个性化综合护理干预在IABP患者中应用的效果评价

目的 比较个性化综合护理干预对IABP患者焦虑抑郁状况、IABP平均应用时间、患者舒适度、护理满意度的影响。方法 将符合条件的80例IABP患者按随机数字法分为实验组和对照组各40例。其中对照组给予常规护理,实验组在常规护理的基础上同时实施个性化的综合护理干预。对护理干预后两组患者焦虑抑郁状况、IABP平均置管时间、舒适度以及护理满意度进行比较。结果 实验组患者焦虑评分在置管后第3天第6天及拔管后低于对照组,差异有统计学意义(p<0.05);实验组抑郁评分在置管后第6天及拔管后低于对照组,差异有统计学意义(p<0.05);实验组IABP平均置管时间为119.4±29.4(h),对照组为141.3±30.7(h),差异有统计学意义(p<0.05);实验组舒适度评分高于对照组,差异有统计学意义(p<0.05);两组护理满意度差异无统计学意义(p＞0.05)。结论 个性化综合护理干预能有效缓解IABP患者焦虑抑郁状况,减少IABP置管时间和提高患者舒适度,从而促进患者躯体和心理的全面康复,对临床护理实践具有指导意义。     

人性化护理在胚胎移植后早期流产患者中的应用价值

目的 分析人性化护理在胚胎移植后早期流产患者中的应用价值.方法 连续选择2013年1月至2015年1月在本院胚胎移植后早期流产患者共46例,按照随机数字表法将其分为观察组和对照组,各23例.观察组给予人性化护理,对照组给予常规护理,对比临床预后.结果 两组患者干预前的焦虑抑郁评分比较,差异无统计学意义(P＞0.05).干预出院时两组患者的焦虑抑郁评分均比干预前降低,且观察组降低的更明显,差异均有统计学意义(P＜0.05).随访6月观察组的焦虑抑郁评分进一步降低,焦虑抑郁患者比例显著低于对照组;对照组焦虑抑郁评分较出院时有所升高,差异均有统计学意义(P＜0.05).两组患者住院时间和护理满意度的比较,观察组平均住院时间为3.2 d,显著短于对照组的5.7 d,患者平均满意度评分为92.4分,显著高于对照组的76.9分,差异均有统计学意义(P＜0.05).结论 人性化护理干预胚胎移植后早期流产患者可显著缓解焦虑抑郁,提高护理满意度,有较大的临床应用价值.     

普外科患者行胃肠减压后人性化护理对护理质量影响分析

目的 探讨人性化护理干预在普外科行胃肠减压操作患者中的应用及对整体护理质量的影响.方法 选择行胃肠减压操作的患者100例,均为本院普外科2016年2月至2017年2月收治随机分组,对照组常规护理与观察组人性化护理干预,各50例.对整体护理质量的影响展开对比.结果 观察组胃肠减压患者一次性置管成功49例,一次置管成功率为98％;非计划拔管2例,非计划拔管率为4％;对照组分别为40例,80％;8例,16％,经比较差异均有统计学意义(均P＜0.05).两组干预前心理状况评分差异无统计学意义(P＞0.05),干预后评分均有下降,观察组更为显著,差异有统计学意义(P＜0.05).观察组护理满意度及知识知晓率均高于对照组,差异有统计学意义(P＜0.05).结论 针对普外科胃肠减压的患者,行人性化护理干预,可改善患者心理状况,提高一次性置管成功率,确保临床安全,增强护理质量,具有非常重要的实施价值.     

人文关怀在手术室护理中的应用效果分析

目的探讨人文关怀在手术室护理中的应用效果。方法选取我院手术患者共100例随机分为观察组和对照组。对照组患者实施常规的手术室护理,观察组患者实施人文关怀护理。采用焦虑自评量表评定患者焦虑情绪改变情况;采用舒适状况量表对评定两组患者舒适度情况。结果观察组患者干预前的焦虑自评分和舒适度评分分别与对照组干预前比较,差异无统计学意义(P>0.05);观察组和对照组干预后的焦虑评分和舒适度评分分别与本组干预前评分比较,差异有统计学意义(P<0.05);观察组干预后的焦虑评分和舒适度评分分别与对照组干预后的焦虑评分和舒适度评分比较,差异有统计学意义(P<0.05)。结论人文关怀护理干预能够显著缓解手术室患者心理情绪,提高护理舒适度高,护理效果显著。     

心理护理干预对老年冠心病并发心律失常患者焦虑、抑郁情绪的影响

目的观察心理护理干预对老年冠心病并发心律失常患者焦虑、抑郁情绪的影响。方法选取94例老年冠心病并发心律失常患者为研究对象,按照随机数表将其随机分为对照组和观察组各47例。对照组给予常规护理模式,观察组在对照组基础上给予心理护理模式。结果护理前,两组焦虑、抑郁评分均无统计学差异(P> 0.05);护理后,两组焦虑、抑郁评分较护理前均降低,且观察组明显低于对照组,差异有统计学意义(P <0.05);观察组满意度明显高于对照组,差异有统计学意义(P <0.05)。结论心理护理可有效降低老年冠心病并发心律失常患者的焦虑、抑郁情况,提高患者对护理服务的满意度。     

PDCA循环法用于外科中心静脉导管护理中的效果观察

目的 观察PDCA循环法用于外科中心静脉导管(CVC)护理中的效果.方法 选取2016年1月至12月在我院治疗的CVC置管患者92例作为研究对象,随机分为两组各46例.给予对照组临床常规护理,观察组则采取PDCA循环法.观察两组干预前后护理人员置管管理能力以及干预过程中不良事件发生情况.结果 干预前两组护理人员置管管理能力评分对比,差异无统计学意义(P＞0.05);干预后观察组护理人员置管管理能力评分结果优于对照组,差异有统计学意义(P＜0.05);观察组置管不良事件发生率低于对照组,差异有统计学意义(P＜0.05).结论 PDCA循环法利于提升外科CVC置管护理质量,降低CVC置管不良事件发生率,改善护理人员CVC管理能力,保障患者输液治疗安全性,临床普及价值高.     

