老年髋部骨折患者的循证护理探析

目的分析老年髋部骨折患者循证护理方法与效果。方法研究对象取2014年4月至2015年4月本院老年髋部骨折86例,依照护理模式差异进行分组。对照组模式为常规护理,共43例;余43例入组实验组,模式为循证护理。观察评定效果,予以对比分析。结果实验组并发症的发生率低(P<0.05),舒适度及满意度高(P<0.05),有显著性差异。结论老年髋部骨折患者循证护理效果较好,可显著减少并发症,提高患者舒适度与满意度,值得推广。     

综合护理干预在透析合并髋部骨折中的应用效果分析

目的分析综合护理干预在透析合并髋部骨折的应用效果。方法随机将80例维持性透析合并髋部骨折患者分成对照组和实验组,每组均为40例;对照组选择常规护理,实验组选择综合护理干预,观察分析两组患者的护理效果。结果在并发症以及护理满意度方面,实验组均显著优于对照组(P <0.05)。结论为透析合并髋部骨折患者提供综合护理干预,能让并发症有效减少,让患者的护理满意度显著提高,值得临床推广。     

循证护理在老年髋部骨折合并糖尿病行内固定术患者中的应用

目的探讨循证护理在老年髋部骨折合并糖尿病行内固定术患者中的应用价值。方法选择2015年10月~2017年3月本院收治的老年髋部80例,其中股骨颈骨折45例,股骨粗隆间骨折35例,按照随机数字法分为两组,各40例,观察组实施本研究循证护理,对照组实施常规护理,包括心理护理、一般护理、手术围术期护理等,股骨颈骨折术式为空心钉内固定术,股骨粗隆间骨折术式为股骨近端防旋髓内钉(PFNA)。结果观察组10米步行耗时短于对照组(P<0.05),齐膝凳子5次坐立耗时短于对照组(P<0.05),观察组术前住院时间短于对照组(P<0.05),术后住院时间短于对照组(P<0.05),观察组术后拄拐下地行走时间及弃拐行走时间均早于对照组(P<0.05)。结论通过循证护理干预,可有效提高老年髋部骨折合并糖尿病患者的术后恢复情况,改善其髋关节功能,促进患者早日康复出院。     

髋部骨折术后优质护理对患者术后并发症、满意度及髋关节功能恢复的影响分析

目的：分析髋部骨折术后优质护理对患者术后并发症、满意度及髋关节功能恢复的影响。方法：选取2019年12月至2020年12月共80例髋部骨折术后患者作为研究对象，根据患者的护理差异性，选取髋部骨折术后采取常规护理的患者为对照组，髋部骨折术后采取优质护理的患者为试验组，观察两组患者的术后并发症、满意度及髋关节功能恢复的情况。结果：试验组患者的术后并发症发生率2.4%显著低于对照组患者21.1%,差异有统计学意义(P<0.05);且试验组患者护理满意度95.2%高于对照组患者84.2%,对比差异有统计学意义(P<0.05)。两组患者手术后的Harris髋关节评分均高于手术前(P<0.05);手术后，试验组患者的Harris髋关节评分高于对照组(P<0.05)。试验组患者的髋关节功能恢复优良率97.6%(41/42)高于对照组73.7%(28/38)(P<0.05)。结论：针对髋部骨折术后的患者采取优质护理服务能够显著降低患者术后并发症发生率，且明显提高整体护理满意度，患者髋关节功能恢复优良率更高；因而采取优质护理更有利于髋部骨折术后患者的恢复。     

循证护理对高龄髋部骨折患者并发症和护理满意度的影响

目的探讨循证护理对高龄髋部骨折患者并发症和护理满意度的影响。方法选取2013年3月-2015年3月医院收治的高龄髋部骨折患者240例,随机分为观察组和对照组各120例。观察组采用循证护理,对照组采用常规护理。观察、比较2组并发症发生率及护理满意度。结果观察组并发症发生率为10.83%明显低于对照组的23.33%,差异有统计学意义(P<0.05)。观察组护理满意度96.66%显著高于对照组的89.16%,差异有统计学意义(P<0.05)。结论循证护理在高龄髋部骨折患者护理方面效果显著,值得临床推广应用。     

医护一体化护理模式在老年髋部骨折患者围术期呼吸道管理中的应用

目的探讨医护一体化护理模式在老年髋部骨折患者围术期呼吸道管理中的应用。方法选择2019年1—12月泰州市人民医院骨科收治的老年髋部骨折患者117例,根据我科新技术开展时间节点分为两组。对照组采用常规护理模式(n=56),试验组采取医护一体化护理模式(n=61)。比较分析两组患者肺部感染的发生率、出院患者满意度、平均住院时间、日均费用。结果术后1周试验组患者肺部感染的发生率较对照组低,差异有统计学意义(P 0.05);试验组患者住院满意度明显高于对照组,平均住院时间和日均费用低于对照组,差异有统计学意义(P 0.05)。结论医护一体化护理模式可以降低老年髋部骨折患者围术期肺部感染的发生率,减轻患者家庭及社会的经济负担,加速患者康复。     

