网络课程评价系统的设计与实现

在分析了当前网络课程评价现状的基础之上,指出了现行评价方法的一些不足之处,并结合本校网络课程的开发及评价,设计了一套利用网络系统为用户提供定量评价的指标体系。     

YAG激光联合RS引流管置入治疗泪道阻塞疗效影响因素分析

目的：探讨YAG激光联合RS引流管治疗泪道阻塞的疗效及独立影响因素。

方法：回顾性分析2015-01/2018-01在我院行激光联合引流管置入治疗的250例泪道阻塞患者病例资料,总结术后疗效并采用Logistic回归分析影响疗效的独立因素。

结果：患者术后临床治疗总有效率为87.9%; 病程(OR=8.654,95% CI：3.740～20.023)、泪道冲洗频率(OR=3.480,95% CI：2.128～5.691)、泪道阻塞长度(OR=0.518,95% CI：0.238～1.131)、拔管时间(OR=0.386,95% CI：0.237～0.628)以及首次手术(OR=14.717,95% CI：10.798～20.059)是影响患者术后疗效独立影响因素。

结论：YAG激光联合RS引流管置入治疗泪道阻塞疗效显著,早期治疗、避免多次手术、术后适度冲洗泪道、控制拔管时间,均有利于提高疗效。     

食管癌组织中lnc RNA DNAJC3-AS1的表达及其与临床病理特征的相关性研究

目的 食管癌(esophageal cancer,EC)组织中lnc RNA DNAJC3-AS1的表达及其与临床病理特征的相关性研究.方法 选取2017年6月～2019年5月宝鸡市人民医院收集的246例EC患者的肿瘤组织及相应的癌旁正常组织为研究对象.通过实时荧光定量PCR法检测lnc RNA DNAJC3-AS1的...     

氟比洛芬酯用于四肢手术的镇痛效应

目的：探讨氟比洛芬酯（凯纷）与芬太尼配伍及单纯芬太尼用于自控静脉镇痛的效果及相关不良反应。方法：70例择期手术患者,按随机数字表法分为两组：芬太尼20μg／kg（A组）,凯纷50mg＋芬太尼10μg／kg（B组）分别于术后6、12、24、48h记录生命体征、VAS评分、自控静脉镇痛按压次数、不良反应（恶心、呕吐、嗜睡、皮肤瘙痒、尿潴留、呼吸抑制）。结果：术后两组生命体征比较差异无显著性;VAS评分、自控静脉镇痛按压次数及不良反应等比较差异均有显著性。结论：凯纷与芬太尼联合用于术后自控静脉镇痛的镇痛效果明确,不良反应少。     

以血栓弹力图为指导预防食管癌患者术后深静脉血栓的护理

目的 探讨以血栓弹力图(TEG)为指导预防食管癌患者术后深静脉血栓(DVT)的护理效果.方法 以80例接受手术治疗的食管癌患者为对象,进行TEG检测,比较干预前后DVT患者及高凝状态患者TEG参数水平变化.结果 80例患者中6例(7.50％)患者发生DVT.DVT患者R值、K值干预后均高于干预前,而 α 角、MA值、C...     

维持性血液透析患者首次使用综合征的护理

目的 探讨维持性血液透析治疗（MHD）患者首次使用综合征（FUS）的有效护理方法.方法 对143例MHD患者在常规透析治疗期间,采取加强生命体征观察、动-静脉瘘保护及心理疏导等综合护理措施,并分析FUS的发生情况.结果 143例MHD患者透析治疗期间,其中发生FUS 4例,发生率为2.8%.结论采取全方位、立体式护理措施,可有效降低FUS发生率,提高患者透析治疗效果.     

骨科患者万古霉素使用的专项点评

目的 通过骨科万古霉素使用情况的专项点评,促进其合理使用。方法 调取本院骨科2011—2013年使用万古霉素的病历,对其适应症、用法用量、疗程、序贯治疗、病原学检查5个方面进行合理性点评。结果 本院骨科不存在滥用万古霉素,重视病原学检查。但存在选药或疗程不合理、药液稀释浓度高以及医师对病原学检查认识不全面等现象。结论 开展万古霉素的专项点评,及时干预使用过程中存在的问题,从而促进其合理使用。     

血清降钙素原在 AECPHD 治疗中的临床意义简

目的 探究血清降钙素原（PCT）在慢性肺源性心脏病急性加重期（AECPHD）治疗中临床应用价值.方法 入选424例AECPHD患者,随机分成PCT治疗组（n=210）和常规治疗组（n=214）.主要观察指标为抗生素的使用时间、住院天数、临床有效率、病情加重例数以及死亡例数等.结果 PCT治疗组在抗生素使用时间、住院天数及二重感染发生例数等方面均少于常规治疗组,具有统计学差异;两组患者在临床有效率、死亡率、加重例数方面无统计学差异.结论 在AECPHD治疗中参考血清PCT水平使用抗生素抗感染治疗可达到有效治疗效果,缩短抗菌治疗时间,避免了过度使用抗生素.     

