目的 研究三七皂苷对高氧诱导的早产儿视网膜病变(ROP)小鼠血管新生及脂联素(APN)和肿瘤坏死因子-α(TNF-α)表达的影响.方法 将45只新生C57BL/6J小鼠按随机数字表法分为正常对照组、ROP组和三七皂苷组,每组15只.采用Smith法建立ROP模型.三七皂苷组小鼠每日腹腔注射三七皂苷药液4μL,正常对照组和ROP组每日腹腔注射同等剂量的0.9％氯化钠溶液.心脏荧光素灌注,做视网膜铺片观察视网膜血管形态.制作视网膜组织切片,苏木素-伊红(HE)染色,观察突破内界膜的内皮细胞核数.酶联免疫吸附法(ELISA)检测血清中APN和TNF-α 的表达水平.结果 形态学观察显示,ROP组视网膜血管有明显增生,而三七皂苷组血管增生减少.ROP组可见大量突破内界膜的内皮细胞核;三七皂苷组仅可见极少量的突破内界膜的内皮细胞核.ROP组和三七皂苷组的内皮细胞核数量为(24.20±6.26)、(3.40±1.03)个,显著高于正常对照组[(0.40±0.12)个],而三七皂苷组较ROP组显著降低,差异有统计学意义(P<0.05).与正常对照组[(16.38±3.56)ng/L、(13.18±1.81)mg/L]相比,ROP组[(33.23±6.96)ng/L、(7.23±1.33)mg/L]和三七皂苷组[(18.54±5.85)ng/L、(11.95±1.79)mg/L]小鼠血清TNF-α的表达水平明显升高,APN的表达水平明显降低,差异有统计学意义(P<0.05),而三七皂苷组则较ROP组小鼠血清TNF-α 的表达水平降低,APN的表达水平升高,差异有统计学意义(P<0.05).结论 三七皂苷可有效抑制视网膜新生血管的生成,其机制可能与上调APN的表达并下调TNF-α的表达有关.

目的 探讨自噬作用在早产儿视网膜病变大鼠病情进展中的调控作用及相关机制.方法 20只SD大鼠随机选取10只孕鼠正常分娩,不做任何特殊处理,待其顺利分娩后选取20只足胎龄幼鼠进行下一步实验;另取10只孕鼠采用脂多糖(LPS)制备早产模型,诱导孕鼠早产,取20只早产幼鼠.将所得幼鼠平均分为正常分娩+空气组、正常分娩+视网膜病变组、早产+空气组、早产+视网膜病变组,每组各10只.对比分析各组大鼠视网膜无血管区和新生血管区面积大小、视网膜血管内皮生长因子(VEGF)和胰岛素样生长因子1(IGF-1)表达水平以及白细胞介素-1β(IL-1β)和白细胞介素-6(IL-6)含量;同时检测幼鼠视网膜组织中自噬小体数量、自噬相关蛋白和Akt、p-Akt、mTOR、p-mTOR蛋白表达水平.结果 相较于正常分娩+空气组,正常分娩+视网膜病变组、早产+空气组、早产+视网膜病变组血管区和新生血管区面积、VEGF和IGF-1 mRNA表达水平、IL-1β和IL-6含量和P62、Akt、p-Akt、mTOR、p-mTOR蛋白表达水平均有所上调,自噬小体数量和自噬相关蛋白Beclin-1、LC3-Ⅱ和ATG5表达水平则有所下降,尤其是以早产+视网膜病变组最为显著(P<0.05).结论 早产儿视网膜病变大鼠病情进展与视网膜组织自噬活性降低有关,且作用机制可能通过Akt-mTOR信号通路调控自噬相关蛋白表达而实现.

目的 探讨多元化护理模式在早产儿视网膜病变筛查中的应用价值.方法 选取我院早产儿750例,随机分为观察组和对照组,各375例,患儿均应用RetCam3数字视网膜照相机进行筛查,给予对照组常规护理,给予观察组多元化护理,对比两组早产儿的视网膜病变诊断率、护理满意度、患儿家属遵医嘱行为和并发症情况.结果 两组新生儿视网膜病变无明显差异(P＞0.05);观察组患儿家属定期复查、预防感染、视力观察以及疾病认知等遵医嘱行为明显高于对照组(P＜0.05);观察组患儿并发症发生率低于对照组(P＜0.05);观察组患儿并发症发生率低于对照组(P＜0.05).结论 对早产儿视网膜病变筛查中应用多元化护理模式可以提升患儿家属的遵医嘱行为,减少患儿的并发症情况,提升护理满意度.

