心理护理在小儿静脉输液中的效果观察

目的探讨心理护理对小儿静脉输液的影响。方法随机将2012年1月至2013年1月在我院儿科进行静脉输液的88例患儿分成两组,观察组与对照组,每组44例。对照组患儿在输液过程中采取常规的护理,观察组患儿在常规护理的基础上加强心理护理,比较两组患儿的一次穿刺的成功率,穿刺过程中的依从性及家长满意率。结果观察组患儿一次穿刺的成功率,穿刺过程中的依从性及家长满意率都明显优于对照组(P<0.01),有统计学意义。结论心理护理干预可明显提高小儿静脉输液过程中的一次穿刺成功率,穿刺依从性及家长满意率,故在小儿静脉输液过程中,应加强对小儿的心理护理。     

心理护理干预对门诊输液患儿静脉输液效果的影响

目的探讨心理护理干预在提高门诊输液患儿静脉输液效果中的作用。方法本研究于2012年1月至2012年12月对在某医院门诊接受静脉输液的患儿进行了心理护理干预,并与仅采用常规护理的对照组静脉输液患儿进行了输液合作率及穿刺成功率对比研究。结果干预组患儿的合作率(97.08%)明显高于对照组(83.33%),且差异具有统计学意义(χ2=36.55,P<0.05)。将两组患儿按照年龄分为1个月²岁,32岁,3⁶岁,76岁,7¹0岁等三个年龄段;对比两组患儿的一次穿刺成功率可以发现干预组总的一次穿刺成功率(92.98%)明显高于对照组(80.41%),且差异具有统计学意义(χ2=23.44,P<0.05)。在各年龄段,干预组的一次穿刺成功率均明显高于对照组,且差异具有统计学意义(χ2=4.96、15.94、3.92,P<0.05)。结论在门诊输液患儿的静脉输液过程中,通过实施相应针对性的心理护理措施能够明显提高静脉输液患儿的合作率与一次静脉穿刺成功率,改善了护患关系,有效降低了护患纠纷的发生率。     

阳性强化法提高儿童静脉输液穿刺效果及依从性的评价

目的 探究阳性强化法应用于静脉输液病儿中对改善穿刺效果及依从性的影响。方法 选取徐州市儿童医院2016年2—10月收治的接受常规护理干预的静脉输液病儿58例作为对照组,再选取徐州市儿童医院2016年11月至2017年7月收治的接受阳性强化法护理干预的静脉输液病儿58例作为观察组。对比两组病儿穿刺疼痛程度、穿刺效果、静脉输液依从性以及家长满意度。结果 护理后,观察组疼痛面容持续时长为(21.91±2.46) s,心率为(105.62±15.22)次/分,分别低于对照组的(36.41±1.01) s、(144.78±12.24)次/分,差异有统计学意义(t＝41.526,15.270,均P＜0.01);观察组穿刺耗时＞5 min比率为25.86%,一次穿刺成功率为93.10%,分别优于对照组的62.07%、68.97%,差异有统计学意义(t＝15.432,9.480,均P＜0.01);观察组静脉输液依从性为87.93%,优于对照组的56.90%,差异有统计学意义([χ2]＝12.472,P＜0.01);观察组病儿家长满意度为93.10%高于对照组,差异有统计学意义([χ2]＝7.616,P＜0.01)。结论 对静脉输液病儿应用阳性强化法有利于缓解病儿疼痛程度,改善穿刺效果,且能有效提升病儿静脉输液依从性以及家长满意度,值得推广。     

综合护理方案在静脉输液儿童中的应用研究

目的探讨综合护理方案在静脉输液儿童中的应用。方法选取2016年6月~2017年1月我院儿科104例静脉输液的儿童为研究对象,将患者按随机数字表法分为观察组和对照组。观察组患儿采取综合护理方案干预,对照组患儿常规干预,比较两组患儿穿刺配合情况及穿刺效果,比较两组患儿家长满意程度,采用Wong-Baker面部表情量表对患儿进行疼痛评分。结果观察组患儿一次穿刺成功率为88.46%,穿刺依从性良好率为92.31%,无药物外渗发生,对照组患儿分别为69.23%、63.46%,对照组患儿药物外渗率为5.77%,差异具有统计学意义(P0.05);观察组患儿Wang-Bkaer笑脸量表评分(2.07±0.33)分,FLACC量表评分(1.24±0.27)分;对照组患儿Wang-Bkaer笑脸量表评分(5.23±0.53)分,FLACC量表评分(4.57±0.41)分,差异具有统计学意义(P0.05)。观察组患儿家长满意度为94.23%,对照组患儿家属满意度为82.70%,差异具有统计学意义(P0.05)。结论综合护理方案在儿童静脉输液应用效果较好,家长满意度更高,值得临床推广使用。     

