目的 探讨超星学习通结合BOPPPS教学模式在健康评估课程中的应用及效果.方法 抽取本校 2019 级 225 名护理本科学生,一二班 111 人为试验组(超星学习通结合BOPPPS教学模式组),三四班 114 人为对照组(传统教学组);试验组授课过程中教师基于超星学习通实现BOPPPS教学模式中课前导言、目标、前测 3 个阶段及课中参与式学习、后测、小结 3 个阶段;对照组采用传统教学模式.通过学生课程成绩、学生评教及课程满意度、护理学生自我导向学习能力量表,分析比较两种教学方法对学生健康评估课程学习的影响.结果 两组学生总评成绩差异有统计学意义(P<0.05),成绩优良率差异无统计学意义(P>0.05);两组学生评教结果差异有统计学意义(P<0.01),对课程满意度评价差异有统计学意义(P<0.05);试验组自我导向学习量表总得分高于对照组(P<0.05),学习意识、学习策略、学习行为等维度得分高于对照组(P<0.05),学习评价、人际关系技能等维度差异无统计学意义(P>0.05).结论 在健康评估课程教学中采用超星学习通结合BOPPPS教学模式可有效提升学生的课程成绩和学习能力.

Objective To observe the effects of hot medicated compress with moxa-salt on the three yang meridians of hand on motor function of the upper limb, upper limb joint range of motion, and hemiplegic hand function in stroke patients with hemiplegia.Methods From March to September 2021, 86 hemiplegia patients after stroke were selected from the Department of Neurological Rehabilitation in Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine. The patients included were randomly divided into experimental group and control group with 43 cases in each group. The control group received routine medical treatment, nursing and rehabilitation training, and the experimental group received hot medicated compress on the three yang meridians of hand with moxa-salt additionally for once a day, 30 minutes each time, and 5 times per week for 4 weeks. Motor function of the upper limb, upper limb joint range of motion, and hemiplegic hand function were evaluated before intervention, 2 and4 weeks after intervention. Results Eighty-one cases completed the trial, with 40 cases in the experimental group, and 41 cases in the control group. There was no statistical difference in upper limb motor function between the two groups after 2 weeks of intervention（P＞0.05）, and the upper limb motor function of the experimental group was better than that of the control group after 4weeks of intervention（P＜0.05）.In terms of the range of motion of the upper limb, after 2 weeks of intervention, the range of motion in shoulder flexion, shoulder extension, shoulder abduction, shoulder pronation and elbow flexion of the experimental group were better than that of the control group（P＜0.05）, and after 4 weeks of intervention, the range of motion of shoulder flexion, shoulder extension,shoulder abduction, internal rotation, external rotation, elbow flexion, carpal flexion and carpal dorsi extension in the experimental group were better than that in the control group（P＜0.05）. There was no significant difference in hemiplegic hand function between the two groups after intervention for 2 and 4 weeks（P＞0.05）. Conclusion Hot medicated compress on the three yang meridians of hand with moxa-salt can effectively improve the motor function of the upper limb and upper limb joint range of motion in stroke patients, however, it has no significant effect on improving hemiplegic hand function.

目的 观察四子散蜡疗手三阴经筋对脑卒中偏瘫患者上肢运动功能、痉挛状态及生存质量的影响.方法 便利选取2020年5月—2021年1月入住福建省某三级甲等康复医院恢复期的脑卒中上肢偏瘫患者作为研究对象,将141例患者随机分为四子散蜡疗组、蜡疗组、对照组,每组各47例.3组均进行常规治疗、护理和康复训练;四子散蜡疗组在此基础上于手三阴经筋循行部位进行四子散蜡疗;蜡疗组在此基础上于手三阴经筋循行部位进行蜡疗;四子散蜡疗组和蜡疗组干预时间均为1次/d,20 min/次,5次/周,连续干预4周.于干预前、干预2周后及干预4周后评估患者上肢运动功能及痉挛程度,干预前后评估患者生存质量.结果 共130例完成试验,四子散蜡疗组剔除1例、脱落3例、中止1例;蜡疗组剔除1例、脱落2例、中止1例;对照组剔除1例、脱落1例.干预4周后,四子散蜡疗组上肢运动功能评分、上肢痉挛改善程度高于对照组(P<0.05);四子散蜡疗组及蜡疗组脑卒中生存质量量表评分高于对照组(P<0.05).广义估计方程结果显示,3组上肢运动功能评分的时间效应与交互效应差异具有统计学意义(P<0.05),上肢痉挛改善程度的时间效应差异具有统计学意义(P<0.05).结论 四子散蜡疗手三阴经筋可提升卒中偏瘫患者上肢运动功能,改善上肢痉挛程度及生存质量.

