健康教育的质量评价对护理工作的作用

健康教育是一种有计划、有目标、有评价的系统教育活动。通过健康教育能帮助病人有一个正确行为和观念，促进身心健康是行之有效的方法。通过三年的临床实践证明，健康教育质量评价对健康教育的开展和提高整体护理的质量起到了一定的促进作用。     

激光治疗新生血管性青光眼

新生血管性青光眼继发于糖尿病性视网膜病变 (ＤＲ)、视网膜中央静脉阻塞(ＣＲＯＶ)等视网膜缺氧性疾病 ,不论花物或手术治疗 ,效果均不理想。我院年来对尚存部分之新生血管性青光眼采用联合激光治疗 ,取得一定疗效 ,报告如下 :1　资料与方法1 1　资料 :共收集我院近 1年来已确诊为新生血管性青光眼、尚存部分视力者共 4例 7眼 ,其中男 1例 2眼 ,女 3例 5眼 ;年龄 4 6～ 72岁 ,继发于ＣＲＶＯ1眼 ,余继发于ＤＲ合并肾功能衰竭 ;视力 :0 .0 1～ 0 .0 8,全部病例均为闭角型青光眼期 ,未接受过眼底激光治疗。1 2　方法 :治疗前半小时常规肌注止…     

胎盘前置状态孕妇中孕期引产的研究进展

胎盘前置状态作为前置胎盘的早期征象，病因迄今尚不明确，其转归情况复杂，治疗难度较大。胎盘前置状态孕妇中孕期因各种原因要求引产时，临床处理较为棘手。笔者拟就胎盘前置状态的病因、产前诊断方法，以及胎盘前置状态孕妇中孕期引产措施的最新研究进展进行综述，旨在为胎盘前置状态孕妇中孕期引产时，临床医师准确评估其病情严重程度，采取最佳个体化策略，保护其生育功能，而将母体损伤降至最低提供依据。     

血清中IL-6和IL-10变化与慢性乙肝急性发作导致肝衰竭的关系

目的 通过分析急性发作慢性乙型肝炎(慢性乙肝)患者体内IL-6、IL-12、γ干扰素和IL-10的变化,探讨急性发作及病情严重程度与细胞因子变化的关系.方法 对154例急性发作及免疫耐受慢性乙肝患者采用ELISA法检测IL-6、IL-12、γ干扰素和IL-10的水平,同时检测肝功能、HBV DNA定量等.结果 处于急性发作的患者年龄较大,HBV DNA定量较低,促炎症因子和抗炎症因子的水平均高于处于免疫耐受的患者:重型肝炎组IL-6的水平(179.80±134.96)pg/ml高于非重型肝炎组(108.80±113.23)pg/ml(P<0.05),而IL-10的水平(12.80±4.96)pg/ml低于非重型肝炎组(20.33±7.35)pg/ml(P<0.05).结论 慢性乙肝急性发作可能与炎症因子的激活相关,IL-6有促进肝损伤作用,而IL-10可能在避免过强免疫损伤中起重要作用.     

四川省部分贫困边远地区乡村医生培训现状调查

目的了解四川省贫困边远地区乡村医生的培训现状和对今后培训的期望,为制定高效可行的乡村医生培训模式提供依据。方法运用整群抽样的方法,并结合问卷调查和定性访谈法调查四川省彭州市及宝兴县302个村卫生室的463名乡村医生的培训现状。结果四川省彭州市和宝兴县贫困边远地区乡村医生＂三偏＂现象严重,表现为年龄偏大、学历偏低和女村医偏少,且地域差异明显。村医在岗培训中加大了对公共卫生和中医中药方面知识的培训;村医实际参加的培训与其期望值间存在较大差异;村医培训费用负担仍然很重;贫困边远地区尚未建立起乡村医生在岗培训制度。结论四川省贫困边远地区的乡村医生在岗培训应数量和质量并重,并结合当地实际情况和农民需求开展。建议尽快制定村医在岗培训制度,改善村医待遇,在稳定现有村医队伍的基础上,培养更多年轻村医。     

