Adaptation of the health literacy universal precautions toolkit for rheumatology and cardiology – Applications for pharmacy professionals to improve self-management and outcomes in patients with chronic disease

Over a decade of research in health literacy has provided evidence of strong links between literacy skills of patients and health outcomes. At the same time, numerous studies have yielded insight into efficacious action that health providers can take to mitigate the negative effects of limited literacy. This small study focuses on the adaptation, review and use of two new health literacy toolkits for health professionals who work with patients with two of the most prevalent chronic conditions, arthritis and cardiovascular disease. Pharmacists have a key role in communicating with patients and caregivers about various aspects of disease self-management, which frequently includes appropriate use of medications. Participating pharmacists and staff offered suggestions that helped shape revisions and reported positive experiences with brown bag events, suggestions for approaches with patients managing chronic diseases, and with concrete examples related to several medicines [such as Warfarin^©] as well as to common problems [such as inability to afford needed medicine]. Although not yet tested in community pharmacy sites, these publically available toolkits can inform professionals and staff and offer insights for communication improvement.     

Who can give ‘spiritual care’? The management of spiritually sensitive interactions between nurses and patients

kevern p. (2012) Journal of Nursing Management  20, 981–989
Who can give ‘spiritual care’? The management of spiritually sensitive interactions between nurses and patients Aims This article considers the purpose of contemporary ‘spiritual care’ in order to help managers make informed decisions about its appropriate delivery in a clinical context. Background Although there are national policies in place concerning spiritual care, surveys indicate that nurses are reluctant to engage with the spiritual needs of patients. Evaluation A consideration of the character of spiritual care indicates the need to take account of the context of contemporary Western society. A model drawn from the social psychology of religion is used to analyse the different types of nurse–patient interaction available in the provision of spiritual care. Key Issues Although religious and spiritual commitments can vary widely, they are subject to the same pressures in a secular and pluralist social context. This enables some general guidelines to be developed. Conclusions Effective spiritual care requires a consideration of both the patient’s and the nurse’s implicit and explicit religious commitments. Implications for nursing management Nurse managers need to take account of the personal commitments of nurses when directing them to offer spiritual care. This article offers a diagnostic tool for deploying nurses in an appropriate way.     

剖宫产同时切除子宫肌瘤减少出血的临床研究

目的探讨剖宫产同时行子宫肌瘤切除术减少出血的临床措施及可行性与安全性。方法收集我院2007年3月-2012年11月因妊娠合并子宫肌瘤行子宫下段剖宫产并子宫肌瘤挖除术者276例，其中研究组135例，术前预先经直肠置入米索前列醇600μg，术中剖宫娩出胎儿后采用压挤法切除肌瘤；对照组141例，术中剖宫娩出胎儿后行传统肌瘤切除手术操作。比较两组手术时间、术中出血量、术后24h阴道出血量、恶露持续时间、产后病率、肛门通气时间。结果研究组术中出血量、术后24h阴道出血量均明显少于对照组，组间差异有统计学意义（P〈0．05），而手术时间、肛门通气时间、恶露持续时间及产后病率比较，组间均无统计学差异（P〉0．05）。结论剖宫产同时行子宫肌瘤切除术，采用压挤法联合术前应用米索前列醇可明显减少术中术后出血，安全可行，值得临床推广。     

Effect of BSA on carbon nanotube dispersion for in vivo and in vitro studies

Carbon nanotubes (CNT) are one of the most promising nanomaterials because of their intrinsic properties. So, it becomes urgent to assess their toxicity. However, CNT are insoluble in aqueous media required for toxicological studies. Thus, we propose a simple method to disperse CNT for toxicological studies using a biomolecule: The albumin. To evaluate this method, several nanotubes were suspended in saline solution (NaCl 0.9%) without or with albumin at a concentration of 0.5 mg/ml or equal as CNT concentration. These suspensions were visually compared to suspensions obtained with classical dispersing methods using Tween 80 or serum. Homogeneity of the suspensions with or without BSA and CNT structure were analyzed by TEM, agglomerates quantification and total carbon dosage. The effect of coupled albumin-CNT was then tested on A549 and U937 cells in vitro and on rats in vivo. Total carbon dosage, agglomerates quantification and TEM revealed that, in the presence of albumin, the tested nanotubes were better dispersed without any modification of their structure. The CNT suspension was tested in vitro and in vivo in rats. Albumin solution alone induced no modification of the biological responses studied (i.e., cell viability in vitro and inflammatory response and histopathology in vivo) compared to the saline. CNT in NaCl or BSA altered cellular viability in vitro in a similar way but results obtained with CNT suspension in the presence of albumin showed a better reproducibility that can be explained by the better homogeneity of the suspensions. CNT in BSA but not in NaCl significantly increased the cell number in BAL and also the number of apparent CNT-containing cells. Taken together, these results highlight the potential importance of CNT dispersion (and thus of the vehicle) for the toxicological studies.     

