation of pr oduct, and induce them and further propose a design scheme of feedback system on product quality information, and then set up the blueprint of the information s ystem of product quality. This thesis included 7 chapters:1.the type of quality information;2.the content of quality information;3.the construction of the se nsitive web for transfering information, and collecting and transfering quality information rapidly and effectively;4.the way and procedure to transfer informa tion;5.the construction of quality information library for all phases; 6.the d isposal of quality information;7.the decision making support system of the mana gement of quality information;8.attach importance to three key factors on impro ving quality concept.
基金Supported by the National Natural Science Foundation of China,No.3206080019 and No.32060182Science and Technology Support Plan of Guizhou Province in China,No.[2020]4Y129Qiannan Prefecture Science and Technology Plan Project,No.[2022]01.
文摘BACKGROUND Alzheimer’s disease(AD)is a serious disease causing human dementia and social problems.The quality of life and prognosis of AD patients have attracted much attention.The role of chronic immune inflammation in the pathogenesis of AD is becoming more and more important.AIM To study the relationship among cognitive dysfunction,abnormal cellular immune function,neuroimaging results and poor prognostic factors in patients.METHODS A retrospective analysis of 62 hospitalized patients clinical diagnosed with AD who were admitted to our hospital from November 2015 to November 2020.Collect cognitive dysfunction performance characteristics,laboratory test data and neuroimaging data from medical records within 24 h of admission,including Mini Mental State Examination Scale score,drawing clock test,blood T lymphocyte subsets,and neutrophils and lymphocyte ratio(NLR),disturbance of consciousness,extrapyramidal symptoms,electroencephalogram(EEG)and head nucleus magnetic spectroscopy(MRS)and other data.Multivariate logistic regression analysis was used to determine independent prog-nostic factors.the modified Rankin scale(mRS)was used to determine whether the prognosis was good.The correlation between drug treatment and prognostic mRS score was tested by the rank sum test.RESULTS Univariate analysis showed that abnormal cellular immune function,extrapyramidal symptoms,obvious disturbance of consciousness,abnormal EEG,increased NLR,abnormal MRS,and complicated pneumonia were related to the poor prognosis of AD patients.Multivariate logistic regression analysis showed that the decrease in the proportion of T lym-phocytes in the blood after abnormal cellular immune function(odd ratio:2.078,95%confidence interval:1.156-3.986,P<0.05)was an independent risk factor for predicting the poor prognosis of AD.The number of days of donepezil treatment to improve cognitive function was negatively correlated with mRS score(r=0.578,P<0.05).CONCLUSION The decrease in the proportion of T lymphocytes may have predictive value for the poor prognosis of AD.It is recommended that the proportion of T lymphocytes<55%is used as the cut-off threshold for predicting the poor prog-nosis of AD.The early and continuous drug treatment is associated with a good prognosis.
基金supported by the National Key Research and Development Program of China(Grant No.2019YFC1605000)National Natural Science Foundation of China(Grant No.31871806)the Beijing Livestock Industry Innovation Team(BAIC05-2023)。
文摘Milk fat globule membrane(MFGM),which contains abundant glycoproteins and phospholipids,exerts beneficial effects on intestinal health and immunomodulation.The aim of this study was to evaluate the protective effects and possible underlying mechanisms of MFGM on cow’s milk allergy(CMA)in aβ-lactoglobulin(BLG)-induced allergic mice model.MFGM was supplemented to allergic mice induced by BLG at a dose of 400 mg/kg body weight.Results demonstrated that MFGM alleviated food allergy symptoms,decreased serum levels of lipopolysaccharide,pro-inflammatory cytokines,immunoglobulin(Ig)E,Ig G1,and Th2 cytokines including interleukin(IL)-4,while increased serum levels of Th1 cytokines including interferon-γand regulatory T cells(Tregs)cytokines including IL-10 and transforming growth factor-β.MFGM modulated gut microbiota and enhanced intestinal barrier of BLG-allergic mice,as evidenced by decreased relative abundance of Desulfobacterota,Rikenellaceae,Lachnospiraceae,and Desulfovibrionaceae,while increased relative abundance of Bacteroidetes,Lactobacillaceae and Muribaculaceae,and enhanced expressions of tight junction proteins including Occludin,Claudin-1 and zonula occludens-1.Furthermore,MFGM increased fecal short-chain fatty acids(SCFAs)levels,which elevated G protein-coupled receptor(GPR)43 and GPR109A expressions.The increased expressions of GPR43 and GPR109A induced CD103+dendritic cells accumulation and promoted Tregs differentiation in mesenteric lymph node to a certain extent.In summary,MFGM alleviated CMA in a BLG-induced allergic mice model through enhancing intestinal barrier and promoting Tregs differentiation,which may be correlated with SCFAs-mediated activation of GPRs.These findings suggest that MFGM may be useful as a promising functional ingredient against CMA.
文摘针对目前ON-OFF控制策略在PLZT驱动器光致应变位移的闭环伺服控制系统中的缺点,提出了一种基于T-S模糊模型的PLZT驱动器应变位移的动态模型及预测控制方法。首先,建立了PLZT驱动器光致应变位移的T-S模糊模型,该模型利用基于减法聚类的模糊C均值聚类算法进行前件辨识,并利用奇异值分解(singular value decomposition, SVD)算法进行后件辨识,所建立模型的有效性通过拟合度仿真加以验证。随后,在所建立的T-S模糊模型的基础上结合预测控制方法对PLZT驱动器的光致应变位移进行闭环控制,并对该算法进行仿真验证。仿真结果显示,在PLZT驱动器微位移的控制中,该文控制算法减小了基于ON-OFF控制策略下的抖振,且具有更好的控制效果。
