急救护理干预在颅脑损伤患者急救中的应用价值

目的探讨急救护理干预在重型颅脑损伤患者急救中的应用价值。方法 83例重型颅脑损伤患者按照采用的护理方式,分为对照组(A组)及急诊护理干预组(B组)。A组由当班护理人员行常规护理救治措施,如保持患者呼吸道通畅;监测生命体征;建立静脉通道并抽血;配合医生气管插管等。B组由2人组成的护理小组实施急诊护理抢救,高年资的责任护士保持呼吸道通畅,监测生命体征以及配合医生气管插管,而辅助护士行建立静脉通道并抽血,遵医嘱及时给药并其他护理。比较两种护理实施过程中患者急诊科救治时间、急诊救治预后、急诊护理满意度、意外事件发生情况以及并发症发生情况等。结果 2组患者急诊科抢救时间比较,A组显著长于B组(P0.05);B组急诊救治预后明显好于A组(P0.05);B组急诊护理满意度明显优于A组(P0.05);2组意外时间发生情况比较,B组明显少于A组(P0.05);B组肺部感染、应激性溃疡、中枢性高热以及电解质紊乱等并发症明显少于A组。结论急救护理能缩短急诊抢救时间,显著提高患者抢救成功率,减少并发症,最大限度保障患者的生命安全。     

ICU重型颅脑外伤患者并肺部感染的护理体会

目的探讨ICU重型颅脑外伤患者并肺部感染的护理效果。方法选取我院2014-01-2015-10收治的ICU重型颅脑外伤并肺部感染患者81例,随机分为对照组40例和观察组41例,对照组予以常规护理,观察组在此基础上实施优质护理,观察2组护理效果。结果对照组GOS评分良好率12.5%,观察组为31.7%,观察组GOS评分良好率明显高于对照组(P0.05);对照组护理满意度67.5%(27/40),观察组为90.2%(37/41),观察组护理满意度明显高于对照组(P0.05)。结论 ICU重型颅脑外伤患者并肺部感染的护理效果突出,值得在临床实践中推广应用。     

综合护理预防高血压脑出血患者肺部感染的效果分析

目的分析综合护理预防高血压脑出血患者肺部感染的效果。方法采用随机平行对照法将我院神经内科101例高血压脑出血住院患者进行分组,对照组50例采用常规护理,观察组51例在常规护理基础上实施更加全面综合护理。对比2组治疗后临床疗效及肺部感染的发生情况。结果观察组总有效率94.11%显著优于对照组80.00%(P0.05),观察组肺部感染发生率7.84%明显低于对照组22.00%(P0.05)。结论综合护理预防高血压脑出血患者的肺部感染,从而改善预后和降低肺部感染发生率,值得临床推广和应用。     

临床快捷护理路径在重型颅脑外伤患者中的应用价值

目的探讨临床快捷护理路径在重型颅脑外伤患者中的应用价值。方法选取我院收治的52例重型颅脑外伤患者,随机均分为对照组(常规护理)和观察组(临床快捷护理路径),比较2组患者抢救时间、抢救费用、住院时间、住院费用和并发症发生率的差异。结果观察组抢救时间、抢救费用和住院时间均显著少于对照组(P0.05);2组患者住院费用比较无显著差异(P0.05);观察组并发症发生率19.2%,显著低于对照组的53.8%(P0.05)。结论在重型颅脑外伤患者中应用临床快捷护理路径效果确切,可显著缩短抢救时间,降低并发症发生率,值得临床推广使用。     

颅脑外伤患者优质护理体会

目的比较优质护理与常规护理对颅脑外伤患者的临床疗效。方法 106例颅脑外伤患者按随机数字表法分哦观察组(优质护理)和对照组(常规护理),每组各53例,分析对比2组的总有效率及总满意率。结果观察组的总有效率为90.56%,高于对照组的60.38%,差异有统计学意义(χ2=13.046,P0.05);总满意率为88.67%,高于对照组的60.03%,差异有统计学意义(χ2=7.756,P0.05);观察组未出现后遗症,对照组出现3例脑外伤后失语,1例脑外伤后癫痫。结论优质护理能够显著提升颅脑外伤患者总有效率,值得临床应用推广。     

