门诊输液室健康教育效果观察

目的 探讨在门诊输液室加强健康教育,提高输液患者的遵医行为,提高患者对疾病相关知识的知晓率,调高患者对护理服务质量的满意度,改善护患关系.方法 选择212例输液患者随机分为观察组和对照组各106例.对照组采用常规的输液护理,观察组在常规输液护理的基础上加强健康教育,二组患者对遵医行为的依从性,以及对疾病、药物、及输液知识的知晓率和对护理服务质量的满意度进行比较.结果 观察组的遵医行为,疾病、药物、输液相关知识的知晓率,以及对护理服务质量的满意度明显提高.结论 加强门诊输液室患者的健康教育可以提高患者的遵医行为及相关知识的知晓率,提高输液患者满意度,改善护患关系.     

三官能团环氧树脂常温固化剂的复配研究及其固化动力学

以间苯二酚二缩水甘油醚(RDGE)和1,1,1-三(对羟基苯基)乙烷为原料,合成了三官能团环氧树脂TEP,并分别与异佛尔酮二胺(IPDA)单一体系和IPDA/2-乙基-4-甲基咪唑(2E4MZ)复合体系进行常温固化。通过DSC、热重分析(TGA)、动态机械热分析仪、耐化学介质以及力学性能测试对比研究了TEP树脂与两种固化体系的固化反应动力学、固化度以及热稳定性。结果表明:复合固化体系较单一固化体系初始表观活化能更低,复合体系固化物的固化程度、玻璃化转变温度、耐腐蚀性均优于单一IPDA固化体系。     

基于核酸预混室温储运技术的荧光定量PCR快速检测鼠疫耶尔森氏菌

目的 实现荧光定量PCR技术在鼠疫现场和基层的应用。方法 本试验将已建立的基于核酸预混室温储运技术的荧光定量PCR方法应用于我国各鼠疫疫源地野生菌株的检测,进行特异性评价。选取分布于我国境内不同鼠疫疫源地野生鼠疫耶尔森氏菌株、鼠疫减毒菌株、耶尔森菌属近缘菌株假结核菌及小肠结肠炎菌进行荧光定量PCR检测。结果 55株鼠疫耶尔森氏菌及鼠疫减毒菌株扩增阳性,假结核耶尔森氏菌、小肠结肠炎耶尔森氏菌无阳性扩增,冻干试剂在室温25 ℃和37 ℃条件下可保存6个月,敏感性与冷冻保存无差异,核酸扩增诊断可在1 h内完成。结论 应用基于核酸预混室温储运技术的荧光定量PCR方法对我国各鼠疫疫源地55株鼠疫耶尔森氏菌检测呈现高度特异性,本试验冻干试剂具有可室温保存、便于运输、检测结果精准、快速等特点,具有较好的鼠疫现场应用前景。     

手术室护士对患者麻醉苏醒期的护理体会

麻醉苏醒期是患者实施手术之后恢复正常生理功能的重要阶段,在这个过程中患者的麻醉深度会逐渐变浅,感觉功能逐渐恢复,自主呼吸逐渐开始自主进行调控,随着感觉功能的恢复患者慢慢清醒。在这一过程中手术室护士做好患者的护理工作非常关键,通过全面的生理与心理护理,保证患者安全度过麻醉苏醒期,减少并发症的发生。     

Case 5

A 53-year-old man with a heavy exposure to asbestos 25 years earlier was admitted to the East Orange Veterans Administration Medical Center with a rapidly enlarging chest wall mass of 4-5 weeks duration.

The mass, overlying the ninth and tenth ribs in the infraaxillary area, was firm. On X-ray the ribs appeared eroded and the mass was seen to extend into the pleural space. A chest wall resection was performed, and the tumor was sharply dissected from the diaphragm to which it was firmly adherent. Grossly, it measured 7.5 X 5.0 X 3.0 cm and was yellow-tan with homogeneous and nodular areas The inferior aspect of the ninth rib was obviously involved and the tumor extended between the pleura and intercostal muscle.

The patient did not receive further therapy and was asymptomatic 7 months after surgery.     

