腹腔镜辅助下子宫肌瘤剥除手术患者的临床路径管理研究

目的 探讨腹腔镜辅助下子宫肌瘤剥除手术患者的临床路径管理.方法 选取2011年3月-2013年3月我院收治行腹腔镜辅助下子宫肌瘤剥除手术患者80例,随机分为实验组和对照组各40例,其中实验组实施临床路径管理,而对照组采用传统的医疗护理干预.结果 实验组患者给予临床路径管理后,其住院时间住院费用均获得了减少,且患者的满意度得到了提高,差异均存在统计学意义（P＜0.05）.结论 临床路径管理在行腹腔镜辅助下子宫肌瘤剥除手术患者围手期的护理模式具有良好的疗效,同时提高了患者的满意度,也有利于新护士的培训.     

益心舒胶囊治疗病毒性心肌炎的临床观察

目的：观察益心舒胶囊对病毒性心肌炎临床疗效。方法：将115例病毒性·,22肌炎患者以随机抽样法分为治疗组和对照组，其中治疗组60例，对照组55例，2组患者均常规给予5％葡萄糖注射液250ml＋三磷酸腺苷（ATP）40mg＋辅酶A200＋维生素C5．0g静脉滴注治疗，1日1次，治疗2周；治疗组患者在常规治疗的基础上，口服益心舒胶囊1次3粒，1日3次，疗程为4周。观察治疗前后2组患者的临床症状、心电图及心肌酶谱等变化。结果：治疗组患者临床症状、心电图、心肌酶谱的改变均明显优于对照组，2组比较差异有统计学意义（P〈0．05）；2组患者治疗前后血尿常规、肝肾功能等各项指标均无异常变化，未见明显不良反应。结论：益心舒胶囊治疗病毒性心肌炎有良好疗效，且安全性好，体现了中药的独特优势。     

普外术后患者行肠外营养的临床疗效评价

目的探讨普外术后患者进行肠外营养补给的临床治疗效果。方法选取在我院就诊的普外术患者共50例,将其分为两组,观察组在手术后进行肠外营养供给,对照组在手术后给患者输入葡萄糖补给,然后观察和比较两组患者手术后营养补给和身体恢复情况。结果观察组患者经过肠外营养供给之后,患者出现并发症的现象要明显低于对照组,并且观察组患者的身体恢复情况也要比对照组好很多。结论手术前后的营养补给能降低手术后并发症的发生率,肠外营养供给对普外手术患者具有重要的作用和意义。     

Six habits to enhance MET performance under stress: A discussion paper reviewing team mechanisms for improved patient outcomes

Effective team decision making has the potential to improve the quality of health care outcomes. Medical Emergency Teams (METs), a specific type of team led by either critical care nurses or physicians, must respond to and improve the outcomes of deteriorating patients. METs routinely make decisions under conditions of uncertainty and suboptimal care outcomes still occur. In response, the development and use of Shared Mental Models (SMMs), which have been shown to promote higher team performance under stress, may enhance patient outcomes. This discussion paper specifically focuses on the development and use of SMMs in the context of METs. Within this process, the psychological mechanisms promoting enhanced team performance are examined and the utility of this model is discussed through the narrative of six habits applied to MET interactions.A two stage, reciprocal model of both nonanalytic decision making within the acute care environment and analytic decision making during reflective action learning was developed. These habits are explored within the context of a MET, illustrating how applying SMMs and action learning processes may enhance team-based problem solving under stress. Based on this model, we make recommendations to enhance MET decision making under stress. It is suggested that the corresponding habits embedded within this model could be imparted to MET members and tested by health care researchers to assess the efficacy of this integrated decision making approach in respect to enhanced team performance and patient outcomes.     

辛伐他汀在脑血栓治疗中的疗效观察

目的：观察辛伐他汀在治疗脑血栓中的临床疗效，以更好地指导脑血栓的临床用药。方法收集2012年1月～2013年1月期间收治的82例脑血栓患者，随机分为观察组与对照组，每组各41例，两组均予以常规治疗，对照组予以口服阿司匹林，观察组在此基础上加用辛伐他汀进行治疗，比较两组的的临床疗效。结果观察组的治疗总有效率为97.6%，显著高于对照组的85.4%（P＜0.05）；治疗6个月、9个月后，观察组的颈动脉斑块IMT均显著低于对照组（P＜0.05）。结论辛伐他汀治疗脑血栓可显著延缓动脉粥样硬化进程，提高临床疗效，值得推广应用。     

Closing the gap: Novel therapies in treating acute lymphoblastic leukemia in adolescents and young adults

Acute lymphoblastic leukemia (ALL) is one of the most common cancer diagnoses identified in adolescents and young adults (AYAs). Although most children with ALL are cured of their disease, AYAs have experienced much worse outcomes over time, with event-free survival ranging from 30 to 45%. This survival disparity is likely due to differences in tumor biology, treatment-related toxicities, and nonmedical issues. This review summarizes these differences as well as focusing on the various trials that have demonstrated superior outcomes with pediatric protocols in AYAs with ALL. Even with the widespread use of these protocols, a treatment gap remains, and novel therapies are one way to address this problem. Still, these therapies also have significant toxicities and unique issues that need to be tested further, especially in the AYA population. The development of more AYA-specific trials will be an important way to examine novel therapies and interventions designed to reduce treatment-related toxicities and improve long-term outcomes.     

CT诊断原发性周围型小肺癌的临床应用价值

目的探讨CT诊断原发性周围型小肺癌的价值。方法回顾性分析44例原发性周围型小肺癌的临床资料,经X线平片检查后行常规CT平扫,同时病灶处行2 mm薄层及动态增强扫描后分析影像征像。结果该病基本征象有分叶征、毛刺征、空泡征、胸膜凹陷征、血管束集征等,病灶呈中等强化。结论 CT薄层扫描与动态增强扫描相结合,能清晰显示病灶内部细微征像,有助于提高诊断准确率。