脑卒中患者自我护理能力与健康状况调查分析

目的:调查了解脑卒中患者自我护理能力和身心健康状况,探讨两者间的关系,为促进患者康复提供干预依据。方法:采用自编一般情况问卷、自我护理能力测定量表(ESCA)、自测健康状况评定量表(SRHMS)对120例社区脑卒中患者进行评定,并进行相关性分析。结果:脑卒中患者中ESCA高等水平占有率为22.5%,中等水平占有率为68.33%,低等水平占有率为9.17%。不同ESCA水平的脑卒中患者SRHMS评分具有显著性差异(P<0.01)。SRHMS分值与ESCA分值呈显著正相关(P<0.05或P<0.01)。结论:脑卒中患者自我护理能力和健康状况不佳,自我护理能力是影响脑卒中患者身心健康的重要因素,提高自我护理能力有助于提高健康水平和生存质量。     

Is automatic CPAP titration as effective as manual CPAP titration in OSAHS patients? A meta-analysis

Purpose  

It is costly and time-consuming to conduct the standard manual titration to identify an effective pressure before continuous positive airway pressure (CPAP) treatment for obstructive sleep apnea (OSA) patients. Automatic titration is cheaper and more easily available than manual titration. The purpose of this systematic review was to evaluate the effect of automatic titration in identifying a pressure and on the improvement of apnea/hyponea index (AHI) and somnolence, the change of sleep quality, and the acceptance and compliance of CPAP treatment, compared with the manual titration.     

慢性间歇低氧致去卵巢小鼠动脉损伤及其与硫氧还蛋白-1的关系

目的 研究雌激素在慢性间歇低氧致血管损伤中的保护作用及其与硫氧还蛋白-1( Trx-1)的关系.方法 36只成熟雌性C57/BL6J小鼠随机分为去卵巢间歇低氧(OVI)组、假手术间歇低氧(SOI)组以及对照组;前两组给予间歇低氧,而对照组间歇给予空气.28 d后,观察小鼠子宫的大小与形态并称重;主动脉弓石蜡切片进行HE染色,光学显微镜观察血管形态并测量血管壁内中膜厚度(IMT);石蜡切片行免疫组化检测Trx-1蛋白表达水平;实时荧光定量PCR检测Trx-1的mRNA相对表达量.结果 HE可见对照组主动脉弓内皮光滑,平滑肌细胞排列较整齐,未见明显异常改变;SOI组可见内皮欠连续,局灶内皮细胞聚集,主动脉弓平滑肌纤维细胞排列紊乱、肥大以及平滑肌纤维样变;OVI组除可见SOI组小鼠的上述改变加重外,另可见血管局灶内膜明显增生以及外膜增厚等改变.对照组、SOI组及OVI组的IMT分别为(38.34±1.01) μm、(50.65±2.09)μm及(64.80+4.31)μm,三组间两两比较差异具有统计学意义(P＜0.01).SOI组(8.59±0.83)及OVI组(5.14±1.01)小鼠胸主动脉Trx-1mRNA相对表达量显著高于对照组(0.18±0.13),差异具有显著统计学意义(P＜0.001);对照组、SOI组及OVI组小鼠主动脉弓Trx-1蛋白表达的累积光密度分别为(0.84±0.10)×103、(6.60±0.45)×103及(2.76±0.28)×103,三组间两两比较差异均具有显著统计学意义(P＜0.001).结论 CIH可导致主动脉弓血管壁形态改变,去卵巢可加重CIH所致主动脉弓的损害,而Trx-1蛋白表达的降低可能参与了此过程.     

Sirolimus therapy for a cGVIID murine model with scleroderma by up-regulating Tregs

目的 基于建立的表现为皮肤胶原沉着的小鼠慢性移植物抗宿主病模型,探讨西罗莫司对该慢性排斥反应的治疗作用及其作用机制.方法 建立B10.D2→BALB/c异基因移植小鼠模型,随机分为两组,异基因移植治疗组(实验组)口服西罗莫司,连续治疗,剂量3 mg/(kg·d);异基因移植对照组(对照组)口服橄榄油.同时移植BALB/c供体小鼠细胞混悬液给受体BALB/c小鼠作为同基因移植组.记录小鼠体质量和状态变化情况;取背部皮肤,进行病理分析;提取RNA,实时荧光定量PCR检测趋化因子(RANTES、MCP-I)及纤维生成相关因子(TGF-β1、胶原I)表达水平的变化;取外周血和脾细胞,通过流式细胞仪分析CD4+CD25+FOXP3+Treg细胞水平的变化.结果 观察期结束(11周)时,西罗莫司治疗组小鼠体质量[(20.43±2.27)g]与橄榄油对照组[(14.13±1.47)g]相比明显恢复(P相似文献   

Impact of an education program launched by diabetic clinic on patients' compliance with screening of chronic complications and blood

目的 探讨专科门诊回访教育对糖尿病患者慢性并发症筛查的影响及血糖控制效果.方法 将118例糖尿病患者随机分成观察组58例和对照组60例.对照组实施常规出院后健康教育和随访,观察组由4名专科护士组成随访小组,采取多形式的回访教育,包括专题讲座、小组互动活动及优惠测血糖活动.两组均干预6个月.结果 干预期间观察组血脂、尿微量白蛋白以及眼部、足部、神经病变筛查率显著高于对照组(P＜0.05,P＜0.01);干预后观察组空腹血糖、餐后2h血糖及糖化血红蛋白显著低于对照组(均P＜0.01).结论 专科门诊回访教育有利于糖尿病患者采取有益的健康行为,积极参与慢性并发症筛查,维持较好的血糖.     

