探讨有氧训练在老年泌尿外科患者中的应用效果

目的 探讨有氧训练在老年泌尿外科患者中的应用效果。方法 800例泌尿外科接受治疗的老年患者,以随机数字表法分为对照组及观察组,每组400例。对照组患者术后接受常规训练,观察组患者术后接受有氧训练。对比两组患者训练前后的情绪改善情况,训练前后的日常生活活动能力以及生活质量情况,术后并发症发生情况。结果 训练后,观察组患者的汉密尔顿焦虑量表(HAMA)评分(12.07±0.76)分、汉密尔顿抑郁量表(HAMD)评分(11.29±0.78)分低于对照组的(16.32±1.87)、(15.82±1.33)分,差异具有统计学意义(P<0.05)。训练后,观察组患者的Barthel指数(BI)评分(88.22±5.82)分、健康调查简表(SF-36)评分(89.93±4.54)分高于对照组的(79.48±5.39)、(78.22±4.29)分,差异具有统计学意义(P<0.05)。训练后,观察组患者的术后并发症发生率3.50%低于对照组的13.00%,差异具有统计学意义(P<0.05)。结论 给予老年泌尿外科患者行有氧训练可有效促进患者心理状态的改善,日常生活活动能力及生活质量的提...     

快速康复外科模式对老年颅内动脉瘤患者神经功能障碍、下肢静脉血栓发生率的影响

目的 探讨快速康复外科模式对老年颅内动脉瘤患者神经功能障碍、下肢静脉血栓发生率的影响。方法 选择100例老年颅内动脉瘤患者，采用抽签法分为观察组（n=51）和对照组（n=49）。对照组给予常规护理干预治疗，观察组在对照组的基础上加用快速康复外科模式治疗。比较两组患者住院时间、出院、格拉斯哥预后（GOS）评分、住院费用、神经功能缺损、Barthel指数（Barthel）评分、生活质量、患者满意度及术后并发症发生情况。结果 观察组住院时间、出院GOS评分及住院费用均显著低于对照组（P<0.05）；治疗前，两组神经功能缺损、Barthel评分水平无明显差异；治疗后，两组神经功能缺损水平均显著降低，且观察组高于对照组，Barthel评分水平显著升高，且观察组高于对照组（P<0.05）；治疗后，两组生活质量评分水平显著升高，且观察组高于对照组，差异有统计学意义（P<0.05）；两组总满意度分别为96.08%,79.59%，差异有统计学意义（P<0.05）；两组术后并发症总发生率分别为7.84%,28.57%，差异有统计学意义（P<0.05）。结论 在老年颅内动脉瘤患...     

早期肠内营养支持治疗急性脑卒中的效果观察

目的：探讨早期肠内营养支持治疗急性脑卒中的效果。方法选取2008年1月~2014年7月本院收治的92例急性脑卒中伴吞咽障碍患者作为研究对象,随机分为观察组（52例）和对照组（40例）。观察组于入院后72 h内给予鼻饲肠内营养支持,对照组采用家庭喂养饮食。比较两组的上肢中臂肌围（AMC）、总淋巴细胞计数（TLC）、血清白蛋白（Alb）、前白蛋白（PA）与血红蛋白（Hb）等各项营养指标,记录两组的低蛋白血症发生率（血清白蛋白约35 g/L）与感染发生率、神经功能缺损程度（NIHSS评分）与日常生活能力（Barthel指数）。结果观察组治疗后的AMC、Alb、PA、TLC与Hb水平显著高于治疗前及对照组治疗后,差异有统计学意义（P<0.05）。观察组的感染发生率与低蛋白血症发生率显著低于对照组,差异有统计学意义（P<0.05）。观察组治疗后的NIHSS评分显著低于对照组治疗后,差异有统计学意义（P<0.05）。观察组治疗后的Barthel指数显著高于对照组治疗后,差异有统计学意义（P<0.05）结论早期给予急性脑卒中患者肠内营养支持,可有效改善患者的营养状况,提高机体免疫力,促进神经功能恢复,降低感染发生率,改善患者的近期预后。     

