口部刺激联合健康教育对孤独症患儿口腔健康行为的影响

目的探讨口部刺激联合健康教育对孤独症患儿口腔健康行为的影响。方法将72例孤独症患儿随机分为对照组(37例)和干预组(35例)。对照组对患儿照顾者行口腔保健知信行健康教育,干预组在对照组的基础上实施口部触觉刺激干预,连续干预2个月。比较干预前后两组患儿口腔健康行为及照顾者口腔保健知信行评分的差异。结果干预后两组照顾者口腔保健知信行评分显著高于干预前,干预组显著高于对照组(均P0.01)。干预后两组患儿口腔保健行为评分显著高于干预前,干预组显著高于对照组(P0.05,P0.01)。结论将口部触觉刺激技术结合口腔健康知信行健康教育,用于孤独症患儿口腔健康行为干预和照顾者指导,能提高孤独症患儿口腔健康行为及照顾者口腔保健知信行程度。     

基于智能“云随访”APP的延续护理对婴儿湿疹的预防作用

目的探讨延续性护理干预配合智能"云随访"APP对婴儿湿疹的预防效果。方法将340例新生儿随机分为观察组和对照组各170例。对照组行常规随访,观察组在此基础上采用智能"云随访"APP进行随访。结果随访至婴儿6月龄时,观察组婴儿湿疹发生率显著低于对照组,湿疹持续时间显著短于对照组;观察组乳母经常进食致敏食物的比例显著高于对照组(P0.05,P0.01)。结论利用智能"云随访"APP对乳母饮食及婴儿喂养进行个性化指导,可提高乳母对致敏食物的认识,有效预防婴儿湿疹及复发率。     

早产儿食物转换期喂养情况的调查

目的了解早产儿食物转换期喂养过程中可能存在的问题。方法采用自行设计的喂养情况问卷对268例纠正月龄12～18个月的早产儿(其中高危儿60例,中危儿55例,低危儿153例)及117例足月儿进行调查。结果早产儿纯母乳喂养率为35.07%,显著低于足月儿的56.41%(P0.01)。母乳喂养早产儿中仅9.13%添加母乳强化剂。早产儿首次引入辅食平均月龄为(4.87±1.39)月,显著早于足月儿的(5.85±1.10)月(P0.01);早产儿引入动物性食物平均月龄为(7.88±2.66)月,为不同食物中最晚。77.24%的早产儿在引入泥糊状食物后又转为流质食物,24.63%晚于纠正9月龄引入颗粒状食物,36.94%晚于纠正12月龄引入条块状食物。结论早产儿纯母乳喂养及母乳强化剂使用比例低。首次引入辅食平均月龄早于足月儿,但动物性食物引入时间晚。辅食性状的引入和转换不合理。应采取母乳喂养现场指导、以模型或实操指导食物转换等多种方式实现早产儿的科学喂养。     

不同方式喂养婴儿贫血状况调查

目的 探讨婴儿期不同喂养方式与贫血的关系，以改进喂养方法，预防贫血。方法 将195例婴儿（4个月内）根据喂养方式不同分为完全母乳喂养组、人工喂养组和发母乳喂养组，2－4个月及6－9个月筛查血红蛋白各1次，贫血者每月复查，直到血红蛋白恢复正常。结果 2－4个月婴儿贫血检出率平均为35.4%，三种喂养方式之间差异无显著性意义；6－9个月婴儿人工喂养组贫血检出率为10.0%，明显低于母乳喂养组（47.7%）和部分母乳喂养组（31.2%），三种喂养方式之间比较，差异有极显著性意义（P＜0.01）。对母乳喂养组贫血婴儿断乳期的膳食调查发现，多数婴儿对含铁丰富的食物摄入过少，而淀粉类食物摄入过多。结论 应加强对母乳喂养婴儿断乳期的营养指导，嘱家长添加含铁丰富的食物，4个月后应常规给予铁剂口服以预防贫血。     

游泳对婴儿运动及语言发育的影响

目的了解味觉发育对婴儿换乳期食物添加困难的影响，以便更好地对孕妇、乳母及婴儿家长进行营养与喂养指导。方法对48名换乳期食物添加困难婴儿（观察组）进行母亲孕期及哺乳期饮食情况和婴儿辅助食品添加时间等内容的调查，并与48名无食品添加困难的婴儿（对照组）进行比较。结果观察组辅助食品添加时间显著晚于对照组（P〈0.01），母亲孕期、哺乳期饮食不良行为发生率显著高于对照组（均P〈0.01）。结论婴儿早期味觉发育与以后的进食行为有关，因此应重视对孕妇、乳母和婴儿家长的营养保健指导。     

