中老年糖尿病患者饮食误区及护理对策

目的纠正中老年糖尿病患者饮食治疗中存在的误区，建立良好的饮食习惯，提高依从性。方法对100例在我科住院糖尿病患者采取问卷调查的形式，了解他们在执行糖尿病饮食治疗中存在的问题，针对问题进行分析归纳并实施护理干预。结果所有患者认识到饮食控制的重要性，89%患者纠正了不良饮食倾向，86%患者建立了正确的饮食习惯，依从性明显提高。结论在糖尿病的饮食控制中，消除饮食误区，及时进行互动式有针对性的反复指导更易让患者理解掌握，做好自我护理管理，有效控制血糖，预防和延缓并发症的发生。     

老年糖尿病患者治疗依从性调查分析及护理干预对策

目的:分析影响老年糖尿病患者治疗依从性的原因,探讨其护理对策,以提高患者生活质量。方法:选取我院2007年6月-2009年12月收治的362例老年糖尿病患者进行调查,分析其影响治疗依从性的原因,将其随机分为两组,各181例,对照组采用常规护理,观察组针对问题采取相关干预措施,比较干预后的效果。结果:影响老年患者治疗依从性的主要因素有文化程度、对疾病和药物的了解、经济状况、记忆力、对治疗的信心等,通过采取干预措施后,观察组的治疗依从性明显高于对照组,比较有统计学意义(P<0.05)。结论:影响老年患者治疗依从性的因素比较多,在治疗过程中应积极采取干预措施,以提高治疗效果。     

知识强化教育对糖尿病患者依从性的影响

目的探讨知识强化教育对糖尿病患者依从性的影响。方法将我院160例住院患者随机分为对照组和观察组各80例，对照组行常规治疗，观察组除常规治疗外，采取知识强化教育，治疗结束分别对两组患者进行依从性的评价。采用自行设计的糖尿病遵医行为调查表，内容包括合理饮食、适当运动、按医嘱用药、血糖监测、定期门诊5个遵医行为项目。结果观察组80例患者76例能完全遵医，对照组能完全遵医患者44例，两组患者遵医程度比较差异有统计学意义(<0.01)。结论知识强化教育可提高糖尿病患者依从性。     

精神分裂症伴发糖尿病的临床特点与护理干预

目的：探讨精神分裂症伴发糖尿病的临床特点与护理干预要点。方法采用回顾性调查方法分析精神分裂症伴发糖尿病的临床特点,总结精神分裂症患者易患糖尿病的高危因素,据此自编筛查表并对入院患者进行筛查,将存在易发因素的128例患者随机分为干预组和对照组,对照组患者入院后常规服用抗精神病药物,按精神病护理常规[1]进行护理,干预组在对照组的基础上实施护理干预。结果干预后对两组患者饮食控制率、治疗依从性、血糖控制率及糖尿病的发生率进行比较,差异有极显著性意义(均<0.05。结论对精神分裂症患者伴发糖尿病的高危因素采取必要的护理干预,可降低精神分裂症患者糖尿病的发生率,提高患者控制饮食与治疗的依从性,控制疾病的发展,减少并发症的发生。     

慢性肾病患者的限盐饮食意愿及团体护理模式的应用

目的:研究慢性肾病(chronic kidney disease,CKD)患者限盐饮食意愿调查及团体护理模式的应用价值.方法:前瞻性研究济南军区总医院180例CKD患者临床病历资料,根据健康信念模式编制限盐饮食意愿调查表,观察患者对限盐饮食的意愿和依从性,分析影响患者限盐饮食意愿的相关因素.根据调查结果开展团体活动护理,探讨团体护理模式对改善患者限盐饮食意愿的应用价值.结果:单因素和多因素分析结果显示文化程度、经济收入、专业知识水平及自觉症状是影响患者限盐饮食意愿的独立因素(P<0.05).护理后CKD患者限盐饮食具有良好依从性的占83.33%,显著高于护理前(P<0.05).结论:CKD患者存在限盐饮食意愿偏低、依从性差的问题,开展团体护理有助于改善患者限盐饮食意愿,提高治疗依从性,具有较高临床应用价值.     

