微信平台技术在社区老年高血压患者合理用药教育和用药依从性中的应用效果

目的 探讨微信平台技术干预在高血压患者合理用药教育和用药依从性中的应用效果。方法 选择2018年1月至2020年1月于北京市海淀区万寿路社区卫生服务中心就诊的256例老年高血压患者为研究对象,采用随机数表法将患者随机分为对照组与观察组,各128例。对照组给予常规健康宣教,观察组给予微信平台技术干预,比较2组患者合理用药、用药依从性及血压控制情况。采用SPSS 18.0统计软件进行数据分析。根据数据类型,分别采用t检验或χ²检验进行组间比较。结果 观察组干预后在药物认知、按时服药、服药方法及不良反应监测方面均优于对照组;高血压治疗依从性量表(TASHP)评分高于对照组;收缩压(SBP)与舒张压(DBP)水平低于对照组;空腹血糖(FPG)、总胆固醇(TC)与甘油三酰(TG)的下降水平优于对照组,差异均有统计学意义(P＜0.05)。结论 通过微信平台技术对老年高血压患者开展随访教育,能有效提高患者对合理用药的认知及用药依从性,有助于控制患者血压,值得在临床推广应用。     

自我管理团队干预对高血压性脑出血康复期患者复发的影响分析

目的研究在高血压脑出血(HICH)康复期使用自我管理团队干预的临床效果以及对复发的影响。方法在本院选取106例HICH康复期患者,资料选取2019年1-12月,选用随机数字表法分为两组,各53例,采取常规出院指导为参照组,采取自我管理团队干预为实验组,对两组干预后临床效果进行分析。结果实验组对比参照组复发率较低,依从率较高(P0.05);干预前两组舒张压、收缩压、服药自我效能量表(MASES)与日常生活能力量表(ADL)评分对比差异无统计学意义(P0.05),干预后对比参照组,实验组舒张压、收缩压较低,MASES、ADL评分较高(P0.05)。结论对HICH康复期患者给予自我管理团队干预,可提升其服药自我效能与依从性,控制患者血压波动,进而改善预后,提升患者生活质量,值得借鉴。     

护理路径对原发性高血压患者服药依从性的影响

目的研究临床护理路径在原发性高血压患者服药依从性中的影响效果。方法抽选我院心血管内科2015年4月-2016年4月78例原发性高血压住院患者,入院当日首先进行服药依从性的问卷调查,了解其服药依从性,依从性高的患者不列入研究范围。然后采用系统随机分组的方式分为两组,采用常规护理干预的作为对照组,进入临床护理路径进行干预的作为干预组。结果干预组患者舒张压水平(92.6±4.2)mm Hg,收缩压水平(132.5±10.5)mm Hg,对照组患者舒张压水平(101.8±6.9)mm Hg,收缩压水平(141.8±15.3)mm Hg,比较具备统计学差异,P0.05。两组患者护理治疗依从性有效率分别为89.7%、51.3%,比较具备统计学差异,P0.05。结论护理路径在原发性高血压患者服药中的干预效果非常理想,有利于提升患者服药依从性。     

PDCA循环法对原发性高血压患者血压、焦虑抑郁情绪、自我效能的影响

目的探讨PDCA(戴明环)循环法(plan-do-check action cycle)对原发性高血压(高血压)患者血压、焦虑抑郁情绪、自我效能的影响。方法选取2015年1月至2016年12月海南省司法医院收治的高血压患者120例,按照随机数字表法分为研究组和对照组,每组60例。对照组以药物为中心,采用传统护理干预方式。研究组以患者为中心,采用PDCA循环法进行护理干预。比较两组护理干预前、干预6个月后的:(1)收缩压(SBP)、舒张压(DBP)变化情况;(2)焦虑及抑郁状况改善情况;(3)自我效能评价情况。结果两组干预后收缩压、舒张压均较干预前明显降低,差异均有统计学意义(P0.01)。研究组干预后收缩压、舒张压均明显低于对照组,差异有统计学意义(P0.01)。研究组干预后焦虑评分、抑郁评分均明显低于干预前(P0.01)。对照组干预前后焦虑评分、抑郁评分无明显统计学差异(P0.05)。研究组干预后焦虑评分、抑郁评分均明显低于对照组(P0.05,P0.01)。两组干预后自我效能评价中各项目评分均明显高于干预前(P0.01)。研究组干预后日常生活评分、健康行为评分、服药依从性评分均明显高于对照组(P0.01)。结论 PDCA(戴明环)循环护理方法能够有效改善高血压患者焦虑、抑郁情绪,提高降压效果,增强患者自我效能。     