组建产—儿多学科团队,从生命孕育期开始,由产科、新生儿科、儿科共同进行连续性延伸护理服务.产—儿多学科连续性延伸护理服务项目的开展,构建了多学科连续性延伸护理服务模式,充分发挥了护士价值,体现了护理专业内涵质量,提高了家长满意度,提升了医院知名度.

目的 探讨多学科宣教在早产儿视网膜病变(ROP)筛查中的效果.方法 选择本院行ROP筛查的150例早产儿作为研究对象,随机分为观察组与对照组,每组75例.对照组予以常规健康教育,观察组予以多学科宣教,比较2组的干预效果.结果 观察组干预后家属视网膜病变认知度评分、观察视力发展评分、预防眼部感染评分、定期检查评分显著高于对照组(P＜0.05).观察组早产儿复诊率、重症率、致盲率显著低于对照组(P＜0.05).治疗前,2组临床活动度评分(CAS)比较,差异无统计学意义(P＞0.05).治疗后,观察组CAS评分为(5.43±2.11)分,显著低于对照组的(7.43±2.21)分(P＜0.05).结论 多学科健康宣教可有效提高早产儿家属的疾病认知度及遵医行为评分,有效提高早产儿的复诊率,有利于早产儿及时接受治疗,减少重症率及致盲率,因此干预效果较好.

目的 分析以营养饮食及心理教育为重点的多层面健康宣教对老年糖尿病患者生活方式、生存质量的影响.方法 将100例老年糖尿病患者随机分为两组,各50例.对照组给予常规健康宣教,观察组在对照组基础上采用以营养饮食及心理教育为重点的多层面健康宣教.比较两组的血糖水平、生活方式、疾病控制情况、饮食知识、行为及生活质量评分.结果 教育后,两组FPG、2 h PG、HbA1c水平均下降,且观察组低于对照组(P<0.05).教育后,观察组生活方式改善情况优于对照组(P<0.05).教育后,两组各项CSSD70评分均升高,且观察组均优于对照组(P<0.05).教育后,两组饮食知识、行为及GQOL-74评分均升高,且观察组高于对照组(P<0.05).结论 对老年糖尿病患者采用以营养饮食及心理教育为重点的多层面健康宣教能够有效控制疾病症状,改善生活方式及生活质量,应用价值显著.

目的 探讨医护一体化无痛管理在泌尿系结石患者围术期疼痛管理中的应用效果.方法 选取200例泌尿系结石手术患者作为研究对象.采用简单随机数字表法将患者分为对照组和观察组,每组100例.对照组采用传统镇痛管理方式,观察组则采用医护一体化无痛管理.采用视觉模拟评分法(VAS)评估2组患者术后当天和术后1、2、3d时的疼痛情况,并记录2组患者睡眠时间及术后住院情况.结果 术后当天,2组VAS评分、睡眠时间比较,差异无统计学意义(P＞0.05);术后1、2、3d时,观察组VAS评分低于对照组,睡眠时间长于对照组,差异有统计学意义(P＜0.05);观察组首次下床活动时间、首次肛门排气时间、术后住院时间均短于对照组,差异有统计学意义(P＜0.05).结论 在泌尿系结石患者围术期实施医护一体化无痛管理,能够缓解患者疼痛程度,改善患者睡眠,促进患者早日康复.

目的 探讨微信平台下的患者与家庭成员健康教育在2型糖尿病患者自我管理中的应用效果,为提高患者自我管理能力、有效控制血糖水平提供借鉴.方法 选择我院收治的126例2型糖尿病患者作为研究对象,按照出院时间先后顺序分为观察组和对照组,各63例.对照组利用微信平台对患者开展健康教育,观察组在此基础上同时对患者家属开展健康教育.比较两组患者生化指标检测结果、自我管理行为评分和家属支持情况.结果 出院后6个月,观察组患者空腹血糖和糖化血红蛋白水平均显著低于对照组(P<0.05).出院后6个月,观察组患者正确用药、合理饮食、规律运动、血糖检测、足部护理评分均显著高于对照组(P<0.05).出院后6个月,观察组患者家属支持评分显著高于对照组(P<0.05).结论 微信平台下的患者与家庭成员健康教育可提高家属对患者的支持度,提高患者自我管理能力,有效控制血糖.

