预防性护理在特重型脑外伤患者鼻饲期间的作用

目的探讨预防性护理对特重型脑外伤患者鼻饲期间并发症发生率及营养水平的影响。方法选取我院2011-01—2014-09收治的特重型脑外伤行鼻饲患者73例,按照护理方案分为对照组(给予常规护理)和观察组(实施预防性护理),比较2组鼻饲期间并发症发生率、营养状况及护理满意度。结果观察组营养状况明显优于对照组,并发症发生率(0)明显低于对照组(19.44%),护理满意度(97.30%)明显高于对照组(77.78%),差异均有统计学意义(P0.05)。结论预防性护理可有效降低特重型脑外伤患者鼻饲期间并发症发生率,改善患者营养状况,并有利于提高患者满意度,值得临床推广应用。     

优质护理措施对脑肿瘤手术患者生活质量的影响

目的探讨优质护理措施对脑肿瘤手术患者生活质量的影响。方法选择2014-01—2016-05在我院行手术治疗住院的脑肿瘤患者,随机抽取82例患者,按照数字表达法分为对照组(常规护理组)41例,观察组(优质护理组)41例。比较2组患者护理前后生活质量评分、术后肺部感染、压疮等并发症及护理满意度。结果护理前2组患者生活质量评分差异无统计学意义(P0.05),护理后观察组生活质量评分明显优于对照组,差异有统计学意义(P0.05);对照组9例发生肺部感染等并发症,发生率21.95%,观察组发生3例,发生率7.31%,差异有统计学意义(P0.05);观察组满意度95.12%,明显高于对照组的75.60%,差异有统计学意义(P0.05)。结论优质护理措施可显著提高脑肿瘤手术患者的生活质量,同时降低其并发症发生率,值得临床推广应用。     

集束化护理预防脑出血患者术后下肢深静脉血栓形成的效果

目的 探讨集束化护理预防脑出血患者术后下肢深静脉血栓形成的效果。方法 回顾性纳入郑州大学第二附属医院2020-01—2021-12收治的行外科手术治疗的脑出血患者126例。根据术后护理方法不同,分为集束化护理组和常规护理组。术后3周监测2组患者股静脉血流速度及凝血功能各项指标,比较2组患者术后下肢深静脉血栓的发生率、术后并发症发生率及患者满意度。结果 术后护理3周,集束化护理组患者的股静脉血流平均速度和峰值速度均显著高于常规护理组,差异有统计学意义(P<0.05);2组患者的凝血功能指标(PT、TT、APTT、FBG)比较,差异无统计学意义(P>0.05);集束化护理组患者术后下肢深静脉血栓发生率及术后并发症发生率均显著低于常规护理组(3.17%vs 17.46%,P<0.05;34.92%vs 14.29%,χ²=7.231,P=0.007)。集束化护理组患者的术后护理满意度显著高于常规护理组(96.83%vs 79.37%,χ²=9.157,P=0.002)。结论 集束化护理虽然对脑出血患者外科手术后的凝血功能指标基本无...     

院前急救与院内急救在高血压脑出血患者救治中的临床效果

目的分析院前急诊在高血压脑出血患者救治中的效果。方法回顾性分析我院2014-01—2016-12收治的240例高血压脑出血患者的临床资料,其中120例未行院前急救,发病后由家属送至急诊科后予以院内急救者为对照组,另120例接受院前急救和院内急救者为观察组。比较2组患者急救反应时间、临床疗效及并发症。结果观察组T1、T2、T3、T5时间均明显短于对照组,差异有统计学意义(P0.05)。对照组死亡14例(11.67%),观察组死亡2例(1.67%),2组病死率比较差异有统计学意义(χ~2=4.821 4,P=0.028 10.05)。观察组总有效率(96.67%,116/120)高于对照组(86.67%,104/120),差异有统计学意义(χ~2=3.927 3,P=0.047 50.05)。观察组并发症发生率(10.00%,12/120)低于对照组(25.00%,30/120),差异有统计学意义(χ~2=4.675 3,P=0.030 60.05)。结论院前急救可缩短高血压脑出血急救时间,提高临床疗效,降低并发症发生率和病死率,明显改善患者预后。     

护理干预对蛛网膜下腔出血的影响

目的探讨护理干预对蛛网膜下腔出血的影响。方法 2组患者接受不同的护理方法,比较2组住院时间、并发症发生情况及满意度。结果观察组住院时间为(45.5±5.1)d,对照组为(62.3±4.9)d,差异具有统计学意义(t=16.80,P0.01)。观察组并发症发生率为4.0%,对照组为16.0%,差异具有统计学意义(χ2=8.00,P0.01)。观察组满意率为96.0%,对照组为80.0%,差异具有统计学意义(χ2=12.12,P0.01)。结论良好的个性化护理能有效减少并发症的发生率,缩短住院时间,提高患者满意度,值得临床推广。     

