乡镇基层医院联合个体自我管理健康教育模式对糖尿病患者依存性和疗效的影响

目的:评价乡镇基层医院联合个体自我管理教育模式对2型糖尿病患者的依存性和疗效的影响.方法:将4个乡镇医院门诊或住院的98例2型糖尿病患者随机分为基层医院联合自我管理教育组(自我管理组50例)和常规治疗对照组(对照组48例)两组.自我管理组除了常规药物治疗外,首先在内科接受连续5天的糖尿病自我管理教育;随后内科培训4个乡镇医院糖尿病专业医师,乡镇基层医院建立个体化治疗健康管理档案,定期接受电话和门诊随访;乡镇医院为自我管理组患者建立自我管理健康教育小组;定期为乡镇医院自我管理健康教育小组讲课.对照组常规药物治疗,仅接受1次常规糖尿病健康教育和常规跟踪随访.评价干预前和实施健康教育管理12个月后的血糖的变化,以及饮食、运动和药物的依存性变化.结果:干预后,两组患者的空腹血糖、2小时餐后血糖和糖化血红蛋白水平均较干预前显著下降,差异有统计学意义(P＜0.05);自我管理组患者的空腹血糖、餐后血糖和糖化血红蛋白水平显著低于对照组,差异均有统计学意义(P＜0.05).干预后,自我管理组以及饮食、运动和药物的依存性与对照组比较,差异有统计学意义(P＜0.05).结论:乡镇基层医院联合个体自我管理健康教育模式加上常规糖尿药物治疗方法,在提高2型糖尿病患者糖尿病知识、自我管理水平与改善糖尿病控制方面优于单独的常规糖尿药物治疗方法.     

同伴教育对社区女性2型糖尿病患者的效果分析

目的:探讨同伴教育对社区女性2型糖尿病患者的效果。方法:选取社区女性2型糖尿病患者49例,分为干预组24例和对照组25例。对照组进行1次常规的糖尿病健康教育,干预组除此之外,还进行为期3个月的同伴教育。干预前、后分别对两组研究对象进行1次简单的体格检查和糖化血红蛋白监测,并利用问卷测定两组研究对象的自我管理行为和生存质量水平。结果:干预后,干预组糖化血红蛋白低于对照组(P<0.05);自我管理行为中问卷的饮食管理、运动管理、足部管理3个维度得分高于对照组(P<0.05);生存质量问卷中生理功能、心理/精神、社会关系及总分得分高于对照组(P<0.05)。结论:同伴教育能够提高社区女性2型糖尿病患者自我管理水平和生存质量,有效控制血糖水平。     

基于知-信-行理论下的健康教育门诊对2型糖尿病患者自我管理行为的影响

目的:研究知-信-行理论下的健康教育门诊对2型糖尿病患者自我管理行为的影响.方法:选取2019年9月—2020年2月在河南大学第一附属医院糖尿病专科门诊建立档案的2型糖尿病患者240例,随机分为对照组119例和观察组121例,对照组采用传统的方法进行健康教育,观察组则在知-信-行理论下进行教育,对比观察两组患者的自我管理行为情况和血糖相关指标(空腹血糖、糖化血红蛋白值)变化.结果:两组患者教育前饮食行为、运动行为、血糖监测行为、足部护理、用药行为和吸烟行为比较差异无统计学意义(P>0.05),教育后与对照组相比,观察组饮食行为、运动行为、血糖监测行为、足部护理、用药行为和吸烟行为得分均较高,差异有统计学意义(P<0.05).教育前两组患者空腹血糖和糖化血红蛋白水平比较无显著差异(P>0.05),教育后观察组空腹血糖和糖化血红蛋白水平优于对照组,两组比较差异有统计学意义(P<0.05).结论:在知信行理论下进行门诊健康教育有利于增加2型糖尿病患者的约束力,可有效改善患者的不良行为和血糖水平.     

