个体化护理在小儿先天性心脏病介入治疗中的效果观察

目的 探究对行介入治疗的先天性心脏病患儿施行个体化护理的效果。方法 借助随机数字表法将2018年6月至2020年6月我院62例先天性心脏病患儿分为对照组（31例,施行常规护理）、观察组（31例,施行个体化护理）。对比两组儿童焦虑性情绪障碍筛查量表评分、家属满意度评分及并发症发生率。结果 观察组护理后儿童焦虑性情绪障碍筛查量表评分较对照组更低,家属满意度较对照组更高,差异有统计学意义（P<0.05）;对比并发症发生率可知,观察组低于对照组,差异有统计学意义（P<0.05）。结论 对行介入治疗的先天性心脏病患儿施行个体化护理有助于减少并发症,家属满意度更高,可行性较佳。     

脑肿瘤患者围手术期的心理护理及并发症护理效果评价

目的研究脑肿瘤患者围手术期的心理护理及并发症护理方法及其应用效果。方法选取2017年1月—2018年12月湖南省脑科医院收治的脑肿瘤患者120例,随机分为两组,每组60例。对照组实施常规围术期护理,试验组实施针对性心理护理及并发症预防护理,比较两组并发症发生率,两组干预前后的不良情绪评分,两组护理满意度。结果试验组并发症发生率为6.67%,低于对照组23.33%的发生率,比较差异有统计学意义(P0.05)。治疗前,两组在不良情绪评分方面比较差异无统计学意义,治疗后,两组的评分都有着提高,试验组的不良反应的评分优于对照组,差异有统计学意义(P0.05)。护理满意度方面,试验组护理满意度为96.67%,对照组的护理满意度为80.00%,试验组明显优于对照组,差异有统计学意义(P0.05)。结论脑肿瘤患者围手术期实施心理护理及并发症护理的效果较好,能有效促使患者不良情绪改善,降低其并发症发生率,临床价值较高。     

糖尿病合并下肢动脉狭窄闭塞患者行介入治疗的全程护理配合分析

目的分析糖尿病合并下肢动脉狭窄闭塞患者行介入治疗的全程护理配合效果。方法研究时段:2017年10月—2018年11月,将该院收治的66例行介入治疗的糖尿病合并下肢动脉狭窄闭塞患者作为研究对象,以不同的护理措施作为分组依据,将研究对象分为对照组、试验组,每组33例。对照组用常规护理,以常规护理为切入点,试验组实施全程护理配合。对比两组护理效果。结果血糖水平、致残率与对照组相比,试验组较低,差异有统计学意义(P0.05);护理满意度、生活质量评分与对照组相比,试验组较高,差异有统计学意义(P0.05)。结论给予糖尿病合并下肢动脉狭窄闭塞行介入治疗的患者全程护理配合措施,既可降低血糖水平、提高护理满意度与生活质量评分,还能减少致残率,值得临床推广应用。     

冠心病介入治疗手术室护理中人性化护理的应用效果研究

目的 研究冠心病介入治疗手术室护理中人性化护理的应用效果。方法 纳入2021年3月至2022年8月我院收治的120例冠心病介入治疗患者,随机分为观察组与对照组,每组60例。对照组实施常规护理,观察组实施人性化护理,比较两组心理状态、疾病认知度与依从性、生活质量、护理风险事件发生率、护理满意度。结果 护理前,两组焦虑、抑郁评分相比,差异无统计学意义（P> 0.05）,护理后,两组焦虑、抑郁评分均降低,且观察组低于对照组,差异有统计学意义（P <0.05）。护理前,两组疾病认知度评分、依从性评分相比,差异无统计学意义（P> 0.05）,护理后,两组疾病认知度评分、依从性评分均提升,且观察组高于对照组,差异有统计学意义（P <0.05）。护理前,两组生活质量评分相比,差异无统计学意义（P> 0.05）,护理后,观察组生活质量评分高于对照组,差异有统计学意义（P <0.05）。观察组护理风险事件发生率低于对照组,差异有统计学意义（P <0.05）。观察组护理满意度高于对照组,差异有统计学意义（P <0.05）。结论 在冠心病介入治疗患者手术室护理...     

护理干预对老年心脏病介入治疗患者的影响

目的 探讨护理干预对老年心脏病介入治疗患者的影响.方法 将100例老年心脏病介入治疗患者按随机数字表法分为观察组和对照组各50例.对照组采用常规护理方法进行护理,观察组按照本研究制定的老年心脏病介入治疗护理干预方案进行护理.观察两组患者术后伤口渗血或血肿、血压下降、围术期失眠等并发症的发生情况,以及两组患者对护理服务的满意度.结果 观察组手术并发症的发生率为4％,低于对照组的20％,差异有统计学意义（P＜0.05）;观察组患者对护理服务的满意率为98％,高于对照组的86％,差异有统计学意义（P＜0.05）.结论 对老年心脏病介入治疗患者采用护理干预方案可有效降低手术并发症的发生率,并提高患者对护理服务的满意率.     