先心病患儿辅食喂养现状及影响因素的多中心研究

目的评价6~12月龄先心病患儿的辅食喂养现状。方法采用自制的先心病婴儿营养管理调查表和婴幼儿喂养指数评价标准(ICFI)收集在5所综合性儿童医院就诊的274名6~12月龄先心病患儿的基本信息和辅食喂养状况,综合评价先心性患儿的营养状况和喂养行为。结果ICFI得分为8.11±4.01,其中6~8月龄(9月龄)患儿得分为6.70±3.72,9~12月龄患儿得分为10.56±3.25;ICFI合格率为9.9%;患儿月龄、母亲学历与ICFI得分显著相关(P0.05,P0.01)。结论先心病患儿的辅食喂养现状堪忧,在较小月龄组患儿中更明显。     

知信行健康教育模式对提高癫痫患者服药依从性的作用

目的探讨知信行健康教育模式提高癫痫患者服药依从性的效果。方法将80例癫痫患者进行配对处理分组,对照组和观察组各40例。对照组按常规进行服药指导,观察组应用知信行模式进行服药指导。结果随访时观察组服药依从性评分显著低于对照组(P<0.01)。结论应用知信行模式进行服药健康指导能够有效提高癫痫患者的服药依从性。     

系统健康教育对大庆社区COPD稳定期患者知信行及生活质量的影响

目的探讨系统健康教育对大庆地区慢性阻塞性肺疾病(COPD)稳定期患者知信行水平及生活质量的影响。方法将大庆市社区155例COPD稳定期患者随机分为对照组(77例)和干预组(78例),对照组进行常规社区护理,干预组在对照组的基础上给予系统健康教育4周,随访至6个月。干预前和干预6个月后采用COPD知信行问卷、COPD评估测试问卷(CAT)进行效果评价。结果干预6个月后,干预组知信行总分及各维度得分显著高于对照组,CAT总分及各维度得分显著低于对照组(P0.05,P0.01)。结论系统健康教育可以提高大庆地区COPD稳定期患者知信行水平和生活质量。     

基于患者参与框架的住院老年患者跌倒预防干预策略的实施

目的探讨基于患者参与框架的住院老年患者跌倒预防干预策略的实施效果。方法根据住院时间将2019年1~6月收治的58例老年患者作为对照组,2019年7~12月收治的58例作为观察组。对照组按常规实施预防跌倒措施,观察组基于患者参与框架制订并实施住院老年患者跌倒预防干预策略,包括“告知、参与、赋权、合作及电子化信息支持”五部分内容。比较干预前后两组参与跌倒预防知信行水平、跌倒效能水平及跌倒发生率。结果干预后观察组参与跌倒预防知识、态度及行为得分和跌倒效能得分显著高于对照组(P<0.05,P<0.01);观察组住院期间无跌倒发生,对照组发生2例。结论基于患者参与框架实施预防住院老年患者跌倒干预策略,可提高患者参与跌倒预防知信行水平和跌倒效能,降低跌倒发生率,保障患者安全。     

知信行健康教育联合辨证施膳对糖尿病患者血糖及生活质量的影响

目的 探讨知信行健康教育联合辨证施膳对2型糖尿病患者血糖及生活质量的影响.方法 将90例2型糖尿病患者采用随机数字表法分为对照组与观察组各45例.对照组按常规对患者进行饮食疗法、运动疗法、药物疗法、血糖监测、糖尿病教育及护理指导;观察组在对照组基础上,给予知信行健康教育联合辨证施膳护理.比较两组血糖控制情况及其生活质量变化.结果 干预后两组血糖、糖化血红蛋白值及生活质量评分比较,处理效应、时间效应及交互效应均P＜0.01,干预后,观察组血糖值基本降至正常范围内.结论 对2型糖尿病患者采用知信行健康教育联合辨证施膳干预,可提高患者治疗依从性,有效控制血糖水平,使患者的生活质量得到整体提高.     

