上海市宝山区5000名学生视力监测与干预情况

目的:通过监测获得宝山区中小学生视力、屈光不良情况,研究行为干预对近视发展有无影响。方法:采用整群随机抽样的方法,在上海市宝山区抽取中小学校5所,参照《眼科全书》近视诊断标准对所有学生进行视力普查,对视力低常学生使用拓普康RA800型验光仪进行电脑验光,选择基础条件相似的两所学校部分班级进行分组,加以行为干预,0.5a后对所测学生进行复查。结果:宝山区学生视力不良率高于上海市平均水平,且随年级升高呈现出阶梯性增长态势。小学生视力不良率已经达到将近50%,初中生达到了70%以上。随着年级增高,轻度屈光不良所占比例越来越低,重度屈光不良所占比例也越来越高,从一年级的10%左右增长到初二年级的30%左右。每个年级监测人群前后两次视力不良对比无统计学差异,每个年级屈光不良分级构成比前后无统计学差异。不能认为采取的干预措施对学生视力不良率的发展产生作用,但是干预对学生护眼知识方面水平的提高比较明显。结论:学生视力不良率随年级升高而逐渐升高,重度屈光不良所占比例也逐渐升高,强化行为干预对限制学生近视发展无明显作用。     

饮食与生活习惯对痤疮发病的影响

目的：确定痤疮发病的危险因素,为干预痤疮的发生和发展提供依据。方法：我科对门诊300例痤疮患者进行了饮食及生活习惯问卷调查,用SPSS17.0软件分析与痤疮发病的危险因素。结果：多因素logistic回归分析,病例组的睡眠不规律比例比对照组高,差异具有统计学意义(P <0.05), 其OR值为1.979>1;病例组食用辛辣食品、甜食等饮食因素的比例较对照组高,但差异无统计学意义(P＞0.05)。结论：未发现饮食因素对痤疮的发病有影响,睡眠不规律可能是痤疮发病的独立危险因素。     

电视胸腔镜治疗自发性气胸的手术配合

总结50例电视胸腔镜治疗自发性气胸的手术配合.主要包括熟悉手术过程、掌握仪器的功能、原理及操作规程,熟悉设备保养.认为良好的手术配合是保证电视胸腔镜治疗自发性气胸疗效的关键.     

高通量测序分析重度寻常痤疮患者和健康人肠道菌群差异

目的 利用高通量测序技术分析重度寻常痤疮患者和健康人肠道菌群的差异.方法 门诊确诊的重度寻常痤疮患者10例及年龄、性别相匹配的健康人10例,分别收集粪便标本,提取细菌DNA,行16S rRNA测序鉴定微生物的种类,并进行菌群差异分析.结果 两组肠道菌群多样性未发现显著差异,仅在肠道菌群的相对丰度上发现个别具有显著差异的菌.两组标本主要由拟杆菌门、厚壁菌门、变形菌门、放线菌门组成.比较两组在门、属水平上菌群相对丰度,差异均无统计学意义;在种水平上,Blautia producta、Coprococcus eutactus在两组间差异有统计学意义.结论 重度寻常痤疮患者和健康人相比,菌群多样性指数未见明显差异.但某些细菌菌种存在显著差异.     

数字化学习平台在手术室护理教学中的应用

总结了数字化学习平台在手术室护理教学中的应用体会.为了改进教学质量,提高实习生的学习积极性,提高教学效率,本院手术室在护理教学上运用中山大学数字化学习平台(blackboard)的多种教学手段,将传统的护理实践教学模式转换成一个新型的数字化护理实践教学模式,包括针对学生需求的课程设计,形式丰富的课件制作,形象直观的教学方式.认为未来的手术室护理教学方式将逐渐走向网络化、远程化.本院施行的数字化教学平台简化了教学过程,提高了教学效率,学生更易接受.     

岛状背阔肌肌皮瓣乳房再造加腋前皱襞重建术的护理配合

Objective To study nursing cooperation of second-stage reconstruction of breast and anterior axillary fold with island latissimus dorsi musculocutaneous flap after Radical Mastectomy. Methods Thirteen patients with severe defect of thoracic wall underwent second-stage reconstruction of breast and anterior axillary fold with island latissimus dorsi musculocutaneous flap and breast implants 1 ～ 4 years after the Radical Mastectomy for breast cancer. The nursing cooperation including preoperative preparation of staffs, surgical instruments, and articles, and methods of intraoperative nursing cooperation were retrospectively analyzed.Results Procedure success was gained in all 13 cases, without operation beingg delayed because of surgicalinstruments or poor cooperation. Flaps survived intraoperatively and postoperatively. Primary healing of incision without any infection was observed for all patients. Satisfactory mammary contour was achieved for all patients uneventfully with absence of any complications. Conclusions Careful preoperative preparation of articles and psychological nursing to gain best cooperation of the patients, and skilled intraoperative nursing cooperation are essential for procedure success.     

