目的 探讨标式锻炼视频联合个人行为 日志在膝关节内侧单间室骨性关节炎患者术后的应用效果.方法 选取2019年10月-2020年9月南阳市某医院收治的104例膝关节内侧单间室骨性关节炎患者为研究对象,根据建档顺序分为对照组(n=52)和研究组(n=52).对照组患者予以常规护理干预,研究组患者在对照组护理基础上予以标式锻炼视频联合个人行为日志干预,2组患者均持续干预2个月.比较2组患者功能锻炼依从性、患肢恢复情况(术后首次下床时间、膝关节屈曲＞90°所需时间、最大屈曲度)及护理满意度,比较2组患者干预前、干预2个月时膝关节功能量表(HSS)评分、骨性关节炎指数量表(WOMAC)评分.结果 研究组患者功能锻炼依从率为90.38％,高于对照组的75.00％,差异有统计学意义(P＜0.05).研究组患者术后首次下床时间、膝关节屈曲＞90°所需时间均短于对照组,最大屈曲度大于对照组,差异均有统计学意义(P＜0.05).干预2个月时,研究组患者HSS评分及WOMAC评分均高于对照组,差异均有统计学意义(P＜0.05).研究组患者服务质量量表各维度(移情性、反应性、可靠性、保证性、有形性)评分均高于对照组,差异均有统计学意义(P＜0.05).结论 标式锻炼视频联合个人行为日志干预应用于膝关节内侧单间室骨性关节炎术后效果明显,可显著提高患者功能锻炼依从性,改善其膝关节功能,促进患者恢复,且护理满意度高.

目的 探究基于健康行动过程取向(HAPA)的护理模式对膝关节疼痛患者疾病认知及自我管理能力的影响.方法 选取郑州大学第二附属医院2020年10月至2022年3月膝关节疼痛拟行手术治疗的134例患者,根据入院时间分为对照组、观察组,各67例.对照组接受常规护理,观察组在此基础上,接受基于HAPA的护理模式.对比两组疾病认知度、美国特种外科医院(HSS)膝关节评分、视觉模拟评分法(VAS)评分、成年人健康自我管理能力测评表(AHSMSRS)评分、护理满意度.结果 观察组疾病认知度较好高于对照组(P<0.05);护理1个月后观察组VAS评分低于对照组(P<0.05);护理1个月后观察组HSS、AHSMSRS评分高于对照组(P<0.05);观察组护理满意度高于对照组(P<0.05).结论 基于HAPA的护理模式可提高膝关节疼痛患者疾病认知,缓解患者疼痛,增强自我管理能力,改善膝关节功能,提升护理满意度.

目的:分析微信手机APP平台下的延续性康复护理干预应用于肩周炎(Scapulohumeral periarthritis,SP)患者的效果.方法:回顾性分析2019年3月至2020年6月间入住我院的99例SP患者的临床资料,按照护理模式的不同分为常规组(n=48)和研究组(n=51).常规组患者采用常规延续性护理干预;研究组采用微信手机APP平台下的延续性康复护理干预.比较两组康复依从性、干预前与干预6个月后生活方式、肩关节功能、日常生活能力、生活质量.结果:研究组康复依从性明显较常规组高(P<0.05);干预6个月后,研究组健康促进生活方式量表(Health promotion lifestyle profile,HPLP)评分、Constant-Murley肩关节功能评分量表(Constant-Murley Shoulder Function Score Scale,CMS)评分、Barthel指数(Barthel Index,BI)评分、生活质量综合评定问卷-74(Comprehensive quality of life assessment questionnaire-74,GQOLI-74)评分均明显较常规组高(P<0.05).结论:微信手机APP平台下的延续性康复护理干预可提高SP患者康复依从性,改善其生活方式,从而利于肩关节功能恢复,增强日常生活能力,提高生活质量.

