基于症状管理策略下的健康教育护理干预对发热患儿家长疾病知晓率及对护理满意度的影响

目的 探讨基于症状管理策略下的健康教育护理干预对发热患儿家长疾病知晓率及对护理满意度的影响。方法 将106例发热患儿及其家长随机分为对照组(常规护理)和研究组(基于症状管理策略下的健康教育护理干预)各53例,对比两组患儿干预后的依从性及护理前后家长疾病知晓率及对护理满意度。结果 入组干预1个月后,研究组患儿家长对疾病各项知识的知晓率人数占比均高于对照组,差异有统计学意义(P<0.05);研究组依从率高于对照组,差异有统计学意义(P<0.05);研究组意外事件均明显低于对照组,患儿家长的护理满意度评价高于对照组,差异有统计学意义(P<0.05)。结论 基于症状管理策略下的健康教育护理干预可有效提高发热患儿家长的疾病知晓率及护理满意度,同时改善患儿治疗依从性,有利于病情康复。     

健康教育路径在小儿喘息性疾病中的应用

目的探讨健康教育路径在小儿喘息性疾病中的应用效果。方法选取我院收治的118例喘息性疾病患儿,随机分为研究组与对照组,每组各59例。研究组给予健康教育路径,对照组给予传统健康教育。比较两组患儿的护理效果。结果研究组患儿疾病复发次数、再次住院次数、住院时间及费用均明显低于对照组,差异均有统计学意义(P0.05)。研究组患儿接受治疗依从性、患儿及家长对护理的满意度与对喘息性疾病知识的掌握程度均明显高于对照组,差异均有统计学意义(P0.05)。结论相比传统健康教育模式,健康教育路径为喘息性疾病患儿提供了更加科学规范的护理教育与指导,能够提高患儿在治疗与护理中的依从性与满意度,有效促进喘息性疾病患儿的痊愈。     

程序化健康教育在儿科护理中的应用效果

目的探索儿科程序化健康教育的方法及对患儿家长的应用效果。方法选择260例住院患儿家长作为研究对象,随机分为观察组(130例)和对照组(130例),对照组采取常规健康教育,观察组给予程序化健康教育,对两组患儿家长健康知识(疾病、用药和预防知识)知晓率及护理满意度进行比较。结果观察组患儿家长疾病知识(118例,90.77%)、用药知识(111例,85.38%)和预防知识(121例,93.08%)的知晓率均高于对照组,差异有统计学意义(P<0.05);观察组患儿家长对护理服务满意度(123例,94.62%)明显高于对照组(101例,77.69%),差异有统计学意义(P<0.05)。结论儿科程序化健康教育可有效提高患儿家长的健康知识知晓率,并改善护患关系。     

基于信息平台的协同护理模式在支气管哮喘患儿中的应用效果分析

目的 探讨基于信息平台的协同护理模式在支气管哮喘患儿中的应用效果。方法 回顾性选取2018年1月～2019年10月我院收治及门诊诊治的80例支气管哮喘患儿作为研究对象,根据护理方案不同分为实验组和常规组,各40例。常规组采用常规护理干预,实验组采用基于信息平台的协同护理模式干预。比较两组患儿的护理效果。结果 护理后实验组患儿吸入治疗依从性、家长哮喘知识掌握度评分均明显高于常规组,差异有统计学意义(P 0.05);实验组患儿肺活量(FVC)、最大呼气流速(PEF)、第1秒用力呼气量(FEV1)水平显著高于常规组,差异有统计学意义(P 0.05);实验组患儿家长的护理总满意度显著高于常规组,差异有统计学意义(P 0.05)。结论 基于信息平台的协同护理模式可有效提高支气管哮喘患儿吸入治疗依从性,改善肺功能,提高家长哮喘知识的掌握度及护理满意度。     

