行动研究在护理领域的应用进展

综述行动研究在护理领域的应用进展,指出行动研究已渗透到护理教育、临床实践、疾病管理、护士培训、社区护理等方面并取得良好成效,国外行动研究发展较为成熟,国内关于行动研究的理论阐述较多,实践研究较少。今后行动研究应更多地应用于社区护理、慢性病病人自我管理等方面。     

CD36 palmitoylation disrupts free fatty acid metabolism and promotes tissue inflammation in non-alcoholic steatohepatitis

1. Download high-res image (151KB)
2. Download full-size image

     

Quantitative Assessment of the Associations Between Interleukin‐8 Polymorphisms and Periodontitis Susceptibility

Background: This review assesses the associations of interleukin‐8 gene (IL‐8) ?251A/T (rs4073) and ?845T/C (rs2227532) polymorphisms with susceptibility to periodontitis. Methods: Several electronic databases were searched for eligible articles. Twelve studies involving 2,233 cases and 2,655 controls were retrieved and analyzed. Odds ratios (ORs) along with 95% confidence intervals (CIs) were calculated to assess the strength of relationship between the IL‐8 polymorphisms and periodontitis risk. Results: No significant association was found for IL‐8 ?251A/T polymorphism with periodontitis in the overall analysis and stratification by periodontitis type and smoking status. Subgroup analysis by ethnicity revealed that ?251A/T T allele and TT genotype were associated with decreased risk of periodontitis in a Brazilian mixed population (T allele versus A allele: OR 0.80, 95% CI 0.68 to 0.94, P_{heterogeneity} = 0.30; TT versus AA: OR 0.65, 95% CI 0.46 to 0.93, P_{heterogeneity} = 0.39; TT versus AA/AT: OR 0.58, 95% CI 0.35 to 0.98, P_{heterogeneity} = 0.01). In addition, ?251A/T T allele was associated with increased periodontitis risk in Asians. Pooled estimates showed that the ?845T/C polymorphism was associated with periodontitis susceptibility in overall analysis and the chronic periodontitis subgroup. In addition, marginal associations were observed between ?845T/C polymorphism and periodontitis in a Brazilian mixed population. Moreover, this association was also confirmed to be significant in Brazilian non‐smokers. Conclusion: This meta‐analysis indicated that both IL‐8 ?251A/T and ?845T/C polymorphisms may be involved in the development of periodontitis in a Brazilian mixed population, whereas the ?251A/T allele T appeared to be a risk factor for periodontitis in Asians.     

Blood donation in China: sustaining efforts and challenges in achieving safety and availability

China has entered a new phase in blood safety and availability through persistent efforts in the past decades. Based on national data from 2008 to 2012, we present a comprehensive review on the blood services ranging from policy and organization, supply, donors, screening and processing, and clinical use to government response in contemporary China. Current evidence suggests that the Chinese blood industries, after continual efforts in reforms on the legal framework and national management system, have been in a relatively steady but bottleneck stage. Although the blood industries have had an impressive track record on management and resolving problems, such as low availability, limited donors, deficient laboratory tests, shortage of blood products, and unnecessary clinical usage of blood still exist nationwide. While medical technology and services have seen a rapid increase in progress in recent years, they have not coordinated with the development of the national health care system. This article presents an analysis with detailed data, rich contents, and recent response from the Chinese government, allowing readers to appreciate how China, a country with more than 19.13% of the world's population, has long endeavored to improve safety and availability of blood. Meantime, the article sincerely welcomes the guidance on policymaking and technical assistance from the international community. Data in this article do not include those of Hong Kong, Macao, or Taiwan.     

齐拉西酮对男性精神分裂症临床疗效及生活质量的影响

目的：探讨齐拉西酮对男性精神分裂症患者临床疗效及生活质量的影响。方法将66例男性精神分裂症患者随机分为两组,每组33例,研究组口服齐拉西酮治疗,对照组口服利培酮治疗,观察10周。于治疗前后采用简明精神病评定量表评定临床疗效,副反应量表评定不良反应,生活质量综合评定问卷评定生活质量。结果治疗后两组简明精神病评定量表评分均较治疗前显著下降（P＜0．01）,两组间评分比较差异均无显著性（P＞0．05）。两组不良反应较轻微,研究组总体不良反应发生率以及锥体外系反应、体质量增加发生率显著低于对照组（P＜0．05）。治疗10周末研究组生活质量综合评定问卷总分及身体健康、心理健康维度分显著高于对照组（ P＜0．05或0．01）。结论齐拉西酮治疗男性精神分裂症疗效显著且与利培酮相当,不良反应发生率低、治疗依从性好,有利于提高患者的生活质量。     

