新生期卡介苗和乙肝疫苗联合接种对哮喘小鼠IFN-γ、IL-4和IL-17A表达的影响

目的:观察新生期卡介苗(BCG)和乙肝疫苗(HepB)联合接种对哮喘小鼠干扰素γ(IFN-γ)、白细胞介素4(IL-4)和白细胞介素17A(IL-17A)表达的影响,探讨BCG和HepB联合接种对气道炎症的影响及可能机制。方法:BALB/c小鼠随机分为BCG和HepB联合接种造模[卵清蛋白(OVA)所致哮喘模型]组(B/H/O组)、BCG接种造模组(B/O组)、HepB接种造模组(H/O组)、BCG和HepB联合接种组(B/H组)、造模组(OVA组)、BCG组、HepB组和生理盐水对照(NS)组,每组6只。B/H/O组和B/H组于第0、7和14天分3次皮下注射1×105CFU的BCG,同时第0和28天分2次下肢腿部肌肉注射HepB 1.5μg,其它组单独接种BCG或HepB。OVA致敏和雾化吸入激发建立哮喘模型;末次激发24 h后取肺组织HE染色;收集支气管肺泡灌洗液(BALF)进行细胞总数计数和嗜酸性粒细胞(EOS)计数;ELISA法检测血清IFN-γ和IL-4及肺组织匀浆IL-17A的水平。结果:肺组织病理观察发现,OVA组、B/O组、B/H/O组和H/O组支气管周围大量炎症细胞浸润,气道上皮细胞增生肥大,B/H/O组和H/O组的炎症程度较OVA组重,B/O组则较OVA组轻。B/H/O组、B/O组和H/O组BALF细胞总数与OVA组比较均下降(P0.05);EOS计数在B/H/O组比B/H组上升(P0.05),B/O组比BCG组上升(P0.05),H/O组比HepB组上升(P0.05)。分别与H/O组、OVA组和NS组比较,HepB组的血清IFN-γ/IL-4比值均升高(P0.05);分别与B/H/O组、B/O组、OVA组和NS组比较,B/H组的血清IFN-γ/IL-4比值均升高(P0.05)。与OVA组比较,B/H/O组和B/O组的肺组织匀浆IL-17A水平均下降(P0.05);与B/O组比较,B/H/O组的肺组织匀浆IL-17A水平进一步下降(P0.05)。结论:卡介苗和乙肝疫苗联合接种有助于减轻哮喘模型小鼠肺部的炎症反应,其机制可能与降低IL-4分泌、提高IFN-γ/IL-4水平和抑制IL-17A的表达有关。     

病例教学法在护理专业课教学中的应用

病例教学是根据教学目的和教学内容的要求，教师运用真实的病例或者经过精心设计的病例，将学生引入特定的情景中，引导学生对病例进行分析。提出问题，并解决问题的一种教学方法。病例教学作为一种生动直观的教学形式，既能加深学生对理论知识的理解和记忆，也有利于实现教学方式从灌输式向启发诱导式的转化，使学生自觉、主动、创造性的学习，培养学生批判性思维的能力。病例教学法以其独特的优势广泛应用于内、外、妇、儿等护理专业课的教学中，但由于缺乏与教材配套的教学病例，受教师的工作经验和知识水平的影响，病例教学在实际应用时出现了较大的随意性；规范性较差。现就病例教学法在护理专业课教学中应用体会介绍如下。[第一段]     

The effects of gossypol on expressions of transforming growth factor-β1, fibronectin and 11β-hydroxysteroid dehydrogenase in nephridial tissue in rats with diabetes mellitus

Objective To observe the effects of gossypol on expressions of transforming growth factor-β1 (TGF-β1), fibronectin (FN) and 11β-hydroxysteroid dehydrogenase (11β-HSD) in nephridial tissue in rats with diabetes mellitus. Methods Thirty male Sprague-Dawley rats were randomly divided into three groups: normal control, type 2 diabetes and gossypol treatment group . After high-fat feeding for 4 weeks, the later two groups were injected with low dosage strepozotocin (30 mg/kg) intraperitoneally to induce type 2 diabetic rat model. The rats in gossypol treated group were given gossypol at the dosage of 15 mg/kg once per day for 4 weeks by gavage. And since the 5th week, the times of gavages had been changed into once per week at the same dosage and lasted to the 12th week . The levels of blood glucose, total cholesterol (TC), low density lipoprotein-cholesterol (LDL-c) were measured. Additionally, the morphological changes of the kidney were studied by light microscopy and transmission electron microscopy respectively. The mRNA expressions of TGF-β1, FN, 11β-HSD and 11β-HSD2 in nephridial tissue were assayed by semi-quantity RT-PCR. The protein expressions of TGF-β1 and FN in nephridial tissue were determined by immunohistochemistry. Results The blood levels of glucose, TC and LDL- c were increased significantly in type 2 diabetic group compared with normal control group(P<0. 01). The volume of glomerulus and the deposition of PAS positive substance in the glomerular interstitium were increased under light microscopy, and the glomerular basal membrane was thicker in type 2 diabetic group than those in normal control group under transmission electron microscopy. The mRNA and protein expressions of TGF-β1 and FN were increased(P<0. 01), and the mRNA expression of 11β-HSD2 was decreased(P<0. 05), while the mRNA expression of 11β-HSD1 was unchanged in type 2 diabetic group compared with normal control group. After the treatment of gossypol, the level of the blood glucose was significantly decreased(P< 0. 01), and the levels of TC, LDL-c showed a trend of decrease but had no statistical differences compared with type 2 diabetic group. The morphology of nephridial tissue was ameliorated in gossypol treatment group. The mRNA and protein expressions of TGF-β1 and FN were decreased(0. 16± 0. 02,0. 22±0. 05 ; 0. 24±0. 06,0. 33±0. 07, P< 0. 05), while the mRNA expressions of 11β-HSD1 and 11β-HSD2 were unchanged compared with type 2 diabetic group. Conclusions Gossypol can relieve the pathologic changes of nephridial tissue, inhibit the expressions of TGF-β1 and FN through decreasing blood glucose of rats with diabetes mellitus.     

