优质护理在低分子肝素治疗不稳定型心绞痛的辅助干预效果观察

目的探讨优质护理在低分子肝素治疗不稳定型心绞痛的辅助干预效果。方法收集本院80例不稳定型心绞痛患者按是否接受优质护理分为2组各40例,对照组患者治疗期间给予常规护理,实验组患者加施优质护理,比较2组患者心绞痛相关临床指标、依从性情况与满意度等。结果实验组患者心绞痛发作次数、持续时间、硝酸甘油用量与镇痛剂使用次数低于对照组,存在显著性差异(P0.05);2组患者实施后依从性评分组间比较存在显著性差异(P0.05);实验组患者护理满意度评价显著性高于对照组,存在显著性差异(P0.05)。结论优质护理在低分子肝素治疗不稳定型心绞痛的辅助干预效果显著。     

临床护理路径在单操作孔胸腔镜肺叶切除术围术期患者中的应用效果

目的探讨临床护理路径在单操作孔胸腔镜肺叶切除术围术期患者中的应用效果。方法将160例行单操作孔胸腔镜肺叶切除术患者按是否愿意接受临床护理路径分为2组各80例,对照组患者给予常规护理,实验组患者加施临床护理路径,比较2组相关临床指标、医生与护师满意评分、并发症与纠纷、护理满意度调查问卷结果。结果实验组患者手术时间、下床时间、住院时间与医疗费用显著低于对照组(P<0.05);实验组患者干预后医生与护师满意度评分与干预前组内比较显著上升、干预后2组间比较存在显著差异(P<0.05);实验组患者总并发症发生率低于对照组(P<0.05),实验组患者护理满意度优于对照组(P<0.05)。结论临床护理路径在单操作孔胸腔镜肺叶切除术围术期患者中的应用效果显著,可提高满意度。     

集束化护理干预在连续性血液净化导管相关性血流感染患者护理中的应用

目的探讨集束化护理干预在连续性血液净化导管相关性血流感染患者护理中的应用效果。方法收集本院362例行连续性血液净化治疗患者随机分为2组,对照组169例患者采用常规护理,实验组193例患者则加施集束化护理干预,比较2组患者置管与相关临床指标、各类型疾病CRBSI感染率、已发生CRBSI的相关临床指标与不良医疗事件、家属总体护理满意度。结果实验组患者置管时间、住院时间与医疗费用显著性低于对照组(P0.05);实验组糖尿病肾病、急性肾衰竭与慢性肾小球肾炎患者CRBSI感染率均显著低于对照组(P0.05);总体CRBSI感染率显著性低于对照组(P0.05);实验组患者发生CRBSI时间显著性高于对照组,CRBSI持续时间显著性低于对照组(P0.05);实验组患者家属总体护理满意度显著性优于对照组(P0.05)。结论集束化护理干预在连续性血液净化导管相关性血流感染患者护理中的应用效果显著,可提高满意度,具有借鉴性。     

优质护理干预在乙型肝炎后肝硬化上消化道出血护理中的影响效果分析

目的探讨优质护理干预在乙型肝炎后肝硬化上消化道出血护理中的影响效果。方法收集110例乙型肝炎后肝硬化上消化道出血患者,按是否愿意接受优质护理分为2组。对照组患者给予常规内科护理,实验组患者在常规内科护理的基础上加施优质护理,比较2组患者护理效果、并发症发生情况、上消化道出血复发情况及护理满意度等。结果实验组患者经优质护理干预后护理效果显效率、护理效果总有效率及护理总满意度显著高于对照组(P0.05);实验组患者经优质护理干预后,便秘、消化不良、并发症总发生率显著性低于对照组(P0.01);实验组患者上消化道出血复发率显著低于对照组(P0.05)。结论优质护理干预在乙型肝炎后肝硬化上消化道出血护理中的影响效果显著,具有护理借鉴意义。     