二维超声对胎儿肺部发育规律的研究

目的探讨二维超声测量胎儿左右肺面积、左右肺纵径、左右肺体积及总肺体积,及通过其测量值评价胎儿肺部发育的应用价值。方法 2013年6月至2014年6月在广东省妇幼保健院进行产前超声检查并足月分娩的孕妇489例,对此489例12~40周胎儿进行二维超声扫查,在四腔心切面应用Trace法分别描迹左肺、右肺面积;在胎儿左、右侧肺最大矢状切面分别测量左、右侧膈顶至左、右肺尖的距离,应用体积公式长(cm)×宽(cm)×高(cm)×0.52分别计算左、右肺体积,总肺体积。应用Bivariate法分析孕周与左右肺面积、左右肺纵径、左右肺体积及总肺体积的相关性,绘制12~40周胎儿左右肺面积、左右肺纵径、左右肺体积及总肺体积的生长曲线,获取12~40周胎儿左右肺体积及总肺体积的第5,25,50,75,95百分位数。结果 (1)孕周与胎儿左右肺面积、左右肺纵径、左右肺体积及总肺体积的Spearson相关系数分别为0.929、0.923、0.923、0.917、0.946、0.943、0.951,且呈正相关,具有统计学意义(P<0.05)。(2)左右肺面积、左右肺纵径、左右肺体积及总肺体积测值的增长速率趋势一致,均随孕周增加而增长;肺面积在孕26周前增长速度较快,26周后增长速度减缓;肺纵径及肺体积在整个孕期呈均速增长,但肺纵径增长速度略快于肺体积。(3)成功获取12~40周胎儿左右肺体积及总肺体积的第5、25、50、75、95百分位数参考值范围。结论 12~40周胎儿左右肺面积、左右肺纵径、左右肺体积及总肺体积随孕周的增加而增长。左右肺体积及总肺体积的第5、25、50、75、95百分位数为产前诊断胎儿肺发育不良提供有价值的参考指标。获取胎儿四腔心切面及左、右侧肺最大矢状切面操作简单、便捷、可行性良好,可能成为一种新型的评价胎儿肺部发育常规手段。     

护理干预对糖尿病伴发焦虑症患者生命质量的影响

目的：探讨护理干预对糖尿病伴发焦虑症患者生命质量的影响。方法将2009年10月至2013年10月住院治疗的糖尿病伴发焦虑症患者100例随机分为研究组和对照组。在药物治疗的基础上,对照组患者给予糖尿病一般性护理,而研究组患者给予护理干预。采用健康状况调查问卷（ SF－36）和汉密顿焦虑量表对比分析两组患者的健康水平及焦虑情况。结果治疗前两组患者的SF－36因子差异均无统计学意义（P＞0．05）,而在治疗后差异均出现统计学意义（P＜0．05）。治疗前研究组和对照组患者的焦虑评分分别为（23．25±4．13）和（22．07±5．77）（ P＞0．05）。治疗后则分别为（11．06±3．61）和（19．58±4．14）（ P＜0．01）。结论通过干预护理可以提高糖尿病伴发焦虑症患者的生命质量,同时减轻患者焦虑情绪,临床效果良好。     

Characterization of a Trichinella spiralis 31 kDa protein and its potential application for the serodiagnosis of trichinellosis

The Trichinella spiralis 31 kDa protein (Ts31) was screened from the excretory-secretory (ES) proteins of muscle larvae (ML) by immunoproteomics using serum from mice infected with T. spiralis at 18 days post infection (dpi). The aim of this study was to characterize the Ts31 protein and to evaluate the potential of the recombinant Ts31 protein (rTs31) for serodiagnosis of human trichinellosis. Ts31 gene was cloned and rTs31 was produced in an E. coli expression system. An anti-rTs31serum recognized the native protein migrating in a 25–55 kDa range by Western blotting of ML crude or ES antigens. Expression of Ts31 gene was observed at all developmental stages of T. spiralis (adult worms, newborn larvae, pre-encapsulated larvae and ML). An immunolocalization analysis identified Ts31 in the cuticle and stichocytes of the parasite. The sensitivity of rTs31-ELISA and ES antigen ELISA for detecting anti-Trichinella IgG antibodies in sera of patients with trichinellosis was 97.83% (45/46) and 86.78% (39/46), respectively (P > 0.05); The specificity of rTs31-ELISA was 99.13% (114/115), which was significantly higher than 85.22% (98/115) of ES antigen ELISA (P < 0.01). The rTs31 protein of T. spiralis could be considered as a potential diagnostic antigen for trichinellosis.     

In vitro TNF blockade enhances ex vivo expansion of regulatory T cells in patients with immune thrombocytopenia

Tumour necrosis factor‐α (TNF) is an inflammatory cytokine that is elevated in a number of autoimmune diseases including immune thrombocytopenia (ITP), a bleeding disorder characterized by low platelet counts. In vitro TNF blockade increases expansion of the regulatory T cell (Treg) IKZF2 (also termed Helios) subset in T cell‐monocyte cocultures from healthy donors, but its role on proliferative responses of Tregs in ITP patients, who have altered immunoregulatory compartment, remains unclear. TNF in CD4+ T cells from patients with chronic ITP were elevated and negatively correlated with peripheral Treg frequencies, suggesting a possible inhibitory effect of TNF on ITP Tregs. In vitro antibody neutralization with anti‐TNF in T cell‐monocyte cocultures resulted in a robust expansion of pre‐existing ITP Tregs, higher than in healthy controls. Similar to the effects of anti‐TNF antibodies, TNF blockade with antibodies against TNFRSF1B (anti‐TNFRSF1B, previously termed anti‐TNFRII) almost doubled ITP Treg expansion whereas neutralization with anti‐TNFRSF1A (anti‐TNFRI) antibodies had no effect on proliferative responses of Tregs. In addition, TNFRSF1B levels on ITP Tregs were significantly elevated, which may explain the increased susceptibility of patient Tregs to the actions of TNF blockade. Altogether, these data raise the possibility that TNF blockers, through their ability to increase Treg proliferation, may be efficacious in ITP patients.