社区护理干预对老年高血压伴糖尿病患者的影响分析

目的通过探讨社区护理干预对老年高血压伴糖尿病患者的影响,旨在为提高高血压伴糖尿病患者的生活质量并有效控制血糖和血压提供理论依据。方法选择2011年1月至2014年1月我社区确诊的老年高血压伴糖尿病患者120例,随机平均分成研究组和对照组两组,对照组给予患者常规护理干预,研究组给予患者心理护理、健康教育、运动护理、饮食护理等综合社区护理干预,对比护理前后收缩压、舒张压、空腹血糖、餐后2 h血糖及胆固醇的变化情况。结果研究组患者治疗后收缩压为131.38 mm Hg(1mm Hg=0.133 kPa)、舒张压为79.71 mm Hg、空腹血糖为7.01 mmol/L、餐后2 h血糖为10.63 mmol/L、胆固醇为4.38 mmol/L,与治疗前均有显著下降,且与对照组比较P<0.05差异有统计学意义。结论应用社区护理干预给予老年高血压伴糖尿病患者进行综合护理干预对于稳定血糖和血压有着重要的作用。     

老年急性冠脉综合征并糖尿病患者的循证护理干预效果

目的观察老年急性冠脉综合征(ACS)合并2型糖尿病患者循证护理干预的效果。方法 66例ACS合并糖尿病老年患者分为常规护理组34例与循证护理组32例,观察两组的收缩压峰值、血胆固醇、空腹血糖、糖化血红蛋白(HbA1c)水平及随访血糖达标率、再次心梗率、猝死率。结果治疗前空腹血糖、HbA1c、收缩压峰值、血胆固醇水平,随访再次心梗率、猝死率等两组差异均无统计学意义;治疗后循证护理组的空腹血糖、HbA1c、收缩压峰值、血胆固醇水平明显低于常规护理组,血糖达标率高于常规护理组,差异有统计学意义。结论 ACS合并糖尿病老年患者给予针对性循证护理干预后,临床疗效及预后有明显改善。     

综合护理干预对老年高血压合并2型糖尿病患者血压、血糖的影响

目的 探讨综合护理干预对老年高血压合并2型糖尿病患者血压、血糖的影响,以期为临床上选择最佳护理方案提供理论依据.方法 选择60例老年高血压合并糖尿病患者为研究对象,均为2型糖尿病.将患者按数字表法随机分为两组各30例,对照组给予常规的对症护理,观察组在常规护理基础上实施综合性护理干预措施,包括心理护理、饮食护理、运动干预、用药干预、健康教育,比较两组患者干预前、干预后1个月、3个月的收缩压、舒张压及空腹血糖的变化情况,以及两组患者的生活质量改善情况.结果 干预后1个月、3个月,观察组收缩压、舒张压及空腹血糖均较干预前明显降低(均P＜0.05),且较对照组降低更显著(t=2.625、2.369、2.589、2.473、2.711、2.157,均P＜0.05).观察组患者的生活质量改善情况明显优于对照组(P＜0.05).结论 综合护理干预能有助于患者血压和血糖的控制,有利于提高患者的生活质量.     

老年高血压合并糖尿病社区健康管理与护理干预效果评价

目的 分析老年高血压合并糖尿病患者应用社区健康管理与护理干预的效果,评价其应用价值。方法 按照本研究制定目标,选取医院在2022年6月至2022年12月内收治的老年高血压合并糖尿病患者共计80例作为研究对象,患者经纳入标准与排除标准筛选后数字编号,随机分组为对照组与研究组,对照组40例患者接受常规护理干预,研究组40例患者接受综合健康管理及护理干预。对比指标有血压（收缩压、舒张压）、血糖（空腹血糖、餐后血糖）、健康知识掌握程度、患者依从性、生活质量（SF-36生活质量量表）、自我管理能力（应用糖尿病自我管理行为能力DSCS、高血压患者自我管理行为HPSMBRS评价分析）。结果 不同管理护理工作实施后,结果显示：与对照组相比,研究组患者血压、血糖指标控制更好,患者健康知识掌握程度得分、依从性、生活质量评分更高,自我管理能力更强,差异均有统计学意义（P <0.05）。结论 针对老年高血压合并糖尿病患者实施社区综合健康管理,并针对患者具体情况实施护理干预能够有效改善患者血压、血糖指标,提高患者对于疾病的认知程度,提高患者对于护理管理依从性,显著提高生活质量与自我管理能力,应用效果好。     

预见性护理干预对预防首发住院精神分裂症患者伴发代谢综合征的影响

目的 分析预见性护理干预对预防首发住院精神分裂症患者伴发代谢综合征的应用效果。方法 选取本院2019年1月至2020年1月收治的86例首发住院精神分裂症患者开展本次试验研究,将其临床资料进行回顾性分析,分组方式选取随机数字表法,将所有患者均分为对照组和观察组两组,每组43例。给予对照组患者常规护理干预,给予观察组患者预见性护理干预,比较两组患者的护理效果及两组患者的三酰甘油（TG）指标、腰围指标、舒张压（DBP）指标、收缩压（SBP）指标、空腹血糖（FBG）指标和高密度脂蛋白胆固醇（HDL-C）指标。结果 与对照组的三酰甘油（TG）指标、腰围指标、舒张压（DBP）指标、收缩压（SBP）指标和空腹血糖（FBG）指标相比,观察组均明显偏低（P <0.05）,与对照组的高密度脂蛋白胆固醇（HDL-C）指标相比,观察明显偏高（P <0.05）;与对照组代谢综合征发生率相比,观察组明显偏低（P <0.05）;与对照组的整体护理满意度和各项生活质量评分相比,观察组明显偏高（P <0.05）;观察组的SAS评分和SDS评分改善情况均明显优于对照组（P <0.05）。结论...     

