诊断Gilbert综合征行低热卡试验及苯巴比妥试验的护理

[目的]探讨吉尔伯特（Gilbert）综合征行低热卡试验及苯巴比妥试验的护理干预。[方法]选取本科行低热卡试验及苯巴比妥试验的住院病人15例,通过护士细致的心理护理,详细的个体化宣教方案及通俗易懂的口语,为病人讲解试验的目的、方法、注意事项,并给予全程指导。[结果]15例病人均能积极配合,顺利完成两项试验,明确诊断为Gilbert综合征。[结论]试验过程中护理干预的实施消除了病人的心理压力,取得了病人的积极配合,为尽快明确诊断提供了重要保证。     

阿尔茨海默病转基因小鼠早期记忆功能障碍与氧化应激损伤关系的实验研究

Objective To investigate the spatial learning and memory ability,the changes of indicators of oxidative stress,and their relationship in transgenic APP/PS1 mouse model of Alzheimer's disease(APP/PS1 mice). Methods The spatial learning and memory ability were assessed by Morris water maze test,and the activity or content of SOD, GSH-PX, MDA, and protein carbonyl in brain tissues were measured by ELISA in the APP/PS1 and wild type (WT) mice. Furthermore, the relationship between the learning and memory performances and the indicators of oxidative stress was examined. Results No significant difference in the spatial learning was observed between the APP/PS1 and WT mice (P ＜0. 05). The spatial memory which was measured as the percentage of time traveling in the targeted quadrant to the total traveling time was significantlydeclined in the APP/PS1 mice(29. 02 ± 4. 27) % as compared with the WT mice(47. 39 ± 6. 01) %(t =0. 000 ,P ＜0. 05). The percentage of length of traveling in the targeted quadrant to the total length traveled was significantly lower in the APP/PS1 mice(28. 85 ±3.77)% compared with the WT mice(46. 70 ±5.60)% (t =0. 000,P ＜0. 05). These findings indicated that the spatial learning and memory ability of APP/PS1 mice was significantly decreased compared to WT mice. There was no significant difference in activity or content of SOD,GSH-PX,and MDA in brain tissues between the APP/PS1 and WT mice (P ＜ 0. 05), while the content of protein carbonyl was significantly elevated in the APP/PS1 mice (2. 67 ±0. 19) than in the WT mice (2. 38 ±0. 15)(t = 0. 008, P ＜ 0. 05). Correlation analysis revealed that the elevated protein carbonyl was negatively correlated with the percentage of length traveled in the targeted quadrant(r = - 0. 639, P ＜ 0. 05) and the percentage of time traveled in the targeted quadrant(r = - 0. 636 ,P ＜ 0. 05). Conclusion The spatial memory impairment was negatively correlated with the elevated protein carbonyl in the APP/PS1 mice, suggesting that protein carbonylation caused by oxidative stress might play an important role in the development of memory impairment in the early stage of Alzheimer's disease.     

浅谈地震伤员手术中的感染控制

手术室是感染的高危科室,是医院工作的重要组成部分,也是手术和抢救患者的重要场所,保证工作人员及伤员的护理安全,防止院内交叉感染是手术室护士的重要职责。在这场突如其来的汶川大地震中,大批地震伤员需要在短时间内紧急手术,情况非常危急,而地震伤员多是由于房屋倒塌、山林滑坡受飞石或重物砸伤,部分伤员长时间受重压,受压组织缺血坏死加上泥土污染,伤口感染严重,在这种紧急的情况下,伤员也无法做常规的术前检查,容易造成伤口感染,我科在抓好护理质量管理的同时,对地震伤员的手术制定了感染控制的预防措施,收到良好效果,现将有关方法介绍如下。     

