心理护理临床路径对妊娠高血压综合征患者心理状态、并发症及母乳喂养情况的影响分析

目的探讨心理护理临床路径对妊娠高血压综合征患者心理状态、并发症及母乳喂养情况的影响。方法选取2016年4月至2019年4月该院收治的79例妊娠高血压综合征患者为研究对象,根据入院日期单双号,将研究对象分为对照组40例及研究组39例。对照组患者接受传统产科护理,研究组在对照组的基础上采用心理护理临床路径进行护理。比较干预前后两组患者的治疗依从性、心理状态、母乳喂养自信心以及产后并发症发生率、泌乳始动时间、母乳喂养情况以及护理满意度。结果与干预前相比,干预后两组患者的治疗依从性和母乳喂养自我效能量表(BSES)评分均明显升高(P<0.05);两组患者的焦虑自评量表(SAS)和抑郁自评量表(SDS)评分明显降低(P<0.05),且研究组显著优于对照组(P<0.05)。与对照组相比,研究组患者产后并发症发生率更低(P<0.05),泌乳始动时间显著缩短(P<0.05),护理总满意度更高(P<0.05)。产后随访1个月,研究组纯母乳喂养率显著高于对照组(P<0.05)。结论心理护理临床路径可有效改善患者的心理状态,提高治疗依从性及母乳喂养自信心,促进乳汁分泌,减少产后并发症,对提高纯母乳喂养率、促进母婴健康具有积极意义。     

健康教育路径对肝硬化腹水患者遵医行为及健康认知的影响

目的探讨健康教育路径对肝硬化腹水患者遵医行为及健康认知的影响。方法选取我院2018年1月至2019年1月收治的肝硬化腹水患者100例作为研究对象,将其随机等分成对照组和观察组,对照组予以常规健康教育,观察组予以健康教育路径干预,比较两组患者遵医行为及健康认知情况。结果观察组治疗复诊、心理自调、用药饮食及生活自护方面依从性明显高于对照组(P<0.05);观察组疾病认知、治疗认知、自护认知及康复认知水平明显高于对照组(P<0.05)。结论健康教育路径在肝硬化腹水患者中的应用,能改善其遵医行为,可强化其健康认知。     

健康教育路径在妊娠期糖尿病患者中的应用

目的探讨健康教育路径在妊娠期糖尿病患者中的应用效果。方法选择我院2017年4月至2019年4月收治的妊娠期糖尿病患者92例为研究对象,随机将其等分为对照组和观察组,对照组采用常规教育模式,观察组采用健康教育路径。比较两组患者血糖水平、分娩结局及生活质量。结果观察组空腹血糖、餐后2 h血糖、糖化血红蛋白均低于对照组(P<0.05);观察组自然分娩率高于对照组(P<0.05);观察组生活质量各项评分均高于对照组(P<0.05)。结论健康教育路径在妊娠期糖尿病患者中应用,能有效控制血糖水平,改善分娩结局及生活质量。     

NKX2-5在乳腺癌患者他莫昔芬耐药中的作用及调控机制

目的探讨NKX2-5在乳腺癌患者他莫昔芬(TAM)耐药中的作用及调控机制。方法采用免疫组化染色检测乳腺癌组织和癌旁组织NKX2-5的表达。利用高通量基因表达数据库(GEO)分析乳腺癌患者的相关资料及NKX2-5表达与乳腺癌患者生存率的关系。构建乳腺癌TAM耐药细胞株(MCF-7/TAM),采用CCK-8试剂盒检测不同浓度TAM处理后细胞增殖的变化,免疫印迹法检测细胞相关蛋白表达,逆转录-聚合酶链反应(RT-PCR)检测细胞NKX2-5 mRNA的表达。结果癌旁组织NKX2-5表达明显高于癌组织(P<0.05)。TAM敏感组织NKX2-5表达明显高于TAM耐药组织(P<0.05)。NKX2-5低表达组总生存率和无病生存率明显低于NKX2-5高表达组(P<0.05);在接受TAM治疗的乳腺癌患者中,NKX2-5低表达组总生存率明显低于NKX2-5高表达组(P<0.05)。与MCF-7细胞比较,MCF-7/TAM细胞NKX2-5蛋白表达明显降低(P<0.05)。采用瞬时转染技术将NKX2-5过表达质粒(Ad-NKX2-5)、空载质粒(Ad-NC)转染MCF-7/TAM细胞(Ad-NKX2-5组、Ad-NC组),NKX2-5小干扰RNA质粒(NKX2-5-siRNA)、空白对照(NC-siRNA)转染MCF-7细胞(NKX2-5-siRNA组、NC-siRNA组)。采用50、100μmol/L TAM处理后,Ad-NKX2-5组细胞增殖抑制率明显高于Ad-NC组(P<0.05),NKX2-5-siRNA组细胞增殖抑制率明显低于NC-siRNA组(P<0.05)。MCF-7/TAM细胞磷酸化p38丝裂原活化蛋白激酶(p-P38MAPK)、磷酸化c-Jun氨基末端激酶(p-JNK)、磷酸化细胞外信号调节激酶(p-ERK)蛋白表达明显高于MCF-7细胞(P<0.05)。Ad-NKX2-5组p-P38、p-JNK、p-ERK蛋白表达明显低于Ad-NC组(P<0.05),NKX2-5-siRNA组p-P38、p-JNK、p-ERK蛋白表达明显高于NC-siRNA组(P<0.05)。结论乳腺癌TAM耐药细胞中NKX2-5表达下调。上调NKX2-5表达或许能通过抑制丝裂原活化蛋白激酶(MAPK)信号通路逆转MCF-7细胞TAM耐药。     

