弯角与传统单、双侧椎体成形术治疗老年骨质疏松性椎体压缩骨折

目的 探讨经皮弯角椎体成形术(PCVP)与传统单、双侧经皮椎体成形术(PVP)治疗老年骨质疏松性椎体压缩骨折(OVCF)的临床效果.方法 选取2018年12月～2020年12月简阳市人民医院收治的OVCF患者126例,分为A组(42例,采用传统双侧PVP手术治疗)、B组(42例,采用传统单侧PVP手术治疗)和C组(42...     

不同价格氧化型染发剂对小鼠睾丸过氧化损伤的影响

将40只小鼠按体重顺序随机分为低价格(0.2元/g)、中价格(0.3元/g)、高价格(0.4元/g)染发剂组和凡士林对照组,每组10只。每周经皮给药5 d,连续3周,实验结束后,测定小鼠精子畸形率、精子数量与睾丸超氧化物歧化酶(SOD)、丙二醛(MDA)、谷胱甘肽(GSH)水平。与对照组相比,低价格组睾丸MDA含量、SOD活力及GSH含量均显著升高(P0.05);高价格组精子畸形率显著高于对照组(P0.05)。提示氧化型染发剂对小鼠睾丸可能具有一定的过氧化损伤作用,且可导致小鼠精子畸形率升高。     

AMP依赖的蛋白激酶二甲双胍对老年大鼠肺气肿作用的实验研究

目的探讨AMP依赖的蛋白激酶(AMPK)二甲双胍在老年大鼠肺气肿中的应用效果。方法取老年24月龄SD大鼠40只,体质量(233.00±12.00)g。按随机数表法将40只大鼠分为空白对照组、模型组、地塞米松组和联合干预组,每组10只。除对照组外,余3组大鼠采用烟熏联合气管内滴注猪胰弹性蛋白酶法制作大鼠肺气肿动物模型。模型构建完成后,对照组与模型组大鼠常规腹腔灌注5 ml生理盐水,1次/d;地塞米松组大鼠腹腔灌注等体积地塞米松2 mg/kg,1次/d;联合干预组大鼠在地塞米松组基础上联合AMPK二甲双胍250 mg/kg腹腔灌注,联合药物体积5 ml。4组大鼠均连续干预14 d。HE染色观察4组大鼠肺组织损伤情况,记录并比较4组大鼠肺组织炎症因子水平[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和IL-8]及生化指标(白细胞计数、中性粒细胞及淋巴细胞比例)。采用SPSS 18.0软件对数据进行分析。根据数据类型,组间比较采用方差分析或两两比较。结果对照组HE染色下未见异常;模型组HE染色下呼吸性支气管、肺泡大小不一,肺泡数量明显减少,肺泡间隔变薄,部分间隔断裂导致肺泡融合等肺气肿样改变;地塞米松组HE染色下肺泡数目略减少,肺泡间隔一般,可见少许间隔断裂,伴有肺气肿样改变;联合干预组HE染色下肺气肿样改变不明显,肺泡数量未见明显减少。对照组大鼠TNF-a、IL-6及IL-8、白细胞计数、中性粒细胞及淋巴细胞比例依次为(178.53±19.55)pg/ml、(96.58±0.06)pg/ml、(74.55±5.68)pg/ml、(3.49±0.68)×10~8/L、(17.35±3.24)%和(12.29±2.45)%,模型组大鼠上述指标依次为(261.39±23.21)pg/ml、(753.23±43.24)pg/ml、(323.59±17.85)pg/ml、(13.29±1.46)×10~8/L、(34.69±4.64)%和(43.53±5.77)%,地塞米松组大鼠依次为(243.66±18.68)pg/ml、(323.32±25.69)pg/ml、(132.31±10.51)pg/ml、(9.48±1.35)×10~8/L、(25.69±5.32)%和(32.51±4.34)%,联合干预组大鼠依次为(213.69±15.32)pg/ml、(102.49±7.46)pg/ml、(89.43±6.59)pg/ml、(6.31±1.12)×10~8/L、(21.59±4.31)%和(21.29±3.45)%。与对照组比较,模型组和地塞米松组TNF-a、IL-6及IL-8、白细胞计数、中性粒细胞及淋巴细胞比例显著升高;与模型组比较,地塞米松组和联合干预组上述指标显著降低;与地塞米松组比较,联合干预组上述指标显著降低,差异均有统计学意义(P0.05)。结论 AMPK二甲双胍用于老年肺气肿大鼠效果理想,可降低炎症因子水平,改善肺组织的损伤。     