综合护理干预在急性心肌梗死患者急救中的应用

目的探讨综合护理干预在急性心肌梗死患者急救中的应用效果。方法收集100例急性心肌梗死患者随机分为2组,对照组患者给予常规护理,实验组患者则加施综合护理干预,比较2组患者出院前心绞痛程度、干预前后生活质量、心理状态、不良心脏事件发生率与家属护理满意度。结果实验组患者躯体活动受限程度、心绞痛稳定状态、心绞痛发作状态、治疗满意程度与疾病认知程度评分组间比较均显著性高于对照组;干预后生理机能、生理职能、躯体疼痛、社会功能、情感职能、精力、精神健康与一般健康状况评分组间比较均显著性高于对照组;焦虑与抑郁评分组间比较均显著性低于对照组;总体不良心脏事件发生率显著性低于对照组;家属满意度显著性优于对照组,2组比较差异有统计学意义(P0.05)。结论综合护理干预在急性心肌梗死患者急救中的应用效果显著,可提高家属满意度,借鉴意义重大。     

综合护理干预在慢性肺源性心脏病合并心力衰竭治疗中的应用效果

目的探讨综合护理干预在慢性肺源性心脏病合并心力衰竭治疗中的应用效果。方法选择100例慢性肺源性心脏病合并心力衰竭患者按是否愿意接受综合护理干预分为2组。对照组患者给予常规护理,实验组患者加施综合护理干预,比较2组患者干预前后1 s用力呼气容量、左室射血分数、6 min步行距离、生活质量、并发症与护理满意度等。结果 2组患者干预后FEV1与LVEF水平组间比较存在显著性差异(P0.05);2组患者干预后6 min步行距离与心衰生活质量水平组间比较存在显著性差异(P0.05);实验组患者心律失常发生率明显低于对照组,存在显著差异(P0.05);实验组患者并发症总发生率显著性低于对照组(P0.05);实验组患者护理满意度显著性优于对照组(P0.05)。结论综合护理干预在慢性肺源性心脏病合并心力衰竭治疗中的应用效果显著,可提高患者满意度。     

风湿免疫疾病中肺部并发症的治疗与护理

目的探讨优质护理干预在风湿免疫疾病患者中的辅助治疗与肺部并发症预防效果。方法收集本院80例风湿免疫疾病患者按是否愿意接受优质护理分为2组,对照组患者给予常规护理,实验组患者加施优质护理干预,比较2组患者干预前后护理质量评分、风湿疼痛情况、并发症与护理满意度调查结果等。结果实验组患者干预后护理质量评分显著性上升(P0.01),2组患者干预后NRS评分显著性下降,2组间比较存在显著性差异(P0.01);实验组患者总并发症发生率显著低于对照组(P0.01),护理满意度调查结果显著优于对照组(P0.01)。结论优质护理干预在风湿免疫疾病患者中的辅助治疗与肺部并发症预防效果显著,可提高满意度,具有借鉴性。     

情志护理联合标准序贯分级在CCU急性心肌梗死患者中的应用

目的：探讨情志护理联合标准序贯分级在CCU急性心肌梗死患者中的应用效果。方法：选取2021年3月1日～2022年7月31日收治的98例CCU急性心肌梗死患者随机分为对照组和研究组各49例，对照组行常规干预联合情志护理，研究组行情志护理联合标准序贯分级干预。比较两组严重心律失常发生率、负性情绪[采用焦虑自评量表(SAS)和抑郁自评量表(SDS)]、生活质量[采用简明健康状况调查问卷(SF-36)]。结果：干预后，两组SAS、SDS评分均低于干预前(P<0.05),且研究组低于对照组(P<0.01);干预后，两组SF-36评分均高于干预前(P<0.05),且研究组高于对照组(P<0.05);研究组并发症总发生率低于对照组(P<0.05);研究组心律失常发生率低于对照组(P<0.01);研究组护理总满意度高于对照组(P<0.05)。结论：给予CCU急性心肌梗死患者情志护理结合标准序贯分级干预有助于改善其预后，及时发现异常病情，提高生活质量，减少并发症发生。     

