护理干预对骨折患者术后焦虑及疼痛的影响分析

目的探讨护理干预应用在骨折患者中对术后焦虑和疼痛的影响及应用效果。方法选择我院手术治疗的骨折患者152例作为研究对象,采取随机数字表法分为观察组和对照组,每组各76例,对照组给予骨科常规护理,观察组采用综合护理干预措施,观察两组护理效果。结果观察组患者护理后焦虑和抑郁情绪改善的幅度优于对照组,组间对比经统计学分析,差异具有统计学意义(P<0.05)。观察组患者术后疼痛评分、护理满意度、住院时间均短于对照组,经统计学分析比较,差异具有统计学意义(P<0.05)。结论采用综合护理干预措施应用在骨折患者中可以减轻患者焦虑和抑郁等负性情绪,减轻术后疼痛程度,提高临床护理满意度,缩短住院时间,值得在临床上大力推广使用。     

围术期综合护理在鼻内镜手术治疗慢性鼻窦炎伴鼻息肉中的应用分析

目的:观察围术期综合护理在鼻内镜手术治疗慢性鼻窦炎伴鼻息肉中的效果.方法:选取2021年1月～2022年5月在河南省中医院耳鼻喉科就诊且在鼻内镜下进行手术的94例慢性鼻窦炎伴鼻息肉患者作为研究对象,按照随机数字表法随机分为对照组和观察组,各47例.对照组给予常规护理,观察组给予围术期综合护理.分别观察患者抑郁自评量表(Self-rating depression scale,SDS),焦虑自评量表(Self-rating anxiety scale,SAS).采用数字分级评分表(Numeric rating scales,NRS)评价患者的疼痛程度.通过满意度问卷表评价患者的护理满意度.比较两组临床疗效及术后并发症发生情况.结果:观察组术后总有效率明显高于对照组(P<0.05).观察组SDS和SAS积分较对照组明显降低(P<0.05).术后8 h、16 h、24 h、72 h,疼痛程度为重度和中度的观察组患者明显少于对照组(P<0.05),疼痛程度为轻度和无的患者明显多于对照组(P<0.05).观察组护理满意率明显高于对照组(P<0.05).观察组术后并发明显低于对照组(P<0.05).结论:围术期综合护理可提高慢性鼻窦炎伴鼻息肉患者术后的康复效果,减轻患者的抑郁焦虑情绪,提高患者满意度.     

多模式镇痛护理对跟骨骨折患者术后疼痛控制及康复锻炼依从性的影响

目的:观察多模式镇痛护理在跟骨骨折患者中的应用效果.方法:选择2018年11月至2019年11月我院接受手术的80例跟骨骨折患者,随机分为观察组(n=42)和对照组(n=38),对照组患者接受常规镇痛护理,观察组在此基础上接受多模式镇痛护理.持续干预4 w后观察患者术后下床时间、住院时间、夜间疼痛次数及康复锻炼依从性、疼痛程度的变化.结果:观察组术后下床时间及住院时间短于对照组(P<0.05),夜间疼痛次数少于对照组(P<0.05);干预后两组康复锻炼依从性及疼痛程度均显著改善(P<0.05),且观察组患者改善程度优于对照组(P<0.05).结论:多模式镇痛护理不仅能提高患者康复锻炼依从性,减轻术后疼痛,缩短住院时间,对于促进患者恢复具有重要意义     

循证护理对胆囊结石腹腔镜手术患者术后康复及疼痛的影响

目的:探讨胆囊结石行腹腔镜手术患者实施循证护理的临床价值。方法:选取2018年2月至2019年1月期间在本院接受腹腔镜手术治疗的胆囊结石患者104例,按照随机原则分为2组,对照组(n=52)给予常规护理,观察组(n=52)在常规护理的同时实施循证护理,比较两组住院时间及住院期间并发症发生情况,护理前(术后当天)及护理后(术后1周)采用视觉模拟评分量表(Visual analogue scale,VAS)评估患者的疼痛情况。结果:护理后观察组VAS评分明显低于对照组,疼痛持续时间明显缩短(P0.05);观察组并发症发生率为3.8%,明显低于对照组(17.3%)(P0.05);观察组住院时间明显短于对照组(P0.05)。结论:针对胆囊结石腹腔镜手术治疗患者实施循证护理,有助于减轻患者疼痛程度、减少并发症发生,对促进患者身体康复有重要价值。     

