护理干预对高血压患者治疗效果的影响

目的探讨护理干预对高血压患者治疗效果的影响及护理措施。方法选取高血压患者56例随机分为观察组和对照组,每组28例。2组均给予常规治疗及护理,观察组同时给予系统的护理干预措施。干预后,观察2组血压控制水平、血压达标情况、对高血压知识的知晓率及治疗依从性。结果干预后2组患者收缩压及舒张压均优于干预前（P〈0.05）;干预后观察组患者收缩压及舒张压明显优于对照组（P〈0.05）。干预后2组患者血压达标率、高血压知晓率及治疗依从性均优于干预前（P〈0.05）;干预后观察组血压达标率、高血压知晓率及治疗依从性明显优于对照组（P〈0.05）。结论护理干预能改善高血压患者的治疗效果及血压达标率,并改善患者治疗依从性。     

护理干预对老年高血压患者自我管理行为的影响研究

目的探究实行护理干预对老年高血压患者自我管理行为产生的影响。方法对120例老年高血压患者进行问卷调查,了解老年高血压患者自我管理行为,探究对自我管理行为产生影响的因素,实行护理干预。对比患者干预前后自我管理行为和血压控制率。结果在进行护理干预前后,高血压患者在知识知晓率、服药的依从性以及血压控制率方面,干预后明显的优于干预前,P<0.05,差异有统计学意义。结论对患者进行护理干预,患者增强对高血压知识的知晓程度,服药的依从性增加,血压控制率提高。     

临床药师对高血压患者随访及用药干预分析

目的:探讨临床药师通过对高血压患者的电话随访及用药指导,对患者知晓率、控制率、治疗率的影响。方法:200例高血压患者随机分为干预组和对照组两组各100例,两组患者均建立电子健康档案,干预组主要通过电话随访方式给与用药指导和健康教育,并和临床医师共同探讨患者用药合理性;对照组不给与干预,5个月后比较干预组及对照组患者的用药依从性、高血压知识的知晓率、治疗率等。结果:干预组高血压知识的知晓率由干预前的32%提高到61%,服药依从性由干预前的51%提高到85%,高血压达标率由干预前的46%提高到78%,干预组与对照组在干预后药物依从性和血压达标率等方面比较差异有统计学意义(P<0.01)。结论:临床药师参与到临床中,对高血压患者进行个体化用药干预和用药教育,能显著提高患者用药依从性,使患者血压达标率明显优于对照组。     

社区管理干预对高血压患者服药依从性及血压控制达标率影响的研究

目的探讨社区管理干预对高血压患者服药依从性及血压控制达标率影响。方法选取我社区中心(2016年1月至2018年1月)收治的社区高血压患者96例,根据不同干预方法分为两组,观察组(n=48)接受社区管理干预,对照组(n=48)接受常规干预,对比两组患者服药依从性和干预前后两组患者血压水平以及血压控制达标率。结果两组患者服药依从性对比差异明显,具有统计学意义(P<0.05)。干预后观察组SBP、DBP水平明显低于对照组,差异具有统计学意义(P<0.05)。干预后1、2、3个月观察组血压控制达标率明显高于对照组,差异具有统计学意义(P<0.05)。结论社区管理干预能有效提高患者服药依从性和血压控制达标率,值得临床推广。     

南站街道高血压分级管理结合患者家属干预效果分析

目的：探讨高血压患者分级管理结合患者家属干预的方法及应用效果。方法2011年1月在本社区建档及管理的2049例高血压患者临床资料中，按管理编号随机抽取400名高血压患者分为干预组和对照组，两组均给予常规降压治疗和一般分级随访管理，干预组结合患者家属干预管理和自我管理。结果经过3年的干预管理，干预组患者在高血压防治知识知晓率、规范服药率、血压的控制率和对照组比较均有统计学差异。结论高血压患者分级管理结合患者家属干预和自我管理，能有效提高高血压防治知识知晓率、规范服药率、血压控制率，从而达到提高生活质量，减缓并发症的发生。     

连续护理干预对农村老年高血压患者健康行为依从性与血压控制效果的探讨

目的探讨连续护理干预对农村老年高血压患者健康行为依从性与血压控制效果的探讨。方法选择120例在我院住院治疗的农村老年高血压患者为研究对象,随机分成观察组与对照组,每组60例,两组均在住院期间给予健康宣教、用药指导及出院指导等常规护理,观察组在患者出院后继续实施护理干预,随访1年,观察两组患者健康行为依从性情况及血压控制效果。结果观察组健康行为依从性明显优于对照组(P<0.05),血压控制效果明显优于对照组(P<0.05)。结论对农村老年高血压患者实施护理干预,有助于提高健康行为依从性和血压控制效果,适合推广应用。     

