目的:了解神经外科护士预防非计划拔管护理知识、态度及行为的现状,为提高临床非计划拔管护理质量提供借鉴.方法:采用自行设计的神经外科护士预防非计划拔管知识、态度、行为问卷对102名护士进行调查分析.结果:神经外科护士知识、态度、行为得分分别为(4.76±0.81)分、(7.34±0.47)分和(6.55±0.75)分.不同工作时间、是否参加非计划拔管培训、是否经历非计划拔管事件神经外科护士的知识得分比较差异有统计学意义(P<0.05);是否经历非计划拔管事件的神经外科护士在态度得分比较差异有统计学意义(P<0.05);不同工作时间的护士在行为得分比较差异有统计学意义(P<0.05).结论:神经外科护士预防非计划拔管护理态度较好,但知识和行为不容乐观,护理管理者应加强护士预防非计划拔管知识培训,从而提升护理质量.

目的 探讨运用PDCA护理管理模式对降低神经外科患者非计划性拔管发生率的作用.方法 选取2017年1月—12月86例神经外科置管患者作为对照组,采用常规护理模式;选取2018年1月—12月86例神经外科置管患者作为观察组,实施PDCA护理管理模式,比较两组患者的非计划性拔管发生率和患者护理满意率.结果 观察组患者的非计划性拔管发生率(2.55％)明显低于对照组(14.14％),其患者满意率(94.19％)明显高于对照组(72.09％),两组间差异比较均具有统计学意义(P<0.05).结论 PDCA护理管理模式能够有效降低神经外科患者的非计划性拔管发生率,提高患者的护理满意度.

总结1例严重电烧伤并发急性肾损伤及癫痫患者的护理经验.依托多学科合作,休克期并发急性肾功能损伤,加强连续性肾替代治疗护理及容量管理,促进肾功能恢复;做好电烧伤创面护理;落实癫痫发作的急救护理和安全管理;全程开展患者心身康复护理.患者于入院后第166天康复出院.

目的 探讨抗凝剂皮下注射护理规范及其效果评价.方法 运用循证方法得出证据形成建议,制订抗凝剂皮下注射标准、用药规范、定位卡和宣教卡,规范护理,并对护理人员进行培训,设计患者资料表、患者问卷和护士问卷对患者和护士进行调查,并用抗凝剂皮下注射不良反应率、患者对抗凝剂皮下注射知识的知晓率和护士对抗凝剂皮下注射规范护理的掌握率进行效果评价.结果 措施实施后抗凝剂皮下注射不良反应率明显下降,患者知晓率明显提高,护士掌握率明显高于培训前,差异有统计学意义(P＜0.05或P＜0.01).结论 应用循证实践规范抗凝剂皮下注射护理,可改善护理质量,保证药物疗效,促进医疗安全.

Monoclonal antibody-targeted therapy has been a hot spot in current clinical cancer treatment. As current antibody drugs have large molecule sizes leading to poor tissue penetration, and high dosage in clinical application leading to high cost, to overcome the problems, the development of new antibody drugs with miniaturization and high potency has become a new trend. In recent years, the conjugates of monoclonal antibodies and cytotoxins, called antibody-drug conjugates (ADCs), have entered the arsenal of anti-cancer drugs, becoming a new format of antibody drugs and attracting extensive attentions. The ADC molecule usually consists of antibody, linker and effector molecule. According to different effector molecules, ADCs can be divided into three categories as chemo-conjugates, immunotoxins and radio-conjugates. When ADC molecules are internalized into cancer cells, cytotoxins will be released by chemical, enzyme degradation or by action of lysosomal proteases, then kill targeted cells by inhibiting protein synthesis, depolymerizing microtubules or breaking double-strand DNA. Recently, two ADC drugs have been approved by the US FDA and more ADC drug candidates are in clinical phase II or III trials which show significantly clinical effects and attracting much attention and competition of pharmaceutical enterprises. In this review, antibody conjugates in the past and present will be summarized and the future development trends and challenges of this type of antibody drugs will be discussed.

Human epidermal growth factor receptor 2 (HER2) belongs to the transmembrane glycoprotein receptor family. Overexpression of HER2 could directly lead to tumorigenesis and metastasis. This phenomenon could be observed in the breast cancer, ovarian cancer, gastric cancer, lung cancer and prostate cancer. Compared with the conventional chemotherapy, the targeted treatment of antibody is more specific and has lower side effects. This review describes the current status of monotherapy and combination therapies of anti-HER2 antibodies, trastuzumab and pertuzumab, with chemotherapeutic drugs. The development trends of new formats of anti-HER2 antibody drugs such as bispecific antibody, immunotoxin are also discussed.

<正>干扰素(IFN-β)是临床治疗多发性硬化症的主要用药,然而IFN-β并不对每个多发性硬化症患者均有效。就此,作者针对IFN-β治疗的反应性差异进行了相关研究,并在多发性硬化症(multiple sclerosis,MS)及实验性自身免疫性脑脊髓炎(exper

新型辅助性T细胞Th17在分化和功能特征上较传统的辅助性T细胞Th1和Th2存在显著的不同。分泌效应分子IL-17A/F和IL-22的Th17细胞与机体抗胞外菌感染和自身免疫疾病免疫病理的关系密切。Th17细胞的分化发育很大程度上依赖于局部微环境的影响,其中活化DC或其他细胞提供的特定细胞因子诱导微环境尤为重要。小鼠系统中,TGF-β和IL-6的共同刺激是Th17细胞分化的始动因素,自分泌细胞因子IL-21参与其分化的正反馈调节,而IL-23在维持其后续的细胞扩增和存活中有重要作用,转录因子RORγt、RORα、STAT3和IRF4参与其中转录水平的调节。此外,Th17细胞的分化发育还受到机体严密的调控。人Th17细胞分化的相关研究证实其中的机制和小鼠存在相似性。深入研究Th17细胞的分化发育将有助于认识Th17细胞在抗感染免疫和自身免疫疾病中的免疫病理机制,也有利于相应治疗靶点的选择。

<正>microRNAs是参与靶基因转录后调控的一类非编码小RNA,它们可分别来源于宿主细胞RNA或病毒RNA。研究证实,病毒编码的microRNAs可靶向宿主细胞或病毒自身基因,调控其表达而实现免疫逃逸和相关致病作用;而宿主细胞编码的microRNAs在抗病毒感染过程存在防御作用,但亦有研究发现宿主细胞microRNAs在病毒感染复制中起促进作用,如miR-122