分析综合护理干预对老年髋部骨折术后下肢深静脉血栓形成的影响

目的 探讨综合护理干预对老年髋部骨折术后下肢深静脉血栓形成的影响.方法 选取2012年～2014年于我院就诊的老年髋部骨折患者共40例,将患者按照入院编号,随机分为两组,观察组和对照组各20例.给予对照组患者常规护理手段与药物治疗;观察组在对照组的基础上,增加综合护理干预.对比两组的DVT发生率、下肢肿胀疼痛发生率以及住院时间.结果术后观察组DVT发生率、下肢肿胀疼痛发生率以及住院时间明显低于对照组,且差异具有统计学意义(P＜0.05).结论 在常规护理手段与药物治疗的基础上,对老年髋部骨折患者行综合护理干预,可以有效的防止患者术后下肢深静脉血栓的形成,缩短住院时间.     

非药物性护理干预对小儿先天性心脏病术后疼痛的影响

目的 了解非药物性护理干预在小儿先天性心脏病术后疼痛治疗中的临床效果.方法 将98例在我院进行先天性心脏病外科手术的患儿随机分为两组.试验组患儿在术后0-12h、12-24h、24-36h内采用针对手术及术后疼痛的非药物性护理干预,对照组采用常规护理.依据行为疼痛评估表(FLACC)对两组患儿的疼痛程度进行评估对比研究.结果 术后36h内,试验组对疼痛的感受程度明显低于对照组,差异有统计学意义(P<0.05).且各时间段FLACC评分显著下降(P<0.05).结论 对先天性心脏病患儿术后实施正确疼痛评估及有针对性的非药物性护理干预,术后的疼痛评分显著下降,减轻了患儿的疼痛程度.     

综合性护理在重症颅脑损伤患者术后护理中的应用

目的：探讨综合性护理在重症颅脑损伤患者术后护理中的应用价值。方法：将60例重症颅脑损伤的患者用随机数字表法分为观察组和对照组,对照组围手术期采用常规护理,观察组术后采用综合护理,比较两组患者的并发症、生命体征、住院时间以及护理满意度。结果：观察组护理后的SOFA、APACHEII评分低于对照组,GCS评分高于对照组,有统计学意义(P<0.05)。观察组的并发症少于对照组,焦虑评分低于对照组,入住ICU、住院时间短于对照组,护理满意度高于对照组,有统计学意义(P<0.05)。结论：综合性护理能减少重症颅脑手术患者术后并发症,改善预后。     

围术期护理对骨关节置换术后患者感染及并发症率的影响分析

目的:探讨围术期护理对骨关节置换术后患者感染及并发症率的影响分析.方法:选取2017年1月-2020年12月本院就诊的185例骨关节置换术患者开展研究,其中2017年1月～2019年6月就诊的93例患者作为对照组(给予常规护理),2019年6月～2020年12月的92例患者作为观察组(围手术期综合护理),比较2组感染发生率、并发症发生率及护理满意度,测定术前、术后炎症因子、应激反应、疼痛程度、膝关节功能、生活质量.结果:观察组感染发生率6.52％、并发症发生率5.43％,低于对照组16.13％,13.97％(P<0.05);观察组护理满意度高于对照组、手术各项指标优于对照组(P<0.05);观察组术后24h、48h和72h疼痛程度评分低于对照组,术后6个月观察组膝关节功能及生活质量评分高于对照组(P<0.05);术后3d观察组IL-6、CRP、COR水平低于对照组(P<0.05).结论:骨关节置换术后患者给予围术期综合护理路径可降低术后感染,改善炎症因子水平,减轻疼痛感、改善其膝关节功能及生活质量.     

