围术期患者舒适护理的管理

目的探讨围术期患者舒适护理的管理、实施方法和效果。方法树立正确的围术期护理理念,注重舒适护理和人文关怀;组织授课,提高舒适护理的理论水平;开展术前访视和术后随访;开展手术体位的规范化培训,提高患者术中体位舒适度;配置手术室舒适护理硬件设备、完善使用;制订围术期舒适护理考核评价标准等。结果患者围术期舒适度提高,患者和手术医生对手术室护士的满意度均得到提高。结论系统、科学的管理能促进手术室护士实施舒适护理,提高患者围术期舒适度,保证手术安全。     

新生儿手术的围术期管理

总结30例新生儿先天性手术的围术期管理。提出术前手术室护士要了解新生儿病情及手术配合特点,术中强调新生儿手术体位摆放、皮肤的护理及对室温和输液的要求,术后协助麻醉师对新生儿进行有效的复苏和保暖工作。要求手术室护士根据新生儿的生理特点和需要做好围术期管理,确保手术顺利进行。     

新生儿手术的围术期管理

总结30例新生儿先天性手术的围术期管理。提出术前手术室护士要了解新生儿病情及手术配合特点，术中强调新生儿手术体位摆放、皮肤的护理及对室温和输液的要求，术后协助麻醉师对新生儿进行有效的复苏和保暖工作。要求手术室护士根据新生儿的生理特点和需要做好围术期管理，确保手术顺利进行。     

舒适护理在无痛人工流产术中的应用体会

目的探讨舒适护理在无痛人工流产术中的应用。方法对90例实施无痛人流者围术期行舒适护理,观察手术效果及其对护理满意度情况。结果本组均成功完成手术,术后受术者情绪稳定,无相关并发症发生,均对护理工作满意。结论对无痛人流手术者围术期实施舒适护理措施,可缓解其身心压力,提高治疗舒适度和满意度,有效保证手术的顺利完成。     

经肛门内窥镜微创手术的护理配合体会

为探讨经肛门内窥镜微创手术（TEM）的护理配合要点．本研究对由手术室腔镜专科护士小组专人负责的14例TEM患者资料及护理体会进行回顾分析。结果显示,14例TEM均顺利完成。结果表明,TEM是近年来开展的一项新技术,通过加强患者围手术期护理,完善各项术前准备．术中密切配合,摆置正确手术体位,术后严密观察病情,可确保TEM安全顺利实施。     

前列腺汽化电切术患者舒适护理探讨

目的探讨将舒适护理运用于前列腺汽化电切术患者整体护理中,观察和评价手术患者术中生理、心理舒适程度。方法选取124例择期前列腺手术患者,随机分为观察组和对照组,观察组以舒适护理模式为框架,制订一套舒适护理措施;对照组则按常规护理,采用自制的调查问卷进行患者自评和护士评价手术患者舒适度。结果经实施舒适护理措施后,观察组患者心理负担减轻,焦虑程度降低,能积极主动配合麻醉和手术,提高对固定体位、疼痛的耐受性,舒适程度明显高于对照组(P0.05)。结论将舒适护理运用于前列腺汽化电切术整体护理中,患者均获得了生理、心理方面的舒适及安全感,以最佳的状态接受治疗。     

浅谈舒适护理在外科急诊手术室中的临床应用

目的探讨舒适护理在外科急诊手术室中的临床作用及效果。方法选取急诊手术室进行手术的110例患者,随机分为常规组和研究组,各55例。常规组给予常规手术模式护理,研究组在常规护理模式的基础上给予全面的舒适护理模式。比较2组患者术后舒适度。结果术后2组舒适度的比较差异有统计学意义(P<0.05)。结论舒适护理在外科急诊手术室护理中的临床应用效果良好,提高了患者舒适度,改善了患者心理素质,为急诊手术的成功提供了保障。     

综合性医院手术室护士专科化管理方法的改进

目的探讨改进综合性医院手术室护士专科化管理方法对手术室医护人员及患者满意度的影响。方法于2015年4月对传统的手术室护士专科化管理方法进行改良,包括采取绝对专科化和相对专科化相结合方式,优化重组护理人力资源;改变专科培训模式,采用医护合作培训方法和专科组内分层级培训;合理搭建值班人员梯队,确保值班期间所有急诊手术的配合质量。比较改进前后手术医生、护士和患者的满意度。结果改进后,手术医生对护士仪器设备使用、体位摆放和手术配合方面的满意率较改进前显著提高(P0.05,P0.01),手术护士对其他专科手术配合能力、全科理论知识、预见性思维、应急反应能力评分显著高于改进前(均P0.01),手术患者对访视宣教内容认知度和手术体位安置舒适度的满意率显著高于改进前(P0.05,P0.01)。结论改进手术室护士专科化管理能满足综合性医院多专科发展需求,提高手术室护理质量。     