目的:探讨穴位贴磁对脑卒中后偏瘫肩痛患者的影响.方法:将92例脑卒中后偏瘫肩痛患者随机分为穴位贴磁组及常规组.常规组接受常规治疗、护理及康复训练;穴位贴磁组在此基础上予以偏瘫侧手三阳经穴位磁疗贴贴压,每周6天,干预4周.观察干预前后和干预4周后肩痛程度、肩关节活动度及干预前后上肢运动功能的变化.结果:两组各42例完成试验.干预后及干预4周后,穴位贴磁组肩痛程度、肩关节活动度(前屈、外展、内旋、外旋)改善均优于常规组(P＜0.05);干预后,穴位贴磁组上肢运动功能评分改善优于常规组(P＜0.05).结论:手三阳经穴位贴磁可缓解卒中后偏瘫肩痛患者的肩痛症状,改善肩关节活动度及上肢运动功能.

Objective: To explore the effect of yam gruel on intestinal permeability in T2DM rats. Methods: 35 male Wistar rats were randomly divided into blank group (n=8) and model group (n=27). The rats in the blank group were given normal diet, and the model group were fed with high-fat diet and intraperitoneal injection of streptozotocin to prepare T2DM rat model. After modeling, the rats were randomly divided into model group, yam gruel group and metformin group. The blank group and model group were given 5 mL normal saline, the yam gruel group was given 5 mL yam gruel, and the metformin group was given 5 mL metformin. Fasting blood glucose (FBG) was measured every week. After the intervention, the histological morphology of colon was observed, and the protein expressions of TNF-α, IL-6, Occludin and ZO-1 in colon tissue, and the expression of Zonulin, LPS, TNF-α, IL-6 and fins in serum were detected. HOMA-IR was calculated. Results: In the model group, the intestinal villi were incomplete and sparsely spaced, accompanied by neutrophil exudation. The above situation in yam gruel group and metformin group was better than that in the model group. In the model group, the protein expression of TNF-α and IL-6 increased (P<0.05), the protein expression of Occludin and ZO-1 decreased (P<0.05), the expression of Zonulin, LPS, TNF-α, IL-6 and FINS increased (P<0.05), FBG and HOMA-IR increased (P<0.05). In the yam gruel group, the protein expression of TNF-α and IL-6 decreased (P<0.05), the protein expression of Occludin and ZO-1 increased (P<0.05), the expression of Zonulin, LPS, TNF-α, IL-6 and FINS decreased (P<0.05), FBG and HOMA-IR decreased (P<0.05). Conclusion: Yam gruel could reduce the intestinal permeability of T2DM rats, and then reduce the systemic inflammatory response, alleviate insulin resistance and improve blood glucose.

目的:探讨基于微信公众号的翻转课堂教学法在急救护理学教学中的应用效果.方法:选取本校护理学专业本科生为观察对象,分为实验组(99人)和对照组(153人),分别采用基于微信公众号的翻转课堂教学法和传统教学法,比较两组教学效果.结果:在考核成绩、自主学习能力方面实验组优于对照组(P<0.01);在教学满意度方面,两组无统计学差异.结论:基于微信公众号的翻转课堂教学法可提升学生自主学习能力,提高知识传递效率.

目的 观察薯蓣粥对2型糖尿病(type 2 diabetes mellitus,T2DM)大鼠磷酸烯醇式丙酮酸羧激酶(phosphoenolpyruvate carboxykinase,PEPCK)、葡萄糖-6-磷酸酶(glucose-6-phosphatase,G6Pase)、肿瘤坏死因子-o(tumor necrosis factor-α,TNF-α)、白细胞介素-6(interleukin-6,1L-6)、C-反应蛋白(C-reactive protein,CRP)和脂联素(adiponectin,APN)等与肝脏糖异生相关指标的变化,从肝脏糖异生角度探讨薯蓣粥的降糖机制,为薯蓣粥的临床应用提供科学依据.方法 60只Wistar大鼠随机分为空白组10只和造模组50只.造模组采用高糖高脂饲料联合腹腔注射小剂量链脲佐菌素(streptozotocin,STZ)制备T2DM大鼠模型,将造模成功的40只大鼠随机分为模型组、薯蓣粥组、二甲双胍组和联合治疗组,各组10只.每组给予相应药物连续灌胃给药6周后,全自动生化分析仪检测空腹血糖(fasting blood glucose,FBG);ELISA检测血清TNF-α、IL-6、CRP和APN含量;RT-qPCR检测PEPCK和G6Pase基因(mRNA)表达;免疫组化检测PEPCK和G6Pase蛋白表达.结果 与空白组比较,模型组大鼠FBG显著升高(P＜0.01);血清TNF-α、IL-6、CRP水平上升,APN水平下降(P＜0.01);肝组织PEPCK、G6Pase mRNA及蛋白表达均增加(P＜0.01).与模型组比较,薯蓣粥组、二甲双胍组和联合治疗组FBG显著降低(P＜0.01);血清TNF-α、IL-6、CRP水平下降,APN水平上升(P＜0.05);肝组织PEPCK、G6Pase mRNA及蛋白表达均减少(P＜0.01);且联合治疗组较薯蓣粥组应用效果更优(P＜0.05).结论 薯蓣粥能够降低T2DM大鼠FBG水平,其作用机制可能与下调T2DM大鼠血清TNF-α、IL-6、CRP水平和上调APN水平,进而减少肝组织PEPCK、G6Pase mRNA及蛋白的表达,减弱肝脏糖异生有关.