IKAP护理模式对脑卒中患者生活质量和治疗依从性的影响

目的 探讨信息-知识-信念-行为(IKAP)护理模式干预对脑卒中患者生活质量和治疗依从性的影响.方法 选择脑卒中患者60例,随机分为观察组和对照组各30例,分别采用IKAP护理模式和传统健康教育护理模式对两组患者进行护理干预.干预前后采用脑卒中影响量表(SIS)评价脑卒中患者的生活质量;采用自我报告法调查患者的治疗依从性情况,计算依从率.对生活质量评分结果和依从率进行统计学分析.结果 干预前,两组患者的生活质量评分、依从率比较,差异均无统计学意义(P>0.05).干预3,6个月,观察组患者的生活质量评分、依从率均显著高于干预前和对照组(P<0.05).且与干预3个月比,干预6个月观察组患者的生活质量评分、依从率明显提高(P<0.05).结论 IKAP护理模式干预对脑卒中患者生活质量和治疗依从性具有明显的提高和改善作用.     

“信息 -知识 -信念 -行为”模式对老年心脑血管疾病病人自我管理及治疗依从性的影响

目的 探讨"信息-知识-信念-行为"(IKAP)模式对老年心脑血管疾病病人自我管理、治疗依从性的影响.方法 选择2018年1—6月北京市和平里医院收治的82例老年心脑血管疾病病人,按照随机数字表法随机分为IKAP组和对照组,各41例.对照组给予常规诊疗、康复护理及必要的健康教育,IKAP组在此基础上,基于IKAP管理模式给予综合性健康干预,共6个月.采用一般自我效能感量表(GSES)、17项版汉密尔顿抑郁量表(HAMD-17)及遵医行为依从性评估量表评估病人的自我效能、心理状态及治疗依从性变化.结果 管理后,IKAP组HAMD评分[(11.66±3.54)分]显著降低,且低于对照组[(14.78±4.51)分](P<0.05).管理后,两组GSES量表评分明显升高,IKAP组GSES量表评分[(3.34±0.41)分]显著高于对照组[(3.04±0.38)分](P<0.05).管理后,IKAP组遵医行为依从性量表中各维度评分均较管理前明显改善,对照组服药、定期复查的评分明显改善,IKAP组服药[(11.43±2.14)分比(9.42±2.08)分]、饮食[(10.84±1.64)分比(8.35±1.90)分]、锻炼[(11.07±2.18)分比(8.24±2.71)分]、定期复查[(11.48±1.89)分比(10.16±1.53)分]各维度评分及总评分[(44.56±5.02)分比(34.87±4.37)分]均显著高于对照组(P<0.05).结论 IKAP模式能改变老年心脑血管疾病病人疾病认知、不良行为,缓解心理状态,提升自我效能和治疗依从性.     

健康教育路径对患儿及其家长哮喘相关知识知晓情况的影响

目的 观察健康教育路径对患儿及其家长哮喘相关知识知晓情况的影响.方法 84例支气管哮喘患儿按数字表法随机分为观察组和对照组,每组各42例.对照组患儿给予常规护理,观察组在常规护理的基础上进行临床健康教育路径.比较两组患儿的治疗依从性、疗效及家长对支气管哮喘知识知晓情况.结果 观察组患儿家长在经过健康教育后对支气管哮喘相关知识知晓情况较健康教育前明显提高(x2=26.25、15.57、35.05,均P＜0.05),而对照组无明显变化(x2=3.11、0.06、0.28,均P＞0.05);在健康教育后观察组患儿家长对支气管哮喘相关知识知晓情况亦明显优于对照组(x2=17.30、6.04、4.09,均P＜0.05).观察组患儿家长健康教育后相关知识知晓评分明显高于对照组(=6.04,P＜0.05).观察组患儿的治疗依从性明显优于对照组,差异有统计学意义(x2 =4.70,P＜0.05).观察组患儿及家长满意度明显优于对照组(x2=6.22,P＜0.05).在随访的6个月,观察组复发8例,复发率为19.05％;对照组复发21例,复发率为50.00％,观察组复发率明显低于对照组,差异有统计学意义(x2 =8.90,P＜0.05).结论 对支气管哮喘儿童及其家长进行健康教育有助于提高支气管哮喘患儿治疗依从性,提高患儿家长对支气管哮喘相关知识知晓率,从而提高治疗效果.     

