初产妇护理中实施自我效能干预护理的价值

目的:探究心初产妇护理中实施自我效能干预护理的价值。方法:从我院选取82例初产妇,随机分成观察组(实施自我效能干预护理)和对照组(常规护理)。比较两组产妇分娩情况。结果:两组产妇在护理干预前自我效能评分差异无统计学意义(P0.05),干预后观察组产妇的自我效能评分明显高于对照组,明显差异(P0.05)。观察组产妇的第一产程、第二产程和总产程时间明显比对照组低,并且观察组产妇自然分娩率78.05%,明显高于对照组46.34%,明显差异(P0.05)。结论:对初产妇实施自我效能干预护理明显提高产妇的自我效能,缩短产程时间,提高自然分娩率,促进产妇顺利分娩。     

拉玛泽呼吸法在产科中的临床应用效果

目的 探讨拉玛泽（Lamaza）呼吸减痛分娩法在产程中的应用效果.方法 将158例健康体检自然分娩的初产妇按照数字表法随机分为两组,对照组79例给予常规产程护理治疗;观察组79例在对照组基础上给予拉玛泽呼吸减痛分娩法在产时实施优质护理干预;并比较两组的效果.结果 观察组产后出血明显低于对照组（P＜0.05）;观察组初产妇第一产程、第二产程及总产程比对照组明显缩短（P＜0.05）,观察组的自然分娩率及新生儿1 min Apgar评分与对照组比较（P＞0.05）;观察组的舒适满意度为98.73％明显高于对照组的87.34％（P＜0.05）;观察组产妇疼痛与焦虑的程度均显著地低于对照组（P＜0.05）;观察组分娩控制感程度明显的高于对照组（P＜0.05）.结论 采用拉玛泽呼吸减痛分娩法指导产妇,可明显缓解产妇的焦虑等不良情绪,减轻孕产妇的分娩疼痛,缩短产程,可有效地提高自然分娩率,降低了产妇的剖宫产率,是一种简便、安全、经济、可靠较方便的非药物性减痛分娩方法.     

产妇分娩过程中人性化护理的应用效果分析

目的:分析产妇分娩过程中人性化护理的应用效果及体会。方法:回顾性分析84例在我院分娩的产妇的临床资料,将其随机分为观察组与对照组,其中对照组采用常规功能性护理模式,观察组则在对照组的基础上进行人性化护理,比较两组患者的母婴结局及护理满意度。结果:观察组产妇的自然分娩率、新生儿Apgar评分显著高于对照组,而剖宫产率显著低于对照组,差异具统计学意义(P0.05)。观察组护理满意度显著高于对照组,差异具统计学意义(P0.05)。结论:在产妇分娩过程中应用人性化护理可有效改善母婴结局,提高产妇对护理服务的满意度,具有较高的临床应用价值。     

心理护理在初产妇分娩中的应用

目的 探讨助产士心理护理在初产妇分娩中的应用效果.方法 选取我院2012年10月-2013年2月收治的100例单胎初产妇,按照护理方法的不同分为对照组（常规护理）和观察组（常规护理＋助产士心理护理）,每组50例,比较两组的护理效果.结果 观察组的第一、第二产程和总产程时间短于对照组,差异有统计学意义（P＜0.05）.两组产妇的第三产程时间差异无统计学意义（P＞0.05）.观察组阴道分娩率高于对照组,观察组产后出血量、焦虑、抑郁评分少于对照组,差异均有统计学意义（P＜0.05）.结论 助产士心理护理是人性化护理的重要体现,可缓解初产妇的不良情绪,帮助产妇正确用力,缩短产程,提高阴道分娩率.     

