呼吸功能训练仪联合呼吸功能锻炼在肺癌患者中的应用效果

目的探讨呼吸功能训练仪联合呼吸功能锻炼在肺癌患者中的应用效果。方法选取2018年6月至2020年2月医院收治的84例肺癌患者作为研究对象,按照随机数字表法分为对照组与观察组,各42例。两组住院期间均接受基础护理,对照组给予呼吸功能锻炼,观察组在对照组基础上加用呼吸功能训练仪,比较两组肺功能指标、康复情况和呼吸道相关并发症发生率。结果干预前,两组肺功能指标比较,差异无统计学意义(P>0.05);术后第7天,观察组用力肺活量(FVC)、第1秒用力呼气量(FEV1)均高于对照组,差异有统计学意义(P<0.05);观察组胸管留置时间、住院时间均短于对照组,差异有统计学意义(P<0.05);观察组呼吸道相关并发症发生率为2.38%,低于对照组的19.05%,差异有统计学意义(P<0.05)。结论呼吸功能训练仪联合呼吸功能锻炼可有效改善肺癌患者的肺功能,减少并发症,加快术后康复进程。     

矽肺并发慢性阻塞性肺疾病稳定期患者呼吸功能锻炼的护理干预

目的观察呼吸功能锻炼的护理干预措施对矽肺并发慢性阻塞性肺疾病(COPD)稳定期患者的临床治疗疗效。方法随机抽取2017年8月至2018年4月泰山医学院附属莱钢医院职业病科住院60例矽肺并发COPD稳定期患者并分为两组。对照组:30例,给予常规治疗加呼吸功能锻炼;观察组:30例,在对照组治疗的基础上给予护理干预措施。2个月后,比较干预前后两组患者的肺功能、血气分析、6 min步行距离。结果干预后观察组第1秒用力呼气容积(FEV1.0)、用力肺活量(FVC)、氧分压(PaO2)及6 min步行距离较对照组明显升高,差异有统计学意义(P<0.05),两组FEV1.0/FVC、二氧化碳分压(PaCO2)的差异无统计学意义(P>0.05)。 结论护理干预措施能有效改善矽肺并发COPD稳定期患者的FEV1.0、FVC、PaO2及6 min步行距离。     

呼吸肌肉锻炼联合八段锦对慢性阻塞性肺疾病患者肺功能及运动耐力影响

目的 探究呼吸肌肉锻炼联合八段锦对慢性阻塞性肺疾病（COPD）患者肺功能以及其运动耐力的影响。方法 选取2021年2月～10月亳州市人民医院收治的COPD急性期患者86例,根据随机数表法将其分为对照组与观察组,每组43例,两组患者均同样进行解痉平喘、控制感染以及祛痰等常规治疗,其中对照组给予呼吸肌肉康复锻炼,观察组则在对照组的基础上联合八段锦康复锻炼。训练结束后,比较两组患者的临床治疗效果、第1秒用力呼气容积（FEV1）、用力肺活量（FVC）、FEV1/FVC、以及6 min步行测试（6MWT）和COPD综合评估测试（CAT）评分情况。结果 治疗后,观察组患者的临床疗效总有效率（93.02%）明显高于对照组,差异有统计学意义（P <0.05）。治疗前两组患者的FEV1、FVC以及FEV1/FVC比较差异无统计学意义（P> 0.05）。治疗后,两组患者的FEV1、FVC以及FEV1/FVC均有了明显好转,且观察组FEV1(2.87±0.17)L、FVC(2.89±0.67)L以及FEV1/FVC(80.55±10.37)%明显优于对照组,差异有统计学意义（P <0.05...     