示教式出院指导方式提高家长对早产儿早期干预依从性临床观察

目的探讨示教式出院指导方式对提高家长对早产儿早期干预依从性的价值。方法选择我院2017年1~12月新生儿科出院早产儿120例,将其按照随机数字表法分为对照组与观察组,每组60例。对照组给予常规干预,观察组则予以示教式出院指导干预,比较两组家长对早产儿的护理技能、护理知识掌握情况,同时比较两组家长对早产儿早期干预的依从性、早产儿预后、再次住院率以及家长满意度。结果观察组早产儿家长对早产儿的护理技能水平、护理知识掌握情况均要明显优于对照组,同时发现观察组家长对早产儿早期干预的依从性高于对照组,观察组患儿预后、再次住院率及家长满意度明显优于对照组,差异均有统计学意义(P均0.05)。结论对早产儿家长予以示教式出院指导,有利于提高家长对护理知识的掌握、促进早期干预计划的顺利实施,保证干预效果,利于早产儿的成长。     

程序化健康教育对热性惊厥患儿治疗依从性和效果的影响

目的：评价程序化健康教育对小儿热性惊厥治疗的依从性和效果的影响。方法：将102例热性惊厥患儿随机分为两组,对照组49例,教育组53例,对照组进行一般健康知识宣教,教育组按整体护理程序对患儿及家长实施程序化健康教育。结果：程序化健康教育组家长掌握相关知识和依从性明显高于一般健康宣教的对照组,教育组的复发率明显低于对照组。结论：程序化健康教育能帮助家长掌握更多的小儿热性惊厥防治知识,为积极应对疾病提供了帮助,提高了治疗的依从性和效果。     

早期家长宣教对新生儿缺氧缺血性脑病预后的影响

目的探讨早期家长宣教对新生儿缺氧缺血性脑病(HIE)预后的影响。方法将HIE患儿82例分为干预组42例和对照组40例。对照组采用常规对症疗法和护理,干预组在此基础上实施音乐疗法、向家长进行健康宣教等。采用盖赛尔(Gesell)发育量表评价2组患儿治疗后智能发育商(DQ)及运动效果。结果干预组患儿在治疗后3、6、9、12个月DQ评分及1岁时运动效果评分均高于对照组,差异均有统计学意义(P<0.01或P<0.05)。结论早期家长宣教可促进HIE患儿智力发育,可有效防治后遗症的发生。     

Susceptibility to erythromycin of anaerobes of the genera Bacteroides, Fusobacterium, Sphaerophorus, Veillonella, Clostridium, Corynebacterium, Peptococcus, Peptostreptococcus

The minimal inhibitory concentrations (MIC) of erythromycin were determined by broth dilution tests for 313 anaerobic strains, most of which were clinical isolates. All the gram-positive anaerobes tested (84 Peptococcaceae, including 21 Peptostreptococcus anaerobius and 15 Peptococcus variabilis; 65 Corynebacterium acnes and 29 Clostridium strains, including 13 C. perfringens) were sensitive (MIC values 0.012 through 3.12 microgram erythromycin/ml); so were 111 cultures of gram-negative anaerobes (52 Bacteroides fragilis, 12 B. thetaiotaomicron, 7 B. vulgatus, 13 B. oralis, 4 B. melaninogenicus, 10 Sphaerophorus necrophorus, 2 Veillonella sp., 11 members of other species). Erythromycin at concentrations of 6.25 through 200.0 microgram/ml was active against 24 strains (1 B. fragilis, 4 Fusobacterium fusiforme, 9 Sph. freundi, 10 Sph. varius). The present results are compared to the limited number of reports existing with regard to the susceptibility of anaerobes to erythromycin.     