健康教育在糖尿病护理中的应用价值分析

目的:探讨健康教育在糖尿病护理中的应用效果。方法:将解放军153医院2011年1月至2012年1月收治的80例糖尿病住院患者随机分为干预组(40例)和对照组(40例),两组均进行常规的治疗和护理,干预组在此基础上对糖尿病患者进行系统的健康教育,比较两组患者糖尿病知识测试优良率及同期空腹血糖、餐后2 h血糖和糖化血红蛋白数据。结果:对照组患者糖尿病知识测试优良率为45.0%,进行系统健康教育的干预组患者为82.5%,显著优于对照组,差异具有统计学意义(P<0.01)。干预组患者空腹血糖、餐后2 h血糖及糖化血红蛋白控制效果显著优于同期对照组患者,差异均具有统计学意义(P<0.05)。结论:健康教育有利于提高糖尿病患者的疾病知识水平和血糖控制效果。     

延续性护理对老年糖尿病患者饮食行为的影响

目的:探讨延续性护理对老年糖尿病患者饮食行为及血糖控制的作用。方法:将125例老年糖尿病患者随机分为观察组64例和对照组61例。对照组患者在出院前接受常规的出院指导和健康教育,而观察组患者在对照组的基础上继续接受延续性护理,分别于干预前及干预6个月后对两组患者的饮食行为和血糖控制情况进行比较。结果:干预前两组患者饮食行为比较,差异无统计学意义(P>0.05),干预6个月后观察组饮食结构合理、食物加工方式合理、每日摄取适量能量及餐次合理等方面的饮食行为显著优于对照组,差异有统计学意义(P<0.05),观察组干预后的空腹血糖、餐后2 h血糖和糖化血红蛋白均低于对照组,差异有统计学意义(P<0.05)。结论:延续护理有利于帮助老年糖尿病患者建立健康的饮食行为,增强自我管理的能力,有效控制血糖。     

全程健康教育用于糖尿病患者管理中的效果观察

目的研究糖尿病患者采用全程健康教育的管理效果。方法选择2017年12月～2019年7月我院接收的糖尿病患者146例为研究对象,按照抽签法分观察组(全程健康教育)与对照组(常规护理)各73例,比较两组患者血糖指标、自我管理行为与管理效果。结果教育前两组血糖指标与自我管理行为比较,差异无统计学意义(P0.05);教育后观察组空腹血糖、餐后2 h血糖与糖化血红蛋白指标较对照组低,饮食、运动、药物与足部护理评分较对照组高,差异有统计学意义(P0.05);观察组管理有效率(98.63%)高于对照组的89.04%,差异有统计学意义(P0.05)。结论糖尿病患者采用全程健康教育管理模式,能有效控制血糖指标、提高患者自我管理行为、提高管理效果、改善预后,值得推荐。     

家庭自我管理在糖尿病儿童居家护理中的应用效果研究

目的:研究家庭自我管理在糖尿病儿童居家护理中的应用效果。方法:选取2015年3月至2016年7月医院住院部收治的糖尿病儿童80例,随机分为对照组(n=40)和观察组(n=40)。对照组采用常规健康宣教的方法护理,观察组在对照组基础上采用家庭自我管理护理,通过出院后的家庭访视及电话回访指导患儿家庭进行居家护理,强化家庭在疾病治疗中的作用。比较两组患儿血糖控制情况、遵医率、并发症发生率及患儿家长糖尿病健康知识掌握度。结果:两组患儿出院前空腹血糖、餐后2 h血糖及糖化血红蛋白水平比较差异无统计学意义(P>0.05);观察组通过家庭自我管理后空腹血糖、餐后2 h血糖及糖化血红蛋白水平,均低于对照组(P<0.05),差异有统计学意义;观察组家庭自我管理后遵医行为中门诊就诊、血糖监测、饮食规律、运动锻炼及安全用药率,均高于对照组(P<0.05);观察组并发症发生率,低于对照组(P<0.05),差异有统计学意义。两组出院前患儿家长糖尿病健康知识掌握度比较差异无统计学意义(P>0.05);观察组出院3个月后患儿家长糖尿病健康知识掌握度高于对照组(P<0.05),差异有统计学意义。结论:糖尿病儿童治疗中实施家庭自我管理效果理想,有利于控制患儿血糖,降低并发症发生率,值得推广应用。     