人性化服务在提高儿科急诊患儿护理质量中的应用价值

目的探讨人性化服务在提高儿科急诊输液患儿护理质量中的重要价值。方法选取2017年9月至2017年11月来我院儿科进行急诊输液的患儿220例为研究对象,随机将其分为对照组110例以及观察组110例,其中对照组患儿采用常规的输液方式,观察组患儿引进个性化服务模式,通过比较两组患儿一次性穿刺的成功率以及患儿及家长对护理满意度问卷调查。结果观观察组一次穿刺的成功率显著高于对照组,差异有统计学意义(P<0.01);观察组在就诊流程、输液环境、服务态度、输液水平方面的满意度(95.4%)显著高于对照组的满意度(75.4%),差异有统计学意义(P<0.05)。结论采用人性化服务在儿科急诊输液中的效果显著,提高患儿和家属的满意度,在儿科的急诊护理中有重要的参考价值。     

急诊小儿静脉输液室静脉穿刺与输液相关护理体会

目的:探讨急诊小儿静脉输液室静脉穿刺与输液相关护理措施,总结经验。方法:选择2016年8月~2017年10月在我院急诊输液室进行输液治疗的80例患儿,等分为对照组与观察组40例,对照组采用常规护理干预,观察组患儿接受综合护理干预,比较两组患儿护理效果。结果:观察组一次成功率高于对照组,不良反应发生率低于对照组,组间数据差异均有统计学意义(P0.05);观察组护理满意度为95.0%,显著高于对照组70.0%(P0.05)。结论:对急诊静脉输液治疗的患儿辅以综合护理干预,能显著提升一次穿刺成功率,减少输液期间不良反应,提升护理服务水平,值得推广。     

无痛注射MFPI技术应用于小儿静脉输液中的价值分析

目的探讨无痛注射MFPI技术应用于小儿静脉输液中的价值,为实际应用提供参考依据。方法选取我院2017年1月～2019年1月所收治小儿静脉输液患者120例,随机分为研究组和对照组。对照组60例,予以常规静脉输液;研究组60例,加用无痛注射MFPI技术。比较组间差异。结果干预前,两组患儿疼痛评分差异无统计学意义(P 0.05);干预后,研究组患儿评分为(1.3±0.5)分,显著低于对照组,差异有统计学意义(t=13.164,P 0.01)。研究组患儿中,一次穿刺成功率为93.33%、输液成功率为98.33%,均高于对照组,差异有统计学意义(χ~2=10.542、6.405,P 0.05)。研究组家长中,非常满意42例、一般满意15例,护理满意度为95%,高于对照组的24例、21例及75%,差异有统计学意义(χ~2=7.908,P 0.05)。结论小儿无痛注射MFPI技术可有效转移患儿注意力、减轻疼痛,有利于提升输液质量及家长满意度,有利于良好医院形象建立,值得推广应用。     

心理护理在儿科门诊输液室患儿及家长中的应用

目的探讨心理护理在儿科门诊输液室患儿及家长中的应用。方法将320例儿科门诊输液患儿按数字表法随机分为对照组和观察组各160例,对照组给予常规输液护理,观察组在常规护理基础上联合心理护理,对比两组患儿治疗依从性及家长满意度。结果观察组患儿依从性好者比例89.38%高于对照组的57.50%,FLACC评分(1.74±1.03)分低于对照组的(3.63±1.22)分,家长总满意率95.63%高于对照组的72.50%,差异均有统计学意义(P<0.05)。结论心理护理可减轻儿科门诊输液中患儿的疼痛反应,提高患儿治疗依从性及家属满意度,和谐护患关系,值得临床广泛推广。     

护理干预在小儿静脉输液中的应用及效果观察

目的研究小儿在静脉输液过程中实施护理干预的临床效果。方法我院选择2010年7月至2012年7月间进行静脉输液的100例儿童,将其均分为观察组和对照组。观察组的患儿接受综合护理措施以及进行心理沟通,对照组的患儿实施常规的输液操作。分别运用WangBaker笑脸量表及FLACC量表对患儿进行静脉穿刺时的疼痛程度进行评分,比较两组患者的一针穿刺成功率以及静脉输液的依从性。结果通过上述指标对观察组和对照组患儿进行检测,差异较为显著,有统计学意义(P<0.05)。结论对需要静脉输液的患儿进行综合护理可以有效的提高患儿的依从性及穿刺成功率,降低患儿对静脉输液的疼痛程度,值得在临床上大力推广使用。     

程序化管理在小儿输液室的应用效果分析

目的探讨程序化管理在小儿静脉输液室中的应用效果。方法2012年6月至2013年3月我院门诊静脉输液的患儿306例,按时间顺序分成对照组和观察组各153例。对照组给予静脉输液常规护理,观察组静脉输液采取程序化管理,比较两组患儿输液治疗的依从性、护理效果及满意度。比较实施程序化管理前后,输液室护士症状自评量表测试结果。结果观察组患儿输液时的依从性、穿刺成功率明显高于对照组;液体渗漏、拔针出血、淤血发生率低于对照组,差异均有统计学意义。输液室护士的SCL-90症状自评量表9项因子评分均在良好水平,除恐怖与实施管理前差异有统计学意义外,其他各项因子差异均无统计学意义。结论程序化管理应用于小儿静脉输液室后,患儿治疗依从性和穿刺成功率均明显提高,液体渗漏等发生率显著降低,得到了患者家属的认可。     

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.     

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.     

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.