高职高专涉外护理专业药理学课程改革

目的探讨涉外护理专业药理学教学改革的方法与效果。方法采取便利取样法,选择2008级专科涉外护理专业的一个班为试验组(n=40),另一个班为对照组(n=40)。试验组采用多种教学方法和《护理药物学》教材,对照组采用传统教学方法和原有的《药理学》教材。比较两组理论考试成绩,并采用自制问卷对试验组学生和临床授课教师进行调查。结果试验组理论考试成绩显著高于对照组(P0.01)。试验组95%的学生认为《护理药物学》内容充实、重点突出,教学形式多样;100%临床教师认为试验组学生提高了学习能力,知识较全面。结论突出护理专业特色的教学改革,有利于提高学生主动学习的积极性和学习效果。     

超敏C反应蛋白与初诊2型糖尿病下肢血管病变的相关性研究

目的 探讨超敏C反应蛋白(hsCRP)与初诊2型糖尿病(T2DM)下肢血管病变发生的关系.方法 测定正常对照组(A组)、初诊T2DM患者(B组)、初诊T2DM下肢血管病变患者(C组)的hsCRP水平和踝肱指数(ABI)变化.结果 与ABI正常的A组相比,ABI正常的B组和ABI降低的C组hsCRP、体质量指数、腰臀围比、收缩压、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、糖化血红蛋白(HbA1 c)显著升高或增加(P＜0.01或P＜0.05)、高密度脂蛋白胆固醇(HDL-C)显著下降(P＜0.05);C组hsCRP(1.10±0.36)vs(0.88±0.36)、LDL-C(4.20±1.09)mmol/L vs(3.25±1.04)mmol/L、HbAlc(10.11± 3.92)%vs(8.10±1.51)%明显高于B组(P＜0.01或P＜0.05),HDL-C明显低于B组(1.24±0.32)mmol/L vs(1.36±0.26)mmol/L(P＜0.05).logisitic回归分析显示,hsCRP是初诊T2DM下肢血管病变独立的危险因子(P=0.029).结论 hsCRP与初诊T2DM的发生相关,升高的hsCRP是促使初诊T2DM并发下肢血管病变的独立危险因素.     

碘缺乏与碘过多大鼠甲状腺定量形态学研究

目的　研究碘缺乏与碘过多对大鼠甲状腺形态结构的影响。方法　将 Wistar大鼠随机分为 3组 ,适碘组 (NI)、高碘组 (HI)、低碘组 (L I) ,观察喂养 12周、2 4周大鼠甲状腺形态结构的变化 ,应用 MIAS- 2 0 0 0型图像分析系统 ,对甲状腺滤泡及滤泡腔进行形态定量测定 ,获得 5项体视学参数 (平均体积 V、平均表面积 S、比表面积 S/ V、数密度 Nv及球形因子 SF)和 1项截面积的定量参数。结果　低碘组大鼠甲状腺滤泡及滤泡腔的 V、S及 SF均明显小于适碘组 ,而 S/ V和 Nv明显大于适碘组 ,上皮细胞体积明显增大 ;高碘组滤泡在实验过程中无明显改变 ,而滤泡腔 V、S在实验的 2 4周时均明显小于适碘组 ,上皮细胞体积增大。结论　碘缺乏导致大鼠甲状腺小滤泡增生性甲肿改变 ,而碘过多在实验中未形成甲肿 ,并随碘过多时间的延长 ,滤泡腔变小 ,上皮细胞增生。     

甲氰咪胍治疗新生儿急性胃粘膜出血60例

1998年 1月～ 2 0 0 1年 12月 ,我们应用甲氰咪胍治疗 60例急性胃粘膜出血新生儿 ,效果满意。现报告如下。临床资料 :本组 60例中男 3 5例 ,女 2 5例 ;入院日龄 :～2 4h者 18例 ,～ 3天者 2 9例 ,～ 7天者 6例 ,～ 14天者 7例。早产儿 10例 ,足月儿 45例 ,过期儿 5例。缺氧缺血性脑病 42例 ,颅内出血和化脓性脑膜炎各 9例。除原发病表现外 ,其急性胃粘膜出血的表现为突然呕吐咖啡样或鲜红色液体 ,腹胀 ,肠鸣音减弱或消失。少数患儿排果酱样大便。累积出血量 <5 0 ml(轻度出血 )者 15例 (2 5 % ) ,5 0～ 10 0 ml(中度出血 )者 3 6例 (60 % ) …     

