女性尿道周围腺癌1例报道并文献复习

目的提高对女性尿道腺癌的认识。方法通过光镜和免疫组化染色,对1例女性尿道周围腺癌进行病理学检查,并进行文献复习。结果本例术后病理诊断为尿道周围腺癌,肿瘤位于尿道与阴道之间,为不同分化程度及形态结构的腺癌。结论腺性尿道炎可能是女性尿道腺癌的起因之一。手术应彻底,女性尿道腺癌对化疗和放疗较敏感。     

Toll样受体4在强直性脊柱炎患者外周血白细胞中的表达及临床意义初探

目的：探讨Toll样受体4（Toll-likereceptor 4,TLR4）在不同人群外周血白细胞的差异表达及其在强直性脊柱炎（ankylosing spondylitis,As）中的意义。方法：应用流式细胞术检测60例AS患者及40例健康对照外周血淋巴细胞、单核细胞和中性粒细胞TLR4的表达。结果：TLR4在外周血淋巴细胞、单核细胞和中性粒细胞均有表达,以单核细胞表达为主;HLA-B27阳性和阴性AS患者外周血3种细胞TLR4的阳性表达率均明显高于对照组（P〈0．001）,但两者之间并无显著差异。结论：TLR4主要表达于外周血单核细胞,但AS患者外周血3种细胞表达均上调,这种上调与HLA-B27阳性与否无关,提示TLR4信号通路的异常与AS的发病相关。     

我国心理护理文献9年回顾性分析

心理护理是在护理过程中运用医学、心理学知识来影响、改变病人的心理问题,促进其康复的方法。其目的是协助医生解决病人存在的各种心理问题,帮助病人尽快适应新的社会角色,调整病人的情绪,缓解病人的心理社会应激[1]。随着医学模式的转变,“人性化关怀”越来越受到重视,“以人为本”的护理管理理念的逐步开展,心理护理备受关注。本文就心理护理9年来的研究做一回顾分析。1资料与方法通过查找中国期刊全文数据库,以心理护理为关键词,查得1995年—2003年的文献3269篇。分别以刊名、年度进行检索,检索出各期刊、各年度载文量。将各期刊1995年…     

高等护理专业法律教育课程的调查研究

目的通过对实习护生、临床带教老师和护理专业教师的问卷调查,旨在了解目前浙江省高等护理专业法律教育的现状、以及护生和护理专业教师对法律知识的掌握情况。方法采用自行设计的3份不同的问卷,分别随机对485名本、专科(含高职)实习护生、192名临床带教老师及75名护理专业教师进行问卷调查。结果目前高等护理法律教育课时数偏少,学期安排不尽合理;护生和护理专业教师法律基础知识薄弱等。结论高等护理专业应加强师生的法律教育,培养师资,改进教学方法,以提高学生的法律意识。     

Measuring symptom prevalence, severity and distress of cancer survivors

The purpose of this paper is to describe patients’ self-reported symptom occurrence, symptom intensity and symptom distress at post-treatment of cancer therapy. A total of 243 outpatients with heterogeneous solid tumours within 12 months following the completion of initial cancer treatment (chemotherapy or radiotherapy) were assessed using the Chinese version of the Memorial Symptom Assessment Scale (MSAS). The mean age of the sample was 54.2 ± 12 and over half (57.6%) were women. The most common diagnoses were breast cancer (26.3%) and colon cancer (23.5%). The median number of symptoms per patient was 8 (range 0–23 symptoms) and the most prevalent were dry mouth (49.8%), lack of energy (46.9%), worry (39.1%), pain (35%) and feeling drowsy (33.7%). The mean symptom severity and distress scores measured on the MSAS were 1.92 ± 0.2 (range 1.7–2.3) and 1.37 ± 0.3 (.9–2), respectively. The prevalence of certain symptoms was influenced by the primary site of cancer. Pain, worrying and difficulty in swallowing were the most clinically important symptoms. In conclusion, intense physical and psychological symptoms were highly prevalent and distressing to cancer survivors. Comprehensive symptoms assessment is a requisite toward effective symptom control.     

