对具有否定心理反应的糖尿病患者的心理护理体会

目的深入了解糖尿病患者的否定心理反应，探讨有效的心理护理，以提高治疗效果。方法对选定的具有否定心理反应的糖尿病患者进行心理护理。结果通过心理护理，所有患者的依从性均得以提高，治疗效果满意，住院时间明显缩短。结论对糖尿病患者实施有效的心理护理，可以提高患者的依从性，使治疗效果理想。     

碘缺乏和甲状腺功能减退对大鼠仔鼠小脑细胞外信号调节激酶1/2蛋白表达的影响

Objective To study the effects of iodine deficiency and hypothyroidism on protein expression of extracellular signal-regulate kinase(ERK1/2) in the cerebellum of rots. Methods Twenty-eight healthy Wistar rots, female, 60 days old, were randomly divided according to their body weight into control group, iodine deficient group and hypothyroidism groups. Hypothyroidism groups in accordance with drinking water containing propylthiouracil(PTU) were divided into doses of 5 mg/L and 15 mg/L groups, 7 rats in each group. Rats after pregnancy, iodine deficient rats were administered with iodine-deficient diet and hypothyroid rats were administered with PTU in drinking water. Pup's cerebellum in each group were weighed on day 14,21,28 and 42. Cerebellum tissue was observed for cerebellar morphology using silver staining and detected for ERK1/2 protein using immunohistochemistry on day 7,14,21,28 and 42. Results On day 14,21,28 and 42, cerebellum weight of pups from iodine-deficient[(0.0945±0.0233), (0.1347±0.0046), (0.1542±0.0094), (0.1949±0.0048)g]were significantly lighter than control[(0.1856±0.0123), (0.2049±0.0098), (0.2268±0.0065), (0.2606±0.0086)g, all P < 0.05]and hypothyroidism groups [for 5 mg/L group: (0.1741±0.0172), (0.1927±0.0103), (0.2181±0.0064), (0.2583±0.0054)g, all P<0.05; for 15 mg/L group: (0.1604±0.0083), (0.1682±0.0103), (0.1996±0.0073) and (0.2579±0.0067)g, all P< 0.05]the difference had statistical significance(F=6.325,8.870, 16.191 and 21.574, all P<0.05). Compared to the controls on day 7, iodine-deficient group didn't have clear layers; on day 21, disappearance of external granule cells from iodine-deficient and 15 mg/L groups was delayed, still two or three layer external granule cells remained; on day 28 and 42, molecular layer from 5, 15 mg/L and iodine-deficient groups and became thinner. Immunohistochemistry showed that on day 7, there was no statistical difference of integrated optical density average of ERK1/2, in all the groups(F=1.102, P>0.05); on day 14,21,28 and 42, integrated optical density average of ERK1/2 in iodine-deficient group[(7.3245±0.5070), (8.3606±1.0683), (9.1217±1.0402), (12.1587±0.7581), all P<0.01]and hypothyroidism groups [for 5 mg/L group: (11.4307±1.5200), (14.919±0.8497), (16.0082±1.1130), (15.7721±0.8293), all P< 0.01; for 15 mg/L group: (7.8538±0.9775), (11.2461±0.8138),(12.78±1.3783), (13.0871±1.1450), all P < 0.01]was significantly lower than those of controls [(16.2831±0.5143), (20.2653±0.9551), (22.7485±1.0267), (22.1725±0.9939), all P < 0.01], the difference having a statistical signifieance(F=16.131,13.543,26.953,41.583, all P<0.01). Conclusions Iodine deficiency and hypothyroidism during critical periods of brain development may change eerebellar morphology and down regulate the protein expression of ERK1/2, which may result in damage of cerebellum development.     

