人文关怀护理干预对门诊护理服务满意度的影响

目的了解通过人文关怀护理干预后就诊者对门诊护士满意度影响。方法护理服务质量满意度调查表共设置17条,每条项目有"满意"、"基本满意"、"不满意"3项选择或"是"与"否"2项选择。"满意"、"基本满意"、"是"项列入优良项目数,"不满意"、"否"项列入不良项目数。对人文关怀护理干预及常规护理的就诊者各50例采用门诊现场问卷调查和集中填表相结合的方式进行满意度调查。结果分别收到人文关怀护理干预组及常规护理组就诊者对门诊护理服务综合评价不良项目179条和21条,两者比较有统计学意义(P<0.05)。结论对门诊就诊者进行人文关怀护理干预可提高门诊护理服务质量及就诊者的满意度。     

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??OBJECTIVE To investigate the correlation of blood concentration and drug dose and reducing lipid efficacy of tectorigenin in atherosclerosis rabbits. METHODS Forty-eight Japanese white rabbits were randomly divided into six groups, the normal control group, model group, high-, middle-and low-dose (50, 25, 12.5 mg??kg^-1??d^-1) tectorigenin groups and atorvastatin (5 mg??kg^-1??d^-1) group. The normal control group was fed with routine forage, and the other groups were fed with high fat forage for the establishment of atherosclerosis model. After 8 weeks, tectorigenin blood concentration was detected by HPLC. After 12 weeks, blood lipids were detected with automatic biochemical analyzer. We sheared the thoracic and abdominal aorta to observe the formation of atherosclerotic plaque and make pathologic examination. RESULTS Steady-state blood concentration increased with the increase of drug dose, there was a positive relationship (r=0.969 1) between them, but not the same proportion. After treatment, serum total cholesterol(TC), triglyceride(TG), low density lipoprotein cholesterol (LDL-C ) levels were decreased and high density lipoprotein cholesterol (HDL-C) were increased in the tectorigenin each dose group, but the effect was weaker than atorvastatin group. CONCLUSION Tectorigenin has obvious effect on reducing blood lipid and anti-atherosclerosis in rabbits, and it is related to the blood concentration and the drug dose.     

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??Oligosaccharide esters have attracted more and more attention along with the study of the chemical constituents of Polygala tenuifolia. Modern pharmacological studies have shown that these compounds have many pharmacological activities, such as neuroprotection, antidepressant effect and improvement of learning ability and memory. This review summarized the research progress of pharmacological effects of oligosaccharide esters from Polygala tenuifolia to provide clues for further study of the neuroprotective effects of Polygala tenuifolia.     

Inflammation Level after Decompression Surgery for a Rat Model of Chronic Severe Spinal Cord Compression and Effects on Ischemia-Reperfusion Injury

Delayed neurological deterioration in the absence of direct spinal cord insult following surgical decompression is a severe postoperative complication in patients with chronic severe spinal cord compression (SCC). The spinal cord ischemia-reperfusion injury (IRI) has been verified as a potential etiology of the complication. However, the exact pathophysiologic mechanisms of the decompression-related IRI remain to be defined. In this study, we developed a practical rat model of chronic severe SCC. To explore the underlying role of inflammation in decompression-related IRI, immunoreactivity of pro-inflammatory cytokines including tumor necrosis factor-alpha (TNF-α) and interleukin-1β (IL-1β) before and after decompression were measured. In addition, expression level of TNF-α and IL-1β was examined with Western blot. Immunohistochemical staining showed negative result in gray matters in the sham group and sham-decompression group. In the severe compression group, strong positive staining of TNF-α and IL-1β were found, suggesting a dramatic infiltration of inflammatory cells in gray matters. Furthermore, the severe compression group showed a significant increase in expression level of TNF-α and IL-1β as compared with the sham group (p < 0.05). In the severe compression-decompression group, both immunostaining and Western blot showed significant increase of TNF-α and IL-1β levels in the spinal cord compared with the severe compression group (p < 0.05). The results demonstrated that surgical decompression plays a stimulative role in inflammation through increasing the expression of inflammatory cytokines in the rat model of chronic severe SCC injury. Inflammation may be one of the important pathological mechanisms of decompression-related IRI of chronic ischemia.     