丹参多酚酸盐联合百令胶囊对老年急性加重期慢性阻塞性肺疾病患者的疗效及对凝血指标和生命质量的影响

目的:探讨丹参多酚酸盐联合百令胶囊对老年急性加重期慢性阻塞性肺疾病(COPD)患者的疗效及对凝血指标和生命质量的影响。方法:选取2014年1月至2016年12月简阳市人民医院收治的老年急性加重期COPD患者122例,按照随机数字表法分为观察组与对照组,每组61例。2组采用常规治疗,对照组给予百令胶囊,观察组在对照组基础上给予丹参多酚酸盐治疗。2组疗程均为10 d。比较2组治疗疗效,治疗前后主要症状评分、凝血指标及生命质量变化。结果:观察组治疗总有效率(91.80%)高于对照组(75.41%)(P0.05);2组治疗后咳嗽、气喘、咯痰评分降低(P0.05);观察组治疗后咳嗽、气喘、咯痰评分低于对照组(P0.05);2组治疗后D-二聚体降低(P0.05);观察组治疗后D-二聚体低于对照组(P0.05);而2组治疗前后PT、TT比较差异均无统计学意义(P0.05);2组治疗后CAT量表评分降低(P0.05);观察组治疗后CAT量表评分低于对照组(P0.05)。结论:丹参多酚酸盐联合百令胶囊对老年急性加重期COPD患者疗效明显,且可降低患者凝血指标D-二聚体变化,改善患者生命质量。     

护理干预对慢性阻塞性肺疾病急性加重期患者负性情绪及治疗依从性的影响

目的：：探讨护理干预对慢性阻塞性肺疾病急性加重期( AECOPD)患者负性情绪及治疗依从性的影响,促进患者康复。方法：选择AECOPD患者60例,随机分为观察组和对照组各30例,对照组实施常规护理,观察组实施护理干预,采用抑郁自评量表( SDS )评价抑郁程度,采用焦虑自评量表( SAS)评价焦虑状态,Morisky量表评估患者用药治疗依从性。结果：护理前两组患者SDS及SAS评分相似,差异无统计学意义( P>0.05);护理后两组患者SDS及SAS评分较本组护理前均下降,但是观察组下降幅度更显著,差异有统计学意义( P<0.05)。护理4周时,观察组患者治疗依从性较好27例、一般3例,对照组较好20例、一般8例和较差2例,差异有统计学意义( P<0.05)。结论：护理干预能有效缓解AECOPD患者焦虑及抑郁程度,使其治疗态度更为积极,提高治疗依从性,有助于改善患者的生存质量。     

血液透析置管感染的护理预防措施

感染是血液透析患者最常见的并发症之一,同时也是透析患者仅次于心血管并发症的第2位死因,病死率为15%～38%[1].血液透析置管感染给临床护理质量提出了更高的要求.本科对血液透析患者采取积极的护理预防措施,感染率得到明显降低.     

2型糖尿病患者社会支持与元担忧的相关分析

目的探讨糖尿病患者社会支持和元担忧的关系,为提高患者生活质量提供科学依据。方法对146例2型糖尿病患者采用《社会支持评定量表》和《元担忧量表》进行测试。结果146例2型糖尿病患者社会支持总分为（35．59±7．26）分与国内常模（44．34±8．38）分,比较差异有统计学意义（t=8．607,P〈0．01）;元担忧分数为（160．87±19．53）分;社会支持与元担忧呈显著性的负相关（r=-0．320,P〈0．01）;以社会支持各维度为自变量,元担忧为因变量,回归方程为Y=16．672＋7．987xl-0．882x2＋0．341x3,三个变量能联合预测元担忧水平29．6％的变异量。结论2型糖尿病患者社会支持低于全国常模,元担忧处于较高水平,社会支持各因素能有效的预测糖尿病患者的元担忧水平。     

经鼻或口气管插管与气管切开的护理干预效果比较

目的总结护理干预在经鼻或口气管插管和气管切开患者中的护理经验,探讨安全更好的护理方式。方法 135例气管插管患者分为A（50例）、B（45例）、C（40例）3组,A组经鼻气管插管,B组经口气管插管,C组行气管切开,均采用护理干预措施,观察3组患者治疗前后血气变化和护理效果。结果 3组患者血气变化差异无统计学意义（P〉0.05）,但A组护理效果较B、C组好,差异均有统计学意义（P〈0.05）。结论经鼻气管插管安全、有效,护理效果好,可减少并发症的发生,值得临床推广应用。     

