本科实习护生患者安全态度及影响因素的调查分析

目的 调查本科实习护生的患者安全态度现状,并分析影响因素,为开展患者安全教育提供参考.方法 采用中文版安全态度问卷(C-SAQ)对重庆市某医学院校的225名本科实习护生进行问卷调查,采用SPSS 20.0软件进行数据分析.结果 实习护生患者安全态度总均分为(3.75±0.54)分,安全态度6个维度的平均分由高到低依次为...     

依托咪酯对豚鼠听诱发电位的影响

为探讨听诱发电位能否作为临床麻醉深度监测手段,采用非镇痛性麻醉药依托咪酯分次注入豚鼠腹腔,根据用药剂量模拟浅、中、深度麻醉,观察豚鼠听觉中潜伏期反应及听性脑干反应变化.结果显示,依托咪酯对听觉中潜伏期反应有明显抑制作用,且随麻醉深度加深而增强,但到一定深度后,出现“饱和”现象;中潜伏期反应谱峰明显向低频移动.依托咪酯对浅麻醉时听性脑干反应影响不显著,当麻醉加深时亦出现明显改变.提示中潜伏期反应及听性脑干反应结合使用,可以作为监测麻醉深度的客观电反应指标.     

运动员维生素E营养水平初探

采用荧光分光光度法对４０名北京体院竞技体校运动员和３０名普通大学生维生素Ｅ（ＶＥ）营养水平作了调查，结果表明：①运动员组与大学生组平均血清ＶＥ含量分别为１．２０±０．２８ｍｇ／ｄｌ和１．３３±０．３３ｍｇ／ｄｌ，运动员明显低于大学生组（Ｐ＜０．０５）。②竞走及中长跑组与短跑组平均血清ＶＥ含量分别为１．２４±０．２６ｍｇ／ｄｌ和１．１８±０．２９ｍｇ／ｄｌ，二者无明显差异（Ｐ＞０．０５）。而将这两组与大学生组比，则短跑组表现的差异大（Ｐ＜０．０５），竞走及中长跑组与大学生组没有显著性差异（Ｐ＞０．０５）。③从血中ＶＥ／ＴＣ（胆固醇）比值看，运动员组虽有低于大学生组的趋势，但两者无显著性差异（Ｐ＞０．０５）。运动员的ＶＥ营养状况是否存在不同于普通大学生的现象仍有待进一步的研究。     

选择性支气管动脉插管药物治疗中,晚期肺癌

对34例中晚期肺癌进行选择性支气管动脉插管药物灌注.药物为 LAK 细胞,IL-2、卡铂、表阿霉素。结果显示,肿块明显消退12例占35.2%,部分消退18例占52.5%、无变化4例占12.7%、总有效率为87.3%。通过对支气管动脉插管技术,灌注疗法同其它治疗方法的优缺点进行比较,认为本疗法优于周围静脉给药且无严重并发症,副作用轻,不失为一种可供选择的治疗方法.     

循证护理在外科护理本科生临床教学中的应用

目的探讨循证护理的应用对提高护理本科生临床护理能力、护理科研能力的作用.方法将98级42名进入外科临床实习的护理本科生随机分为对照组(20人)和实验组(22人).对照组按原教学模式(参照护理常规实施护理带教),实验组按循证护理模式实施带教.实习结束时对两组护生进行综合技能考试和实习护理论文质量评分.结果实验组综合技能成绩及护理论文质量均显著优于对照组(均P＜0.05).结论应用循证护理模式带教,有利于提高护理本科生的临床护理能力和护理科研能力.     