外科机器人在头颈部肿瘤手术中的应用进展

近年来,适用于头颈部肿瘤的外科机器人的研发取得了长足的进步,达芬奇机器人手术系统已经更新到第4代,单孔柔性机器人、Flex机器人等外科机器人不断涌现,增强现实、术中超声、荧光成像等新技术也相继被应用到外科机器人研发中。本综述主要阐述了这些外科机器人的特点,并依次对其在口咽、喉、下咽、咽旁间隙等头颈部肿瘤中的应用现状、优势及不足等进行概述。     

儿童多发性硬化生活能力、神经心理和眼科预后长期随访观察

目的通过对儿童多发性硬化（MS）系统随访,总结其躯体、心理预后及视力特点。方法回顾性收集首都医科大学附属北京儿童医院近10年来经McDonald诊断标准评估确诊的MS病历,对病程3年以上的MS病例进行系统的随访,随访内容包括日常生活活动能力评估（ADL）,扩展的功能障碍量表评分（EDSS）,神经心理评估（抑郁、焦虑、注意力、社会生活能力）和智力检测,眼科检查［最佳矫正视力、光学相干断层扫描(OCT)测量视神经纤维层(RNFL)厚度、图形视觉诱发电位(P-VEP)］等,对预后进行综合分析。 结果23例MS患儿进入分析。男10例,女13例,平均起病年龄7.7岁;复发缓解型20例,进展复发型2例,继发进展型1例。23例均复发,次数1～10次。平均随访7.7（3.6～14）年,均行ADL评分,完全依赖和中度依赖各1例,均为进展复发型;16例行EDSS评分,EDSS 0分 11例,EDSS≤2.5分4例,EDSS 4.0分1例（为进展复发型）;15例完成神经心理检查,韦氏智力测验2例低于平常,2例边界,1例社会适应能力临界,6例存在注意力缺陷,4例存在轻度焦虑情绪,均无抑郁情绪。16例患儿32眼完善眼科检查,30眼矫正视敏度0.5～1.5,视野无异常,余2眼仅存光感;合并视神经炎MS患儿眼底均提示视神经萎缩,OCT检查结果显示视神经眼在各个象限的RNFL厚度与无视神经炎眼相比明显变薄（P＜0.001）;P-VEP检查中视神经炎眼较无视神经炎眼P100潜伏期明显延长,振幅明显减低（P＜0.05） 结论儿童MS复发缓解型预后尚好,多合并视神经萎缩,但无视力严重受损;其他类型预后差,多遗留躯体残疾及视力残疾,OCT检查可对视神经受累程度定量测定。儿童MS可出现认知损害、焦虑和注意力缺陷等多种神经心理问题。     

千草脑脉通合剂活血作用研究

目的考察千草脑脉通合剂的活血作用。方法建立大鼠动静脉旁路血栓模型和大鼠血瘀模型,观察药物对于血栓形成、血液粘度和凝血四项的影响。结果千草脑脉通对于ADP(二磷酸腺苷)诱导的血小板聚集无抑制作用,但是可以抑制血栓形成,降低血液粘度,延长活化部分凝血酶时间,减少血浆纤维蛋白原含量。结论千草脑脉通合剂可以显著改善血液流变学和凝血四项参数,具有较好的活血作用。     

褪黑素治疗重症急性胰腺炎的机制研究

褪黑素是一种高效的内源性抗氧化剂,不仅可以有效清除氧自由基,还可通过抑制NF-κB的激活而发挥抗炎作用。最新研究表明,针对急性重症胰腺炎的两个重要发病学说,褪黑素具有靶向治疗作用。     

分析探讨更年期卵巢衰退动物模型与肾虚动物模型

文章对现存更年期卵巢衰退动物模型与肾虚动物模型进行了深入的分析探讨,提出了西医卵巢衰退理论与中医肾虚理论相结合的新理念,为建立更为接近临床更年期综合征症状的动物模型的提供新思路。