多媒体操作平台在护理学基础实验教学中的应用

目的提高护理学基础实验教学效果。方法将2007级护理本科生分为实验组和对照组各30人。对照组采用教师示范、学生练习的常规教学方法 ;实验组利用多媒体操作平台模拟操作过程,学生先虚拟练习,随后进入实验操作室练习。结果实验组操作技能考核成绩、人文关怀及综合分析能力得分显著高于对照组(P0.05,P0.01)。结论多媒体操作平台融入临床实际情景,具有直观、生动等特点,从而增强学生操作练习的感性认识和兴趣,提高学生的操作技能、人文关怀及综合分析能力。     

绍兴县农村地区开展社区护理的卫生资源调查

目的 调查绍兴县农村开展社区护理的卫生资源情况,为合理配置医疗资源、优化从业人员素质、构建现代化农村社区护理模式提供参考.方法 采用问卷调查法对19个农村社区卫生服务机构和381位从事农村社区护理的社区护士进行调查.结果 医疗资源分布有地区差异,每万人拥有医疗资源水平较低:健康教育室0.7间,康复室1.2间,妇儿保健室0.4间;社区护士数与农村居民数比1∶1877;社区护士平均年龄(30.84±6.88)岁;专职进行健康教育、社区预防等工作的社区护士占43.8％,不同学历、不同年龄段的社区护士对知识需求不同.结论 绍兴县农村社区医疗资源配置低、分布不均,护理人力资源结构年轻化、职称学历低、专业性不强,建议合理资源配置、优化人员结构、丰富在职培训.     

急性放射性皮炎防治的研究进展

放射治疗是用各种不同能量的射线照射肿瘤,以抑制和杀灭肿瘤细胞的一种治疗方法,但放射线在杀伤肿瘤细胞同时也会损伤人体正常组织细胞.放射治疗过程中高达90％～95％的患者会出现不同程度的呈剂量依赖性的急性放射性皮炎(radiation-induced dermatitis),急性放射性皮炎在放射治疗过程中几乎不可避免,其中有1/3的患者可发展成湿性脱皮[1],给患者造成极大痛苦,降低了患者生活质量,并增加了感染危险,如预防、治疗不恰当或不及时,病情迁延常引起损伤加重,形成溃疡,有的甚至需要植皮手术治疗,将严重影响放射治疗的进程,降低放射治疗效果,给患者带来生理和心理创伤及经济压力.近年来随着三维适行放射治疗、调强放射治疗等新技术的应用,急性放射性皮炎的发生率不仅没有下降,反而呈现上升的趋势,临床医务人员一直在不断探索急性放射性皮炎的防治手段,以最大限度地减轻急性放射性皮炎,提高照射野皮肤对放射治疗的耐受性.现将急性放射性皮炎的防治进展综述如下.     

多媒体操作平台在护理学基础实验教学中的应用

目的重组手术室急诊手术交班程序,提升手术室急诊手术护理质量。方法分析现有交接班流程存在的问题,对手术室急诊手术交班时间、形式、地点、内容进行了重组、充实,建立一套标准化急诊手术交班程序并全面实施。结果急诊交班制度重组前后,由交接班引起的工作缺陷发生率比较,差异有统计学意义（P〈0.01）。结论重组后的手术室急诊手术程序化交班制度可有效提升急诊手术护理质量,减少护理工作缺陷。     

社区护理现状及管理初探

社区护理是我国护理事业的新兴领域,从目前的发展情况看,尚处于雏形阶段,其相应的配套管理措施更不完善,因此认清社区护理的发展情况和存在的问题,不断完善社区护理管理,是当前我国护理事业发展的重要内容,也是社区卫生服务健康发展的主要方向。1社区护理的现状和存在的问题1.1