天玑骨科机器人辅助脊柱手术护理标准操作程序的建立与应用

目的 建立天玑骨科机器人辅助脊柱手术护理标准操作程序，并探讨其在临床中的应用效果。方法选择2019年7月至2020年6月行机器人辅助脊柱手术患者112例作为对照组，实行常规围术期护理措施。2020年7月至2021年6月的132例患者作为观察组，按照标准操作程序进行围术期护理。比较两组患者手术体位安置用时，机器人使用时间，围术期意外事件发生率及医生满意度。结果对照组术前体位安置所需时间、机器人使用时间及机器人运行意外事件发生率显著短于或低于对照组，医生满意度显著高于对照组（均P＜0.05）。结论天玑骨科机器人辅助脊柱手术护理标准操作程序的建立有效规范了手术室护士的护理行为，可提升手术室工作效率与护理质量。     

舒适护理在肺癌合并糖尿病患者围术期中的应用

目的探讨舒适护理在肺癌合并糖尿病患者围术期中应用方法及效果。方法随机将40例肺癌合并糖尿病患者分为对照组及观察组,对照组给予常规护理,观察组在常规护理基础上给予舒适护理。结果观察组患者术后并发症明显低于对照组,围术期舒适度及护理满意度高于对照组。结论对肺癌合并糖尿病患者围术期应用舒适护理,可有效减少术后并发症,提高患者舒适度及满意度。     

2015年乳腺癌辅助化疗进展

【摘要】〓乳腺癌是危害我国女性健康的头号杀手,尽管近年来辅助化疗的研究进展突飞猛进,但临床中仍有不少问题未能明确,如辅助化疗的合适人群、化疗的开始时间、蒽环及紫杉类的地位和用法、强化维持治疗的作用、疗效及预后的生物标志物等。本文结合乳腺癌辅助化疗在临床上的常见问题和2015年各大乳腺癌会议阐述乳腺癌辅助化疗的最新进展。     

Alterations in T-Cell Subset Frequency in Peripheral Blood in Obesity

Background: Obesity affects the regulation of immune and inflammatory responses. This study characterizes differences in peripheral blood lymphocyte phenotype in obese humans. Methods: Frequencies of lymphocyte subsets among peripheral blood mononuclear cells were compared between 10 obese (BMI ≥35) and 10 lean subjects, as determined by antibodies directed against cluster differentiation (CD) markers. Results: Obese patients demonstrated an increased frequency of CD3+CD4+ T-cells (mean difference 12%, P=0.004), a decreased frequency of CD3+CD8+ T-cells (mean difference 9.4%, P=0.016) and an increased frequency of CD3+CD8+CD95+ T-cells (mean difference 13.3%, P=0.032). No other differences among T-cell or monocyte subsets were noted. Conclusions: Obesity is associated with alterations in frequencies of peripheral CD4+ and CD8+ T-cells and aberrations in the expression of CD95 among CD8+ T-cells. These data suggest both CD4+ and CD8+ T-cell compartments, as well as the regulation of CD95 expression on CD8+ T-cells, as targets for further study into obesity's effects on the immune system.     

西宁地区烧伤病人动脉血气分析观察

对高海拔地区的27例烧伤病人动脉血气变化进行了分析和观察。结果证明:无论是存活病人还是死亡病人伤后均存在有低氧血症问题。并且在死亡病人和烧伤合并吸入性损伤病人其低氧血症的发生早于单纯烧伤病人。提示:吸入性损伤病人应立即行气管切开术以保障氧气供给,单纯烧伤病人可常规吸氧以维持正常血 PaO_2,ARDS 均发生在合并吸入性损伤的病人,高频喷射通气技术对纠正低氧血症有一定效果。     

Controversies in Fistula in Ano

Managing a complex fistula in ano can be a daunting task for most surgeons; largely due to the two major dreaded complications—recurrence & fecal incontinence. It is important to understand the anatomy of the anal sphincters & the aetiopathological process of the disease to provide better patient care. There are quite a few controversies associated with fistula in ano & its management, which compound the difficulty in treating fistula in ano. This article attempts to clear some of those major controversies.     