柔性管理单元护理模式在临床护理管理中的应用

目的探讨在临床护理管理中应用柔性管理单元护理模式的应用效果。方法随机将广东省罗定市人民医院2019年6月至2020年6月的住院治疗患者228例分为两组,对照组114例给予常规护理,观察组114例给予柔性管理单元护理模式,比较两组护理质量评分、护理满意度以及焦虑和抑郁评分的差异。结果在护理质量评分方面,对照组和观察组实施前各项质量评分比较,差异无统计学意义(P 0.05),实施后,观察组基础护理、特级和一级护理、护理文书的书写、急救药品管理、病房管理、重点环节管理和器材管理评分均高于对照组,差异有统计学意义(P 0.05);在护理满意度方面,观察组护理总满意度为92.98%,明显高于对照组的80.70%,差异有统计学意义(P 0.05);对照组和观察组实施前患者焦虑和抑郁评分比较,差异无统计学意义(P 0.05);实施后,对照组和观察组焦虑和抑郁评分较本组实施前均有明显下降,差异有统计学意义(P 0.05),并且观察组实施后焦虑和抑郁评分均低于对照组,差异有统计学意义(P 0.05)。结论在临床护理管理中应用柔性管理单元护理模式可以有效提升患者的临床护理质量,在帮助患者疏导自身住院期间焦虑和抑郁情绪的同时提高患者的护理满意度,临床应用效果显著。     

系统护理对肠梗阻患者心理负担的影响

目的探讨系统护理对肠梗阻患者心理负担的影响效果。方法选取2013年2月~2014年3月我院胃肠外科收治的120例肠梗阻患者为研究对象,采用随机分组方法将其分为观察组和对照组,每组60例。对照组采用常规护理方法进行护理,观察组采用系统护理方法进行护理,比较两组患者焦虑情绪、疼痛情况、抑郁状况、满意度及舒适度。结果观察组焦虑情绪和痛疼评分明显低于对照组,两组比较差异有统计学意义(P0.05);观察组患者无抑郁和轻度抑郁患者均多于对照组,中度和重度抑郁患者均明显少于对照组,比较差异有统计学意义(P0.05);观察组患者满意度和舒适度分别为96.67%、90.00%,明显高于对照组的83.33%和75.00%,两组比较差异有统计学意义(P0.05)。结论对肠梗阻患者采用系统护理,能明显减少患者焦虑情绪、抑郁发生,降低术后疼痛,增加患者满意度和舒适度,能帮助患者有效减轻心理负担,提高治疗效果,值得在临床中推广应用。     

PICC置管的化疗患者细节性护理效果观察

目的探究对PICC置管的化疗患者实施细节性护理效果。方法选取本院2016年10月～2018年6月间收治的45例化疗患者作为研究对象,采用随机数字表法分为实验组与对照组,对照组22例采用常规置管护理,实验组23例采用细节性护理,观察两组护理效果、并发症及患者护理满意度、PICC对日常生活影响评分情况。结果实施细节性护理的实验组,一次置管成功率高于对照组,导管堵塞率及非计划拔管率都低于对照组,差异均有统计学意义(P 0.05);实验组并发症发生率为4.3%,对照组22.7%,差异有统计学意义(P 0.05);实验组患者护理总满意率为95.7%,对照组为68.2%,差异有统计学意义(P 0.05)。实验组日常生活的影响评分明显高于对照组,差异有统计学意义(P 0.05)。结论 PICC置管化疗患者实施细节性护理干预,提高了一次置管成功率、减少了并发症、提高了患者护理满意度、改善了生活质量,值得采用。     

前馈护理模式对老年耐多药结核病患者的干预效果

目的:探究前馈护理模式对老年耐多药结核病患者的干预效果.方法:选取我院在2018-10～2019-10收治的80例老年耐多药结核病患者作为研究对象.按随机数表法将其分为观察组和对照组各40例.对照组患者施行常规护理措施,观察组在对照组的护理措施基础上给予前馈护理模式,护理3个月.比较两组护理后治疗转归情况;采用焦虑自评量表(SAS)、抑郁自评量表(SDS)分析护理前后患者焦虑、抑郁程度;采用问卷调查两组患者护理后健康知识知晓情况、服药依从性.结果:观察组患者治疗成功率明显高于对照组,差异有统计学意义(P＜0.05);护理前,两组SDS、SAS评分比较,差异无统计学意义(P＞0.05);护理后,两组的SDS、SAS评分均明显降低,且观察组明显低于对照组,差异有统计学意义(P＜0.05);护理后,观察组健康知识知晓情况、服药依从性及护理满意度显著高于对照组,差异有统计学意义(P＜0.05).结论:前馈护理干预措施能够显著提高老年耐多药结核病患者服药依从性,缓解患者焦虑、抑郁情绪,促进患者恢复.     

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.     

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.     

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.     

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.