护理干预对老年高血压患者自我管理行为的影响研究

目的分析护理干预对老年高血压患者自我管理行为的影响。方法以174例老年高血压患者作为观察组,对患者进行综合护理干预,另选我院同期150例老年高血压患者作为对照组,对该组进行常规护理干预,对比两组护理前后患者健康知识知晓程度、依从性以及血压控制情况。结果观察患者接受综合护理干预后,健康知识得分、服药依从性和血压控制人数显著高于对照组,差异有统计学意义(P<0.05)。结论护理干预可提高老年高血压患者自我行为管理,护理干预值得应用和推广。     

青年缺血性脑卒中相关危险因素分析

近年来，青年脑卒中患者日益增多，国内外对其危险因素的研究结果存在分歧，有学者认为其主要因素是高血压及动脉硬化，也有的认为脂代谢异常起重要作用。本文选取我院1999年1月至2004年8月收治的青年缺血性脑卒中患者80例，并对其临床资料分析如下。     

硒芪合剂对肝细胞保护作用研究

目的研究硒芪合剂对肝细胞保护作用。方法通过给大鼠25％CCl4(0.2ml/100g),1/3d,sq,连续30d制备肝损伤模型,测定大鼠血清一些酶活性及某些肝维化指标。结果用硒芪合剂4.66g/d和2.33g/d治疗,连用60d,能显著预防CCl_4诱发肝损伤,能降低大鼠血清AST、ALT、GGT及LDH等。同时也能降低PCⅢ、LN、HA等。结论硒芪合剂对CCl_4诱发大鼠肝损伤有保护及治疗作用。其机制可能与该药具有抗氧化损伤,保护细胞膜有关。     

碘缺乏和甲状腺功能减退对大鼠仔鼠小脑细胞外信号调节激酶1/2蛋白表达的影响

Objective To study the effects of iodine deficiency and hypothyroidism on protein expression of extracellular signal-regulate kinase(ERK1/2) in the cerebellum of rots. Methods Twenty-eight healthy Wistar rots, female, 60 days old, were randomly divided according to their body weight into control group, iodine deficient group and hypothyroidism groups. Hypothyroidism groups in accordance with drinking water containing propylthiouracil(PTU) were divided into doses of 5 mg/L and 15 mg/L groups, 7 rats in each group. Rats after pregnancy, iodine deficient rats were administered with iodine-deficient diet and hypothyroid rats were administered with PTU in drinking water. Pup's cerebellum in each group were weighed on day 14,21,28 and 42. Cerebellum tissue was observed for cerebellar morphology using silver staining and detected for ERK1/2 protein using immunohistochemistry on day 7,14,21,28 and 42. Results On day 14,21,28 and 42, cerebellum weight of pups from iodine-deficient[(0.0945±0.0233), (0.1347±0.0046), (0.1542±0.0094), (0.1949±0.0048)g]were significantly lighter than control[(0.1856±0.0123), (0.2049±0.0098), (0.2268±0.0065), (0.2606±0.0086)g, all P < 0.05]and hypothyroidism groups [for 5 mg/L group: (0.1741±0.0172), (0.1927±0.0103), (0.2181±0.0064), (0.2583±0.0054)g, all P<0.05; for 15 mg/L group: (0.1604±0.0083), (0.1682±0.0103), (0.1996±0.0073) and (0.2579±0.0067)g, all P< 0.05]the difference had statistical significance(F=6.325,8.870, 16.191 and 21.574, all P<0.05). Compared to the controls on day 7, iodine-deficient group didn't have clear layers; on day 21, disappearance of external granule cells from iodine-deficient and 15 mg/L groups was delayed, still two or three layer external granule cells remained; on day 28 and 42, molecular layer from 5, 15 mg/L and iodine-deficient groups and became thinner. Immunohistochemistry showed that on day 7, there was no statistical difference of integrated optical density average of ERK1/2, in all the groups(F=1.102, P>0.05); on day 14,21,28 and 42, integrated optical density average of ERK1/2 in iodine-deficient group[(7.3245±0.5070), (8.3606±1.0683), (9.1217±1.0402), (12.1587±0.7581), all P<0.01]and hypothyroidism groups [for 5 mg/L group: (11.4307±1.5200), (14.919±0.8497), (16.0082±1.1130), (15.7721±0.8293), all P< 0.01; for 15 mg/L group: (7.8538±0.9775), (11.2461±0.8138),(12.78±1.3783), (13.0871±1.1450), all P < 0.01]was significantly lower than those of controls [(16.2831±0.5143), (20.2653±0.9551), (22.7485±1.0267), (22.1725±0.9939), all P < 0.01], the difference having a statistical signifieance(F=16.131,13.543,26.953,41.583, all P<0.01). Conclusions Iodine deficiency and hypothyroidism during critical periods of brain development may change eerebellar morphology and down regulate the protein expression of ERK1/2, which may result in damage of cerebellum development.     