Objective To analyze the risk factors and clinical characteristics of preterm infants and full-term infants for providing a scientific basis for early diagnosis and reducing the morbidity. Methods Totally 127 preterm infants and 41 full-term infants with septicemia were collected from January 2014 to December 2016,and the high-risk factors,infection pathways,clinical manifestations, laboratory indicators and complications differences were analyzed in two groups. Results The proportion of cesarean section,preg-nancy hypertension,respiratory distress syndrome,deep venous catheter,mechanical ventilation and antibiotic application were signifi-cantly higher in preterm patients than those in full-term patients(P < 0. 05). The main infection pathway was multiple respiratory infec-tion in preterm infants with sepsis(44. 1%)and blood flow in full-term infants(65. 9%). The preterm infants were prone to manifesting the decrease of oxygen saturation(65. 4% vs 14. 6%),dyspnea(40. 2% vs 12. 2%),apnea(28. 3% vs 9. 8%)and stress hyperglyce-mia(38. 6% vs 14. 6%),while the full-term infants were prone to having jaundice(61. 0% vs 32. 3%)and abnormal body temperature (53. 7% vs 17. 3%). The white cell count and PCT value in full-term infants was significantly higher than that of preterm infants(P <0. 05). In preterm infants,the proportions of decreased white cell count and thrombocytopenia were significantly higher than those of full-term infants group(P < 0. 05). There was no statistically significant difference in complication and fatality rate between the two groups. Conclusion There are more risk factors of sepsis in preterm infants than that of full-term infants. Clinical characteristics and laboratory data are also different between preterm and full-term infants. These should be paid attention in making the treatment proce-dure.

Objective To study the effect of humanized nursing intervention in children with severe viral meningitis complicated with respiratory failure.Methods A total of 100 children with severe viral meningitis complicated with respiratory failure who underwent treatment in our hospital were selected as the subjects.All patients were divided into control group and study group,with 50 cases in each group.The children in the control group received routine care,and the study group was given humanized nursing intervention on the basis of conventional nursing care in the control group.The function recovery time,the time of fever,the time of seizure elimination,the time of vomiting elimination and the length of hospital stay were compared and analyzed.Results The time of awake,fever time,convulsive elimination time,vomiting elimination time and hospitalization time were shorter in the study group than the control group (P ＜ 0.05);After 1 month of nursing,The effect of joint activity and pain,motor function and sensory function were better than nursing before and study group was better than that in the control group (P ＜ 0.05).Conclusion Humanized nursing intervention in children with severe viral meningitis combined with respiratory failure has significant effect,can effectively shorten the symptoms of remission time and length of stay,and promote rehabilitation of children,so it is worth promoting.

新生儿没有对疼痛的描述能力 ,而且神经系统的发育不够完善 ,疼痛的敏感性较差 ,由疼痛刺激产生的应激反应不太显著 ,因此新生儿的疼痛没有引起人们的关注.但疼痛会致使新生儿发生一些行为反应和生理反应 ,这些反应可能会对其产生近期和远期的不良影响[1 ] .

Objective To explore the effect of individualized psychological nursing intervention on the psychological status of patients with prostate cancer.Methods 40 cases of prostate cancer patients since September 2014-2016 year in October admitted to hospital were randomly selected,were randomly divided into two groups,the control group (20 cases) received routine nursing intervention,the observation group (20 cases) of individual psychological intervention based on routine nursing.The patients were assessed with self rating Depression Scale (SDS) and self rating Anxiety Scale (SAS) before and after nursing.The quality of life of the two groups were compared.Results The urination and PSA in two groups before and after nursing in two groups after nursing,average urine flow rate,compared with before treatment were significantly improved,and those parameters the study group improved more significantly (P ＜ 0.05);the serum PSA levels of two groups were significantly decreased,and those parameters the study group improved more significantly (t =14.05 P ＜ 0.05).After nursing,the two groups of patients with SDS and SAS scores than before treatment were significantly improved,thescores in the observation group were significantly lower than those in the control group (P＜ 0.05),at the same time,two groups of patients after nursing quality of life was significantly improved,and those parameters the study group improved more significantly (P ＜ 0.05).Conclusion Psychological nursing intervention in patients with prostate cancer,can effectively alleviate the depression and anxiety status of patients,improve the quality of life of patients,promote the rehabilitation of patients as soon as possible,it is worthy of popularization and Application.

