循证护理在外周静脉留置针培训中的应用

目的 探讨循证护理在外周静脉留置针培训教学中的应用效果.方法 将141名三年制专科护理班学生分为实验班(71名)和对照班(70名),在临床实习前行外周静脉留置针培训教学,对照班采用传统方法进行培训,实验班采用循证护理方法进行培训.结果 实验班外周静脉留置针操作考核成绩及对教学效果的评价显著优于对照班(均P＜0.01).结论 运用循证护理方法对学生进行外周静脉留置针培训,可提高其操作能力,使学生更快与临床接轨,并有益于提高综合能力.     

三步法护理程序在内科护理学教学中的应用

目的探讨三步法护理程序在内科护理学教学中应用的可行性。方法将113名高护专业学生随机分为实验班（57名）和对照班（56名）。在内科护理学教学中，对照班运用护理程序五步法（护理评估、护理问题或护理诊断、护理目标、护理措施、护理评价或效果评价）教学，实验班运用三步法（护理评估、护理问题或护理诊断、护理措施）护理程序教学。比较两班期中、期未考试合格率，并采用自设问卷调查两班学生对教学方法的评价。结果实验班期中、期未考试合格率显著高于对照班（均P〈0．05），对目前教学方法的接受率及学习效果满意率显著高于对照班（均P〈0．01）。结论采用三步法护理程序进行内科护理学教学，减少了教学步骤和识记内容，有利于提高学生的学习兴趣和教学效果。     

护理程序教学法在基础护理教学中的运用

为探讨适应现代护理模式、提高护生综合素质的方法，将98级6个班（300人）随机分为实验班为对照班，各32个班（150人），以实验班为对象，将护理程序贯穿于护理教学全过程，并与对照班（进行常规护理教学）比较学生的能力。结果：①实验班学生分析、判及运用护理程序的能力明显高于对照班（P＜0．01）。②实验班学生在实施护理操作时，对病人的解释，关心、尊重及个性化操作与对照班比较，差异有极显著性（P＜0．01），学生的沟通、表达、观察及解决问题的能力有明显提高，提示应用护理程序教学 法对学生素质提高有显著效果。     

教与学角色互换教学法在护理教学中的实施

目的探讨教与学角色互换的教学法在护理教学中的应用效果。方法对147名在校学生进行分组教学，其中实验班76名采用教与学角色互换教学法，对照班71名采用传统教学法。学期结束后对两班学生进行理论考核和问卷调查。结果实验班理论考试成绩为（87.50±7.34）分，对照班（71.30±8.41）分，两班比较，差异有显著性意义（P〈0.01）。问卷调查显示，78.90%～98.70%实验班学生对角色互换教学法持肯定态度，54.9％～69.0％对照班学生对传统教学法的肯定态度，两组比较，差异有显著性意义（均P〈0.01）。结论教与学角色互换教学法可刺激学生自主学习，诱发学生学习兴趣，增强学生自信，同时也可提高教学质量。     

社区护理学实践技能教学方法的研究

目的 探讨提高护生社区护理学实践操作技能的教学方法。方法 将380名护生按年级分为对照班200名（2002～2003级）和实验班180名（2004～2005级）。对照班按传统的社区护理实践课程进行教学．即授课后由教师按教学大纲要求，联系社区教学点，分组进行社区护理实践。实验班增加实践课学时，建立模拟社区护理实训中心。根据不同教学内容设计实践情号，采用问题探究式及多媒体等多种形式分段教学。结果78．9％～100％实验班护生认为教学改革增强了社区护理实践技能，提高了护生分析问题和解决问题的能力，有利于综合素质的培养。实验班理论考试成绩、操作技能考核成绩及综合能力评分与对照班比较，差异有显著性意义（均P〈0．05）。结论 社区护理实践教学改革可提高护生理论知识、操作技能及综合能力。     

循证护理在中专护生基础护理教学中的应用

目的 探讨循证护理在基础护理学(下称基护)教学中的应用效果,提高护生的批判性思维能力.方法 随机抽取1个教学班62人作为实验班,另一教学班63人作为对照班.对照班采用传统授课法按教材内容讲解;实验班在基护课程开课前讲授循证护理基础知识,课堂教学中选择部分内容进行循证护理教学和实践.结果 实验班基护理论成绩、信息载体与场所利用率及对教材知识采取批判性思维的比例显著高于对照班(均P＜0.05),实验班67.74%～100%护生对该教学方法持肯定态度.结论 基护教学中引入循证护理有利于培养护生的批判性思维能力,提高教学效果.     

