语言刺激在老年患者静脉注射中的应用研究

目的探讨不同语言刺激对老年患者静脉注射时的疼痛反应差异及原因。方法选择2013年1~12月收治的220例老年患者,随机分为正性语言刺激组和负性语言刺激组各110例。在静脉注射前分别给予相应的正性语言刺激和负性语言刺激,比较两组患者自我疼痛感觉及相关指标差异。结果负性语言刺激组在满意度测评、疼痛程度方面优于正性语言刺激组,差异有统计学意义(P<0.05),两组患者在焦虑程度、血压变化、脉搏变化方面比较,差异无统计学意义(P>0.05)。结论负行语言刺激可减轻老年患者静脉注射的疼痛反应,有利于患者的治疗。     

护理干预在小儿腹型过敏性紫癜中的护理效果观察

目的探讨综合性护理干预在腹型过敏性紫癜患儿中的应用效果。方法选择我院腹型过敏性紫癜患儿共60例,上述患者随机分为观察组和对照组。对照组患儿给予腹型过敏性紫癜常规护理干预,观察组患儿给予综合性护理干预。采用视觉模拟评分法对两组患儿护理干预后腹痛疼痛程度进行评分。采用Hamilto焦虑量表对两组患儿护理干预后焦虑状态进行评分。结果观察组护理干预后疼痛评分低于对照组,差异有统计学意义(P<0.05)。观察组患儿护理干预后躯体焦虑、精神焦虑和焦虑总分评分均低于对照组,差异有统计学意义(P<0.05)。结论有效的护理干预能够显著改善腹型过敏性紫癜患儿焦虑状态,缓解腹痛,护理效果显著,值得借鉴。     

盐酸曲马多治疗学龄期儿童麻醉苏醒期导尿管不适

目的观察术毕前静脉注射曲马多治疗学龄期患儿全身麻醉苏醒期间导尿管不适感的疗效。方法将择期泌尿系统手术男性患儿50例按数字随机法分成治疗组和观察组,治疗组静脉注射盐酸曲马多1 mg/kg(稀释成10 mL),观察组静脉注射0.9%氯化钠注射液10 mL。术毕拔管于麻醉恢复室进行导尿管不适感评估,观察并记录恶心、呕吐发生情况并进行镇静程度评分。结果治疗组患儿尿管不适中度及重度低于观察组,差异有统计学意义(P<0.05或P<0.01);治疗组轻度恶心的发生率高于观察组,差异有统计学意义(P<0.05);镇静评分方面,治疗组轻度镇静患儿多于观察组,差异有统计学意义(P<0.05)。结论术毕前静脉注射曲马多能缓解学龄期患儿全身麻醉苏醒期间导尿管不适感。     

术前应用右美托咪定对学龄前儿童的有效性探讨

目的探讨术前应用右美托咪定对学龄前儿童术前焦虑和应激激素的影响。方法择期行下腹部手术的学龄前患儿100例,随机分右美托咪定组(D组)和对照组(C组),各50例,D组右美托咪定0.5μg/kg稀释到20 ml,C组为等量生理盐水,单次静脉微量泵注,20 min内泵注完毕。在病房泵注前(T1)、病房泵注结束(T2)2个时间点,以改良耶鲁围术期焦虑量表(m YPAS)评估焦虑水平;所有患儿于术前1 d同一时刻和麻醉前取血测去甲肾上腺素(NE)、肾上腺素(E)、皮质醇(CS)。结果两组患儿在T1时刻焦虑程度差异无统计学意义(P>0.05);D组患儿在T2时刻的焦虑评分明显低于C组,差异具有统计学意义(P<0.01)。C组患儿焦虑评分T2时刻明显高于T1,差异有统计学意义(P<0.05),D组患儿T1、T2时刻焦虑评分差异无统计学意义(P>0.05)。两组患儿术前1 d所测E、NE、CS差异无统计学意义(P>0.05)。C组麻醉前E、NE、CS明显高于术前1 d,差异具有统计学意义(P<0.01),D组麻醉前E、NE、CS与术前1 d比较差异无统计学意义(P>0.05);组间比较,D组麻醉前所测E、NE、CS明显低于C组,差异有统计学意义(P<0.01)。结论术前应用右美托咪定干预,可消除患儿焦虑,减少应激激素分泌,减轻其应激反应。     