认知行为护理在老年糖尿病患者中的应用效果

目的探讨认知行为护理在老年糖尿病患者中的应用效果。方法选取2017年6月至2019年6月夏邑县第二人民医院收治的70例老年糖尿病患者为研究对象,按随机数表法分为对照组(35例)与观察组(35例)。对照组接受常规护理,观察组在对照组基础上接受认知行为护理。随访3个月,比较两组血糖水平(空腹血糖、餐后2 h血糖、糖化血红蛋白水平)及自我管理能力(饮食控制、运动锻炼、遵医用药、血糖监测)评分。结果随访3个月后,两组空腹血糖、餐后2 h血糖、糖化血红蛋白水平均较干预前下降,且观察组下降幅度大于对照组,差异有统计学意义(均P<0.05)。随访3个月后,观察组饮食控制、运动锻炼、遵医用药、血糖监测评分均高于对照组,差异有统计学意义(均P<0.05)。结论认知行为护理对老年糖尿病患者干预效果显著,可降低患者血糖水平,增强自我管理能力。     

急性脑卒中合并糖尿病患者健康教育的效果分析

目的探讨健康教育对急性脑卒中合并糖尿病患者的效果.方法将80例急性脑卒中合并糖尿病患者随机分入对照组与观察组,每组40例.对照组患者接受常规治疗与护理,观察组患者除接受常规治疗与护理外,还接受系统化的健康教育,包括住院期间健康教育及出院后6月内的延续.比较两组干预前后血糖、糖化血红蛋白的变化,应用改良Barthel指数评估患者日常生活能力(ADL)的差异,调查患者及家属对疾病相关知识的知晓率、对临床服务的满意度.结果出院后半年观察组空腹血糖、餐后血糖及糖化血红蛋白显著优于对照组,差别具有统计学意义(P<0.01);出院后6月Barthel指数评分显著高于对照组,差别具有统计学意义(P<0.01);出院时患者及家属对疾病相关知识的知晓率、对临床服务的满意度显著优于对照组,差别具有统计学意义(P<0.01).结论对急性脑卒中合并糖尿病患者进行系统化的健康教育可增加患者及家属疾病相关知识,提高患者治疗依从性,加强自我管理,有利于肢体功能的恢复,提高患者生活质量,并提高对临床服务的满意度.     

浅谈对2型糖尿病患者子女进行健康教育对2型糖尿病患者血糖控制情况的影响

目的：探讨对2型糖尿病患者子女进行健康教育对2型糖尿病患者血糖控制情况的影响。方法：随机选取2012年9月-2013年2月在我科住院的60例子女在身边的2型糖尿病患者，并将其平均分为对照组和干预组。对照组患者接受2型糖尿病的常规治疗、护理和健康教育，试验中未对其子女进行健康教育。干预组患者除了接受2型糖尿病的常规治疗、护理和健康教育外，其子女需接受多种形式的健康教育。治疗结束随访6个月，比较两组患者糖尿病的控制情况。结果：①与治疗前相比，干预组患者子女的糖尿病知识水平显著提高，且前后差异具有统计学意义(P<0.05)。②预组患者空腹血糖的控制情况、餐后2h血糖的控制情况和糖化血红蛋白的水平均优于对照组患者，且两组间的差异具有统计学意义(P<0.05)。结论：对2型糖尿病患者的子女实施健康教育可以显著提升其对糖尿病知识的认识水平，从而促使其帮助2型糖尿病患者控制血糖。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.