延续性护理对降低脑卒中阿司匹林二级预防患者再入院率的影响

目的研究延续性护理对降低脑卒中阿司匹林二级预防患者再入院率的影响。方法以2015年2月~2016年3月我院收治的74例脑卒中阿司匹林二级预防患者为研究对象,按照护理差异,分为两组,各组37例,对照组接受常规护理,研究组于其基础上接受延续性护理,对比两组PLT、MPV、PAR、PT、aPTT与再入院率。结果研究组PT与aPTT明显大于对照组,且PAR、MPV明显小于对照组(P0.05);研究组再入院率为2.7%,明显低于对照组16.2%(P0.05)。结论对脑卒中阿司匹林二级预防患者予以延续性护理干预措施,可改善血液抗凝效果,降低疾病复发机率。     

下腔静脉成形治疗复发性布-加综合征

目的　探讨复发性布 -加综合征的治疗方法。方法　常温非体外循环下阻断梗阻上、下端的下腔静脉 ,切开梗阻部位 ,取出血栓 ,矫正畸形 ,用自体心包补片成形下腔静脉。结果　 3 9例术后均肝脾肿大缩小 ,腹水消失或减少 ,下腔静脉压力降低 6～ 11cmH2 O。B超检查显示 :全部病人术后原下腔静脉狭窄处直径 3 .5cm ,血流通畅。术后 7例出现短暂血尿 ,5例出现心功能不全 ,其中 2例出现胸水 ,无 1例住院死亡。随访 3个月～ 6年 ,3例术后 1年内死于多器官功能衰竭 ,1例死于肺部疾病 ,2例术后 2年死于其他非相关疾病。 4例失访。 2 9例恢复正常生活 ,无复发肝脾大、腹水。结论　常温非体外循环下腔静脉成形治疗复发性布 -加综合征是一种有效的手术方法     

新疆地区维吾尔族35岁以上人群肾功能与动脉僵硬度的相关性

目的 研究新疆地区维吾尔族人群的肾功能与动脉僵硬程度的相关性.方法 应用四阶段分层整群随机抽样方法,于2007年10月至2010年3月,在乌鲁木齐市、克拉玛依市、阜康市、吐鲁番地区、和田地区、伊犁哈萨克自治州、阿勒泰地区抽取了35岁以上,资料完整的维吾尔族城乡居民4312人,进行研究分析.用简化MDRD公式计算估计肾小球滤过率(eGFR).测量双侧臂-踝脉搏波速度(b-aPWV),取双侧的平均值与eGFR做线性相关性分析,并对b-aPWV的影响因素进行校正.结果 eGFR与平均b-aPWV值呈负相关(R=0.174,P＜0.01).运用Stepwise多重线性回归校正年龄、性别、体质量指数、收缩压、舒张压、腰围、臀围、尿酸、空腹血糖、总胆同醇、三酰甘油、低密度脂蛋白后,eGFR仍与b-aPWV呈负相关(P=0.012).结论 新疆地区35岁以上维吾尔族人群的肾功能与动脉僵硬度存在负相关.     

后腹腔镜下腔静脉后输尿管成形术患者的护理

目的探讨腹腔镜腔静脉后输尿管成形术的护理要点。方法对8例腔静脉后输尿管的患者进行了腹腔镜腔静脉后输尿管成形术,分析总结患者的术前准备、术后护理及出院的情况。结果所有手术均取得成功,术中无并发症,患者均治愈出院。随访3个月,超声、IVP检查示无输尿管狭窄、肾积水较前减轻或者消失。结论结合腹腔镜的护理,术前对患者的心理及生理方面进行充分的准备、术后做好患者的饮食、饮水、活动、相关并发症的观察及出院指导是保证手术效果的关键。     

Use of genetically modified allograft to deliver local immunomodulatory molecule with minimal systemic toxicity in a rat model of allogeneic skin flap transplantation