围手术期呼吸训练器呼吸功能锻炼在心胸外科患者快速康复护理中的应用效果

目的探讨围手术期呼吸训练器呼吸功能锻炼在心胸外科患者快速康复护理中的应用效果。方法选取2019年3月至2020年3月于福建医科大学附属龙岩第一医院接受心胸外科手术的70例患者作为研究对象,随机分为对照组和观察组,各35例。对照组采用常规呼吸训练开展康复护理,观察组在对照组基础上采用呼吸训练器开展呼吸功能锻炼快速康复护理,比较两组肺功能、术后康复情况及并发症情况。结果护理后,观察组用力肺活量(FVC)、1 s呼气量(FEV 1)及最大深吸气量(IC)变化均优于对照组,差异均有统计学意义(P<0.05);观察组术后拔管及住院时间均短于对照组,差异均有统计学意义(P<0.05);观察组术后并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论围手术期呼吸训练器呼吸功能锻炼在心胸外科患者快速康复护理中的应用效果显著,可改善肺功能,缩短术后拔管及住院时间,降低术后并发症发生率。     

密闭式吸痰器与开放式吸痰管吸痰在急诊机械通气患者中的应用效果

目的 探讨密闭式吸痰器与开放式吸痰管在急诊机械通气患者中的应用效果。方法 选择2019年1月至2021年12月医院收治的68例急诊机械通气患者作为研究对象，按照随机数字表法分为观察组与对照组，每组34例。观察组采用密闭式吸痰器吸痰，对照组采用开放式吸痰管吸痰，均连续干预5 d，比较两组血气分析指标[动脉血脉氧分压(PaO₂)、动脉血二氧化碳分压(PaCO₂)及血氧饱和度(SpO₂)]、呼吸频率、心率、吸痰总量、肺功能指标[用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、FEV1/FVC]和并发症。结果 干预后，两组PaO₂及SpO₂均高于干预前，且观察组均高于对照组，差异有统计学意义(P<0.05)；干预后，两组PaCO₂均低于干预前，且观察组低于对照组，差异有统计学意义(P<0.05)；干预后，观察组呼吸频率及心率低于对照组，吸痰总量多于对照组，差异有统计学意义(P<0.05)；干预后，两组FVC、FEV1及FEV1/FVC均高于...     

基于CGA的分级护理联合呼吸专项训练对高龄肺癌胸腔镜手术患者的护理效果

目的 探讨基于老年综合评估(CGA)的分级护理联合呼吸专项训练，对高龄肺癌胸腔镜手术患者肺部并发症和呼吸功能的影响。方法 将2020年9月-2022年8月医院行肺癌胸腔镜手术的高龄患者作为研究对象，其中2020年9月-2021年8月采用传统护理联合呼吸专项训练的43例患者纳入对照组，根据组间性别、年龄、肺癌分期、肺癌分型等基线资料均衡可比的原则，在2021年9月-2022年8月选择采用基于CGA的分级护理联合呼吸专项训练的52例患者纳入观察组。所有患者均连续干预2周。比较干预前后两组患者呼吸功能[用力肺活量(FVC)、一秒量比预计值(FEV1%)、第1秒呼吸容积(FEV1/FVC)]、氧合指标[血氧饱和度(SpO₂)、动脉血氧分压(PaO₂)、动脉二氧化碳分压(PaCO₂)]变化；比较干预期间两组患者并发症发生率。结果 护理干预前，两组患者FVC、FEV1%和FEV1/FVC呼吸功能指标水平比较，差异无统计学意义(P>0.05)；护理干预后，两组FVC、FEV1%、FEV1/FVC水平较干预前均上升，且观察组高于对...     

行为训练联合快速康复护理对肺癌患者术后呼吸功能及生活质量的影响

目的:探究行为训练联合快速康复护理对肺癌患者术后呼吸功能及生活质量的影响。方法:以2018年1月~2019年7月为研究时段,选择本院收治的肺癌手术患者进行研究,共72例,将其随机编号,采取抽签法分为对照组和试验组,各36例,前者给予常规护理,后者进行行为训练联合快速康复护理,比较呼吸功能和生活质量情况。结果:两组护理前1周用力肺活量(FVC)第1秒用力呼气容积(FEV1)、FEV1/FVC和生活质量评分组间比较,差异无统计学意义,P>0.05,护理3个月后两组上述指标均较护理前升高,P<0.05,组间比较试验组更高,P<0.05。结论:针对肺癌手术患者,行为训练联合快速康复护理能够改善患者呼吸功能,促使其生活质量提升,更利于患者预后恢复,值得推荐。     