依托医联体的个体化康复指导在髋关节置换术后老年患者中的应用

［摘要］　目的　观察以医联体为依托的个体化康复指导在髋关节置换术后老年患者中的应用效果。方法　选择2018年5月至2020年5月于佛山复星禅城医院行髋关节置换术的老年患者85例,以社区为单位进行分组,将与该院建立医联体的7个社区内的43例患者设为观察组,未与该院建立医联体的7个社区内的42例患者设为对照组。两组住院期间均接受常规护理及康复指导。对照组出院后第1、3、6个月进行门诊随访。观察组开展以医联体为依托的个体化康复指导。比较两组髋关节功能评分、日常生活能力评分及护理满意度。结果　两组出院时髋关节功能评分、改良Barthel指数（MBI）量表评分比较,差异无统计学意义（P>0.05）。观察组出院后6个月髋关节功能评分为（88.39±6.57）分,MBI量表评分为（85.59±7.40）分,护理总满意率为93.02%,对照组分别为（79.28±9.42）分、（77.98±9.34）分、71.43%,观察组均高于对照组,差异有统计学意义（P<0.05）。结论　以医联体为依托的个体化康复指导能够改善髋关节置换术后老年患者髋关节功能及日常生活能力,提高护理满意度,值得推广。     

强化沟通对泌尿外科手术伴糖尿病患者心理应激的影响

目的 探讨强化沟通对泌尿外科手术伴糖尿病患者心理应激的影响。方法 选取该院2019年3月—2021年7月收治的80例泌尿外科手术伴糖尿病患者,根据护理方案的不同进行分组,各40例。两组患者均接受常规护理,研究组患者在此基础上实施强化沟通护理。比较两组患者护理前后焦虑自评量表（SAS）与抑郁自评量表（SDS）评分、并发症发生率以及护理满意度。结果 两组患者护理前SAS与SDS评分比较,差异无统计学意义（P>0.05）,研究组患者护理后SAS与SDS评分分别为（37.39±1.61）分、（39.51±1.46）分,明显低于对照组的（48.87±1.53）分、（49.74±1.38）分,差异有统计学意义（P<0.05）;研究组患者围术期并发症发生率为2.50%,显著低于对照组的25.00%,差异有统计学意义（P<0.05）;研究组患者护理满意度为97.50%,显著高于对照组的75.00%,差异有统计学意义（P<0.05）。结论 强化沟通能够减轻泌尿外科手术伴糖尿病患者心理应激反应,可以减少围术期并发症的发生,而且患者的护理满意度更高,可以取得更好的护理效果。     

泌尿外科疾病合并糖尿病的老年患者围手术期护理

目的探讨泌尿外科疾病合并糖尿病的老年患者围手术期护理的措施。方法选取102例在该院就诊的泌尿外科疾病合并糖尿病患者进行研究,随机分为两组,对照组51例行基础护理,实验组性针对性护理,对比两组护理干预前后两组并发症情况及空腹血糖情况,采用焦虑自评量表(SAS)评估患者心理状况的变化。结果试验组发生并发症率15.7%,对照组发生并发症率49.0%,组间比较差异有统计学意义(P0.05)。治疗前对比两组血糖水平、SAS评分均差异无统计学意义(P0.05),干预后试验组患者空腹血糖水平及SAS评分明显低于干预前(P0.05)。实验组51例患者经针对性围术期护理干预后对护理服务的总满意度为94.1%,对照组患者经常规护理干预后对护理服务的总满意度为74.5%,实验组患者护理总满意度显著高于对照组,组间比较差异有统计学意义(P0.05)。结论围手术期的针对性护理措施使试验组手术后并发症的发生率显著低于对照组,并且试验组空腹血糖水平及SAS评分下降明显,表明针对性的围术期护理可有效改善患者预后,可推广应用。     

链霉蛋白酶与二甲硅油对胃镜检查微小病变检出率影响的比较

探讨链霉蛋白酶与二甲硅油对胃镜检查微小病变检出率影响，统计353例接受无痛胃镜检查的患者，分为试验组（予链霉蛋白酶联合碳酸氢钠）176例和对照组（予二甲硅油联合碳酸氢钠）177例。记录两组胃镜检查时视野清晰度、检查时长、冲洗次数、微小病灶检出率、早期癌检出率及不良反应发生率等临床指标。试验组和对照组比较视野清晰度［（1.84±0.51）分比（2.15±0.48）分，t=-5.900］、胃底黏液性状［（1.04±0.43）分比（1.46±0.76）分，t=-6.347］和冲洗次数［（0.76±0.66）次比（1.18±0.72）次，t=-5.628］等方面，差异有统计学意义（P<0.001）。试验组检查时长略高于对照组［（10.01±4.40）min比（8.98±4.22）min，t=2.239，P=0.026］。试验组微小病变检出率显著高于对照组］［97.73%（172/176）比91.53%（162/177），χ2=6.665，P=0.010］。在炎性增生、息肉、癌前病变和癌的检出率方面，试验组与对照组差异均无统计学意义（P>0.05）。两组患者均无术前喝药不适，试验组和对照组各有4例发生术中呛咳，术中呛咳发生率差异无统计学意义（P>0.999），术后均无不良反应。术前服用链霉蛋白酶可显著提高胃镜下视野清晰度并提高微小病变检出率，有助于发现胃内早期病变。     

个体化术中护理对腹部肿瘤合并糖尿病患者压疮风险的影响

目的观察个体化术中护理对腹部肿瘤合并糖尿病患者压疮风险的影响。方法选取该院2017年3月—2018年3月期间收治的腹部肿瘤合并糖尿病患者78例,随机分为观察组和对照组,各39例,对照组给予常规围术期护理,观察组实施常规围术期护理加个体化术中护理,对比两组的护理效果。结果观察组的护理满意度97.44%、术后3 d压疮评分(14.81±2.31)分均优于对照组79.49%、(12.31±2.41)分,差异有统计学意义(P0.05)。观察组术中、术毕体温均高于对照组,差异有统计学意义(P0.05)。结论个体化术中护理可有效降低腹部肿瘤合并糖尿病患者压疮发生的风险,值得推广。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.