深部组织压力性损伤评估与预防的研究进展

对深部组织压力性损伤评估与预防两方面进行总结。量化评估技术包括超声检测、皮肤水分含量测试、激光多普勒血流检测及皮肤热成像检测4项;预防措施包括采用多种评估工具综合应用以提高评估准确性,预防性使用减压工具及辅助治疗等减少深部组织压力性损伤的发生,以期为临床护理早发现、早干预提供参考。     

周细胞在脊髓损伤中的作用

脊髓损伤(SCI)会导致患者自主神经功能、运动和感觉功能丧失,对患者的生活质量产生极大影响[1].SCI的病理变化包括损伤部位缺血、缺氧、神经元受损、瘢痕组织形成和炎性反应等[2].近年来, SCI的病理变化机制研究日趋深入,周细胞作为脊髓微环境的重要组成部位,在SCI的病理过程中发挥着重要作用.SCI发生后神经元轴突遭到破坏,这一过程伴随着血-脊髓屏障的破坏,神经胶质细胞和神经元细胞活化,并分泌多种副产物(包括基质金属蛋白酶、游离氧自由基、趋化因子和细胞因子)[3].各种免疫细胞渗入损伤部位[4],受损区域周围还会产生星形胶质细胞,小胶质细胞同样会被激活[5-6].     

受压界面皮肤温度变化与压力性损伤关系的研究进展

阐述人体皮肤温度的概念,对受压界面皮肤温度升高、降低与压力性损伤的关系以及监测皮肤温度变化对压力性损伤发生的预测应用现状进行综述,旨在为研究预防压力性损伤的新方法、新策略提供信息和方向。     

细胞自噬在脊髓损伤中作用的研究进展

近年来,细胞自噬在脊髓损伤中的研究逐渐成为热点,但脊髓损伤后早期自噬激活所起的作用尚有争议。其原因在于细胞自噬在脊髓损伤中的作用具有两面性:一方面自噬能诱导自噬性细胞死亡的发生并参与细胞凋亡的发生,另一方面自噬能促进受损变性蛋白的代谢以及抑制细胞凋亡。然而究其对脊髓损伤后修复的利弊作用,早期自噬激活的程度具有决定作用,脊髓损伤后适当地上调自噬水平可促进受损变性蛋白的代谢并抑制细胞凋亡,而过度激活自噬可能引发自噬性细胞死亡。     

脊髓损伤后细胞凋亡的诱导因素研究进展

脊髓损伤(spinal cord injury,SCI)包含脊髓组织原发损伤和一系列组织代谢障碍所致的继发性损伤,其治疗是困扰医学界的难题之一。本文对脊髓损伤细胞凋亡的作用、诱导因素和防治途径作一综述。1细胞凋亡在脊髓损伤中的重要作用脊髓损伤包括原发性脊髓损伤和继发性脊髓损伤,而细胞凋亡是继发性脊髓损伤的重要组成部分。脊髓损伤后出现的脊髓神经细胞死亡不是缘于直接损伤而是细胞凋亡所致[1]。细胞凋亡是一种固有的自然生理过程,它通过清除死亡细胞和代谢产物维持人体各系统组织的稳定,而且这种清除过程不伴有局部炎症是其最大的特点。有研…     

床旁超声用于压力性损伤评估的研究进展

对床旁超声用于评估压力性损伤的机制、床旁超声在压力性损伤评估中的临床应用、床旁超声在压力性损伤评估中的挑战进行综述,为护理人员在临床中使用床旁超声评估压力性损伤提供借鉴,以实现早发现、早干预.     

急性皮肤衰竭与压力性损伤评估鉴别研究进展

对急性皮肤衰竭和压力性损伤的定义及病因、发病机制、二者的评估与鉴别等方面进行论述,提出相关的建议与展望,旨在提高临床护理人员对急性皮肤衰竭和压力性损伤的认知,正确判断与处理,减轻患者痛苦与促进康复.     

