电话随访在患者出院随访中的应用价值

目的 探讨电话随访在患者出院随访中的应用价值.方法 选取该院2015年6～12月出院的老年高血压患者90例,随机分为观察组和对照组每组45例.两组均给予出院指导,对照组出院后不进行干预,观察组进行电话随访,比较两组院外的自我管理能力及血压控制情况.结果 观察组干预后的日常生活、健康行为、血压监测、服药依从性等方面的自我管理行为均优于对照组(均P<0.05).观察组干预后的收缩压、舒张压均低于对照组(均P<0.05).结论 电话随访能够提高老年高血压患者出院后的自我管理能力,改善血压控制水平.     

自我管理处方对2型糖尿病患者自我管理行为及自我效能的影响

目的 探讨自我管理处方在2型糖尿病（T2DM）患者中的应用效果。方法 110例T2DM患者分为观察组（56例）和对照组（54例）,两组患者在住院期间进行相同的糖尿病宣教,出院后对照组予以传统健康教育,观察组在对照组的基础上应用自我管理处方进行健康教育。比较两组患者出院前、出院6个月后的血糖情况以及自我管理行为、自我效能评分。结果 两组患者出院前的自我管理行为及自我效能得分差异均无统计学意义（P_均>0.05）,血糖情况组间差异无统计学意义（P>0.05）。出院6个月后门诊随访,观察组的自我管理得分以及自我效能得分均高于对照组,差异有统计学意义（P<0.05）;血糖指标控制效果优于对照组,差异有统计学意义（P<0.05）。结论 自我管理处方不仅能提高T2DM患者的自我管理能力,增强自我效能,也可以良好控制血糖指标。     

强化护理干预对老年高血压患者血压状况及提高自我管理能力的影响

目的探讨强化护理干预对老年高血压患者血压状况及自我管理能力改善的影响。方法选取我院2016年3～2016年10月收诊的老年高血压患者86例,按照随机数字表法分为观察组和对照组各43例。对照组给予常规护理,观察组在对照组基础上给予强化护理干预。随访6个月后,统计对比两组患者血压状况及自我管理能力评分。结果护理干预后1、3、6个月时,观察组舒张压、收缩压低于对照组,差异有统计学意义(P0.05);护理干预后观察组自我管理能力评分均高于对照组,差异有统计学意义(P0.05)。结论对老年高血压患者采取强化护理干预,可改善血压状况,提升患者自我管理能力。     

基于“互联网+”的高血压“5+1”医护患协同延伸管理模式探讨

目的:探讨基于"互联网+"的出院高血压患者"5+1"医护患协同延伸管理模式的运行效果。方法:选取2018年1月至2018年11月本院心内科88例高血压出院患者,随机分成对照组和观察组各44例。对照组实施出院后定期电话随访和短信群发科普延伸管理模式,观察组实施基于"互联网+"基础上的"5+1"医护患协同延伸管理模式。跟踪研究对比患者出院后6个月的血压控制水平、身体质量指数(BMI)、高血压治疗依从性和自我管理达标率。结果:出院时两组患者血压和BMI比较无明显差异(P> 0.05);出院后6个月回访,观察组患者血压及BMI明显低于对照组;观察组患者按时服药、合理饮食、控制体质量、自测血压和定期门诊回访方面的治疗依从性和自我管理达标率明显优于对照组,差异均有统计学意义(P<0.05)。结论:通过互联网对高血压出院患者实施"5+1"医护患协同延伸管理模式,患者血压血脂控制理想,身体质量指数明显改善,高血压治疗依从性和自我管理能力明显提高。     

院外健康指导对老年高血压患者健康行为及治疗效果的影响

目的：探讨院外健康指导在老年高血压患者健康行为及治疗效果的影响。方法选取2012年7月至2013年3月于我院接受高血压治疗,病情稳定后出院的100例老年高血压患者,随机分为观察组和对照组,各50例。对照组出院时给予出院指导,观察组在对照组的基础上进行院外健康指导,比较两组患者出院后的健康行为、幸福程度以及疗效的保持情况。结果观察组患者高血压自我监测、遵医嘱服药、并发症预防、饮食知识、运动方案及健康行为总分方面的得分均显著高于对照组,差异有统计学意义（ P＜0.05）。观察组的正性幸福因子得分显著高于对照组,负性幸福因子得分低于对照组,主观幸福总分显著高于对照组,差异有统计学意义（P＜0.05）。两组患者出院时的收缩压和舒张压均无统计学意义（P＞0.05）。观察组随访时的收缩压、舒张压与出院时无统计学意义（P＞0.05）,且均显著低于对照组,差异有统计学意义（P＜0.05）。结论院外健康指导有利于老年高血压患者出院后自觉采纳健康行为,减少不良生活方式对血压的影响,保持治疗效果。     