护理专案对膝关节置换术后患者功能锻炼的影响

目的:分析护理专案对膝关节置换术后患者功能锻炼的影响.方法:将2020年1月至2022年1月期间我院收治的116例行膝关节置换术患者纳入本研究,采用随机数表法将其分为两组,每组58例.对照组患者给予常规护理干预,观察组患者给予护理专案干预,两组均干预4 w.干预完成后统计两组的首次下床时间、实现屈膝90°时间、实现直腿抬高时间、住院天数和关节僵硬、切口感染、下肢深静脉血栓(Deep venous thrombosis,DVT)、便秘的发生情况,并于干预前1 d和干预完成后1 d使用视觉模拟疼痛评分(Visual analogue scale,VAS)评估疼痛情况,使用美国特种外科医院评分(Hospital for special surgery,HSS)评估膝关节情况,使用三维步态分析系统分析步态情况.结果:观察组患者的首次下床时间、实现屈膝90°时间、实现直腿抬高时间、住院天数均短于对照组(P<0.05);干预1 w、2 w、4 w后观察组的VAS评分均低于对照组,而HSS评分、步幅、步速均高于对照组(P<0.05);干预后观察组的术后并发症总发生率明显低于对照组(P<0.05).结论:膝关节置换术后患者采用护理专案干预能够在一定程度上改善疼痛、膝关节和步态情况,降低并发症的发生率,促进术后康复.     

护理干预对胰十二指肠切除术后患者生理及心理健康的影响

目的:探讨护理干预对胰十二指肠切除术(PD)术后患者生理及心理健康的影响。方法:选取于我院行PD手术的80例患者为研究对象,按随机数字表法将患者分为观察组和对照组,每组40例,术后对照组患者给予常规外科护理干预,观察组患者给予综合护理干预处理,观察比较两组患者干预后胃肠道功能恢复情况、干预前后心理状况、生活质量健康量表(SF-36)评分、焦虑和抑郁自评量表评分,干预后护理满意度及依从性,同时记录术后并发症发生情况。结果:干预后观察组患者肠鸣音恢复时间、肛门排气时间、排便时间及住院时间显著短于对照组(t=-5.595,-7.641,-3.306,-2.797;P0.05)。干预后观察组患者SAS和SDS评分显著低于对照组(t=-9.323,-5.831;P0.05)。干预后观察组患者SF-36各维度评分均显著高于对照组(t=3.078,5.848,2.969,4.032,4.103,2.164,3.871,4.524;P0.05)。观察组护理满意率和护理依从性均显著高于对照组,差异具有统计学意义(χ~2=4.804,4.242;P0.05)。观察组患者术后并发症发生率显著低于对照组,差异具有统计学意义(χ~2=4.132,P0.05)。结论:通过对PD术后患者进行综合护理干预能够有效改善患者心理健康状况,提高患者治疗依从性及护理满意度,同时有利于减少住院时间,降低术后并发症,具有良好临床应用价值。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

Hypo- und Hypermagnesämie aus kardiologischer Sicht

Zusammenfassung Eine Reihe pathologischer Zustände bedingen Magnesiummangel. Zustände mit Hypermagnesämie sind ebenfalls bekannt, doch wesentlich seltener. Für den Kardiologen beachtenswert ist, daß unter Therapie mit bestimmten Diuretica bei Herzinsuffizienz, bei Herzinfarkt, Kardiomyopathie, Digitalisintoxikation und bestimmten Herzrhythmusstörungen Hypomagnesämie beobachtet wurde. Leider kann in der klinischen Routine nur ein extracelluläres Magnesiumdefizit durch Serumbestimmungen gemessen werden; über Magnesiummangel einzelner Organe kann nichts ausgesagt werden. Hinweise für Magnesiummangel geben aber neben der Messung des Serumspiegels Anamnese, klinischer Befund, bestimmte EKG-Veränderungen wie auch evtl. Hypokalämie, ein Zustand, bei dem sich oft — besonders bei Aldosteronismus — parallele Veränderungen zeigten.Tierexperimente deuten darauf hin, daß infarktähnliche Läsionen unter Magnesiummangel entstehen, doch ob Herzinfarkt beim Menschen durch Magnesiummangel ausgelöst werden kann, ist noch ungeklärt. In Leichenherzen zeigte sich im Infarktgebiet neben Calciumakkumulation signifikanter Magnesiumverlust, wobei unklar blieb, ob sich Ursache oder Folge des Infarktes widerspiegelten. Falls ein ursächlicher Zusammenhang besteht, ist er im Myokardstoffwechsel selbst zu suchen, wie bei der Alkoholkardiomyopathie, wo myokardialer Magnesiummangel zumindest als pathogenetischer Teilfaktor anerkannt wird. Andererseits versucht man aber auch Beziehungen zwischen Atherosklerose, Blutgerinnung und Hypomagnesämie herzustellen, in der Meinung, daß Magnesiummangel auch über den coronaren Pathomechanismus des Herzinfarktes wirken könnte. Sicher scheint, daß gewisse EKG-Veränderungen und Herzrhythmusstörungen durch einen irritierten Magnesiumhaushalt bedingt sein können, da sie bei Gabe bzw. Entzug von Magnesium verschwinden. Daß Magnesiummangel die Glykosidtoleranz verringert, wird tierexperimentell bestätigt. Unter Hypomagnesämie bewirkt Acetylstrophanthidin eher und länger Rhythmusstörungen als ohne, außerdem lassen diese sich durch Magnesiumgaben eliminieren. Da in gewissen Fällen spontane und digitalisinduzierte Herzrythmusstörungen durch Magnesiuminjektionen beseitigt wurden, scheint Magnesium als Therapeuticum angebracht. Einsatz verschiedener Magnesiumsalze bei Angina pectoris, degenerativen Herzerkrankungen und Herzinsuffizienz ohne geprüften und offensichtlich gestörten Magnesiumhaushalt ist fragwürdig, weil keine eindeutigen klinischen Erfolgsbeweise vorliegen. Immerhin mag es aber larvierte, durch Serumbestimmungen nicht erfaßbare Mangelzustände geben. Allgemein erscheint es aus kardiologischer Sicht ratsam, den Magnesiumhaushalt zu überwachen und in entsprechenden Fällen auszugleichen, um möglichen Myokardläsionen oder fatalen Herzrhythmusstörungen entgegenzuwirken.     