人性化护理对提高产妇自然分娩率的价值分析

目的：本文通过分析在本院住院分娩的初产妇进行全程陪伴分娩与人性化护理干预的临床资料,探讨人性化护理在提高自然分娩率方面的临床价值。方法：选取2008年11月～2009年10月在本院住院分娩的初产妇400例,随机分为两组,观察组进行人性化护理分娩,对照组进行传统护理模式分娩。结果：观察组产妇的自然分娩率为72.0%,与对照组的41.0%相比差异有统计学意义（P〈0.05）。结论：通过全程陪护分娩的护理方式,加上人性化护理干预措施,能够有效提高自然分娩率,降低剖宫产的比例,确保产妇与婴儿的安全,具有良好的临床价值。     

初产妇应用人性化护理干预分娩的效果分析

目的 观察人性化护理在初产妇自然分娩中的应用效果.方法 300例住院正常足月待产的初产妇随机分为观察组158例和对照组142例,对照组给予常规产科护理,观察组采取人性化护理.对两组的分娩方式、疼痛程度进行观察比较.结果 与对照组比较,观察组自然分娩率升高(P<0.05),产妇分娩疼痛程度减轻(P<0.05),差异有统计学意义.结论 人性化护理干预应用于初产妇自然分娩中效果满意,值得借鉴.     

助产士心理护理在初产妇分娩中的应用

目的 分析助产士心理护理在初产妇分娩中的临床效果.方法 选取镇江市丹徒区人民医院2011年5月-2013年2月的住院初产妇100例,按照护理方法的不同分为观察组和对照组,每组50例,对照组采用常规护理,观察组在对照组的基础上采用助产士心理护理,比较两组的护理效果.结果 观察组的第一、第二产程和总产程时间短于对照组（P＜0.05）.两组产妇的第三产程时间比较,差异无统计学意义（P＞0.05）.观察组产后出血量、焦虑、抑郁评分少于对照组,阴道分娩率高于对照组（P＜0.05）.结论 助产士采用心理护理是人性化护理的重要体现,可缓解初产妇的不良情绪,帮助产妇正确使用腹压,缩短产程,提高阴道分娩率.     

助产士引导的全程心理干预对初产妇的临床影响分析

目的助产士引导的全程心理干预对初产妇的临床影响。方法回顾性分析2016年7月～2018年6月徐州市贾汪区人民医院收治分娩的初产妇168例,根据是否由助产士陪护分为观察组(90例)和对照组(78例)。对照组产妇给予常规助产、护理模式。观察组给予助产士引导的全程心理干预对初产妇。观察产妇分娩的产程时间、妊娠结局与新生儿结局。妊娠结局包括剖宫产、自然分娩、胎吸。新生儿结局包括新生儿体重及出生后5分钟Apgar评分。应用焦虑自评量表(SAS)、抑郁自评量表(SDS)于入院时与分娩后24h对患者情绪状态进行评估。观察两组产后并发症发生情况,主要包括宫缩乏力、产后出血、产褥感染、盆腔粘连等。结果与对照组比较,观察者总产程明显缩短,自然分娩率明显升高,剖宫产率及钳产率明显降低,新生儿出生后5分钟Apgar评分明显升高,差异有统计学意义(P 0.05)。观察组新生儿体重较对照组有所升高,但差异无统计学意义(P 0.05)。两组入院时SAS评分和SDS评分比较,差异无统计学差异(P 0.05)。分娩后观察组SAS评分与SDS评分明显低于对照组,差异有统计学意义(P 0.05)。观察组并发症发生率明显低于对照组,差异有统计学意义(17.95%vs 6.66%,χ士引导的全程心理干预可明显改善初产妇焦虑、抑郁心理,提高自然分娩率,缩短产程,有利于新生儿结局,降低产妇产后宫缩乏力、产后出血、产褥感染、盆腔粘连并发症发生率。     