电子支气管镜下支架植入联合氩气刀治疗恶性肿瘤引起中央气道狭窄的临床观察

目的观察电子支气管镜下支架植入联合氩气刀治疗恶性肿瘤引起中央气道狭窄的临床疗效,缓解患者呼吸困难症状。方法回顾31例患者的临床资料,分析支架一次性置入成功率等、治疗前后p H值、动脉血氧分压(Pa O2)、动脉血二氧化碳分压(Pa CO2)、动脉血氧饱和度(Sa O2)、用力肺活量(FVC)、一秒用力呼气容积(FEV1)和气促评分变化,评价治疗后中央气道狭窄疗效,以及术后并发症及处理情况。结果30例患者支架一次性置入成功,成功率96.77%。治疗1周,患者气道阻塞症状减轻,p H值、Pa O2、Pa CO2、Sa O2及FVC、FEV1较治疗前明显改善,差异有统计意义(P0.05)。气道支架置入后1周,呼吸困难症状均明显缓解,治疗后患者气促评分明显优于治疗前,差异有统计意义(P0.05)。治疗即刻及治疗后3月患者中央气道狭窄疗效相似,差异无统计意义(P0.05)。术后6例咽喉及胸骨后疼痛、10例刺激性咳嗽、7例痰中带血、3例术后再次狭窄、1例大咯血猝死和1例术后支架边缘出现瘘口。中央气道狭窄程度级别越高,并发症发生的例次越高,差异有统计意义(P0.05)。结论电子支气管镜下支架植入联合氩气刀能有效缓解恶性肿瘤引起的中央气道狭窄,快速缓解患者呼吸困难症状,是非常有效的姑息治疗手段之一,但是中央气道狭窄程度越重,术后并发症发生率越高。     

SD大鼠脊髓损伤后微环境的模拟实验

BACKGROUND: We built Sprague-Dawley rat models with mild, moderate, and severe spinal cord injuries to accord with the spinal cord injury types for basic empirical study, and consequently to further understand the microenvironmental change in Sprague-Dawley rats with spinal cord injury, and to provide help for clinical treatment. OBJECTIVE: To observe the changes in nerve function, pathological manifestation and motor sensory evoked potential in Allen’s models and Sprague-Dawley rats with complete spinal cord transection at different time points after spinal cord injury by simulating the microenviroment in Sprague-Dawley rats. METHODS: A total of 125 healthy adult female Sprague-Dawley rats were selected and randomly divided into group sham operation group, 100 gcf hit potential group (20 g×5 cm), 200 gcf hit potential (20 g×10 cm), 300 gcf hit potential group (20 g×15 cm), and spinal cord complete transection group with 25 rats in each group. At 1, 5, 7, 14 and 28 days after model establishment, the degree of spinal cord injury was identified by the BBB scores of motion function, motor evoked potential, and pathological section. RESULTS AND CONCLUSION: (1) Totally 24 Sprague-Dawley rats died in the experiment. The death rate and the rate of complications were highest in the spinal cord complete transection group. The BBB score of each group was decreased. The BBB scores in every group increased as time went on. There were significant differences between each surgery group and the sham operation group at corresponding time points (P < 0.05).  No significant difference was found between the 300 gcf hit potential group and the spinal cord complete transection group at corresponding time points (P > 0.05). (2) In each surgery group, the infiltration of inflammatory cells and obvious swelling of neurons were visible at 1 day after injury. Neural cells reduced with time prolonged. At 28 days after injury, a large number of astrocytes proliferated, scar and spinal cord cavity formed. Above symptoms were worse in the 300 gcf hit potential group and spinal cord complete transection group than in the 100 gcf and 200 gcf hit potential groups. (3) Significant differences in amplitude and latency were detectable between each surgery group and the sham operation group (P < 0.05). No significant difference in amplitude and latency was detected between the 300 gcf hit potential group and the spinal cord complete transection group at corresponding time points (P > 0.05). Results confirmed that hit potential of 20 g×5 cm, 20 g×10 cm and 20 g×15 cm can simulate the microenvironment of Sprague-Dawley rats with mild, moderate and severe spinal cord injury. The rate of complication was lower in modified Allen’s model of different hit potentials than in models of spinal cord complete transection, and was more accorded with basic research.