Safety assessment of poloxamers 101, 105, 108, 122, 123, 124, 181, 182, 183, 184, 185, 188, 212, 215, 217, 231, 234, 235, 237, 238, 282, 284, 288, 331, 333, 334, 335, 338, 401, 402, 403, and 407, poloxamer 105 benzoate, and poloxamer 182 dibenzoate as used in cosmetics

Poloxamers are polyoxyethlyene, polyoxypropylene block polymers. The impurities of commercial grade Poloxamer 188, as an example, include low-molecular-weight substances (aldehydes and both formic and acetic acids), as well as 1,4-dioxane and residual ethylene oxide and propylene oxide. Most Poloxamers function in cosmetics as surfactants, emulsifying agents, cleansing agents, and/or solubilizing agents, and are used in 141 cosmetic products at concentrations from 0.005% to 20%. Poloxamers injected intravenously in animals are rapidly excreted in the urine, with some accumulation in lung, liver, brain, and kidney tissue. In humans, the plasma concentration of Poloxamer 188 (given intravenously) reached a maximum at 1 h, then reached a steady state. Poloxamers generally were ineffective in wound healing, but were effective in reducing postsurgical adhesions in several test systems. Poloxamers can cause hypercholesterolemia and hypertriglyceridemia in animals, but overall, they are relatively nontoxic to animals, with LD(50) values reported from 5 to 34.6 g/kg. Short-term intravenous doses up to 4 g/kg of Poloxamer 108 produced no change in body weights, but did result in diffuse hepatocellular vacuolization, renal tubular dilation in kidneys, and dose-dependent vacuolization of epithelial cells in the proximal convoluted tubules. A short-term inhalation toxicity study of Poloxamer 101 at 97 mg/m(3) identified slight alveolitis after 2 weeks of exposure, which subsided in the 2-week postexposure observation period. A short-term dermal toxicity study of Poloxamer 184 in rabbits at doses up to 1000 mg/kg produced slight erythema and slight intradermal inflammatory response on histological examination, but no dose-dependent body weight, hematology, blood chemistry, or organ weight changes. A 6-month feeding study in rats and dogs of Poloxamer 188 at exposures up to 5% in the diet produced no adverse effects. Likewise, Poloxamer 331 (tested up to 0.5 g/kg day(-1)), Poloxamer 235 (tested up to 1.0 g/kg day(-1)), and Poloxamer 338 (at 0.2 or 1.0 g/kg day(-1)) produced no adverse effects in dogs. Poloxamer 338 (at 5.0 g/kg day(-1)) produced slight transient diarrhea in dogs. Poloxamer 188 at levels up to 7.5% in diet given to rats in a 2-year feeding study produced diarrhea at 5% and 7.5% levels, a small decrease in growth at the 7.5% level, but no change in survival. Doses up to 0.5 mg/kg day(-1) for 2 years using rats produced yellow discoloration of the serum, high serum alkaline phosphatase activity, and elevated serum glutamicpyruvic transaminase and glutamic-oxalacetic transaminase activities. Poloxamers are minimal ocular irritants, but are not dermal irritants or sensitizers in animals. Data on reproductive and developmental toxicity of Poloxamers were not found. An Ames test did not identify any mutagenic activity of Poloxamer 407, with or without metabolic activation. Several studies have suggested anticarcinogenic effects of Poloxamers. Poloxamers appear to increase the sensitivity to anticancer drugs of multidrug-resistant cancer cells. In clinical testing, Poloxamer 188 increased the hydration of feces when used in combination with a bulk laxative treatment. Compared to controls, one study of angioplasty patients receiving Poloxamer 188 found a reduced myocardial infarct size and a reduced incidence of reinfarction, with no evidence of toxicity, but two other studies found no effect. Poloxamer 188 given to patients suffering from sickle cell disease had decreased pain and decreased hospitilization, compared to controls. Clinical tests of dermal irritation and sensitization were uniformly negative. The Cosmetic Ingredient Review (CIR) Expert Panel stressed that the cosmetic industry should continue to use the necessary purification procedures to keep the levels below established limits for ethylene oxide, propylene oxide, and 1,4-dioxane. The Panel did note the absence of reproductive and developmental toxicity data, but, based on molecular weight and solubility, there should be little skin penetration and any penetration of the skin should be slow. Also, the available data demonstrate that Poloxamers that are introduced into the body via routes other than dermal exposure have a rapid clearance from the body, suggesting that there would be no risk of reproductive and/or developmental toxicity. Overall, the available data do not suggest any concern about carcinogenesis. Although there are gaps in knowledge about product use, the overall information available on the types of products in which these ingredients are used, and at what concentration, indicates a pattern of use. Based on these safety test data and the information that the manufacturing process can be controlled to limit unwanted impurities, the Panel concluded that these Poloxamers are safe as used.     