在提高社区老年高血压患者服药遵从行为中采用基于跨理论模型的社区家庭访视护理干预的作用

目的探究在提高社区老年高血压患者服药遵从行为中采用基于跨理论模型的社区家庭访视护理干预的作用。方法选取2016年1月～2017年6月就诊于我院及我院下属的社区卫生服务站的老年高血压患者63例,随机分为对照组和研究组,对照组31例,研究组32例,对照组给予常规家庭访视护理方案,研究组采用跨理论模型进行社区家庭访视护理干预,为期6个月,比较干预后两组患者的服药依从性、行为改变阶段跨越率、血压。结果干预后研究组和对照组的正确用药率分别为90.6%和61.3%,研究组显著高于对照组(P 0.05);研究组的阶段向前跨越率显著高于对照组(71.9%和32.3%,P 0.05);干预1个月、6个月后研究组的收缩压均显著低于对照组(P 0.05),舒张压无明显差异(P 0.05)。结论在干预老年高血压患者的服药遵从行为时采用跨理论模型进行社区家庭访视护理可提高患者的正确用药率,进而良好控制其血压。     

护理干预对老年高血压患者自我管理行为的影响研究

目的分析护理干预对老年高血压患者自我管理行为的影响。方法以174例老年高血压患者作为观察组,对患者进行综合护理干预,另选我院同期150例老年高血压患者作为对照组,对该组进行常规护理干预,对比两组护理前后患者健康知识知晓程度、依从性以及血压控制情况。结果观察患者接受综合护理干预后,健康知识得分、服药依从性和血压控制人数显著高于对照组,差异有统计学意义(P<0.05)。结论护理干预可提高老年高血压患者自我行为管理,护理干预值得应用和推广。     

依托团队服务的社区原发性高血压患者家庭血压自我检测模式的效果评价

目的：评价依托团队服务的社区原发性高血压患者家庭血压自我检测模式的效果。方法：选取2014年中心建档的原发性高血压病患者100例,分为对照组和干预组。两组患者均给予常规管理：干预组另给予患者家庭血压自我检测模式干预。3年干预后,对两组的高血压知晓率、治疗依从性、血压达标率进行评价分析。结果：干预组在高血压知晓率、治疗依从性、血压控制情况均有明显的提高,与对照组相比差异有统计学意义（P＜0.01）;高血压相关行为与干预前及对照组相比差异有统计学意义（P＜0.01）。结论：依托团队服务的社区原发性高血压患者家庭血压自我检测模式对高血压患者的管理起到明显的效果,对社区高血压管理有推广价值。     

不同的健康教育方式对农村老年高血压患者治疗依从性的影响

目的：探讨不同的健康教育方式对农村老年高血压患者治疗依从性的作用及意义。方法选取2009年1月-2013年1月本院收治的160例高血压患者,随机分为观察组79例,对照组81例。观察组采取入院时宣教、每天查房宣教、出院时宣教、出院后电话随访;对照组采取入院时宣教、责任护士专题宣教、出院时宣教;以提高诊疗的依从性。结果观察组患者服药依从性为65%,血压达标率55%,定期检测率40%;对照组患者服药依从性为25%,血压达标率21%,定期检测率11%;两组比较差异均有统计学意义（ P﹤0.05）。结论高血压患者的不同的健康教育对农村老年患者的预后有非常重要,健康教育和健康促进可显著提高高血压防治知识的知晓率、健康生活方式的形成率和治疗依从率。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.     

Pharmacological treatment of COVID-19: an opinion paper

The precocity and efficacy of the vaccines developed so far against COVID-19 has been the most significant and saving advance against the pandemic. The development of vaccines has not prevented, during the whole period of the pandemic, the constant search for therapeutic medicines, both among existing drugs with different indications and in the development of new drugs. The Scientific Committee of the COVID-19 of the Illustrious College of Physicians of Madrid wanted to offer an early, simplified and critical approach to these new drugs, to new developments in immunotherapy and to what has been learned from the immune response modulators already known and which have proven effective against the virus, in order to help understand the current situation.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.