新型帕胺缓释剂对高血压患者的血压及生存质量的影响

Asfirst－usedantihypertensivetoprimaryhypertension，di－uretichasproventodecreasetheincidencerateandfatalityrateofcardiacdiseaseandangiopathyagainandagain．Itisadvocatedthatlow－doseandstabilizingantihypertensiveshouldbeusedac－cordingtoInternationalSpecialityGuides．Indapadmideisammo－nia－sulfonic－acidamidethiazides．Whenitdecreasetheresistancesofbloodvessel，improvethecompliancesofartery，andrelievethethickeningofleftventricle，indapadmidecannotinfluencethemetabolismofsaccharideandlipid．…     

Pathophysiological changes and mechanism of cerebral pathological after high-energy firearm wound in extremities of dogs

INTRODUCTIONExtremityinjuriesarecommoninmodernfirearmwounds，constitut－ing５０％－６０％ofthetotal[１－２]．Remoteeffecti．e．remoteorgansortissuesinjurywilloccurbesidesseriousandextensiveinjuryofthelocalinjurytractandsurroundingtissues，inwhichcerebralinjuryiscommon[３－５]．PaststudiesshowedextremityinjuriescouldcausechangesinEEG，neuropeptide，andcerebralcirculation．Butnore－portonC－fosgeneexpressionwasfound．SUBJECTSANDMETHODSExperimentalanimalgrouping，establishmentofanim…     

透穴针刺法治疗痹症222例

Background：Itisconsideredthatarthralgiasyndromeincludescervicalspondylopathy，scapulohumeralperiarthritis，kneejointret－rogradedegeneration，calcaneuspainetc．．Point－through－pointacupuncturemeansatreatmentwithoneneedlepenetratingtwopointsonceresultinginseparatingadhesion，dredgingthechannel，relievingpainquickly．IntraditionalChinesemedicinepainoccurswhenthechannelisnotdredged．Weobservedthisinourstudy．Objective：Toobservethetherapeuticeffectofpoint－through－pointacupunctureonarthralg…     

Investigation of survival time and disability characteristics in 5 subjects with bilateral thalamus infarction near median line

Background：Bilateralthalamusinfarctionnearmedianlineisuncommoninclinic．Reportsconcernedwiththisconditionsweremoreless．ItischaracterizedbyconsciousdisorderandKorsakoffsyndrome．Themaincausedmaybetheinjuryofintralaminarnu－clei，dorsomedialnuclei，andinjuryofcorticalmatter，mammalillarybodies，fasciculusthalamicusaroundcerebralchamerII－I．Comprehensingthedisabilitycharacteristicsinpateintswithbi－lateralthalamusinfarctionnearmedianlineisimportantfordirec－tionofrehabilitation．Whilestudyo…     

Home rehabilitation care of hypoxicischemic encephalopathy:a case report

GENERALDATAChild，male，agedtwomonths．Thepatientwasdiagnosedhavingsevereasphyxiaandhavingnobreathingandheartbeatwhenborn．Andthechildwasdiagnosedashypoxic－ischemicencephalopathy，hydro－cephalusandgraysyndromethroughBultrasonicwaveandCTcom－binedwithkindsofbiochemicalexamintationsafteremergencytreat－mentinDepartmentofPediatricsofourhospital．Thephysicalexami－nationshowedweaknessofleftbody，slightastrophyofleftlowerlimbmuscle，headdeviateleftly，increasingofmusculartensionofrightlower…     

曲美他嗪对陈旧性心肌梗死康复期运动耐量的影响

Persistentinsufficientflowofcoronaryarterywillleadtohi－bernationofpartialmyocardiumfollowingmyocardialinfarctionduetocoronaryheartdisease，andthusdecreasingheartfunction，ex－ercisetolerance，andqualityoflifeduringrehabilitationphase．TMZ，theinhibitorof３－KAT，playsthecardinalroleinen－ergymetabolismofmyocardium．Inpresentstudy，weobservedim－pactofTMZonexercisetoleranceofpatientswitholdmyocardialinfarction．１Subjectsandmethod１．１Subjects５８patientssufferedfromcoronaryscopyorclini－…     