心血管手术患者术中压力性损伤的研究进展

分析心血管手术患者术中压力性损伤发生原因及相关因素,对常用压力性损伤风险评估工具进行评价,常用的评估工具包括Waterlow量表、Braden量表和Norton量表及针对手术患者开发的压力性损伤风险评估工具。提出应重视对此类患者术中压力性损伤相关因素的有效识别,进一步探讨心血管手术特异性的相关因素以及不同类型患者相关因素的差异性,为制定有针对性的预防措施提供参考。     

手术室专用Munro压力性损伤风险评估量表的研究进展

本文通过文献复习,阐述手术室专用Munro压力性损伤风险评估量表的研究进展,以期为手术患者压力性损伤的风险因素筛查及管理提供参考.     

生命末期患者压力性损伤管理的研究进展

综述生命末期患者压力性损伤的流行病学、诱发因素、评估工具及干预现状,提出其诱发因素包括年龄、活动障碍、营养状况、基础疾病等内在因素及压力、摩擦力、剪切力、潮湿、住院时间长等外在因素,其干预包括压力再分布、伤口护理、皮肤护理、营养支持、疼痛护理等.     

健康行为及其影响因素研究进展

健康行为的概念有学者认为是个体为维持健康或促进健康,达到自我满足、自我实现而采取的行为;其内容包括生活方式、情绪管理、避免危害健康的行为及体检等;影响因素有心理因素、社会及人口学因素及其他因素对健康行为的影响;研究方法包括质性研究和定量研究;健康行为研究存在的问题主要为缺乏对健康知识与行为之间差异性的研究,问卷调查法或访谈法易出现偏倚。严格不记名调查,测量生物学指标可控制偏倚的发生。提出影响健康行为的因素是多方面的,应对个体的整体健康行为进行综合性深入研究。     

癌症患者述情障碍及影响因素研究进展

介绍了述情障碍的概况、述情障碍在癌症患者中的现况及其影响因素,提出应识别癌症患者的述情障碍,从而制订有效的干预方案。旨在促进我国关于癌症患者述情障碍研究深入开展,为施加干预、改善癌症患者的生活质量提供依据。     

A review of the factors influencing the prognosis of medulloblastoma. The importance of cell differentiation

The clinical, therapeutic, and histological features of 54 patients with medulloblastoma were analyzed retrospectively by a multivariate approach with regard to prognosis. The overall 5-year survival rate was 60%, with 48% of patients free of recurrence at 5 years. Cell differentiation, when present, was associated with a significantly longer recurrence-free period. Seventy-two percent of patients with the histological finding of cell differentiation were recurrence-free at 5 years. A marginally significant increase in the 5-year survival rate was also seen in association with differentiation. Only 34% of the patients whose tumor exhibited necrosis were alive at 5 years. There was no statistically significant difference in 5-year survival for children under 3 years of age or for the group of children aged 5 years or under. However, a significantly larger fraction (72%) of the group aged 5 years or under had a recurrence-free period of 5 years or more. Other factors including sex, extent of surgical resection. Chang tumor stage, posterior fossa radiation dose, and adjuvant chemotherapy did not influence prognosis.     

脑卒中患者久坐行为现状及其影响因素研究进展

综述脑卒中久坐行为定义及分类、久坐行为现状,从人口学、环境、疾病相关症状、心理状态、行为改变动机及社会支持因素等方面归纳分析脑卒中患者久坐行为影响因素,以期为制订有效干预方案降低脑卒中患者久坐行为提供参考。     

压力性损伤防治的卫生经济学评价研究进展

从压力性损伤卫生经济学评价常用方法(包括成本分析、成本最小化分析、成本一效果分析、成本—效用分析和成本—效益分析)和模型(包括决策树模型和马尔可夫模型)、压力性损伤预防和治疗的卫生经济学评价现状3个方面进行综述,总结当前的研究结果并指出不足,为日后开展相关研究和进行护理决策提供参考.     

Treatment of ependymomas. Clinical and non-clinical factors influencing prognosis: a review

We review the epidemiological and clinical features of ependymomas as described in published series as well as the effect on outcome of various treatment strategies.     

The contemporary role of antioxidant therapy in attenuating liver ischemia-reperfusion injury: a review.