目的 探讨老年人术前营养状况与腰椎退变性侧弯术后亚综合征谵妄的关系.方法 选取2016年3月至2020年9月郑州大学第一附属医院骨科收治的因腰椎退变性侧弯接受减压矫形手术治疗的老年(≥65岁)患者62例.评估患者术前营养状况,包括微营养评分(MNA-SF评分)、体质量指数(BMI)、酒精摄入情况等;评估功能状态(巴塞尔指数);术后连续3 d进行综合征谵妄(MDAS评分)评估.Pearson相关分析用于确定年龄、MNA-SF评分、BMI、功能状态等变量和MDAS评分之间的关系;对于存在相关性的变量利用分层线性回归模型进一步评估其对MDAS评分的影响.结果 术前MNA-SF评分与术后3 d总体平均MDAS评分呈负相关(P<0.05);BMI水平与术后第1天的MDAS谵妄严重程度评分呈负相关(P<0.05);年龄与每日MDAS评分及术后3 d的平均MDAS评分均呈正相关(P<0.05);MNA-SF评分≤10时与年龄呈负相关(P<0.05);酒精摄入、巴塞尔指数功能状态评分和术前禁食时间均与亚综合症谵妄(SSD)无关(P>0.05).营养状况与SSD的关系通过分层多元线性回归分析,该模型纳入MNA-SF评分(≤10分)与年龄和BMI进行分析,解释"MDAS"的变化的贡献率(解释方差比率)是26％(R2=0.26,F=3.75,P<0.001).结论 术前营养状况与老年人腰椎术后出现SSD症状相关;应当将营养风险评估纳入老年人术前预防谵妄策略之中.

目的:探讨应用渐进性肌肉放松训练联合疼痛管理对下肢骨折患者疼痛、精神心理状态和康复效果的影响.方法:选取2018年3月-2019年3月入院的45例下肢骨折患者纳入对照组,采用常规模式干预,2019年4月-2020年3月入院的45例下肢骨折患者纳入观察组,采用渐进性肌肉放松训练联合疼痛管理干预,两组均为期干预8周.观察两组患者的疼痛情况、舒适度、心理状态、下肢功能恢复情况、躯体自理能力及生活质量状况.结果:干预后观察组Kolcaba简化舒适度量表(GCQ)评分明显高于对照组(t=3.245,P＜0.05);观察组焦虑自评量表(SAS)、抑郁自评量表(SDS)评分明显低于对照组(t=2.497,2.171;P＜0.05),观察组下肢功能评价量表(LEFS)评分明显高于对照组(t=3.467,P＜0.05),而躯体自理量表(PSMS)评分则明显低于对照组(t=3.504,P＜0.05),观察组生活质量量表(GQOLI-74)中躯体功能、心理功能、社会功能、物质生活状态评分明显高于对照组(t=3.656,3.869,5.069,2.733;P＜0.05).结论:渐进性肌肉放松训练联合疼痛管理能有效缓解下肢骨折患者的负性情绪和疼痛程度,提升躯体自理能力、治疗的舒适度和生活质量,有助于促进下肢功能恢复.

目的:探讨多学科协作(MDT)式护理干预对中重度癌痛患者疼痛数字评分(NRS)及护理工作满意度的影响.方法:选取2019年1月至2020年4月中重度癌痛患者76例,按照入院顺序不同分为研究组、对照组,各38例.对照组采用常规护理,研究组在常规护理基础上采用MDT式护理.比较两组干预前后疼痛程度(NRS评分)、心理状态(HAMA、HAMD评分)及护理工作满意度.结果:干预后研究组NPS评分低于对照组(P＜0.05);干预后研究组HAMA评分、HAMD评分低于对照组(P＜0.05);研究组护理工作满意度94.73％(36/38)高于对照组73.68％(28/38)(P＜0.05).结论:MDT式护理干预可缓解中重度癌痛患者疼痛程度,改善其负性情绪,增强患者护理工作满意度.