微信小程序在糖尿病前期患者健康教育中的应用效果

目的:研究微信小程序在糖尿病前期患者健康教育中的应用效果。方法:于我院治疗的100例糖尿病前期患者被随机分为常规教育组(51例)和微信小程序组(49例,在常规教育组基础上接受微信小程序健康教育),两组均干预12周。观察比较两组干预前后血糖水平、干预后心血管危险因素知识认知水平、运动处方及饮食处方依从性。结果:随访期间,常规教育组5人退出,微信小程序组4人退出。与常规教育组比较,干预后,微信小程序组糖负荷后2h血糖水平[(8.39±0.77)mmol/L比(8.02±0.61)mmol/L]显著降低,心血管危险因素知识问卷得分[(18.11±2.76)分比(22.02±2.05)分]、运动处方达标周数比例[(45.29±13.68)%比(72.96±15.51)%]、饮食依从性问卷得分[(8.28±1.85)分比(10.76±2.22)分]均显著升高(P<0.05或<0.01)。结论:使用微信小程序进行健康教育可显著提高糖尿病前期患者运动的效果,饮食的依从性,提高心血管危险因素认知水平,改善血糖水平,对提高综合管理效果具积极意义。     

延续护理对癫疒间患者服药依从性与自我效能感的影响观察

以我院2015年4月到2016年4月收治的63例癫疒间患者为研究对象,采用随机数字表法将其分为观察组(32例)和对照组(31例)。对照组患者采用常规护理方式,观察组患者在对照组基础上实施延续护理。比较两组患者出院3个月和10个月的服药依从性与自我效能感。结果观察组患者出院后各时间段的服药依从性与自我效能感明显优于对照组,差异显著,(P0.05),具有统计学意义。结论对癫疒间患者实施延续护理能够有效提升其服药依从性和自我效能感。     

延续性自我管理教育对精神分裂症合并糖尿病患者服药依从性与自我效能的效果观察

目的观察应用延续性自我管理教育对精神分裂症合并糖尿病患者服药依从性与自我效能的影响效果。方法该文择取2016年2月—2017年2月该院收治78例精神分裂症合并糖尿病患者进行研究,按照随机分组方法将所选患者分为常规组和研究组,每组各39例,常规组患者行以常规健康教育,研究组患者行以延续性自我管理教育。结果出院后6、12个月,研究组患者的完全依从率均高于常规组(P0.05)。入院时两组患者自我效能评分无显著差异,但出院后6、12个月,研究组患者的自我效能评分高于常规组(P0.05)。结论对精神分裂症合并糖尿病患者行以延续性自我管理教育可以取得良好效果,提升患者的服药依从性和自我效能,值得推广和应用。     

基于链式管理的多学科健康教育模式应用于原发性高血压患者中的效果分析

目的探究基于链式管理的多学科健康教育模式应用于原发性高血压患者中的效果。方法选取2018年1月至2019年1月于我院就诊的原发性高血压患者106例,按照随机数字表法分为对照组和研究组,各53例。对照组予以常规健康教育模式,研究组采用基于链式管理的多学科健康教育模式,观察两组患者干预前后血压情况、高血压知识水平和服药依从性评分及行为模式转变。结果干预后,研究组舒张压、收缩压均明显低于对照组P0.05),HK-LS评分、MAS-8评分、健康行为模式率均明显高于对照组(P0.05)。结论基于链式管理的多学科健康教育模式可有效提升原发性高血压的降压效果、高血压知识水平及服药依从性,促进其进行健康行为模式。     

