基于人文理念的护理质量例会实践与体会

建立以人文理念为核心的护理质量分析例会制度，每月召开门诊护士长、护士组长、护士代表例会，分析、讲评门诊护理服务中存在的问题，并提出改进方案，持续改进门诊护理服务质量。     

Effects of decreased insulin-like growth factor-1 stimulation on hypoxia inducible factor 1-α protein synthesis and function during cutaneous repair in diabetic mice

Insulin-like growth factor-1 (Igf-1), a critical mediator of tissue repair, is significantly decreased in diabetic wounds. Furthermore, decreased levels of hypoxia-inducible factor 1-alpha (Hif-1alpha) and its target genes are also associated with impaired wound healing in diabetic mice. The aim of our study was to examine whether the reduced levels of Igf-1 are responsible for the reduction in Hif-1alpha protein synthesis and activity in diabetic wounds. We provide evidence that Igf-1 regulates Hif-1alpha protein synthesis and activity during wound repair. In addition, Igf-1 stimulated phosphytidylinositol 3-kinase activity in diabetic fibroblasts, which, in turn, increased activation of the translational regulatory protein, p70 S6 kinase. Moreover, improved healing of diabetic wounds by addition of recombinant IGF-1 protein was associated with an increase in Hif-1alpha protein synthesis and function in vivo.     

氨溴索对慢性阻塞性肺疾病大鼠模型肺的保护作用

①目的　探讨氨溴索对肿瘤坏死因子α(TNF α)在慢性阻塞性肺疾病 (COPD)大鼠模型肺内表达与分布的影响以及肺泡Ⅱ型上皮细胞超微结构的影响。②方法　实验大鼠随机分为 3组 :健康对照组 (n =8) ,COPD模型组 (n =1 2 ) ,氨溴索干预组 (n =1 2 )。采用熏吸香烟并气管内注入脂多糖法建立大鼠COPD模型 ,氨溴索干预组于COPD模型开始建立时腹腔注射氨溴索溶液 4 0mg/ (kg·d) ,连续 4 0d。观察各组气道炎症的病理特点、超微结构特点、血气指标、肺泡平均内衬间隔、平均肺泡数。应用原位杂交法检测TNF α基因表达的相对含量。③结果　所建COPD模型的病理以及病理生理学改变符合人类COPD的特点。氨溴索干预组肺泡平均内衬间隔、平均肺泡数、TNF α表达强度与健康对照组、COPD模型组比较差异有显著性 (F =3.2 4～ 1 1 .1 1 ,q =4 .74～ 36 .2 2 ,P <0 .0 1 ) ;动脉血氧分压、二氧化碳分压差异亦有显著性 (F =3.30、8.79,q =3.5 0～ 8.6 9,P <0 .0 5 )。 ④结论　长期应用氨溴索对COPD大鼠模型气道炎症有明显的抑制作用     

68例社区获得性肺炎病原及临床特征分析

目的　 68例外周血白细胞正常或降低的社区获得性肺炎 (CAP)病原及临床特点分析。方法　检测CAP患者呼吸道及血液标本的常见病原体 ,并分析其临床特点。结果　军团菌属占 2 2 .1 % (1 5/ 68) ,肺炎支原体占 1 1 .8% (8/ 68) ,病毒占 1 6 .2 % (1 1 / 68) ,其中甲型流感病毒 2例、乙型流感病毒 5例 ,副流感病毒 1例 ,腺病毒 1例 ,艾滋病病毒 2例。细菌占 2 .9% (2 / 68) ,有 47.1 % (32 / 68)不能明确病原体 ,混合感染率为 8.8% (6/ 68)。病毒性肺炎、军团菌肺炎及肺炎支原体肺炎的临床症状、体征、外周血白细胞、胸部影像均无特异性 ,其鉴别需靠病原学检查。结论　外周血白细胞正常或降低的CAP病因主要为非典型病原体和病毒 ,对此类CAP的经验治疗应首选大环内酯类抗生素或抗病毒药物。     

当归对肺纤维化大鼠肺形态学及胶原的影响

目的　观察当归对博莱霉素所致的肺间质纤维化大鼠的肺形态学及胶原的影响 ,探讨其作用机制。方法　 36只大鼠随机分为对照组、模型组及当归组。气管内注入博莱霉素复制大鼠肺间质纤维化模型 ,次日当归组每日腹腔内注射当归注射液 15 0mg/kg,于第 7及第 2 8天每组分别处死 6只大鼠 ,观察肺间质纤维化形成的病理变化及血清Ⅰ型胶原的含量。结果　当归能明显减轻肺泡炎和肺纤维化程度 ,与模型组比较 ,当归组血清Ⅰ型胶原含量于第 7、 2 8天明显降低 (P均 <0 0 5 )。结论　当归能减慢肺间质纤维化的进程 ,对肺间质纤维化有一定的保护作用。     

《金匮要略》通便法探析

通便法即指运用通大便的方法使燥屎、瘀血、宿食、痰饮及虫积等有形之邪从大便而出的一种方法。本文结合《金匮要略》原文对仲景对该法的运用加以探讨。     

Targeted Thrombolytic Therapy

Venous and arterial thrombosis are closely related to many severe diseases, especially to cardiovascular and cerebrovasular disorders. Thrombolytic therapy has been proven to be an effective method to treat such disease, which decreased the mortality and morbidity greatly.