互联网+随访管理系统促进区域性老年髋部骨折术后康复研究

目的 探究互联网+随访管理系统促进区域性老年髋部骨折术后康复的应用效果。方法 选取2019年1月至2021年1月我院收治的40例接受常规术后康复+随访管理系统老年髋部骨折患者纳入对照组;另将同期40例采用常规术后康复联合互联网+随访管理系统的老年髋部骨折患者纳入研究组。两组连续干预3个月。比较出院时、出院后1个月、出院后3个月的Harris髋关节评分量表评分(HHS)和自我管理能力实施量表(ESCA)评分,比较干预3个月结束时护理满意度、并发症发生率。结果 干预3个月期间,两组并发症发生情况比较,差异无统计学意义(P>0.05);出院后1、3个月时,两组HHS评分逐渐升高,且研究组高于对照组,差异有统计学意义(P<0.05);出院后1、3个月时,两组ESCA评分逐渐升高,且研究组高于对照组,差异有统计学意义(P<0.05);干预3个月结束时,研究组护理满意度高于对照组,差异有统计学意义(P<0.05)。结论 互联网+随访管理系统可促进区域性老年髋部骨折患者术后康复,提高自我管理能力和护理满意度,且不增加术后并发症。     

电话回访式健康教育在冠心病合并高血压患者中的应用

目的探讨出院电话回访式健康教育在冠心病合并高血压患者中的应用效果。方法选取我院2013年1月至2018年1月收治的320例冠心病合并高血压患者为研究对象,随机将其等分为观察组与对照组,对照组给予常规护理、健康宣教及出院指导,观察组在对照组的基础上给予联合出院电话回访式健康教育干预,比较两组患者干预前后血压变化、自我管理行为评分、Morisky服药依从性量表(MMAS-8)评分及西雅图心绞痛量表(SAQ)评分。结果干预后两组患者舒张压比较差异无统计学意义(P> 0. 05),干预后观察组收缩压显著低于对照组(P <0. 05),自我管理行为评分、MMAS-8评分及SAQ评分均显著高于对照组,差异均有统计学意义(P <0. 05)。结论出院电话回访式健康教育干预可有效控制冠心病合并高血压患者血压水平,提高患者自我管理行为能力、服药依从性及生活质量,值得临床推广应用。     

延续性护理对高血压脑出血手术患者术后再出血率的影响

目的探讨延续性护理对高血压患者术后再出血率的影响。方法将80例高血压患者随机分为观察组和对照组,对照组出院后不进行干预,观察组给予延续性护理,比较2组出院后的健康行为、血压控制情况、生活能力及再出血率。结果2组患者均随访6~12个月,观察组的疾病知识、药物管理、自我监测、症状管理等健康行为评分均高于对照组,差异有统计学意义(P0.05)。观察组的收缩压和舒张压均低于对照组,生活能力评分高于对照组,差异有统计学意义(P0.05)。观察组的再出血率低于对照组,但差异无统计学意义(P0.05)。结论延续性护理能够促使高血压脑出血患者术后养成健康行为,提高血压控制水平,降低再出血率。     

短信平台教育在慢性肾脏病患者自我管理中的应用

目的通过短信平台定期向慢性肾脏病患者发送自我管理及健康教育内容,以增强患者的自我效能、改善其自我管理能力。方法选择2011年11月至2012年4月瑞金医院肾脏内科诊断为慢性肾脏病1～4期且能独立查看手机短信的患者108例,按随机数字表法分为两组:短信对照组患者接受常规健康指导;短信干预组患者出院后,护士通过医院短信平台向患者手机定期发送短信,内容主要为自我管理及健康教育内容;比较两组患者出院后3个月的自我管理行为及自我效能。结果出院前,两组患者的自我管理行为及自我效能水平差异均无统计学意义(P>0.05);出院后3个月,短信干预组在运动锻炼、饮食控制、认知症状管理、与医生沟通等方面的自我管理得分及症状管理、疾病共性管理等方面的自我效能得分均高于对照组,差异有统计学意义(P<0.05)。结论短信平台教育能提高慢性肾脏病患者的自我管理能力,增强其自我效能。     