互联网医疗下个案管理在中青年高血压患者中的应用效果

目的分析互联网医疗下个案管理在中青年高血压患者中的应用效果。方法选取2016年1月—2017年6月上海市嘉定区安亭医院收治的中青年高血压患者100例,采用随机数字表法分为对照组和研究组,每组50例。对照组患者给予高血压分级管理,研究组患者给予互联网医疗下个案管理;两组患者均连续干预6个月。比较两组患者干预前后血压、总胆固醇、三酰甘油及自我效能评分,干预后血压达标率、治疗依从性评分、疾病认知率、健康行为改善情况、健康调查简表(SF-36)评分及生活满意度量表(SWLS)评分。结果 (1)干预前两组患者收缩压(SBP)、舒张压(DBP)、总胆固醇、三酰甘油及自我效能评分比较,差异无统计学意义(P0.05);干预后研究组患者SBP、DBP、总胆固醇、三酰甘油低于对照组,自我效能评分高于对照组(P0.05)。(2)干预后研究组患者血压达标率,治疗依从性评分,高血压认知率,按时服药、戒烟限酒、体育锻炼、合理膳食、情绪稳定、治疗不适与医护联系者所占比例高于对照组(P0.05);两组患者高脂血症认知率比较,差异无统计学意义(P0.05)。(3)干预后研究组患者生理职能评分、社会功能评分、总体健康评分及SF-36总分高于对照组(P0.05)。(4)干预后研究组患者SWLS评分高于对照组(P0.05)。结论互联网医疗下个案管理可有效降低中青年高血压患者血压及总胆固醇、三酰甘油,提高患者血压控制效果、治疗依从性、疾病认知水平及生活质量,改善患者自我健康管理能力及健康行为。     

家庭自我管理监测表在出院高血压患者中的应用效果

目的分析自我管理监测表在出院高血压患者中的应用效果。方法选取2014年5月—2016年3月成都市第一人民医院收治的高血压患者156例,随机分为对照组和观察组,每组78例。对照组患者出院后给予常规高血压健康教育,观察组患者在对照组基础上采用家庭自我管理监测表进行管理。比较两组患者干预前及干预半年后血压,空腹血糖,血浆同型半胱氨酸(Hcy)水平,血清总胆固醇、低密度脂蛋白、高密度脂蛋白水平及干预半年后自我效能评分。结果干预前两组患者收缩压、舒张压、空腹血糖及血浆Hcy水平比较,差异无统计学意义(P0.05);干预半年后观察组患者收缩压、舒张压、空腹血糖及血浆Hcy水平低于对照组(P0.05)。干预前两组患者血清总胆固醇、低密度脂蛋白及高密度脂蛋白水平比较,差异无统计学意义(P0.05);干预半年后观察组患者血清总胆固醇、低密度脂蛋白水平低于对照组,高密度脂蛋白水平高于对照组(P0.05)。干预半年后观察组患者服药行为、遵医嘱行为、健康行为、日常生活管理行为评分及自我效能总分高于对照组(P0.05)。结论家庭自我管理监测表在出院高血压患者中的应用效果良好,有利于更好地控制患者血压、血糖、血脂,提高患者自我管理能力。     

Three layer functional model and energy exchange concept of aging process

Relying on a certain degree of abstraction, we can propose that no particular distinction exists between animate or living matter and inanimate matter. While focusing attention on some specifics, the dividing line between the two can be drawn. The most apparent distinction is in the level of structural and functional organization with the dissimilar streams of ‘energy flow’ between the observed entity and the surrounding environment. In essence, living matter is created from inanimate matter which is organized to contain internal intense energy processes and maintain lower intensity energy exchange processes with the environment. Taking internal and external energy processes into account, we contend in this paper that living matter can be referred to as matter of dissipative structure, with this structure assumed to be a common quality of all living creatures and living matter in general. Interruption of internal energy conversion processes and terminating the controlled energy exchange with the environment leads to degeneration of dissipative structure and reduction of the same to inanimate matter, (gas, liquid and/or solid inanimate substances), and ultimately what can be called ‘death.’ This concept of what we call dissipative nature can be extended from living organisms to social groups of animals, to mankind. An analogy based on the organization of matter provides a basis for a functional model of living entities. The models relies on the parallels among the three central structures of any cell (nucleus, cytoplasm and outer membrane) and the human body (central organs, body fluids along with the connective tissues, and external skin integument). This three-part structural organization may be observed almost universally in nature. It can be observed from the atomic structure to the planetary and intergalactic organizations. This similarity is corroborated by the membrane theory applied to living organisms. According to the energy nature of living matter and the proposed functional model, the decreased integrity of a human body's external envelope membrane is a first cause of the structural degradation and aging of the entire organism. The aging process than progresses externally to internally, as in single cell organisms, suggesting that much of the efforts towards the restoration and maintenance of the mechanisms responsible for structural development should be focused accordingly, on the membrane, i.e., the skin. Numerous reports indicate that all parts of the human body, like: bones, blood with blood vessels, muscles, skin, and so on, have some ability for restoration. Therefore, actual revival of not only aging tissue of the human body's membrane, but the entire human body enclosed within, with all internal organs, might be expected. We assess several aging theories within the context of our model and provide suggestions on how to activate the body's own anti-aging mechanisms and increase longevity. This paper presents some analogies and some distinctions that exist between the living dissipative structure matter and inanimate matter, discusses the aging process and proposes certain aging reversal solutions.     