β-半乳糖苷酶在体内外成骨细胞中的表达

目的 研究β—半乳糖苷酶(β—gal)在成骨细胞中的表达状况，为阐明MorquioB综合征的发病机制提供依据。方法 裸鼠各器官和骨组织标本行X-gal染色检测。抽取羊和人骨髓行骨髓基质细胞(BMSCs)培养，分为4组：I：Adv-hBMP-2转染组；Ⅱ：Adv—β—gal转染组；Ⅲ：未转染组；Ⅳ：地塞米松诱导组。分别行X-gal染色和RT-PCR检测β—gal的表达。结果 裸鼠骺板两侧、骨膜内面及松质骨的成骨细胞和破骨细胞可见多量β—gal的表达。未转染BMSCs组有少量β—gal的表达，其他3组细胞的β—gal表达增高。结论成骨细胞和破骨细胞可表达多量β—gal，该两种细胞的β—gal缺乏可能是MorquioB综合征骨骼异常的直接原因。     

Smoking-Attributable mortality in Spain in 2016

IntroductionSmoking-attributable mortality (SAM) is a valuable indicator that can be used to characterize the course and health burden of the smoking epidemic. The aim of this paper was to estimate SAM in Spain in 2016 in the population aged 35 and over, using the best available evidence.MethodsA smoking prevalence-dependent analysis based on the estimation of population-attributable fractions was performed. Smoking prevalence (never, former, and current smokers) was calculated from a combination of the Spanish Health Survey (2016) and the European Health Survey (2014); the relative risk of death among current and former smokers was taken from the follow-up of various cohorts; and mortality rates were obtained from National Center for Statistics data. SAM estimates are presented globally, and by sex, age groups, and major disease categories: cancer, cardiometabolic diseases and respiratory diseases.ResultsIn 2016, 56,124 deaths were attributed to tobacco consumption, 84% in men (47,000), and 50% in the population aged over 74 (27,795). Overall, 50% of SAM was due to cancer (28,281), 65% of which was lung cancer. One in 4 attributable deaths (13,849) occurred before the age of 65.ConclusionsOne in 7 deaths in Spain in 2016 were attributable to smoking. This estimation of SAM clearly highlights the great impact of smoking on mortality in Spain, mainly due to lung cancer and chronic obstructive pulmonary disease.     

MicroRNAs in hepatic pathophysiology in diabetes

MicroRNAs(miRNAs or miRs) are small approximately 22 nucleotide RNA species that are believed to regulate diverse metabolic and physiological processes.In the recent past,several reports have surfaced that demonstrate the role of miRNAs in various biological processes and numerous disease states.For a disease as complex as diabetes,the emergence of miRNAs as key regulators leading to the disease phenotype has added a novel dimension to the area of diabetes research.On the other hand,the liver,a metabolic hub,contributes in a major way towards maintaining normal glucose levels in the body as it can both stimulate and inhibit hepatic glucose output.This equilibrium is frequently disturbed in diabetes and hence,the liver assumes special significance considering the correlation between altered hepatic physiology and diabetes.While the understanding of the mechanisms behind this altered hepatic behavior is not yet completely understood,recent reports on the status and role of miRNAs in the diabetic liver have further added to the complexities of the knowledge of hepatic pathophysiology in diabetes.Here,we bring together the various miRNAs that play a role in the altered hepatic behavior during diabetes.     

Fluid-phase transcytosis in the primate epididymis in vitro and in vivo

Ligated tubules from the corpus epididymidis of men and monkeys were incubated in medium containing horseradish peroxidase (HRP) as a marker for fluid-phase endocytosis. HRP was localized by light and electron microscopy after 0, 15, 30 and 60 min of incubation. Movement between the cells was prevented by tight junctions, but bypass of this barrier was apparently achieved by an intracellular vesicular mechanism leading to a time-dependent appearance of HRP in the lumen. Uptake of HRP into basal cells and capture by the lysosomal apparatus of principal cells were also observed. HRP-filled vesicles also appeared in the basal, mid and apical cytoplasm of epithelial cells in the caput 1 h after injection of the tracer into the epididymal circulation of the monkey, suggesting that this pathway also operates in vivo.