PBL教学法在蒙医护理学教学中的运用与思考

PBL教学法是一种以学生为主体、以问题为中心的积极有效的教学法,侧重于培养学生分析问题、解决问题的能力。PBL教学法的应用非常广泛,已在多所医学院校推广。笔者将结合教学实践经验,阐述在蒙医护理学教学中运用PBL教学法的优势与存在的问题。     

老年高血压患者糖代谢异常分析

<正> 随着我国老龄人口的增加,高血压患者随之增加。高血压与糖代谢异常并存最常见,伴发糖代谢异常后,高血压患者发生心血管并发症的危险可增加2～3倍。因此,高血压患者应该关注血糖代谢情况,即使血糖在正常葡萄糖耐量(NGT)阶段,如果有其他高危因素,应早期高度重视。本研究通过对高血压患者行口服葡萄糖耐量试验(OGTT)检测,     

Clinical analysis of inpatients with hyperglycemia in the medical intensive care units——Data of Shanghai Renji Hospital from 2002 to 2009

Objective To analyze the association of the morbidity,the management of blood glucose,and the prognosis of patients with hyperglycemia in the medical intensive care units(ICU).Methods Medical records of ICU patients of Renji Hospital from 2002 to 2009 were reviewed using Medical Record Inquiry System,and the data were retrospectively analyzed.Results(1)2631 subjects were included in the present study,blood glucose was determined at least once during hospitalization in 2168 of them.The incidence of hyperglycemia was 26.3%,in which 12.9% presented a known history of diabetes and 13.4% without.In the patients with diabetes history,93.2% of them received anti-diabetic treatment during hospitalization.mainly with oral anti-hyperglyeemic agents (53.0%)or subcutaneous insulin injection(24.9%).However,in the patients without diabetes history,84.4% were not treated against hyperglycemia.The mortality was increased in the latter group(30.4% vs13.9%,P<0.01).(2)In the patients with diabetes history,the mortality in patients whose blood glucose>10 mmol/L was higher than those with blood glucose≤7.0 mmol/L(20.5% vs 9.9%,P<0.05):while in the patients without diabetes history,the mortality began to rise as blood glucose>7.0 mmol/L(P<0.01).(3)Multiple stepwise regression analysis revealed that the average blood glucose level was an independent risk factor for death(OR=1.26).Conclusions The ICU patients showed a high prevalence of hyperglycemia,the management of hyperglycemia should be emphasized.Hyperglycemia in critically ill patients might be an independent risk factor of increased mortality.     

心血管疾病与糖代谢异常

近年来,我国心血管疾病与糖尿病的发生率均呈上升趋势,两者之间的关系愈来愈受到人们的关注。欧洲心脏调查和中国心脏调查均证实,冠心病与糖尿病及高血糖状态关系密切。有报道,冠心病、高血压住院患者糖代谢异常率高达60.6％。因此,临床医生应当高度关注心血管疾病患者糖代谢异常的病态。     

中西医结合治疗输尿管结石15例体会

中西医结合治疗输尿管结石１５例体会曹布道温都日夫河北省霸州市华北石油第十二综合服务处医院（河北０６５７０３）尿石症是泌尿系统的常见病，包括肾结石、输尿管结石、膀胱结石和尿道结石。常急性发作，疼痛剧烈。从１９９７年４月～１９９７年８月本院收治输尿管结石...     

他汀类药物在急诊PCI术后对IL-6hs-CRP及无复流的影响

目的：观察他汀类药物在急性心肌梗死患者急诊经皮冠状动脉成形术（PCI）后对IL-6、高敏C反应蛋白（hs-CRP）及无复流现象的影响.方法：将急性心肌梗死患者行急诊PCI者分为未使用他汀类药物组（A组）及使用他汀类药物组（B组）;并将A组分为：有发生无复流组（A1组）及未发生无复流组（A2组）,将B组分为：有发生无复流组（B1组）及未发生无复流组（B2组）,对各组的IL-6、高敏C反应蛋白及无复流现象进行分析.结果：A组53例（67.95％）,A1组15例（19.23％）,A2组38例（48.72％）,B组25例（32.05％）,B1组4例（5.13％）,B2组21例（26.92％）.使用他汀类药物组发生无复流现象比例显著低于未使用他汀类药物组（P=0.027）.未发生无复流现象组患者（A2组、B2组）IL-6、高敏C反应蛋白显著低于发生无复流现象组患者（P=0.015,P=0.027）;1B2组患者IL-6、高敏C反应蛋白显著低于A2组（P=0.001,P=0.012）;B1组患者IL-6、高敏C反应蛋白同A1组差异无显著性（P=0.147,P=0.178）.结论：无复流现象在服用他汀类药物的急性心肌梗死患者急诊PCI术中明显减少,且他汀类药物明显降低IL-6、高敏C反应蛋白.     

蒙药哈它各其－７ 散促进大鼠压疮创面愈合的实验研究

目的：探讨蒙药哈它各其－７ 散对大鼠压疮创面愈合的影响及其作用机制的研究。方法：本研究通 过体外磁片加压方法制备大鼠 ＩＩＩ 期压疮模型，采用 Ｗｅｓｔｅｒｎ ｂｌｏｔ 法检测大鼠压疮创面组织 ＶＥＧＦ、ＨＩＦ－１α 蛋白 表达情况。结果：蒙药哈它各其－７ 散可上调压疮创面组织 ＶＥＧＦ、ＨＩＦ－１α 蛋白表达。结论：蒙药哈它各其－７ 散 对模型大鼠压疮创面促愈和修复的作用机制可能与上调压疮创面组织 ＶＥＧＦ、ＨＩＦ－１α 蛋白的表达相关。