脑卒中患者对个性化思维导图式健康教育体验的质性研究

目的探讨脑卒中患者对个性化思维导图式健康教育的体验。 方法采用质性研究中的现象学研究方法,选取广东省某三甲医院10例脑卒中患者为研究对象,以半结构式访谈的方法录音并收集资料,根据Colaizzi分析法对访谈资料进行整理、分析,提炼主题。 结果脑卒中患者对个性化思维导图式健康教育的体验可以归纳为三个主题,主题1：个性化思维导图有助于提高对脑卒中相关知识的掌握;主题2：个性化思维导图有助于促进健康行为;主题3：思维导图可以成为传播健康知识的工具。 结论个性化思维导图可以帮助脑卒中患者系统掌握脑卒中疾病相关知识,促进患者更多地采取健康行为,增进患者与家属、朋友的沟通。     

极化液个体化治疗对外科高血糖患者出院后的影响调查

目的:分析极化液个体化治疗对外科高血糖患者出院后的影响。方法:采用问卷填写方式,对我院2287例(包括入院前已存在糖尿病者125例)接受静脉极化液个体化治疗出院1a后的外科高血糖患者的极化液不良反应情况进行调查。结果:所有被调查者无1例继发糖尿病、高血压、低血糖症或对胰岛素产生心理依赖感;0.6%的被调查者担心日后仍会出现后遗症;在入院前即存在糖尿病且出院后正在使用胰岛素的患者中,有98.5%认为胰岛素能明显减轻糖尿病病情;在入院前即存在糖尿病或高血压且出院后未接受胰岛素治疗的患者中,100.0%认为外科住院期间大剂量使用胰岛素对糖尿病病情或高血压无影响;接受极化液补充营养、控制高血糖、抗炎、保护胰岛B细胞功能的患者分别占99.3%、96.9%、38.3%、5.5%。结论:极化液个体化治疗外科高血糖安全性高,不会出现后遗症。少数患者对极化液怀有恐惧心理,提示医护人员有必要加强对极化液使用的宣传工作。     

9例住院患者氨茶碱血药浓度监测

对 9例服用氨茶碱的住院患者进行血药浓度监测 ,结果提示临床研究给药方案个体化的重要性     

308例血液透析患者饮食护理体会

目的通过对血液透析患者的饮食护理,提高其疗效及生活质量。方法通过宣传教育、小讲课等方法对维持性血液透析患者的饮食进行管理,制定个体化食谱,改善血液透析患者饮食结构。结果维持性血液透析患者能够坚持合理饮食,痛苦轻,并发症少。结论采取科学合理的饮食护理,有利于提高透析患者的生活质量。     

分化型甲状腺癌患者需要个体化的TSH抑制

分化型甲状腺癌(DTC)流行特征在变化,促甲状腺素(TSH)抑制疗法也在改进.TSH的抑制程度,既要考虑分化型甲状腺癌复发和患者死亡的危险,也应考虑TSH抑制治疗可能带来的危害.不同的分化型甲状腺癌患者需要不同的TSH抑制程度.

Abstract：

The epidemic characteristics of differentiated thyroid cancer(DTC)are changing, thyrotropin(TSH)suppressive therapy is also improving in recent years. The risks of recurrence and the death of patients, as well as the adverse effects of levothyroxine sodium treatment should be fully considered during thyroid hormone administration for patients of DTC. Hence, the degree of TSH suppression should be individualized in patients with DTC.     