心肌梗死并发心力衰竭患者应用循证护理干预的效果观察

目的研究循证护理对心肌梗死并发心力衰竭患者的干预效果。方法选取收治的110例心肌梗死并发心力衰竭患者,随机分为对照组和研究组各55例。对照组给予常规护理,研究组给予循证护理,比较两组治疗情况(24 h心动图复常时间、住院时间)、并发症、护理满意度及治疗前后心理状态、生活质量。结果干预后,研究组24 h心动图复常时间、住院时间显著短于对照组(P<0.05);焦虑自评量表(SAS)、抑郁自评量表(SDS)评分均低于对照组(P<0.05);并发症发生率显著低于对照组(P<0.05);生活质量评分显著高于对照组(P<0.05);护理总满意率显著高于对照组(P<0.05)。结论循证护理干预可有效改善心肌梗死并发心力衰竭患者的心理状态,促进患者身体恢复,减少并发症发生,有助于提升患者生活质量及满意度,值得临床推广应用。     

瑞通立与尿激酶联合低分子肝素治疗急性心肌梗死疗效及安全性观察

目的 比较重组人组织型纤溶酶原激酶衍生物(瑞通立)与尿激酶联合低分子肝素治疗急性ST段抬高型心肌梗死的临床疗效及安全性.方法 将80例急性ST段抬高型心肌梗死随机分为治疗组和对照组,其中治疗组40例,给予瑞通立以及低分子肝素;对照组40例,给予尿激酶和低分子肝素.观察并比较两组患者的血管再通率、出血并发症、心律失常发生率、急性期病死率等.结果 治疗组血管再通率明显高于对照组,差异有统计学意义(P＜0.05);治疗组并发症、心律失常发生率明显低于对照组,差异有统计学意义(P＜0.05);而两组患者急性期病死率比较差异未见统计学意义(P＞0.05).结论 相对于尿激酶,瑞通立联合低分子肝素能更有效的开通闭塞血管,且安全性较好,并发症较低.     

现代残疾康复理念、政策与社区康复体系研究

本研究分析了当代残疾康复的理念和理论架构,构建了以国际公约、决议和政策、国内法律和政策以及操作性工具3个层次的康复理论体系;运用包容性发展,分析探讨了当代社区康复的体系和特点;就发展康复事业、为残疾人提供全面系统的康复服务提出相关的政策建议。     

国内外唇腭裂专科护理发展现状的文献研究及分析

目的了解和分析国内唇腭裂专科护理工作发展的现状。方法检索并分析万方医学网、中国知网、Springer Link及PubMed英文数据库近6年有关唇腭裂手术的围术期护理、患儿的喂养、手术安全管理、围术期疼痛研究以及心理护理的相关文献。结果共检索出国内文献89篇(核心期刊20篇)、国外文献22篇,其中围术期护理38篇、患儿的喂养16篇、手术安全管理10篇、围术期疼痛研究10篇、心理护理15篇。结论与国外文献相比,国内论文总结和回顾性居多,应增加研究探讨性论文,从而促进唇腭裂临床护理工作专科化的发展。     

我院文职护士管理和培训的实践与体会

目的构建文职护士培训、使用及管理的科学方法。方法通过规范管理、科学施训、作为骨干大胆任用等多种管理方式,使文职护士得到充分的发展。结果文职护士群体成长为医院优秀骨干,首批满3年的文职护士顺利通过续聘考核。结论科学的管理培训是文职护士成长的重要基石,对医院护理管理有着重要作用。     

城乡学童个性行为特征调查

目的探讨农村与城市儿童的个性行为特征。方法将97名农村学龄儿童设为农村组,97名城市学龄儿童设为城市组,采用艾森克个性问卷一儿童版和Achenbach’s 行为量表一儿童版进行评定分析。结果两组学龄儿童艾森克个性问卷各维度评分均无显著性差异（P均〉0．05）,且与全国常模相一致（P均〉0．05）;农村组男学童Achenbach’s行为量表违纪行为、攻击行为及外向型因子分均显著高于城市组,女学童退缩、社交问题因子分均显著高于城市组（P〈0．05或0．01）,其他因子分均无显著性差异（P均〉0．05）。结论农村与城市儿童个性无显著差异,而农村儿童存在较多的行为问题,可能与其所受教养和生活方式有关。     