助产士全程陪护配合心理干预对初产妇负性情绪及产程的影响

目的探讨助产士全程陪护配合心理干预对初产妇负性情绪及产程的影响。方法选取2014年6月~2015年12月入住本院的156例初产妇作为研究对象,随机分成观察组和对照组,每组各78例。对照组产妇给予常规助产、护理模式;观察组给予用助产士全程陪护配合心理干预。观察两组的分娩结局与初产妇分娩的各产程时间。应用焦虑自评量表(SAS)、抑郁自评量表(SDS)于入院时与分娩后24h对患者情绪状态进行评估。并对比分析两组产妇并发症发生率。结果观察组中71例初产妇为自然分娩,7例剖宫产,自然分娩率为91.23%;对照组初产妇43例自然分娩,35例剖宫产,自然分娩率为55.13%。两组初产妇自然分娩率比较,差异有统计学意义(χ2=5.386,P0.05)。观察组初产妇自然分娩的总产程用时(7.89±1.52)h,明显低于对照组初产妇自然分娩的总产程用时(12.47±2.07)h,差异均有统计学意义(χ2=5.386,P0.05)。两组产妇入院时,均有轻中度的焦虑、抑郁,两组的SAS、SDS评分无统计学意义(P0.05)。分娩后两组患者焦虑、抑郁情况均有明显好转(P0.05),且观察组SAS评分与SDS评分明显低于对照组,差异有统计学意义(P0.05)。比较两组初产妇产后并发症发生率,观察组明显低于对照组,差异有统计学意义(χ2=8.482,P0.05)。结论助产士全程陪护配合心理干预可以有效缓解初产妇的负性情绪,提高自然分娩率,缩短产程,降低产后并发症发生率,建议在实际工作中推广使用。     

耳穴贴压法潜伏期分娩镇痛对产妇疼痛程度及炎性细胞因子表达的影响

目的评价耳穴贴压法潜伏期分娩镇痛对产妇疼痛程度及炎性细胞因子表达的影响。方法选取我院2018年1月～2019年3月阴道分娩初产妇100例,采用随机数字表法分为观察组和对照组,观察组产妇潜伏期利用耳穴贴压法镇痛,对照组产妇采用传统分娩方式,观察产妇不同时期炎性因子表达水平,比较两组新生儿Apgar评分、第一产程时间、镇痛满意率及VAS评分。结果两组产妇在不同时期的白介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)的蛋白活性差异有统计学意义(P 0.05);在T2～6时期,观察组产妇以上指标明显低于对照组,差异有统计学意义(P 0.05);观察组新生儿在1、5min的Apgar评分与对照组比较差异无统计学意义(P 0.05);观察组第一产程时间、镇痛满意率均显著优于对照组,差异有统计学意义(P 0.05);观察组产妇潜伏期VAS评分显著低于对照组(P 0.05),但活跃期评分两组比较差异无统计学意义(P 0.05)。结论对潜伏期分娩镇痛采用耳穴贴压法可以明显的降低炎性细胞因子的活性,缩短产妇第一产程的时间,降低产妇的疼痛程度,同时还可以增加产妇对镇痛的满意率。     

Role of glutathione in reduction of arsenate and of gamma-glutamyltranspeptidase in disposition of arsenite in rats

Arsenate (AsV), the environmentally prevalent form of arsenic, is converted sequentially in the body to arsenite (AsIII), monomethylarsonic acid (MMAsV), monomethylarsonous acid (MMAsIII), and dimethylarsinic acid (DMAsV) and some trimethylated metabolites. Although the biliary excretion of arsenic in rats is known to be glutathione (GSH)-dependent, involving transport of arsenic-GSH conjugates, the role of GSH in the reduction of AsV to the more toxic AsIII in vivo has not been defined. Therefore, we studied how the fate of AsV is influenced by buthionine sulfoximine (BSO), which depletes GSH in tissues. Control and BSO-treated rats were given AsV (50 micromol/kg, i.v.) and arsenic metabolites in bile, urine, blood and tissues were analysed by HPLC-HG-AFS. BSO increased retention of AsV in blood and tissues and decreased appearance of AsIII in blood, bile (by 96%) and urine (by 63%). The biliary excretion of MMAsIII was also nearly abolished, the appearance of MMAsIII and MMAsV in the blood was delayed and the renal concentrations of these monomethylated arsenicals were decreased by BSO. Interestingly, appearance of DMAsV in blood and urine remained unchanged and the concentrations of this metabolite in the kidneys and muscle were even increased in response to BSO. To test the role of gamma-glutamyltranspeptidase (GGT) in arsenic disposition, the effect of the of the GGT inhibitor acivicin was investigated in rats injected with AsIII (50 micromol/kg, i.v.). Acivicin lowered the hepatic and renal GGT activities and increased the biliary as well as urinary excretion of GSH, but failed to alter the disposition (i.e. blood and tissue concentrations, biliary and urinary excretion) of AsIII and its metabolites. In conclusion, shortage of GSH decreases not only the hepatobiliary transport of arsenic, but also reduction of AsV and the formation of monomethylated arsenic, while not hindering the production of dimethylated arsenic. While GSH plays an important role in the disposition and toxicity of arsenic, GGT, which hydrolyses GSH and GSH conjugates, apparently does not influence the fate of the GSH-reactive trivalent arsenicals in rats.     