Objective To explore the effect of non nutrition sucking and massage on gastrointestinal function in very low birth weight infants in NICU.Methods A total of 62 very low birth weight infants in NICU of our hospital were selected as study subjects.According to the order of entering NICU time,they were divided into observation group (33 cases) and control group (29 cases).The control group only treated with gastric tube feeding and the observation group was treated with non nutrition sucking and massage on the basis of the control group.The changes of body weight and gastrointestinal function in two groups were analyzed and compared.Results There was no significant difference in birth weight of the neonates in two groups at birth (P ＜0.05).At 7th,14th and 28th day after birth,the body mass of the observation group were significantly higher than those of the control group (P ＜ 0.05).The indicators of defecation and feeding in the observation group were better than that of the control group (P ＜ 0.05).In addition,the incidence rates of vomiting,abdominal distention,gastric retention and pathoglycemia of the observation group during feeding period were significantly lower,and the symptoms improved times were significantly lower than that in the control group (P ＜ 0.05).Conclusion Non nutrition sucking and massage can promote maturation of gastrointestinal function,reduce the occurrence of feeding intolerance,accelerate the early growth and development of very low birth weight infants.

Objective:To probe into the application effect of structure process result theory in clinical nursing teaching management.Methods:A total of 386 nursing students were selected as control group from July 2013 to April 2014,another 390 nursing students were selected as observation group from July 2014 to April 2015. The patients in control group used the traditional teaching management model,while the patients in observation group adopted teaching management structure based on structure process result theory.The level and quality of teaching were compared before and after the implementation,the theory examination scores and satisfaction rate of clinical nursing teaching were also compared between two groups of nursing students.Results:After the implementation,the quality and level of teaching in teaching staff were higher than that before the implementa-tion(P<0.05);The theory examination scores and satisfaction rate of clinical nursing teaching in observation group were higher than that in control group(P<0.05).Conclusion:The teaching management system based on the structure process result theory was helpful to improve the quality of clinical nursing teaching.

目的 探讨护理干预对阿奇霉素序贯疗法治疗小儿支原体肺炎的临床疗效.方法 将本院100例支原体肺炎患儿均给予阿奇霉素序贯疗法,根据随机数字法,分为对照组(常规护理)和观察组(护理干预),各50例,比较2组治疗的临床疗效、症状消失、住院时间以及治疗依从性.结果 与对照组相比,观察组治疗的显效率显著增高(P＜0.05);与对照组相比,观察组发热、咳嗽、肺部啰音、住院时间均显著缩短(P＜0.05);与对照组相比,观察组患儿对治疗依从性显著增高(P＜0.05).结论 阿奇霉素序贯疗法治疗小儿支原体肺炎期间,护理干预能够提高患者治疗的临床疗效,提升患儿对治疗的依从性.

目的 探讨微信平台在早产儿出院随访干预中的应用效果.方法 将本院新生儿科收治的100例早产儿随机分为观察组和对照组,对照组仅给予出院指导,出院后定期复诊评估.观察组出院后采用微信平台随访干预,比较2组早产儿家长的健康知识掌握以及早产儿的发育情况.结果 观察组家长的喂养知识、生活护理、生长发育知识及早期护理干预知识的掌握率显著高于对照组(P＜0.05).观察组出院后6个月的体质量和身长增长速度大于对照组,各项智能发育评分显著高于对照组(P＜0.05).结论 微信平台随访能够提高早产儿家长早期护理干预知识的掌握率,促进早产儿的身体和智能的发育.