精神分裂症患者治疗依从性调查与护理干预

目的:分析影响精神分裂症患者治疗依从性的因素,探讨护理干预的效果。方法:选取我院2007年1月-2009年6月收治的302例精神分裂患者,随机分为对照组,采用常规护理;观察组,针对不良因素采取相关护理干预,各151例,比较两组服药依从性。结果:影响精神分裂症患者治疗依从性的因素比较多,通过护理干预后,观察组服药依从性明显优于对照组,比较有统计学差异(P<0.05)。结论:分析影响精神分裂症患者服药依从性的因素,制定有效的护理干预措施,对提高患者治疗依从性具有重要意义。     

影响糖尿病患者药物治疗依从性相关因素临床分析

目的 探讨影响糖尿病患者药物治疗依从性的相关因素。方法 回顾性分析我院于2016年8月~2017年7月所收治的2型糖尿病患者168例,根据药物治疗依从性的好与差分为两组,比较两组患者在性别、年龄、病程、疾病认知水平、服药种类、服药次数及月收入等方面的差异,并分析影响患者药物治疗依从性的相关因素。结果 168例患者当中50例药物治疗依从性好,118例药物治疗依从性差;药物治疗依从性差患者的年龄、服药种类、服药次数高于药物治疗依从性好的患者,而疾病认知水平及月收入则低于药物治疗依从性好的患者,组间比较差异具有统计学意义（P＜0.05）;经分析,年龄大、服药种类多、服药次数多、疾病认知水平低及月收入低是导致患者治疗依从性差的主要原因。结论 影响糖尿病患者药物治疗依从性的因素有很多,应依患者实际情况采取具针对性的措施以提高患者服药依从性,保证患者血糖水平能控制于允许范围内。     

口腔正畸临床依从性的探讨

目的了解口腔正畸临床依从性的影响因素,探讨提高口腔正畸临床依从性的方法。方法对500例接受口腔正畸治疗的患者进行分析、总结。结果口腔正畸临床依从性不但体现在如何对待矫治装置、是否按预约时间复诊、口腔卫生的保持等,还包括心理状态、个性特征及家庭和社会环境等多方面。通过健康教育、加强医患交流、心理辅导、简化治疗等措施能改善口腔正畸患者的临床依从性。结论在正畸治疗的各个阶段,对各种心理类型的患者有针对性地采用不同的对策,进行心理辅导,消除不良心态,使其在治疗过程中保持良好的依从性,可帮助正畸患者取得良好、稳定的疗效。     

护理干预对糖尿病患者饮食依从性的影响

目的 探讨护理干预对糖尿病患者饮食依从性的影响.方法 选取二院于2011年7月～2012年7月的100例糖尿病患者,按照不同的护理手段,随机分为对照组和观察组,每组患者50例.对照组采用常规护理,观察组在常规护理的基础上加用护理干预.对比分析两组患者的饮食依从性和临床疗效.结果 两组患者治疗后,观察组患者治疗后的各项指标显著优于对照组患者,P＜0.05具有统计学意义.观察组患者的临床疗效和治疗依从性显著优于对照组患者,P＜0.05,差异具有统计学意义.结论 对于老年糖尿病患者采用护理干预,可以显著改善糖代谢,降低糖尿病并发症,增强患者的生命质量,疗效显著,具有临床价值意义,可以大力推广.     

抑郁对糖尿病患者自我管理能力的影响

目的:探讨抑郁对糖尿病患者自我管理能力的影响。方法:175例门诊糖尿病患者根据9条目患者健康问卷(patient health questionnaire-9,PHQ-9)评定结果,分为糖尿病伴抑郁组(PHQ-9≥12分,n=63)、糖尿病不伴抑郁组(PHQ-912分,n=112),采用自制调查表采集患者一般资料,同时进行糖尿病患者自我管理知识、态度、行为评价量表行为分量表(diabetes self-management behavior assessment sub-scale,DSBAS)的评定。结果:①糖尿病伴抑郁组患者DSBAS总分(t=-6.784,P0.01)及运动评分(t=-5.000,P0.01)、遵嘱服药评分(t=-2.161,P0.05)、足部护理评分(t=-2.994,P0.01)、血糖血压监测评分(t=-2.621,P0.01)、并发症检查评分(t=-3.376,P0.01)评分,均低于不伴抑郁组;糖尿病伴抑郁组自我管理依从性不良的比例,显著高于不伴抑郁组(χ~2=11.156,P0.01);②Logistic回归分析显示,抑郁可正向预测自我管理依从性不良(β=1.582,P0.01),而住院次数可逆向预测自我管理依从性不良(β=-0.763,P0.01)。结论:抑郁可能是导致糖尿病患者自我管理依从性不良的一个危险因素。     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.