整体护理以人为本

南丁格尔曾说:"护理是一门艺术,从事这门艺术需要有极大的心理准备."这既是对护士的最高赞誉,也是对护士的最高要求.     

护士的情绪与差错事故的关系及对策

护理学是一门科学性、技术性、服务性很强的综合性应用科学,护理工作是精细艺术中之最精细者,是衡量护理质量最敏感的指标,所以,护士的心里因素与差错事故具有相关性.护士工作的情绪好坏直接影响着护理差错事故的发生与否.如何预防和杜绝差错事故的发生,已引起护理管理部门的高度重视.     

浅谈如何有效的实施护理管理

护理管理既是一门艺术,同时也是一门科学.护士长是医院护理工作的基层管理者,具有协调科室关系,沟通信息的桥梁作用,同时也担负着科室及病房管理专业指导等多重任务,对提高医院整体护理水平发挥着重要作用.在临床护理工作中,护理管理既要为病人服务,同时又要为护士创造一个宽松的工作环境,这就要求护士长必须进行科学管理.护士长的有效管理技巧,是提高护理质量,树立护理专业形象的关键.     

浅谈护士职业危害因素与安全防护

护理工作是一门为人类健康与生命服务的专业.在从事大量护理操作中首当其冲的是护士,虽然护理操作都是建立在严格消毒隔离的基础上,但临床工作中无论是对患者的护理,还是各项侵入性医疗检查、治疗等技术操作,都离不开护士的直接参与.所以作为医院管理者,制订护士职业危害的防护措施要提到重要的议事日程上来,预防传染病,关爱每一位护理人员的健康,是我们的职业道德和责任.     

美学在临床护理工作中的应用

美学是研究自然界、社会和艺术领域中美的一般规律与原则的科学。在整体护理开展的今天 ,美学与护理的联系越来越受到人们的重视。一个完美的护士不仅要有扎实的专业理论知识和基本技能 ,还要具备一定的美学、人际沟通等人文学科方面的知识。以美学原理指导护理实践 ,对于提高整体护理水平有着十分重要的意义。1　护士的心灵美心灵美是人的内心世界的美。主要指理想、道德、情感、情操、文化修养等。它将影响并决定着护士对待护理工作及患者的根本态度 ,影响和制约着护士的行为和工作质量。由于护士职业的特殊性 ,要求护士首先要有高尚的情…     

新入职护士情绪和压力状态及需求分析

目的 探索新入职护士情绪状态和工作压力的情况,了解新入职护士的需求状况,为护理管理者对新入职护士进行全面评估.方法 纳入新入职护士为观察组,工作3年以上护士为对照组,用情绪状态量表(POMS)、护士工作压力源量表和护士应具备的核心能力量表对观察组和对照组进行问卷调查,对情绪状态、压力源情况和需求状况进行统计学分析.结果 在情绪状态方面,紧张-焦虑、抑郁-沮丧、愤怒-敌意、疲劳-惰性和困惑-迷茫得分高于对照组,观察组有力-好动得分低于对照组,差异均有统计学意义(P<0.05).与对照组相比,观察组在护理专业及工作、工作量及时间分配、工作环境及资源和护理患者方面差异有统计学意义(P<0.05),两组在管理及人际关系方面差异无统计学意义(P>0.05).新入职护士认为需要加强努力的核心能力中,总得分最高的前4位分别是熟悉各种疾病的治疗和护理、具备对护理对象实施整体护理的能力、掌握规范的护理基本操作和提供专科知识的咨询.总得分最后2位是称职的护理教育者和护理科研能力.结论 新入职护士工作压力源处于较高水平,情绪状态较差,护理管理者应针对新入职护士可能存在的压力和情绪问题提供咨询和帮助,通过改善工作环境,合理进行人力配置,加强相关培训,帮助新入职护士在专业上迅速成长,消除其较高的压力和较差的情绪状态.     

神经内科护士应具备的心理素质

１对护理工作要有正确的认识 护理工作烦琐细致，是“最精明的一门艺术”，人的生老病死都离不开护士。在整个医院的工作中，从门诊病人就诊、急症抢救、住院治疗与观察，直至病人痊愈出院，无一不是护士在担负着第一线工作。护士的基本职责就是与医生共同保护生命，减轻痛苦，增进健康。热爱本职工作；致力于护理事业的发展，以高度责任感和同情心努力做好护理工作，使患者减轻痛苦，恢复健康，是每位护士义不容辞的责任。 热爱本职工作是做好护理工作，特别是神经科护理工作的关键。神经科大部分病人，病情危重，卧床病人多，老年病人多，…     

现代护士礼仪修养

护士礼仪是一种专业文化模式,是研究护理交往艺术的学问.出具有礼仪的基本特征以外,还具有护士专业的文化特性.通过对新上岗护士的培训,我们的口号是如何当好一个"合格,受欢迎的护士".对护士与病人交往中的言、行、举止、姿态、眼神、表情、微笑及片刻的沉默都必须注意技巧问题.护士必须达到礼仪规范,才能应用护理程序更好的为患者服务.     

浅谈护理职业道德

护理医德就是护理人员应具备的职业道德。它是护理人员和病人之间及工作中的协助者之间关系的行为准则,是社会道德现象在护理专业的体现。从护理学这门科学的特点和护理工作的性质与任务来看,一个合格的护士,不仅要掌握扎实的理论基础,娴熟的操作技能,较丰富的临床经验,还必须具有良好的职业道德修养。护理人员同病人接触最多,她们的一言一行直接影响着病人的情绪。护士教育     

护理工作中的美学思想

如何培养护理工作者感受美、鉴赏美和创造美的能力,是护理教育工作的重中之重。下面通过笔者的工作体会从4个方面谈谈护理工作中的美学思想。1美学概念美是在特定的时间、空间和条件下的和谐,它以感情形式启迪人们的智慧,使人们热爱生活、愉悦身心。美是人类在创造外在文明的同时所获得的内在文明。美学是一门理论科学,是哲学的一个分支,是关于美和艺术的哲学思考,是研究人类审美活动最一般规律的科学。2美学与护理奥斯特洛夫斯基说:“要是没有内心的美,我们常常会厌恶他漂亮的外表。”护理工作的特殊性,要求护士将内在美与外在美融为一体,…     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.