Comparison of short-term and long-term protocols for stabilization and preservation of RNA and DNA of Leishmania, Trypanosoma, and Plasmodium

Molecular tools continue to be important in the prevention and control of parasitic diseases. However, using these techniques directly in the field remains a major challenge. Therefore, the preservation of clinical samples collected from endemic field areas for later analysis remains an important preanalytical process. This study aimed at identifying a suitable protocol for stabilization and preservation of RNA and DNA in bioclinical specimens for Trypanosoma, Leishmania, and Plasmodium research. Both spiked and unspiked blood samples were preserved in 7 protocols (different media; storage temperatures). Samples were evaluated for possible degradation of DNA and RNA along the storage duration up to the 10th week. Nucleic acid targets were assessed as follows: (i) Trypanosoma and Plasmodium RNA analysis was done using real-time nucleic acid sequence-based amplification (RT-NASBA) for 18S rRNA and for stage-specific Pfs25 mRNA, respectively; (ii) Trypanosoma DNA assessment analysis was conducted by using a conventional PCR for 18S rDNA; (iii) Leishmania RNA analysis was performed with a quantitative NASBA for 18S rRNA and Leishmania DNA assessment with an RT-PCR for 18S rDNA. Findings suggested that a newly developed L3™ buffer proved to be reliable and suitable for both short- and long-term preservation of parasite nucleic acid material. This buffer is envisaged to be suitable for utilization in field situations where resources are limited.     

History of violence and subjective health of mother and child

Objective: To study the self-reported prevalence of experienced violence among a cohort of women about two years after giving birth, their health during pregnancy, pregnancy outcomes and their experience of their child’s health.

Setting and subjects: In 2011, a total of 657 women participated in phase III of the Childbirth and Health Cohort Study in Icelandic Primary Health Care, 18 to 24 months after delivery. The women had previously participated in phase I around pregnancy week 16 and phase II 5–6 months after delivery. Data were collected by postal questionnaires.

Main outcome measures: Women’s reported history of experienced violence, sociodemographic and obstetric background, self-perceived health, the use of medications and their child’s perceived health.

Results: In phase III, 16% of women reported experiencing violence. These women felt less support from their current partner (p?p?p?p?p?p?=?0.008).

Conclusions: Our study confirms that a history of violence is common among women. A history of violence is associated with various maternal health problems during and after pregnancy, a higher rate of caesarean sections and maternal reports of health problems in their child 18–24 months after birth.

• KEY POINTS

• Violence is a major concern worldwide. Understanding the impact of violence on human health and developing effective preventive measures are important elements of any public health agenda.

• ??The reported prevalence of experiencing violence was 16% among women attending antenatal care in the primary health care setting in Iceland.

• ??Women with a history of violence reported worse health in general during pregnancy and delivered more often by caesarean section, compared to women with no such history.

• ??Mothers with a history of violence also evaluated the general health of their child as worse than women with no such history.

• ??The findings of this study support the importance of recognizing and addressing experienced violence among women in primary care.

     

Rates and risks of transmission of smallpox and mechanisms of prevention

In 1980, the World Health Organization declared smallpox eradicated from the world; the last known natural case had occurred in Somalia in 1977, and the United States had stopped routinely vaccinating its citizens in 1972. However, with increasing concerns regarding domestic and international terrorism, smallpox has resurfaced as a potential threat to global health. We review the direct and indirect modes of smallpox transmission and how patterns of transmission vary substantially, depending on the severity of circulating disease, vaccination status, environmental and socioeconomic factors, and the setting of an outbreak. We examine mechanisms for controlling outbreaks of disease and preventing further transmission in the event of an outbreak, with an emphasis on smallpox vaccination.     