Objective To evaluate the therapeutic effect by the combination of silver needle and pulsed radiofrequency applied to C2 dorsal root ganglion in the treatment of patients with cervicogenic headache.Methods Eighty-six patients with cervicogenic headache of both sexes,aged 14-71,from October 2013 to August 2015 in the Second Affiliated Hospital of Zhengzhou University,were randomly divided into radiofrequeucy group (43 cases) and combined group (43 cases).Patients were treated with pulsed radiofrequency at C2 dorsal root ganglion in the radiofrequency group.Silver needle treatment was used after the pulsed radiofrequency at C2 dorsal root ganglion in the combined group.VAS and pressure pain threshold (PPT) were evaluated at 1 day,3 months and 12 months after the treatment.Results No differences were found in VAS and PPT before the treatment between the two groups (P＞0.05).Compared with pre-treatment,VAS decreased significantly at 1 day,3 months,12 months after the treatment in the two groups (P＜0.05).VAS was even lower significantly at 3,12 months after the treatment in the combined group than that in the radiofrequency group (P＜0.05).Compared with pre-treatment,PPT increased significantly at 3,12 months after the treatment in the two groups (P＜0.05).PPT and the effective rate were even higher significantly at 3,12 months after the treatment in the combined group than those in the radiofrequency group (P＜0.05).Conclusion Silver needle and pulsed radiofrequency at C2 dorsal root ganglion is effective in the treatment of patients with cervicogenic headache,and its long-term effect is better than C2 dorsal root ganglion pulse radiofrequency therapy alone.

带状疱疹是由于水痘 - 带状疱疹病毒引起的急性皮肤病,当患者感染该病毒后部分患者将会引起水痘,但是部分患者感染后不会出现水痘,成为隐性感染 [1].国内学者研究表明 [2]:水痘 - 带状疱疹病毒感染后能沿着神经移动到脊髓后根神经节中,并潜伏在该部位,当宿主细胞免疫下降后,病毒将会被激活,引起神经节发炎、坏死.同时,再次激活的病毒能沿着周围神经纤维再次移动到皮肤发生带状疱疹并伴有疼痛,且患者年龄越大疼痛越重,严重影响患者健康及生活 [3].带状疱疹皮疹愈合后持续 1 个月及以上的疼痛称为带状疱疹后神经痛,是带状疱疹最常见的严重并发症.目前,临床上对于带状疱疹后神经痛主要给予甲钴胺、普瑞巴林、维生素 B1 支持治疗为主,虽然能减轻患者疼痛,但是部分病人治疗过程中由于缺乏有效的护理干预,导致患者心理波动较大,影响患者治疗预后 [4].医护一体化疼痛管理属于是一种新型的护理模式,更加强调医护各尽其责、分工协作;而心理干预是指在心理学理论指导下有计划、按步骤地对一定对象的心理活动、个性特征或心理问题进行影响,朝着预期目标变化的过程 [5].因此,本研究旨在探讨医护一体化疼痛管理联合心理干预在带状疱疹后神经痛患者中的护理效果及对患者疼痛程度及负性情绪的影响,报道如下.

目的 探究综合护理干预对阿尔茨海默病患者生存质量的改善效果.方法 选取68例阿尔茨海默病患者分为两组.对照组予以常规护理,研究组予以综合护理干预.比较两组患者生活质量的改善情况.结果 干预后,研究组的HAMD、HDS、ADL评分显著优于对照组(P＜0.05).结论 对阿尔茨海默病患者施行综合护理干预,可有效改善患者的生存质量,护理效果显著.

目的 探讨经皮神经电刺激(TENS)治疗跟痛症的临床疗效.方法 将70例跟痛症患者随机分为对照组和治疗组,对照组采用牵伸锻炼,治疗组在对照组的基础上采用T ENS治疗,分别于治疗前、治疗后1周、1个月和3个月时采用视觉模拟评法分(VAS)对晨起第一步和一天中最痛时进行疼痛程度评定.结果 治疗后1周、1个月、3个月时,2组晨起VAS评分和最痛VAS评分均较治疗前明显降低,治疗组降低更为显著;治疗组在治疗后各时间点的晨起VAS评分和最痛VAS评分均低于对照组.结论 经皮神经电刺激治疗跟痛症疗效确切,优于单纯应用牵伸锻炼.

