风险管理在产科护理中的应用观察

目的：观察风险管理在产科护理中的应用效果。方法469例产妇作为对照组,选取同期治疗的521例产妇作为研究组。对照组实施常规管理护理,研究组实施风险管理护理。对比两组护理投诉、护理纠纷、护理差错的发生率、对护理工作的满意度。结果研究组护理投诉事件发生率为0.38%,对照组为1.92%,差异有统计学意义(P<0.05);研究组护理纠纷事件发生率为0,对照组为1.07%(P<0.05);护理差错事件的发生率为1.15%,对照组为3.20%,差异有统计学意义(P<0.05);研究组对护理工作满意度得分为(96.85±9.28)分,对照组为(85.33±12.26)分,差异有统计学意义(P<0.01)。结论在产科护理中实行护理风险管理,可有效的防止护理风险事件的发生,使护理质量得以提高。     

细节护理在儿科护理中的效果对比

目的观察细节护理在儿科护理中的效果。方法选取自2014年7月至2015年7月沈阳市第一人民医院儿科收治的患儿70例,采用信封法随机分为试验组和对照组,对照组35例,采用普通护理方法,试验组35例,在对照组基础上采用细节护理干预,观察患儿家长的满意度和护理纠纷发生率。结果试验组优于对照组,有统计学差异(P<0.05)。结论细节护理干预可以明显提高患儿家长满意度和降低护理纠纷发生率。     

综合护理在新生儿呼吸机相关性肺炎中的应用及对其护理满意度影响评价

目的评价综合护理在新生儿呼吸机相关性肺炎中的应用及对其护理满意度影响。方法随机抽取60例本院自2015年3月～2018年3月收治的行呼吸机治疗的新生儿,采用随机数字表法将其分为对照组(30例)、实验组(30例),给予对照组患儿常规护理,给予实验组患儿综合护理,分析两组临床指标、呼吸机相关性肺炎发生率、家长护理满意度、护理措施合格率。结果临床指标、呼吸机相关性肺炎发生率对比显示实验组低于对照组(P 0.05);家长护理满意度、护理措施合格率对比显示实验组高于对照组(P 0.05)。结论综合护理应用于新生儿呼吸机治疗过程中,既可改善临床指标、提高护理措施合格率,又可减少呼吸机相关性肺炎发生率、提高护理满意度,临床应用价值较高,值得推广。     

护理干预对小儿重症肺炎的临床作用探讨

目的探讨护理干预对小儿重症肺炎的临床作用。方法选取2012年3月至2015年3月我院收治的重症肺炎患儿60例作为研究对象,按照1∶1比例分为对照组(n=30)和试验组(n=30),对照组给予常规护理,试验组在此基础上给予护理干预,比较2组患儿住院时间、病死率以及患儿家长满意度。结果试验组患儿家长满意度为96.7%,显著优于对照组患儿家长满意度66.7%,有统计学意义(P<0.05);试验组患儿住院时间为(12.5±4.0)d、病死率为30.0%,对照组患儿住院时间为(17.7±3.6)d、病死率为3.3%,2组比较,差异具有统计学意义(P<0.05)。结论小加强儿重症肺炎的临床护理干预,可显著缩短治疗时间,降低病死率,提高患儿家长满意度,促进快速康复,值得临床使用和全面推广。     

新生儿缺氧缺血性脑病应用循证护理的效果评价

目的评价分析新生儿缺氧缺血性脑病应用询证护理的效果。方法 144例新生儿缺氧缺血性脑病患儿,按照数字表法分成对照组和试验组,各72例。对照组使用常规护理措施,试验组在常规护理的基础上进行循证护理,比较两组患儿治疗总有效率、平均住院时间、并发症发生率以及家属满意度评分。结果对照组患儿治疗总有效率为79.2%,试验组患儿治疗总有效率为91.7%,两组比较差异具有统计学意义(P<0.05);试验组平均住院时间短于对照组,两组比较差异具有统计学意义(P<0.05);对照组患儿并发症发生率为13.9%、试验组患儿并发症发生率为2.8%,两组比较差异具有统计学意义(P<0.05);对照组家属满意度评分低于试验组,差异具有统计学意义(P<0.05)。结论应用循证护理进行缺氧缺血性脑病患儿的护理,能够有效的降低治疗时间,减少并发症的出现,提高家属满意度,更有助于护理质量的提升,具有广泛的临床应用前景。     

细节管理和风险管理在儿科病房中的应用效果观察

目的 探讨细节管理和风险管理在儿科病房中的应用效果.方法 选择我院2015年3月至2016年2月儿科病房患儿400例对象并随机分为A组和B组.A组采取常规护理管理;B组给予细节管理和风险管理.比较两组患儿父母对护理管理的满意度;风险评估、风险预防、风险处理、细节管理质量评分;护理风险、临床纠纷、投诉发生率.结果 B组患儿父母对护理管理的满意度显著比A组高(P<0.05);B组风险评估、风险预防、风险处理、细节管理质量评分显著比A组好(P<0.05);B组护理风险、临床纠纷、投诉发生率显著比A组低(P<0.05).结论 细节管理和风险管理在儿科病房中的应用效果确切,可有效提高风险评估、预防和控制质量,强化细节管理,预防风险的发生,减少纠纷和投诉,患儿家长满意,值得借鉴.     