滥用抗生素的伦理反思

滥用抗生素已经成为世界性难题。虽然抗生素抗感染确实有效,但是,过度使用抗生素会使病原茵产生耐药性,产生各种不良反应以及造成医疗资源浪费等负面作用。导致抗生素滥用的原因主要是医疗机构公益性弱化。媒体的不当报道和药品广告助推了患者的认知误区。加强医德建设,坚持不伤害、以病人为本和为社会负责的原则,才能有效遏制抗生素滥用。     

根据鼻中隔偏曲制定个体化鼻内镜治疗方案的临床应用研究

目的探讨根据鼻中隔偏曲制定个体化鼻内镜治疗方案的临床应用价值,以提高鼻中隔偏曲的治疗效果。方法回顾性分析103例鼻中隔偏曲患者行个体化鼻内镜治疗的临床资料。结果术后随访3～6个月,治愈98例,好转5例,无效0例,所有患者鼻中隔居中,无穿孔,无鼻中隔飘动,鼻腔通气良好。结论根据鼻中隔偏曲制定个体化鼻内镜治疗,疗效好,并发症少,安全性高,值得临床应用推广。     

Individualization and Quality Improvement: Two New Scales to Complement Measurement of Program Fidelity

Fidelity scales have been widely used to assess program adherence to the principles of an evidence-based practice, but they do not measure important aspects of quality of care. Pragmatic scales measuring clinical quality of services are needed to complement fidelity scales measuring structural aspects of program implementation. As part of the instrumentation developed for the National Implementing Evidence-Based Practices Project, we piloted a new instrument with two 5-item quality scales, Individualization (a client-level quality scale) and Quality Improvement (an organizational-level quality scale). Pairs of independent fidelity assessors conducted fidelity reviews in 49 sites in 8 states at baseline and at four subsequent 6-month intervals over a 2-year follow-up period. The assessors followed a standardized protocol to administer these quality scales during daylong site visits; during these same visits they assessed programs on fidelity to the evidence-based practice that the site was seeking to implement. Assessors achieved acceptable interrater reliability for both Individualization and Quality Improvement. Principal components factor analysis confirmed the 2-scale structure. The two scales were modestly correlated with each other and with the evidence-based practice fidelity scales. Over the first year, Individualization and Quality Improvement improved, but showed little or no improvement during the last year of follow-up. The two newly developed scales showed adequate psychometric properties in this preliminary study, but further research is needed to assess their validity and utility in routine clinical practice.     

卵巢低反应人群的个体化控制性卵巢刺激的研究进展

卵巢低反应（poor ovarian response,POR）人群主要表现为对促性腺激素反应不良,周期结局较差,它的管理是辅助生殖技术中面临的主要难题之一。近几年提出的基于博洛尼亚标准的波塞冬标准对POR患者进行分层,更有利于患者的个体化管理,在一定程度上有利于改善患者的妊娠结局。本文将从POR患者的诊断、排卵方案的...     

An in silico model using prognostic genetic factors for ovarian response in controlled ovarian stimulation: A systematic review

PurposeTo study the use of in silica model to better understand and propose new markers of ovarian response to controlled ovarian stimulation before IVF.MethodsA systematic review and in silica model using bioinformatics. After the selection of 103 papers from a systematic review process, we performed a GRADE qualification of all included papers for evidence-based quality evaluation. We included 57 genes in the silica model using a functional protein network interaction. Moreover, the construction of protein-protein interaction network was done importing these results to Cytoscape. Therefore, a cluster analysis using MCODE was done, which was exported to a plugin BINGO to determine Gene Ontology. A p value of < 0.05 was considered significant, using a Bonferroni correction test.ResultsIn silica model was robust, presenting an ovulation-related gene network with 87 nodes (genes) and 348 edges (interactions between the genes). Related to the network centralities, the network has a betweenness mean value = 102.54; closeness mean = 0.007; and degree mean = 8.0. Moreover, the gene with a higher betweenness was PTPN1. Genes with the higher closeness were SRD5A1 and HSD17B3, and the gene with the lowest closeness was GDF9. Finally, the gene with a higher degree value was UBB; this gene participates in the regulation of TP53 activity pathway.ConclusionsThis systematic review demonstrated that we cannot use any genetic marker before controlled ovarian stimulation for IVF. Moreover, in silica model is a useful tool for understanding and finding new markers for an IVF individualization.ProsperoCRD42020197185Supplementary InformationThe online version contains supplementary material available at 10.1007/s10815-021-02141-0.