心理干预对子宫肌瘤手术患者的影响

目的探讨心理干预对子宫肌瘤手术患者的影响。方法将62例子宫肌瘤患者随机分为观察组和对照组各31例。2组患者均采用手术治疗子宫肌瘤,在入院时即给予子宫肌瘤常规护理。观察组在常规护理基础上实施心理干预,包括入院时心理护理、术前心理护理、术后心理护理。采用焦虑自评量表(SAS)和抑郁自评量表(SDS)对2组患者护理干预前和干预后进行焦虑和抑郁程度评定,观察2组患者对术中疼痛强度的反应。结果观察组护理干预后焦虑、抑郁评分均低于对照组,差异有统计学意义(P<0.05)。观察组无痛、轻微不适及不适22例占71.0%,对照组无痛、轻微不适及不适9例占29.0%,2组比较差异有统计学意义(P<0.05)。结论心理护理干预能够改善子宫肌瘤手术患者的负性情绪,有助于减轻术中疼痛,护理效果显著。     

心理护理干预对传染病患者负性情绪的效果观察

目的观察心理护理干预对传染病患者负性情绪的影响,为临床护理工作提供参考。方法将218例传染病患者随机分为观察组和对照组各109例。全部患者均给予常规基础护理干预,观察组在此基础上给予心理护理干预。比较2组焦虑抑郁程度及护患满意率。结果与护理干预前比较,2组焦虑自评量表(SAS)、抑郁自评量表(SDS)评分均有不同程度的下降;观察组下降程度明显大于对照组,差异均有统计学意义(P<0.05)。观察组护患满意率为99.08%明显高于对照组的92.66%,差异有统计学意义(P<0.05)。结论心理护理干预对改善传染病患者负性情绪具有积极的临床意义,并可增进护患关系,值得推广应用。     

赏识教育配合功能锻炼干预对儿童下肢干骺端骨折功能恢复的影响

目的：探讨赏识教育配合功能锻炼干预对儿童下肢干骺端骨折功能恢复的影响。方法：选择2020年5月—2021年5月收治的121例儿童下肢干骺端骨折患儿为研究对象,按随机数字法分为观察组(61例)和对照组(60例)。对照组实施常规治疗和功能锻炼,观察组在此基础上配合赏识教育。干预4周后,比较两组患儿的患肢疼痛程度、肿胀情况、锻炼依从率及下肢功能恢复状况。结果：干预前,两组患儿视觉模拟量表(VAS)评分比较差异无统计学意义(P>0.05);干预后,两组VAS评分均降低(P<0.05),且观察组VAS评分低于对照组,差异有统计学意义(P<0.05)。干预后两组患儿肿胀值均下降,且观察组低于对照组(P<0.05)。观察组患儿的锻炼依从率高于对照组,差异有统计学意义(P<0.05)。干预前,两组患儿功能恢复评分比较差异无统计学意义(P>0.05);干预后,观察组患儿的功能恢复评分高于对照组,差异有统计学意义(P<0.05)。结论：赏识教育配合功能锻炼干预能加快儿童下肢干骺端骨折的功能恢复,减缓术后疼痛、肿胀情况,提高患儿功能锻炼的依从性。     

精神心理治疗对甲状腺功能亢进患者围手术期疼痛及情绪的影响

目的探讨精神心理治疗对甲状腺功能亢进患者围手术期疼痛及情绪的影响。方法明确诊断后和术前分别使用焦虑自评量表评分,并观察手术中的疼痛情况,分别比较两组间的上述两种指标。结果实验组确诊后和术前焦虑程度评分低于对照组,两组比较差异有统计学意义(P<0.05);手术中疼痛程度低于对照组(P<0.01),两组之间比较差异有统计学意义。结论实施精神心理治疗可改善患者围手术期疼痛和焦虑程度。     

手足口病患儿血清hs-CRP、PCT水平和血气分析检测的临床意义

目的:观察手足口病(HFMD)患儿超敏 C 反应蛋白(hs-CRP)、降钙素原(PCT)水平和血气分析结果的变化,探讨其临床意义。 方法:将收治的 102 例 HFMD 患儿分为普通组(n=40)、重症组(n=35)和危重症组(n=27),另选择 30 例健康儿童为对照组。 检测各组患儿血清 hs-CRP、PCT 水平和血气分析[动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、血乳酸(Lac)和酸碱度(pH)]指标。 结果:经单因素方差分析(one-way ANOVA),四组患儿血清 hs-CRP 和 PCT 浓度比较差异有统计学意义(P<0.05);三组 HFMD 患儿血清 hs-CRP 和 PCT 浓度均高于对照组,差异有统计学意义(P<0.05);危重症组患儿血清 hs-CRP 和PCT 浓度均高于其他各组,差异有统计学意义(P<0.05);重症组患儿血清 hs鄄CRP 和 PCT 浓度均高于普通组,差异有统计学意义(P<0.05)。 危重症组患儿 PaO2 和 pH 低于普通组和对照组,PaCO2和Lac水平高于普通组和对照组,差异均有统计学意义(P<0.05);重症组患儿 PaO2 和 pH 水平低于对照组,PaCO2 和 Lac 水平高于对照组,差异均有统计学意义(P<0.05);普通组PaO2 和 pH 水平略低于对照组,PaCO2 和 Lac 水平略高于对照组,但差异均无统计学意义(P>0.05)。 结论:血清 hs-CRP、PCT水平和血气分析指标与 HFMD 患儿病情严重程度存在相关性,可作为早期诊断 HFMD 的参考指标。     