爱人参与的自我管理教育对妊娠高血压患者血压控制与自护能力的影响

目的 观察爱人参与的自我管理教育对妊娠高血压患者自我护理能力及血压控制的影响.方法 选择120例妊娠高血压患者,按其爱人的参与意愿分为两组,试验组采用爱人参与的自我管理教育,对照组行常规护理模式.观察两组患者干预前及干预后3个月自我护理能力评分、血压控制效果及满意度.结果 干预后,试验组患者空腹血压达标率明显高于对照组(66.67％比55.00％),差异有统计学意义(P＜0.05);同时试验组自我护理能力显著高于对照组,差异有统计学意义(均P＜ 0.05);试验组满意度高于对照组(90.00％比66.67％),差异有统计学意义(P＜0.05).结论 爱人参与的自我管理教育能提高妊娠高血压综合征患者的自我护理能力,有效控制血压,值得推广和应用.     

护理干预对老年高血压患者治疗效果的影响

目的 探讨护理干预对老年高血压患者治疗效果的影响.方法 92例老年高血压患者随机分为对照组与和干预组各46例.对照组给予常规护理,干预组在对照组基础上给予护理干预措施.比较两组患者干预前后的血压控制情况,患者对疾病知识的掌握情况、服药依从性情况、并发症发生率以及患者对护理的满意度.结果 干预组干预后收缩压、舒张压分别为(134.2±11.2)mm Hg、(72.3±6.2) mm Hg,均明显低于对照组的(145.1±3.5)mm Hg、(85.2±8.0)mm Hg(t =2.983、2.763,均P＜0.05);干预组患者对疾病的掌握程度、服药依从性、以及对护理的满意度均优于对照组(x2=4.923、5.125、6.342,均P＜0.05).结论 对高血压患者实施全面的护理干预,能显著提高治疗效果及生活质量.     

循证护理在剖宫产术后疼痛护理中的应用

目的评价分析循证护理在剖宫产术后疼痛护理中的应用价值。方法按照随机原则将2013年1月至213年12月我科收治的剖宫产患者560例分成对照组和试验组各280例,对照组患者应用常规护理措施,试验组患者应用循证护理措施,对两组患者术后的疼痛评分、术后24 h睡眠时间及患者的满意度进行比较。结果对照组患者术后的疼痛评分为(5.74±2.33)分、试验组患者术后的疼痛评分为(3.96±1.85)分,试验组低于对照组,两组比较差异具有统计学意义(P<0.05);对照组患者术后24 h睡眠时间为(6.74±1.58)h、试验组患者术后24 h睡眠时间为(9.24±2.11)h、试验组高于对照组,两组比较差异具有统计学意义(P<0.05);对照组患者术后满意度为77.1%、试验组患者术后满意度为93.9%,试验组高于对照组,两组比较差异具有统计学意义(P<0.05)。结论针对可能导致剖宫产术后的疼痛因素及早的进行循证护理,能够有效的减轻患者术后的疼痛感、促进患者术后的早日康复、提高患者的满意度,有助于护理质量的提高。     

骨质疏松性髋部骨折术后患者应对方式与生存质量的相关性研究

目的 探讨骨质疏松性髋部骨折术后患者应对方式与生存质量的相关性.方法 按照随机数字表法将114例骨质疏松性髋部骨折手术患者分为试验组和对照组,每组57例.对照组患者采取西医常规围术期护理,试验组患者采取中西医结合护理,观察2组患者的应对方式,进一步按照不同应对方式进行分组,比较不同应对方式对患者生存质量的影响,进一步分析应对方式与生存质量的相关性.结果 试验组患者积极应对评分明显高于消极应对,对照组患者积极应对评分明显低于消极应对,差异有统计学意义(P<0.05);试验组积极应对率明显高于对照组,差异有统计学意义(P<0.05);积极应对组躯体健康和精神健康各维度评分均明显高于消极应对组,差异有统计学意义(P<0.05);积极应对与躯体健康、精神健康均呈正相关(P<0.05),消极应对与躯体健康、精神健康均呈负相关(P<0.05).结论 骨质疏松性髋部骨折术后患者不同应对方式与生存质量有明显相关性,采取中西医结合护理干预可有效改善患者应对方式,提高术后生存质量.     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Pharmacological treatment of COVID-19: an opinion paper

The precocity and efficacy of the vaccines developed so far against COVID-19 has been the most significant and saving advance against the pandemic. The development of vaccines has not prevented, during the whole period of the pandemic, the constant search for therapeutic medicines, both among existing drugs with different indications and in the development of new drugs. The Scientific Committee of the COVID-19 of the Illustrious College of Physicians of Madrid wanted to offer an early, simplified and critical approach to these new drugs, to new developments in immunotherapy and to what has been learned from the immune response modulators already known and which have proven effective against the virus, in order to help understand the current situation.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.