OBJECTIVE Aberrant DNA methylation that leads to the inactivation of related genes plays important roles in development and progression of lung cancer.This stduy was to investigate the methylation status of GSTP1 gene in bronchoalveolar lavage fluid of patients with lung cancer,and to explore its clinical value in the diagnosis of lung cancer.METHODS A total of 100 patients from the First Affiliated Hospital of Zhengzhou University during 2015-10-01 to 2016-01-31 were collected,the lung cancer group was constituted by 80 lung cancer patients (small and non-small cell lung cancer),and the control group contained 20 patients with benign lung diseases (pneumonia,COPD and phthisis).PCR and high resolution melting assay (PCR-HRM) method were used to analyze the promoter methylation of GSTP1 gene,and the results were analyzed with clinical and pathological features.RESULTS The methylation frequency of the promoter of GSTP1 gene in the lung cancer group was 42.5％ (34/80),which was significantly higher than that in the control group 15.0％ (3/20)(P=0.023).There were no significant correlations between the methylation status of GSTP1 gene and age,gender or pathological type of patients with lung cancer (P values were 0.397,0.853 and 0.751).The methylation frequency of the promoter of GSTP1 gene in stage Ⅰ and Ⅱ patients with lung cancer was significantly lower than that of the stage Ⅲ and Ⅳ patients (P=0.013),but obviously higher than that of the control group (P=0.033).The methylation frequency of the promoter of GSTP1 gene in well and moderately differentiated patients with lung cancer was significantly lower than poorly differentiated patients (P9=0.010),but obviously higher than that of the control group(P=0.026).CONCLUSIONS The changes of the methylation status of GSTP1 gene are associated with lung cancer pathogenesis and malignant degree.The detection of the promoter methylation of GSTP1 gene might be valuable in the diagnosis of lung cancer.

Objective:To investigate the effect of NF-κB p65siRNA of IL-17 inducing the expression of MCP-1 in the primary cultured cardiac myocytes.Methods:The cardiac myocytes were isolated from neonatal mice by different adhesion method.NF-κB P65 siRNA was transfected into cardiac myocytes and the rates of transcription and translation of MCP-1 were detected by RT-PCR and enzyme-linked immunosorbent assay( ELISA) ,the rates of transcription and translation of P-P65 and P65 were detected by RT-PCR and Western blot.Results:Compared with negative siRNA group,the expression of the MCP-1 at mRNA and protein levels were increased in negative siRNA +IL-17 group(P<0.05).Compared with negative siRNA group,the expression of the MCP-1 at mRNA and protein levels were decreased in NF-κB P65 siRNA group( P<0.05).Compared with negative siRNA+IL-17 group,the expression of the MCP-1 at mRNA and protein levels were decreased in NF-κB P65 siRNA+IL-17 group(P<0.05).The expression of the NF-κB P65 at mRNA and protein levels in cardiac myocytes were specifically and extensively suppressed by NF-κB P65 siRNA(P<0.05).After stimulated by IL-17,the amount of P-P65 in the cardiac myocytes was significantly increased in time-dependent manner compared with that of black group( P<0.05) , but the levels of P65 changed little ( P>0.05 ) .Conclusion: IL-17 stimulates MCP-1 expression in cardiac myocytes via NF-κB activation,and NF-κB P65 siRNA can effectively inhibit the upregulation of IL-17 on MCP-1.

Objective:To evaluate the clinical outcome of the combination of short-period fertilization with early rescue intracytoplasmic sperm injection(R-ICSI)after complete failure of in vitro fertilization(IVF).Methods:From Jan 2009 to June 2010,709 fresh cycles of assisted reproductive techniques were analyzed,including 82 cycles R-ICSI and 627 cycles of intracytoplasmic sperm injection(ICSI) at the same period.The normal fertilization rate,abnormal fertilization rate,high-quality embryo rate,embryo implantation rate,clinical pregnancy rate and abortion rate were compared.Results:There was no statistically difference between R-ICSI and ICSI in normal ferti1ization rate,high-quality embryo rate,embryo implantation rate,clinical pregnancy rate and abortion rate,but there was statistically difference between them in abnormal fertilization rate(5.0% vs 3.0%)(P<0.05).Conclusion:The combination of short-period fertilization with R-ICSI can find and rescue fertilization failure timely and get better clinical effect.

目的探讨帕金森病患者的护理措施,寻求有效的护理方法。方法将符合帕金森病的患者96例随机分为观察组和对照组。2组均在积极治疗的同时施以常规护理,观察组在此基础上再施以安全护理和心理护理。比较2组的安全意外发生率和护理满意度。结果观察组患者的安全意外发生率明显低于对照组,通过调查,观察组患者的满意度高于对照组。结论在积极治疗和基础护理的同时施以安全护理和心理护理有助于帕金森病患者的康复,并可有效降低安全意外发生率,提高护理满意度。