手术室泌尿外科护理专科组的设置及培训

目的探讨手术室泌尿外科护理专科组的设置及培训方法。方法在手术室设立泌尿外科护理专科组,按专科化模式培养手术室泌尿外科护理专科护士,建立培训考核体系。结果该法提高了工作质量,手术医生和病人对手术室的满意度得到提高。结论手术室专科护士和专科组长的设置培养,能适应外科手术日益专科化发展的需求,提高工作质量和工作效率,值得推广应用。     

PI3K-Akt-eNOS信号转导通路在吗啡促人脐静脉内皮细胞一氧化氮合成中的作用

Objective To evaluate the role of phosphatidyhnositol 3-kiuase-Akt-endothelial nitric oxide synthase (PI3K/Akt/eNOS) signal transduction pathway in nitric oxide (NO) synthesis increased by morphine in cultured human umbilical vein endothelial cells (HUVECs). Methods HUVECs were inoculated in 24 well palates in vitro. Three experiments were performed in this study. In experiment Ⅰ , HUVECs were randomly divided into 4 groups of 6 wells each: control group (group C) and morphine group (group MM1～3). In group M1～3,morphine with the final concentration of 1 μmol/L was added, and then the cells were incubated for 3, 6 and 12 h respectively. NO synthesis was viewed with fluorescence microscope and NO content was measured. In experiment Ⅱ , HUVECs were randomly divided into 4 groups of 6 wells each: group C and group M1～3. In group M1～3,morphine with the final concentrations of 0.01, 1 and 100 μmol/L was added respectively, and then the cells were incubated for 6 h. NO content was measured. In experiment Ⅲ, HUVECs were randomly divided into 5 groups of 6 wells each: group C, group M, group M + wortmannin (W) (group MW), group M + SH-5 (group MS) and group M + L-NAME (group ML). In group M, morphine with the final concentration of 1 μmol/L was added. In group MW, wortmannin (a PI3K specific inhibitor) was added and 15 min later, morphine with the final concentrations of 5 and 1 μmol/L was added. In group MS, SH-5 (an Akt specific inhibitor) was added and 15 min later, morphine with the final concentrations of 10 and 1 μmol/L was added. In group ML, L-NAME (an eNOS specific inhibitor) was added and 15 min later, morphine with the final concentrations of 0.5 and 1 μmol/L was added. The cells were then incubated for 6 h and NO content was measured in each group. Results In experiment Ⅰ , morphine treatment increased the endothelial NO synthesis in a time-dependent manner (P <0.05). In experiment Ⅱ , morphine treatment increased the endothelial NO synthesis in a concentration-dependent manner (P < 0.05). In experiment Ⅲ, increased NO synthesis by morphine treatment was abolished by wortmannin, SH-5, or L-NAME. Conclusion Morphine can increase NO synthesis in cultured HUVECs in concentration- and time-dependent manners, and the mechanism may be related to the activation of the PI3K-AKT-eNOS signal tranaduction pathway.     

浅谈提高护理人员职业素质

护理工作是医院整体工作的重要组成部分。护理队伍的建设关系到提高医院管理水平,提高医疗护理质量,加速医院现代化建设。护理人员的职业素质—职业道德修养,是由护理工作的性质与任务所决定的。护理人员日夜工作在患者身边,担负着贯彻执行治疗方案,严密观察病情、预防并发症的发生及参加抢救危重患者的重要任务。护士与患者接触多,患者有什么话,最先对护士说,     

人胎肝胞质液治疗亚急性肝坏死一例报告

1 临床资料 患者女,49岁,江苏农民。1989年7月1日始发热头痛、全身不适、乏力、腹胀纳减、恶心呕吐进行性加重,18日在当地医院查肝功SB 198.4μmol/L,TFT+++,TTT 7U,ZnTT14U,A/G:3.3/2.4,PT 19.5s(对照13.5s),ALT>200U,拟诊为亚急性重症肝炎,经综合治疗后病情未见好转并出现腹水,于1989年8月12日转来我院。查体:T37.5℃,P92次/min,R20次/min,BP13.3/9.2kPa(100/70