鞍区肿瘤术后电解质紊乱的观察及护理

鞍区肿瘤术后发生电解质紊乱例数较多,特别是血钠紊乱。如果发现不及时或处理不当,会导致严重的后遗症,甚至危及生命。目的总结鞍区肿瘤切除术后出现电解质紊乱的护理要点。方法选取2007年至2009年间我科室行鞍区肿瘤全切手术患者37例,进行回顾性分析。结果术后电解质紊乱30例,均得到有效的控制,无一例病例因电解质紊乱导致病情恶化。结论术后对血钠严密监测,并针对临床出现的症状和病情特点进行观察和护理。可有效控制电解质紊乱。     

胃癌中iNOS与HIF-1α表达的相互关系及临床意义

目的:研究诱导型一氧化氮合酶(iNOS)与缺氧诱导因子-1α(HIF-1α)在胃癌中表达的相互关系,探讨他们在胃癌的发生发展、浸润和转移中的作用.方法:2001-01/2002-03手术切除,病理证实为腺癌的胃癌标本54例,患者术前均未行化疗或放疗,另取正常胃组织15例作对照.应用免疫组化SP法检测胃癌及正常胃组织中iNos和HIF-1α的表达,光镜下观察iNOS及HIF-1α蛋白表达,分析iNOS与HIF-1α的表达关系及临床意义.结果:胃癌中iNOS和HIF-1α的表达明显高于正常胃组织(66.67% vs 6.67%P<0.05;74.07%vs 0% P<0.01),其表达与胃癌TNM分期、肿瘤浸润深度和淋巴结转移显著相关(P<0.05或0.01).胃癌组织中iNOS与HIF-1α的表达呈正相关(r=0.596,P<0.05).结论:iNOS和HIF-1α在胃癌的发生发展中起重要作用,联合检测可作为判断胃癌恶性程度和预后的指标.     

Effect of statins use on the prevention of venous thromboembolism： a meta-analysis

ObjectiveTo estimate the effect of statins use on the prevention of venous thromboembolism (VTE).MethodsWe systematically searched MEDLINE (1980-June 2012), EMBASE (1980-June 2012), Google Scholar, Cochrane Library, and ISI Web of Science, manually reviewed references, and contacted experts. Case-control studies and cohort studies that compared any dose of statin with no statin or placebo are included. Data extraction and study quality evaluation were independently conducted in duplicate.Results12 studies including four cohort studies and eight case-control studies were identified and eligible for meta-analysis. Upon meta-analysis, statin use was associated with a statistically significant reduction in the odds of developing VTE (OR 0.91, 95% CI 0.86–0.96).ConclusionThis meta-analysis of current and available literature suggests that statins can reduce patient's risk of developing VTE. Due to the limitations of observational study, this conclusion should be considered with caution, and additionally, specifical well-designed trials are needed.     

Comparison of three medication adherence measures in patients taking warfarin

In order to improve warfarin adherence, we must first know the rate of non-adherence and the reasons for it. Assessment of warfarin adherence is important in improving patients’ warfarin-taking behavior and International Normalized Ratio (INR) control. This study aimed to compare three medication adherence measures in patients taking warfarin: the 8-item Morisky Medication Adherence Scale (MMAS), the 100-point Visual Analogue Scale (VAS) and medication refill adherence (MRA). A cross-sectional observational study was conducted in a convenience sample of 174 patients taking warfarin at an anticoagulation clinic. A survey questionnaire that included the MMAS, VAS, and demographic and warfarin-related clinical questions was administered to patients in English or Chinese depending on their preferences. The MRA and INR values were retrieved from hospital electronic databases. Most participants were adherent to warfarin as indicated by the three measures. A weak association was found between the MMAS and the other two adherence measures. The MMAS and MRA were associated with the percentage of INRs within range in the past 2 weeks. Moreover, the MRA was weakly associated with time within the therapeutic INR range in the past 3 months and 2 weeks. The findings provide insights into the differences among three medication adherence measures and may assist healthcare providers to select the most suitable measure for the assessment of warfarin adherence.     

