授权赋能教育在慢性心衰患者的知信行效果

目的探讨授权赋能教育在慢性心衰患者的知信行效果。方法选取2017年9月-2019年2月我院收治的慢性心衰患者,共93例,运用随机数字表法进行分为对照组(n=45)和试验组(n=48),对照组施以常规教育模式,试验组在常规基础上施以授权赋能教育,观察两组患者对疾病知识的知晓率情况、对疾病的态度情况、不良行为比较。结果试验组的疾病知识的知晓率为95.83%,明显高于对照组的80.00%,差异显著(χ^2=5.583,P=0.018);对疾病的态度明显改善;不良行为明显较少,与对照组相比差异显著(P<0.05)。结论授权赋能教育能够有效的改善慢性心衰患者心脏康复的知信行的效果。     

地舒单抗在类风湿性关节炎中的应用

骨质疏松是类风湿性关节炎的常见并发症。地舒单抗是一种可与核因子kappa-B 受体激动剂配体结合 的全人源性单克隆抗体，能抑制破骨细胞活性，增加骨密度，减少骨折发生率，并且安全性良好。地舒单抗越来越 多的用于类风湿性关节炎的治疗。地舒单抗可以增加类风湿关节炎患者的骨密度，阻止骨侵蚀和关节周围骨质 流失的发生，降低骨折的发生率，但不影响滑膜炎症和关节活动度。地舒单抗与治疗类风湿性关节炎的药物联合 应用可协同抑制骨侵蚀，且耐受性良好，感染的发生率并未增加，同时需关注颌骨坏死和非典型股骨骨折等罕见 副作用，建议补充维生素D 及钙剂预防低钙血症。地舒单抗在停药后，警惕骨密度下降及锥体骨折等风险，建议 在医师指导下停药，可在停药后转换为双膦酸盐等继续治疗。     

Interrelationships Between BDNF,Superoxide Dismutase,and Cognitive Impairment in Drug-Naive First-Episode Patients With Schizophrenia

The pathogenesis and etiology of schizophrenia (SCZ) remains unclear. Accumulating studies showed that complex interrelationships between brain-derived neurotrophic factor (BDNF) and an imbalanced redox system has a crucial role in the psychopathology of SCZ. However, the influence of the interrelationships of BDNF and superoxide dismutase (SOD) on cognitive impairment and clinical symptomatology in drug-naive first-episode (DNFE) SCZ patients has not been studied thoroughly. Serum BDNF levels, plasma total SOD, manganese-SOD (Mn-SOD), copper/zinc-containing SOD (CuZn-SOD) activities, and malondialdehyde (MDA) levels were measured in 327 DNFE patients with SCZ and 391 healthy controls. Cognitive functions were measured using the Repeatable Battery for the Assessment of Neuropsychological status (RBANS) and clinical symptoms were evaluated by the Positive and Negative Syndrome Scale (PANSS). Compared with the controls, the DNFE patients had increased activities of total SOD and CuZn-SOD, and reduced levels of BDNF and MDA. BDNF levels were positively correlated with CuZn-SOD activity in patients. In addition, we found that elevated Mn-SOD and CuZn-SOD activities were related to PANSS depression factor. Moreover, an interactive effect of BDNF levels and Mn-SOD activity was associated with attentional index score in the patients. Therefore, our findings suggested that interrelationships between BDNF and antioxidant mechanisms might underlie the pathological mechanisms of cognitive impairments and symptomatology in the DNFE patients with SCZ.