目的 探讨个性化半需求喂养在早产儿中的应用价值.方法 选取2014年1月～2016年3月在我院出生的早产儿94例,依据随机数字表法分为观察组(个性化半需求喂养)和对照组(常规喂养)各47例,比较两组早产儿相关指标.结果 观察组早产儿的恢复至出生体质量时间、胎便排尽时间、达营养性喂养时间均明显低于对照组,14d体重增长及14d头围增长幅度均显著高于对照组(P＜0.05).干预后,观察组早产儿的胃泌素、胃动素、白蛋白均明显高于对照组,总胆红素均显著低于对照组(P＜0.05).观察组早产儿的呕吐、腹胀、胃潴留、胃功能紊乱及喂养不耐受率均明显低于对照组(P＜0.05).结论 个性化半需求喂养能够明显改善早产儿胃肠功能,促进胃泌素、胃动素分泌,加速早产儿生长、发育,值得临床推广应用.

目的：评价复方丹参滴丸治疗脑血栓康复期的临床疗效与安全性。方法：以陕西省人民医院神经外科收治的脑血栓患者作为研究对象，观察组与对照组各纳入患者50例，均给予内科保守治疗、康复治疗，对照组给予安慰剂，观察组给予复方丹参滴丸，对比相关指标。结果：4周后，观察组与对照组 PLT 低于治疗前、观察组低于对照组，观察组与对照组 PU 、ICAex 高于治疗前、观察组高于对照组，观察组 HCT 高于治疗前、对照组，差异具有统计学意义。3个月后，观察组与对照组神经功能缺损评分低于治疗前、观察组低于对照组，差异具有统计学意义。两组均无不良反应。结论：在常规治疗基础上，口服复方丹参滴丸，有助于增强颅内灌注，减轻神经功能损伤，增强康复治疗效果。

目的:探讨延续性护理在改善慢性心力衰竭患者生活质量和自我管理能力中的临床意义.方法:将130例患者随机分为观察组和对照组,每组各65例.对照组采用常规护理进行干预,观察组患者在常规护理的基础上予以延续性护理干预,比较两组患者在护理后的生活质量及自我管理能力.结果:观察组的6 min步行距离、生活完全自理率均明显高于对照组(均P＜0.01),再次住院率明显低于对照组(P＜0.01);护理后观察组的生活质量(如社会活动情况、抑郁心理情况、日常生活能力及焦虑心理症状)均明显高于对照组(均P＜0.01),观察组的自我管理能力优于对照组(P＜0.01).结论:延续性护理可促进慢性心力衰竭患者的治疗,在提升其生活质量和改善自我管理能力方面有着良好的效果,值得临床推广应用.

Objective To investigate the clinical effect of Bifidobacterium Tetravaccine tablets combined with Compound Ocimun Oil Oral Suspension in the treatment of children with rotavirus enteritis. Method 86 cases of children with rotavirus enteritis in our hospital from January 2014 to January 2015 were selected as the research objects. According to the random principle, they were divided into control group and observation group, 43 cases in each group. Control group children were treated with rehydration and other routine treatments, and took Bifidobacterium Tetravaccine tablets orally at the same time;observation group children were treated with Compound Ocimun Oil Oral Suspension on the basis of control group treatment. Compared the clinical e?cacy, serum interleukin (IL)-6 and IL-17 levels before and after treatment, and the stool frequency and stool intestinal flora imbalance degree between the two groups after treatment. Result The total effective rate of control group was 69.77%(30/43), observation group was 93.02%(40/43), and the difference between the two groups was significant (P<0.05). After treatment, serum levels of IL-6, IL-17 of both groups had significantly decreased (P < 0.05), and levels of these inflammatory factors of observation group were significantly lower than control group (P<0.05). 3~4 days after treatment, observation group children with intestinal dysbacteriosis forⅠ,Ⅱ,Ⅲdegree were 44.19%, 48.83%, 6.96%, successively;theratios of control group were 60.47%, 25.58%, 13.95%, respectively. There was obvious difference observed in the ratio ofⅡdegree between the two groups (P<0.05). Since the third day after intervention treatment, compared with control group disorder of intestinal flora improved and stool frequency of observation group were significantly reduced (P < 0.05). Conclusion Bifidobacterium Tetravaccine tablets combined with Compound Ocimun Oil Oral Suspension in the treatment of rotavirus enteritis can improve curative effect, relieve the disorder of children with intestinal flora, reduce the risk of secondary bacterial infection.