目的 研究天疱疮患者家属照顾者的情感体验,为该群体制定针对性干预和支持提供参考依据.方法 运用质性研究中的现象学研究方法,通过目的抽样法,对2021年9月—2022年6月的13名天疱疮患者家属照顾者进行深入的半结构访谈,采用Colaizzi分析法对资料进行分析.结果 天疱疮住院患者家属照顾者情感体验归纳为以下5个主题:家属照顾者的认知缺乏,家属照顾者经济及心理负担重,对治疗中使用激素药物的顾虑较多,家属照顾者能够为患者提供正向的引导与支持,家属照顾者生活质量的负面影响.结论 护理人员应关注家属照顾者的情感体验,加强疾病知识及用药讲解,并进行心理疏导,增加治疗信心,达到促进患者康复的目的.

目的 探讨药浴治疗寻常型银屑病过程中配合综合护理干预的临床效果.方法 随机抽取150例、2017年～2019年在我院接受药浴治疗的寻常型银屑病患者,参照护理方式的差异划分为对照组(常规护理干预,n=75)与观察组(综合护理干预,n=75).针对两组患者的临床疗效展开分析.结果 干预后,同比对照组患者,观察组患者的治疗总有效率呈更高显示,且差异显著(P<0.05).结论 临床针对寻常型银屑病患者进行药浴治疗的同时辅助综合护理干预的效果显著.

Objective To evaluate the efficacy of vapour compresses for infant eczema,in order to provide a rationale for its clinical use.Methods Sixty inpatients and outpatients were randomly divided into two groups,30 cases per group.The treatment group was treated with herbal vapour compresses,while the control group was treated with herbal bath for 3 days.Results At the end of treatment,the EASI scores were significantly lower in the treatment group than in the controls(6.30 ± 1.96 vs.14.50 ± 1.85,P ＜0.01).The effective rates in the treatment group were significantly higher than that in the controls(96.67％ vs.73.33％,P ＜0.01).No serious adverse reactions were observed in the two groups.Conclusion The vapour compresses is safer and more effective than herbal bath.

目的 探讨胃力康颗粒联合疏肝调胃汤治疗反流性食管炎疗效及对胃肠动力的影响.方法 将58例反流性食管炎患者随机分为2组,对照组29例给予胃力康颗粒治疗,观察组29例在此基础上给予疏肝调胃汤治疗,观察2组治疗前后中医证候积分、胃肠动力变化情况,统计2组疗效及不良反应发生情况.结果 2组治疗后烧心、泛酸、脘腹胀满、呃逆、嗳气、情志抑郁、食欲不振、善太息、嘈杂中医证候评分均显著降低(P均<0.05),且观察组中医证候评分显著低于对照组(P<0.05);2组治疗后胃肠动力学指标胃半排空时间、胃排空时间、胃动素和胃泌素水平均低于治疗前(P均<0.05),且观察组胃半排空时间、胃排空时间、胃动素和胃泌素水平均低于对照组(P均<0.05);观察组治疗后总有效率显著高于对照组(P<0.05);2组不良反应发生率比较差异无统计学意义(P>0.05).结论 胃力康颗粒联合疏肝调胃汤治疗反流性食管炎疗效较佳,可显著降低中医证候评分,并可加快胃排空进程,下调胃动素和胃泌素水平,且临床应用安全.

Both acitretin and methotrexate are effective in ameliorating psoriatic lesion. However, their combination has been seldom reported in the treatment of psoriasis because of the warning regarding the potential hepatotoxicity of the drug interactions. This study was designed to investigate the effectiveness of such combination therapy for psoriasis vulgaris, and the potential benefit as well as side effect during the treatment. Thirty-nine patients with psoriasis vulgaris were treated with acitretin, methotrexate or their combination or as control. Similarly, K14-VEGF transgenic psoriasis-like mice were treated with these drugs. Human primary keratinocytes and hepatic stellate cells were used for analyzing their effect in vitro. The results showed that the combination therapy exhibited higher effectiveness in remitting skin lesion, but did not significantly affect the liver function of both patients and mice. Moreover, the combination groups showed less elevation of profibrotic factors in sera when compared with methotrexate alone groups accordingly. Furthermore, primary keratinocytes expressed more involucrin as well as loricrin and proliferated more slowly on the combined stimulation. Interestingly, such combination treatment induced lower expression of profibrotic factors in hepatic stellate cells. In conclusion, the acitretin-methotrexate combination therapy for psoriasis vulgaris can achieve higher effectiveness and result in less liver fibrosis.