Attitudes and use of complementary medicine in men with prostate cancer

PURPOSE: Patients with cancer are increasingly incorporating complementary therapies into the overall treatment. We determine the prevalence and patterns of use of complementary therapies among patients with prostate cancer. MATERIALS AND METHODS: Patients attending 6 urology institutions for prostate cancer management completed a self-administered questionnaire on complementary therapy. All men diagnosed with prostate cancer were eligible, regardless of age, stage of disease or treatment. RESULTS: A total of 1,099 patients returned the questionnaire. The overall response rate was 78.5%. Complementary therapies had previously been or were currently being used by 23.5% (258) and 18.2% (200) of patients, respectively. Higher levels of education and income were associated with greater use of complementary therapy (p <0.002 by logistic regression). Patients with progressive disease or those primarily treated with hormones were most likely to use complementary therapy. Among the patients using complementary therapy 90% believed that it would help them live longer and improve quality of life, 60% believed it would relieve symptoms and 47% expected it to cure disease. CONCLUSIONS: Complementary therapies are used by a large number of patients with prostate cancer, particularly those with progressive disease or who have undergone multiple treatments. Health care providers need to recognize this growing pattern of use of complementary therapy. Among patients who use complementary therapy the perception of benefit is much greater than that supported by scientific data. Future research should aim to unravel the complex psychosocial dynamics that influence the decision to use complementary therapy by men with prostate cancer and to educate patients about the efficacy of such therapies.     

Analytical accuracy and reliability of commonly used nutritional supplements in prostate disease

PURPOSE: We determine the analytical accuracy and reliability of commonly used nutritional supplements for prostate disease by comparing the amounts of active ingredients of several brands of vitamin E, vitamin D, selenium, lycopene and saw palmetto. We also compared the amounts of active compound in different lots of the same brand to determine the consistency of the manufacturing process. MATERIALS AND METHODS: Samples purchased at pharmacies and specialty stores were sent for independent chemical analysis. The measured dose was compared to the stated dose on the product label. Analysis of variance was performed to test for significance in interlot reliability. RESULTS: Vitamin E (7 samples) and selenium (5) were within a range of -41% to +57% and -19% to +23% of the stated dosage, respectively. All vitamin D brands (4 samples) were within 15% of the stated dose. Saw palmetto (6 samples) were within a range -97% to +140% of the stated dosages with 3 containing less than 20% of the stated dosages. Lycopene brands were between -38% and +143% of stated dosages. Among the reliability assays 1 of 3 brands of vitamin E, 1 of 2 brands of selenium and 1 of 2 brands of saw palmetto demonstrated statistical differences in interlot dosage (p <0.0055, approximate 20% to 25% differences in dose). The 1 assayed form of vitamin D was reliable between lots. CONCLUSIONS: Commonly used nutritional supplements for prostate disease vary widely in measured dose. Saw palmetto demonstrated tremendous variability with some samples containing virtually no active ingredients. In contrast, the more regulated substances we measured, such as vitamins and minerals, demonstrated less variation.     

Prevalence and correlates of selected alternative and complementary medicine in adult renal transplant patients

Abstract: Background/Significance: The use of complementary and alternative medicine (CAM) has increased considerably in the general population in recent decades. However, the prevalence of CAM use in renal transplant patients has not yet been assessed. Aim: To determine the prevalence and correlates of CAM use among renal transplant patients (RTX) who are more than one year post transplant. Methods: This secondary data analysis used data from Part 1 of the Supporting Medication Adherence in Renal Transplantation (SMART) study, which tested prevalence, determinants and consequences of non‐adherence regarding immunosuppressive medication in kidney transplant (renal TX) patients. The study’s convenience sample consisted of 356 patients recruited from two Swiss outpatient transplant clinics during their annual examination visits (mean age: 53±13; male: 58%). The use of CAM as well as the specific kind of CAM used was assessed through structured interviews. Assessed CAM use correlates were age, gender, education, depressive symptomatology, comorbidity and smoking status. Relationships between CAM use and candidate correlates were explored using multiple logistic regression. Results: The prevalence of CAM use in this sample of renal TX patients was 11.8%. Most frequently used alternative medicines were Homeopathy (42.9%) and Chinese medicine (23.8%). Two patients used St John’s wort. The percentage of patients using Homeopathy (5.1%) and herbal medicine (2%) was similar to that of the general Swiss population (HO: 6.1% & HM: 2.6%). Significant correlates for CAM use were younger age (p=0.017; OR=0.96; 95%CI=0.93‐0.99) and female gender (p=0.035; OR=2.13; 95%CI=1.05‐4.3). Conclusion: Every eighth renal transplant recipient in this sample used some form of CAM. Of these, some used herbal medicines, of which some are known to interfere with certain immunosuppressive treatment (St John’s wort/Chinese medicines). These findings indicate that it is important for health care providers working in renal TX to assess CAM use.     