Expression of core?binding factor alpha 1 and collagen Ⅱ in patients with chronic kidney disease stage 5

Objective To study the relationship between the medial artery calcification and expression of core?binding factor alpha 1 (Cbfα?1) and collagen Ⅱ (ColⅡ) in chronic kidney disease(CKD) stage 5 patients. Methods Pieces of radial arteries were taken from 40 patients with CKD stage 5 during internal arteriovenous fistula operation. Ten patients with subtotal gastrectomy and normal renal function were chosen as control. The vessels were examined for calcification by von Kossa stain and for the presence of Cbfα?1 and ColⅡ by immunohistochemistry. According to von Kossa stain, CKD stage 5 patients were divided into no calcification group, mild?moderate calcification group and severe calcification group. Other related factors including serum calcium,phosphate, intact parathyroid hormone (iPTH), C?reactive protein (CRP), triglyceride(TG), cholesterol(TC) and low?density lipoproteins(LDL) were also detected. Results Seventeen (42.5%) of CKD Stage 5 patients showed vascular calcification, while calcification was not found in controls. Most calcification occurred in medial layer．Positive immunohistochemical staining of core?binding factor and ColⅡ was found in the smooth muscular cell plasma of medial layer in the vessels with calcification. However, above positive staining was also observed in 78.3% of no calcification group. But there was little staining in control group. Positive staining score of Cbfα?1 and ColⅡ in severe calcification group was significantly higher than that in no calcification group. Same findings were obtained in mild?moderate calcification group, but the difference between them was not statistically significant. CRP and Ca×P were positively correlated with staining score of Cbfα?1 and ColⅡ. Serum phosphate was positively correlated with Cbfα?1 (r=0.786, P<0.01) and ColⅡ (r=0.785, P<0.01) respectively． Conclusions 42.5% of CKD stage 5 patients in our group shows vascular calcification, which occurrs mainly in medial layer. High expression of Cbfα?1 and ColⅡ can be observed in vascular calcification of radial arteries, which is earlier than vascular histological changes. Cbfα?1 and ColⅡ may be involved in the development of vascular calcification.     

高龄胃癌患者腹腔镜胃切除术安全性与近期疗效

目的:评价为高龄胃癌患者行腹腔镜胃切除术的安全性及近期疗效.方法:回顾分析2008年7月-2011年12月87例行胃切除术高龄(≥70岁)胃癌患者的临床资料,其中39例行腹腔镜手术(腔镜组),48例行开腹手术(开腹组),比较两组患者的一般情况、手术指标、术后恢复情况、并发症情况及治疗效果.结果:两组患者性别、中位年龄、术前合并症、ASA术前危险度评分、疾病类型均无明显差异(均P＞0.05).与开腹组比较,除平均手术时间无明显差异外(P＞0.05),腔镜组术中平均出血量(73 mL vs.309 mL),肠功能恢复时间(4.1 d vs.5.5 d),进流食时间(4.2 d vs.6d),平均住院时间( 19.1 d vs.25.2 d),术后心肺并发症发生率(28.2％ vs.56.3％)均明显减少(均P＜0.05).平均随访29个月,腹腔镜组和开腹组患者总生存率分别是57.1％和65.9％ (P＞0.05).结论:为高龄患者行腹腔镜胃癌切除术安全可行,可减少患者术中出血量,降低术后心肺并发症的发生率,加快术后胃肠功能恢复.     

护理老年骨质疏松性骨折 ——护士压力源相关因素调查分析及对策

目的 随着生物-心理-社会医学模式的转变,全新护理老年骨质疏松性骨折对骨科护士身心健康所造成的压力及危害的压力源,为骨科护士减轻压力、提高护士生活质量提供依据。方法 自行设计骨科临床一线护士压力源调查表进行调查。调查表包括5个方面共13种压力源,在相对范围内对80%以上护士造成压力的压力源作为共同压力源。结果 骨科临床一线护士共同压力源来自 超负荷及紧张的工作状态,工作量大,护理人员紧缺,医院优质护理服务要求严格,注重专科内涵,社会支持保障不足,年轻护士专科知识不过硬,心理,自我提升（考试、晋升、考核）,家庭社会,以及工作环境压力等。结论 医院护理管理者在注重提高优质护理服务质量的同时,必须关注护士的身心健康,制定有效的减压措施,以维护骨科护理队伍的稳定。