目的 观察慢性鼻-鼻窦炎伴鼻息肉(CRSwNP)患者鼻内镜术后鼻息肉复发情况,分析复发的影响因素.方法 选择2016年8月至2018年8月珠海市人民医院收治的615例完成鼻内镜手术治疗的CRSwNP患者为研究对象,随访2年统计患者鼻息肉复发情况,自制调查问卷对复发和未复发患者进行调查,记录患者的相关资料,经单因素与多因素Logistic回归分析CRSwNP患者鼻内镜术后鼻息肉复发的影响因素.结果 615例完成鼻内镜手术治疗的CRSwNP患者随访2年发现,83例患者鼻息肉复发,复发率为13.50％.复发组患者多发性鼻息肉、术后感染、吸烟的比例高于未复发组[53.01％(44/83)比11.84％(63/532)、28.92％(24/83)比3.95％(21/532)、57.83％(48/83)比21.05％(112/532)](P<0.01),复发组嗜酸粒细胞计数高于未复发组[(0.48±0.12)×109/L比(0.38±0.06)×109/L](P<0.01).多因素Logistic回归分析结果显示,多发性鼻息肉、嗜酸粒细胞升高、术后感染、吸烟是CRSwNP患者鼻内镜术后鼻息肉复发的影响因素(P<0.01).结论 CRSwNP患者鼻内镜术后鼻息肉复发率较高,可能与多发性鼻息肉、嗜酸粒细胞百分比值高、术后感染、吸烟等因素有关,临床应重视上述因素并及时对伴有上述因素的患者实施干预.

目的:探讨全程精细化护理结合中药雾化助力对悬雍垂腭咽成形术患者的影响.方法:选取2019年1月1日～2020年8月31日收治的90例阻塞性睡眠呼吸暂停低通气综合症患者为研究对象,均择期行悬雍垂腭咽成形术,根据入院时间顺序分为观察组和对照组各45例.对照组采用常规护理结合简易雾化,观察组采用全程精细化护理结合中药雾化助力;比较两组术后疼痛评分[采用视觉模拟评分法(VAS)],患者满意度及知识掌握率.结果:两组VAS评分、患者满意度及知识掌握情况比较差异均有统计学意义(P<0.05).结论:全程精细化护理结合新型雾化器中药雾化助力,对悬雍垂腭咽成形术后患者具有促进康复的作用,能减少患者术后疼痛,提高患者满意度及知识掌握率.

目的:探讨层级链式护理模式在行鼻负压洗鼻治疗鼻窦炎患儿中的应用效果.方法:按随机数字表法将2018年3月1日～2019年3月31日收治的120例行鼻负压洗鼻患儿分为观察组和常规组各60例,观察组采用层级链式护理模式,常规组采用常规护理干预;比较两组负压洗鼻疗效改善情况、清洗不良反应发生情况及复发情况,评估患儿家属满意度[采用纽卡斯尔满意度量表(NSNS)].结果:观察组负压洗鼻总有效率、家属总满意率高于常规组(P<0.05),不良反应发生率、复发率低于常规组(P<0.01,P<0.05).结论:层级链式护理模式应用于鼻窦炎患儿鼻负压洗鼻治疗中,有助于提高负压洗鼻疗效、安全性和患儿家属满意度,降低复发率,对患儿病情改善有利.

目的:探讨个案循环跟进护理在功能性鼻内窥镜术后患者中的应用方法及效果.方法:将168例行功能性鼻内窥镜术的鼻窦炎患者随机分为对照组和观察组各84例,对照组给予常规护理,观察组给予个案循环跟进护理,比较两组护理效果.结果:观察组健康教育知晓率、复查依从性、护理满意度均优于对照组(P<0.05).两组干预后生活质量评分高于干预前(P<0.05),观察组干预后生活质量评分高于对照组(P<0.05).结论:个案循环跟进护理可提高功能性鼻内窥镜术后患者健康教育知晓率及复查依从性,改善患者生活质量.