Acute effects of hyperglycemia and hyperinsulinemia on hepatic oxidative stress and the systemic inflammatory response in rats

OBJECTIVES: Intensive blood glucose control to a target value of 80-110 mg/dL has been shown to reduce morbidity and mortality in surgical intensive care unit patients. This was attributed predominantly to correction of hyperglycemia, based on multivariate regression analysis. However, the effects of glucose and insulin have not been independently evaluated. This study investigated the development of hepatic oxidative processes and systemic inflammatory response in rats with different levels of induced hyperglycemia and hyperinsulinemia. The effects of a modest increase in blood glucose following glucose infusion at a level adequate to meet energy requirements, hyperinsulinemia induced by a hyperinsulinemic euglycemic clamp with administered glucose in similar amounts, and marked hyperglycemia and hyperinsulinemia secondary to glucose infusion on hepatic oxidative stress and systemic inflammatory response in vivo were examined. DESIGN: Controlled laboratory study. SETTING: Medical school laboratory. SUBJECTS: Specific pathogen-free male Sprague-Dawley rats. INTERVENTIONS: Blood glucose was monitored over 3 hrs. At the end of study, the serum concentrations of insulin, tumor necrosis factor-alpha, interleukin-1, and alpha1 acid glycoprotein were determined. Malondialdehyde and total glutathione content were measured in the liver. MEASUREMENTS AND MAIN RESULTS: Glucose infusion adequate to provide energy requirements resulted in a modest increase in blood glucose (143+/-8 mg/dL) and hyperinsulinemia (45 microU/mL) and did not induce measurable hepatic oxidative stress or systemic inflammation. A hyperinsulinemic euglycemic clamp (insulin 112+/-9 microU/mL) resulted in evidence of increased oxidative processes in the liver but no change in hepatic antioxidant capacity or evidence of systemic inflammation. When hyperglycemia (approximately 350 mg/dL) and hyperinsulinemia (167+/-9 microU/mL) were induced by excess glucose infusion, rats manifested hepatic oxidative stress, antioxidant depletion, and a mild systemic inflammatory response. CONCLUSIONS: Hyperglycemia is a major cause of the systemic inflammatory response. Maintaining normal blood glucose, by avoiding overfeeding and providing insulin therapy when necessary, appears key to minimizing oxidative stress and systemic inflammation when intravenous nutrition is provided.     

多媒体在注射法教学中的应用

注射法是将无菌药液注入体内，达到预防疾病、治疗疾病的目的。在《基础护理学》教学中，注射法既是教学的重点，也是教学的难点。传统的教学法是先课堂讲授，再到实验室进行训练，这种方式造成了理论与技术相脱节，学生不能即学即练，加之演示视野窄，学生不能真正看清每一动作细节，以至学生在练习时不会定位，不敢进针，产生恐惧心理。将多媒体技术引入注射法教学，把注射部位的神经、血管与肌肉的解剖关系制成动画，从不同角度、不同侧面清晰地展示注射部位与解剖之间的关系，从而阐述注射部位选择的重要性，同时将注射过程进行分解，尤其是突出演示局部进针的动作，为学生提供形象、生动、直观的教学方法，提高了课堂教学效果，减轻了学生的心理压力。     

分层培训在神经外科护士岗位管理中的应用

本研究对神经外科护士进行分层培训,内容包括:根据护士的能级要求与专业技术等级,制定层级目标及计划;将培训的具体时间表穿插到日常工作中,理论培训与操作培训交叉进行。经过分层培训建立了有一定专业特色的护理队伍,提高了护理队伍的整体素质,提高了护士的科研能力与团队协作能力。     

中西医结合治疗老年人心脑血管病用药研究

目的:研究并探讨中西医结合疗法在老年人心脑血管疾病中的治疗作用,以期能够为老年人心脑血管疾病的临床治疗提供可靠的参考依据。方法:选取2012年1月至2015年12月解放军二五四医院收治的300例老年心脑血管疾病患者作为此次研究的对象,采取计算机随机分组法将这300例老年心脑血管疾病患者分为对照组、观察组,每组150例。对照组采取单纯西医治疗方案进行治疗,观察组在西医治疗基础上采取中西医结合疗法。比较2组患者的临床总有效率,并对2组患者治疗前后的血压、血糖、血脂以及血液流变学指标进行比较。结果:观察组的临床总有效率为97.33%,对照组的临床总有效率为89.33%,2组相比,差异有统计学意义(P0.05)。与治疗前相比,治疗后2组患者的血压(收缩压、舒张压)、血糖(空腹血糖、餐后2 h血糖)、血脂(总胆固醇、三酰甘油、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇)以及血液流变学指标(红细胞压积、红细胞电泳时间、红细胞沉降率、血浆黏度)均明显得到改善(P0.05),但在治疗后,观察组的血压、血糖、血脂以及血液流变学指标较对照组明显更优(P0.05)。结论:在老年心脑血管疾病患者的临床治疗中,采取中西医结合疗法进行治疗可取得满意的疗效,能够有效促进血压、血糖、血脂的控制,有效抑制红细胞的聚集,阻遏病情发展。