Traditional and complementary medicine (T/CM) in the treatment of erection difficulties – experience from the Asian Men's Attitudes To Life Events and Sexuality (MALES) study

BackgroundLittle is known about the practice, perceptions and experience of using traditional and complementary medicine (T/CM) for erection difficulties among Asian men.MethodsA total of 10,934 Asian men living in China (n = 2,055), Japan (n = 877), Korea (n = 2,000), Malaysia (n = 3,000) or Taiwan (n = 2,002) were recruited via random digit dialing, street interception and face-to-face interview in the Asian Men's Attitudes To Life Events and Sexuality (MALES) Phase I study. The Phase II study was comprised of a total of 1,286 men who experienced erection difficulties and who lived in China (n = 255), Japan (n = 228), Korea (n = 225), Malaysia (n = 380) or Taiwan (n = 228).ResultsUse of T/CM for erection difficulties (9.1%) was relatively low compared to conventional medicine (83.5%). Among those that seek help and treatment from T/CM, the majority were respondents from Malaysia, followed by respondents from China, whereas respondents from Japan and Korea ranked lowest. Use of a combination of alternative and conventional therapy was prevalent. Erection difficulty was amongst the highest in terms of preference of treatment seeking using traditional approaches after back pain, arthritis and gout. Overall outcome was expressed as ‘Partly satisfied’ with T/CM treatment for erection difficulties. The main reason that T/CM outweighs conventional medicine was because it was perceived that T/CM had fewer side effects than conventional medicine (56.1%). Users of T/CM were mostly middle-aged, married, employed, and perceived their health status and the severity of their erection dysfunction as moderate.ConclusionsThe findings help to identify the differences in practices and beliefs about T/CM among Asian countries and provide useful information to conventional practitioners about the alternative help- and treatment-seeking behaviors for erectile difficulties.     

基因表达谱芯片用于检测脓毒症小鼠肺组织基因表达的改变

目的：筛选脓毒症小鼠肺组织中与正常组织差异表达的基因并作初步功能分析。方法：在小鼠盲肠结扎一穿孔术(CLP)引起小鼠的脓毒症模型上，采用含有2201个小鼠基因cDNA克隆的表达谱基因芯片，检测并分析脓毒症小鼠肺组织在CLP后6h、12h的基因表达变化并以计算机软件筛选出差异表达的基因。结果：在CLP后6h和12h，共筛选出80个与假手术对照组相比出现差异表达的已知功能基因，其中表达上调和下调者各40个；聚类分析发现其中包括免疫相关基因、急时相反应与热休克反应相关基因、抗氧化反应基因、细胞骨架相关基因以及多种细胞代谢和信息传递相关基因。结论：脓毒症性急性肺损伤涉及到一系列与炎症、免疫、应激、抗氧化、能量代谢与细胞骨架相关的基因表达异常；采用基因芯片俭测技术有利于全面揭示脓毒症中的基因表达模式，快速高效地发现新的研究目标和基因治疗途径。     

Evidence for contamination of herbal erectile dysfunction products with phosphodiesterase type 5 inhibitors

PURPOSE: We determined if pharmacological dosages of phosphodiesterase type 5 inhibitors (PDE5) inhibitors were present within a group of natural products marketed for the treatment of erectile dysfunction. MATERIALS AND METHODS: Seven herbal products marketed for the treatment of erectile dysfunction were purchased via the Internet or at local health food stores. Specimens were batched, relabeled and blindly analyzed for contamination with PDE5 inhibitors. High performance liquid chromatography and mass spectrometry were used to detect evidence of contamination with sildenafil, tadalafil or vardenafil. RESULTS: Of the 7 tested products 2 contained pharmacological dosages of sildenafil and tadalafil. Contamination with vardenafil was not identified. Mean dosages of sildenafil and tadalafil were 30.2 and 19.7 mg, respectively. CONCLUSIONS: A significant proportion of natural products marketed for erectile dysfunction contains PDE5 inhibitors. Although marketed as natural products devoid of adverse effects, these agents are known to have potentially fatal drug interactions with nitrates. Better regulation of the natural health products industry is urged.