Plasma microRNAs as biomarkers for myotonic dystrophy type 1

Myotonic dystrophy type 1 (DM1) lacks non-invasive and easy to measure biomarkers, still largely relying on semi-quantitative tests for diagnostic and prognostic purposes. Muscle biopsies provide valuable data, but their use is limited by their invasiveness. microRNA (miRNAs) are small non-coding RNAs regulating gene expression that are also present in biological fluids and may serve as diseases biomarkers. Thus, we tested plasma miRNAs in the blood of 36 DM1 patients and 36 controls. First, a wide miRNA panel was profiled in a patient subset, followed by validation using all recruited subjects. We identified a signature of nine deregulated miRNAs in DM1 patients: eight miRNAs were increased (miR-133a, miR-193b, miR-191, miR-140-3p, miR-454, miR-574, miR-885-5p, miR-886-3p) and one (miR-27b) was decreased. Next, the levels of these miRNAs were used to calculate a “DM1-miRNAs score”. We found that both miR-133a levels and DM1-miRNAs score discriminated DM1 from controls significantly and Receiver–Operator Characteristic curves displayed an area under the curve of 0.94 and 0.97, respectively. Interestingly, both miR-133a levels and DM1-miRNAs score displayed an inverse correlation with skeletal muscle strength and displayed higher values in more compromised patients.In conclusion, we identified a characteristic plasma miRNA signature of DM1. Although preliminary, this study indicates miRNAs as potential DM1 humoral biomarkers.     

影响卵巢癌患者持续性化疗的相关因素及对策

目的探讨影响卵巢癌患者持续性化疗的相关因素及应采取的相应对策。方法对十堰市人民医院2009年6月～2010年6月妇科收治的30例不愿持续性化疗的卵巢癌患者,通过交谈法、倾听法、电话随访方式进行调查,分析其不愿持续性化疗的原因,进行有针对性的心理疏导、相关知识宣教,并采取经济支持、健康教育、社会支持等措施。结果 30例患者都愉快地接受持续性化疗。结论实施有效的伦理干预、健康教育、社会支持等措施,可以促进卵巢癌患者坚持化疗,以延长其生命并提高其生活质量。     

医患纠纷的经济学分析及对策

医患纠纷是由于患者在医院就医期间发生的许多问题导致的一种不和谐人际关系的外在表现。近年来,呈现不断上升的趋势。本文用经济学原理,通过经济模型,分析医患纠纷的经济学内涵,以此为基础提出医患纠纷的解决方案,以维护医疗环境及社会的和谐稳定,为我国经济建设做出医疗行业的贡献。     

早期活动对ICU机械通气患者谵妄发生的影响

目的探讨早期活动对ICU机械通气患者谵妄发生的影响。方法将我院2016年10月-2017年4月ICU收治的137例机械通气患者随机分组并进行常规护理干预和早期活动干预,分别在入住ICU后第1天、第2天、第3天及停机械通气时对患者进行谵妄(CAM-ICU)评估、APACHEII评分,并记录患者ICU停留时间,分析早期活动对谵妄发生,病情改善及ICU停留时间的影响。结果与对照组相比,早期活动组在入院第3天后可以显著降低患者的ICU谵妄发生率、APACHEII评分,缩短患者ICU停留时间,差异有统计学意义(P0.05)。结论专业的早期活动可以降低ICU机械通气患者谵妄的发生率,改善患者病情。     

A European evaluation of the patients’ role in clinical education: A six-country cross sectional study

AimThe aim of this study was to analyse the patients’ role in clinical education in terms of facilitative student-patient relationship in Finland, Germany, Iceland, Ireland, Lithuania and Spain and factors promoting a more facilitative relationship in clinical education.BackgroundNursing students’ bedside learning is reliant on patients and the establishment of a person-centred approach develops from the relationships with patients.DesignA multi-country, cross-sectional design was implemented.MethodsSurvey data were collected from graduating nursing students and patients between May 2018 and March 2019. The survey consisted of a 13-item facilitative sub-scale of the Student-Patient Relationship Scale as the main outcome measure, which was identical for both populations. In addition, background factors were surveyed with single questions and other scales. Associations between facilitative relationship and background factors were studied with linear models.ResultsAltogether, 1796 students and 1327 patients answered the survey. Overall, both students and patients regarded their relationship as facilitative, but students’ (median 4.23, 95% confidence interval 4.15–4.23) evaluations were higher than patients’ (median 3.75, 95% confidence interval 3.69–3.77). The students’ and patients’ evaluations differed from each other significantly in all other countries except in Ireland and Lithuania. Corresponding associations for both populations were found in terms of the country and students’ cultural confidence.ConclusionsResults signal favourable grounds for students’ bedside learning and patient participation in clinical education with the potential to foster a person-centred approach.     

Histoire et fonctions des Unités pour Malades Difficiles (1re partie). Du quartier de sûreté à l’Unité pour Malades Difficiles de Villejuif,plus d’un siècle de prise en charge

This article is the first in a series of three, dedicated to the history and functions of what is known as a UMD in France: Unités pour Malades Difficiles, or “Units for Difficult Patients”. This particular article focuses on the oldest such secure structure, UMD Henri Colin, created in 1910 in Villejuif as a quartier de sûreté, or a “secure ward”. The article aims to detail evolutions in treatment and the types of patient treated over more than one hundred years, parallel to social change. Four distinct chronological periods are examined, for their perspective on professional practice as much as for the reasons given for patients’ admission and the psychopathological profiles of “dangerous” patients. Clinical vignettes are used to illustrate this historical evolution.     

综合护理干预在腰椎疾病患者脊柱融合术后康复中的作用

目的 探讨护理干预在腰椎疾病患者脊柱融合术后康复中的作用。方法 对我院收治的180例行脊柱融合术治疗的腰椎疾病患者实施综合护理干预,比较患者治疗及护理前后的疼痛VAS评分、身体功能JOA评分、直腿抬高角度、腰背伸高度。结果 患者术后6个月疼痛VAS评分、身体功能JOA评分、直腿抬高角度、腰背伸高度较术前均明显改善。结论 对行脊柱融合术治疗的腰椎疾病患者采取综合护理干预有助于手术恢复,能有效缓解疼痛,恢复腰椎运动与神经功能。     

糖尿病患者出院的护理干预

目的：探讨糖尿病患者出院后的护理。方法对糖尿病患者进行知识宣教、饮食及运动指导。结果通过药物治疗、饮食及运动三者完美结合，对提高患者的生活质量，延长患者生命有重要意义。结论患者完全可以有正常的生活和工作，同样可以长寿。