对妇产科护士进行疼痛管理培训的必要性探讨

目的．了解妇产科护士在临床护理中实施疼痛管理的现状。方法对二甲以上医院妇产科护士125人进行问卷调查,数据用SPSS软件进行统计处理。结果83．1％的护士疼痛管理知识缺乏194．9％的护士认为有必要对疼痛患者采取有效的镇痛措施;26．3％的护士能否准确评估患者的疼痛程度并采取镇痛措施。结论对妇产科护士进行疼痛管理知识的培训非常有必要。     

对护理人员避光药物安全用药知识的调查

目的 了解护士对避光药物安全用药及管理现状.方法 采用问卷调查法及现场考核法,对110名护理人员进行避光药物安全用药认知及用药指导及药品管理的调查和考核.结果 护士对避光药物安全用药的认知正确率仅为61.17%,对避光药物管理的知识正确率为68.0%.对相关药理知识的掌握为52.38%,用药指导正确率为65%.不同工作年限,学历,职称及职务的护理人员对避光药物相关药理知识掌握情况差异有统计学意义.结论 提高护士对避光药物安全用药认知、安全用药管理及相关药理知识的学习,可不断提高服务质量和患者满意率.     

在职护士与实习护生疼痛管理知识认知比较

摘要：目的了解在职护士和实习护生疼痛管理知识认知现状，为制订疼痛管理教育对策提供依据。方法采用自行设计的问卷对某二级甲等医院70名在职护士及71名实习护生进行调查。结果20项调查内容中，在职护士与实习护生分别有10项和13项正确率低于60％，她们均在疼痛管理态度维度正确率最高，对疼痛治疗的认知水平最低，差异有显著性（P〈0．01）。结论在职护士和实习护生疼痛管理知识的认知水平较低，且存在认知偏差，建议医院设计有效的疼痛培训项目提高其疼痛管理知识认知水平。     

骨科护理人员对疼痛管理相关知识及认知态度的调查

目的：调查某地市三级甲等综合医院骨科护理人员对骨科患者术后疼痛管理的认知态度,以提高骨科护理人员对术后患者疼痛症状的重视度。方法：采取自行设计的问卷对我院50名护理人员进行疼痛管理认知调查。结果：骨科护士对疼痛评估方法了解不全面,对疼痛相关知识掌握欠缺。结论：骨科护士疼痛管理知识及能力有待提高,可经过多种方式进行培训。     

疼痛护理认知能力对疼痛控制影响的调查与分析

目的探讨疼痛护理认知能力对疼痛控制的影响。方法对某医院参加讲座的部分护理人员进行现场问卷调查。结果14项问卷内容中选择正确率在50％以上的仅有6项，护理人员有关疼痛护理和治疗的认知能力明显不足。结论加强对护理人员的疼痛护理相关知识教育，使他们在疼痛护理的知识和态度方面有所转变，有利于减少疼痛对病人的损害，提高疼痛病人的生活质量。     

骨科患者术后疼痛认知调查分析与对策

目的对骨科术后患者的疼痛进行认知调查并分析，制订合适的疼痛管理对策。方法采用自行设计的问卷表，对骨科住院术后3d的136例患者进行调查，调查术后患者对疼痛相关知识的需求、对术后疼痛症状的认知、相关经历及镇痛理念。结果82．4％的患者认为，医护人员在术前有必要讲解疼痛知识；61％的患者认为术后切口疼痛程度与医生手术技术有关；75％的患者没意识到疼痛会对功能康复有影响；76．5％的患者在术前对术后切口疼痛存在焦虑；经历中度及以上切口疼痛的患者占61．8％。结论改变患者疼痛认知，对疼痛进行有效的管理。管理对策有改变认知，医院政策支持，建立疼痛管理沙龙小组，提高疼痛管理技能，创造疼痛管理病区环境。     

术后疼痛护理现状分析及对策

1术后疼痛中存在的障碍分析(1)害怕成瘾:麻醉药是术后止痛药的主要药物,害怕对麻醉药的成瘾是直影响有效疼痛控制的主要障碍,医生不愿开麻醉处方,护士不愿给病人用止痛药,病人尽可能的不用或少用。把临床上病人因疼痛加剧需要增加药物用量或者因疼痛需要继续应用止痛药的情况当作成瘾。从而使护士害怕继续给病热病人用药,尽量拖延用药或不给药,阻碍了有效的疼痛控制。(2)疼痛评估不准确、不及时:①疼痛评估缺乏常规性:护士会常规地监测术后病人的生命体征,但对术后疼痛评估缺乏常规性。②疼痛评估方法不正确:护士在护理手术病人时,一般询问…     

ICU护理人员对危重患者疼痛护理相关知识及应用现状的研究

目的探讨ICU护理人员对危重患者疼痛护理相关知识及应用现状,寻求较理想的疼痛干预护理模式。方法对我院3个专科ICU病房的32名护理人员采取问卷调查的形式进行调查。收集信息,分析疼痛护理相关知识及应用现状。结果不同特征的护理人员对疼痛护理的认知存在差异。获得疼痛护理知识最主要途径为工作后的继续教育,ICU危重患者不能交流、护理工作量大、评估工具不适用制约了疼痛护理的发展;高素质的护士人员、团队协作、具体的护理方案有助于疼痛护理的发展。结论强化ICU护士的疼痛教育,了解ICU护理工作中的优势和不足,促进疼痛护理质量的提升。     

加强社区门诊护理探讨

目的探讨社区门诊护理的作用。方法在门诊开展健康教育，加强护理，技术性指导。结果病人对护士的满意度提高了，病人对用药知识提高了，增加了病人及家属对疾病预防知识的认知。结论护理人员以病人为中心可大大提高护理质量。     

护士对护理安全相关内容认知状况调查及分析

护理安全是护理工作的核心，各种护理安全不良事件不仅可以损害病人的身心健康，甚至可以威胁病人的生命，护理人员如果对护理相关内容认识不足，很大程度上增加了护理工作风险性。本调查采取自制问卷调查表，在乌鲁木齐地区4所二级以上医院随机抽取临床护士200名，对护理安全相关内容认知状况进行调查。旨在了解乌鲁木齐地区护士对护理安全相关知识认知现状，提出数据资料，为进一步开展有关工作提供依据。     

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

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.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.