人性化护理干预在老年结肠癌合并肠梗阻患者中的效果分析

目的探讨人性化护理干预在老年结肠癌合并肠梗阻患者中的护理效果。方法选择我院2009-11—2012-11结肠癌合并肠梗阻患者60例,随机分为观察组和对照组。观察组在常规护理基础上给予人性化护理干预,对照组给予常规护理。观察2组患者术后并发症情况及护理满意度。结果观察组切口感染发生率1.0%,肺部感染发生率3.3%,无下肢静脉血栓发生,粘连性肠梗阻发生率3.3%。对照组切口感染发生率为40.0%,肺部感染发生率33.3%,下肢静脉血栓发生率20.0%,粘连性肠梗阻发生率为30.0%。观察组发生率均低于对照组,差异有统计学意义(P0.05)。观察组患者对护理满意度为93.4%,对照组为63.3%,观察组护理满意度高于对照组,差异有统计学意义(P0.05)。结论人性化护理干预能够降低老年结肠癌合并肠梗阻患者术后并发症的发生率,提高患者对护理的满意度,护理效果显著。     

专病一体化护理干预在重度颅脑损伤中的应用效果观察

目的探讨专病一体化护理干预在重度颅脑损伤中的应用价值。方法抽取2015-07—2016-08我院62例重度颅脑损伤患者,根据护理方案不同分为对照组(n=31)和研究组(n=31)。对照组采用常规护理干预,研究组在常规护理基础上实施专病一体化护理干预。对比护理前后2组认知功能(MMSE)、日常生活活动能力(BI)及语言能力(BDAE)评分变化情况,并统计2组并发症发生率、护理满意度。结果护理前2组MMSE评分、BI评分及BDAE分级对比差异无统计学意义(P0.05),经护理,研究组MMSE评分、BI评分及BDAE分级均优于对照组,差异有统计学意义(P0.05);研究组并发症发生率(9.68%)低于对照组(35.49%),护理满意度(96.77%)高于对照组(74.19%),差异有统计学意义(P0.05)。结论对重度颅脑损伤患者实施专病一体化护理干预效果显著,可有效改善患者认知功能、日常生活活动能力及语言能力,降低并发症发生率,提高护理满意度,值得推广。     

预见性护理对高血压脑出血患者肺部感染的作用

目的探讨预见性护理对高血压脑出血患者肺部感染的控制效果。方法选择2012-06—2014-02收治的高血压脑出血患者120例,随机分为对照组和观察组各60例,对照组实施普通护理,观察组在对照组基础上实施预见性呼吸道护理、肺炎预防护理等,对比2组患者肺部感染情况及患者的满意度。结果对照组肺部感染12例(20.00%),观察组肺部感染2例(3.33%),观察组明显优于对照组,差异有统计学意义(P=0.006);对照组护理满意度为75.00%,观察组为96.67%,观察组明显优于对照组,差异有统计学意义(P=0.017)。结论针对高血压脑出血患者实施预见性护理可以有效降低肺部感染发生率,临床效果确切,值得推广应用。     

心理护理干预模式对脑出血围术期患者神经功能及家属心理状态的影响

目的探讨心理护理干预模式对脑出血围术期患者神经功能及家属心理状态的影响。方法抽取2013-09—2016-11我院收治的98例脑出血患者,根据入院顺序分为2组各49例。对照组行围手术期常规护理干预,观察组在此基础上加强心理护理干预。对比2组入院时及出院时神经功能(NIHSS)评分、生活质量(SF-36)评分及家属负性情绪[焦虑(HAMA)、抑郁(HAMD)]评分,并统计2组护理满意度。结果入院时,2组NIHSS评分、SF-36生活质量评分差异无统计学意义(P0.05);出院时,观察组NIHSS评分低于对照组,SF-36生活质量评分高于对照组,差异有统计学意义(P0.05);入院时2组家属HAMA、HAMD评分差异无统计学意义(P0.05);出院时,观察组家属HAMA、HAMD评分低于对照组,差异有统计学意义(P0.05);观察组护理满意度95.92%(47/49),高于对照组的79.59%(39/49),差异有统计学意义(P0.05)。结论心理护理干预模式有利于促进脑出血围术期患者神经功能恢复、缓解家属负性情绪,对提高患者护理满意度及生活质量具有重要临床意义。     

