品管圈活动对血液透析患者营养不良情况的影响

目的：探讨品管圈活动对血液透析患者营养不良情况的影响。方法选取2012年6月~2014年7月在本院行血液透析的80例患者作为研究对象,以2012年6月~2013年6月作为品管圈活动前,以2013年7月~2014年7月作为品管圈活动后。比较品管圈活动前后人体学测量和生活指标的变化情况,记录营养不良发生率。结果活动后的营养不良发生率为25.0%,显著低于活动前的55.0%,差异有统计学意义(P<0.05)。活动后的TSF、AMC、Alb、TF、Hb水平显著高于活动前,差异有统计学意义(P<0.05)。结论品管圈活动能够改善血液透析患者的营养状况,降低营养不良发生率。     

品管圈活动降低食管癌术后并发症的效果观察

目的明确品管圈活动降低食管癌术后并发症的实际效果。方法从本院选取2015年3月至2017年3月收治的食管癌手术患者48例作为对象,分为对照组和研究组,每组24例患者。两组患者均应用常规护理模式,研究组患者加用品管圈活动。对两组患者的护理满意度、治疗依从性以及并发症发生情况进行比较和分析。结果研究组患者护理满意度更高,P<0.05;研究组患者治疗依从性更高,P<0.05;研究组患者并发症发生率更低,P<0.05,差异具有统计学意义。结论品管圈活动能够有效提高食管癌患者的治疗依从性以及护理满意度,避免患者发生并发症,值得推广和运用。     

品管圈在手术室护理管理中的应用效果

目的:探讨品管圈在手术室护理管理中的应用效果。方法:本院手术室护理质量管理于2017年1月至12月期间实施品管圈活动,选择90例手术患者作为观察组,另选择2016年1月-12月期间未实施品管圈活动阶段本院收治的90例手术患者作为对照组,比较两组护理满意度,观察护理风险发生情况。结果:观察组护理满意度均显著优于对照组,P0.05;观察组护理风险事件发生率111%显著低于对照组7.78%,P0.05。结论:在手术室护理管理中落实品管圈活动可进一步减少护理风险事件的发生,提高患者对手术室护理的评价,具有较高的应用价值。     

干预护理在老年白内障合并青光眼患者手术中的应用效果

目的：探讨干预护理在老年白内障合并青光眼患者手术中的应用效果。方法选取2013年1月~2014年1月本院眼科收治的100例白内障合并青光眼患者作为研究对象,随机分为对照组和观察组。对照组采用常规护理,观察组采用干预护理方法进行护理,比较两组的术后焦虑、抑郁、疼痛评分,并发症发生率及护理满意度。结果观察组的焦虑、抑郁、疼痛评分及术后并发症发生率显著低于对照组,差异有统计学意义(P<0.05)。观察组的护理满意度显著高于对照组,差异有统计学意义(P<0.05)。结论干预护理在老年白内障合并青光眼患者手术中的应用效果显著,可减少患者的不良情绪,降低术后并发症发生率,提高护理满意度,值得临床推广应用。     

品管圈活动对提升神经内科病房优质护理质量的影响

目的探讨在神经内科病房实施品管圈活动对提升优质护理质量的影响。方法于2014年1~6月在我院神经内科病房实施品管圈活动,选取本科室的20名护士作为考核对象,比较实施品管圈活动前后的护理质量。随机抽取在神经内科实施品管圈前后的60例患者进行问卷调查,比较两组患者的护理满意度和住院时间。结果实施品管圈活动后,神经内科病房护士的服务意识、操作能力、解决问题能力和预见性护理能力评分均高于实施前,交接班时间长于实施前,比较差异均具有统计学意义(P<0.05);实施后的满意度评分高于实施前,住院时间时间短于实施前,比较差异均具有统计学意义(P<0.05)。结论实施品管圈活动可增强神经内科护理人员的服务意识,提升操作能力、解决问题能力和预见性护理能力,提高患者的护理满意度,缩短住院时间,提升护理质量。     

