耳甲电针对冷应激大鼠脂蛋白代谢的调节作用

ObjectiveTo explore whether auricular concha eletroacupuncture (ACEA) is effective in regulating lipid-lipoprotein metabolism in rats submitted to cold stress.MethodsThirty-six adult male Sprague–Dawley rats were placed in four groups(9 rats in each group), the rats in three groups of which were submitted to cold stress for fourteen days, the last one of which was a control group. After the cold stress process, in those three groups, the rats of one group were with no treatment (stress only), two were treated with either ACEA or auricular margin eletroacupuncture (AMEA) repeated for fourteen days. On the 14th day, all the rats were sacrificed after all experimental procedure for blood sampling. Blood glucose, triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) levels were tested by using the collected serum. Plasma lecithin-cholesterol acyltransferase (LCAT) was measured with ELISA kit.ResultsACEA down-regulated the TG level (P < 0.05) and LDL-C level (P < 0.05), and up-regulated HDL-C level (P < 0.05) and LACT level (P < 0.05). AMEA did not regulate the bio-markers.ConclusionACEA played an important role in regulating lipid-lipoprotein metabolism in rats submitted to cold stress.     

股骨转子间骨折的稳定性重建概念演化与研究进展

目的总结近年来股骨转子间骨折在稳定性重建方面的概念演化与研究进展。方法查阅国内外相关文献并结合自身经验，从股骨转子间骨折的解剖特点、稳定型骨折与不稳定型骨折分类、稳定性复位与不稳定性复位、术中加压初始稳定与术后滑动二次稳定、内固定术后稳定性评估、早期下地站立负重等方面进行总结分析。结果股骨转子间骨折发生于股骨颈干骺端转换区，具有天然的内翻不稳定倾向。骨折复位质量是影响后续内固定物安放的最重要前提因素。判断骨折复位质量有对线和对位两方面，对线采用 Garden 指数；在对位方面，随着皮质对位理念（正性、中性、负性）的提出，特别强调前内侧皮质的相互砥住支撑（解剖、正性），是获得骨折稳定性复位的关键，而不再强调后内侧小转子骨块的作用。术后影像学的稳定性评分为早期下地站立负重提供了量化指标。但术中的前内侧皮质支撑复位，在术后头颈骨块滑动获得二次稳定的过程中，仍有皮质对位丢失现象，需研究其危险因素和防范措施。结论股骨转子间骨折在取得良好对线的基础上，只要获得了前内侧皮质的相互砥住和支撑，并用内固定器械维持住，就获得了术后稳定性。术后稳定性评分优良者，可以安全地早期下地负重、站立行走活动。     

针刺和聚焦冲击波疗法对肩袖肌腱病的止痛作用:一项回顾性临床研究

ObjectiveThe purpose of the study is to evaluate whether the clinical effects of focused extracorporeal shockwave therapy (f-ESWT) and acupuncture anticipate the clinical response in patients with rotator cuff tendinopathy in the short term.DesignAn observational retrospective clinical study.Setting/LocationPhysical Medicine and Rehabilitation Unit, Sant'Andrea University Hospital in Rome, Italy.Subjects/InterventionsWe analyzed retrospectively thirty patients (22 females and 8 males) with rotator cuff tendinopathy.Fifteen patients underwent f-ESWT and acupuncture combined therapy (Group A) and fifteen patients underwent only f-ESWT therapy (Group B).Outcome measuresThe outcome measures were the Visual Analogic Scale (VAS), Assessment Shoulder and Elbow Scale (ASES) and Roles and Maudsley Score (RMS). The follow-ups were T0 (pre-treatment), T1 (3 weeks after the start of the treatment), and T2 (at 8 weeks). In order to compare groups, the ANOVA and Friedman tests were adopted.Group A patients had a more rapid and statistically significant improvement trend in VAS (P <0.001), ASES scale (P <0.001), and a higher level of satisfaction to treatment assessed by RMS (P<0.001) than group B in the short term.ConclusionsThe study showed that combined treatment decreases the recovery time of the shoulder involved in terms of pain and motor function in the short term. However, these results shall be confirmed by controlled randomized studies.     

临床路径教学法在ICU新进护士前3个月护理带教中的应用效果观察

目的探讨在ICU新进护士的前3个月护理带教中,采取临床路径教学法的效果。方法选取该院2016年1月—2018年1月ICU新进的60名护士为研究对象,将护士分成两组,即研究组与对照组,每组30名,对照组采取一对一的护理带教模式,研究组则采取临床路径教学法的护理带教模式,观察两组带教效果。结果护理带教后,研究组护士在理论与操作考核成绩上均要显著高于对照组(P<0.05);研究组新进护士对临床实践能力、应急能力、工作能力及学习兴趣的认可率均显著高于对照组(P<0.05)。结论针对ICU新进护士,在前3个月的护理带教中,实施临床路径教学法的带教模式,可显著提高护士理论与操作能力,且护士对护理带教模式的认可度也高。     

解析安全护理管理模式在妇产科手术室护理中的效果

目的分析在妇产科手术室护理中采取安全护理管理模式的临床效果。方法选入该院于2017年8月-2019年3月期间妇产科进行手术的患者66例,以抽签法的形式将其分为研究组和对照组,分别为33例。对照组行常规护理,研究组在此基础上加行安全护理管理模式,对比两组患者的各类护理不安全事件的发生概率、各项护理质量评分。结果研究组各类护理不安全事件的发生概率低于对照组(P<0.05);研究组各项护理质量评分高于对照组(P<0.05)。结论在妇产科手术室护理中进行安全护理管理模式,可以减少不安全事件的发生,医患纠纷等,提高了护理质量,促使手术能够顺利的进行,值得在临床上推广和应用。