目的 探究门诊电子喉镜检查前患者健康教育的重要性.方法 选取2017年1～3月我院620例门诊电子喉镜检查患者,按随机数字表法分成A、B两组,每组310例,A组患者采用常规护理,B组加上健康教育,在检查后通过问卷调查,对患者的焦虑、抑郁情绪、知识掌握情况及满意度进行了解.结果 经过健康教育后,B组的焦虑评分和抑郁评分明显低于A组,差异有统计学意义(P＜0.05);B组知识掌握率为95.16％,明显高于A组的85.16％,差异有统计学意义(P＜0.05);B组满意度为94.52％,明显高于A组的80.00％,差异有统计学意义(P＜0.05).结论 门诊电子喉镜检查前患者健康教育能够显著改善患者的焦虑、抑郁情绪,提高知识掌握水平及对护理人员的满意度,在喉镜检查的护理过程中十分重要.

Bone marrow-derived mesenchymal stem cells can differentiate into a variety of adult cells. Brain-derived neurotrophic factor (BDNF) is briefly active during differentiation and induces mesenchymal stem cells to differentiate into nerve cells. In this study, we cloned human BDNF to generate a recombinant pcDNA3.1(−)-BDNF vector and transfected the vector into bone marrow-derived mesenchymal stem cells. We selected these cells with Geneticin-418 to obtain BDNF-BMSCs, which were induced with retinoic acid to obtain induced BDNF-BMSCs. The transfected cells displayed the typical morphology and surface antigen profile of fibroblasts and were observed to express clusters of differentiation 29, 44, and 90 (observed in matrix and stromal cells), but not clusters of differentiation 31, 34, and 45 (observed in red blood cells and endothelial cells), via flow cytometry. Enzyme-linked immunosorbent assays showed that transfected bone marrow-derived mesenchymal stem cells secreted more BDNF than non-transfected bone marrow-derived mesenchymal stem cells. Immunocytochemistry and real-time reverse transcription polymerase chain reaction analysis showed that non-induced BDNF-BMSCs maintained a higher proliferative capacity and expressed higher amounts of brain-derived neurotrophic factor, nestin, neuron-specific enolase, and glial fibrillary acid protein than non-transfected bone marrow-derived mesenchymal stem cells. An additional increase was observed in the induced BDNF-BMSCs compared to the non-induced BDNF-BMSCs. This expression profile is characteristic of neurocytes. Our data demonstrate that bone marrow-derived mesenchymal stem cells transfected with the BDNF gene can differentiate into nerve-like cells in vitro, which may enable the generation of sufficient quantities of nerve-like cells for treatment of neuronal diseases.

目的：探讨分期护理对喉环状软骨上部分切除及喉功能重建术患者的应用效果。方法选取收住的的喉环状软骨上部分切除及喉功能重建术患者40例，根据护理方式的不同分为分期护理组和对照组，每组20例。对照组给予常规护理，分期护理组根据术前、术后的不同时期的护理要点给予针对性护理。比较两组患者恢复效果、心理状况和患者满意度。结果分期护理组的患者满意度、患者的心理状况、术后恢复效果均优于对照组（均P＜0.05）。结论对喉环状软骨上部分切除及喉功能重建术患者实施分期护理措施能够有效提高临床治疗效果，提高患者满意度，具有较高的临床应用价值。

Objective To compare the outcomes of temperature-controlled radiofrequency-assisted endoscopic partial tonsillectomy and adenoidectomy(A) and conventional tonsillectomy and adenoidectomy(B) in elder children with obstructive sleep apnea-hypopnea syndrome(OSAHS).Method 65 children(6-12 year old) with OSAHS are studied.There are 32 patients underwent A and 33 patients underwent B.Data of surgery time,bleeding volume were collected and analysed.Casesof OSAHS were monitored with polysomnography(PSG),and the parameters obtained before operation and 12 months after operation were analyzed.Results Surgery times ofAare statistically shorter than those of B,bleeding volumes ofAare significantly less than those of B.Two groups are effective in curative effect.Conclusion Temperature-controlled radiofrequency-assisted endoscopicoperation can reduce bleeding volume and shorten surgery time and the effect is satisfactory.