在基础护理教学中运用CBE的尝试

为了提高学生综合能力，培养实用型高素质的护理人才。以95-97年级9个护士班共377人为对象，分别于每个年级中随机抽取1个班为实验班（129人），采用CBE教学模式教学；其余为对照班（248人），采用传统教学模式教学。结果实验班理论成绩和操作一次达标率均高于对照班，其综合能力也明显高于对照班。提示CBE教学模式在基础护理教学中具有科学性、实用性，值得进一步推广。     

三步法护理程序在内科护理学教学中的应用

目的 探讨三步法护理程序在内科护理学教学中应用的可行性.方法 将113名高护专业学生随机分为实验班(57名)和对照班(56名).在内科护理学教学中,对照班运用护理程序五步法(护理评估、护理问题或护理诊断、护理目标、护理措施、护理评价或效果评价)教学,实验班运用三步法(护理评估、护理问题或护理诊断、护理措施)护理程序教学.比较两班期中、期末考试合格率,并采用自设问卷调查两班学生对教学方法的评价.'结果实验班期中、期末考试合格率显著高于对照班(均P＜0.05),对目前教学方法的接受率及学习效果满意率显著高于对照班(均P＜0.01).结论 采用三步法护理程序进行内科护理学教学,减少了教学步骤和识记内容,有利于提高学生的学习兴趣和教学效果.     

护士礼仪理论与实践结合考核体系的构建与实施

目的构建合适的护士礼仪考核体系，以提高教学质量。方法将137名护理本科学生按班级分为对照班（66人）和实验班（71人）。对照班采用传统的闭卷考试，实验班采用理论考核与实践考核相结合的方法进行考核。结果两班对考核分数能否体现自身的真实水平，考核是否公开、公正，是否促进对知识及技能的掌握及是否喜欢考试的过程4方面评价结果差异有显著性意义（均P〈0．01）。结论理论与实践相结合的考核体系符合护士礼仪教学课程的要求，有助于提高教学质量。     

鱼骨图在老年患者外周静脉置管中的应用效果

目的探讨鱼骨图在老年患者外周静脉留置管中的应用效果。方法将120例老年住院患者随机分为对照组与干预组各60例。对照组采用常规方法行外周静脉置管．干预组应用鱼骨图进行外周静脉留置针程序护理。结果干预组一次穿刺成功率显著高于对照组（P〈0．05）；置管后并发症发生率显著低于对照组（P〈0．01）；留置时间显著长于对照组（P〈0．01）。结论鱼骨图能提高老年患者外周静脉留置针一次穿刺成功率．减少置管后并发症．王正长詈管留器时间.     

杭州健康女性定量骨超声测定原发性骨质疏松

目的 评价杭州健康女性骨超声速度(SOS)值随增龄减少和骨质疏松患病率，建立杭州地区女性骨超声速度值参考数据库。方法 定量超声法测定1208例杭州地区健康女性桡骨远端(RAD)，第3指骨近节(PLX)，第V跖骨(MTR)和胫骨中段(TIB)的超声速度值。结果 RAD、PLX、MTR和TIBSOS峰值(Peak of SOS)均出现在40-45岁，TJB的SOS峰值出现在35—40岁，此后随年龄增长而下降。绝经后妇女在绝经后早期和晚期各有1个SOS快速减少期，前见于桡骨近端，平均年减少率为2．4％，后见于胫骨中段，平均年减少率为1．8％。各部位骨SOS累积减少率随年龄增长而增加，到85岁4部位累积减少为13％-18％。60岁以后骨质疏松性症(OP)检出率为45％-70％，OP检出率以桡骨远端最高，60-70岁平均为67％，第3指骨近端次之约50％，胫骨中段最低为36％；75岁以后分别为70％，65％和45％。结论 全身各部位骨超声速度值到达峰值的年龄不同，峰值也各有差异。绝经后妇女骨超声速度值随年龄增加减少较快，应予激素和补钙治疗，桡骨远端为本地区SOS检测和OP检出的敏感部位。     

Importance of echocardiography in prognosis of surgical outcomes in cholecystitis in elderly patients

The authors propose to use more often echocardiography (EchoCG) in examination of elderly (over 60 years) of age patients with cholecystitis that permits to increase surgical activity to 92.4%. Left ventricular ejection fraction is the most informative. When this fraction is lower than 45% surgery must be recommended on vital indications only. EchoCG was used in 155 patients with cholecystitis, 131 of them were operated. 2 (1.52%) patients died due to acute cardio-vascular insufficiency and pulmonary artery thromboembolism.     