动态血压与心电图在妊娠期高血压疾病中的应用价值分析

目的 研究动态血压与心电图监测在妊娠期高血压疾病中的应用效果。方法 选取2018年1月至2021年2月我院收治的180例妊娠期高血压患者作为观察组,并选择同期健康妊娠者80例作为对照组,均进行24 h动态血压与心电图监测,观察两组动态血压、心电图。结果 观察组24 h平均收缩压舒张压、最高舒张压收缩压、夜间平均收缩压舒张压、收缩负荷、舒张负荷均高于对照组,差异有统计学意义(P<0.05);观察组平均血压夜间下降率低于对照组,差异有统计学意义(P<0.05);观察组心电图中心律失常发生率38.33%、ST-T改变发生率21.11%,高于对照组16.25%、10.00%,差异有统计学意义(P<0.05)。结论 妊娠期高血压采取妊娠期动态血压与心电图监测,能够很好掌握血压变化,以及心电图变化情况,对后期诊断治疗提供重要意义,值得应用。     

Evaluation of intervention strategy of thalassemia for couples of childbearing ages in Centre of Southern China

BackgroundTo describe the free intervention strategy of thalassemia for childbearing couples in Guangzhou.MethodsRoutine hematology examinations were conducted for 137,222 couples. Among them, 37,501 couples who had mean corpuscular volume (MCV) <82 fL or mean corpuscular hemoglobin <27 pg were elected for Hb analysis and the deletions of four common α‐thalassemia mutation. Reverse dot blot for common nondeletional α‐thalassemia and β‐thalassemia was selectively used. Three thousand twenty‐two couples randomly selected were offered all those tests as a control group. Sanger sequencing, multiplex ligation‐dependent probe amplification and next‐generation sequencing were used for rare thalassemia. High‐risk couples were offered prenatal diagnosis at 10–13 weeks’ gestation based on informed consent.ResultsThe carrier rates of α‐, β‐, and αβ‐thalassemia and δβ thalassemia/deletional HPFH were 7.7%, 3.02%, 0.5% and 0.059% respectively. Of them, 1.37% were identified as at‐risk couples and 345 couples terminated the pregnancy. No severe α‐ and β‐thalassemia births were observed. In the control group, two β‐ thalassemia carriers and one case with −α^3.7/αα^QS were misdiagnosed, but all at‐risk couples were found, and we could save 1,523,774 ¥ using our strategy. The cut‐off points of 73.46 fL and 23.25 pg would be useful to find −α⁺/α^T thalassemia.ConclusionThe intervention strategy was cost‐effective and offered reference in population thalassemia screening.     

Evaluation of radical scavenging properties of shikonin

With the aim of developing effective anti-inflammatory drugs, we have been investigating the biochemical effects of shikonin of “Shikon” roots, which is a naphthoquinone with anti-inflammatory and antioxidative properties. Shikonin scavenged reactive oxygen species like hydroxyl radical, superoxide anion (O₂^•−) and singlet oxygen in previous studies, but its reactivity with reactive oxygen species is not completely understood, and comparison with standard antioxidants is lacking. This study aimed elucidation of the reactivity of shikonin with nitric oxide radical and reactive oxygen species such as alkyl-oxy radical and O₂^•−. By using electron paramagnetic resonance spectrometry, shikonin was found unable of reacting with nitric oxide radical in a competition assay with oxyhemoglobin. However, shikonin scavenged alkyl-oxy radical from 2,2''-azobis(2-aminopropane) dihydrochloride with oxygen radical absorbance capacity, ORAC of 0.25 relative to Trolox, and showed a strong O₂^•−-scavenging ability (42-fold of Trolox; estimated reaction rate constant: 1.7 × 10⁵ M⁻¹s⁻¹) in electron paramagnetic resonance assays with CYPMPO as spin trap. Concerning another source of O₂^•−, the phagocyte NADPH oxidase (Nox2), shikonin inhibited the Nox2 activity by impairing catalysis when added before enzyme activation (IC₅₀: 1.1 µM; NADPH oxidation assay). However, shikonin did not affect the preactivated Nox2 activity, although having potential to scavenge produced O₂^•−. In conclusion, shikonin scavenged O₂^•− and alkyl-oxy radical, but not nitric oxide radical.     

Development of the Measure of Experiential Aspects of Participation for People With Physical Disabilities

Objectives

To create a parsimonious, psychometrically sound measure of experiential aspects of participation (MeEAP) for people with physical disabilities.

