针对重症颅脑损伤患者开展临床护理路径的效果分析

目的探讨重症颅脑损伤患者实施临床护理路径的临床疗效。方法选取我院2011年3月至2013年5月收治的重症颅脑损伤患者98例,随机将患者分为对照组及观察组,每组49例,对照组采用传统常规护理模式,观察组实施临床护理路径,比较两组患者的临床疗效。结果观察组的救治时间、住院时间、住院费用、并发症发生率及满意度等均优于对照组,比较差异有统计学意(P<0.05)。结论重症颅脑损伤患者实施临床护理路径,可有效提高临床疗效、减少住院时间、住院费用、并发症发生率,直接提高了患者的生活质量,值得临床上推广应用。     

临床护理路径在ICU呼吸衰竭中的应用效果

目的 分析临床护理路径在ICU呼吸衰竭患者中的应用效果.方法 随机选取2013年2月～2014年2月本院ICU收治的104例呼吸衰竭患者,按照不同护理方法,分为观察组与对照组,每组52例,对照组采取常规护理,观察组采用临床护理路径,比较两组的护理效果.结果 观察组ICU入住时间、呼吸机使用时间均短于对照组,住院费用明显少于对照组,差异有统计学意义（P＜0.05）.观察组并发症发生率为9.62％,明显低于对照组的38.46％,差异有统计学意义（P＜0.05）.观察组护理满意度为96.15％,明显高于对照组的71.15％,差异有统计学意义（P＜0.05）.结论 临床护理路径应用于ICU呼吸衰竭患者可降低并发症发生率,有利于促进患者的病情恢复,缩短住院时间,提高患者满意度.     

整体责任护理在重症肺炎患者中应用效果

目的探讨整体责任护理在重症肺炎患者中应用效果。方法分别选取2014年1月~2014年12月间我院收治重症肺炎患者38例作为常规组和研究组,分别采用常规护理和整体责任护理,比较两组患者护理并发症、呼吸机使用时间、每日护理时间、住院时间及患者家属满意度。结果研究组护理并发症低于常规组,患者家属满意度高于常规组(5.26%vs 34.21%,94.74%vs 63.16%,P0.05)。研究组患者呼吸机使用时间、每日护理时间及住院时间均短于常规组,两组间各值比较差异有统计学意义(P0.05)。结论整体责任护理应用于重症肺炎患者可降低护理并发症发生,缩短患者呼吸机使用时间、护理时间和住院时间,提高患者家属满意度,具有较高应用价值。     

乳腺癌手术患者应用临床护理路径的疗效分析

目的探讨并分析乳腺癌手术患者应用临床护理路径护理的疗效。方法选取我院2015年1月~12月接收的乳腺癌行改良根治手术治疗的女性患者60例作为本次研究对象,随机分成对照组和观察组,对照组给予常规护理,观察组给予临床护理路径护理,观察并对比2组护理效果。结果观察组平均住院时间显著低于对照组,平均住院费用显著少于对照组,并发症发生率显著低于对照组,护理满意度显著高于对照组,差异均有统计学意义(P<0.05)。结论对乳腺癌手术患者采用临床护理路径护理,可有效提高患者治疗效率,缩短住院时间,节省住院费用,降低并发症发生率,提高护理服务质量和患者满意度,值得临床推广应用。     

临床路径护理模式在急性阑尾炎手术中的应用

目的探讨临床路径护理模式对急性阑尾炎(AA)手术疗效、护理质量及满意度的影响。方法把140例符合入选标准的AA手术患者按护理方案不同分为对照组70例和观察组70例。对照组给予常规护理,观察组给予临床路径护理。比较两组患者住院时间、住院费用、手术时间、切口愈合良好率、并发症发生率、护理质量评分及满意度。结果与对照组相比,观察组住院时间显著缩短,住院费用显著减少,差异均有统计学意义。观察组手术时间显著短于对照组,切口愈合良好率显著高于对照组,并发症发生率显著低于对照组,差异均有统计学意义。观察组护理人员形象与职业素养评分、术中护理综合评分及满意度均明显高于对照组,差异均有统计学意义。结论临床路径护理模式在AA手术中取得较好效果,可以缩短患者手术时间、住院时间,减少住院费用,提高切口愈合良好率,降低并发症发生率,提高护理满意度。     