猪尾导管心包引流治疗浆膜腔炎患者改善生存质量的观察

Severelymultipleserouscavityinflammationdefyinterventioninclinic．Mostpatientswithseverelymultipleserouscavityin－flammationdiedofcardiactampondate，whichaffectsprognosis．Inrecentyears，itwasreportedthateffectsofdrainageonma－lignantcardiaceffusionweresatisfying．Whetherdrainageisef－fectiveintreatingmultipleandsevereserouscavityinflammationremainsunknownandnorelatedreportsisavailable．Incombina－tionwithintracardiacdepartment，wesuccessfullytreatseverelymultipleserouscavityinflammationafterc…     

中国部分地区中老年人群骨质蔬松症流行病学研究

Theresearchisthelargesteffortonosteoporosisthathasbeenundertaken，andoneofthefewcountry－wideglobalefforts．TheresearchisespeciallyimportantwiththesuggestionthatChinesehavelowbonedensityingeneral，andtherapidagingoftheChinesepopulation犤１－２犦．１Materialsandmethods１．１SubjectsSubjectswereobtainedwithinformedconsentfrom５５９３HannationalityandregisteredinfiveareasofChinaincludingNorth，South－middle，East，South－westandNorth－eastbythestrati－fied－multi－steps－clustersamplingmethod…     

The utilization of interventional therapy in recovery of cervical spondylopathy

Cervicalspondylopathyisoneofcommondiseaseindepartmentoforthopaedies．Ithappenedinoldpeopleusually，buttheincidenceageisyounger，thisdiseasebringshugepainanddiscommoditytopa－tients，soit'simportanttosearchsimpleandeffectiverecoverymethod．Atpresentmostofpatientscan'tgetwellcompletelyusing，non－operationtherapysuchasmassageandphysicaltherapy．PCDtreatingcervicalspondylopathyisonekindofsimpleandefficientin－terventionaltherapyutilizedinrecentyears．Wehadtreated２６pa－tientswithPCDandtheallth…     

顽固性颈性眩晕不同治疗方案的前瞻性研究

Vertigoofcervicaloriginisrelatedofvertebralarterycom－pressionsyndromedevelopedbyprolapsedofintervertebraldisc，disorderofzygapophysialjoint，andmyofascitisintheneckre－gion．Somedatareporteditaccompaniedthechangeofmicrocir－culationandbloodviscosityalso．Itmaybemulti－agents．Inthistheprospectivestudy，１８３patientsofobstinatevertigocausedcervicalsyndromewiththechangeofmicrocirculationandbloodviscosityweretreatedwithoneofthreeprojectsdifferently．Agroup，acupotomentandmanipulativereduction；…     

早期不同营养支持对重型颅脑损伤患者康复的影响

1 Subjects and method 1.1 Choice of cases All cases should match the following condition.⑴ The patients were admitted in 6 h after trauma and diagnosed originally head injured with Glasgow Coma Scale(GCS)≤ 8;⑵ The patients whose age from 18 to 60;⑶ The patients had no diabetes mellitus or the other endocrinism that had influence on nutrition and metabolism;⑷ The patients had no severe complicated trauma of important organs,no external hemorrhage or internal hemorrhage and no more than 800 ml blood transfused if operated.We had carried out this study from October 1998 to June 2000.140 cases,89 males and 51 females.     

