全喉切除患者嗅觉障碍评估与干预的研究进展

全喉切除术是治疗中晚期喉癌的主要方法,可显著提高患者生存率,但手术也给机体的整体功能带来许多负面影响。嗅觉障碍是全喉切除术后患者常见问题之一且对患者的日常生活产生严重危害和影响,国外学者早已关注到全喉切除患者嗅觉障碍问题并开展干预研究,而国内却鲜见相关文献报道。本文对全喉切除患者嗅觉障碍的发生现状、恢复情况、发生原因、嗅觉功能评估方法及嗅觉功能康复的干预措施进行综述,旨在为我国医护人员促进全喉切除患者嗅觉功能康复提供借鉴。     

普外科手术患者术后疼痛相关因素研究

目的观察和分析年龄、性别和护理干预与普外科患者手术后疼痛分级的关系。方法以我院普外科2010年10月～2011年10月住院进行手术的528例患者作为研究年龄、性别与术后疼痛关系的观察对象，按患者年龄分为少年组、青年组、中年组、老年组；按性别分为男性组和女性组；将我院2011年11月～2012年7月进行手术的305例患者随机分为观察组和对照组，观察护理干预对术后疼痛的影响。观察组给予综合性护理干预，对照组给予普外手术一般护理；按照主诉疼痛分级法，将患者术后的疼痛感觉分为四组：无疼痛组、轻度疼痛组、中度疼痛组、重度疼痛组。运用分级资料的统计学分析方法（Kruskal—WallisH检验、Spearman秩相关分析），分析普外科手术后疼痛程度分别与患者年龄、护理干预的相关性。结果普外科手术后疼痛程度与年龄之间有明显相关性（疼痛程度与年龄的比较结果Y。=9．341，P〈0.05，Spearman相关系数为rs=0．128，P〈0.05。普外科手术后疼痛程度与性别无明显关系（X^2=3．184，P=0．364〉0．05），普外科手术后疼痛程度与护理干预之间有明显相关性（x^2=3．184，P=0．364〉0．05），Spearman相关系数rs=0．177，P〈0.05。结论普外科患者手术后疼痛程度与年龄有明显关系，年龄越大，手术后疼痛程度越高；性别与术后疼痛程度之间无相关性；术后进行系统护理干预，可以明显减轻患者的疼痛程度。     

下肢静脉曲张术后并发静脉血栓的有效护理干预

目的:分析对下肢静脉曲张术后并发静脉血栓患者的有效护理干预措施。方法:以2019年6月~2019年6月我院收治的42例下肢静脉曲张患者为研究对象,随机分为两组,各21例,对照组常规护理,实验组实施有效护理干预,对比护理效果。结果:对照组下肢静脉曲张术后患者的并发深静脉血栓发生率高于实验组患者,差异具备统计学价值;实验组下肢静脉曲张术后患者的护理满意度高于对照组患者,差异显著且具备统计学意义。结论:下肢静脉曲张术后实施有效护理干预可降低并发静脉血栓发生率,同时提升患者护理满意度,有效改善患者预后,促进患者康复,也有利于维护良好的护患关系,因此应在临床实践中对有效护理干预进行推广与普及。     

Systematic review and meta-analysis of fear of falling and fall-related efficacy in a widely disseminated community-based fall prevention program

BackgroundFear of falling restricts mobility and increases fall risk among older adults. Fall-related efficacy (i.e. the confidence to perform activities without falling), a construct related to fear of falling, has also been associated with active living and fall prevention. This study statistically synthesized the program effects of A Matter of Balance Volunteer Lay Leader (AMOB/VLL) model, designed to improve fall-related efficacy and promote daily activities among community-dwelling older adults.MethodsResearch articles and doctoral dissertations that examined the effect of the AMOB/VLL on fear of falling and fall-related efficacy were searched from multiple databases. A random effects model was used to compute mean weighted effect sizes, 95 % CIs, and heterogeneity (I²). Bias was examined through a funnel plot and Egger’s test. Factors associated with heterogeneity were also explored.ResultsSeventeen AMOB/VLL studies involving 3,860 participants were identified. The pooled effects of the 13 studies with sufficient information for effect size calculation, were −0.29 (95 % CI: −0.40, −0.19) for fear of falling and 0.51 (95 % CI: 0.42, 0.60) for fall-related efficacy. Effect sizes differed partially due to outcome measures of fall-related efficacy. Covariate adjustment and study quality were not associated with differences in effect sizes. No substantial evidence of asymmetry and publication bias was found.ConclusionThis study provides evidence supporting AMOB/VLL as an effective intervention for reducing fear of falling and improving fall-related efficacy. A greater consistency in outcome measures is needed to optimally capture changes in fear of falling and fall-related efficacy among community-dwelling older adults.     

Potential role of the gut microbiota in neuromyelitis optica spectrum disorder: Implication for intervention

The gut microbiota plays an important role in the occurrence and development of neuroimmunological diseases. Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune disease of the central nervous system that is characterized by the peripheral production of the disease-specific serum autoantibody aquaporin-4 (AQP4)-IgG. Recently, accumulating evidence has provided insights into the associations of gut microbiota dysbiosis and intestinal mucosal barrier destruction with NMOSD, but the underlying pathogenesis remains unclear. Thus, a microbiota intervention might be a potential therapeutic strategy for NMOSD by regulating the gut microbiota, repairing the intestinal mucosal barrier, and modulating intestinal immunity and peripheral immunity.     

Building immunization decision-making capacity within the World Health Organization European Region

A National Immunization Technical Advisory Group (NITAG) is a multi-disciplinary body of national experts that provides evidence-based recommendations to policy-makers, assisting them in making sound immunization policy and programme decisions. The World Health Organization (WHO) Regional Office for Europe is working to strengthen the capacity of newly-established NITAGs and has targeted efforts on low- and middle-income countries. The Regional Office, in collaboration with WHO Headquarters and USA Centers for Disease Control and Prevention (CDC), developed a new training strategy and held training workshops to improve NITAGs’ functioning and ability to make evidence-based recommendations. Feedback from countries that participated in trainings indicated that the updated training materials and interactive approach with follow-up technical support enabled them to align their NITAG charters and processes with WHO recommendations. To ensure continued progress, global and regional partners such as WHO and CDC should continue providing technical support to recently established NITAGs.