波动性高血压与中膜板层变化的动物实验

目的　为了验证和完善关于波动性血压可引起主动脉中膜板层分离 ,从而导致Stan fordB型夹层动脉瘤的假说。方法　通过犬的动物模型设计 ,同时加大血压的波动性和应用悬吊法来加大应力对主动脉弓与主动脉降段交界处的作用。结果　在施加血流动力学应力作用影响后 ,主动脉弓与主动脉降段交界处中膜可较明显地形成 3个板层区。结论　用本实验方法 ,验证了波动性高血压可以造成主动脉弓与主动脉降段交界处中膜板层的分离破坏。在一定角度上解释了StanfordB型胸主动脉夹层动脉瘤形成和发展趋势。     

Epidemiology of classical risk factors in stroke patients in the Middle East

The Middle East (ME) is an ethnically and economically diverse region. A systematic review of all stroke studies conducted in the ME was carried out, with the aim of determining the prevalence of classic vascular risk factors (CRFs) across this region. Additionally, the prevalence of CRFs in the ME was compared to that of a US cohort. Prospective and retrospective ME stroke studies published from 1994 to 2014 were searched for that specifically reported on the prevalence of CRFs. The Z test for proportions was used to determine the significance of differences in CRF rates between the ME and non‐ME studies. A total of 21 724 stroke patients from 13 nations in the ME were included. The prevalence rates for CRFs in the ME stroke population were hypertension, 62.1%; diabetes, 33.1%; dyslipidaemia, 36.8%; ischaemic heart disease, 24.6%; smoking, 19.3%; and atrial fibrillation, 13.6%. Compared to the US cohort, ME patients had a lower prevalence of all CRFs except diabetes (P < 0.0001) and smoking (P = 0.05). Compared with stroke patients in the USA, those in the ME have a significantly higher prevalence of diabetes and smoking. Education and lifestyle modification is perhaps the most effective strategy in reducing the risk of stroke in this population.     

Manual Aspiration Thrombectomy Using Penumbra Catheter in Patients with Acute M2 Occlusion : A Single-Center Analysis

ObjectiveThe efficacy and safety of manual aspiration thrombectomy using Penumbra in an acute occlusion of large intracranial arteries has been proven in many previous studies. Our study aimed to retrospectively assess the efficacy and safety of manual aspiration thrombectomy using Penumbra in patients with small vessel occlusions (M2 segment of the MCA).MethodsWe conducted a retrospective review of 32 patients who underwent manual aspiration thrombectomy using the Penumbra 4 MAX Reperfusion Catheter for treatment of an M2 occlusion between January 2013 and November 2014. We evaluated immediate angiographic results and clinical outcomes through review of patient electronic medical records.ResultsThere were slightly more men in this study (M : F=18 : 14) and the median age was 72.5 (age range : 41–90). The rate of successful recanalization (TICI grade ≥2b) was 84% (27/32). NIHSS at discharge and favorable clinical outcomes at 3 months were significantly improved than baseline. Median initial NIHSS score was 10 (range : 4–25) and was 4 (range : 0–14) at discharge. Favorable clinical outcomes (mRS score ≤2 at 3 months) were seen in 25 out of 32 patients (78%). There were no procedure-related symptomatic intracerebral hemorrhages. One patient expired after discharge due to a cardiac problem.ConclusionManual aspiration thrombectomy might be safe and is capable of achieving a high rate of successful recanalization and favorable clinical outcomes in patients with distal cerebral vessel occlusion (M2).     

案例分析法在护生护理核心制度培训中的应用

目的探讨案例分析法在护生护理核心制度培训中的应用效果。方法针对14项护理核心制度,由带教老师收集临床工作中相关案例,整编为实践情景案例和警示案例,并每月集中进行护理核心制度案例讨论分析,通过案例分析引导护生自我思考,促进护生对护理核心制度的理解、掌握和落实。结果护生对案例分析法培训的满意率达83.3%～95.5%;护生的护理核心制度理论考试合格率为90.9%;培训后护理差错发生数相对下降。结论应用案例分析教学法对护生进行护理核心制度培训,能够紧密将理论与实践结合起来,促进护生对核心制度的理解认识,使核心制度在工作中得到较好的落实。