循证护理在应用无创正压通气治疗COPD患者舒适护理中的应用

目的探讨循证护理在应用无创正压通气治疗慢性阻塞性肺病(chronic obstructive pulmonary disease,COPD)患者舒适护理中的应用效果。方法选择在本科室住院的COPD患者143例,分为实验组75例和对照组68例。实验组引进循证护理理念、制订护理计划、进行护理实践;对照组运用传统护理方法进行护理。比较两组患者舒适度的差异。结果实验组患者舒适感觉优于对照组,两组比较,Z=317.373,P<0.05,差异具有统计学意义。结论循证护理作为一种科学的护理模式,在应用无创正压通气治疗的COPD患者的护理中切实可行,能有效地提高患者的舒适度。     

舒适护理在手外科患者中的应用

目的：探讨舒适护理在手外科患者中的应用效果。方法将60例手外科患者随机分为两组,均予以常规护理干预,研究组在此基础上予以舒适护理,观察1周。采用焦虑自评量表评定两组患者的焦虑情绪,同时统计两组患者的满意度。结果住院1周末两组患者焦虑自评量表评分均较入院时显著下降（P＜0.01）,研究组较对照组下降更明显（P＜0.05）,研究组满意率显著高于对照组（ P＜0.05）。结论将舒适护理应用于手外科可显著缓解患者的焦虑情绪,提高患者的满意度。     

妇产科恶性肿瘤手术患者应用舒适护理的效果评价简

目的：探讨妇产科恶性肿瘤手术患者应用舒适护理的效果。方法选取我科2009年1月～2012年10月确诊并行手术治疗的60例恶性肿瘤患者为研究对象。将其随机分为舒适护理组31例和常规护理组29例。常规护理组采用常规护理。舒适护理组在常规护理的基础上实施舒适护理。比较两组护理前后的焦虑、抑郁评分,生活质量评分及护理工作满意度。结果舒适护理组干预后SAS、SDS、SF-36评分显著优于常规护理组（P＜0．01,P＜0．05）。两组满意度比较,舒适护理组患者满意度明显高于常规护理组（P＜0．05）。结论舒适护理可显著降低妇产科恶性肿瘤患者的术后焦虑、抑郁情绪,提高生活质量及满意度。     

轻密度布比卡因与重密度布比卡因用于下肢手术的临床麻醉效果对比研究

[目的]对比研究轻密度布比卡因和重密度布比卡应用于下肢手术的临床麻醉效果。[方法]选取2010年1～12月在某院因行下肢手术而实施腰麻-硬膜外联合麻醉的患者120例作为研究对象,将所有患者按照使用布比卡因的比重不同分为轻密度组和重密度组,分别向下腔蛛网膜注射轻密度和重密度布比卡因。比较两组患者的麻醉效果、麻醉时间、术中低血压发生率、BCS舒适评分及并发症情况,综合评价轻密度布比卡因和重密度布比卡因在下肢手术患者中的临床效果。[结果]两组患者麻醉效果、麻醉时间及并发症比较差异无统计学意义,P值均﹥0.05;BCS舒适度评分及低血压发生率比较,轻密度组患者较重密度组患者有明显优势,P值均﹤0.05,均具有统计学意义。[结论轻密度布比卡因和重密度布比卡因在下肢手术患者中的麻醉效果及麻醉时间方面大致相当,但使用轻密度布比卡因较重密度布比卡因在麻醉舒适度和麻醉过程中低血压发生率及舒适度比较,有明显优势。     

Characteristics of the control of human thermoregulatory behavior

The aim of this study was to characterize several of the thermal input(s) that influence thermo-behavior in humans. Eight male subjects completed two trials in which they were free to initiate an exit from a hot chamber (45 °C) to a cold chamber (10 °C; H → C) or from a cold chamber to a hot chamber (C → H). Upon initiating an exit from the chamber, mean skin temperature (T_Sk), rectal temperature (T_Rectal), subjective thermal comfort, and time in the climate chambers prior to exit were recorded. Thermo-behavior was defined as the initiation of exit. All variables were similar (P ≥ 0.05) between the two trials. T_Sk and thermal comfort at H → C were significantly (P ≤ 0.05) higher (34.0 ± 1.1 °C, and 7.3 ± 0.6, respectively) than at C → H (29.4 ± 0.9 °C, and 3.0 ± 0.6, respectively). No significant differences (P ≥ 0.05) were found between H → C and C → H for T_Rectal (H → C: 37.0 ± 0.2 °C vs. C → H: 37.0 ± 0.2 °C) or time prior to exit (H → C: 3.9 ± 2.3 min vs. C → H: 3.9 ± 1.7 min). The frequency distributions and the probability of the initiation of exit curves at H → C and C → H for both T_Sk and thermal comfort were significantly negatively skewed (P ≤ 0.05) and normally distributed, respectively (P ≥ 0.05). Skin temperature appears to be an important thermal input mediating thermo-behavioral responses. This behavioral response appears to be more precise when exposed to hot temperatures compared to cold temperatures.     