安宫降压丸联合厄贝沙坦片治疗原发性高血压的临床研究

目的探讨安宫降压丸联合厄贝沙坦片治疗原发性高血压的临床疗效。方法选取2017年4月—2018年4月在宝鸡市中心医院接受治疗的原发性高血压患者90例,根据用药的差别分为对照组(45例)和治疗组(45例)。对照组口服厄贝沙坦片,起始剂量0.15 g/次,1次/d,根据病情增至0.3 g/次,1次/d。治疗组在对照组基础上口服安宫降压丸,6 g/次,2次/d。两组患者均治疗4周。观察两组患者临床疗效,同时比较治疗前后两组患者血压变化、生活质量评分和血清学指标。结果治疗后,对照组临床有效率为80.00%,显著低于治疗组的97.78%,两组比较差异具有统计学意义(P0.05)。治疗后,两组24 h mSBP和24 h mDBP均显著降低(P0.05),且治疗后治疗组24 h mSBP和24 h mDBP水平明显优于对照组(P0.05)。治疗后,两组生理功能、心理功能、社会关系和环境领域评分均显著升高(P0.05),且治疗后治疗组各生活质量评分明显高于对照组(P0.05)。治疗后,两组血清可溶性凝集素样氧化低密度脂蛋白受体1(sLOX-1)、单核细胞趋化蛋白1(MCP-1)、转化生长因子β1(TGF-β1)和内皮素-1(ET-1)水平均显著降低,一氧化氮(NO)水平显著升高,同组治疗前后比较差异具有统计学意义(P0.05),且治疗后治疗组上述血清学指标明显优于对照组(P0.05)。结论安宫降压丸联合厄贝沙坦片治疗原发性高血压临床疗效好,有利于提高患者生活质量,具有一定的临床推广应用价值。     

Prognostic value of changes in spinal cord signal intensity on magnetic resonance imaging in patients with cervical compressive myelopathy

Background contextSignal intensity on preoperative cervical magnetic resonance imaging (MRI) of the spinal cord has been shown to be a potential predictor of outcome of surgery for cervical compressive myelopathy. However, the prognostic value of such signal remains controversial. One reason for the controversy is the lack of proper quantitative methods to assess MRI signal intensity.PurposeTo quantify signal intensity and to correlate intramedullary signal changes on MRI T1- and T2-weighted images (WIs) with clinical outcome and prognosis.Study designRetrospective case study.Patient samplePatients (n=148; cervical spondylotic myelopathy, n=102 and ossified posterior longitudinal ligament, n=46) who underwent surgery for cervical compressive myelopathy and had high signal intensity change on sagittal T2-WI MRI before surgery between 2006 and 2010.Outcome measureNeurologic assessment was conducted with the Japanese Orthopedic Association (JOA) scoring system for cervical myelopathy. The rate of neurologic improvement was calculated with the use of preoperative and postoperative JOA scores.MethodsQuantitative analysis of MRI signal on both T1- and T2-WIs via use of the signal intensity ratio (SIR; signal intensity of lesion relative to that at C7-T1 disc level) was performed. Correlations between SIR on T1- and T2-WIs and preoperative JOA score, JOA improvement rate, disease duration, and MRI morphologic classification (cystic or diffuse type) were analyzed. Multivariate regression analysis for JOA improvement rate was also analyzed. In a substudy, 25 patients underwent follow-up MRI starting from 6 months after surgery to analyze the relationship between changes in SIR on follow-up MRI and clinical outcome.ResultsSIR on T1-WIs, but not SIR on T2-WIs, correlated with postoperative neurologic improvement. The disease duration correlated negatively with SIR on T1-WIs and JOA improvement rate but not with SIR on T2-WIs. SIR on T2-WIs of “cystic type” was significantly greater than of “diffuse type,” but SIR on T1-WI and JOA improvement rate were not different in the two types. Stepwise multivariate regression analysis indicated that SIR on T1-WIs and long disease duration were significant predictors of postoperative neurologic outcome. SIR on follow-up T1-WI and changes in SIR on T1-WI after surgery correlated positively with postoperative improvement rate. SIR on follow-up T2-WI and changes on T2-WI correlated negatively with postoperative neurologic improvement.ConclusionsOur results suggest that low intensity signal on preoperative T1-WIs but not T2-WIs correlated with poor postoperative neurologic outcome. Furthermore, decreased signal intensity on postoperative T1-WIs and increased signal intensity on postoperative T2-WIs are predictors of poor neurologic outcome.