原发性皮肤CD4+小/中等大小T细胞淋巴组织增殖性疾病4例临床病理分析

目的探讨原发性皮肤CD4~+小/中等大小T细胞淋巴组织增殖性疾病的临床特点、组织学特征、诊断及鉴别诊断。方法分析4例原发性皮肤CD4~+小/中等大小T细胞淋巴组织增殖性疾病的临床资料、病理形态、免疫表型及基因重排,并复习相关文献。结果 (1)原发性皮肤CD4~+小/中等大小T细胞淋巴瘤好发于中老年人的头颈部,常为单发结节。(2)肿瘤细胞弥漫浸润真皮层。(3)肿瘤细胞小～中等大,轻～中度异形性,大细胞少于30%。(4)肿瘤细胞CD4~+/CD8~-,一般不表达CD30和细胞毒性标记。(5) T细胞受体克隆性重排。结论原发性皮肤CD4~+小/中等大小T细胞淋巴瘤属于少见的皮肤原发T细胞淋巴组织增殖性疾病,肿瘤完整切除后预后较好。     

健康教育对乳腺癌患者非保乳术后患肢功能恢复的影响

目的 探讨健康教育对乳腺癌术后患者患肢功能恢复的作用.方法 98例单侧乳腺癌根治术后患者随机分为实验组和对照组,并对实验组实施健康教育.结果 实验组患者患侧肢体功能锻炼效果明显优于对照组,两组有明显差异性.结论 健康教育有助于乳腺癌术后患者功能恢复.     

柴胡疏肝散加味联合熊去氧胆酸治疗胆囊炎的疗效探析

目的：探讨柴胡疏肝散加味联合熊去氧胆酸在胆囊炎治疗中的临床效果。方法：将我院2013年8月～2014年7月收治的112例胆囊炎患者随机分为研究组和对照组,对照组采用熊去氧胆酸治疗,研究组采用柴胡疏肝散加味联合熊去氧胆酸治疗,比较患者的临床疗效、McGill 疼痛量表评分。结果：治疗后,研究组的总有效率显著高于对照组,PPI、PRI 与 VAS 评分明显优于对照组。结论：柴胡疏肝散加味联合熊去氧胆酸是一个疗效确切的治疗胆囊炎的药物组合,具有良好的应用前景。     

健康教育在人工肝治疗中的实施

我国作为病毒性肝炎的患病大国,重型肝炎(简称重肝)的患病率相对亦较高,病人常因肝细胞急性或慢性大量坏死出现肝衰竭,有毒代谢产物在体内大量堆积,并由此引发其它多脏器功能衰竭,出现多种并发症,病情复杂、危重、预后差、病死率较高,一直是临床治疗护理中的重点及难点.20世纪末,人工肝脏研究的持续深入与广泛应用为重肝患者安全渡过肝衰竭危险期乃至最终战胜疾病创造了有利条件,赢得了宝贵的时间.我科从2002年8月开始应用非生物型人工肝脏支持系统辅助治疗重肝,收到较好的临床疗效.为了确保治疗的顺利实施,预防或降低治疗中可能出现的多种并发症,治疗后病人能够迅速康复,我们在常规治疗护理的基础上,依据病人的患病特征及人工肝治疗的需要,加大了健康教育的力度,干预其日常生活及行为,效果良好.     

碘缺乏和甲状腺功能减退对大鼠仔鼠小脑cAMP反应元件结合蛋白表达的影响

目的 研究碘缺乏和甲状腺功能减退对大鼠仔鼠小脑cAMP反应元件结合蛋白(CREB)表达的影响.方法 分别选用低碘饲料及丙基硫尿啼啶(propylthiouracil,PTU)饮水诱导建立低碘及甲状腺功能减退Wistar大鼠动物模型,按体重随机分成对照组、甲状腺功能减退组(5 mg/L PTU组、15 mg/L PTU组)和碘缺乏组,出生后第14天(PN14)、PN21、PN28、PN42时,测定仔鼠小脑重量,PN7、PN14、PN21、PN28、PN42时取小脑组织进行免疫组织化学链霉菌抗生物素蛋白-过氧化物酶(SP)染色,用图像分析方法分析大鼠仔鼠小脑皮质CREB表达情况.结果 PN14、PN21、PN28、PN42时,碘缺乏组小脑重量显著低于对照组和甲状腺功能减退组(P＜0.05).PN7时,各组之间小脑组织CREB平均积分光密度值差别不明显,而PN14,PN21,PN28和PN42时,5、15 mg/L PTU组和碘缺乏组平均积分光密度值均低于对照组(P＜0.05).结论 碘缺乏和甲状腺功能减退可降低大鼠仔鼠小脑组织CREB表达,影响神经系统的发育.

Abstract：

Objective To study the effects of iodine deftcieney and hypothyrosis on protein expression of CREB in the cerebellum of rats.Methods Iodine deficient rats were administered with iodine-deficient diet and hypothyroid rats were administered with PTU in drinking water.Female Wistar pregnant rats (n=28)were randomly divided into four groups:control group,iodine deficient group,5 mg/L PTU group and 15 mg/L PTU group.On PN14,PN21,PN28,pups cerebellum in each group were weighed.On PN7.PN14,PN21,PN28,cerebellum tissue were determined for CREB protein detection by immunohistochemistry.Results Cerebellum weights of pup from iodine-deftcient were significantly lighter than control,5 mg/L and 15 mg/L groups on PN14,PN21,PN28 and PN42.In the result of immunohistochemistry:on PN7,there was no significant difference in all the groups.On PN14,PN21,PN28 and PN42,CREB expression in 5,15 mg/L and iodine-deficient groups was significantly lower than that of the control group(P＜0.05).Conclusion Iodine deficiency and hypothyrosis during critical periods brain development may down regulate the protein expression of CREB,which may result in damage of serebellum development.