实习护生多元文化护理认知现状调查

目的 探讨护理实习生多元文化护理的认知水平及影响因素,为提高多元文化护理水平提供课程设置依据及建议.方法 采用"特需护士多元文化护理调查问卷"基础上修改的问卷(5个维度),对6所学校的207名护生在同一时间内进行问卷调查,对数据进行统计及分析.结果 多元文化护理认知总分(179.17±15.552)分,其中理论知识得分最低(26.11±7.893)分..不同学习时间实习护生在总分、理论知识及饮食文化三个维度有显著性差异(P＜0.01,P＜0.01,P＜0.05),且总分、理论知识、语言沟通的得分与学习时间呈正相关(P＜0.01,P＜0.01,P＜0.05).综合性院校及专科性院校护生认知总分在理论知识、宗教风俗和隐私保护三个维度存在显著性差异(P＜0.01,P＜0.01,P＜0.05);大专护生的多元文化护理总分、理论知识及语言沟通得分显著高于本科护生的得分(P＜0.05,P＜0.01,P＜0.01);不同英语级别实习护生的总分有显著性差异(P＜0.01,P＜0.05);学过多元文化护理的护生理论知识得分显著高于未学过者(P＜0.01);三甲医院护生理论知识、宗教风俗及饮食文化三个维度的得分显著高于二甲医院护生的得分(P＜0.01,P＜0.01,P＜0.05).结论 护理实习生的多元文化护理认知水平亟待提高,必须填补多元文化护理教育缺口.     

Use of the Culture Care Theory and ethnonursing method to discover how nursing faculty teach culture care

As the world becomes increasingly multicultural, transcultural nursing education is critical to ensuring a culturally competent workforce. This paper presents a comprehensive review of literature and results of an ethnonursing pilot study using the Culture Care Theory (CCT) to discover how nursing faculty teach culture care. The literature revealed that despite 50 years of transcultural nursing knowledge development through theory, research and practice, there remains a lack of formal, integrated culture education in nursing. The importance of faculty providing generic and professional care to nursing students and using an organising framework to teach culture care was discovered. Additionally, care was essential for faculty health and well-being to enable faculty to teach culture care. This unique use of the theory and method demonstrates its usefulness in discovering and describing the complex nature of teaching culture care. Larger scale studies are predicted to further substantiate the CCT, building the discipline of nursing.     

Association between duration of storage of transfused red blood cells and morbidity and mortality in adult patients: myth or reality?

BACKGROUND: The duration of red blood cell (RBC) storage before transfusion may alter RBC function and, therefore, influence the incidence of complications.
STUDY DESIGN AND METHODS: With a computerized literature search from 1983 to 2008, 27 studies reporting the relationship between age of transfused RBCs and physiologic variables or incidence of complications in adult patients were identified.
RESULTS: Three studies (one abstract only, two foreign language) were excluded. The 24 remaining studies were grouped according to the patient population: cardiac surgery (eight studies), colorectal surgery (three), intensive care unit (ICU; seven), and trauma (six). The studies were too heterogeneous to allow a formal meta-analysis. Twenty-one of the 24 studies were single-center, and 12 were retrospective. The number of patients was highly variable, ranging from 15 to 6002. In cardiac surgery, two studies reported an increased risk of mortality but had statistical limitations. In colorectal surgery, two studies that addressed the effect on postoperative infections in the same database but with different designs yielded conflicting results. In general ICU patients, two retrospective studies reported a significant correlation between length of RBC storage and microcirculatory alterations or mortality, but the results were not confirmed in subsequent prospective, double-blinded studies. In trauma, five studies reported a correlation between RBC age and development of infection, multiple organ dysfunction, or mortality.
CONCLUSIONS: From the currently available published data, it is difficult to determine whether there is a relationship between the age of transfused RBCs and outcome in adult patients, except possibly in trauma patients receiving massive transfusion.     

Critique of transcultural practices in end-of-life clinical nursing practice

TOPIC: Transcultural nursing practices for terminally ill patients. PURPOSE: To examine several criticisms of transcultural nursing theory in end-of-life care. SOURCES: Published literature and interviews with nurses. CONCLUSIONS: Nurses often encounter barriers that impede their ability to provide ideal end-of-life care.     