院前急诊护理对急性颅脑损伤合并昏迷患者救治及预后影响

目的分析院前急诊护理对急性颅脑损伤合并昏迷患者救治及预后影响。方法选取我院收治的急性颅脑损伤合并昏迷患者共112例,随机分为2组各56例。对照组采用常规护理,观察组实施院前急诊护理。对比2组恢复率、护理满意度以及神经功能缺损评分。结果观察组恢复率、护理满意度及神经功能缺损评分均明显优于对照组(P0.05)。结论针对急性颅脑损伤合并昏迷患者,实施院前急诊护理效果显著,可有效改善患者的神经功能,值得推广应用。     

不同吸痰方式对颅脑损伤患者肺功能及肺感染的影响

目的分析不同吸痰方式对于颅脑损伤患者肺功能及肺感染的影响。方法 2012-10-2013-03于我院住院治疗的重型颅脑损伤患者63例,随机分为联合吸痰组(32例)和常规吸痰组(31例),分析联合吸痰组和常规吸痰组心率、呼吸次数、日吸痰量、痰黏稠度、不同时间氧分压、二氧化碳分压、PaO2/FiO2、黏膜出血发生率及肺部感染发生率。结果联合吸痰组和常规吸痰组心率及呼吸次数差别无统计学意义(P0.05);联合吸痰组的日吸痰量为(85.71±4.13)mL,常规吸痰组的日吸痰量为(62.26±6.97)mL,联合吸痰组的日吸痰量显著高于常规吸痰组(P0.05);联合吸痰组的痰液黏稠度显著低于常规吸痰组(P0.05);联合吸痰组第1、3、7天的氧分压、PaO2/FiO2均显著高于常规吸痰组(P0.05),二氧化碳分压显著低于常规吸痰组(P0.05);联合吸痰组的黏膜出血发生率及肺部感染发生率显著低于常规吸痰组(P0.05)。结论支气管镜灌洗联合浅部吸痰能够改善颅脑损伤患者的通气、换气功能,减少气道黏膜损伤,控制肺部感染,护理工作离不开临床医师配合,支气管镜灌洗联合浅部吸痰用于颅脑损伤患者是新型护理与临床结合的模式。     

系统护理预防脑出血患者肺部感染的效果观察

目的探讨系统护理预防脑出血患者肺部感染的效果。方法采用随机平行对照法将我院神经内科85例脑出血住院患者进行分组,对照组42例采用常规护理,观察组43例在常规护理基础上实施系统护理。比较2组临床疗效及肺部感染发生情况。结果观察组总有效率95.35%,明显高于对照组的80.95%,差异有统计学意义(P0.05);观察组肺部感染发生率4.65%,明显低于对照组的19.05%,差异有统计学意义(P0.05)。结论系统护理能够有效改善脑出血患者的预后,同时降低肺部感染率,提高临床疗效,值得推广应用。     

精细化护理对重度颅脑外伤患者神经功能及活动能力的改善效果

目的探讨精细化护理对重度颅脑外伤患者神经功能及活动能力的改善效果。方法选取郑州大学第一附属医院2016-01—2017-12收治的重度颅脑外伤患者90例,随机分为对照组和观察组各45例,分别予以常规护理和精细化护理,比较2组干预后神经功能及活动能力改善情况。结果护理后,观察组神经功能缺损(NIHSS)评分改善程度明显优于对照组(P0.05);Fugl-Meye运动量表(FMA)评分和Barthel日常生活能力评价量表(BI)评分改善程度也明显优于对照组(P0.05)。结论临床对重度颅脑外伤患者实施精细化护理有助于促进患者神经功能恢复,提高活动能力。     

颅脑外伤开颅探查术的手术配合

目的探讨颅脑外伤开颅探查术的手术配合。方法临床纳入颅脑外伤行开颅探查术者70例,随机分为对照组与研究组,分别给予常规护理和全面护理,观察2组治疗结局及患者家属对护理工作的满意度,总结手术配合经验。结果研究组临床治愈率88.57%,对照组为62.86%,2组比较差异有统计学意义(P0.05);研究组家属对护理工作满意率为85.71%,对照组为62.86%,2组比较差异有统计学意义(P0.05)。结论通过在颅脑外伤开颅探查术中实施全面护理干预,能够有效提高临床治愈率,值得推广。     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