健康教育路径在颅内动脉瘤介入手术患者中的应用效果评价

目的探讨健康教育路径在颅内动脉瘤介入术后患者中的应用效果。方法采用便利抽样法,选取2018年8月—2019年3月华中科技大学同济医学院附属同济医院神经外科确诊为颅内动脉瘤且行支架辅助栓塞术的80例患者为研究对象,依据随机数字表法分为观察组和对照组各40例。观察组采用健康教育路径,对照组采用常规健康教育模式,比较两组患者出院指导质量量表(QDTS)、出院准备度量表(RHDS)、自我管理能力量表得分及护理满意度。结果实施健康教育路径后,除需要内容外,观察组患者出院QDTS总分及各维度得分、RHDS总分及各维度得分、自我管理能力量表总分及各维度得分均高于对照组,两组比较差异均有统计学意义(P<0.05)。观察组对护理工作满意率为97.50%(38/40),高于对照组的77.50%(31/40),两组比较差异有统计学意义(P<0.05)。结论对颅内动脉瘤介入术后患者实施健康教育路径,规范了护理人员健康教育行为,体现了以患者为中心的理念,值得推广应用。     

重症监护室机械通气病人肠内营养支持临床护理路径的应用研究

[目的]探讨重症监护室(ICU)机械通气病人肠内营养支持临床护理路径的应用效果。[方法]将60例导致呼吸衰竭而接受机械通气病人按照随机数字表法分为对照组、观察组,每组30例,对照组采用常规肠内营养支持护理模式进行护理,观察组采用ICU机械通气肠内营养支持临床护理路径模式进行护理。观察两组病人干预前后营养指标、呼吸机相关性肺炎(VAP)、胃潴留、高血糖、误吸、黏膜糜烂、腹胀、腹泻等并发症发生率情况,花费营养费用,机械通气时间,住院时间。[结果]干预后观察组病人营养状况优于对照组(P<0.05);机械通气时间、住院时间、所花费的营养费用观察组均少于对照组(P<0.05);并发症发生率观察组低于对照组(P<0.05)。[结论]临床护理路径在ICU机械通气病人肠内营养支持的应用效果满意,可改善病人营养状况,节约医疗资源,降低不良反应发生率。     

结局指标在缺血性脑卒中病人康复护理路径中的应用研究

[目的]运用护理结局指标构建缺血性脑卒中病人康复护理路径,为护士在临床服务全过程中提供标准化的语言链接和可供度量的尺度,同时培养临床护士发现、思考、解决问题的能力,也为病人在临床就医体验提供规范化、连续性、科学化的护理服务模式。[方法]通过病例回顾性研究和文献研究,由2名研究者独立提取护理记录的相关概念、归类到缺血性脑卒中46项核心护理结局。[结果]最终10项护理结局中有33个结局指标差异具有统计学意义(P<0.01),包括上肢肌力、下肢肌力、爬楼梯的耐受性、以有效的步态行走、慢走、中速行走、走、平衡、协调、步态、表现正常的能力水平、显示完成日常任务的能力、表现出适当的修饰和卫生、括约肌伸缩性、排便时肌肉的伸缩性、排便无须辅助措施、如厕、沐浴、走路、吞咽测试的结果、对食物的容受、吞咽不适、音质变化、正确使用支持器械、采取正确推重物的技巧、表现出肌力良好、充足的液体摄入、排尿模式、意识的尿意、说道感到焦虑、血压升高、说道恐慌感、恐慌感。[结论]以护理结局指标为导向构建的缺血性脑卒中病人康复护理路径,可为病人在临床就医体验提供规范化、连续性、科学化的护理服务模式,提高医护工作的水平。     

