社区心理干预对肿瘤患者和家属焦虑及抑郁的影响分析

目的：探讨社区心理干预对肿瘤患者和家属焦虑及抑郁的影响。方法：将225例肿瘤患者及家属随机分为心理干预组115例和对照组110例。采用焦虑自评量表和抑郁自评量表评估。结果：干预前患者及家属焦虑自评量表和抑郁自评量表评分高于常模;干预后,干预组患者及家属的焦虑自评量表和抑郁自评量表评分较对照组低,组间差异有统计学意义（P＜0.05）。结论：肿瘤患者及家属不同程度存在焦虑和抑郁。全科模式的心理干预能够改善社区肿瘤患者和家属的焦虑及抑郁状况,提高生活质量。     

基于臂部牵引吊带改进乳腺癌根治术体位在乳腺癌患者手术中的应用效果研究

目的：探讨基于臂部牵引吊带改进乳腺癌根治术体位在乳腺癌患者手术中的应用效果。方法：选择2021年1-12月于汕头大学医学院第二附属医院择期行乳腺癌根治术的患者150例,以随机数字表法分为观察组、对照组,每组75例。对照组采用常规手术体位进行手术,观察组以基于臂部牵引吊带改进乳腺癌根治术中体位接受手术治疗。对两组患者的手术情况、术后并发症发生情况、医师操作舒适度、术后生活质量评分、护理满意度进行统计比较。结果：观察组手术时间短于对照组、术中出血量少于对照组、术中无影灯调节次数低于对照组,差异均有统计学意义(P<0.05)。术后观察组患者的皮肤压红、上肢外展>90°、静脉血栓的发生率均低于对照组(P<0.05)。观察组医师操作的总舒适度为93.33%,高于对照组的78.67%(P<0.05)。术后观察组生活质量评分(躯体功能、心理功能、社会功能、物质生活评分)均高于对照组(P<0.05)。观察组患者的护理总满意度为92.00%,高于对照组的77.33%(P<0.05)。结论：基于臂部牵引吊带改进乳腺癌根治术中体位在乳腺癌患者术中的应用效果良好,有利于手术...     

乳果糖联合复方聚乙二醇电解质散在结肠镜检查中的应用效果研究

目的:探讨乳果糖联合复方聚乙二醇电解质散在结肠镜检查中的应用效果。方法:选取2017年1月-2019年12月于湖北省中西医结合医院消化内科门诊接受结肠镜检查的519例患者作为研究对象,按照随机数表法分为对照组与观察组。对照组以复方乙二醇电解质散作为清肠剂,观察组在对照组的基础上加用乳果糖,比较两组高质量肠道清洁率、退镜时间及结肠腺瘤检出率。结果:观察组高质量Boston肠道准备评分量表(BBPS)、肠道腺瘤检出率高于对照组,退镜时间短于对照组,差异有统计学意义(P<0.05)。结论:乳果糖联合复方聚乙二醇电解质散应用于结肠镜肠道准备中,有助于发现结肠小病变,可进一步提高腺瘤检出率及肠道清洁度,降低结肠镜检查的漏诊率,故应予以推广。     

卡托普利联合前列地尔治疗糖尿病肾病的疗效及药副作用发生情况分析

目的 探讨卡托普利联合前列地尔治疗糖尿病肾病的疗效及副作用发生情况分析。方法 选取65例糖尿病肾病患者作为研究对象。对照组为卡托普利治疗患者30例；观察组为卡托普利联合前列地尔治疗患者35例。比较两组药物治疗后的总有效率、治疗前后24h尿蛋白（UTP）、血肌酐（SCr）及血尿素氮（BUN）指标水平变化以及用药过程中不良反应的发生情况。结果 观察组治疗总有效率显著高于对照组（P<0.05）；治疗后，观察组和对照组的UTP、SCr及BUN指标水平均较前明显下降，其中观察组指标降低更为显著（P<0.05）；不良反应的总发生率两组间差异无统计学意义（P>0.05）。结论 卡托普利联合前列地尔序贯治疗方案应用于糖尿病肾病中，在显著减少蛋白尿、高血压和水肿等症状的同时降低UTP、SCr及BUN指标，且不良反应少，具有较高安全性，可在临床应用。     

Effect of acid sphingomyelinase on nonalcoholic fatty liver disease via PPARα- PGC-1α pathway北大核心CSCD

Aim To investigate the effects of acid sphingomyelinase(ASMase)on high-fat induced nonalcoholic fatty liver disease in mice and its regulation of PPARα- PGC-1α pathway. Methods ASMase knockout mice based on C57BL/6 background were constructed. Closed group heterozygotes were obtained through hybridized with wild-type mice(ASMase+/-),together with the littermate WT mice were prepared for NAFLD model in this study. The experiment was divided into four groups:WT+Chow:the WT mice were fed with normal diet for 12 weeks; WT+HFD:the WT mice were fed with high-fat diet for 12 weeks; ASMase+/-+Chow:the ASMase+/- mice were fed with normal diet for 12 weeks; ASMase+/- +HFD:the ASMase+/- mice were fed with high fat diet for 12 weeks. Biochemical method was used to detect serum TC,TG and liver TC,TG contents and liver function such as ALT and AST. Oil red staining,HE staining,Masson staining and Sirius red staining were performed to detect liver lipid accumulation,hepatocyte morphology and liver fibrosis. AmplexTM red sphingomyelinase kit was applied to detect ASMase activity. Western blot was performed to detect protein expressions of ASMase,PPARα,PGC-1α and CPT1. Results WT+HFD group displayed hypercholesterolemia and liver dysfunction. Levels of liver triglyceride(TG)were significantly higher than those in WT+Chow group(P<0.05 or P<0.01). Meanwhile,the hepatocytes showed marked steatosis,balloon-like changes,and fibrosis. Protein expression and activity of ASMase in liver increased significantly(P<0.01 or P<0.001),whereas CPT1,PPARα and PGC-1α expressions were not statistically significant compared with matched control group. Heterozygously ASMase-deficient mice reduced the elevated liver TG induced by HFD,as well as improving balloon-like changes and liver fibrosis. Furthermore,the expressions of PPARα,PGC-1α and CPT1 were up-regulated in ASMase+/- +HFD mice compared with WT+Chow group.Conclusions ASMase promotes hepatic steatosis and fibrosis,which may be related to its inhibition of PPARα-PGC-1α pathway. © 2023 Publication Centre of Anhui Medical University. All rights reserved.