Teach-Back健康教育模式对学龄期手足口病患儿家属疾病认知水平及防护行为的影响

目的:探讨Teach-Back健康教育模式对学龄期手足口病(HFMD)患儿家属疾病认知水平及防护行为的影响。方法:2018年7月—2020年11月选取我院学龄期113名HFMD患儿家属为研究对象,按照随机数字表法分为对照组56例与观察组57例,对照组给予常规健康教育干预,观察组给予Teach-Back健康教育模式干预,观察两组患儿家属疾病认知水平、行为干预遵从率、患儿症状改善状况。结果:干预后,观察组患儿家属发病原因、传播途径、隔离治疗、并发症预防认知评分高于对照组(P<0.05);观察组患儿家属消毒隔离措施、饭前便后洗手、勤晒衣被、居家开窗通风遵从率高于对照组(P<0.05);观察组患儿发热、口腔溃疡、皮疹、食欲减退改善时间短于对照组(P<0.05)。结论:对学龄期HFMD患儿家属开展Teach-Back健康教育模式,可明显提高家属对疾病认知水平,提高行为干预遵从率,促进患儿恢复。     

Functions of the endothelium and its role in hematopoietic cell transplantation

The endothelium is a single-layered structure that responds to physical and chemical signals with various factors it synthesizes. In the early days of its discovery, as the inner wall of the vessels, the endothelium was thought to be a simple barrier that lays on the surface. Over time it is discovered that endothelium maintains body homeostasis with the molecules it synthesizes, despite its simple single-layer structure. It has been accepted as an important organ that contributes to the maintenance of vascular tone, cell adhesion, inflammation, vascular permeability and coagulation. Any imbalance in these physiological and pathological events causes endothelial dysfunction. This can cause many diseases such as atherosclerosis, hypertension, diabetes, or it can occur because of these. Endothelial related disorders may also complicate hematopoietic stem cell transplantation (HSCT), which is used to treat various hematologic and neoplastic diseases. These life-threatening complications include graft-versus-host disease, hepatic veno-occlussive disease, transplant-associated thrombotic microangiopathy and diffuse alveolar hemorrhage. They share a similar pathophysiology involving endothelial cells with different clinical presentations. Therefore, current researche on the issue is putting the endothelium under the spotlight for novel markers and treatment options that should be used to monitor or treat at least some of these complications following HSCT.     

肠运动昼夜节律及其外科临床意义

肠运动存在昼夜节律，表现为白天活跃，夜间减弱或消失，这是一种内生性的、由时钟基因控制的生物节律。肠运动节律既可与中央节律保持高度一致，也可独立于中央节律而对外周环境刺激做出反馈。外科手术会破坏肠运动的昼夜节律，而围手术期合理使用褪黑素、五羟色胺（5-HT）受体激动剂和非甾体类解热镇痛药等药物则有助于促进此节律的恢复。外科医生了解肠运动节律的机制，有助于加深术后肠麻痹（POI）的认识，再基于时辰药理学，在合适的时机以适宜的剂量给药，或许能进一步缩短POI时间，促进肠运动功能尽早恢复。