慢性乙型肝炎病毒感染者外周血单个核细胞表达程序性死亡分子-1及其配体与血清乙型肝炎病毒DNA水平的相关性

Objective To study the relationship between programmed death-1 (PD-1)/programmed death-1 ligand (PD-L1) expressions and serum hepatitis B virus (HBV) DNA levels in chronic hepatitis B (CHB) patients. Methods A total of 137 CHB patients and 10 healthy controls were enrolled in the study. The peripheral blood mononuclear cells (PBMCs) were isolated from fresh blood samples. HBV-specific cytotoxic T lymphocyte (CTL) was expanded in vitro in 64 human leucocyte antigen (HLA)-A2 positive patients. Flow cytometry was used to detect HLA-A2 type,expressions of PD-1/PD-L1 on PBMCs and PD-1 on HBV specific CTL. Interferon gamma (IFN-γ)was measured by commercial enzyme-linked immunosorbent assay (ELISA) kits. PD-1/PD-L1expressions on PBMCs, HBV-specific CTL and IFN-γ level in PBMC culture medium were compared among patients with different baseline HBV DNA levels. Ten hepatitis B e antigen (HBeAg) positive patients were treated with telbivudine for 24 weeks. The above mentioned parameters were determined and compared before and after the antiviral treatment. Independent-samples t test were used to compare means between two groups and one-way A NOVA were used to compare means among multigroups. We used the pearson corretation test to assess corretation significance. Results The PD-1 and PD-L1 expressions on PBMCs in patients with baseline HBV DNA＜3 lg copy/mL, 3-6 lg copy/mL and ＞6 lg copy/mL were all significant higher than those in healthy control group, but no statistical differences were found. PD-1 expressions on HBV-specific CTL in the three CHB patient groups were (69.3±11.2)%, (76.5±9. 1)% and (78.0±11.7)%, respectively. However, PD-1 expression on HBV-specific CTL was higher, while the frequency of HBV-specific CTL cells was lower in HBV DNA ＞6 lg copy/mL group compared to HBV DNA＜3 lg copy/mL group. The above parameters, including expressions of PD-1 and PD-L1, the frequency of HBV-specific CTL and its PD-1 expression were not significantly different between HBeAg-positive group and HBeAg-negative group. Compared with baseline, PD-1 and PD-L1 expression decreased obviously accompanying with increase of HBV-specific CTL cells frequency and IFN-γ level after 12 weeks and 24 weeks of telbivudine treatment. Conclusions PD-1 expression on HBV-specific CTL correlates with serum HBV DNA level, but not HBeAg status in CHB patients. Suppression of HBV replication can reduce PD-1/PD-L1 expressions and partially restore HBV specific CTL function.     

探索中医药院校的实验教学模式——基于建构主义理论解析大学生中药材标本采集及制作

高校教育与建构主义理论之间存在着本体与方法意义上的契合.我校实验教学示范中心以建构主义理论为基础,从教育本质、教学过程、学习思维、教学环境方面进行改革,组织并实施了"大学生中药材标本采集及制作";通过对实例的解析及反思,探索适用于中医药院校的实验教学模式,为构建培养中医药创新人才的实验教学体系提供有效例证.     

应用大剂量Svate－3挽救急性重症缺血肢体的临床研究（附8例报告）

应用大剂量Ｓｖａｔｅ－３挽救急性重症缺血肢体的临床研究（附８例报告）首都医科大学附属北京安贞医院血管外科吴庆华，邓洪儒，苑超，陈忠，杨宝钟，勇强，唐小斌，吴章敏，寇镭，毛磊，刘辉，杜筠急性动脉栓塞、动脉硬化血栓形成、重症脉管炎等疾病往往可以引起肢体坏...     

梧州,柳州和北海三市鼻咽癌群体筛查比较

报告梧州，柳州和北海三市７７７２０人鼻咽癌血清学方法群体筛查结果，检出鼻咽癌３０例，早期２９例，早诊率９６％，人群鼻咽癌检出率３８．６０／１０万，以梧州市最高（６６．０９／１０万）依次为北海市（３４．８３／１０万）柳州市（１１．５３／１０万），说明说明ＥＢ病毒血清学方法普查可以检出鼻咽癌和早期鼻咽癌，达ＩＩ级预防目的。