Evaluation of anticonvulsant activity of hydroalcoholic extract of Mussaenda philippica on animals

ObjectiveTo evaluate the anticonvulsant activity of hydroalcoholic extracts of leaves and sepals of Mussaenda philippica (M. Philippica) and its fractions (methanol, dioxin and aqueous) against pentylene tetrazole (PTZ), maximal electroshock (MES), Strychnine (STR), Picrotoxin induced convulsions at different dose levels.MethodsThe anticonvulsant effect of extracts was studied by the MES, PTZ, STR and Picrotoxin-induced seizure.ResultsThe extract at 100 and 200 mg/kg, produced a significant (P <0.01) dose dependent increase in onset of convulsion compared to the control in MES, PTZ, strychnine and picrotoxin-induced seizures.ConclustionsThe data obtained indicates that Hydroalcoholic extracts of M. philippica leaves and sepals may help to control grandmal and petitmal epilepsy.     

Patterns of pain: meta-analysis of microarray studies of pain

Existing microarray gene expression profiling studies of tonic/chronic pain were subjected to meta-analysis to identify genes found to be regulated by these pain states in multiple, independent experiments. Twenty studies published from 2002 to 2008 were identified, describing the statistically significant regulation of 2254 genes. Of those, a total of 79 genes were found to be statistically significant “hits” in 4 or more independent microarray experiments, corresponding to a conservative P < 0.01 overall. Gene ontology-based functional annotation clustering analyses revealed strong evidence for regulation of immune-related genes in pain states. A multi-gene quantitative real-time polymerase chain reaction experiment was run on dorsal root ganglion (DRG) and spinal cord tissue from rats and mice given nerve (sciatic chronic constriction; CCI) or inflammatory (complete Freund’s adjuvant) injury. We independently confirmed the regulation of 43 of these genes in the rat-CCI-DRG condition; the genetic correlates in all other conditions were largely and, in some cases, strikingly, independent. However, a handful of genes were identified whose regulation bridged etiology, anatomical locus, and/or species. Most notable among these were Reg3b (regenerating islet-derived 3 beta; pancreatitis-associated protein) and Ccl2 (chemokine [C-C motif] ligand 2), which were significantly upregulated in every condition in the rat.     

Investigation of health perspectives of those with physical disabilities: the role of spirituality as a determinant of health

Summary

Lymphoedema of the arm is a disabling complication of surgery for cancer of the breast. It occurs in a significant proportion of patients and tends to occur later after the operation. Radiation increases the incidence. It needs to be differentiated for tumour recurrence and venous obstruction. Aetiology may include surgical technique, radiation and infection. Prevention is important as treatment is difficult. Treatment may include drugs, particularly benzopyrones, and enzymes, physiotherapy, elastic sleeves and surgery.

Zusammenfassung

Das Arm-Lymphoedem ist eine meist irreversible, verunstaltende und invalidisierende Komplikation nach Mastektomie wegen Mammakarzinom. Es tritt bei einer beträchtlichen Zahl mastektomierter Patientinnen auf, oft erst nach längerer Latenzzeit. Zusätzliche Bestrahlung erhöht die Häufigkeit des Vorkommens. Tumor-Rezidiv oder venöse Stauung müssen sets ausgeschlossen werden. Die Ursachen des Lymphoedems liegen im chirurgischen Eingriff, der Radiotherapie und komplizierenden Infekten. Prävention ist sehr wichtig, da die Behandlung schwierig ist. Sie kann mit Medikamenten erfolgen, insbesondere mit Benzopyrenen und Enzymen, mit Physiotherapie, komprimierenden Gummiärmeln oder durch chirurgische Korrektureingriffe.

Résumé

Le lymphoedème du bras est une complication de l'intervention chirurgicale pour le traitement du cancer du sein. Il se déclare chez un nombre important de patients et dans de nombreux cas n'apparait qu'un certain temps aprés l'operation. La radiothérapie augmente sa fréquence. On doit distinguer entre récurrence de la tumeur et occlusion véneuse. La méthode de détermination de ses causes comprend les techniques chirurgicales, la radiothérapie et l'infection. Sa prévention est importante étant donné que son traitement est difficile. Il peut ětre traité à l'aide de médicaments, en particulier benzopyrènes et enzymes, de physiothérapie, de gaines élastiques et d'interventions chirurgicales.     

Development of a Computerized Adaptive Testing System of the Functional Assessment of Stroke

Objective

To develop a computerized adaptive testing system of the Functional Assessment of Stroke (CAT-FAS) to assess upper- and lower-extremity (UE/LE) motor function, postural control, and basic activities of daily living with optimal efficiency and without sacrificing psychometric properties in patients with stroke.