阿奇霉素治疗孕妇肺炎支原体感染的疗效观察及不良反应监测分析北大核心CSCD

目的探讨阿奇霉素治疗孕妇肺炎支原体感染的疗效及安全性。方法选取医院2015年7月-2016年7月医院产科收治的60例肺炎支原体感染孕妇,根据治疗方案的不同将患者分为观察组和对照组,每组各30例;所有患者入院后均配合进行相关检查,予以对症治疗,观察组在此基础上予以阿奇霉素进行治疗,对照组予以红霉素进行治疗,观察两组患者临床治疗效果、体温恢复正常时间、咳嗽咳痰好转时间、肺部啰音消失时间、不良反应及治疗后用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、FVC/FEV1、深吸气量(IC)。结果与对照组相比,观察组治疗后痊愈率53.33%及总有效率为93.33%均明显提升,差异有统计学意义(P<0.05);且观察组患者体温恢复正常时间、咳嗽咳痰好转时间、肺部啰音消失时间及住院时间均显著缩短,差异有统计学意义(P<0.05);观察组患者的轻微腹痛、恶心呕吐、注射部位疼痛及丙氨酸氨基转移酶(ALT)等不良反应率显著低于对照组,差异有统计学意义(P<0.05);观察组患者FVC、FEV1、VC/FEV1及IC均显著低于对照组,差异有统计学意义(P<0.05)。结论阿奇霉素对妊娠期妇女伴肺炎支原体感染治疗效果良好,临床症状缓解较快,不良反应较少,临床应用前景广阔。     

胸腔镜下右胸食管癌根治术治疗食管癌的效果及安全性

目的观察胸腔镜下经右胸食管癌根治术治疗食管癌的效果及安全性。方法选取2016年1—12月收治的食管癌患者92例,运用随机数表法将其分为观察组与对照组,每组46例。观察组采取胸腔镜下经右胸、上腹食管癌根治术,对照组给予临床常规右剖胸、上腹两切口食管癌根治术。观察两组术前术后1s用力呼气容积(forced expiratory volume in one second,FEV1)与FEV1/用力肺活量(forced vital capacity,FVC)、术中出血量、住院时间与术后并发症发生情况。计数资料比较用χ2检验,计量资料比较用t检验,P0.05为差异有统计学意义。结果治疗前两组FEV1、FEV1/FVC对比,差异无统计学意义(均P0.05);治疗后观察组FEV1、FEV1/FVC检测结果[(50.14±4.83)L、(70.58±8.69)%]优于对照组[(49.58±5.26)L、(63.36±7.41)%],且观察组术中出血量(192.36±55.49)m L、住院时间(11.74±2.58)d均少于对照组[(254.21±70.14)m L、(18.25±4.17)d],差异有统计学意义(均P0.05);观察组术后相关并发症发生率(8.70%)低于对照组(32.61%),差异有统计学意义(P0.05)。结论胸腔镜下右胸食管癌根治术治疗食管癌疗效确切,利于改善患者肺功能,缩短治疗时间,术后相关并发症发生率低。     

循证护理在预防呼吸机相关性肺炎中的应用

目的探讨循证护理在预防呼吸机相关性肺炎中的应用效果。方法选取2015年1月-2016年7月湖北省某医院收治的60例行机械通气的患者为研究对象,采用随机数字表法分为对照组与观察组,每组30例。对照组采用常规护理,观察组实施循证护理,比较2组患者护理前后的肺功能指标及护理后呼吸机相关性肺炎发生率。结果观察组患者护理后呼吸机相关性肺炎发生率为6.67%(2/30),低于对照组患者的26.67%(8/30),差异有统计学意义(P0.05)。护理前,2组患者第一秒用力呼气容积(FEV1),用力肺活量(FVC)及FEV1/FVC水平比较,差异无统计学意义(P0.05);护理后,2组患者FEV1,FVC及FEV1/FVC大于护理前,且观察组患者FEV1,FVC及FEV1/FVC大于对照组,差异均有统计学意义(P0.05)。结论在机械通气患者治疗过程中实施循证护理,有助于减少呼吸机相关性肺炎的发生,可有效改善患者肺功能,值得推广应用。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.