妊娠期糖尿病发病逐年增高且病机未明,给患者和社会带来严重的疾病负担.近年来,脾虚在妊娠期糖尿病病程中的影响日益凸显.通过系统梳理和分析古代及现代文献,综述脾与妊娠期糖尿病(GDM)在病机上的密切关系:表现为脾虚化湿,湿聚成痰,发为GDM;脾虚气滞,土壅木郁,形成GDM;脾不散精,瘀阻脉络,引发GDM并发症,为临床早期干预与护理提供理论参考.

目的:系统评价基于格林模式的健康教育对2型糖尿病病人代谢指标、自我效能、生活质量的影响,为相关研究的开展提供循证医学依据.方法:计算机检索中国知网、万方数据库、维普数据库、PubMed、the Cochrane Library、CINAHL Complete、EMbase中关于格林模式的健康教育对2型糖尿病病人影响的随机对照试验,并追踪参考文献,检索时限为建库至2021年12月31日.由2名研究者独立筛选文献并交叉核对文献质量,按照Cochrane系统评价手册5.1.0的质量评价方法评价纳入文献的质量.采用RevMan 5.4软件进行Meta分析.结果:共纳入12篇文献,涉及2 598例2型糖尿病病人.Meta分析结果显示,基于格林模式的健康教育可以改善病人的糖化血红蛋白、餐后2 h血糖、空腹血糖、体质指数、收缩压、低密度脂蛋白胆固醇,增加病人自我效能、减少并发症(P＜0.05).但对腰围、舒张压、总胆固醇、高密度脂蛋白胆固醇、生活质量效果不显著(P＞0.05).结论:现有证据表明,基于格林模式的健康教育可以改善2型糖尿病病人的糖化血红蛋白、餐后2 h血糖、空腹血糖、体质指数、收缩压、低密度脂蛋白胆固醇、自我效能评分,降低并发症发生率.但对腰围、舒张压、总胆固醇、高密度脂蛋白胆固醇、生活质量无改善作用.今后还需要开展高质量、大样本的随机对照试验进一步探讨基于格林模式的健康教育对于病人的影响.

目的:研制基于双任务训练理论的脑卒中患者双任务康复训练组合箱,以满足脑卒中患者的认知及上肢运动功能的康复需求.方法:该组合箱由箱盖、箱体、抽屉、训练板、各训练子件及语音系统6个部分组成.箱盖、箱体和抽屉构成组合箱的主体部分,用于罩收训练板及收纳训练子件.训练板一侧通过活页转动件转动连接于箱体的一侧,语音系统镶嵌在训练板上.结果:应用该组合箱进行训练,可实现患者上肢屈伸、内收、旋转等活动,改善患者的上肢运动功能及患者的认知学习能力,增强训练的趣味性,从而提升患者依从性.结论:该组合箱可用于脑卒中患者的上肢运动功能及认知功能的康复,且训练内容丰富、针对性强,具有广阔的市场需求和推广前景.

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.

随着信息技术时代的飞速发展,传统的以课堂教学方式进行的《康复护理学》实训课程教学模式已无法满足高质量康复护理人才的培养需求,需要推动信息化教学,融合虚拟仿真技术.研究阐明虚拟仿真教学手段的必要性,基于"具身认知"理论,通过梳理教学目的,创新课程内容,将虚拟仿真教学平台与康复护理实训课堂进行有机结合,构建了实训课程教学的新模式,以期锻炼学生的专业素质、专业技能和创新思维,培养康复护理高阶应用型人才.

目的 探讨运动呼吸锻炼康复疗法对稳定期慢阻肺患者肺功能、运动耐力及生活质量的影响.方法 选取80例稳定期慢阻肺患者作为研究对象,随机分为实验组和对照组,每组40例.对照组采取常规治疗方法,实验组在对照组基础上增加呼吸运动锻炼康复疗法干预.比较了治疗前与治疗1个月后两组患者肺功能(FEV1,FVC,FEV1∶FVC)差异,也比较了出院时与出院3个月两组患者生活质量(CAT评分)与运动耐力(6MWT距离)差异.结果 治疗1个月后实验组患者FEV1,FVC,FEV1∶FVC值均高于对照组;无论是出院时,还是出院3个月,实验组的CAT值均低于对照组,6MWT值均高于对照组.结论 呼吸运动锻炼康复疗法干预对增强慢阻肺稳定期患者的肺功能,提升患者的运动耐力,改善患者的生活质量具有良好作用.