社区健康管理对老年缺血性脑卒中患者预后的影响

目的 探讨社区健康管理对老年缺血性脑卒中患者生活质量、心理状态及并发症的影响.方法 88例患者采用随机数字表法分为两组,接受社区健康管理组33例（观察组）,未接受社区健康管理组55例（对照组）,对脑卒中1年后患者进行家访,评估患者的生活质量、抑郁和焦虑程度及并发症发生情况.结果 两组患者治疗后Barthel指数均显著高于治疗前（t=7.24、4.61,均P＜0.05）,且观察组治疗后Barthel指数显著高于对照组（t=3.72,P＜0.05）.经过干预后观察组焦虑与抑郁评分明显改善,与对照组比较差异均有统计学意义（t=4.58、8.32,均P＜0.05）.观察组并发症发生率为9.1%（3/33）,显著低于对照组的30.9%（17/55）（χ^2=5.59,P＜0.05）.结论接受社区健康管理模式能有效减轻患者的不良心理情绪,提高老年缺血性脑卒中患者的生活质量,减少并发症,是一种值得推广的护理模式.     

PFNA与DHS内固定治疗老年股骨粗隆间骨折的效果比较分析

目的：比较PFNA与DHS内固定治疗老年股骨粗隆间骨折的效果。方法选取40例股骨粗隆间骨折患者作为研究对象,随机分为观察组和对照组,各20例。观察组给予PFNA治疗,对照组给予DHS治疗。比较两组的优良率及并发症发生率。结果观察组的优良率为90.00%,显著高于对照组的70.00%,差异有统计学意义（P<0.05）。观察组的并发症发生率为5.00%,显著低于对照组的30.00%,差异有统计学意义（P<0.05）。结论 PFNA治疗老年股骨粗隆间骨折效果显著,术后并发症发生率低,值得临床推广应用。     

整体护理在老年股骨颈骨折中的应用

目的：探讨整体护理对老年股骨颈骨折患者的效果。方法选取扬州市广陵区中医院2013年1月~2014年12月收治的53例老年股骨颈骨折患者,将患者随机分成观察组和对照组。观察组给予整体护理,对照组采用骨科常规护理,调查护理后患者的满意度和并发症发生率,对护理效果进行评估。结果护理后,观察组的满意度（92.6%）明显高于对照组（61.5%）,差异有统计学意义（P<0.05）;观察组的并发症发生率（3.8%）明显低于对照组（23.1%）,差异有统计学意义（P<0.05）。结论对老年股骨颈骨折患者实施整体护理可提高患者满意度,降低并发症发生率,从而促进骨折愈合,提高患者的生活质量。     

健康宣教在老年骨质疏松性髋部骨折患者护理中的价值

目的 分析探讨健康宣教在老年骨质疏松性髋部骨折患者护理中的应用价值。方法 选择中国人民解放军陆军七十三集团军医院2021年30例老年骨质疏松性髋部骨折患者为研究对象,使用随机数字表法分组,其中对照组采用常规护理,观察组加用健康宣教护理,将两组护理前后的心理状态、自我照顾能力、生活质量以及护理后的护理效果、并发症发生情况、患者对护理实施满意度进行比较。结果 使用汉密尔顿焦虑量表（HAMA）和汉密尔顿抑郁量表（HAMD）对两组患者负面情绪进行评分,两组患者干预前HAMA与HAMD评分差异无统计学意义（P> 0.05）,干预后观察组患者的负性情绪得分低于对照组（P <0.05）;改进的Barthel指数用于评估患者的自给自足能力,护理前两组Barthel指数差异不大（P> 0.05）,护理后,观察组Barthel指数评分高于对照组（P <0.05）。使用生活强度量表（SF-36）评估患者的生活质量,护理后,观察组SF-36得分高于对照组（P <0.05）;观察组护理总有效率高于对照组（P <0.05）;观察组并发症发生率低于对照组（P <0.05）;...     