腺垂体功能减退症临床特征变化分析

目的探讨腺垂体功能减退症患者的病因结构变化及临床表现。方法回顾性分析我院2013-01—2016-12住院及门诊78例腺垂体功能减退症患者的临床资料。结果男32例(41.03%),女46例(58.97%);诊断时年龄11~89岁,平均62.5岁;鞍区占位(包括术前及术后)52例(66.67%),席汉综合征8例(10.26%),空泡蝶鞍9例(11.65%),病因不明8例(10.26%),垂体-下丘脑发育不良1例(1.28%)。首次就诊科室:纳差厌食、恶心呕吐就诊于消化内科36例(46.15%)最常见。ACTH+TSH+Gn+G激素缺乏为19例最多,占24.36%,ACTH+TSH+Gn缺乏15例,占19.23%。结论腺垂体功能减退症病因结构发生变化,发病人群、首发症状及受累激素也不同,患者女性多于男性,发病年龄偏高,症状不典型,分布于临床多个科室,其中以低钠血症为首发临床表现就诊消化内科最多。     

Standards of instrumentation of EMG

Standardization of Electromyography (EMG) instrumentation is of particular importance to ensure high quality recordings. This consensus report on “Standards of Instrumentation of EMG” is an update and extension of the earlier IFCN Guidelines published in 1999. First, a panel of experts in different fields from different geographical distributions was invited to submit a section on their particular interest and expertise. Then, the merged document was circulated for comments and edits until a consensus emerged.The first sections in this document cover technical aspects such as instrumentation, EMG hardware and software including amplifiers and filters, digital signal analysis and instrumentation settings. Other sections cover the topics such as temporary storage, trigger and delay line, averaging, electrode types, stimulation techniques for optimal and standardised EMG examinations, and the artefacts electromyographers may face and safety rules they should follow. Finally, storage of data and databases, report generators and external communication are summarized.     

帕金森病运动症状进展分析

目的分析帕金森病(PD)患者运动症状进展特点。方法采用PD统一评分量表(UPDRS)Ⅲ对912例PD患者进行评估。结果与病程1年的患者比较,除病程1~2年的患者外,其他病程患者的UPDRSⅢ评分、强直分、姿势或步态异常分、轴性症状总分、言语分、步态分显著升高(均P0.05),病程5~6年及14年患者的震颤分,病程5~6年、7~8年、9~13年、14年患者的运动迟缓分、姿势分显著升高(P0.05~0.01)。轴性症状进展速度高于UPDRSⅢ评分。结论 PD患者病程早期UPDRSⅢ评分进展快,震颤症状进展独立于其他症状,轴性症状评分较UPDRSⅢ更敏感地反映疾病加重趋势。     

Effects of prevention of afferentation of the development of the chick optic lobe

BONDY, S. C., M. E. HARRINGTON AND C. L. ANDERSON. Effects of prevention of afferentation on the developmentof the chick optic lobe. BRAIN RES. BULL. 3(5) 411–413, 1978.—The effects of unilateral extirpation of the right optic cup of the three-day incubated chick embryo upon the rate of synthesis and the stability of DNA in the non-innervated optic lobe, have been studied. This surgical procedure prevents innervation of the optic lobe contralateral to the removed eye, while the other optic lobe is normally innervated by retinal ganglion cells of the remaining eye. At the 20th day of incubation, the DNA content of the non-innervated lobe was below that of the paired lobe receiving normal innervation. This deficiency of cell number was caused by two events; death of an excess number of neurons formed early in embryogenesis and a reduced rate of glial proliferation in the later stages of incubation.     