新生儿病房护理不安全因素及预防措施探析

目的探讨新生儿病房护理不安全因素及有效预防措施,以及安全护理模式对新生儿病房中新生儿不安全事件发生率的影响,为提高新生儿病房护理效果以及降低新生儿不安全事件发生率提供可靠依据。方法对照组新生儿采取一般临床护理模式;研究组新生儿在采取上述常规临床护理模式的基础上,对新生儿护理不安全因素进行分析,并根据分析结果,给与相应的安全护理措施。观察并记录两组新生儿发生不安全事件情况,并进行患儿家属对护理人员的满意度调查,对结果进行统计学分析,得出结论。结果研究组新生儿不安全事件发生率为6．00％,患儿家属对护理工作满意度评分为（95．42±2．21）分,明显优于对照组新生儿不安全事件发生率为24．00％,患儿家属对护理工作满意度评分为（88．04±2．10）分,且P〈0．05,两组患儿护理结果对比分析具有统计学意义。结论对新生儿病房在进行常规护理措施的基础上,针对其不安全因素实施安全护理模式,能够有效降低新生儿发生不安全事件几率,提高患儿家属对护理工作满意度,值得临床推广应用。     

细节管理在儿科护理管理中的应用

目的 探讨细节管理在儿科护理管理中的临床应用。方法 回顾性分析2010年4月至2013年6月在该院就诊的78例儿科患儿的临床资料,将其分为对照组和研究组各39例。对照组患儿根据儿科护理要求给予常规护理,研究组患儿在对照组基础上给予细节护理管理。比较两组患儿护理质量评分、护理纠纷情况及护理满意度。结果 研究组护理质量评分大于或等于90分的比例[94.87%(37/39)]明显高于对照组[64.10%(25/39)],差异有统计学意义(P<0.05);采用细节管理后,研究组护理纠纷发生率、护理满意度[5.13%(2/39)、94.87%(37/39)]明显优于对照组[20.51%(8/39)、71.79%(28/39)],差异均有统计学意义(P<0.05)。结论 通过在儿科护理中实施细节管理,不仅减少了护理纠纷的发生率,也提高了护理服务质量及患儿和家长的满意度,值得在临床推广应用。     

优质护理在儿科病房中的应用效果研究

目的研究优质护理在儿科病房中的应用效果。方法通过数字随机法将我科收治的252例患儿分为观察组和对照组,给予观察组优质护理,给予对照组常规护理,将两组患儿家长的护理满意度进行对比。结果两组患儿家长的护理满意度(分别为96.03%和84.13%)差异具有统计学意义(P<0.05)。结论优质护理在儿科病房中的应用效果显著,对提高护理质量,尤其是患儿家长的满意度这一方面具有明显优势,值得推广。     

急危重症患者转运途中应用护理风险管理效果

目的:研究在急危重症患者转运途中应用护理风险管理的效果.方法:收集2014年1月—2015年1月转运的28例急危重症患者为对照组,采用常规转运方式,收集2015年3月—2016年3月转运的28例急危重症患者为观察组,采用护理风险管理.对比两组转运期间接收科室满意度、患者满意度、转运不当发生率.结果:观察组科室接收满意度为(93.15±2.18)分,患者满意度为(91.42±2.24)分,对照组分别为(72.56±2.48)分和(78.15±3.46)分,组间差异有统计学意义(P<0.05).观察组转运不当发生率为3.57%(1/28),明显低于对照组的17.86%(5/28,P<0.05).结论:急危重症患者在转运途中应用护理风险管理能有效提高接收科室满意度和患者家属满意度,降低转运不当发生率,值得推广应用.     

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.     

Pharmacological treatment of COVID-19: an opinion paper

The precocity and efficacy of the vaccines developed so far against COVID-19 has been the most significant and saving advance against the pandemic. The development of vaccines has not prevented, during the whole period of the pandemic, the constant search for therapeutic medicines, both among existing drugs with different indications and in the development of new drugs. The Scientific Committee of the COVID-19 of the Illustrious College of Physicians of Madrid wanted to offer an early, simplified and critical approach to these new drugs, to new developments in immunotherapy and to what has been learned from the immune response modulators already known and which have proven effective against the virus, in order to help understand the current situation.     

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.     

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.