Objective:To explore the effect of pulmonary rehabilitation training based on Chronic Obstructive Pulmonary Disease (GOLD) classification on self-efficacy and rehabilitation effect in patients with acute exacerbation of chronic obstructive pulmonary disease.Methods:From May 2019 to April 2021, a total of 85 patients with acute exacerbation of chronic obstructive pulmonary disease who were admitted to China-Japan Union Hospital of Jilin University were selected and divided into the observation group (43 cases) and the control group (42 cases) using the random number table method. The control group received routine pulmonary rehabilitation training, and the observation group conducted pulmonary rehabilitation training based on GOLD classification. Two weeks after intervention, the self-efficacy, pulmonary function, 6-Minute Walking Test (6MWT), quality of life, and the condition of adverse reactions were compared between the two groups.Results:Two weeks after intervention, the scores of dyspnea management, emotion, physical activity, safety behavior, and total score of self-efficacy of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05). The forced exhalation volume in one second (FEV1), forced vital capacity (FVC), FEV1/FVC and 6MWT of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05). The scores of respiratory symptoms, activity limitation, disease impact on life and total score of St. George's Respiratory Questionnaire (SGRQ) of the observation group were lower than those of the control group, and the differences were statistically significant ( P<0.05). There were no serious adverse reactions in two groups. Conclusions:Pulmonary rehabilitation training based on GOLD classification can help patients' promote the recovery of lung function, improve their self-efficacy and the quality of life, which has good security.

脊柱嗜酸性肉芽肿（EG）是一种以骨质破坏、组织细胞增生和嗜酸性细胞浸润为主要特点的良性肿瘤样疾病。该病起病隐匿,患者最初的临床症状往往缺乏特异性,常以局部疼痛或病理性骨折就诊。且早期实验室检查与影像学表现也缺乏特异性,Fermando等[1]对其所穿刺活检的患者进行统计,发现穿刺活检的阳性率不足50%。所以临床中对于

Objective To study the role and mechanism of let-7a in cerebral ischemia-reperfusion injury.Methods Rats were divided into Sham group,Control group,anti-let-7a group and GFP group and 6 rats were in each group.Rats in Control group,anti-let-7a group and GFP group were given saline by tail vein,anti-let-7a expression of AAV-9 plasmid or control empty plasmid experiments respectively,and then establish cerebral ischemia and reperfusion model.Infarct volume was examined using TTC staining and apoptosis was evaluated using Tunel staining and caspase-3 detection.The expression of TNF-α and IL-6 in brain tissue was detected by ELISA and qRT-PCR.The regulation of let-7a on the expression of MKP1 was confirmed by Western blot,qRT-PCR and luciferase assay.Results The infarct volume of anti-let-7a group was significantly smaller than that of GFP group and control group,the number of apoptotic cells,the expression of caspase-3,TNF-α and IL-6 in brain tissue were significantly lower than that of GFP group and Control group.Let-7a binds to the MKP1 mRNA 3''UTR end and down-regulates the expression of MKP1 in PC12 cells.Conclusion Knockout of let-7a can inhibit the activation of MAPK signaling pathway by regulating the expression of MKP1,thus excerting the neuroprotective effect against inflammatory reaction and apoptosis after cerebral ischemia-reperfusion.

阿尔茨海默病( AD)是一种由神经系统变性引起的疾病,又叫老年痴呆症. 近年来,我国AD的发病也逐年上升. 目前药物治疗是治疗AD最主要方式之一. 本文对AD发病机制的各种学说与氧化应激的关系进行综述.

目的：探讨医院应急护理队员的规范化培训对提高应急护理人员的应急处置能力的效果。方法选取我院的应急队员38名，组成三个内科组，三个外科组，进行为期3个月的规范化培训，培训内容包括急诊急救、应急救援理论知识及急救综合技能，培训采用理论授课、情景模拟、示教、带教等多种形式。比较培训前后的理论及技能的考核成绩，同时评定培训前后应急队员的自我效能感。结果与培训前比较，应急护理队员急诊急救、应急相关理论及急救综合技能考核成绩均显著提高（均P＜0．001），同时应急队员培训前后的自我效能总量表平均得分分别为20．24分、37．25分。结论通过护理应急队员的规范化培训，极大提高了护理人员的应急处置能力，同时护士的自我效能感也得到提高。