目的 探讨四子散盐熨手三阴经筋对脑卒中偏瘫患者上肢痉挛的康复护理效果.方法 将108例恢复期脑卒中上肢痉挛偏瘫患者随机分为两组各54例.对照组采用常规治疗、护理和康复训练;干预组在此基础上施予四子散盐熨手三阴经筋,干预4周后评价效果.结果 对照组49例、干预组48例完成全程研究进入结果分析.干预后干预组上肢痉挛缓解程度、运动功能提高程度、临床结局评分显著优于对照组(P＜0.05,P＜0.01);治疗过程中未发生生命体征变化及局部损伤.结论 四子散盐熨手三阴经筋可有效缓解卒中患者上肢痉挛状态,改善上肢运动功能及临床结局.

Focal cerebral ischemia-reperfusion injury is closely related to hyperglycemia and gut microbiota imbalance, while gut microbiota contributes to the regulation of brain function through the gut-brain axis. Previous studies in patients with diabetes have found that 'yam gruel' is a classic medicated diet made from Dioscorea polystachya, increases the content of Bifidobacterium, regulates oxidative stress, and reduces fasting blood glucose levels. The research reported here investigated the effects of 'yam gruel' on the cognitive function of streptozotocin-induced diabetic rats with focal cerebral ischemia-reperfusion injury and explored the mechanism underlying the role of the gut-brain axis in this process. 'Yam gruel' was shown to improve cognitive function as indicated by increased relative content of probiotic bacteria, and short-chain fatty acids in the intestinal tract and cerebral cortex reduced oxidative stress and inflammatory response and promotion of the expression of neurotransmitters and brain-derived neurotrophic factor. Thus, it is concluded that 'yam gruel' has a protective effect on cognitive function via a mechanism related to the gut-brain axis.

目的 探讨四子散加粗盐循经热熨对脑卒中恢复期痉挛性偏瘫患者的影响.方法 使用随机数字表法将86例患者分为试验组和对照组,各43例,两组均接受常规治疗、护理和康复训练.在此基础上,试验组施予四子散加粗盐循经热熨,每天1次,每次30 min,每周5次,干预4周.观察干预前、干预2周后和干预4周后痉挛程度及运动功能的变化.结果 干预4周后,试验组上下肢痉挛程度、综合痉挛量表得分、肢体运动功能评分较干预前均显著改善(P＜0.01);干预4周后,试验组上下肢痉挛程度改善有效率均高于对照组,差异具有统计学意义(P＜0.05).重复测量方差分析结果显示,综合痉挛量表总分及各维度得分的时间效应有统计学意义(P＜0.01),综合痉挛量表总分与腱反射得分的时间效应与处理效应的交互作用有统计学意义(P＜0.01);上下肢肢体运动功能评分的时间效应、处理效应与时间效应的交互作用有统计学意义(P＜0.01).结论 四子散加粗盐循经热熨在一定程度上可能改善脑卒中痉挛性偏瘫患者的肢体痉挛程度,提高患者的运动功能.