HPLC法测定抗妇炎胶囊中木兰花碱、黄柏碱、药根碱、巴马汀、小檗碱、槐果碱、苦参碱、氧化槐果碱、槐定碱和氧化苦参碱

目的 采用高效液相色谱（HPLC）法同时测定抗妇炎胶囊中木兰花碱、黄柏碱、药根碱、巴马汀、小檗碱、槐果碱、苦参碱、氧化槐果碱、槐定碱和氧化苦参碱10种活性成分。方法 采用InerSustain AQ-C₁₈色谱柱（250 mm×4.6 mm,5 μm）,流动相A：乙腈–无水乙醇（80∶20）,流动相B：0.1%磷酸溶液,梯度洗脱,检测波长220 nm,体积流量1.0 mL/min,柱温30℃,进样量10 μL。结果 木兰花碱、黄柏碱、药根碱、巴马汀、小檗碱、槐果碱、苦参碱、氧化槐果碱、槐定碱和氧化苦参碱分别在2.69～134.50、1.95～97.50、0.63～31.50、0.86～43.00、11.95～597.50、0.59～29.50、6.08～304.00、4.85～242.50、1.66～83.00、19.79～989.50 μg/mL线性关系良好（r≥0.999 3）;平均回收率分别为99.11%、98.23%、96.95%、97.78%、100.02%、97.21%、99.66%、99.52%、98.81%、100.08%,RSD值分别为1.04%、1.23%、1.37%、1.65%、0.70%、1.28%、0.65%、0.81%、1.11%、0.63%。结论 建立的HPLC法可用于抗妇炎胶囊中10种活性成分的测定,作为抗妇炎胶囊质量控制方法。     

Strength of drug habits: For heroin,morphine, methadone,alcohol, barbiturates,pentobarbital, benzedrine,cocaine, and marijuana

The drug habits for 78 confirmed opiate addicts were studied on eight scales from the Process Association Test of Addiction (PATA) for many drug names. Through cluster analysis eight stages of addiction were defined: “to be clean”, “to learn about drugs”, “to hustle”, “to chip” (also “to be high”), to be psychologically dependent or “to need a shot”, “to be hooked”, “to kick a habit” and “to be in treatment”. Associations stimulated by the words heroin and morphine were very similar over the eight stages of addiction in opiate addicts. The subjects were especially inclined to associate morphine and heroin with the most severe level of addiction, “to be hooked”. Associations to both methadone and cocaine were elevated at the “hooked” stage, but in other respects associations to these drugs were opposite. Thus, associations to cocaine were focused on the stage of psychological dependence and the lower intermediate stage of addiction, “to chip” and “to be high”, whereas associations to methadone suggested a turning away from addiction as indicated by avoidance associations (“to come down” and “to kick a habit”) as well as associations to “treatment” and “to be clean”. Marijuana, Benzedrine, “goofball” (barbiturates) and alcohol habits were prominent at an intermediate stage of addiction (“to chip” and “to be high”). Avoidance associations were common for Benzedrine and “goofballs” (also pentobarbital) but not for marijuana or alcohol. “Hustling” associations were frequent for marijuana but not for alcohol.     