心理护理对甲状腺手术患者66例效果的影响

目的观察心理护理对甲状腺手术患者的临床效果。方法 132例甲状腺手术患者随机分为观察组和对照组各66例,对照组给予甲状腺围手术期常规护理,观察组在对照组护理基础上给予心理护理,比较2组汉密尔顿焦虑量表(HAMA)评分及术后疼痛程度。结果观察组术前、术后HAMA评分均低于对照组,差异有统计学意义(P<0.05和P<0.01);术后疼痛轻于对照组,差异有统计学意义(P<0.05)。结论心理护理能降低甲状腺手术患者应激反应,缓解患者焦虑、恐惧情绪,减轻患者术后疼痛程度。     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

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.

     

Lung disease and PKCs

The lung offers a rich opportunity for development of therapeutic strategies focused on isozymes of protein kinase C (PKCs). PKCs are important in many cellular responses in the lung, and existing therapies for pulmonary disorders are inadequate. The lung poses unique challenges as it interfaces with air and blood, contains a pulmonary and systemic circulation, and consists of many cell types. Key structures are bronchial and pulmonary vessels, branching airways, and distal air sacs defined by alveolar walls containing capillaries and interstitial space. The cellular composition of each vessel, airway, and alveolar wall is heterogeneous. Injurious environmental stimuli signal through PKCs and cause a variety of disorders. Edema formation and pulmonary hypertension (PHTN) result from derangements in endothelial, smooth muscle (SM), and/or adventitial fibroblast cell phenotype. Asthma, chronic obstructive pulmonary disease (COPD), and lung cancer are characterized by distinctive pathological changes in airway epithelial, SM, and mucous-generating cells. Acute and chronic pneumonitis and fibrosis occur in the alveolar space and interstitium with type 2 pneumocytes and interstitial fibroblasts/myofibroblasts playing a prominent role. At each site, inflammatory, immune, and vascular progenitor cells contribute to the injury and repair process. Many strategies have been used to investigate PKCs in lung injury. Isolated organ preparations and whole animal studies are powerful approaches especially when genetically engineered mice are used. More analysis of PKC isozymes in normal and diseased human lung tissue and cells is needed to complement this work. Since opposing or counter-regulatory effects of selected PKCs in the same cell or tissue have been found, it may be desirable to target more than one PKC isozyme and potentially in different directions. Because multiple signaling pathways contribute to the key cellular responses important in lung biology, therapeutic strategies targeting PKCs may be more effective if combined with inhibitors of other pathways for additive or synergistic effect. Mechanisms that regulate PKC activity, including phosphorylation and interaction with isozyme-specific binding proteins, are also potential therapeutic targets. Key isotypes of PKC involved in lung pathophysiology are summarized and current and evolving therapeutic approaches to target them are identified.     

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.     

Gender-related symptoms and correlates of alcohol dependence among men and women with a lifetime diagnosis of alcohol use disorders

This study explored gender-related symptoms and correlates of alcohol dependence in a crosssectional study of 150 men and 150 women with a lifetime diagnosis of alcohol use disorders (AUD). Participants were recruited in equal numbers from treatment settings, correctional centres and the general community. Standardized measures were used to determine participants' use of substances, history of psychiatric disorders and psychosocial stress, their sensation seeking and family history of substance use and mental health disorders. Multivariate analyses were used to detect patterns of variables associated with gender and the lifetime severity of AUD. Men had a longer history of severe AUD than women. Women had similar levels of alcohol dependence and medical and psychological sequelae as men, despite 6 fewer years of AUD. More women than men had a history of severe psychosocial stress, severe dependence on other substances and antecedent mental health problems, especially mood and anxiety disorders. There were differences in family history of alcohol-related problems approximating same-gender aggregation. The severity of a lifetime AUD was predicted by its earlier age at onset and the occurrence of other disorders, especially anxiety, among both men and women. The limitations in the generalizability of these findings due to sample idiosyncrasies are discussed.     

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.