探讨将临床护理路径运用到优质护理中的好处

目的探讨将临床护理路径运用到优质护理中的好处。方法选取157例第一诊断为短暂性脑缺血发作的符合路径条件的患者,随机分为实验组80例,对照组77例。两组均以整体护理为基础,实验组80例实施临床护理路径模式护理;对照组77例实施常规护理。对两组患者在平均住院天数、平均住院费用、患者及家属满意度方面进行统计分析。结果实验组在平均住院天数、平均住院费用、患者及家属满意度上得分均显著高于对照组,两组比较差异有统计学意义(P<0.05)。结论将临床护理路径运用到优质护理中能缩短患者住院时间、降低患者住院费用、提高患者及家属的满意度。将高质量、高效能、低成本的临床护理路径运用到优质护理之中值得推广,是提高护理品质的一种有效模式。     

硅溶胶的浓度对磷酸盐包埋料性能的影响

目的 评价硅溶胶浓度对包埋料性能的影响。方法 分别使用SiO2含量为0％、10％、20％、30％、40%的硅溶胶调拌包埋同一包埋料，检测气孔率、抗压强度、凝固膨胀率和热膨胀率．并包埋铸造100个钴铬合金帽状修复体，检测边缘浮出量。结果 当硅溶胶的浓度小于20％时，随着硅溶胶浓度的提高，凝固膨胀和热膨胀明显增大，铸件的边缘浮出量明显减小；当硅溶胶浓度在20％-40％时，随着硅溶胶浓度的提高，抗压强度明显增大，铸件的边缘浮出量变化不大。结论 使用SiO2含量为30％左右的硅溶胶所得的包埋料各方面性能都较优良，建议使用30％左右的硅溶胶。     

内热针联合云克疗法治疗膝关节骨性关节炎的疗效及其对患者IL-1和TNF-a水平的影响

目的:观察内热针联合云克疗法治疗膝关节骨性关节炎的临床疗效,以及检查其对患者白细胞介素-1(IL-1)和肿瘤坏死因子-a(TNF-a)水平的影响。方法:选取2012年6月至2013年3月武汉市普仁医院收治的膝关节骨性关节炎患者70例,随机分为观察组和对照组,每组35例,观察组患者给予内热针联合云克疗法治疗,对照组患者仅给予云克疗法治疗,疗程为6周。分别测定治疗前和治疗后不同时期2组患者的IL-1和TNF-a水平。并观察2组治疗前和治疗后不同时期膝关节HSS评分。结果:治疗后,2组患者各个时期的IL-1和TNF-a水平较治疗前明显下降(P0.05);且观察组的IL-1和TNF-a水平较对照组的显著下降,差异有统计学意义(P0.05);治疗后观察组各个时期的膝关节HSS评分明显高于对照组(P0.05)。结论:内热针联合云克疗法对治疗膝关节骨性关节炎有着明显的疗效,其机制可能是通过有效地降低抑制膝关节骨性关节炎患者的IL-1和TNF-a水平来减轻炎性反应,从而减缓膝关节的退化,值得临床作进一步推广。     

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??Secretory phospholipase A2 group ??A is an enzyme that hydrolyzes the sn-2 ester in glyceroacyl phospholipids present in lipoproteins and cell membranes. There have been an increasing number of reports regarding the pathogenesis of the enzyme in cardiovascular,tumor and autoimmune diseases in recent years and drug development targeting the enzyme is receiving more and more attention as a result. This article reviews research RESULTS in the above areas and current status of drug development based on reported sPLA2-II inhibitors.     

亮丙瑞林治疗子宫内膜异位症效果及对性激素、生育功能影响

目的对亮丙瑞林治疗子宫内膜异位症的效果进行观察,并分析其对患者性激素、生育功能的影响情况。方法选择2014年10月至2016年10月武汉科技大学附属医院(武汉市普仁医院)诊治的60例接受腹腔镜手术治疗的子宫内膜异位症患者作为研究对象。随机分成观察组、对照组,每组各30例。对照组仅接受腹腔镜手术治疗,观察组则在对照组基础上加用亮丙瑞林予以治疗。对两组患者的治疗效果、性激素水平变化情况、生育功能以及并发症、复发情况进行比较。结果观察组治疗总有效率为93.3%,明显高于对照组患者的73.3%,差异具有统计学意义(P<0.05);观察组治疗后的FSH、LH、E2改善情况明显优于对照组,差异具有统计学意义(P<0.05);观察组排卵、月经恢复正常时间均明显短于对照组,差异具有统计学意义(P<0.05);观察组术后2年妊娠成功率明显高于对照组,差异具有统计学意义(P<0.05);观察组的并发症、复发情况明显少于对照组,差异具有统计学意义(P<0.05)。结论亮丙瑞林应用于子宫内膜异位症治疗中能够有效提高患者的治疗效果,改善其生育功能,且安全性较高。     

单独发生于脑干的脑后部可逆性脑病综合征1例

脑后部可逆性脑病综合征(Posterior reversible encephalopathy syndrome,PRES)是近年来认识的一种可逆性神经综合征.其症状包括头痛、癫痫、意识错乱、视物模糊等,多伴有明显的高血压.最早于1996年由Hinchey提出,MRI最突出的表现是累及大脑半球后部(顶枕叶为主)白质区弥漫性对称性大片长T1长T2信号,并且呈可逆性.随着人们认识的提高,发现病变不仅累及顶枕叶白质,还可累及皮层、脑干及小脑等其它区域,并且也可引起不可逆性神经功能缺失.我院即发现1例单独发生于脑干的不典型PRES,现报告如下.     