The effects of OX40-OX40 ligand (OX40L) costimulatory pathway blockade to prevent T-cell-mediated acute rejection were investigated in a rat model of allogeneic superficial inferior epigastric artery flap transplantation. An ex vivo gene transfer technique was used to modify allografts to locally deliver an immunomodulatory molecule. The flaps were separated from donors, perfused with an adenoviral vector expressing the OX40 immunoglobulin (AdOX40Ig) for 1 hour, and incubated at 37°C for 2 hours. Before transplantation, the flaps were flushed with phosphate-buffered saline solution to remove unincorporated viral particles. Recipients were randomly divided into 5 groups, and treated with topical OX40Ig gene transfer, a single low dose of rapamycin alone, or a combination of agents. Graft survival was assessed using histopathologic classification of skin rejection. All animals in the untreated group (n = 9) or the group treated with adenovirus expressing green fluorescence protein (n = 9) developed grade 3 clinical rejection by postoperative day 7. No significant difference was observed in graft survival between the locally treated AdOX40Ig groups (mean [SD], 8.1 [0.7] days) and the untreated groups (7.7 [1.2] days) could be observed (P > .05, t test). Graft survival in the locally treated AdOX40Ig groups was extended to 18.7 (1.2) days when transduction was combined with a low dose of rapamycin, a significant improvement over survival with rapamycin treatment alone (13.2 [0.6] days) (P < .01). These results demonstrated that local immunomodulation by the allograft itself and low-dose rapamycin treatment promote graft acceptance. This protocol may enable reduction of the dosage of immunosuppressive drugs needed for successful inhibition of acute rejection in the early postoperative period.     

Apogossypolone, a novel inhibitor of anfiapoptotic Bcl-2 family proteins, induces autophagy of PC-3 and LNCaP prostate cancer cells in vitro

Limited treatment options are available for aggressive prostate cancer. Gossypol has been reported to have a potent anticancer activity in many types of cancer. It can increase the sensitivity of cancer cells to alkylating agents, diminish multidrug resistance and decrease metastasis. Whether or not it can induce autophagy in cancer cells has not yet been determined. Here we investigated the antiproliferative activity of apogossypolone （ApoG2） and （-）-gossypol on the human prostate cancer cell line PC3 and LNCaP in vitro. Exposure of PC-3 and LNCaP cells to ApoG2 resulted in several specific features characteristic of autophagy, including the appearance of membranous vacuoles in the cytoplasm and formation of acidic vesicular organelles. Expression of autophagy-associated LC3-Ⅱ and beclin-1 increased in both cell lines after treatment. Inhibition of autophagy with 3-methyladenine promoted apoptosis of both cell types. Taken together, these data demonstrated that induction of autophagy could represent a defense mechanism against apoptosis in human prostate cancer cells.     

静脉营养支持对老年COPD并Ⅱ型呼吸衰竭患者生活质量的影响

目的探讨静脉营养支持治疗对COPD呼吸衰竭患者生活质量的影响。方法将60例COPD呼吸衰竭患者随机分为对照组和观察组各30例。对照组采用常规治疗方法 ,观察组在此基础上加用静脉营养支持治疗,即静脉滴注白蛋白5g/d、复方氨基酸250ml/d、脂肪乳250ml/d等,每30分钟巡视1次,并及时给予患者心理疏导。于6周后采用生活质量测评表(QOL)进行评估。结果两组日常生活能力、社会活动情况、抑郁心理状况、焦虑心理症状及QOL总分比较,差异有统计学意义(均P0.01)。结论 COPD呼吸衰竭患者存在较严重的营养不良,静脉营养支持治疗能提高COPD患者的生活质量。     

乌鲁木齐三级甲等医院有创呼吸机管理现状调查

目的了解乌鲁木齐地区三级甲等医院有创呼吸机管理的现状,为促进呼吸机管理规范化、合理化提供依据。方法采用自行设计的问卷对乌鲁木齐地区三级甲等医院20个ICU的呼吸机清洗、消毒、保养、维护管理方式进行调查。结果 20个ICU中60.0%使用全自动清洗消毒机清洗消毒呼吸机外置管路;90.0%能每24小时彻底更换1次湿化液,但仅有20.0%的湿化罐7d更换1次;75.0%的ICU呼吸机的外表面管理较好;55.0%的护士长不知道呼吸机内部气路特点;30.0%的ICU由呼吸治疗师负责呼吸机的日常使用和维护。结论呼吸机清洗、消毒、保养、维护管理不统一,护士长需加强呼吸机管理知识学习,以达到科学管理呼吸机,避免患者发生呼吸机相关性肺炎。