Environmental risk factors and their role in the management of atopic dermatitis

Introduction: The etiology of atopic dermatitis (AD) is multifactorial with interaction between genetics, immune and environmental factors.

Areas covered: We review the role of prenatal exposures, irritants and pruritogens, pathogens, climate factors, including temperature, humidity, ultraviolet radiation, outdoor and indoor air pollutants, tobacco smoke exposure, water hardness, urban vs. rural living, diet, breastfeeding, probiotics and prebiotics on AD.

Expert commentary: The increased global prevalence of AD cannot be attributed to genetics alone, suggesting that evolving environmental exposures may trigger and/or flare disease in predisposed individuals. There is a complex interplay between different environmental factors, including individual use of personal care products and exposure to climate, pollution, food and other exogenous factors. Understanding these complex risk factors is crucial to developing targeted interventions to prevent the disease in millions. Moreover, patients require counseling on optimal regimens for minimization of exposure to irritants and pruritogens and other harmful exposures.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

HLA genes in Amerindians from Mexico San Vicente Tancuayalab Teenek/Huastecos

Huastecos or Teenek Amerindians are presently living at North East Mexico (San Luis Potosi State). They have probably one of the most ancient culture of Mexico and Central America together with Mayas and Olmec groups with which also show close relationships. Proximity to Atlantic Ocean/Mexican Gulf originated that Spaniards had very early contact with them at about 1519 CE or before. In the present paper we have aimed to study HLA gene profile which may be useful for HLA and disease epidemiology and transplant programs in Teeneks. HLA-DRB1*04:07, -DRB1*14:06 and -DRB1*04:11 have been found in high frequency like in other Amerindian groups. High frequency typical Amerindians HLA extended haplotypes have been found, such as A*02-B*35-DRB1*04:07-DQB1*03:02; A*68-B*39-DRB1*04:07-DQB1*03:02 and A*02-B*39-DRB1*04:07-DQB1*03:02; also new haplotypes have been described, like A*02-B*52-DRB1*04:11-DQB1*03:02, A*68-B*35-DRB1*14:02-DQB1*03:01 and A*68-B*40-DRB1*16:02-DQB1*03:01. Genetic proximity is observed not only to linguistically close Mayans, but also to Mazatecans, Mixtecans and Zapotecans, who speak an altogether different languages; it shows once more that genes and languages do not correlate. This population was greatly diminished after European contact between 1500 and 1600 years CE; in fact, North and South America First Inhabitants population was brought from 80 down to 8 million people because of diseases (i.e.: measles, smallpox or influenza), slavery and war.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.