Objective:To investigate the correlation between and serum immunoglobulin,IgG subclasses and the level of serum immunoglobulin in children with recurrent respiratory tract infection (RRTI).Methods:30 children with recurrent respiratory tract in-fection were selected as observation group,the other 30 healthy children were selected as control group.Serum levels of immunoglobu-lin,cellular immunity,IgG subclasses and IgG subclasses in the two groups were observed.Results:IgM was significantly lower in the observation group than that in the control group (P <0.05);IgG2 and IgG4 were significantly lower in the observation group than thoes in the control group (P <0.05).In the observation group,there were 14 cases of IgG subtype,accounting for 46.7%.Among them,8 cases were single defects,which accounted for 57.1 % of all IgG subtypes,IgG4 being the most important subtype,accounting for 35. 7% (5 /14),followed by IgG3,accounting for 14.3% (2 /14);joint defects in a total of 6 cases,accounting for 42.9%,mainly for IgG2 +IgG4,accounting for 35.7% (5 /14).The observation group with CD3 and CD4 levels were significantly lower than those of the control group (P <0.05).Conclusion:Recurrent respiratory tract infection lead to the capsular polysaccharide of bacteria with c IgM, IgG2 +IgG4 and CD3 +,CD4 + T cell disorder in children.

Objective To observe the clinical effect of nasal continuous positive airway pressure (CPAP) in the treatment of children with bronchiolitis complicated by respiratory failure. Methods A total of 98 children with bronchiolitis complicated by respiratory failure treated in our hospital from January 2014 to December 2014 were select-ed, which were divided into observation group and control group according to the order of admission, each with 49 chil-dren. The two groups were both given antispasmodic, suctioning, anti-infective treatment, as well as correction of elec-trolyte imbalance. The observation group received CPAP therapy, while the control group was treated with nasal cannu-la oxygen therapy. Blood gas indicators, clinical symptoms and treatment time were compared between the two groups. Results 12 h, 24 h after treatment, heart rate (HR), blood acidity (pH), arterial carbon dioxide pressure (PaCO2), oxy-gen saturation (SpO2), arterial oxygen tension (PaO2) in the two groups were all significantly improved compared with those before treatment (P<0.05), and the indexes of the observation group were significantly better than those of the con-trol group (P<0.05). The cyanosis disappeared time, shortness of breath disappeared time, heart rate recovery time, wheezing disappeared time and length of hospital stay were significantly shorter in the observation group than the con-trol group (P<0.05). The effective rate was 69.39%in the observation group 3 d after treatment, significantly higher than 48.98%in the control group (P<0.05). Conclusion Using nasal continuous positive airway pressure for adjunctive ther-apy in children with bronchiolitis complicated by respiratory failure can shorten the treatment time, relieve symptoms, and improve clinical outcomes.

BackgroundNurses are known to work in stressful environments, which might lead to severe mental illness and impaired quality of life. However, little research has been done to address this problem in Chinese nurses. This study aimed to assess psychological distress and quality of life in Chinese nurses, and to examine the relation among these problems.MethodA cross-sectional survey was done in Shaanxi province during June to December, 2013. 1700 nurses were recruited, 1570 of whom completed questionnaires. Depression was measured with the Center for Epidemiologic Studies Depression scale, and anxiety was measured with the State-Trait Anxiety Inventory. Quality of life was assessed using the 36-item short-form health survey (SF-36). A general linear model was used to investigate whether quality-of-life measures showed significant difference among participants with different psychological symptoms after adjustment for confounding variables. The research proposal and data access were approved by the Ethics Review Committee of the Second Hospital of Xi'an Jiaotong University, Xi'an, China. Individual written assent was provided by all nurses in the study. The study dataset contained no identifying information, and all research data were kept confidential. This consent procedure was approved by the Ethics Review Committee of the Second Hospital of Xi'an Jiaotong University.Findings389 (25%) of 1570 participants had depression. 911 (58%) participants had state anxiety, whereas trait anxiety was reported in 780 (50%) participants. All subscales of SF-36 scores of nurses who had depression were significantly lower than those of nurses without depression (p=0·003). All subscales of SF-36 scores, except physical function, of the nurses with high anxiety scores were significantly lower than those of the nurses with low anxiety scores (p=0·0003). Depression was significantly associated with poor overall quality of life (β=107·874; p=0·0005) and all other seven domains of quality of life (p=0·016). Significant effects of social anxiety (β=59·760; p=0·029) and trait anxiety (β=57·908, p=0·027) were reported in overall quality of life.InterpretationDepression and anxiety are each associated with poor quality of life in nurses in Shaanxi province. Moreover, depression has more pervasive effects than anxiety on non-mental domains of nurses' quality of life.FundingNone.

应用外涂药物治疗是皮肤病治疗的主要方法之一。部分药物外涂后常需用指腹或手掌边涂药边按摩，以促进药物吸收，从而增强疗效。但当双手活动受限，或皮肤损害位于背部或其他双手难以触及的部位时，患者难以自行完成涂药工作。为此，笔者结合临床实际，设计了电动涂药器，在临床应用中具有省时、省力和操作方便等优点，具有良好的经济效益和潜在使用价值。现介绍如下。