碘缺乏和甲状腺功能减退对大鼠仔鼠小脑细胞外信号调节激酶1/2蛋白表达的影响

Objective To study the effects of iodine deficiency and hypothyroidism on protein expression of extracellular signal-regulate kinase(ERK1/2) in the cerebellum of rots. Methods Twenty-eight healthy Wistar rots, female, 60 days old, were randomly divided according to their body weight into control group, iodine deficient group and hypothyroidism groups. Hypothyroidism groups in accordance with drinking water containing propylthiouracil(PTU) were divided into doses of 5 mg/L and 15 mg/L groups, 7 rats in each group. Rats after pregnancy, iodine deficient rats were administered with iodine-deficient diet and hypothyroid rats were administered with PTU in drinking water. Pup's cerebellum in each group were weighed on day 14,21,28 and 42. Cerebellum tissue was observed for cerebellar morphology using silver staining and detected for ERK1/2 protein using immunohistochemistry on day 7,14,21,28 and 42. Results On day 14,21,28 and 42, cerebellum weight of pups from iodine-deficient[(0.0945±0.0233), (0.1347±0.0046), (0.1542±0.0094), (0.1949±0.0048)g]were significantly lighter than control[(0.1856±0.0123), (0.2049±0.0098), (0.2268±0.0065), (0.2606±0.0086)g, all P < 0.05]and hypothyroidism groups [for 5 mg/L group: (0.1741±0.0172), (0.1927±0.0103), (0.2181±0.0064), (0.2583±0.0054)g, all P<0.05; for 15 mg/L group: (0.1604±0.0083), (0.1682±0.0103), (0.1996±0.0073) and (0.2579±0.0067)g, all P< 0.05]the difference had statistical significance(F=6.325,8.870, 16.191 and 21.574, all P<0.05). Compared to the controls on day 7, iodine-deficient group didn't have clear layers; on day 21, disappearance of external granule cells from iodine-deficient and 15 mg/L groups was delayed, still two or three layer external granule cells remained; on day 28 and 42, molecular layer from 5, 15 mg/L and iodine-deficient groups and became thinner. Immunohistochemistry showed that on day 7, there was no statistical difference of integrated optical density average of ERK1/2, in all the groups(F=1.102, P>0.05); on day 14,21,28 and 42, integrated optical density average of ERK1/2 in iodine-deficient group[(7.3245±0.5070), (8.3606±1.0683), (9.1217±1.0402), (12.1587±0.7581), all P<0.01]and hypothyroidism groups [for 5 mg/L group: (11.4307±1.5200), (14.919±0.8497), (16.0082±1.1130), (15.7721±0.8293), all P< 0.01; for 15 mg/L group: (7.8538±0.9775), (11.2461±0.8138),(12.78±1.3783), (13.0871±1.1450), all P < 0.01]was significantly lower than those of controls [(16.2831±0.5143), (20.2653±0.9551), (22.7485±1.0267), (22.1725±0.9939), all P < 0.01], the difference having a statistical signifieance(F=16.131,13.543,26.953,41.583, all P<0.01). Conclusions Iodine deficiency and hypothyroidism during critical periods of brain development may change eerebellar morphology and down regulate the protein expression of ERK1/2, which may result in damage of cerebellum development.     

半肝切除术三种肝血流阻断方法对手术预后的影响研究

目的探讨在半肝切除术中分别应用三种不同的肝血流阻断法,观察其应用效果及对术后患者预后的影响。方法选取自2010年11月至2011年11月在新桥医院住院需实施半肝切除术的患者共120例,将其作为临床研究对象,并依据随机数字原则分为A、B、C组,每组40例,A组患者采取Pringle法进行肝血流阻断,B组患者采取选择性出入肝血流阻断术,C组患者采取肝悬吊法联合选择性出入肝血流阻断术。观察并比较3组患者的疗效及预后情况。结果 3组患者的手术时间、肝血流阻断时间差异无统计学意义(P>0.05);A组患者术中出血量和平均输血量较B、C组多;A组患者的血清清蛋白含量明显低于B、C两组,而血清总胆红素和丙氨酸氨基转移酶较B、C两组高;A组患者并发症的发生率为37.50%,明显高于B、C组的发生率15.00%、12.50%;术后2年内,B、C两组患者的生存率分别为72.50%、75.00%,明显高于A组患者,A组患者的预后较差,差异有统计学意义(P<0.05)。B、C两组间比较无明显差异(P>0.05)。结论选择性出入肝血流阻断术在半肝切除术中不仅明显减少术中出血量和输血量,还降低术后并发症的发生率及肝功能的损害程度,且术后2年内的生存率较高,预后情况较好。     