日常生活方式干预对老年冠心病患者临床指标的影响

目的：探析日常生活方式干预对老年冠心病患者临床指标的影响,进一步分析老年患者主观幸福感,为护理工作提供参考。方法筛选自2014年2月至2016年2月收治的老年冠心病患者98例,参照随机数字表分为研究组和对照组,每组49例。给予对照组患者常规干预,给予研究组患者常规基础上加用日常生活方式干预,比较干预前后,2组患者体重指数（BMI）、三酰甘油（TG）、收缩压（SBP）、舒张压（DBP）、总胆固醇（TC）、空腹血糖（GLU）、低密度脂蛋白（ LDL）等临床指标,应用老年主观幸福度自评表评估2组患者主观幸福感,采用状态焦虑量表评价患者焦虑情况。结果在干预后,2组患者的临床指标均有所下降,研究组各指标要显著低于对照组,差异有统计学意义（P＜0．05）;研究组患者焦虑感要明显低于对照组（ P ＜0．05）;研究组患者的主观幸福感要明显高于对照组,差异有统计学意义（ P ＜0．05）。结论日常生活方式干预可以有效改善老年患者的临床指标,能够显著降低患者焦虑感并提高其主观幸福感,在临床护理工作中,有重要的应用意义,建议临床予以推广应用。     

饮食护理干预对2型糖尿病患者的影响分析

目的探讨饮食护理干预对2型糖尿病患者的临床影响。方法将我院从2015年11月至2017年2月接收的2型糖尿病患者78例作为此次研究对象,随机把患者分成研究组及对照组,2组各有39例患者,对照组应用常规护理,研究组在常规护理基础上给予饮食护理干预,比较两组患者的护理效果。结果研究组患者护理后空腹血糖、餐后2 h血糖以及体质量指数均要显著低于对照组(P<0.05);研究组患者健康饮食与体质量控制情况要显著好于对照组(P<0.05)。结论加强2型糖尿病患者的饮食护理干预具有显著护理效果,能够显著改善血糖水平控制效果,值得临床推广。     

度拉糖肽注射液配合低碳水化合物早餐饮食疗法对老年糖尿病患者糖脂代谢紊乱的影响

目的 探讨度拉糖肽注射液配合低碳水化合物早餐饮食疗法对老年糖尿病患者糖脂代谢紊乱的影响。方法 选取2021年1～12月，140例老年糖尿病患者，随机分为2组，对照组应用二甲双胍片配合低碳水化合物早餐饮食疗法，研究组应用度拉糖肽注射液配合低碳水化合物早餐饮食疗法。结果 与对照组比较，研究组干预后餐后2 h血糖(2hPG)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)指标均低于对照组(P<0.05);与对照组比较，研究组干预后三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)指标均更低，高密度脂蛋白胆固醇(HDL-C)指标更高(P<0.05);与对照组比较，研究组干预3个月、6个月时的自我效能评分均更高(P<0.05);与对照组比较，研究组干预后社会心理、一般生活、医疗状况、体力状况、病情评分及总分均高于对照组(P<0.05)。结论 老年糖尿病患者使用度拉糖肽注射液配合低碳水化合物早餐饮食疗法治疗，能平稳地控制患者的血糖，明显改善血脂代谢，显著提升患者的自我效能感，提高患者生活质量。     

荷芪散治疗代谢综合征的临床护理干预

目的探讨分析临床综合护理干预在荷芪散治疗代谢综合征中的应用价值。方法选取本院于2010年7月～2012年9月收治的94例接受荷芪散治疗的代谢综合征患者,将所有患者随机分成实验组与对照组,两组均为47例。对照组接受常规治疗护理,实验组在对照组的基础上接受综合护理,对比分析两组患者的临床疗效。结果经过护理干预,实验组BMI、腰围、空腹血糖、三酰甘油（TG）、高密度脂蛋白（HDL-C）、收缩压（SBP）、舒张压（DBP）要明显优于对照组（P〈0.05）,且干预后实验组知识评分、心理依从性、饮食依从性、运动依从性、检测依从性评分明显优于对照组（P〈0.05）。结论护理干预能够提高荷芪散治疗代谢综合征的临床疗效,值得推广。     