功能锻炼在胸腰椎骨折合并脊髓损伤患者护理工作中的应用

目的探讨功能锻炼在胸腰椎骨折合并脊髓损伤患者护理工作中的应用。方法回顾性分析我院2014-05—2015-05收治的90例胸腰椎骨折合并脊髓损伤患者的临床资料,按照就诊时间顺序分为常规护理组与功能锻炼组,每组45例,对比2组康复情况、并发症发生率、焦虑抑郁评分。结果常规护理的康复恢复率为62.22%,功能锻炼组为82.22%,功能锻炼组的康复恢复率明显高于常规护理组,差异具有统计学意义(χ2=4.79,P0.05)。常规护理组并发症发生率为22.22%,功能锻炼组为8.89%,功能锻炼组的并发症发生率明显低于常规护理组,差异具有统计学意义(χ2=4.62,P0.05)。锻炼组焦虑评分与抑郁评分相比均明显低于常规护理组,差异具有统计学意义(t=4.32,P0.05;t=4.52,P0.05)。结论于常规护理基础上加用功能锻炼护理可提高胸腰椎骨折合并脊髓损伤患者的康复效果,降低并发症发生率,降低焦虑抑郁评分,值得推广与应用。     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

腺垂体功能减退症临床特征变化分析

目的探讨腺垂体功能减退症患者的病因结构变化及临床表现。方法回顾性分析我院2013-01—2016-12住院及门诊78例腺垂体功能减退症患者的临床资料。结果男32例(41.03%),女46例(58.97%);诊断时年龄11~89岁,平均62.5岁;鞍区占位(包括术前及术后)52例(66.67%),席汉综合征8例(10.26%),空泡蝶鞍9例(11.65%),病因不明8例(10.26%),垂体-下丘脑发育不良1例(1.28%)。首次就诊科室:纳差厌食、恶心呕吐就诊于消化内科36例(46.15%)最常见。ACTH+TSH+Gn+G激素缺乏为19例最多,占24.36%,ACTH+TSH+Gn缺乏15例,占19.23%。结论腺垂体功能减退症病因结构发生变化,发病人群、首发症状及受累激素也不同,患者女性多于男性,发病年龄偏高,症状不典型,分布于临床多个科室,其中以低钠血症为首发临床表现就诊消化内科最多。     

Standards of instrumentation of EMG

Standardization of Electromyography (EMG) instrumentation is of particular importance to ensure high quality recordings. This consensus report on “Standards of Instrumentation of EMG” is an update and extension of the earlier IFCN Guidelines published in 1999. First, a panel of experts in different fields from different geographical distributions was invited to submit a section on their particular interest and expertise. Then, the merged document was circulated for comments and edits until a consensus emerged.The first sections in this document cover technical aspects such as instrumentation, EMG hardware and software including amplifiers and filters, digital signal analysis and instrumentation settings. Other sections cover the topics such as temporary storage, trigger and delay line, averaging, electrode types, stimulation techniques for optimal and standardised EMG examinations, and the artefacts electromyographers may face and safety rules they should follow. Finally, storage of data and databases, report generators and external communication are summarized.     

帕金森病运动症状进展分析

目的分析帕金森病(PD)患者运动症状进展特点。方法采用PD统一评分量表(UPDRS)Ⅲ对912例PD患者进行评估。结果与病程1年的患者比较,除病程1~2年的患者外,其他病程患者的UPDRSⅢ评分、强直分、姿势或步态异常分、轴性症状总分、言语分、步态分显著升高(均P0.05),病程5~6年及14年患者的震颤分,病程5~6年、7~8年、9~13年、14年患者的运动迟缓分、姿势分显著升高(P0.05~0.01)。轴性症状进展速度高于UPDRSⅢ评分。结论 PD患者病程早期UPDRSⅢ评分进展快,震颤症状进展独立于其他症状,轴性症状评分较UPDRSⅢ更敏感地反映疾病加重趋势。     

Frequency of accumulation of filaments in adaxonal cytoplasm of Schwann cells of myelinated fibers of rat spinal roots

Summary The frequency of accumulation of 6-nm filaments in the adaxonal cytoplasm of Schwann cells in the 6th lumbar dorsal and ventral roots was evaluated in 4-, 8-, 26- and 45-week-old Sprague-Dawley rats. The frequency was higher in 4- and 8-week-old (growing) rats than in 26- and 45-week old (mature) rats, and also higher in ventral than in dorsal roots in 4-, 8- and 26-week old rats. There were no clusters on certain groups of myelinated fibers according to the size of transverse axonal area, in both the ventral and dorsal roots. Therefore, this accumulation may reflect certain functions of the adaxonal cytoplasm of Schwann cell during natural growth and maturation of the axon and myelin sheath.     