品管圈活动在神经外科住院患者中的应用效果

目的探讨品管圈活动在神经外科住院患者中的应用效果。方法随机抽选遵义医学院第五附属(珠海)医院神经外科2015年3~12月住院进行输液治疗患者480例和护士16名,按照参加品管圈活动前后随机分为对照组和观察组,对照组(活动前)为2015年3~6月住院患者236例和护士8名,观察组(活动后)为2015年7~12月参加品管圈活动的244例患者和护士8名,开展"降低静脉输液药物外渗发生率"的品管圈活动的244例患者为观察组。结果通过开展品管圈活动以来,两组患者静脉输液穿刺一次性成功率分别为:观察组为96.72%,对照组为93.64%,差异有统计学意义(P<0.05);输液外渗发生率分别为:对照组为12.30%,观察组为4.67%,差异有统计学意义(P<0.05)。静脉炎的发生率观察组为1.20%,对照组为5.78%,差异有统计学意义(P<0.05)。护士对品管圈的应用意义、高危高渗药物的认知、团队成员的互助协作理念、提升护理服务质量、参与活动信心和集体荣誉感6个方面的评分均显著提高(P<0.05)。结论品管圈活动的开展,加强了护士对高危、高渗药物专业知识的认知,规范了安全输液的操作,提高了静脉输液穿刺一次性成功率,降低输液外渗率和输液并发症的发生,值得临床推广应用。     

品管圈管理理念和方法在提高护理不良事件上报率中的应用

目的探讨品管圈管理理念和方法在护理不良事件管理中的作用。方法以自愿形式成立由护士组成的管理活动小组,把品管圈活动的重要管理方法"头脑风暴法"和"根本原因分析法"应用于护士不主动上报不良事件的原因调查和对策制订和实施等步骤中,以提高不良事件的上报率。结果将品管圈管理理念和方法应用在护理不良事件上报管理中后,上报率显著提高,发生率明显下降,与实施前比较,差异有统计学意义(均P<0.01)。结论将品管圈管理理念和方法应用在护理不良事件上报管理中能显著提高上报率,有效降低不良事件发生率,保障患者安全,提高护理安全管理质量。     

手术室优质护理配合在老年白内障超声乳化手术患者中的应用效果

目的 探讨手术室优质护理配合在老年白内障超声乳化手术患者中的应用效果。方法 选取2021年1月至7月在牡丹江医学院附属红旗医院行白内障超声乳化手术的72例老年患者作为研究对象,采用随机数字表法将其分为对照组和观察组,各36例。对照组患者采用常规手术室护理配合,观察组患者采用手术室优质护理配合。比较两组患者术前及术后3个月视力水平、眼压水平变化情况和并发症总发生率。结果 观察组患者术后3个月的视力高于对照组,差异有统计学意义（P<0.05）。观察组患者眼压低于对照组,差异有统计学意义（P<0.05）。观察组患者的并发症总发生率低于对照组,差异有统计学意义（P<0.05）。结论 手术室优质护理配合应用至老年白内障超声乳化手术中不仅能够保障手术顺利开展,亦提升手术疗效,降低并发症风险,故值得借鉴。     

实施手术室护理精细化管理措施对骨科手术室安全隐患的干预效果分析

目的探究实施手术室护理精细化管理措施对骨科手术室安全隐患的干预效果。方法选取本院2015年6月至2017年6月收治的358例骨科手术患者作为实验组,选取本院2013年1月至2015年1月收治的358例骨科手术患者作为对照组。实验组实施手术室护理精细化管理措施,对照组实施常规手术室护理,比较两组对手术室安全隐患的干预效果。结果实验组手术室护理存在的安全隐患为3.07%低于对照组8.37%,实验组院内感染发生率0.84%(3/358)低于5.31%(19/358)。实验组血管、神经损伤发生率1.12%(4/358)低于对照组5.03%(18/358)。差异均具有统计学意义(P<0.05)。结论实施手术室护理精细化管理措施对降低手术并发症有显著效果,是使手术风险降低的有效措施,可以切实保证手术室安全。     

品管圈活动在手术交换车安全管理的应用研究

目的探讨品管圈活动在手术交换车使用安全管理中的作用,以有效提高工作效率,保证护理安全。方法进行现状调查、原因分析、设定目标、制定对策、组织实施、效果检查及巩固措施等程序,开展品管圈活动。比较手术患者转运交接班工作改善前后总目标及子目标改善情况。结果实施后患者的护理差错发生率、手术交换车安全隐患发生率与实施前比较均呈降低趋势,差异有统计学意义(P<0.05)。实施后患者住院和护士工作的满意度与实施前比较呈上升趋势,差异有统计学意义(P<0.05)。结论实施品管圈活动可以保证手术交换车安全,同时还提高了圈员的质量管理意识、创新意识及组织策划能力,值得临床推广应用。     

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.     

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.     

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.