高血压脑出血合并高血糖行护理干预的临床效果观察

目的观察高血压脑出血合并高血糖行护理干预的临床效果。方法 94例高血压脑出血合并高血糖患者随机分为对照组和研究组,每组47例,给予对照组常规护理,给予研究组采取优质护理干预,记录并分析两组相关情况。结果护理后,研究组收缩压≥140 mm Hg（1 mm Hg=0.133 kPa）、舒张压≥90 mm Hg的患者数量显著少于对照组,空腹血糖〉6.1 mmol/L、餐后2 h血糖〉7.8 mmol/L的患者人数比对照组更少;脱水、运动障碍以及感染症状改善情况都显著优于对照组,比较差异均有统计学意义（P〈0.05）。结论高血压脑出血合并高血糖行优质护理干预的临床效果更良好,值得临床推广。     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg x kg(-1)) or i.p. (50 mg x kg(-1)) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) 1 x h(-1) x kg(-1) in the male rat and 10.6 (95% CI: 7.5, 15.0) 1 x h(-1) x kg(-1) in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was approximately 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p < 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p < 0.001) in plasma obtained from the male (8.8 +/- 2.0%) compared with the female rat (11.7 +/- 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Trichinellosis in immigrants in Switzerland

We describe a case of trichinellosis diagnosed at the Division of Infectious Diseases, Hospital of Lugano, in January 2009. This case was associated with a cluster of cases and was traced to the consumption of contaminated meat after a wild boar hunt in Bosnia.     

Changes in angiopoietin expression in glomeruli involved in glomerulosclerosis in rats with daunorubicin-induced nephrosis

AIM: To study the potential pathological role of endogenous angiopoietins in daunorubicin-induced progressive glomerulosclerosis in rats. METHODS: Seventy male Wistar rats were allocated randomly into a daunorubicin group (DRB; n=40) or a control group (n=30). The rats in the DRB group were injected with DRB (15 mg/kg), in their tails. Subsequently, at intervals of 1, 2, 4, 6, 8, and 12 weeks, 5 male Wistar rats in each group were chosen randomly for 24 h urinary protein quantitative measurements (24 h UPQM), and determination of plasma tumor necrosis factor alpha (TNF-alpha), angiopoietin-1 (Ang1), and angiopoietin-2 (Ang2) levels. Kidney sections were examined by electron microscopy, Periodic Acid Schiff (PAS) staining, immunohistochemical staining and in situ hybridization histochemistry. RESULTS: As glomerulosclerosis progressed in the DRB group, expression of Ang1 mRNA and protein in glomeruli decreased and expression of TNF-alpha protein, Ang2 mRNA and protein in glomeruli increased. Expression of Ang1 mRNA and protein in glomeruli were negatively correlated with 24 h UPQM, Fn protein expression, and mean area of extracellular matrix (MAECM). In comparison, expression of Ang2 mRNA and protein in glomeruli were positively correlated with 24 h UPQM, Fn protein expression and MAECM; furthermore, there was a positive correlation between plasma Ang2 and 24 h UPQM. Plasma TNF-alpha and expression of TNF-alpha in glomeruli were positively correlated with expression of Ang2 mRNA and protein in glomeruli. There was a negative correlation between Ang1 protein expression and Ang2 protein expression in glomeruli. CONCLUSION: During DRB-induced glomerulosclerosis, podocyte injury led to a shift in the balance of Ang1 and Ang2 in glomeruli. Increased TNF-alpha in plasma and glomeruli may upregulate Ang2 expression in glomeruli. Elevated Ang2 in both plasma and glomeruli may mediate protein permeability through the glomerular filtration barrier. Moreover, local expression of Ang2 may facilitate the progress of glomerulosclerosis by upregulating a component expression of extracellular matrix.     

Hyperkalaemia in patients in hospital

A survey of all laboratory blood specimens with a plasma potassium concentration greater than or equal to 5.5 mmol/L was conducted over a three month period. Of 331 specimens with hyperkalaemia, 71 were excluded because the specimens was haemolysed, old or contaminated. The laboratory served a population of 348,561 and during this time measured the plasma potassium on 25,016 occasions. Sixty-six outpatients and 20 neonates were not evaluated. The survey was undertaken on 86 of 102 inpatients (46 males), 48 of whom were over 66 years of age. Fifty-seven patients were admitted under a medical service and 29 under a surgical service. Fifty-nine had a single episode of hyperkalaemia. Thirty-two underwent a surgical procedure. The commonest contributing factor was impaired renal function which was present in 71 (83%) patients. Although a definitive causative role for drugs could be identified in only five patients, in 52 (60%) patients drugs were a contributing factor (potassium supplements 24, ACE inhibitors 16, nonsteroidal antiinflammatory drugs 12). Thirty-five of the 86 (41%) patients died during their hospital admission. Nineteen of the 35 deaths occurred within three days of the hyperkalaemia being recorded. A normal plasma potassium was eventually documented in 50 of the 86 patients. Of the remaining 36 patients, 25 (69%) subsequently died. In general the treatment of patients with hyperkalaemia focused on identifying and treating the underlying cause. Hyperkalaemia must always be considered seriously and regard given to the overall clinical status of the patient, with particular attention to drug therapy, renal and cardiac function, acid base status and the possibility of sepsis.