微透析取样技术在中药体内分析中的应用研究进展

本文综述了微透析取样技术在中药体内分析中的应用,介绍微透析取样技术的原理、组成、探针类型、特点,重点阐述了微透析取样技术在测定脑、血液、皮肤等组织器官中中药有效成分浓度的应用实例。表明微透析取样技术在中药药效研究中具有广阔的前景。     

应用PASS系统分析我院2010年住院医嘱

目的:了解我院2010年住院患者的合理用药情况,探讨如何利用合理用药监测系统( PASS)提高合理用药水平.方法:利用PASS对我院2010年15 966例住院患者的1 184 997条用药医嘱进行监测,以黑色警示医嘱为依据,收集不合理用药信息,并对监测结果进行统计、分析.结果:不合理用药医嘱50 261条,发生率为4.24％.绝对禁止黑色医嘱5441条,主要为药物相互作用(66.54％)、注射液体外配伍(17.86％)、用法用量(15.46％)、儿童警告(1.14％).结论:应用PASS系统能有效监测医嘱中的不合理用药情况,有利于提高临床合理用药水平,但PASS系统尚存在局限性,有待进一步完善.     

Changes in levels of dependency and predictors of mortality in elderly people in institutional care in Dunedin

The 1983 study of dependency of subjects in institutional care in Dunedin was repeated two years later. A significant increase in levels of dependency in residential homes, particularly in the Religious and Welfare sector was found. In 1983 there were 29 high dependency residents and 73 medium dependency residents in residential homes. In 1985 these numbers had increased to 55 and 86 respectively. There was no change in the number of low dependency residents. In 1983, 6 high dependency residents had been admitted to residential home care in the year prior to the study. In 1985 the number of high dependency residents recently admitted had increased to 23. There had also been a significant increase in the dependency of patients in Religious and Welfare continuing care hospitals. Of the 933 subjects in institutional care in 1983 who were able to be followed, 354 (37.9%) died in the following 2 years. Mortality rate was higher for those in hospital care (48.1%) than for those in residential home care (29.6%). Mortality rates were higher in more dependent subjects and this was evident for each measure of dependency.     

应用PASS系统对我院2008年住院医嘱的分析

目的监测分析2008年我院住院患者用药情况。方法将PASS系统嵌入医生工作站、临床药学工作站等子系统,构建合理用药计算机网络系统,对住院医嘱进行及时监测,将监测结果向医生反馈,并对其进行统计、分析。结果2008年共监测医嘱3 620 241条,不合理医嘱908条,占0.02%。不合理医嘱中,配伍禁忌(381条)占41.96%,用法用量(381条)占41.96%,药物相互作用(108条)占11.89%,儿童用药(38条)占4.19%。经与医生沟通后,更改不合理医嘱856条,占94.27%。结论PASS系统可有效监测医嘱中的不合理用药,通过与医生交流,大大减少药物不良事件的发生,值得临床推广应用,也为临床药师开展工作带来了极大的便利。但PASS系统尚存在局限性,有待进一步完善。     

Role of desacetylation in the detoxification of cephalothin in renal cells in culture