Release of endogenous catecholamines from slices of hypothalamus of rats

The release of endogenous catecholamines from superfused slices of rat hypothalamus was studied under basal conditions and during release evoked by 40 mM K⁺. Catecholamines in superfusates, and in extracts of the tissue after stimulation, were isolated by column chromatography and quantitated by liquid chromatography with electrochemical detection. Norepinephrine (NE) was not consistently demonstrable in superfusate collected under basal conditions, but 40 mM K⁺ caused the release of from 2 to 4 ng/g of tissue per min. The addition of cocaine to the superfusate caused increases in basal and evoked release of NE. Epinephrine (E) could be measured in superfusates of slices from male but not female rats and then only when cocaine was added to the superfusate. Accordingly, the concentration of E in hypothalamus was greater in male rats than in female rats. Dopamine (DA) was not consistently measurable in the spontaneous overflow from slices either in the presence or absence of cocaine. K⁺-evoked release of DA could be demonstrated in slices from female rats. The addition of cocaine increased the evoked release of DA from slices from both sexes. Corticosterone, added to cocaine, had no effects on the efflux of any of the catecholamines. The experiments suggest that neuronal reuptake of all catecholamines is very efficient in the hypothalamus both under basal conditions and during evoked release.     

Effects of prevention of afferentation of the development of the chick optic lobe

BONDY, S. C., M. E. HARRINGTON AND C. L. ANDERSON. Effects of prevention of afferentation on the developmentof the chick optic lobe. BRAIN RES. BULL. 3(5) 411–413, 1978.—The effects of unilateral extirpation of the right optic cup of the three-day incubated chick embryo upon the rate of synthesis and the stability of DNA in the non-innervated optic lobe, have been studied. This surgical procedure prevents innervation of the optic lobe contralateral to the removed eye, while the other optic lobe is normally innervated by retinal ganglion cells of the remaining eye. At the 20th day of incubation, the DNA content of the non-innervated lobe was below that of the paired lobe receiving normal innervation. This deficiency of cell number was caused by two events; death of an excess number of neurons formed early in embryogenesis and a reduced rate of glial proliferation in the later stages of incubation.     

《绵阳市社会心理服务工作管理办法》解读

2018年,国家卫生健康委员会等10部委联合发布《关于印发全国社会心理服务体系建设试点工作方案的通知》,四川省绵阳市被列为全国第一批试点地区。绵阳市人民政府依据《中华人民共和国精神卫生法》等相关法律法规和文件精神,结合前期调查研究和社会心理服务工作的试点实际,编制出台了《绵阳市社会心理服务工作管理办法》,并于2021年12月25日起施行。本文围绕社会心理服务的相关概念、办法总则、重点内容、保障措施等方面进行解读,以期为社会心理服务工作的规范、持续和有效开展提供参考。     

Function of circle of Willis

Nearly 400 years ago, Thomas Willis described the arterial ring at the base of the brain (the circle of Willis, CW) and recognized it as a compensatory system in the case of arterial occlusion. This theory is still accepted. We present several arguments that via negativa should discard the compensatory theory. (1) Current theory is anthropocentric; it ignores other species and their analog structures. (2) Arterial pathologies are diseases of old age, appearing after gene propagation. (3) According to the current theory, evolution has foresight. (4) Its commonness among animals indicates that it is probably a convergent evolutionary structure. (5) It was observed that communicating arteries are too small for effective blood flow, and (6) missing or hypoplastic in the majority of the population. We infer that CW, under physiologic conditions, serves as a passive pressure dissipating system; without considerable blood flow, pressure is transferred from the high to low pressure end, the latter being another arterial component of CW. Pressure gradient exists because pulse wave and blood flow arrive into the skull through different cerebral arteries asynchronously, due to arterial tree asymmetry. Therefore, CW and its communicating arteries protect cerebral artery and blood–brain barrier from hemodynamic stress.     

阿立哌唑对精神分裂症患者生活质量的影响

目的:比较阿立哌唑与利培酮对精神分裂症患者生活质量的影响。方法:60例精神分裂患者随机平分为两组各30例,分别给予阿立哌唑和利培酮治疗。疗程8周。用生活质量综合评定问卷-74(GQOLI-74)、阳性与阴性症状量表(PANSS)及副反应量表(TESS)评定疗效及不良反应。结果:阿立哌唑与利培酮均能显著提高精神分裂症患者生活质量,但阿立哌唑在改善GQOLI-74总分、躯体健康及社会功能维度优于利培酮。结论:阿立哌唑治疗有利于提高精神分裂症患者生活质量。