骨科护理临床路径在治疗踝关节骨折患者中的应用

目的探讨骨科护理临床路径在踝关节骨折治疗的效果。方法收集在我院治疗的106例踝关节骨折的患者,随机分为观察组和对照组各53例,对照组予以常规护理,观察组予以骨科临床护理路径护理,护理干预周期为6个月,比较护理后两组患者的术后并发症、住院费用、住院时间、对护理的满意度、健康教育知识掌握情况等指标。结果骨科临床护理路径护理组患者的术后并发症、住院费用、住院时间、对护理的满意度、健康教育知识掌握情况等显著优于常规护理组。结论在踝关节骨折患者实施骨科临床路径护理,能有效减少患者术后并发症的发生,降低住院费用,缩短住院时间,值得在临床上推广使用。     

集束化护理策略在重症颅脑损伤置鼻肠管患者中的应用

目的 探讨集束化护理策略在重症颅脑损伤置鼻肠管患者中的应用效果.方法 将2014年1月至12月于本科住院的置鼻肠管患者87例随机分为对照组(n=43)和实验组(n=44).实验组在常规护理的基础上给予集束化护理,对照组仅给予常规护理.比较2组意外堵管、返流误吸、管饲相关性腹泻等并发症发生率、住院天数及住院费用.结果 实验组各种并发症发生率低于对照组,住院天数及住院费用少于对照组(P＜0.05),差异有统计学意义.结论 对重症颅脑损伤患者实施集束化护理可降低置鼻肠管并发症,促进患者胃肠道功能恢复,提高患者生活质量,减少患者住院天数,降低住院费用,可应用于临床.     

6S管理模式在ICU重症患者中的应用及效果

目的探讨6S管理模式在ICU重症患者中的应用及效果。方法将本院ICU2011年7月～2012年12月收治的100例重症患者随机分为两组．对照组患者给予常规护理,观察组患者则接受6S管理模式指导下的护理措施．比较两组患者并发症的发生率、住院时间、住院费用和患者家属对护理的满意度。结果观察组患者并发症发生率为2．00％,明显少于对照组患者的12．00％（P〈0．05）,观察组患者平均住院时间和平均住院费用明显少,低于对照组患者（P〈0．05）,观察组患者家属对护理的满意度明显高于对照组患者（P〈0．05）。结论6S管理模式指导下的护理干预措施能够明显减少并发症的发生,缩短平均住院时间,减少平均住院费用,还能提高患者对护理的满意度。     

手术室护理路径在腹腔镜手术护理中的应用研究

目的探讨应用围术期临床护理路径对腹腔镜手术患者的影响效果。方法选取2011年4月至2013年4月腹腔镜手术患者100例,随机分为观察组和对照组各50例,对照组给予围手术期常规护理,观察组在围手术期常规护理的基础上给予临床护理路径管理。观察对比两组的术后并发症发生率、手术时间、住院时间、住院费用及患者的满意度。结果观察组术后并发症的发病率明显低于对照组,手术时间、住院时间和住院费用明显低于对照组,患者的满意度明显高于对照组,具有显著性差异P<0.05。结论临床护理路径是一种有效的护理方法,在手术室护理中具有重要参考价值。     

临床护理路径对子宫肌瘤患者的影响

目的：比较临床护理路径和常规护理对子宫肌瘤患者的影响。方法选取本院收治的52例子宫肌瘤患者,均采用手术治疗,将患者均分为对照组和观察组,观察组给予临床护理路径,对照组给予常规护理。比较两组患者的住院时间、住院费用、健康知识掌握率、并发症发生率及护理满意度。结果观察组的住院时间显著短于对照组,住院费用显著少于对照组,并发症发生率显著低于对照组（P＜0.05）;观察组的健康知识掌握率和护理满意度分别为92.3%、96.2%,均高于对照组的73.1%和80.8%,两组比较,差异有统计学意义（P＜0.05）。结论临床护理路径用于子宫肌瘤患者的效果确切,可缩短住院时间,有效提高护理质量和护理满意度。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.