Objective To investigate the influence of Ezrin genes on glioma growth through gene silencing and overexpression of Ezrin.Methods According to Ezrin gene sequence in GenBank,Using Designer3.0(Genepharma)software designed shRNA DNA oligo which used four sites of Ezrin gene as target to synthesize and clone shRNA's vectors pGPU6/GFP/Neo,and construct shRNA vector.U87 cells were transfected the shRNA's vectors by Liposomes LipofectimineTM 2000 after restriction enzyme and DNA sequencing analysis.After 48 hours,Ezrin mRNA and the expression of protein was detected by RT-PCR and Western blot to screen effective shRNA vector.Then U87 cells were transfected by the effective shRNA vectors and expression vectors of Ezrin gene,the cells were collected and inoculated in the nude mouse brain,and glioma animal model was prepared.Then we observed the growth of cells in the nude mouse brain in the laser confocal microscopy.Results The shRNA-Ezrin is correct by restriction enzyme and DNA sequencing analysis.RT-PCR and Western blot results showed that shRNA-Ezrin-2 can silent its expression,and made the expression of mRNA and protein reduced.It was identified to be efficient shRNA vector.It was observed a few of shRNA-Ezrin 2 transfected U87 cells migration in the nude mouse brain less than control group in the laser confocal microscopy,while in pEGFP-C1 / Ezrin transfection group,the cells migration are relatively more.Conclusion Volid shRNA vectors of Ezrin gene was constructed and screened successfully.Ezrin gene involved in migration and infiltration of U87 cells in the nude mouse brain.

相关研究表明,对于非糖尿病的腹膜透析患者,使用等渗腹透液时血糖及胰岛素水平无明显变化。我们最近遇到了1例腹膜透析小于半年发生糖耐量减低的患者,现报道如下。男,47岁,间断关节疼痛15年,发现肾功能异常2年,加重伴恶心、胸闷3天,于2010年3月22日入院。入院后相关化验:尿素氮30.34mmol/L,

目的:探讨急诊护理中风险管理的应用,最大限度的降低护理风险的发生,提高护理管理质量。方法:通过对护理风险发生因素的分析,制定相应的措施、应急预案,降低投诉和纠纷的发生率。结果:护理人员提高了风险意识,增强了主观能动性,护患关系得到了明显改善,护理纠纷明显下降。结论:风险意识的提高,风险管理的加强,使护理质量明显提高,使患者得到了安全、规范、满意的优质服务。

<正>临床实习对于护理专业的学生非常关键,能够将课堂理论学习和今后临床实习有机联系起来。而急诊科又是一个特殊的科室,无论是带教的老师还是实习护生都会面临各种问题和挑战。急诊科是医院的前沿,是抢救急危重患者的重要场所。

<正>护理学是一门综合性的应用科学,实践性很强,其教学过程主要是由课堂教学、临床实习两部分组成。临床实习会使护生将课堂教学学到的理论知识和技能与实践相结合。临床带教应根据护生及急诊的特点,制定计划,组织教学,开展讨论,并进行考核,使护生在急诊实习期内,进一步强化急救的理论知识和操作技能,为今后成为一名合格的医护人员打下

Objective To observe the effect of improved venous puncture method and provide basis for popularizing the method which is rapid, painless and of less trauma. Methods According to single-blind random method, 2 132 patients undergone venous puncture treatment in the emergency department of our hospital from August 2008 to August 2009 were selected and divided into two groups: improved group ( 1 066 cases) and traditional group( 1 066 cases). Observed the effect of two groups. Results Improved method was superior to traditional method in pain easing, and there was statistical difference between the two groups (Z = 21.95 ,P ＜0.01 ). Improved method could increase puncture success ratio, with statistical significance as compared to traditional method ( x2 =36.61 ,P ＜0.01 ). Also, zhe former had more rapid venous return ( u = 196. 50,P ＜0. 01 ) and less incidence of bleeding of penetration points and subcutaneous ecchymosis after needle withdrawing ( x2 = 11.76 ,P ＜ 0. 01 ) than the latter. Conclusions Improved puncture method is of less pain and higher puncture success ratio and is superior to the traditional method.

<正>中心静脉置管(central venous catheter,CVC)是经过皮肤直接自颈内静脉、锁骨下静脉和股静脉等进行穿刺,沿血管走向直至腔静脉的插管。CVC已广泛应用于临床,但是中心静脉导管相关感染(CVC-RI)是其中最重要的并发症,已引起广泛重视。美国疾病控制中心(CDC)报道[2],美国平均CRS-BSI感染率为5.3/1000导管留置日,感染患者中平均病死率为12%～25%,因此CVC-RI日益引起重视,下面就其诊断、

急诊科是医院诊治、抢救急、危、重患者的重要科室,也是培养护生急救能力的关键场所[1].为适应现代急救医学的发展,缩短有效抢救时间,提高抢救成功[2],急诊护理人员不仅具备扎实的理论知识,丰富的临床经验,而且要具备精湛的急救技术.

简易呼吸器是最简单的借助气械加压的人工呼吸装置,具有使用方便,痛苦轻,并发症少,便于携带,有无氧源均可立即通气的特点.我科在临床急救及转运过程中采用简易呼吸器辅助呼吸,改善了患者的呼吸功能.有效的纠正了低氧血症,大大地提高了抢救成功率.

分析综合医院急诊科护士易产生心理疲劳的原因,探索预防及调节方法,对提高保障护士的心理卫生与健康,充分调动护士的主观能动性,以适应现代"生物、心理、社会"这一新的医学模式,提高护理质量,防止医疗护理差错和护患纠纷的发生起到了较好的作用.