地震伤员165例术中容量治疗的护理

四川汶川8.0级地震中受创伤者,需要手术救治的伤员大多伤情复杂,因其损伤严重、开放性损伤多、创面外渗、长时间未能进食等原因,容易出现有效血容量锐减,因而地震伤休克发生率高[1],故此类伤员术中容量治疗尤为重要。我们对2008-05-13/2008-05-18手术救治的165例汶川“5·12”大地震伤员的容量治疗过程加强护理,保证地震伤员术中救治的最佳效果,现报告如下。1临床资料1.1一般资料本组男85例,女80例,年龄2~91(平均45.7)岁。受伤至手术救治时间27~146.5(平均79.7)h。手术种类包括:挤压综合征、椎体、骨盆及四肢骨折切开复位内固定术、开颅血肿清除术、截肢术、清创缝合术等。1.2术中容量治疗护理方法1.2.1建立静脉通路经手术救治的地震伤员均为严重创伤所致的损伤,其骨折伤员多、开放性损伤多、复合伤多、出血量大,由于地震的强大暴力所致,伴有的软组织损伤也较严重,术前正确评估每例伤员体液丢失及失血情况。所有伤员进入手术室后,根据病情和手术部位,用18G留置针连接三通建立静脉通道,麻醉前及时补液。避免在实施麻醉过程中或手术进程中发生低血压甚至低血容量性休克。1.2.2合理运用容量疗法补充有...     

重组沙门菌表达结核分枝杆菌ESAT-6及其特异性免疫应答分析

Objective To determine the immune responses induced by recombinant Salmonella ty-phimurium expressing the secreting antigen ESAT-6 of Mycobacterium tuberculosis. Methods ESAT-6 cod-ing gene was cloned and identified by PCR and sequencing. Prokaryotic expression plasmid pYA33-esat car-rying the ESAT-6 coding sequence was constructed firstly and electro-transformed into an attenuated strain X4550 of Salmonella typhimurium, the recombinant bacteria was named as X4550(33-esat). C57BL/6 mice were immunized intranasally (I. N) with 108 CFU recombinant bacteria at day 0 and 18. Cells from spleen, lung, mesenteric lymph node (MLN) and Peyer's patch (PP) were collected from mice after second immu-nization, and the specific IFN-γ-secreting cells and IL-4-secreting cells were detected by ELISPOT assay u-sing ESAT-6 peptide as stimulus. Furthermore, CTL effects were in vivo evaluated by CFSE assay. Results The results showed that cellular immune responses specific for ESAT-6 could be detected by ELISPOT assay. In lung and PP cells, immune responses against ESAT-6 were biased toward Th1 type, the frequency of IFN-γ-secreting cells was much higher than that of IL-4-secreting cells. In splenocytes and MLN cells, the anti-gen specific immune responses acted as Thl and Th2 balance, the frequency of IFN-γ-secreting cells was close to that of IL-4-secreting cells. CFSE assay indicated that recombinant bacteria could induce the high level of CTL effects specific for ESAT-6 peptide. Conclusion These results suggested that recombinant Sal-monella typhimurium X4550(33-esat) not only can induce cellular immune responses, but also can elicit specific CTL responses after I. N immunization. It also provided the useful information for the control of infec-tious disease of tuberculosis.     

预见性护理联合睡眠管理对小儿肺炎睡眠质量的影响

目的：分析小儿肺炎实施预见性护理联合睡眠管理对小儿睡眠质量的影响。方法：选取2020年5月至2023年1月福建省诏安县医院收治的小儿肺炎患儿78例作为研究对象,按照随机数字表法随机分为对照组和观察组,每组39例。对照组采取常规护理,观察组采取预见性护理联合睡眠管理,对2组不良反应、护理前后肺功能以及睡眠质量等情况进行比较。结果：2组护理后咳嗽、气促、发热、肺啰音等临床症状消失时间比较,观察组均少于对照组,差异均有统计学意义(均P<0.05);2组不良反应发生率比较,差异无统计学意义(P>0.05);2组护理前各项肺功能指标无差异(均P>0.05),护理后观察组均优于本组护理前及对照组,差异均有统计学意义(均P<0.05);护理前2组匹兹堡睡眠质量指数(PSQI)等各项目评分比较,差异均无统计学意义(均P>0.05),护理后入睡时间、睡眠时间、睡眠效率、睡眠质量、睡眠障碍、催眠药物、日间功能障碍及PSQI总分低于本组护理前及对照组护理后,差异均有统计学意义(均P<0.05)。结论：对小儿肺炎来说,仅施以常规护理对患儿的睡眠改善不明显,但经过预见性护理联...     