Simultaneous measurement of bupivacaine, etidocaine, lidocaine, meperidine, mepivacaine, and methadone

A gas-liquid chromatographic method for the simultaneous measurement of bupivacaine, etidocaine, lidocaine, meperidine, mepivacaine, and methadone in serum is described. The drugs and the internal standard, prilocaine, are extracted from 1 ml of serum. The procedure involves a two-step extraction and injection of the extract into a gas chromatograph equipped with a 10-ft OV-11 glass column and a nitrogen-phosphorus detector. The temperature gradient program results in a run time of 16 min and retention times for meperidine, prilocaine (internal standard), lidocaine, etidocaine, mepivacaine, methadone, and bupivacaine of 3.8, 5.4, 6.0, 8.7, 11.0, 11.7, and 14.8 min, respectively. Standard curves for all drugs were linear over the 80 to 2,000-ng/ml range and recovery of all components averaged 97 +/- 2% with the lowest detection limit of 10 ng/ml for all drugs except meperidine and methadone, which were 20 ng/ml. The within-day coefficients of variation ranged from 12 to 8% at 500 ng/ml. The day-to-day coefficients of variation of the slope and intercept values ranged from 2 to 0% and 130 to 3%, respectively. Response factors of the nitrogen-specific collector varied with the drug analyzed and resulted in peak area variation at constant offset and attenuation of 30%. This method is intended and adequate for therapeutic monitoring of chronically treated pain patients who are being given various combinations of local anesthetic and/or narcotic agents.     

New antiretroviral drugs: a review of the efficacy,safety, pharmacokinetics,and resistance profile of tipranavir,darunavir, etravirine,rilpivirine, maraviroc,and raltegravir

Background: The introduction and approval of new antiretroviral agents in the US and Canada bring new opportunities and new challenges. Arguably, for the first time ever, clinicians have the drugs necessary to achieve the goal of suppressing HIV RNA to levels less than 50 copies/mL in even the most treatment-experienced patients and in those with extensive drug-limiting resistance mutations. However, the use of these new agents is complicated by many drug–drug interactions and – to some extent – pre-existing mutations. To derive maximum durability from the use of these newer drugs, a thorough understanding of their indications and limitations is critical. Objective: To thoroughly review the six most recently approved or soon-to-be-approved antiretroviral drugs in the US and Canada: tipranavir, darunavir, etravirine, rilpivirine, maraviroc, and raltegravir. Methods: Discussion of the indications for, and pharmacokinetics, resistance profile, activity, toxicity, and clinical trials results of, the six new agents. Results/conclusions: These six new agents have resulted in marked progress towards the goal of being able to provide HIV-infected individuals with the drugs necessary to achieve decades of durable suppression of HIV without substantial toxicity.     

Disposition of fluvastatin, an inhibitor of HMG-COA reductase, in mouse, rat, dog, and monkey

The physiological disposition of fluvastatin, a potent inhibitor of hydroxymethylglutaryl-CoA reductase and thus cholesterol synthesis, has been studied in the mouse, rat, dog, and monkey using 14C- or 3H-labeled drug. Oral doses of fluvastatin were absorbed at a moderate to rapid rate. The extent of absorption was dose-independent and was essentially complete in all four species studied. However, the drug was subject to extensive presystemic hepatic extraction followed by direct excretion via the bile, thus minimizing the systemic burden and yielding high liver/peripheral tissue concentration gradients for fluvastatin and its metabolites. Only at high doses far exceeding the intended human daily dose of ca 0.6 mg kg-1 did fluvastatin bioavailability approach unity, apparently due to saturation of the first-pass effect. Dose-normalized blood levels of fluvastatin and total radioactivity were higher in the dog than in the other species, suggesting a smaller distribution volume in the former. Fluvastatin was partially metabolized before excretion, the extent of metabolism being smallest in the dog and greatest in the mouse. The half-life of intact fluvastatin ranged from 1-2h in the monkey to 4-7h in the dog. Regardless of the dose or dose route, the administered radioactivity was recovered predominantly in feces, with the renal route accounting for less than 8 per cent of the dose. No tissue retention of radioactivity was observed, and material balance was essentially achieved within 96h after dosing.