临床路径在病人健康教育中的应用现状及展望

介绍了临床路径在病人健康教育中的应用范围及实施状况，提出健康教育路径将更好地契入诊疗临床路径中，以及病人健康教育路径书的规范化及变异管理规范化的发展方向。     

探讨健康教育护理路径干预在对慢性化脓性中耳炎患者睡眠质量和护理满意度的影响

目的分析健康教育护理路径干预在对慢性化脓性中耳炎患者睡眠质量和护理满意度的影响。方法此次研究对象为我院2019年4月~2020年4月期间收治的58例慢性化脓性中耳炎患者,以随机数字表法分对照组和观察组,每组29例,观察两组睡眠质量与护理满意度。与本研究,按照护理方法的差异将其分为对照组与观察组,每组39例,对两组护理前后的心理状态进行比较。结果护理后,观察组匹茨堡睡眠质量指数量表(PSQI)评分低于对照组,且护理满意度高于对照组(P<0.05)。结论在慢性化脓性中耳炎患者中实施健康教育护理路径干预,可促进患者睡眠质量与护理满意度的提升。     

腹股沟斜疝手术患者应用临床护理路径的护理效果分析

目的探讨腹股沟斜疝手术患者应用临床护理路径的临床效果。方法收集2013年1月～2014年4月来我院进行腹股沟斜疝手术的患者81例,根据护理方法分为研究组41例,对照组40例。比较住院时间、住院总费用、疾病知识掌握程度及护理满意度。结果与对照组比较,研究组住院时间较短,住院总费用较低,疾病知识掌握程度优良率、护理满意度较高（P〈0.05）。结论在腹股沟斜疝手术患者中实施临床护理路径护理效果显著,能使患者的住院时间缩短、住院总费用降低,疾病知识掌握程度优良率及护理满意度提高。     

Theory of rodent navigation based on interacting representations of space

We present a computational theory of navigation in rodents based on interacting representations of place, head direction, and local view. An associated computer model is able to replicate a variety of behavioral and neurophysiological results from the rodent navigation literature. The theory and model generate predictions that are testable with current technologies. © 1996 Wiley-Liss, Inc.     

Facilitation of kindling by prior induction of long-term potentiation in the perforant path

Previous studies have revealed that a form of synaptic potentiation resembling long-term potentiation (LTP) occurs at various sites as a result of stimulation that leads to kindling. The present study evaluates what role this synaptic potentiation plays in the development of kindling following periodic stimulation of the entorhinal cortex of the rat. LTP was repetitively induced in the pathway from the entorhinal cortex (EC) to the dentate gyrus (DG) by daily stimulation with high frequency trains that led to LTP, but did not evoke afterdischarge (AD). Subsequently, animals received stimulation designed to induce kindling (that led to AD), and this stimulation was delivered once per day until kindled seizures were induced. While repetitive induction of LTP was not sufficient to produce kindling, prior induction of LTP significantly increased the rate of subsequent kindling as evidenced by a decrease in the number of kindling stimulations required to induce the kindled state. As a group, animals that had received stimulation designed to induce LTP developed kindled seizures after an average of 10 AD's, whereas a control group that had received non-potentiating stimulation required 25 AD's. These results indicate that LTP at EC-DG synapses cannot represent the mechanism of kindling following EC stimulation. However, synaptic potentiation at this site can facilitate the development of epileptogenesis in response to subsequent activation of the perforant path.     

临床护理路径在脑卒中患者神经性吞咽障碍训练中的应用

目的探讨临床护理路径在脑卒中患者神经性吞咽障碍训练中的应用效果。方法将2012年1~10月在本院神经内科住院的60例脑卒中伴有神经性吞咽障碍患者,按入院先后顺序,分为实验组和对照组,每组各30例。对照组采用常规护理方法进行吞咽障碍训练,实验组采用临床护理路径进行吞咽障碍训练。出院前比较两组患者吞咽功能改善情况。结果实验组患者吞咽功能改善明显优于对照组,两组比较,差异具有统计学意义(P0.05)。结论应用临床护理路径在脑卒中伴神经性吞咽障碍患者中进行有针对性、系统的吞咽功能训练,可有效改善患者吞咽功能,提高患者生活质量,值得临床推广应用。     

路径化健康教育改善肠造口病人自我效能

目的:评价路径化健康教育提高肠造口病人自我效能的效果。方法 :2012年5月至12月于我院外科肠造口术病人80例,分为干预组和对照组各40例,干预组采用路径化健康教育,对照组采用传统健康教育,分别在病人术前、术后1周及出院时,采用造口自我效能量表调查并比较两组病人自我效能。2015年电话随访调查两组病人术后自我效能。结果:干预组肠造口病人术后1周自我效能评分(74.35±27.90)高于对照组病人自我效能评分(51.30±22.58),P0.05)。术后随访病人62例,失访18例,失访率为22.5%。术后随访干预组病人自我效能评分(108.27±12.29)高于对照组病人自我效能评分(93.93±13.23),P<0.05。结论:应用路径化健康教育能改善肠造口病人术后自我效能。     

The Effect of Heat Source Path on Thermal Evolution during Electro-Gas Welding of Thick Steel Plates

In recent years, the shipbuilding industry has experienced a growing demand for tighter control and higher strength requirements in thick steel plate welding. Electro-gas welding (EGW) is a high heat input welding method, widely used to improve the welding efficiency of thick plates. Modelling the EGW process of thick steel plates has been challenging due to difficulties in accurately depicting the heat source path movement. An EGW experiment on 30 mm thickness E36 steel plates was conducted in this study. A semi-ellipsoid heat source model was implemented, and its movement was mathematically expressed using linear, sinusoidal, or oscillate-stop paths. The geometry of welding joints, process variables, and steel composition are taken from industrial scale experiments. The resulting thermal evolutions across all heat source-path approaches were verified against experimental observations. Practical industrial recommendations are provided and discussed in terms of the fusion quality for E36 steel plates with a heat input of 157 kJ/cm. It was found that the oscillate-stop heat path predicts thermal profile more accurately than the sinusoidal function and linear heat path for EGW welding of 30 mm thickness and above. The linear heat path approach is recommended for E36 steel plate thickness up to 20 mm, whereas maximum thickness up to 30 mm is appropriate for sinusoidal path, and maximum thickness up to 35 mm is appropriate for oscillate-stop path in EGW welding, assuming constant heat input.     

“健康中国”视域下农村卫生体制优化探讨

在实施健康中国战略的时代背景下,理应持续优化农村医疗卫生体制,加速推进农村公共医疗服务均等化,更好地维护农民群体的发展权利。但当前,由于农村发展不充分使得农村卫生体制的改革优化遭遇了诸多难题。具体包括经济迟滞难以提供充足发展资源、留守难题加码卫生体制改革压力以及农民发展农村的信心下降弱化改革的群众基础等难题。为此,应该通过加强整体规划、多方筹措改革资源、构筑专属留守群体的卫生应急体系以及创新改革手段等工作来优化农村卫生体制改革。