HLA class II DQA and DQB epitopes: Recognition of the likely binding sites of HLA-DQ alloantibodies eluted from recombinant HLA-DQ single antigen cell lines

Donor-specific antibodies (DSA) in sera of sensitized transplant patients are often produced against the specific epitopes on mismatched HLA antigens. In this study, we selected sera from 30 kidney transplant patients with DSA and AMR to define DQ epitopes. Using adsorption and elution assays, we identified 18 antibody reaction patterns to define 6 new epitopes and to confirm 12 previously defined epitopes. In one patient case, one mismatched antigen produced 3 different antibodies and, in another, antibodies were produced against the alpha and beta chains of the same antigen. For some sera, a single epitope can explain reactions for 27 of the 29 DQ beads in the single antigen panel.     

快速康复外科护理策略在老年股骨转子间骨折病人围术期中的应用

目的:探讨快速康复外科(ERAS)护理策略在老年股骨转子间骨折病人手术室护理中的应用效果。方法:随机抽样法选取2017年1月—2018年12月医院100例老年股骨转子间骨折手术病人,使用随机数字表法分为对照组与研究组各50例。对照组采用常规手术室护理,研究组采用手术室ERAS护理。比较两组病人体温(术前、术中、术后)、术中出血量、住院时间、生理应激指标、心理应激状况、术后住院期间并发症发生情况。结果:研究组病人术中、术毕体温高于对照组,术中出血量少于对照组,住院时间短于对照组(P<0.05);干预后研究组病人心率、收缩压、舒张压低于对照组,SAS、SDS评分低于对照组(P<0.05);研究组病人术后并发症发生率仅为4.00%,低于对照组的18.00%(P<0.05)。结论:老年股骨转子间骨折手术室护理中应用ERAS护理可减轻病人手术应激反应,促进术后恢复,预防相关并发症。     

领导生命周期理论在提高手术室护士预防静脉血栓水平中的应用

目的:探讨领导生命周期理论在提高手术室护士预防静脉血栓(VTE)水平中的应用效果.方法:选取2019年2月—2019年12月本院手术室护士56人作为研究对象,按照随机数字表法,将护士分为观察组和对照组各28人.对照组护士采用常规培训计划进行干预,观察组护士在此基础上采用基于领导生命周期理论的培训模式进行干预.经过6个月的干预,比较两组护士干预期间所管病人VTE发生率,以及干预前后预防VTE知识问卷得分、护士工作满意度量表(MMSS)得分.结果:观察组护士所管病人VTE发生率低于对照组,差异具有统计学意义(P<0.05).两组护士VTE知识问卷得分均高于干预前,观察组护士VTE知识问卷得分、MMSS得分高于对照组,差异均具有统计学意义(P<0.05).结论:基于领导生命周期理论的培训模式有利于提高手术室护士预防VTE知识掌握程度,改善护士工作满意度,同时有效降低病人VTE发生率.     

Early CPAP protocol in preterm infants with gestational age between 28 and 32 weeks: experience of a public hospital

BackgroundThe use of continuous positive airway pressure (CPAP) applied early after birth improves several outcomes when compared with intubation and invasive mechanical ventilation. “Early CPAP” protocols vary in relation to the pressure level, type of interface used, and studied sample.ObjectiveThis study compared intubation rate, exogenous surfactant use, and hospitalization length (among other variables) prior to and after adopting an “early CPAP” protocol in preterm infants with gestational age between 28 and 32 weeks, using intermediate pressures and short binasal prongs.MethodsThis was a retrospective study conducted in a public university hospital in Brazil. All preterm infants with gestational age between 28 and 32 weeks were included in the study. The newborns born between January 2011 and December 2012, prior to the protocol being implemented, were considered the historical control group, and those born after implementation, between February 2013 and August 2014 were considered the intervention group.ResultsThe participants in both groups had similar baseline characteristics (p > 0.05). There were significant reductions in intubation rate (89% versus 73%, p = 0.02), exogenous surfactant use (86% versus 67%, p = 0.02), and median (Q1 - Q3) days of invasive mechanical ventilation [4 (2 - 14) versus 1 (0.15–9), p = 0.01] and length of hospital stay in days [56 (42–77) versus 42 (35–71), p = 0.02].ConclusionsThe findings demonstrate positive outcomes of the early CPAP protocol. This protocol used simple and affordable equipment available in the hospital which could easily be reproduced in other centers, generating better outcomes for preterm infants and reducing hospital expenses.