Application of humanistic care to the reengineering of nursing process at maternity hospital

目的 从流程管理入手,探讨保证护理服务与人文关怀有机融合的有效途径.方法 依据卓越护理流程设计的原则、华生人文关怀理论、患者需求、患者权利,对所有直接服务于患者的护理项目中的人文关怀措施进行个性化设计,对设计后的流程试运行3个月,并在实施过程中不断征求患者的意见,定稿后进行培训和执行.结果 流程再造实施后患者对护理服务11项指标评价及舒适达标、护理质量、安全评价显著优于实施前(均P＜0.01).结论 将人文关怀融入各项护理流程再造中,有利于提高护理服务质量和患者满意度.     

FAK silencing inhibits leukemogenesis in BCR/ABL‐transformed hematopoietic cells

Focal adhesion kinase (FAK) is constitutively activated and tyrosine phosphorylated in BCR/ABL‐transformed hematopoietic cells, but the role it plays during leukemogenesis remains unclear. Here, we examined the effects of RNA interference‐mediated FAK silencing on leukemogenesis induced by a BCR/ABL‐transformed cell line. Transduction of BCR/ABL‐BaF3 cells with FAK shRNA inhibited FAK expression and reduced STAT5 phosphorylation, but induced caspase‐3 activation. In vitro studies showed that treatment with FAK shRNA resulted in impaired cell proliferation and colony formation, while increasing cell apoptosis. Mice that received transplants of BCR/ABL‐BaF3 cells with FAK shRNA displayed significantly prolonged survival time and diminished leukemia progression. In addition, FAK silencing enhanced in vitro and in vivo efficacy of ABL tyrosine kinase inhibitor imatinib in BCR/ABL‐BaF3 cells. Our results suggest that FAK is critical for leukemogenesis and might be a potential target for leukemia therapy. Am. J. Hematol. 2009. © 2009 Wiley‐Liss, Inc.     

原发性肝癌的遗传流行病学研究

目的　研究原发性肝癌的遗传模式 ,探讨本病的遗传与环境的交互作用。方法　采用Penrose法、简单分离分析和Falconer法对乙型肝炎表面抗原 (HBsAg)阳性队列中的 10 0例原发性肝癌家系资料进行遗传流行病学研究。先证者样本来自同地区 9万名 8年随访队列人群 ,分析遗传模式并将队列中家系样本发病情况分别与队列人群和一般人群的发病情况进行比较 ,计算遗传度。结果　先证者家系一级亲属肝癌发生率为 4 .0 % ,高于一般人群发生率 (0 .4 4 % ) ,也高于队列人群的肝癌发生率 (1.0 3% )。HBsAg阳性在先证者家系中存在聚集 ,且HBsAg阳性与肝癌的发生有强相关(OR =8.4 4 ,95 %CI :3.37～ 2 0 .0 6 ,P <0 .0 0 1) ;应用Penrose法计算 ,同胞肝癌发生率 一般人群肝癌发生率 (s q)接近 1 q1 2 ;简单分离分析提示不符合单因子遗传模式 ;与一般人群遗传度相比 (5 9%±7% ) ,队列人群遗传度h2 =4 2 %± 6 % ,P <0 .0 5。在控制了HBsAg后 ,一般人群遗传度下降为4 7%± 7% ,队列人群遗传度下降为 2 9%± 8%。结论　肝癌不符合单基因遗传模式 ,为一多因子疾病 ,受遗传与环境的综合影响。     

湿润烧伤膏联合敏感抗生素外用治疗压疮

目的探讨压疮治疗的有效方法。方法将90例溃疡期压疮患者随机分为观察组、对照Ⅰ组、对照Ⅱ组各30例。观察组清创后采用湿润烧伤膏外涂加敏感抗生素外敷治疗。对照Ⅰ组采用湿润烧伤膏外涂加抗生素全身治疗。对照Ⅱ组采用庆大霉素湿敷。结果观察组治愈率显著优于对照Ⅱ组。愈合时间显著短于对照Ⅰ组、Ⅱ组（均P〈0．01）；治愈率与对照Ⅰ组比较。差异无显著性意义（P〉0．05）。结论湿润烧伤膏外涂加敏感抗生素外敷治疗溃疡期压疮疗效显著。可促进创面愈合。