Pterostilbene pre-treatment reduces LPS-induced acute lung injury through activating NR4A1

ContextPterostilbene (PTE), a common polyphenol compound, exerts an anti-inflammatory effect in many diseases, including acute lung injury (ALI).ObjectiveThis study explores the potential mechanism of PTE pre-treatment against lipopolysaccharide (LPS)-induced ALI.Materials and methodsSixty Sprague-Dawley rats were divided into control, ALI, 10 mg/kg PTE + LPS, 20 mg/kg PTE + LPS, and 40 mg/kg PTE + LPS groups. At 24 h before LPS instillation, PTE was administered orally. At 2 h before LPS instillation, PTE was again administered orally. After 24 h of LPS treatment, the rats were euthanized. The levels of inflammatory cells and inflammatory factors in the bronchoalveolar lavage fluid (BALF), the expression of nuclear receptor subfamily 4 group A member 1 (NR4A1), and the nuclear factor (NF)-κB pathway-related protein levels were detected. NR4A1 agonist was used to further investigate the mechanism of PTE pre-treatment.ResultsAfter PTE pre-treatment, the LPS induced inflammation was controlled and the survival rate was increased to 100% from 70% after LPS treatment 24 h. For lung injury score, it decreased to 1.5 from 3.5 after treating 40 mg/kg PTE. Compared with the control group, the expression of NR4A1 in the ALI group was decreased by 20–40%. However, the 40 mg/kg PTE pre-treatment increased the NR4A1 expression by 20–40% in the lung tissue. The results obtained with pre-treatment NR4A1 agonist were similar to those obtained by pre-treatment 40 mg/kg PTE.ConclusionsPTE pre-treatment might represent an appropriate therapeutic target and strategy for preventing ALI induced by LPS.     

Gastroprotective effects of water extract of domesticated Amauroderma rugosum against several gastric ulcer models in rats

ContextAmauroderma rugosum (Blume & T. Nees) Torrend (Ganodermataceae) is an edible mushroom with medicinal properties. However, the effects of A. rugosum on gastric ulcer remain unclear.ObjectiveTo investigate the gastroprotective efficacy of water extract of A. rugosum (WEA) on gastric ulcer.Materials and methodsSprague-Dawley rats were randomly grouped as control, model, lansoprazole and 200, 100 and 50 mg/kg of WEA. After pre-treatment for seven days, ethanol- and indomethacin-induced gastric ulcer models were established. The gastric ulcer and histopathology were investigated. Enzyme-linked immunosorbent assay (ELISA), quantitative polymerase chain reaction (Q-PCR) and Western blot assays were conducted to explore the potential anti-inflammatory effect and mechanism of WEA. Additionally, the pyloric ligation model was used to explore the influence of WEA on gastric acid and mucus.ResultsPre-treatment with WEA (200, 100 and 50 mg/kg) effectively reduced ulcerous area in both ethanol-induced (71%, 88% and 71%) and indomethacin-induced (77%, 65% and 86%) gastric ulcer model. The gastric levels of tumour necrosis factor-alpha (TNF-α) (34% and 50 mg/kg), interleukin-6 (IL-6) (32% and 100 mg/kg) and interleukin-1β (IL-1β) (36%, 45% and 41%) were reduced significantly (p < 0.05) by WEA. Serum nitric oxide was decreased significantly (p < 0.05) at 200 and 50 mg/kg and PGE2 concentration was increased remarkably (p < 0.05) at 100 mg/kg. Gene expression of inflammasome Nlrp3, and the nuclear translocation of nuclear factor-κB (NF-κB) P65 were significantly decreased by WEA pre-treatment. However, the pH of gastric acid and secretion of mucus did not show any significant change.ConclusionsThe gastroprotective effect of WEA on gastric damage is attributed to anti-inflammation through the inhibition on NF-κB P65 nuclear migration and Nlrp3 gene expression.