通用设计原则与产品研发策略

本文介绍了通用设计的概念和设计原则,并阐述了根据此原则实施通用设计的产品研发策略。通用设计惠及的不仅是残疾人,也惠及了包括普通公众在内的广泛人群,以及企业。应将通用设计的原理应融入政府相关政策和未来发展的规划中,为残疾人以及更多人群提供合理便利的通用设计产品。     

Prevalence and severity of nausea and vomiting of pregnancy and effect of vitamin supplementation.

OBJECTIVE: Although nausea and vomiting of pregnancy is the most common medical condition during pregnancy, there are many unanswered questions regarding its cause, epidemiologic features and optimal management. The objectives of this study were to ascertain the prevalence of nausea and vomiting in a sample of Canadian women, to characterize the distribution of their severity and to investigate the role of vitamin B6 deficiency in their etiology. DESIGN: Prospective study. SETTING: Antenatal counselling service for pregnant women. PATIENTS: Three cohorts of women: a prospective, population-based cohort of 193 women, to estimate the rate and severity of nausea and vomiting (cohort A); a cohort of 555 women who sought advice for nausea with or without vomiting, to study the correlation between the maximal daily number of episodes of vomiting and maximal weight loss (cohort B); and a prospective cohort of 301 women who reported vomiting, to correlate vitamin supplementation with vomiting (cohort C). INTERVENTIONS: All 3 cohorts were interviewed during the counselling session, and cohort B was followed up prospectively. OUTCOME MEASURES: Frequency of nausea and vomiting, weight loss, maximal number of daily episodes of vomiting, rate of multivitamin supplementation. RESULTS: Overall, 67% of the women in cohort A reported experiencing nausea or vomiting, or both; 22% reported vomiting, and 9% experienced weight loss. In cohort B there was a significant correlation between the maximal number of daily episodes of vomiting and maximal weight loss, although there was wide variation (r2 = 0.25, p < 0.001). There was a highly significant correlation between the number of daily vomiting episodes and mean weight loss (r2 = 0.99). In cohort C, vomiting was significantly associated with lack of supplementation with multivitamins before 6 weeks' gestation (p = 0.002). CONCLUSIONS: The relation between number of daily vomiting episodes and mean weight loss may serve as a clinical tool to assess the severity of nausea and vomiting in pregnancy and the success of anti-emetics and rehydration regimens. Further study is needed to elucidate the biologic basis of the observed association between vomiting and lack of multivitamin supplementation in early pregnancy.     

胃癌DNA含量与E-cad、EGFR表达的关系及其意义

目的　探讨胃癌组织DNA含量与E cad、EGFR表达的关系 ,评价其在浸润、转移潜能及预后判断中的作用。方法　应用图像分析仪及SP免疫组化法检测 30例正常胃黏膜上皮、30例不典型增生和 5 0例胃癌组织DNA含量与E cad、EGFR蛋白表达情况。结果　①正常胃黏膜上皮、Ⅰ、Ⅱ、Ⅲ级不典型增生及胃癌组的DI、PI、S %、>5c %逐渐增高 ,与胃癌分期、淋巴结转移显著相关 (P <0 0 1)。②E cad在正常胃黏膜上皮阳性表达率 10 0 % ,EGFR呈阴性表达 ;Ⅰ、Ⅱ、Ⅲ级不典型增生及胃癌E cad阳性表达率逐渐降低 ,EGFR的阳性表达率逐渐升高 ,且差异显著 (P <0 0 5 ) ;E cad表达减弱、EGFR表达升高与胃癌分化差、淋巴结转移显著相关 (P <0 0 1)。③E cad表达阴性的胃癌DNA指数及EGFR表达水平显著高于E cad阳性 (P <0 0 1)。结论　检测DNA含量及E cad、EGFR蛋白表达有助于胃癌的早期诊断及转移潜能和预后的判断。