甲状腺功能减退症患者左心室功能改变的临床研究

甲状腺功能减退症(简称甲减),是由于甲状腺激素(thyroid-hormone,TH)合成及分泌减少,或其生理效应不足所致机体代谢降低的一种疾病.呈逐年增加趋势,TH缺乏可引起心动过缓,心排出量减少,心包积液和胸腔积液.重症者发生黏液性水肿性心肌病及心肌酶学水平的变化,尤其是血清肌酸激酶的升高,最终导致心脏结构及功能的改变.本研究对我院53例重症甲减患者病史、心肌酶学、超声心动图等变化规律进行了观察,寻找甲减心肌损伤的相关因素,探讨TH水平与左心室功能的关系.     

Comparison of acute toxicities between two postoperative concurrent chemoradiotherapy regimens of capecitabine with or without oxaliplatin in patients with stage Ⅱ and Ⅲ rectal cancer

Objective To compare the acute toxicities between two prospective, non-randomize phase Ⅱ trials on adjuvant radiochemotherapy of capecitabine with or without oxaliplatin in patients with stage Ⅱ and Ⅲ rectal cancer. Methods From March 2005 to November 2007,based on two fulfilled phase Ⅰ studies,two phase Ⅱ trials were launched respectively to further observe the tolerance and toxicity. In one tria1,118 patients were treated with concurrent capecitabine and radiotherapy (Cap-CRT trial), with radio-therapy of DT50 Gy/25 F/5 wks to the pelvis, and capecitabine at a dose of 1600 mg/m2/d(d1-d14,3 weeks per cycle). In the other trial, 90 patients received concurrent oxaliplatin, capecitabine and radiothera-py(Cap-Oxa-CRT trial), with the same radiotherapy schedule, while oxaliplatin at a dose of 70 mg/m2(d1, d8) and capecitabine of 1300 mg/m2/d(d1-d14,3 weeks per cycle). Results There was no significant difference in the delay of radiotherapy (10.2% vs 6.7%, X2=0.80, P=0.460) or chemotherapy (9.3% vs 19.1%, X2=4.80,P=0.090) between Cap-CRT and Cap-Oxa-CRT trials. Grade 1-4 leukopenia,diar-rhea and nausea were the most common acute side-effects in the both trials, accounting for 70.2%, 65.9% and 42.3%, respectively. When comparing with Cap-CRT trial, Cap-Oxa-CRT trial had significantly more grade 1-4 non-hemotological toxicities, mainly in Gl,including nausea (68.9% vs 22.0%, X2=46.90, P= 0.000), diarrbea(76.7% vs 57.6%, X2=13.50, P=0.009), fatigne(47.8% vs 13.7%, X2=18.90,P= 0.000), hand-foot syndrome (14.4% vs 4.2%, X2=7.10, P=0.029), and inappetence (50.0% vs. 27.9%, X2 = 25.70, P=0.000), but not in hematological toxities of leukopenia, anemia or thrombocytope-nia. Of all the patients,grade 3 and grade 4 toxicities were diarrhea(24.0% and 1.0%),leukopenia(4.3% and 0.0%),radiation-induced dermatitis(3.8% and 0.0%),cramping abdominal pain(1.0% and 0.0%) and fatigue(0.5% and 0.0%). Only grade 3 and 4 diarrhea was significantly more in Cap-Oxa-CRT trial than in Cap-CBT trial(33.0% vs 18.6%, X2=5.90,P=0.023). Conclusions For patients with stage Ⅱ and Ⅲ rectal cancer,both the postoperative concurrent radiochemotherapy regimens are tolerable,though Cap-Oxa-CRT trial has more grade 3 and 4 diarrhea.     

护士仪表、语言、行为在护理工作中的作用

临床工作中，护士和患接触最密切、最广泛、最深入，而护士的举止、言行、仪表又都会引起患的复杂反应。笔体会如下。     

邻指逆行指动脉皮瓣修复手指末节皮肤脱套伤

手指末节皮肤脱套伤目前尚无十分理想的修复方法。 1995年～ 2 0 0 0年我们应用邻指逆行指动脉皮瓣修复 11例 ,效果较好 ,报告如下。1　临床资料本组男 9例 ,女 2例 ,年龄 17～ 4 5岁。均为机器致伤手指末节皮肤、软组织套状撕脱、指骨及肌腱外露。其中食指 4例 ,中指 2例 ,环指 3例 ,小指 2例。均于伤后 5小时内手术。手术方法 :食、环指末节皮肤脱套伤分别采用中指桡、尺侧逆行指动脉皮瓣修复 ;中、小指末节皮肤脱套伤分别采用环指桡、尺侧逆行指动脉皮瓣修复。按伤指皮肤、软组织缺损的大小 ,沿供指中节侧方向背侧及掌侧设计皮瓣 ,皮瓣呈…     

