门诊护理干预对提高老年糖尿病病人生活质量评价分析

[目的]调查研究门诊护理干预对老年糖尿病病人生活质量的影响。[方法]采用随机法将50例老年糖尿病病人分为观察组和对照组各25例,两组病人采用相同的治疗方案,观察组采用门诊护理方法,对照组采用常规的护理方案进行护理。[结果]观察组在实施护理后的情绪明显好转,对疾病护理后的焦虑程度为35.56分±9.05分,与对照组的52.25分±7.12分比较,差异具有统计学意义(P<0.05)。两组病人的心率与血压状况相比存在较大的差异性(P<0.05)。[结论]通过门诊护理干预,可以有效提高老年糖尿病病人的生活质量,提高战胜疾病的信心。

CDX2 protein expression compared to alcian blue staining in the evaluation of esophageal intestinal metaplasia

AIM: To compare the sensitivity and specificity of CDX2 and alcian blue (AB) pH 2.5 staining in identifying esophageal intestinal metaplasia.METHODS: One hundred and ninty-nine biopsies from 186 patients were retrospectively reviewed and categorized as Barrett’s esophagus (BE) (n = 108); non-Barrett’s esophagus (NBE) (n = 48); columnar blue cells (CB) and esophageal glands (EG) (n = 43). The biopsies were stained with AB and immunostained for CDX2 using a mouse monoclonal antibody from Biogenex (clone CDX2-88) and the Ventana Discovery X automated immunostainer. The positive and negative predictive value of each group was used to determine the predictive power of CDX2 and AB in diagnosing intestinal metaplasia.RESULTS: All of the 108 BE biopsies (100%) were positive for AB and 102 of them (94.4%) were positive for CDX2. The six BE patients (5.6%) who failed to stain with CDX2 were found to have lost the focus of intestinal metaplasia upon deeper sectioning for immunostaining. Both AB and CDX2 were negative in 43 out of 48 (89.6%) NBE cases. Five NBE patients (10.4%) were falsely positive for AB due to the presence of EG and CB in these biopsies. These cases were all CDX2 negative. In addition, 5 AB negative NBE were found to be CDX2 positive. Based on these results the CDX2 immunostain had similar sensitivity but higher specificity (100% vs about 91%) than AB in detecting intestinal type metaplasia in these samples. Our data shows that CDX2 has a better PPV in detecting intestinal metaplasia as compared to AB (95.6% vs 71.5%, respectively).CONCLUSION: CDX2 has a better positive predictive value than AB in detecting intestinal metaplasia. CDX2 may be useful when challenged by gastro-esophageal biopsies containing mimikers of BE.