诱导化疗对局部晚期鼻咽癌放疗远期疗效的影响

目的：探讨诱导化疗对局部晚期鼻咽癌放疗远期疗效的影响。方法：回顾性分析120例Ⅲ、1Va期鼻咽癌患者按治疗方法分为两组（化放组及单放组）。放疗采用直线加速器照射鼻咽及颈部,鼻咽剂量DT70—76Gy,7—7．5周,颈部剂量DT50—70Gy,5—7周。诱导化疗采用DDP＋5-Fu方案。结果：化放疗组1、3、5年生存率分别为98％、76％、20％;单放组分别为96％、60％、18％,无显著性差异（P〉0．05）。化放组远处转移率为20．9％,单放组为41．7％,两组比较有显著性差异（P〈0．05）。结论：诱导化疗能降低局部晚期鼻咽癌放疗的远处转移率,但没有提高生存率。     

造口袋在肿瘤患者引流中的应用

<正>肿瘤患者常常用到经皮穿刺的引流管,如常见的胸腔闭式引流管、腹腔引流管、心包穿刺引流管、肾造瘘引流管、膀胱造瘘引流管等,目的是引流出积液或尿液,以缓解压迫,改善症状。当渗液较多时,易污染被服甚至引起感染及腐蚀局部皮肤,需要多次更换,增加痛苦及费用,也增加了护理人员的工作量。我科将造口袋应用于肿瘤患者渗液收集,效果满意,现将方法介绍如下。1材料与方法1.1材料普通造口袋1个。     

视频教育结合宣传册提高手足口病患儿家庭护理效果的研究

目的 探讨视频教育结合宣传册对提高手足口病患儿家庭护理的效果。 方法 在门、急诊抽取207例手足口病患儿,将其随机分成观察组(107人)及对照组(100人)。观察组患儿家长给予视频结合宣传册进行宣教,对照组单一采用宣传册宣教。比较两组家长家庭护理知识的掌握情况,并对两组患儿的家庭护理效果进行随访。 结果 宣教后,观察组家长对手足口病家庭护理知识的掌握情况好于对照组;观察组比对照组患儿症状较早得到缓解。 结论 视频教育结合宣传册可提高患儿家长对手足口病家庭护理知识的掌握水平,有效提高家庭护理水平,促进患儿康复。     

老年骨折患者的心理特点及护理干预

现在医学模式认为,任何疾病的发生都与社会、心理、生物三个因素有关。随着社会的进步,人口老龄化已成为世界性突出问题。老年人经不起心理创伤因素的冲击,骨折后老年病人会表现出一系列机体的改变,特别是通过植物神经系统、内分泌系统等作为中介,造成心血管、内分泌和肌肉、骨骼、血管、神经等器官和系统的功能改变,因此护理干预对加     

邓高丕辨治妊娠恶阻经验

总结邓高丕教授治疗妊娠恶阻的临床经验。妊娠恶阻之病机有虚有实,虚者表现为脾胃虚弱或肝肾两虚,实者表现为肝气郁结或肝火旺盛,虚实夹杂者则表现为脾胃虚弱而痰湿阻滞。治疗当以补虚、降火、解郁、祛痰为法。呕吐轻者予中药内服,呕吐重者可采用中药直肠滴注给药,配合穴位贴敷、穴位注射、艾灸、耳穴压豆等中医特色疗法,并注重调节情志及饮食结构,以提高和巩固疗效。