Comparison of acute toxicities between two postoperative concurrent chemoradiotherapy regimens of capecitabine with or without oxaliplatin in patients with stage Ⅱ and Ⅲ rectal cancer

Objective To compare the acute toxicities between two prospective, non-randomize phase Ⅱ trials on adjuvant radiochemotherapy of capecitabine with or without oxaliplatin in patients with stage Ⅱ and Ⅲ rectal cancer. Methods From March 2005 to November 2007,based on two fulfilled phase Ⅰ studies,two phase Ⅱ trials were launched respectively to further observe the tolerance and toxicity. In one tria1,118 patients were treated with concurrent capecitabine and radiotherapy (Cap-CRT trial), with radio-therapy of DT50 Gy/25 F/5 wks to the pelvis, and capecitabine at a dose of 1600 mg/m2/d(d1-d14,3 weeks per cycle). In the other trial, 90 patients received concurrent oxaliplatin, capecitabine and radiothera-py(Cap-Oxa-CRT trial), with the same radiotherapy schedule, while oxaliplatin at a dose of 70 mg/m2(d1, d8) and capecitabine of 1300 mg/m2/d(d1-d14,3 weeks per cycle). Results There was no significant difference in the delay of radiotherapy (10.2% vs 6.7%, X2=0.80, P=0.460) or chemotherapy (9.3% vs 19.1%, X2=4.80,P=0.090) between Cap-CRT and Cap-Oxa-CRT trials. Grade 1-4 leukopenia,diar-rhea and nausea were the most common acute side-effects in the both trials, accounting for 70.2%, 65.9% and 42.3%, respectively. When comparing with Cap-CRT trial, Cap-Oxa-CRT trial had significantly more grade 1-4 non-hemotological toxicities, mainly in Gl,including nausea (68.9% vs 22.0%, X2=46.90, P= 0.000), diarrbea(76.7% vs 57.6%, X2=13.50, P=0.009), fatigne(47.8% vs 13.7%, X2=18.90,P= 0.000), hand-foot syndrome (14.4% vs 4.2%, X2=7.10, P=0.029), and inappetence (50.0% vs. 27.9%, X2 = 25.70, P=0.000), but not in hematological toxities of leukopenia, anemia or thrombocytope-nia. Of all the patients,grade 3 and grade 4 toxicities were diarrhea(24.0% and 1.0%),leukopenia(4.3% and 0.0%),radiation-induced dermatitis(3.8% and 0.0%),cramping abdominal pain(1.0% and 0.0%) and fatigue(0.5% and 0.0%). Only grade 3 and 4 diarrhea was significantly more in Cap-Oxa-CRT trial than in Cap-CBT trial(33.0% vs 18.6%, X2=5.90,P=0.023). Conclusions For patients with stage Ⅱ and Ⅲ rectal cancer,both the postoperative concurrent radiochemotherapy regimens are tolerable,though Cap-Oxa-CRT trial has more grade 3 and 4 diarrhea.     

护理专业人才培养的现状与展望

多年来,我国护理人才的培养沿袭固定的模式,即初中毕业生进入护校,经过3年的专业培养,毕业后由国家统一分配至各级医疗机构,从事护理工作,再根据各单位的需要决定其具体工作岗位.这时,毕业生年龄大约在十八九岁左右,经过5年以上的一线锻炼,开始进入婚育年龄阶段,大约在30岁左右进入一个事业稳定时期,在专业技能及人际交往等方面,趋于成熟.这时,她可能会成为一名一线护理骨干或护士长.但与此同时,长期的工作、家庭压力及倒班等不规律的作息时间又使得她在35岁以后,精力、体力逐渐下降,40岁后更加明显,如晚上夜班时打针看不清血管,极易疲劳而又不易恢复.所以一名护士真正能在一线岗位上工作的时间也就只有在40岁以前,那么进入工作状态的时间越早,相对她在一线工作的时间也就会越长.