小剂量红霉素治疗减少COPD患者急性加重的作用

目的评价小剂量红霉素治疗对慢性阻塞性肺疾病（COPD）患者的肺功能及急性加重程度的影响。方法选择100例稳定期COPD患者,随机分为两组（Ⅰ组和Ⅱ组）,每组50例患者。Ⅰ组患者口服红霉素,400 mg/d;Ⅱ组患者口服维生素B2,10 mg/d,治疗1个月后,比较两组COPD患者的肺功能及急性加重程度的影响。结果红霉素组与对照组比较,口服红霉素治疗组患者患感冒次数明显降低（P=0.001）。两组患者年龄、性别、肺功能无明显差异。红霉素组有6例患者（12%）患2次以上感冒,而对照组有37例（75%）。对照组与红霉素组比较,患感冒的相对危险性是9.24（95%可信性区间CI,3.91~31.75,P=0.001）。红霉素组患者急性加重次数比对照组明显减少（P〈0.001）。对照组有26例（52%）出现1次或多次急性加重,红霉素组有5例（10%）经历1次或多次急性加重。对照组与红霉素组比较,急性加重的相对危险性是4.70（95%CI,1.52~14.3,P=0.006）。对照组严重急性加重的患者比红霉素组多（P=0.001）。结论小剂量红霉素治疗能减少COPD患者的急性加重,对肺功能无影响。红霉素治疗不但能预防COPD患者的急性加重,而且能降低COPD急性加重的严重程度。     

对存在焦虑抑郁情绪的慢性肾衰患者实施综合护理干预的效果分析

目的 :探讨分析对存在焦虑抑郁情绪的慢性肾衰患者实施综合护理干预的临床效果。方法 :选取2012年1月至2013年12月间我院收治的慢性肾功能衰竭患者74例作为研究对象,采用随机数字表法将其分为对照组(37例)和观察组(37例),为对照组患者进行常规护理,为观察组患者在进行常规护理的基础上实施综合护理干预,观察对比两组患者干预前后SAS和SDS评分的改善情况,并将对比的结果及两组患者的临床资料进行回顾性的分析。结果 :实施护理干预前,对照组患者的SAS评分为(57.4±3.9)分,观察组患者的SAS评分为(56.2±4.1)分,二者之间的差异不显著(P>0.05),不具有统计学意义。实施护理干预后,对照组患者的SAS评分为(55.6±4.4)分,观察组患者的SAS评分为(35.8±2.1)分,两组患者的SAS评分较干预前相比均有明显的改善,且观察组患者的改善程度更为明显,差异显著(P<0.05),具有统计学意义。实施护理干预前,对照组患者的SDS评分为(56.3±4.3)分,观察组患者的SDS评分为(55.7±4.1)分,二者之间的差异不显著(P>0.05),不具有统计学意义。实施护理干预后,对照组患者的SDS评分为(54.4±4.3)分,观察组患者的SDS评分为(34.7±2.5)分,两组患者的SDS评分较干预前相比均有明显的改善,且观察组患者的改善程度更为明显,差异显著(P<0.05),具有统计学意义。结论 :对存在焦虑抑郁情绪的慢性肾衰患者实施综合护理干预的临床效果显著,此方法不仅能改善患者焦虑及抑郁的情绪,还能提高患者的生存质量,值得在临床上推广应用。     

FasL基因表达对缺氧状态下直肠癌细胞增殖凋亡的影响

Objective To elucidate the effect of FasL gene expression on the proliferation and apoptosis of hypoxic rectal carcinoma cells. Methods The normoxic expression level of FasL in HR-8348 subtype cells (HR-8348B, HR-8348L, HR-8348F and HR-8348As) with different invasive power were verified by Western blot. Hypoxia models for HR-8348B, HR-8348L, HR-8348F and HR-8348As were constructed with chemical modeling, then the FasL levels in all groups at 12 h after hypoxia were quantitated by Western blot. Distribution of different cell life cycles was determined with flow cytometry. Cell reproductive activities were detected with MTT method, and cell apoptesis was assessed with TUNEL. Results FasL protein was pigmentized at the position of 40 000 by Western blot, and the expression level of FasL was significantly higher in HR-8348F cells than those in HR-8348B, HR-8348L and HR-8348As cells(F=361.149, P<0.01) in normoxia. At 12 h after hypoxia, the FasL level was also significantly higher in HR-8348F cells than those in other groups (F=278.766, P<0.01), but was not markedly different as compared to themselves in normoxia (t=1.762, P>0.05). The proliferation index was significantly higher in HR-8348F (60.43±3.72) than those in HR-8348B (40.01±3.30), HR-8348L (41.30±4.06) and HR-8348As cells (35.87±4.39), respectively (F=39.477, P<0.01). However, both inhibition rate of proliferation and apoptotic index were remarkably lower in HR-8348F (17.30±1.98 and 13.10±1.04) than those in HR-834B (33.70±4.33 and 21.60±1.31), HR-8348L (34.20±3.92 and 20.10±1.15), and HR-8348As (38.00±4.55 and 23.90±1.23), respectively (F=28.811 and 76.462, respectively, P<0.01). Conclusion The expression enhancement of intracellular FasL in rectal carcinoma in hypoxia can lead to accelerated proliferation and reduced apeptosis of cells, which will promote tumor cells to adapt microenvironmental hypoxia.     

247例低能量He—Ne激光血管内照射的操作体会

２４７例低能量Ｈｅ—Ｎｅ激光血管内照射的操作体会赵菲广东省深圳市福田医院内二科关键词激光，血管低能量Ｈｅ—Ｎｅ激光血管内照射血液（ＩＬＩＢ）疗法是近年来一种新兴的治疗方法。它能降低血液内中分子物质和全血粘度，增强红细胞变形能力，改善微循环，调节机体免...     

