Haemodynamic and neurohumoral responses in elderly patients with postural hypotension

Haemodynamic and neurohumoral responses to head-up tilt were measured in 28 elderly patients with postural hypotension (EPPH) and 12 healthy elderly subjects (HE). There were no differences in catecholamines between the groups and only noradrenaline increased on tilt (P less than 0.001). Plasma renin activity and aldosterone were similar in HE and EPPH in the supine and tilt positions. In both groups vasopressin increases (P = 0.032), and plasma volume decreases were the same (P = 0.673). Supine EPPH had higher heart rates (P = 0.019) but similar cardiac indices (P = 0.621). Both had similar changes on tilting (P = 0.975 and P = 0.341). Stroke volume decrease was higher in HE (35%) than EPPH (23%; P less than 0.001). HE showed an increase in peripheral resistance on tilting with no change in EPPH (P = 0.005). EPPH had larger coefficients of variation for all variables. The differences in haemodynamic responses and the similarity of neurohumoral responses during tilting suggest end-organ failure in EPPH with individual variations. Postural hypotension in old age is not a single entity.     

运用换位思考加强护士素质培养

目的 :加强护士素质培养 ,提高护理服务质量。方法 :将其他行业的“视顾客为上帝”的服务宗旨引入护士素质教育中 ,影响护士自发的追求美的职业形象。结果 :融洽了护患关系 ,提供了高质量的护理服务。结论 :职业素质的培养是高质量护理服务的基础     

自发性食管破裂病人的护理

总结10例自发性食管破裂病人的护理体会。保持引流管通畅，防治低血容量性休克及感染性休克，预防肺炎及肺不张是护理的重要环节；加强营养，做好心理护理及皮肤护理对疾病恢复起积极作用。     

IGF1R signalling in testicular germ cell tumour cells impacts on cell survival and acquired cisplatin resistance

Testicular germ cell tumours (TGCTs) are the most frequent malignancy and cause of death from solid tumours in the 20‐ to 40‐year age group. Although most cases show sensitivity to cis‐platinum‐based chemotherapy, this is associated with long‐term toxicities and chemo‐resistance. Roles for receptor tyrosine kinases other than KIT are largely unknown in TGCT. We therefore conducted a phosphoproteomic screen and identified the insulin growth factor receptor‐1 (IGF1R) as both highly expressed and activated in TGCT cell lines representing the nonseminomatous subtype. IGF1R was also frequently expressed in tumour samples from patients with nonseminomas. Functional analysis of cell line models showed that long‐term shRNA‐mediated IGF1R silencing leads to apoptosis and complete ablation of nonseminoma cells with active IGF1R signalling. Cell lines with high levels of IGF1R activity also showed reduced AKT signalling in response to decreased IGF1R expression as well as sensitivity to the small‐molecule IGF1R inhibitor NVP‐AEW541. These results were in contrast to those in the seminoma cell line TCAM2 that lacked IGF1R signalling via AKT and was one of the two cell lines least sensitive to the IGF1R inhibitor. The dependence on IGF1R activity in the majority of nonseminomas parallels the known role of IGF signalling in the proliferation, migration, and survival of primordial germ cells, the putative cell of origin for TGCT. Upregulation of IGF1R expression and signalling was also found to contribute to acquired cisplatin resistance in an in vitro nonseminoma model, providing a rationale for targeting IGF1R in cisplatin‐resistant disease. © 2017 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland.     

影响护士长心理健康的因素

介绍了国内外有关护士长心理健康的研究现状,阐述了影响护士长心理健康的因素及其完善护士长心理健康的必要性。     

624例代谢综合征病人的健康教育及饮食和运动干预

[目的]探讨健康教育及饮食和运动干预对代谢综合征(metabolicsyndrome,MS)病人生活习惯及体重质量指数的影响.[方法]对624例MS病人进行健康教育及饮食和运动干预.[结果]健康教育、饮食和运动干预6个月后,关于MS的问卷调查答题正确率从27.6%上升至89.4%;蔬菜、水果的摄入增加,糖类、脂肪的摄入减少;中老年组体重指数下降.[结论]针对性的健康教育、科学合理的饮食结构调整、适合老年人的运动方式,能够使中老年MS病人的体重减轻,有利于身体的康复,延缓疾病的进程.     

大连傅家庄海滨疗养区的特点

目的本文综述了大连傅家庄海滨疗养区的微小气候特点、空气负离子浓度、夏季水、气、沙温度变化、日光辐射强度及日光浴和海水浴对机体的影响研究近况。并说明其医疗价值。方法查阅资料并在日光浴和海水浴后，检测血脂、血粘度及免疫功能。结果疗养后血清胆固醇降低、免疫功能增强、血脂明显下降、血粘度降低。结论为各类人员的保健疗养和高血压、神经衰弱等疾病康复提供了科学依据。     

甲状腺结节超声特征对细针抽吸活检无效率的影响分析

目的探讨影响甲状腺结节超声引导下细针抽吸活检(US-FNA)无效率的超声特征。方法选取我院存在恶性风险的甲状腺结节患者235例(共251个结节),根据其常规超声特征(结节大小、位置深度、钙化类型、钙化比例及实性比例)进行分组,均行US-FNA检查并依据Bethesda分类标准判断标本无效率(BethesdaⅠ类为无效,Bethesda≥Ⅱ类为有效),比较各类型分组的无效率,分析相关超声特征对无效率的影响。结果US-FNA无效率比较:①根据结节大小分组,A1组(0.5 cm≤最大径<1.0 cm)无效率最高(42.4%);②根据结节位置深度分组,C2组(深层)无效率最高(41.9%);③根据钙化类型分组,C3组(粗钙化)无效率最高(49.1%);④根据钙化比例分组,D4组(50%<钙化比例≤75%)和E4组(钙化比例>75%)无效率较高,分别为75.0%、80.0%;⑤根据实性比例分组,A5组(0<实性比例≤25%)和B5组(25%<实性比例≤50%)无效率较高,分别为83.3%、80.0%,上述无效率较高组与相应特征类别中的其他组比较,差异均有统计学意义(均P<0.05)。结论甲状腺结节较小(0.5 cm≤最大径<1.0 cm)、位置位于深层、粗钙化、钙化比例>50%、实性比例≤50%等均在一定程度上会造成US-FNA结果不满意。     

管理制度是护理差错发生的重要影响因素

目的:探讨管理体制对护理差错发生的重要影响。方法:对近6年多以来发生的63例护理差错进行回顾性分析。结果:注射类差错及因查对不严造成的差错占比例最高。结论:护理管理者应重视管理制度、工作程序、方法及护理材料的改进和不断完善,降低护理差错的发生。