中医康抚辅以炒茴香热敷法在肾癌根治手术后护理研究

目的：探讨中医康抚辅以炒茴香热敷法在肾癌根治手术后的护理中的作用。方法：收集我院2010年6月—2012年12月收治的肾癌根治术后腹胀患者200例,随机分配到中医康抚组和中医康抚辅以炒茴香热敷法组,比较两组患者的肾癌根治手术后胃肠恢复的情况,并对此进行统计学分析,最后比较两组方法的疗效。结果：采用中医康抚护理组和中医康抚辅以炒茴香热敷法组的患者平均首次排气时间分别为（8.6±1.5）h与（4.8±1.2）h,平均腹胀消失时间分别为（16.2±2.1）h和（8.9±1.6）h;视觉模拟评分到2分时,两组患者的时间分别为（20.9±1.1）h和（16.3±0.5）h,均具有显著统计学差异（P〈0.05）。结论：中医康抚辅以炒茴香热敷法对肾癌根治手术后患者的胃肠功能恢复的疗效更明显。     

64排CT在创伤性颅脑损伤中的应用研究

目的探讨64排CT在创伤性颅脑外伤中的应用及临床价值。方法回顾性分析我院108例创伤性颅脑损伤患者的临床资料,所有患者均于入院半小时内完成64排CT检查,并针对病情给予相应临床治疗。结果所有患者经64排CT检查后明确诊断,配合相应的临床干预,出院时按格拉斯哥分级标准（GCS）评定预后,治愈86例,中残14例,重残2例,植物生存1例,死亡5例。结论 64排CT在创伤性颅脑损伤的特殊部位颅骨骨折、脑组织损伤及CT图像计分等方面应用,明显降低了漏诊和误诊率,有效指导了临床后续治疗,提高了患者生存质量。     

火焰原子吸收光谱法测定柏树叶中Zn Mn的含量

目的:测定柏树叶中Zn、Mn元素的含量。方法:HNO3∶HClO4(4+1)分解样品,火焰原子吸收光谱法测定柏树叶中微量元素Zn、Mn的含量。结果:柏树叶中含有丰富的微量元素Zn、Mn,含量分别为37.25μg/g,21.75μg/g,RSD<2.2%,加标回收率88.90%～108.00%。结论:柏树叶中含有丰富的微量元素且Zn的含量大于Mn。     

商河县生活垃圾无害化处理场库区杂填土地基处理

针对山东省商河县生活垃圾无害化处理场工程地质条件及垃圾堆载特点，介绍了地基处理方法的选用原则，根据地勘建议做水泥深层搅拌桩处理，与建筑常用的强夯法、换填法等处理方法进行综合分析比选，确定采用强夯法处理最为适合，并提出了具体的施工方法，对强夯后地基进行载荷试验检测，结果符合设计要求。     

用于老年基础医学研究与临床辅助诊断的神经肽Y及其受体Y1-6检测方法的初步设想

神经肽Y（NPY）作为机体内一种主要的神经递质和能量调控因子，广泛参与机体各种生理功能的调节，是维持机体内环境稳态的重要物质之一。随着对其研究的不断深入，人们发现它可通过与特定靶细胞膜上不同NPY受体Y1-6的特异性结合而启动并激活相应细胞信号传导通路，从而参与对机体生理功能和靶细胞增殖分化的调控，且NPY及其受体在体内的表达水平又可影响机体的正常生理功能、细胞代谢活动、以及这种改变所诱导或促进或参与的某些老年性疾病的发生、发展及转归，并对相关药物的防治带来明显影响。因此，对NPY及其受体含量的检测项目已成为相关老年性疾病与合并症的发病机制分析、疾病进程观察、治疗效果评价、疾病痊愈判断及预后跟踪随访的重要辅助诊断指标之一。为此，本文通过对可用于老年基础医学研究与临床辅助诊断的NPY及其受体检测的酶联免疫吸附法、放射免疫测定法、荧光免疫检测法、化学发光免疫分析法、免疫组织化学法、压电石英晶片免疫传感器法、免疫印迹法、斑点免疫层析及胶体金法、受体放射配基结合分析法、放射自显影法、液体芯片技术、微粒子酶免分析法等进行NPY及其受体检测方法的综述，并提出前瞻性设想和设计，希望这些用于检测NPY及其受体指标的方法能为未来老年医学的研究和临床应用奠定基础。