FasL基因表达对缺氧状态下直肠癌细胞增殖凋亡的影响

Objective To elucidate the effect of FasL gene expression on the proliferation and apoptosis of hypoxic rectal carcinoma cells. Methods The normoxic expression level of FasL in HR-8348 subtype cells (HR-8348B, HR-8348L, HR-8348F and HR-8348As) with different invasive power were verified by Western blot. Hypoxia models for HR-8348B, HR-8348L, HR-8348F and HR-8348As were constructed with chemical modeling, then the FasL levels in all groups at 12 h after hypoxia were quantitated by Western blot. Distribution of different cell life cycles was determined with flow cytometry. Cell reproductive activities were detected with MTT method, and cell apoptesis was assessed with TUNEL. Results FasL protein was pigmentized at the position of 40 000 by Western blot, and the expression level of FasL was significantly higher in HR-8348F cells than those in HR-8348B, HR-8348L and HR-8348As cells(F=361.149, P<0.01) in normoxia. At 12 h after hypoxia, the FasL level was also significantly higher in HR-8348F cells than those in other groups (F=278.766, P<0.01), but was not markedly different as compared to themselves in normoxia (t=1.762, P>0.05). The proliferation index was significantly higher in HR-8348F (60.43±3.72) than those in HR-8348B (40.01±3.30), HR-8348L (41.30±4.06) and HR-8348As cells (35.87±4.39), respectively (F=39.477, P<0.01). However, both inhibition rate of proliferation and apoptotic index were remarkably lower in HR-8348F (17.30±1.98 and 13.10±1.04) than those in HR-834B (33.70±4.33 and 21.60±1.31), HR-8348L (34.20±3.92 and 20.10±1.15), and HR-8348As (38.00±4.55 and 23.90±1.23), respectively (F=28.811 and 76.462, respectively, P<0.01). Conclusion The expression enhancement of intracellular FasL in rectal carcinoma in hypoxia can lead to accelerated proliferation and reduced apeptosis of cells, which will promote tumor cells to adapt microenvironmental hypoxia.     

HPLC测定人血浆中阿莫西林含量

目的 建立HPLC测定人血浆中阿莫西林含量的方法.方法 血浆经6%三氯乙酸沉淀蛋白后进行HPLC分析,色谱柱为Dikma DiamonsilTM C18,5 μm,150 mm×4.6 mm,流动相为0.01 mol·L-1的KH2PO4-甲醇(84:16),NaOH调pH＝6.90,柱温为30 ℃,流速1.0 mL·min-1,紫外检测波长为228 nm.结果 血浆内源性物质对样品测定没有干扰.阿莫西林在血浆中的线性范围为0.50～40μ g·mL-1,血浆中回收率>85%.阿莫西林的日内、日间RSD<10%.结论 该方法简便、灵敏、准确、可用于人血浆中阿莫西林含量的测定以及临床药学研究.     

冠心病介入术后患者对健康教育讲座的需求调查

目的：探讨冠心病介入术后患者对健康教育讲座的需求。方法：将2006年1月-2007年12月2年间参加我科“冠心病介入俱乐部”健康教育讲座共238例进行问卷调查。调查内容为讲座授课内容、讲座组织形式和举办周期的需求。结果：冠心病介入术后患者对运动、饮食、家庭急救知识需求百分率均〉85％，70.1％的患者认为家属健康教育是讲座的内容之一；集体讲课是认可度最高的讲座组织形式；66.3％患者愿意每月参加健康教育讲座。结论：医护人员应重视患者对健康教育讲座的需求，加强生活方式指导、急救知识培训和对家属的健康教育。     

加入冠心病介入俱乐部对经皮冠状动脉介入治疗术后患者的影响研究

目的 成立冠心病介入俱乐部,建立合理的护理干预模式,使经皮冠状动脉介入治疗术(PCI)后的患者建立健康的生活方式,提高出院随访率及治疗依从性,以减少冠心病患者心血管事件的发生.方法 动员238例已行PCI的患者,加入介入俱乐部,经过健康教育干预、生活方式干预、个体化的用药监控,分别在1年、2年进行危险因素指标评价.结果 加入俱乐部患者1年及2年后,不良的生活方式明显改善;血压、血脂、空腹血糖均较加入俱乐部前明显下降,有统计学意义.每月1次随访率由原来的53.8%上升至84.9%.服药依从性由原来56.7%上升至89.1%.结论 建立冠心病介入俱乐部对PCI术后患者进行护理干预,达到帮助患者建立良好的生活方式,控制原发病,以期可达到预防心血管事件,降低再狭窄率,降低再住院率及医疗费用.     

血管封堵器的临床应用效果观察

目的探讨血管封堵器的止血效果及护理观察。方法共有86例患者,41例患者接受血管封堵器止血,为血管封堵器组;45例行人工压迫止血,为人工压迫组。观察两组止血效果、卧床时间及并发症。结果两组止血成功率(人工压迫组86%,血管封堵器组95%)、止血时间[人工压迫组(19.3±5.5)min,血管封堵器组(1.0±0.3)min]、肢体制动时间[人工压迫组(8.0±2.7)h,血管封堵器组(2.0±1.5)h]均有显著性差异(P<0.001)。人工压迫组3例患者局部形成血肿。血管封堵器组仅2例患者拆线后伤口局部有少量渗血,无1例患者出现血肿或大出血。结论血管封堵器止血安全有效,可缩短介入治疗后卧床时间,减轻患者的痛苦,减少护士的护理工作量。