Objective To investigate the knowledge,attitude,and behavior (KAP) in diabetic osteoporosis (DO) patients with high risk of osteoporotic fractures in Fuzhou community,and to analyze the influential factors of osteoporosis knowledge tests,which may provide evidences for the community health education.Methods From December 2016 to March 2017,191 DO patients with high risk of osteoporotic fractures predicted by fracture risk assessment tool (FRAX) were involved in the survey.The level of KAP was evaluated by using osteoporosis knowledge tests (OKT),osteoporosis self-efficacy scale (OSES),and selfdesigned questionnaire of osteoporosis health behavior.The data were collected to explore the affecting factors.Results The average score of OKT was 0.44 ± 0.16.The dimension score of the calcium knowledge was the highest,but the score of risk factors was the lowest.The patients with higher education degree and male patients got higher scores.In the survey of osteoporosis selfefficacy,the average score of OSES was 129.13 ± 26.07,and the score of exercise self-efficacy was lower than that of dietary calcium self-efficacy.In the survey of osteoporosis health behavior,the average score of health behavior was 31.74 ± 6.88.The dimension score of taking calcium and vitamin D supplements was lowest.Conclusion Females and patients with lower education should be paid more attention in osteoporosis health education.In order to decrease osteoporosis fractures,the education of risk factor knowledge and KAP should be focused,and diverse exercise programs and more sources of calcium intake should be provided.

目的 总结心肌梗塞患者护理工作中开展早期康复护理的具体方法以及应用效果,为临床护理工作提供可靠的依据.方法 选取我院在以往一年之内所接诊的急性心肌梗塞患者资料100例开展对比分析,根据护理方案的差异将所选患者进行分组,给予对照组常规护理,给予研究组早期康复护理,比较研究组和对照组患者的生活质量,将所得各项数值进行统计学计算.结果 研究组患者接受早期康复护理措施之后,其生活质量改善程度显著高于对照组,并发症产生几率显著低于对照组,两组比较存在统计学差异(P<0.05).结论 临床中针对急性心肌梗塞患者,在其护理工作中开展早期康复护理,能够显著改善患者的生活质量,减少并发症的出现,应该在临床中给予大力的推广和应用.

目的 探讨一体化护理管理在手术器械消毒供应室中的应用效果.方法 选取福建中医药大学附属人民医院手术室2016年11月—2017年12月使用过的各类手术器械384件,随机分为对照组和观察组,各192件.对照组实施常规护理消毒管理,观察组实施一体化护理消毒管理.比较两组手术器械消毒合格率和手术器械消毒满意度.结果 观察组手术器械消毒合格率、手术器械消毒满意度高于对照组(P<0.05).结论 一体化护理管理在手术器械消毒供应室中的应用效果较好,可有效提升手术器械消毒合格率和手术器械消毒满意度,从而降低院内感染发生风险,有效提医院整体护理质量,保证患者的生命安全.

Objective:To explore the effect of Zhi tune music on motor function of cerebral ischemic stroke hemiplegic (CISH) patients with Qi deficiency and blood stasis syndrome.Methods:A total of 90 CISH patients with Qi deficiency and blood stasis syndrome were randomized into Zhi tune group (n=45) and conventional control group (n=45). Zhi tune group accepted listening to music of Zhi tune in addition to general treatment and care while conventional control group only received general treatment and care. The treatment lasted for four weeks in both groups. The Fugl-Meyer assessment scale, clinic neurological function deficit scale for stroke, and traditional Chinese medicine (TCM) symptomatic grading and quantifying standard were used to evaluate the therapeutic effect of both groups.Results:After the treatment, the upper and lower extremities'FMA scores of both groups were increased significantly (P<0.05), and the increasing amplitude of lower extremities'FMA score of Zhi tune group was higher than that of conventional control group (P<0.05). The neurological function deficit scales of both groups after the treatment were decreased significantly (P<0.05), and the decreasing amplitude of Zhi tune group was higher than that of conventional control group (P<0.05). The TCM symptomatic therapeutic effect of Zhi tune group was better than that of conventional control group (P<0.05).Conclusion:Zhi tune music could improve motor function of lower extremities, repair nervous functional deficiency, and improve TCM syndrome of CISH patients with Qi deficiency and blood stasis syndrome.

目的 探讨角调音乐对脑卒中恢复期抑郁患者汉密尔顿抑郁量表(HAMD)评分、血清5-羟色胺(5-HT)的影响. 方法 将105例脑卒中恢复期抑郁患者按电脑随机数法分为角调音乐组、西洋音乐组、空白对照组各35例,3组均接受常规治疗和护理,在此基础上,角调音乐组聆听角调音乐,西洋音乐组聆听西洋音乐,3组疗程均为4周.观察试验前后HAMD-17积分及血清5-HT含量的变化. 结果 经4周干预,角调音乐组试验后第2、4周HAMD评分较试验前明显降低(P＜0.01或P＜0.05),血清5-HT含量明显升高. 结论 角调音乐可提高患者血清5-HT的含量,有效改善脑卒中恢复期抑郁患者抑郁症状.