脊髓胶质细胞在小鼠骨癌痛形成中的作用

Objective To evaluate the role of gliocyte in the spinal cord in the development of bone cancer pain (BCP) in mice. Methods Forty male C3H/He mice aged 8-10 weeks weighing 18-22 g were randomly divided into 4 groups ( n = 10 each) : group I sham operation (group S) , group II BCP, group Ⅲ PBS and group IV minocyline (group M) . In group BCP, PBS and M, bone cancer pain was produced by injection of NCTC2472 fibrosarcoma cell suspension (2 x 105 cells) 10 μl into medullary cavity of calcaneus bone, while in group S, PBS solution 10 μl was injected instead of cancer cell suspension. In group PBS and M, PBS 5 μl and minocyline 5 μl (dissolved to 0.2 mmol/L in PBS)_were given IT immediately before cancer cell inoculation once a day for 11 consecutive days respectively. Mechanical pain threshold was measured at 1 d before cancer cell inoculation, and at 0, 3, 5, 7, 9 and 11d after cancer cell inoculation. Cold pain threshold was measured at 3, 7, 9 and 11d after cancer cell inoculation. The animals were killed after measurement of pain threshold and L4-6, segment of spinal cord was removed for determination of GFAP and CD11b expression by Western blot. Results Compared with group S, mechanical pain threshold was significantly increased at 3-11 d after cancer cell inoculation in group BCP and PBS, and at 3 and S d after cancer cell inoculation in group M, and cold pain threshold was significantly increased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was up-regulated in group BCP, PBS and M ( P < 0.05) . Compared with group BCP, mechanical pain threshold was significantly decreased at 3-11 d after cancer cell inoculation, cold pain threshold was significantly decreased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was down-regulated in group M ( P <0.05) . ConclusionThe activiton of gliocyte in the spinal cord is involved in the development of bone cancer pian in mice.     

脊髓胶质细胞在小鼠骨癌痛形成中的作用

Objective To evaluate the role of gliocyte in the spinal cord in the development of bone cancer pain (BCP) in mice. Methods Forty male C3H/He mice aged 8-10 weeks weighing 18-22 g were randomly divided into 4 groups ( n = 10 each) : group I sham operation (group S) , group II BCP, group Ⅲ PBS and group IV minocyline (group M) . In group BCP, PBS and M, bone cancer pain was produced by injection of NCTC2472 fibrosarcoma cell suspension (2 x 105 cells) 10 μl into medullary cavity of calcaneus bone, while in group S, PBS solution 10 μl was injected instead of cancer cell suspension. In group PBS and M, PBS 5 μl and minocyline 5 μl (dissolved to 0.2 mmol/L in PBS)_were given IT immediately before cancer cell inoculation once a day for 11 consecutive days respectively. Mechanical pain threshold was measured at 1 d before cancer cell inoculation, and at 0, 3, 5, 7, 9 and 11d after cancer cell inoculation. Cold pain threshold was measured at 3, 7, 9 and 11d after cancer cell inoculation. The animals were killed after measurement of pain threshold and L4-6, segment of spinal cord was removed for determination of GFAP and CD11b expression by Western blot. Results Compared with group S, mechanical pain threshold was significantly increased at 3-11 d after cancer cell inoculation in group BCP and PBS, and at 3 and S d after cancer cell inoculation in group M, and cold pain threshold was significantly increased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was up-regulated in group BCP, PBS and M ( P < 0.05) . Compared with group BCP, mechanical pain threshold was significantly decreased at 3-11 d after cancer cell inoculation, cold pain threshold was significantly decreased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was down-regulated in group M ( P <0.05) . ConclusionThe activiton of gliocyte in the spinal cord is involved in the development of bone cancer pian in mice.     