青中年脑梗死与颈动脉粥样硬化的关系

目的 研究中青年脑梗死与颈动脉粥样硬化的关系.方法 应用彩色多普勒超声仪对中青年脑梗死患者 66 例、36例非脑血管病患者和正常体检者(对照组)行颈部血管超声检查.检测血管壁的厚度和斑块的大小及厚度,观察颈动脉粥样硬化斑块的数目及部位,计算斑块积分及血管狭窄程度.结果 中青年脑梗死患者颈动脉内膜增厚,动脉粥样硬化斑块的发生率明显高于对照组,斑块积分为轻中度的颈动脉粥样硬化,颈动脉血管多为轻中度狭窄.结论 颈动脉粥样硬化与青中年脑梗死关系密切,颈动脉超声检查对脑梗死的发生有极好的预测价值.     

大气PM_(2.5)采样滤膜中16种元素的动态反应池-电感耦合等离子体质谱测定法

目的采用动态反应池(DRC)技术消除质谱干扰,对电感耦合等离子体质谱(ICP-MS)法测定大气PM_(2.5)采样石英滤膜中16种化学元素的方法进行改进。方法应用单因素试验设计,对反应气(氨气)流量和Rpq等DRC模式相关条件进行优化,随后对经混合酸体系微波消解法处理后的石英滤膜样品进行检测,并配合在线内标法对质谱干扰进行校正。结果除砷和硒元素外,本方法对其余14种元素检出限均优于标准模式(STD)方法,符合《空气污染物对人群健康影响监测工作手册(2016版)》规定的方法学要求。测定过滤介质大气颗粒物2783标准参考物显示,测定结果均在理论值范围内,精密度为3.4%~9.4%。结论改进方法能有效消除谱线干扰、基体干扰和物理干扰等,适合同时测定大气颗粒物中16种化学元素,可满足日常样品的检测需求。     

骨髓增殖性肿瘤发病分子机制研究进展

经典的BCR/ABL阴性的骨髓增殖性肿瘤(MPN),包括真性红细胞增多症(PV)、原发性血小板增多症(ET)、原发性骨髓纤维化(PMF),是一组起源于多能造血干细胞的恶性骨髓增殖性疾病。单一的JAK2基因V617F突变并不能解释3种疾病临床表现的差异。最近的研究表明,JAK2V617F突变负荷、其他MPN相关基因突变,如TET2、ASXL1等,以及遗传易感性可能参与了MPN复杂的发病机制。本文就这3方面研究进展作一综述。     

血细胞形态学检查室间质量评价结果分析与人员能力提高

目的 通过参加国家卫生健康委临床检验中心(National Center for Clinical Laboratories, NCCL)室间质量评价活动评估临床实验室形态学检查的检测能力,协同开展专项培训与人员能力评估,促进实验室质量提高。方法 实验室通过NCCL网站查看电子版质评图片,完成图片识别与结果上报,收到回报结果后开展自我评估,对自评不通过项目进行原因分析与人员形态学专项培训。结果 2013年至2020年共参加24次血细胞形态学检查室间质量评价活动,考查237幅图片,实验室自评不通过5幅图片,项目总符合率为97.89%。专项培训后,实验室人员血细胞形态学考核成绩明显提高,总成绩中位数由96(90,100)增长到98(96,100),人员合格率由89.3%上升到97.3%。结论 鉴于血细胞形态学检查在疾病诊治中的重要作用,提高符合率达到100%是我们工作中的要求,针对不符合的每一个错误结果进行认真分析和人员培训,加强人员能力比对、定期进行能力考核等,保证为临床诊疗提供准确检验依据。