Unusual responses of nocturnal pineal melatonin synthesis and secretion to swimming: Attempts to define mechanisms

Abstract: The effect of swimming at night on rat pineal melatonin synthesis was compared with that of light exposure at night. Rats were forced to swim at 0030 hr (lights out at 2000 hr) and sacrificed by decapitation 15 and 30 min later, immediately after swimming. Other groups of animals were exposed to white light (650μW/cm²) for 15 and 30 min at same time. Swimming caused a rapid and highly significant drop in the melatonin content in the pineal gland; however, the activity of N-acetyltransferase (NAT), the supposed rate limiting enzyme in the melatonin production, was not changed. Despite the drop in pineal melatonin levels, serum concentrations of the indole remained elevated in the rats that swam. In contrast, melatonin levels in the pineal and serum of light exposed rats fell precipitously, accompanied by a significant suppression of NAT activity. Since we anticipated that the strenuous exercise associated with swimming may induce release of artrial natriuretic peptide (ANP) from the heart, which in turn could cause the release of pineal melatonin, in a second study we injected physiological saline intravenously to stretch the cardiac muscle and release ANP. Three milliliters of normal saline was injected during the day into the jugular vein of anesthetized rats that were pretreated with isoproterenol to stimulate pineal melatonin production. Animals were killed 15 min after the saline injection, and pineal NAT activity and pineal melatonin levels were measured. The saline injections caused no alteration in the elevated levels of either NAT or melatonin. These data suggest that the disparity in pineal NAT activity (which was high) and pineal melatonin (which was low), in animals swum at night, may not be caused by ANP which is released during strenuous exercise such as swimming.     

Melatonin and photoperiodic time measurement: Seasonal breeding in the sheep

Abstract: Well-established circadian physiology supports the view that photoperiodic time measurement utilizes the coincidence between the presence of light and a photosensitive phase of a 'biological clock' to alter reproductive status—the so-called external coincidence model of seasonal breeding. In this review, we examine the mechanism whereby photoperiod interacts with presumed suprachiasmatic nuclei activity to allow endogenous melatonin to normally synchronize reproductive activity to the optimal time of year. The Romney Marsh sheep is particularly explored as an experimental model. It is suggested that the on/off activity of seasonal reproduction may be a robust mechanism able to be predictably manipulated by the judicious use of the light/dark cycle and exogenous melatonin, but firmly based on circadian principles.     

Serological survey of HIV and syphilis in pregnant women in Madagascar

Objectives Peripartal transmission of human immunodeficiency virus (HIV) and Treponema pallidum, the causative agent of syphilis, leads to severe consequences for newborns. Preventive measures require awareness of the maternal infection. Although HIV and syphilis testing in Madagascar could be theoretically carried out within the framework of the national pregnancy follow‐up scheme, the required test kits are rarely available at peripheral health centres. In this study, we screened blood samples of pregnant Madagascan women for HIV and syphilis seroprevalence to estimate the demand for systemic screening in pregnancy. Methods Retrospective anonymous serological analysis for HIV and syphilis was performed in plasma samples from 1232 pregnant women that were taken between May and July 2010 in Ambositra, Ifanadiana, Manakara, Mananjary, Moramanga and Tsiroanomandidy (Madagascar) during pregnancy follow‐up. Screening was based on Treponema pallidum haemagglutination tests for syphilis and rapid tests for HIV, with confirmation of positive screening results on line assays. Results Out of 1232 pregnant women, none were seropositive for HIV and 37 (3%) were seropositive for Treponema pallidum. Conclusions Our findings are in line with previous studies that describe considerable syphilis prevalence in the rural Madagascan population. The results suggest a need for screening to prevent peripartal Treponema pallidum transmission, while HIV is still rare. If they are known, Treponema pallidum infections can be easily, safely and inexpensively treated even in pregnancy to reduce the risk of transmission.     