产超广谱β-内酰胺酶大肠埃希菌的检测及耐药性分析

目的研究产超广谱β-内酰胺酶（ESBLs）大肠埃希菌的发生及耐药性，为临床抗感染治疗合理使用抗生素提供指导。方法用美国临床实验室标准化研究所推荐的初筛试验和表型确证试验检测ESBLs产生株，使用最低抑菌浓度法和K—B法检测临床各类标本中分离的216株大肠埃希菌对22种抗生素的耐药情况。结果216株大肠埃希菌ESBLs检出率为59．3％，产ESBLs大肠埃希菌对大多数β-内酰胺类药物明显耐药，并对氨基糖苷类、氟喹诺酮类多数耐药，耐药率明显高于非产ESBLs大肠埃希菌，但对亚胺培南100％敏感。结论产ESBLs大肠埃希菌大多为多重耐药菌，其耐药性明显高于非产ESBLs大肠埃希菌，临床微生物实验室应加强对产ESBLs菌株的监测。     

Comparative Study on the Generation and Characteristics of Debris Induced by Fretting and Sliding

Objectives: The aim of the present work was to comparatively investigate the generation and characteristics of fretting and sliding wear debris produced by CuNiAl against 42CrMo4. Methods: Tribological tests were conducted employing a self-developed tribometer. Most experimental conditions were set the same except for the amplitudes and number of cycles. Morphological, chemical, microstructural and dimensional features of the worn area and debris were investigated using optical microscope (OM), X-ray diffraction (XRD), scanning electron microscopy (SEM) with energy dispersive spectroscopy (EDS) and a laser particle sizer. Outcomes: Not only wear scar profiles but also the wear debris color, distribution and generated amount under fretting and sliding wear modes were quite different, which can be attributed to the significant difference in wear mechanisms. Particle size analysis indicates that the fretting debris has a smaller size distribution range; the biggest detected fretting and sliding wear debris sizes were 141 μm and 355 μm, respectively. Both fretting and sliding debris are mainly composed of copper and its oxides, but the former shows a higher oxidation degree.     

Performance,Reaction Pathway and Kinetics of the Enhanced Dechlorination Degradation of 2,4-Dichlorophenol by Fe/Ni Nanoparticles Supported on Attapulgite Disaggregated by a Ball Milling–Freezing Process

Attapulgite (ATP) disaggregated by a ball milling–freezing process was used to support Fe/Ni bimetallic nanoparticles (nFe/Ni) to obtain a composite material of D-ATP-nFe/Ni for the dechlorination degradation of 2,4-dichlorophenol (2,4-DCP), thus improving the problem of agglomeration and oxidation passivation of nanoscale zero-valent iron (nFe) in the dechlorination degradation of chlorinated organic compounds. The results show that Fe/Ni nanoparticle clusters were dispersed into single spherical particles by the ball milling–freezing-disaggregated attapulgite, in which the average particle size decreased from 423.94 nm to 54.51 nm, and the specific surface area of D-ATP-nFe /Ni (97.10 m²/g) was 6.9 times greater than that of nFe/Ni (14.15 m²/g). Therefore, the degradation rate of 2,4-DCP increased from 81.9% during ATP-nFe/Ni application to 96.8% during D-ATP-nFe/Ni application within 120 min, and the yield of phenol increased from 57.2% to 86.1%. Meanwhile, the reaction rate K_obs of the degradation of 2,4-DCP by D-ATP-nFe/Ni was 0.0277 min⁻¹, which was higher than that of ATP-nFe/Ni (0.0135 min⁻¹). In the dechlorination process of 2,4-DCP by D-ATP-nFe/Ni, the reaction rate for the direct dechlorination of 2,4-DCP of phenol (k₅ = 0.0156 min⁻¹) was much higher than that of 4-chlorophenol (4-CP, k₂ = 0.0052 min⁻¹) and 2-chlorophenol (2-CP, k₁ = 0.0070 min⁻¹), which suggests that the main dechlorination degradation pathway for the removal of 2,4-DCP by D-ATP-nFe/Ni was directly reduced to phenol by the removal of two chlorine atoms. In the secondary pathway, the removal of one chlorine atom from 2,4-DCP to generate 2-CP or 4-CP as intermediate was the rate controlling step. The final dechlorination product (phenol) was obtained when the dechlorination rate accelerated with the progress of the reaction. This study contributes to the broad topic of organic pollutant treatment by the application of clay minerals.     

Low-Temperature,Efficient Synthesis of Highly Crystalline Urchin-like Tantalum Diboride Nanoflowers

Urchin-like tantalum diboride (TaB₂) nanoflowers were successfully synthesized via a high-efficiency and energy-saving methodology, molten-salt and microwave co-modified boro/carbothermal reduction, using less expensive B₄C as a reducing agent. By taking advantage of the synergistic effects of the molten-salt medium and microwave heating conditions, the onset formation temperature of TaB₂ was drastically reduced to below 1000 °C, and phase-pure powders of TaB₂ nanoflowers were obtained at temperatures as low as 1200 °C within only 20 min. Notably, the present temperature conditions were remarkably milder than those (>1500 °C for several hours) required by conventional reduction methods, which use the strong, but expensive, reducing agent, elemental boron. The resulting urchin-like TaB₂ nanoflowers consisted of numerous uniform single-crystalline nanowires with lengths up to 4.16 μm, and high aspect ratios >10. This result indicated that the as-synthesized urchin-like TaB₂ nanoflowers possessed high specific surface area and anisotropic morphology, which were favorable not only for sintering, but also for toughening their bulk counterparts.