目的：探讨高血压并发脑卒中恢复期患者的血压各参数与中医体质类型的相关性。方法采用“中医体质量表”对符合纳入条件的福建省某三甲医院120例住院患者进行现场问卷调查，同时记录患者的血压各参数（如收缩压、舒张压、平均动脉压、脉压），并对两者之间的相关性进行分析。结果患者主要体质类型为痰湿质（38例，31.67％）、阴虚质（28例，23.33％）、气虚质（21例，17.50％）、血瘀质（14例，11.67％）；痰湿质与收缩压、脉压、平均动脉压呈正相关（P＝0.020，0.037，0.046），阴虚质与脉压呈正相关（P＝0.018），气虚质与收缩压呈正相关（P＝0.026），血瘀质与脉压呈正相关（ P＝0.022）。结论高血压并发脑卒中恢复期患者主要偏颇体质与血压各参数之间存在相关性，其中痰湿质最为突出，而血压各参数中以PP最为显著，为临床患者的体质调护、血压控制提供依据。

[目的]探讨概念图教学策略在《健康评估》课程中的应用及效果.[方法]抽取本校2012级220名护理本科学生,甲班110人为试验组(概念图教学组),乙班110人为对照组(传统教学组).试验组授课过程中教师采用概念图呈现的方式展示教学目标,并选择部分内容进行概念图授课,同时要求学生分组制作概念图;对照组采用传统教学模式.运用概念图态度问卷、中文版评判性思维倾向量表、护理学生自我导向学习能力量表、学生课程考试方法,分析、比较两种教学方法对学生健康评估的思维及学习能力的影响.[结果]两组学生总评成绩差异无统计学意义(P＞0.05),试验组学生的综合题得分、优秀率(≥85分)优于对照组(P＜0.05);学生对概念图教学总体上持肯定态度;试验组评判性思维倾向总得分高于对照组(P＜0.05),寻求真理、思想开放、分析能力、求知欲、认知成熟度各维度得分高于对照组(P＜0.05或P＜0.01);试验组自我导向学习量表总得分高于对照组(P.＜0.05),学习意识、学习策略、学习行为、学习评价各维度得分高于对照组(P＜0.05或P＜0.01).[结论]在《健康评估》课程教学中应用概念图策略可有效改善学生的思维和学习能力.

[目的]探讨探究式教学在急危重症护理学教学中的应用效果.[方法]在重症监护模块教学中,对实验组108名学生采用探究式教学,对对照组103名学生采用传统教学法,比较两组理论考核成绩,并对实验组进行问卷调查.[结果]实验组理论成绩高于对照组(P＜0.01),大多数学生对探究式教学模式持肯定态度.[结论]探究式教学应用于急危重症护理教学受到学生欢迎,可提高成绩.

[目的]引进亚伯达组织背景测评量表(Alberta Context Tool,ACT)并检测其性能,为我国循证护理实践组织背景的评估提供测量工具.[方法]对原英文版量表进行翻译、回翻译、请原作者校订、预测试、修订后,在杭州市的三级综合医院中选取545名护士对中文版ACT性能进行正式检验.检测项目包括可行性、信度和效度.[结果]中文版ACT由8个维度,52个条目组成,完成时间为6～15min(10.64+1.99min),有效回收率为94％,Cronbach's α系数为0.908,重测信度ICC值为0.996.结构效度检测中所提取的16个公因子的累积方差贡献率为66.21％.[结论]中文版ACT具有较好的可行性和信度;结构上与原英文版量表相同,有效保证了测量内涵和外延上的同质性,适合在中国特定的文化背景下应用.

目的 分析不同体质的中风先兆证(PAS)患者发生脑梗死的风险,为开展PAS体质干预研究提供参考.方法 对75例PAS患者采用ABCD2评分,按分值分为低危组(0～3分)、中危组(4～5分)和高危组(6～7分),并用“中医体质量表”对患者进行体质判定,观察不同体质、不同风险患者第2天及第7天的脑梗死发生率.结果 PAS患者体质以痰湿质、阴虚质多见,分别为32.00％、24.00％;患者第2天及7天内进展为脑梗死者分别为8例及13例,7天脑梗死发生率为17.33％;不同卒中风险分级的7天内脑梗死发生率比较,差异有统计学意义(P＜0.05);不同体质7天内脑梗死发生率比较,差异无统计学意义(P＞0.05),发生率以痰湿质最高为25.00％,其次是阴虚质为16.67％;痰湿质、阴虚质与ABCD2评分呈正相关(P＜0.05),平和质与其呈负相关(P＜0.05).结论 不同体质的PAS患者可能存在不同的脑梗死风险,痰湿质最高,其次是阴虚质,临床可针对患者体质开展PAS的干预.