Variabilité des concentrations plasmatiques de l’angiotensinogène et risque d’hypertension artérielle chez le rat transgénique

Aim

Genetic polymorphisms of the human angiotensinogen gene are frequent and may induce up to 30% increase of plasma angiotensinogen concentrations with a blood pressure increase of up to 5 mmHg. Their role for the pathogenesis of human arterial hypertension remains unclear. High plasma angiotensinogen levels could increase the sensitivity to other blood pressure stressors.

Methods

Male transgenic rats with a 9-fold increase of plasma angiotensinogen concentrations and male non-transgenic rats aged 10 weeks were treated or not with NG-Nitro-L-arginine-methyl ester for 3 weeks in their drinking water (n = 3/group). Systolic blood pressure and body weight were measured at baseline and at the end of the study when left ventricular weight and ventricular expression of angiotensin I-converting enzyme and procollagen Iα1 were determined (polymerase chain reaction).

Results

At baseline, transgenic rats had +18 mmHg higher bood pressure and –8% lower body weight compared to non-transgenic rats (P < 0.05) without significant changes for the vehicle groups throughout the study (P > 0.05). NG-Nitro-L-arginine-methyl ester increased blood pressure, left ventricular weight and left ventricular weight indexed for body weight by +41%, +17.6% and +18.6% (P < 0.05) in transgenic and +25%, +5.3% and +6.7% (P > 0.05) in non-transgenic rats compared to untreated animals, respectively. Cardiac gene expression showed no differences between groups (P > 0.05).

Conclusion

Increased plasma angiotensinogen levels may sensitize to additional blood pressure stressors. Our preliminary results point towards an independent role of angiotensinogen in the pathogenesis of human hypertension and associated end-organ damage.     

Morphological and immunocytochemical heterogeneity of cultured pinealocytes from one-week-and two-month-old rats: Planimetric and densitometric investigations

Abstract: In vitro preparations of rat pinealocytes are widely used for biochemical analyses of signal transduction processes. This paper deals with morphological and immunocytochemical features of such preparations. Special attention was paid to the problems of whether pinealocytes represent a heterogeneous cell population and how such heterogeneity may develop during ontogeny. The investigations were performed with cells which were obtained from the pineal organ of one-week-and two-month-old rats, attached to synthetic peptide-coated coverslips or tissue culture chamber slides, and maintained under in vitro conditions overnight. The attached cells were then fixed with paraformaldehyde. These preparations yielded monolayers of spherical cells of different sizes; most cells were isolated, but some of them were aggregated and formed small clusters. On the average, the cells from the one-week-old animals were smaller than the cells from the two-month-old animals. Immunocytochemical demonstration of S-antigen, a pinealocyte-specific marker, showed that the majority of the cells from two-month-old animals were intensely or moderately labelled. Pinealocytes from one-week-old animals were less S-antigen immunoreactive. Only very few cells (less than 1% displayed glial fibrillary acidic protein (GFAP)-immunoreactivity. Planimetric investigations of the cell size and semiquantitative densitometric investigations of the intensity of the S-antigen immunoreaction revealed that (i) pinealocytes kept in vitro form a heterogeneous cell population, and that (ii) this heterogeneity increases during postnatal development from one-week-old to two-month-old animals. Two groups of pinealocytes can be distinguished based on their developmental fate: pinealocytes of one group grow dramatically, but show only a moderate increase in S-antigen immunoreactivity, and pinealocytes of the other group retain their size, but display a distinct increment in S-antigen immunoreacti vitv.     

MUTATION FREQUENCY IN NURSES AND PHARMACISTS WORKING WITH CYTOTOXIC DRUGS

Individuals occupationally exposed to cytotoxic drugs may be at risk owing to the effects of these agents on DNA. As an index of DNA damage, in vivo mutations were measured in lymphocytes from 24 oncology nurses or pharmacists and 24 matched controls. Mutation frequency was significantly increased in exposed individuals and appeared to be related to duration of exposure. However, the overall magnitude of the increase was small and its biological significance remains to be determined.