Release of endogenous catecholamines from slices of hypothalamus of rats

The release of endogenous catecholamines from superfused slices of rat hypothalamus was studied under basal conditions and during release evoked by 40 mM K⁺. Catecholamines in superfusates, and in extracts of the tissue after stimulation, were isolated by column chromatography and quantitated by liquid chromatography with electrochemical detection. Norepinephrine (NE) was not consistently demonstrable in superfusate collected under basal conditions, but 40 mM K⁺ caused the release of from 2 to 4 ng/g of tissue per min. The addition of cocaine to the superfusate caused increases in basal and evoked release of NE. Epinephrine (E) could be measured in superfusates of slices from male but not female rats and then only when cocaine was added to the superfusate. Accordingly, the concentration of E in hypothalamus was greater in male rats than in female rats. Dopamine (DA) was not consistently measurable in the spontaneous overflow from slices either in the presence or absence of cocaine. K⁺-evoked release of DA could be demonstrated in slices from female rats. The addition of cocaine increased the evoked release of DA from slices from both sexes. Corticosterone, added to cocaine, had no effects on the efflux of any of the catecholamines. The experiments suggest that neuronal reuptake of all catecholamines is very efficient in the hypothalamus both under basal conditions and during evoked release.     

Frequency of accumulation of filaments in adaxonal cytoplasm of Schwann cells of myelinated fibers of rat spinal roots

Summary The frequency of accumulation of 6-nm filaments in the adaxonal cytoplasm of Schwann cells in the 6th lumbar dorsal and ventral roots was evaluated in 4-, 8-, 26- and 45-week-old Sprague-Dawley rats. The frequency was higher in 4- and 8-week-old (growing) rats than in 26- and 45-week old (mature) rats, and also higher in ventral than in dorsal roots in 4-, 8- and 26-week old rats. There were no clusters on certain groups of myelinated fibers according to the size of transverse axonal area, in both the ventral and dorsal roots. Therefore, this accumulation may reflect certain functions of the adaxonal cytoplasm of Schwann cell during natural growth and maturation of the axon and myelin sheath.     

《绵阳市社会心理服务工作管理办法》解读

2018年,国家卫生健康委员会等10部委联合发布《关于印发全国社会心理服务体系建设试点工作方案的通知》,四川省绵阳市被列为全国第一批试点地区。绵阳市人民政府依据《中华人民共和国精神卫生法》等相关法律法规和文件精神,结合前期调查研究和社会心理服务工作的试点实际,编制出台了《绵阳市社会心理服务工作管理办法》,并于2021年12月25日起施行。本文围绕社会心理服务的相关概念、办法总则、重点内容、保障措施等方面进行解读,以期为社会心理服务工作的规范、持续和有效开展提供参考。     

Function of circle of Willis

Nearly 400 years ago, Thomas Willis described the arterial ring at the base of the brain (the circle of Willis, CW) and recognized it as a compensatory system in the case of arterial occlusion. This theory is still accepted. We present several arguments that via negativa should discard the compensatory theory. (1) Current theory is anthropocentric; it ignores other species and their analog structures. (2) Arterial pathologies are diseases of old age, appearing after gene propagation. (3) According to the current theory, evolution has foresight. (4) Its commonness among animals indicates that it is probably a convergent evolutionary structure. (5) It was observed that communicating arteries are too small for effective blood flow, and (6) missing or hypoplastic in the majority of the population. We infer that CW, under physiologic conditions, serves as a passive pressure dissipating system; without considerable blood flow, pressure is transferred from the high to low pressure end, the latter being another arterial component of CW. Pressure gradient exists because pulse wave and blood flow arrive into the skull through different cerebral arteries asynchronously, due to arterial tree asymmetry. Therefore, CW and its communicating arteries protect cerebral artery and blood–brain barrier from hemodynamic stress.     

阿立哌唑对精神分裂症患者生活质量的影响

目的:比较阿立哌唑与利培酮对精神分裂症患者生活质量的影响。方法:60例精神分裂患者随机平分为两组各30例,分别给予阿立哌唑和利培酮治疗。疗程8周。用生活质量综合评定问卷-74(GQOLI-74)、阳性与阴性症状量表(PANSS)及副反应量表(TESS)评定疗效及不良反应。结果:阿立哌唑与利培酮均能显著提高精神分裂症患者生活质量,但阿立哌唑在改善GQOLI-74总分、躯体健康及社会功能维度优于利培酮。结论:阿立哌唑治疗有利于提高精神分裂症患者生活质量。