A review of transcultural nursing

In this article, transcultural nursing is reviewed in the light of the literature mainly relevant to the British context. The key features of transcultural nursing are examined in the context of multicultural Britain as follows: definitions, racism, ethnocentrism, culture, diversity, transcultural health care practice and nurse education. Models of transcultural care practice and contemporary developments in cultural care are also explored. There is evidence from emerging literature that innovations are taking place in promoting transcultural care practice and education. However, the article concludes that much practice-based research is still needed to establish transcultural nursing in Britain.     

脑卒中患者利手与语言优势半球的关系

背景利手一直作为判断语言优势半球的方法,汉字为表意文字,与拼音文字不同,语言优势半球可能也会不同.目的分析母语为汉语的脑卒中患者利手与语言优势半球的关系.设计病例观察.单位牡丹江医学院附属红旗医院神经内科.对象纳入牡丹江医学院附属红旗医院神经内科2003-02/2004-06住院的经CT或MRI证实的脑卒中患者400例.男249例,女151例;平均年龄(67.45±5.67)岁;病程2～4周.方法应用北京医科大学第一医院神经内科的利手判定标准进行利手判定,应用西部失语检查法进行失语症的分类.主要观察指标脑卒中患者利手与语言优势半球的关系.结果按实际处理分析,400例均进入结果分析.①右利手366例,非右利手34例.②左侧半球病变237例,有169例失语的患者;右侧半球病.变163例,有9例失语的患者.③右利手366例中,左侧半球病变218例,有158例失语;右侧半球病变148例,有7例失语.非右利手34例中,左侧半球病变19例,有11例失语;右侧半球病变15例,有2例失语.结论母语为汉语的人种中,脑卒中患者右利手者优势半球多为左侧大脑半球,少数为右侧大脑半球;非右利手者优势半球仍多为左侧大脑半球,极少数为右侧大脑半球.     

The impact of empirical studies of spirituality and culture on nurse education

Aims and objectives. The aim of this paper is to share reflectively how my empirical studies on spirituality and culture have had an impact upon nurse education. Background. Spirituality and cultural dimensions of care are considered to be integral to holistic care. The healing potentials of spiritual and cultural care are well documented. The commitment to the research programme came due to the concern within early literature on nursing that the provision of spiritual care for patients is inadequate. Methods. The research programme used action research comprising largely qualitative approaches. As the holistic and multiperspective nature of spirituality and culture requires a multidisciplinary approach and flexibility of methodology, various research techniques were used. Results. The findings from the research programme led to the development of theories, models and conceptual literature on spiritual and cultural care. In particular, two models evolved from the studies: the ASSET for spiritual cares education and training and the ACCESS for transcultural care practice. The critical incident studies provide insights into nurses’ roles in spiritual care interventions. The phenomenological study highlights that chronically ill patients use spiritual strategies in coping with their illness. Conclusion. Overall, the paper offers a body of evidence that has an impact upon curriculum development in nurse education and nursing practice. Relevance to clinical practice. The ASSET model offers a framework for spiritual care education. The ACCESS model offers a framework for transcultural care practice. The critical incident studies map out nurses’ roles in spiritual and cultural care with scope for development of care intervention models for the future. The coping mechanisms study highlights how patients use spiritual coping strategies such as prayer and other resources to cope with their chronic illnesses.     

Transcultural nursing: a selective review of the literature, 1985–1991

This paper reviews selected work, published in nursing journals between 1985 and 1991, on the subject of transcultural nursing The papers were selected by the use of a computerized literature search at the Royal College of Nursing library, using the keywords transcultural, multicultural, crosscultural and cultural The benefits and limitations of such an approach will be discussed along with an introduction to transcultural nursing The Journal papers were then reviewed under eight headings, theory and concepts, nurse education, health education and patient teaching, clinical, counselling, sexuality, care of the child and research Common themes and problems are discussed