The toxicity of three cephalosporin antibiotics to rabbit kidney cells in culture was compared to their known nephrotoxic potential in vivo (cephaloridine greater than cefazolin greater than cephalothin). While cephalothin is considered to be a relatively nonnephrotoxic cephalosporin when administered to many species including humans and rabbits, in several in vitro systems involving rabbit renal tissue, cephalothin was comparatively more toxic than anticipated based on in vivo data. Cephalothin is extensively desacetylated in rabbits to a less microbiologically active metabolite, desacetylcephalothin. When a microsomal S9 fraction from rabbit kidney was added to the in vitro assay in cultured rabbit renal cells, cephalothin was desacetylated and its toxicity to kidney cells was reduced. The addition of S9 in vitro provided a toxicity ranking of the cephalosporins that correlated with their known in vivo nephrotoxic potentials (cephaloridine greater than cefazolin greater than cephalothin). The in vitro detoxification of cephalothin by S9 was blocked by the coadministration of the esterase inhibitor, aminocarb. Desacetylcephalothin was relatively nontoxic to rabbit renal tissue in vitro. These results suggest that the desacetylation of cephalothin in vivo represents a previously unrecognized mechanism of detoxification of this cephalosporin antibiotic. Furthermore, this mechanism of detoxification may be applicable to other acetylated cephalosporins.     

2009年某院住院患者抗真菌药用药调查

目的:分析讨论某院抗真菌药使用的合理性,为临床安全有效地使用抗真菌药提供参考。方法:回顾性统计分析某院2009年住院患者抗真菌药用药信息。结果:2009年某院住院患者抗真菌药DDDs排名前3名分别为:氟康唑、制霉菌素和伊曲康唑;使用金额排名前3名分别为:氟康唑、米卡芬净及卡泊芬净;更换一种抗真菌药进行治疗的患者数为176人,在全部患者中占13.4%。结论:应进一步强化用药指征的意识,提高标本送检率,同时改善某些抗真菌用药不合理更换的现象,以避免耐药性发生,从而更好更长远地体现抗真菌药的治疗价值。     

Kinetics of in vitro metabolism of methoxyphenamine in rats

1. Methoxyphenamine (MP) was metabolized in vitro by rat liver preparations to O-desmethylmethoxyphenamine (O-desmethyl-MP), N-desmethylmethoxyphenamine (N-desmethyl-MP) and 5-hydroxymethoxyphenamine (5-hydroxy-MP). These metabolic pathways were inhibited by SKF 525-A and carbon monoxide, which indicates that these reactions were mediated at least partly by an NADPH-dependent cytochrome P-450 system. 2. Strain differences in the metabolism of this drug in vitro were observed in female Lewis and Dark Agouti (DA) rats, which are proposed models for human debrisoquine phenotypes. Methoxyphenamine O-demethylase and 5-hydroxylase activity in DA rats were lower than those in Lewis rats. 3. The metabolic transformation of methoxyphenamine in vitro to O-desmethyl-MP was inhibited competitively by debrisoquine and sparteine. This indicates that the cytochrome P-450 isoenzyme mediating the metabolism of MP to O-desmethyl-MP is similar to that mediating metabolism of debrisoquine and sparteine. However, no inhibition was observed with methenytoin.     

Comparison of in vitro cell models in predicting in vivo brain entry of drugs

Although several in vitro models have been reported to predict the ability of drug candidates to cross the blood-brain barrier, their real in vivo relevance has rarely been evaluated. The present study demonstrates the in vivo relevance of simple unidirectional permeability coefficient (P(app)) determined in three in vitro cell models (BBMEC, Caco-2 and MDCKII-MDR1) for nine model drugs (alprenolol, atenolol, metoprolol, pindolol, entacapone, tolcapone, baclofen, midazolam and ondansetron) by using dual probe microdialysis in the rat brain and blood as an in vivo measure. There was a clear correlation between the P(app) and the unbound brain/blood ratios determined by in vivo microdialysis (BBMEC r=0.99, Caco-2 r=0.91 and MDCKII-MDR1 r=0.85). Despite of the substantial differences in the absolute in vitro P(app) values and regardless of the method used (side-by-side vs. filter insert system), the capability of the in vitro models to rank order drugs was similar. By this approach, thus, the additional value offered by the true endothelial cell model (BBMEC) remains obscure. The present results also highlight the need of both in vitro as well as in vivo methods in characterization of blood-brain barrier passage of new drug candidates.