脊髓胶质细胞在小鼠骨癌痛形成中的作用

Objective To evaluate the role of gliocyte in the spinal cord in the development of bone cancer pain (BCP) in mice. Methods Forty male C3H/He mice aged 8-10 weeks weighing 18-22 g were randomly divided into 4 groups ( n = 10 each) : group I sham operation (group S) , group II BCP, group Ⅲ PBS and group IV minocyline (group M) . In group BCP, PBS and M, bone cancer pain was produced by injection of NCTC2472 fibrosarcoma cell suspension (2 x 105 cells) 10 μl into medullary cavity of calcaneus bone, while in group S, PBS solution 10 μl was injected instead of cancer cell suspension. In group PBS and M, PBS 5 μl and minocyline 5 μl (dissolved to 0.2 mmol/L in PBS)_were given IT immediately before cancer cell inoculation once a day for 11 consecutive days respectively. Mechanical pain threshold was measured at 1 d before cancer cell inoculation, and at 0, 3, 5, 7, 9 and 11d after cancer cell inoculation. Cold pain threshold was measured at 3, 7, 9 and 11d after cancer cell inoculation. The animals were killed after measurement of pain threshold and L4-6, segment of spinal cord was removed for determination of GFAP and CD11b expression by Western blot. Results Compared with group S, mechanical pain threshold was significantly increased at 3-11 d after cancer cell inoculation in group BCP and PBS, and at 3 and S d after cancer cell inoculation in group M, and cold pain threshold was significantly increased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was up-regulated in group BCP, PBS and M ( P < 0.05) . Compared with group BCP, mechanical pain threshold was significantly decreased at 3-11 d after cancer cell inoculation, cold pain threshold was significantly decreased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was down-regulated in group M ( P <0.05) . ConclusionThe activiton of gliocyte in the spinal cord is involved in the development of bone cancer pian in mice.     

脊髓胶质细胞在小鼠骨癌痛形成中的作用

Objective To evaluate the role of gliocyte in the spinal cord in the development of bone cancer pain (BCP) in mice. Methods Forty male C3H/He mice aged 8-10 weeks weighing 18-22 g were randomly divided into 4 groups ( n = 10 each) : group I sham operation (group S) , group II BCP, group Ⅲ PBS and group IV minocyline (group M) . In group BCP, PBS and M, bone cancer pain was produced by injection of NCTC2472 fibrosarcoma cell suspension (2 x 105 cells) 10 μl into medullary cavity of calcaneus bone, while in group S, PBS solution 10 μl was injected instead of cancer cell suspension. In group PBS and M, PBS 5 μl and minocyline 5 μl (dissolved to 0.2 mmol/L in PBS)_were given IT immediately before cancer cell inoculation once a day for 11 consecutive days respectively. Mechanical pain threshold was measured at 1 d before cancer cell inoculation, and at 0, 3, 5, 7, 9 and 11d after cancer cell inoculation. Cold pain threshold was measured at 3, 7, 9 and 11d after cancer cell inoculation. The animals were killed after measurement of pain threshold and L4-6, segment of spinal cord was removed for determination of GFAP and CD11b expression by Western blot. Results Compared with group S, mechanical pain threshold was significantly increased at 3-11 d after cancer cell inoculation in group BCP and PBS, and at 3 and S d after cancer cell inoculation in group M, and cold pain threshold was significantly increased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was up-regulated in group BCP, PBS and M ( P < 0.05) . Compared with group BCP, mechanical pain threshold was significantly decreased at 3-11 d after cancer cell inoculation, cold pain threshold was significantly decreased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was down-regulated in group M ( P <0.05) . ConclusionThe activiton of gliocyte in the spinal cord is involved in the development of bone cancer pian in mice.     

脊髓胶质细胞在小鼠骨癌痛形成中的作用

目的 评价脊髓胶质细胞在小鼠骨癌痛形成中的作用.方法 健康雄性C3H/He小鼠40只,周龄8～10周,体重18～22 g,随机分为4组(n=10):假手术组(S组)、骨癌痛组(B组)、PBS组(P组)和米诺环素组(M组).S组跟骨骨髓腔内注射PBS 10 μl;余3组跟骨骨髓腔内注射含2×105个骨纤维肉瘤细胞的PBS 10 μl制备骨癌痛模型,于造模前即刻开始PBS组鞘内注射PBS 5μl,M组鞘内注射米诺环素(用PBS溶解为0.2 mmol/L)5μl,1次/d,连续11 d.于造模前1 d、造模后即刻、3、5、7、9、11 d时测定机械痛阈;于造模后3、7、9、11 d机械痛阈测定结束后测定冷痛阈.痛阈测定结束后处死小鼠,取脊髓组织,测定神经胶质纤维酸性蛋白(GFAP)和CD11b的表达水平.结果 与S组比较,B组和P组造模后3-11 d时、M组造模后3、5 d时机械痛阈升高,B组、P组和M组造模后7～11 d时冷痛阈升高,脊髓CD11b和GFAP表达上调(P<0.05).与B组比较,M组造模后3-11 d时机械痛阈降低,造模后7-11 d时冷痛阈降低,脊髓CD11b和GFAP表达下调(P<0.05).结论 脊髓胶质细胞(星形胶质细胞和小胶质细胞)的激活参与了小鼠骨癌痛的形成.     