规范化急诊护理干预在急性脑梗死中的应用

目的 探讨规范化急诊护理干预在急性脑梗死（ACI）中的应用效果。方法 选取2018年2月至2020年3月北京大学首钢医院急诊科收治的122例ACI患者作为研究对象,按照随机数字表法分为观察组（n=61）与对照组（n=61）。观察组采用规范化急诊护理干预,对照组采用常规护理方法。比较两组干预前、干预后2周美国国立卫生院神经功能缺损评分量表（NIHSS）评分和日常生活活动能力（Barthel指数）评分,以及两组干预后并发症发生率、干预前后自我效能感评分。结果 干预前,两组NIHSS及Barthel评分比较,差异无统计学意义（P> 0.05）;干预后2周,观察组患者的NIHSS评分低于对照组,Barthel评分高于对照组,差异有统计学意义（P <0.05）;观察组患者口腔牙龈出血、颅内出血、脑疝等并发症总发生率低于对照组,差异有统计学意义（P <0.05）;干预前,两组患者自我效能感评分比较,差异无统计学意义（P> 0.05）,干预后,观察组自我效能感评分高于对照组,差异有统计学意义（P <0.05）。结论 ACI治疗期间,采用规范化急诊护理干预展开辅助治疗,可...     

临床护理路径应用于首次脑梗死患者的效果评价

目的探讨临床护理路径应用于首次脑梗死患者的临床疗效。方法选取2012年10月至2013年10月我院收治的72例急性脑梗死患者为研究对象,将其随机均分为实验组与对照组,对照组采用常规护理方法,实验组在常规护理的基础上予以临床护理路径进行护理,比较两组护理前后FAM积分及Barthel指数变化情况、患者满意度及并发症发生率。结果相比于护理前,护理后FAM积分及Barthel指数均显著改善,比较有显著性差异,具有统计学意义(P<0.05);两组护理前FAM积分及Barthel指数比较无显著性差异(P>0.05);实验组护理后FAM积分及Barthel指数较对照组明显改善,比较有显著性差异(P<0.05);接受不同模式的护理后问卷调查结果显示实验组患者满意度为86.11%,对照组患者满意度为63.89%,两组患者满意度比较有显著性差异(P<0.05);实验组出现1例肺部感染,并发症发生率为2.78%;对照组出现5例肺部感染,3例泌尿系统感染,2例压疮,并发症发生率为27.78%,两组并发症发生率比较有显著性差异(P<0.05)。结论采用临床护理路径护理首次脑梗死患者能显著改善患者肢体运动功能及日常生活能力,显著提高患者满意度,值得在临床上进一步应用。     

医护一体化在促进老年四肢骨折术后恢复的作用

目的 探讨医护一体化在促进老年四肢骨折术后恢复的作用。方法 将我院于2016年1月～2019年6月收治的126例老年四肢骨折患者按照随机数字表法分为两组,对照组63例予以常规护理,研究组63例予以医护一体化护理。比较两组患者睡眠质量、Barthel指数、自我效能、生活质量以及并发症发生情况。结果 两组患者干预前睡眠障碍率、Barthel指数、自我效能及生活质量评分比较,差异无统计学意义(P 0.05),干预后两组睡眠障碍率均较干预前显著降低,Barthel指数、自我效能及生活质量均较干预前显著升高,组间比较差异有统计学意义(P 0.05)。研究组并发症发生率(9.52%)低于对照组(25.40%)(P 0.05)。结论 医护一体化在老年四肢骨折患者中应用可显著改善患者睡眠质量,提升患者日常生活能力、自我效能以及生活质量,降低并发症发生风险。     

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.     

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.