动态增强MRI定量参数与乳腺癌分子亚型的关系

目的 探讨不同分子亚型乳腺癌动态对比增强MRI(DCE-MRI)定量参数及其与预后因子的关系。 方法 回顾性分析78例乳腺浸润性癌患者治疗前的MRI,测量定量参数K^trans、K_ep和V_e。测定免疫组化指标ER、PR和HER-2,并对分子亚型进行归类。比较不同分子亚型间及雌激素受体(ER)、孕激素受体(PR)、人类表皮生长因子受体(HER-2)不同表达状态时的DCE-MRI定量参数。 结果 最终68例入组,其中Luminal A型24例,Luminal B型19例,HER-2+型10例,三阴性乳腺癌(TNBC)15例。K_ep值在不同分子亚型间差异有统计学意义(P<0.01)。Luminal A型和TNBC的K^trans、K_ep和V_e值的差异均有统计学意义(P均<0.05)。4个亚型中,TNBC的K^trans和K_ep值最大,V_e值最小。ER-者K_ep值高于ER+者;PR-者K_ep值亦高于PR+者,PR-者与PR+者K^trans差异有统计学意义。 结论 通过K^trans、K_ep和V_e值可鉴别Luminal A型乳腺癌和TNBC;不同分子亚型及不同ER、PR表达状态的乳腺癌的K_ep值不同。     

Validation of the Japanese Version of the Functional Assessment of Cancer Therapy-Cognitive Function Version 3

ContextCancer therapy–induced cognitive impairment adversely affects the quality of life of patients with cancer but cannot be detected by neuropsychological tests.ObjectivesThis study aimed to validate a Japanese version of the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) version 3, which is a self-report measure of the cognitive concerns of patients with cancer.MethodsThe FACT-Cog was translated into Japanese and pilot tested with five patients with breast cancer and five patients with hematologic malignancy. Study participants were recruited in Hiroshima University Hospital and Kagawa Breast Clinic in Hiroshima, Japan. Patients with breast cancer (N = 236) responded to the resultant assessment and Functional Assessment of Cancer Therapy-General version 4. The internal consistency and concurrent and construct validity of the FACT-Cog were examined.ResultsThe Cronbach's alphas of the four FACT-Cog subscales, namely, CogPCI, CogOth, CogPCA, and CogQOL, were 0.95, 0.73, 0.93, and 0.88, respectively. The item-to-domain correlations ranged from 0.211 to 0.920. Most of the FACT-Cog subscales were significantly correlated with other subscale and total scores (r = 0.133–0.425). Structural equation modeling was barely acceptable (χ2 = 1361.8, df = 489, P < 0.001; goodness of fit index = 0.731, adjusted goodness of fit index = 0.691, comparative fit index = 0.848, root-mean-square error of approximation = 0.087).ConclusionThe Japanese version of the FACT-Cog is a valid and reliable self-report measure of the cognitive function of patients with breast cancer. Its utility to clinicians and researchers in measuring the cognitive concerns of patients with cancer in Japan will serve as a further test of its validity.     

Brazilian versions of the Measure of Processes of Care-20 and Measure of Processes of Care-Service Providers: translation,cross-cultural adaptation and reliability

BackgroundThe Measure of Processes of Care (MPOC) questionnaires evaluate Family-Centered Practice (FCP) in services for children with developmental disorders. The MPOC-20 and MPOC-SP are completed by parents and by rehabilitation professionals, respectively, and are widely used in several countries.ObjectivesTo translate and cross-culturally adapt the MPOC-20 and MPOC-SP to Brazilian Portuguese and evaluate their reliability and internal consistency.Methodsthis study included translation, back-translation, cognitive interviews, testing of the pre-final versions, analysis of reliability and of internal consistency of the final versions. Respondents included parents and rehabilitation professionals from rehabilitation centers in four capital cities in Brazil.ResultsTranslation and cultural-adaptation procedures ensured the Brazilian versions were understandable and semantically equivalent to the original MPOC-20 and MPOC-SP. Pre-final and final versions were analyzed and vetted by the original authors. The MPOC-20 internal consistency Cronbach's alpha varied between 0.61 and 0.91 (n = 107), the test-retest reliability ICC varied between 0.44 and 0.83 and the standard error of measurement varied between 0.66 and 0.85 (n = 50). The MPOC-SP internal consistency Cronbach's alpha varied between 0.52 and 0.83 (n = 92), the test-retest reliability ICC between 0.83 and 0.90, and the standard error of measure between 0.34 and 0.46 (n = 62).ConclusionThe Brazilian versions of the MPOC-20 and the MPOC-SP are in general stable and sufficiently reliable. They are relevant to the evaluation of FCP and provide information that can improve health services and ensure better care.