A comparative study of biweekly disposable contact lenses: silicone hydrogel versus hydrogel

Background: Our aim was to compare the clinical performance of a biweekly (second generation) silicone hydrogel lens and a biweekly hydrogel lens worn for daily wear modality. Methods: We used a double‐masked study, in which non‐presbyopic, asymptomatic and adapted soft lens wearers were recruited. Subjects wore a silicone hydrogel lens in one eye and a hydrogel lens in the other (lens types and eyes were randomly assigned) for one month. Lenses were replaced every two weeks. Contact lens fitting, pre‐lens tear film thinning time, vision, corneal integrity and lens deposits were assessed before and every fortnight after delivery of new lenses. A questionnaire was used to compare the subjective performance of the two lens types. Results: Thirty of the 33 subjects completed the study. There were no significant differences in lens fitting (centration and movement), pre‐lens tear film thinning time, vision or corneal integrity between the two lens types. Statistically, there was no significant difference in lens deposits between the two lens types but silicone hydrogel lenses tended to have more Grade 3 to 4 lipid deposits than hydrogel lenses. Subjects found no significant differences between the two lens types in terms of vision and comfort. Preference for silicone hydrogel lenses increased from 33 at the first after‐care visit to 50 per cent at the second after‐care visit. Conclusion: This short‐term study demonstrates that the performance of silicone hydrogel and hydrogel lenses is comparable but the former tends to build up more lipid deposits than the latter. We did not find better performance in terms of ocular integrity of silicone hydrogel lenses compared to the hydrogel lenses, probably because the subjects were adapted asymptomatic contact lens wearers before commencing the study. Contact lens wearers having hypoxia‐related problems are likely to benefit from using silicone hydrogel lenses, as these lenses provide at least three times more oxygen than conventional hydrogel lenses.     

冠心病介入治疗术后应用Angio-Seal血管闭合器并发症及舒适度的临床观察

目的探讨冠心病介入治疗术后使用Angio-eal血管闭合器的并发症及舒适度。方法150例经皮冠脉介入治疗的患者,按术后是否应用Angio-Seal血管闭合器止血,分为常规压迫止血组75例和血管闭合器组75例,观察两组血管并发症的发生率和舒适度。结果血管闭合器组较常规压迫止血组血肿发生率明显减少（P〈0.01）。腰背酸痛、失眠、烦躁、尿潴留等症状明显减少,舒适度增加（P〈0.05）。结论冠心病介入治疗术后使用Angio-Seal血管闭合器安全有效,能明显减少血肿等的发生率,提高舒适度。     

Social,thermal, and temporal influences on isolation-induced and maternally potentiated ultrasonic vocalizations of rat pups

Sensory and temporal factors have been demonstrated to be involved in the regulation of isolation-induced ultrasonic vocalizations (USV) of young rats. Sensory cues include thermal, olfactory, and tactile modalities. Temporal factors include the time spent in isolation. The goal of the present research was to examine the interaction of these factors in both isolation-induced and maternally potentiated USV. Maternal potentiation of USV occurs when a brief interaction with the dam, even a passive (anesthetized) dam, elicits an augmented vocal response to a subsequent isolation, with rates of USV in rat pups well above those emitted in standard isolation tests. We found that passive maternal potentiation of USV did occur under all conditions tested. Neither a 30-min prior isolation nor high ambient temperature prevented an increase in USV rate over the rate of the original isolation. After 30-min isolation at warm temperatures when the rate of USV had fallen to zero, the pups increased vocalization in the presence of the dam as well as in the subsequent isolation. Temporal and thermal factors also interacted significantly in regulating the level of the USV emitted by the pups during the first isolation, in the presence of the anesthetized dam, and during the second isolation.     

Effect of intra-operative magnesium sulphate on pain relief and patient comfort after major lumbar orthopaedic surgery

The effects of intra-operative magnesium sulphate on pain relief after major lumbar surgery were investigated in 24 patients. Patients were randomly allocated to receive either an infusion of 50 mg x kg(-1) magnesium sulphate or an equivalent volume of saline at induction of anaesthesia. Anaesthesia was induced with propofol and remifentanil. Tracheal intubation was facilitated using rocuronium. Maintenance was achieved with remifentanil and sevoflurane in nitrous oxide/ oxygen. Intra-operative monitoring included standard equipment and neuromuscular transmission. During surgery, neuromuscular block recovery was longer in the magnesium group. Postoperative opioid consumption and pain scores were lower in the magnesium group. The first night's sleep and the global satisfaction scores were better in the magnesium group. The results of the study support magnesium sulphate as a useful adjuvant for postoperative analgesia after major lumbar surgery.     

Dental practitioners’ use of health risk assessments for a variety of health conditions: Results from the South Atlantic region of The National Dental Practice-Based Research Network

BackgroundAn important step in integrating dental and medical care is improving understanding of the frequency and characteristics of dental practitioners who conduct health risk assessments (HRAs).MethodsFrom September 2017 through July 2018, active dentist and hygienist members of the South Atlantic region of The National Dental Practice-Based Research Network (N = 870) were invited to participate in a survey evaluating their HRA practices (screening, measuring, discussing, referring patients) for 6 health conditions (obesity, hypertension, sexual activities, diabetes, alcohol use, tobacco use). For each health condition, the authors used ordinal logistic regression to measure the associations among the practitioner’s HRA practices and the practitioner’s characteristics, barriers, and practice characteristics.ResultsMost of the 475 responding practitioners (≥ 72%) reported they at least occasionally complete 1 or more HRA steps for the health conditions except sexual activities. Most practitioners screened (that is, asked about) and gave referral information to affected patients for diabetes (56%) and hypertension (63%). Factors associated with each increased HRA practice for 2 or more outcomes were non-Hispanic white compared with Hispanic practitioner (cumulative odds ratio [COR] obesity, 0.4; 95% confidence interval [CI], 0.2 to 0.8; and COR diabetes, 0.3; 95% CI 0.2 to 0.8), male compared with female practitioner (COR tobacco, 0.3; 95% CI, 0.2 to 0.7; and COR hypertension, 0.4; 95% CI 0.2 to 0.8), and practitioner discomfort (COR, obesity and alcohol use, 0.7; 95% CI, 0.6 to 0.9; and COR, sexual activities 0.6; 95% CI 0.5 to 0.8).Conclusions and Practical ImplicationsDental practitioners are conducting HRA practices for multiple conditions. Interventions should focus on reducing practitioner discomfort and target non-Hispanic white, male practitioners.