With the rapid development of rehabilitation in China,professional education in occupational therapy (OT) has witnessed significant expansion and changes in recent years.Professional doctorates in OT and other health care professions have gained increasing attention and popularity in China.Confusion exists for emerging professional doctorates in China and the international community.The purpose of this article is to introduce and describe the concept of professional doctorates,with an emphasis on doctor of occupational therapy (OTD) degree.Training and education of a professional doctorate in OT is illustrated via an OTD program in the USA.And the increased residency/fellow program after post OTD graduation was explaind and discussed.This review will provide guidance for the development of OT education in China.

Evidence based practice (EBP), emerged at the turn of 70s and 80s in the 20th century, has been developed rapidly and been applied to medical rehabilitation field and other health care professions such as occupational therapy and physical therapy. Development and application of EBP, however, is still hindered by various internal and external factors. After reviewing pertinent previous literature, this paper systematically examined the factors that influence the EBP in foreign rehabilitation therapists'service, such as organizational environment, education and training of rehabilitation professionals, therapists'perception, and professionals'practice setting and time, etc., discussed the implications to EBP in rehabilitation therapists'service in China and offered suggestions to the further development in current China.

At present,nanotechnology is one of the most promising technologies in scientific,it has been widely used in chemical,material,medicine,food and energy fields. In this paper,the nanotechnology related policy of the government planning and development at home and abroad,its basic application status in the field of food science,and its development direction is prospected.

为我国抗生素安全监管工作提供参考。对我国目前抗生素使用及安全监管现状进行分析，借鉴发达国家的安全监管实践经验。加强对法规及标准的建设、建立完备的监督管理体系、提高检验检测水平、加大对合理用药的引导、教育和宣传以及增强生产经营企业及其从业人员的责任意识，有利于提高监管资源的利用效率并提高合理用药的安全性。

Konjac glucomannan is a natural macromolecular polysaccharide macromolecular which has gelling property and is widely used in food,medicine,chemical,biological,materials and other fields. Research on the mechanism of gel is one of hotspots in the field of polysaccharide macromolecular. Gel structure could affect gel property,therefore it is important to understand the gel mechanism. Konjac glucomannan gel formation mechanism is very complex,to start with gel structure is an appropriate way. The paper summarizes the advances in the study on structure analysis of konjac glucomannan,the effects of structure on performance as well as the problems on gel formation by different gel structure. The paper proposed the research direction in the study the gel forming mechanism and provided solutions to the existing problems of KGM gel.

Objective To evaluate the quality status of domestic cefazolin sodium for injection and existing problems.Methods According to the general requirements of national assessment programs in 2009 and 2011,use statutory testing methods and combine with the exploratory research to evaluate the quality of domestic cefazolin sodium for injection by statistical analysis of the results.Results The qualified rate is not high enough in 2009,clarity of solution was the main cause of failure.The qualified rate is 97.8% in 2011,the cause of failure was also the clarity of solution.Conclusions Through the evaluative testing,the quality status of domestic cefazolin sodium for injection has significantly improved.The results of the stability testing in samples show that the influence of medicines by some harmful substances in the rubber stopper is a lengthy process,using coated rubber stopper is able to prevent the substance that have an impact on the clarity of solution migration into the sample.

OBJECTIVE To establish a high performance size exclusion chromatography(HPSEC) method for the determination of cefbuperazone polymer.METHODS A TSK G2500 PWxL column(7.8mm×30cm) was used with the mobile phase consisting of phosphate buffer solution[0.005mol·L~(-1) disodium hydrogen phosphate- 0.005mol·L~(-1) sodium dihydrogen phosphate(61:39)]-(95:5) at a flow rate of 0.5mL·min~(-1),the detection wavelength was at 254 nm,the injection volume was 10μL and the concentration of polymers was quantified by external standard method of reference oneself.RESULTS For HPSEC method,the calibration curves were linear in the range of 2.00μg·mL~(-1)～40.00μg·mL~(-1) for cefbuperazone(r=1.0000),and the limit of quantitation was 1×10~(-4) mg·mL~(-1),the RSD for replicate injections of reference solution was 0.4%(n= 5),and the calibration curves were linear in the range of 0.25 mg·mL~(-1)～4.00mg·mL~(-1) for cefbuperazone sodium(r=1.0000),and the repeatability for 5 measurement results was 0.8%.CONCLUSION This method can be used in separating the polymers from cefbuperazone sodium preferably,and is suitable for controlling the quality of this drug.

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The text introduce the theory of microwave drying and discuss the application of microwave technology in fresh flowers drying, mainly including sterilizing and effect of color, nutrition and figuration.