脊髓胶质细胞在小鼠骨癌痛形成中的作用

Objective To evaluate the role of gliocyte in the spinal cord in the development of bone cancer pain (BCP) in mice. Methods Forty male C3H/He mice aged 8-10 weeks weighing 18-22 g were randomly divided into 4 groups ( n = 10 each) : group I sham operation (group S) , group II BCP, group Ⅲ PBS and group IV minocyline (group M) . In group BCP, PBS and M, bone cancer pain was produced by injection of NCTC2472 fibrosarcoma cell suspension (2 x 105 cells) 10 μl into medullary cavity of calcaneus bone, while in group S, PBS solution 10 μl was injected instead of cancer cell suspension. In group PBS and M, PBS 5 μl and minocyline 5 μl (dissolved to 0.2 mmol/L in PBS)_were given IT immediately before cancer cell inoculation once a day for 11 consecutive days respectively. Mechanical pain threshold was measured at 1 d before cancer cell inoculation, and at 0, 3, 5, 7, 9 and 11d after cancer cell inoculation. Cold pain threshold was measured at 3, 7, 9 and 11d after cancer cell inoculation. The animals were killed after measurement of pain threshold and L4-6, segment of spinal cord was removed for determination of GFAP and CD11b expression by Western blot. Results Compared with group S, mechanical pain threshold was significantly increased at 3-11 d after cancer cell inoculation in group BCP and PBS, and at 3 and S d after cancer cell inoculation in group M, and cold pain threshold was significantly increased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was up-regulated in group BCP, PBS and M ( P < 0.05) . Compared with group BCP, mechanical pain threshold was significantly decreased at 3-11 d after cancer cell inoculation, cold pain threshold was significantly decreased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was down-regulated in group M ( P <0.05) . ConclusionThe activiton of gliocyte in the spinal cord is involved in the development of bone cancer pian in mice.     

脊髓胶质细胞在小鼠骨癌痛形成中的作用

Objective To evaluate the role of gliocyte in the spinal cord in the development of bone cancer pain (BCP) in mice. Methods Forty male C3H/He mice aged 8-10 weeks weighing 18-22 g were randomly divided into 4 groups ( n = 10 each) : group I sham operation (group S) , group II BCP, group Ⅲ PBS and group IV minocyline (group M) . In group BCP, PBS and M, bone cancer pain was produced by injection of NCTC2472 fibrosarcoma cell suspension (2 x 105 cells) 10 μl into medullary cavity of calcaneus bone, while in group S, PBS solution 10 μl was injected instead of cancer cell suspension. In group PBS and M, PBS 5 μl and minocyline 5 μl (dissolved to 0.2 mmol/L in PBS)_were given IT immediately before cancer cell inoculation once a day for 11 consecutive days respectively. Mechanical pain threshold was measured at 1 d before cancer cell inoculation, and at 0, 3, 5, 7, 9 and 11d after cancer cell inoculation. Cold pain threshold was measured at 3, 7, 9 and 11d after cancer cell inoculation. The animals were killed after measurement of pain threshold and L4-6, segment of spinal cord was removed for determination of GFAP and CD11b expression by Western blot. Results Compared with group S, mechanical pain threshold was significantly increased at 3-11 d after cancer cell inoculation in group BCP and PBS, and at 3 and S d after cancer cell inoculation in group M, and cold pain threshold was significantly increased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was up-regulated in group BCP, PBS and M ( P < 0.05) . Compared with group BCP, mechanical pain threshold was significantly decreased at 3-11 d after cancer cell inoculation, cold pain threshold was significantly decreased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was down-regulated in group M ( P <0.05) . ConclusionThe activiton of gliocyte in the spinal cord is involved in the development of bone cancer pian in mice.