Oxidative stress is an important factor in many pathological conditions such as inflammation, cancer, ageing and organ response to ischemia-reperfusion. Humans have developed a complex antioxidant system to eliminate or attenuate oxidative stress. Liver ischemia-reperfusion injury occurs in a number of clinical settings, including liver surgery, transplantation, and hemorrhagic shock with subsequent fluid resuscitation, leading to significant morbidity and mortality. It is characterized by significant oxidative stress but accompanied with depletion of endogenous antioxidants. This review has 2 aims: firstly, to highlight the clinical significance of liver ischemia-reperfusion injury, the underlying mechanisms and the main pathways by which the antioxidants function, and secondly, to describe the new developments that are ongoing in antioxidant therapy and to present the experimental and clinical evidence about the role of antioxidants in modulating hepatic ischemia-reperfusion injury.     

Indian hedgehog在软骨细胞力学信号转导作用的研究进展

软骨细胞力学是近几年生物力学发展的新领域,是细胞工程和组织工程学的基础,细胞的形态、结构、功能及其新陈代谢、分化都与力学有着密切的关系。力学对维持软骨细胞生物学功能必不可少,机械应力联合其他化学分子共同调节关节软骨的生理和病理变化[1]。软骨细胞通过细胞骨架、细胞外基质、离子通道、细胞膜受体等来感受力学信号,并且结合基因表达来调控自身的代谢活动[2]。近年来研究发现Indian hedgehog为力学敏感性的基因[3]。本文主要对软骨细胞力学生物学转导机制以及与Indian hedgehog信号通路进行综述。     

Knowledge of intensive care unit nurses about medical device-related pressure injury and analysis of influencing factors

To investigate ICU nurses' knowledge level with regard to device-related pressure injuries in northern, central, and southern China and analyse its influencing factors. A total of 261 ICU nurses participated in this cross-sectional survey A convenience sampling method was used to select ICU nurses as respondents from one hospital in each of the six cities of Taiyuan, Wuhan, Xianning, Guangzhou, Foshan, and Huizhou. Data were collected using the MDRPI Knowledge Questionnaire. The questionnaire was developed by the investigators based on a summary of evidence of MDRPI, which has been reviewed and validated by experts. The obtained data were analysed using SPSS software. The average rate of the correct response about MDRPI was 60.54% (15.74 ± 2.90). The lowest percentage of correct responses was on the “concept and staging” dimension rated 28% (0.56 ± 0.67). The “skin assessment” dimension rated 39.2% (1.57 ± 0.84). Multiple linear regression analysis showed that the factors influencing the MDRPI knowledge of ICU nurses included hospital grade, the highest educational attainment, whether or not they had wound care certification, when they last attended MDRPI training or lectures, and whether or not they had attended MDRPI training or lectures. The level of knowledge of nurses about MDRPI was insufficient. Training of ICU nurses on MDRPI should be emphasised at the institutional level. MDRPI training contents should be based on clinical evidence and updated timely. There is a need to focus on the training of wound care certification and education.     

The role of lysophosphatides in cell injury.

Septic shock, particularly that resulting from Escherichia coli endotoxemia, has been associated with vascular perfusion abnormalities but also has been associated with organ damage, in particular hepatic, renal, cardiac, and pulmonary dysfunction. These changes and the biochemical finding of uncoupled oxidative phosphorylation in isolated mitochondria have been reported to occur prior to the onset of vascular perfusion abnormalities. This conceivably could be accounted for on the basis of release of phospholipase A and increased fatty acids in that fatty acids are potent uncouplers of oxidative phosphorylation. These experiments were done in vivo on rat liver and homogenates as well as extracted mitochondria and microsomes of rats 28 hr after treatment with an LD_70–90 dose of endotoxin. Experiments were also conducted with in vitro incubation of rat hepatic lysosomes for various times and various concentrations of endotoxin. The results of these experiments show no significant difference from control values of the various phospholipids analyzed subsequent to endotoxin treatment. It must be concluded on the basis of these experiments that the damage observed biochemically and by electron microscopy is related to some cause other than the membranolytic effect of lysophosphatides.