Objective To determine the effect of the modified UW (University of Wisconsin)solution in the treatment of acute renal tubular necrosis in newborn swine. Methods Ten one-week-old newborn swine were used to establish the animal model of acute renal tubular necrosis by clamping their renal arteries,and were divided into two groups: the model group( n = 5 ) and the treatment group ( n = 5 ) in which fructose diphosphate sodium UW solution was used. Sham surgery was performed on other five swine, which were used as the sham group. At 12 h,l d,2 d,3 d and 7 d after the operation,the urine volume,urine protein,blood urea nitrogen(BUN) and creatinine(Cr) were determined. At 12 h ,24 h and 7 d after the operation ,renal pathological examination was conducted. Results The renal pathological examination and the blood biochemistry tests showed that the animal model was successful. BUN and Cr in the model group and the treatment group were significantly higher than those in the sham group at 12 h after operation(P ＜0. 05) ,and they arrived at their peak values at 2 d after operation,showed remarkable decline at 7 d,especially in treatment group,and returned to the level of the sham group. The urine protein in the model group and treatment group were higher than those in the sham group at various times(P ＜0.05 or P ＜0.01) and it peaked at 1 d after operation,then declining gradually,especially in the treatment group. Compared with the sham group,there were a significant decrease in the urine volume at various times in the model group(P ＜0. 05 or P ＜0. 01 ) ,while in the treatment group,the decrease in the urine volume were significant only at 12 h, 1 d and 2 d( P ＜ 0. 05 ) ,and turned insignificant at 3 d and 7 d. The pathological examination showed that the pathological changes in the treatment group were significantly milder than those in the model group. Conclusion The modified UW solution is effective in reducing the acute renal tubular necrosis in newborn swine.

Objective To evaluate the effect of positive psychotherapy on the mental health,behaviors of social avoidance and distress in psoriasis patients.Methods Fifty-nine patients with psoriasis were randomly assigned to two groups.The patint in the experiment group received positive psychotherapy while the patients in the control group receiving routine nursing care.The patients were investigated with Symptom Checklist-90(SCL-90) and Social Avoidance and Distress Scale before and after intervention.Results After the intervention,there were significant differences between the two groups in the factor scores of somatization,obsessive-compulsive symptoms,interpersonal sensitivity,depression,anxiety,hostility,terrorism,and psychiatric symptoms(P<0.05),as well as the score of social avoidance and distress(P<0.05).Conclusion Positive psychotherapy can improve the mental health and increase social behaviors of patients with psoriasis.

目的:观察小剂量肝素预防过敏性紫癜性肾炎(HSPN)肾损害的有效性。方法:采用随机方法152例过敏性紫癜(HSP)患儿分为肝素治疗组(80例),对照级(72例)。两组患儿均同时给予相同的基础综合治疗,包括脱敏改善血管脆性,H2受体阻滞剂,甲氰咪呱等对症治疗,直至临床症状消失。肝素组在此基础上加用小剂量肝素钠按80~120u/(kg.次)+10%葡萄糖(50~100m l)静脉输注,连续5d,治疗前及结束时肝素治疗组监测血凝4项,开始治疗后,随访期间每周(3个月内)及每2周(3个月以后)检测尿常规。结果:平均随诊6个月,肝素治疗组较对照组过敏性紫癜肾炎肾损害发生率明显降低,且有显著差异性。结论:肝素可有效预防或减少紫癜性肾炎的发生。

<正> 重度膝骨性关节炎是一种难治性疾病,是导致成人长期残疾的第二大病因。对重度膝骨性关节炎,国内外均主张进行膝关节置换。但有相当一部分患者因为无力负担巨额治疗费用,不愿接受手术治疗。为此,需要探索一种有效、可行、经济的治疗方案,但尚未见到系统非手术治疗重度膝骨性关节炎的报道。笔者于1999-06-06至2008-06-30,采用由内服中药,神经阻滞,针刀松解,中药熏蒸,功能锻炼

OBJECTIVE:Children with Tourette's syndrome (TS) have a poor treatment compliance due to side effects and inconvenient administration of oral drugs. This study explored the efficacy and safety of clonidine transdermal patch for treating TS in children. METHODS:A total of 119 children with TS were randomly treated with the clonidine transdermal patch (n=65) or with oral haloperidol (n=54). The therapeutic efficacy was assessed based on the results of the Yale Global Tic Severity Scale (YGTSS) 4 weeks after treatment. RESULTS:The clonidine transdermal patch group showed a higher reduction in the overall tic symptom scores (61.5+/-7.5%) than that in the haloperidol group (41.0+/-6.3%; p<0.05). Clonidine transdermal patch treatment was effective in 53 patients (81.5%) and 36 patients (67.5%) showed effective to oral haloperidol (p>0.05). Mild side effects (decrease of blood pressure and dizziness) were observed in 1 patient in the clonidine transdermal patch group. Mild hypermyotonia, drowsiness or lassitude as side effects occurred in 6 patients in the haloperidol group. CONCLUSIONS:Clonidine transdermal patch is effective for the treatment of TS in children and its side effects are mild and rare.

AIM:To investigate pneumonia with heart failure (HF)of serum heart-type fatty acid binding egg white No.(H-FABP)level changes of pneumonia with heart failure in children with the clinical value.METHODS:Children with pneumonia complicated by heart failure 42 cases studied,40 cases of simple pneumonia and 35 cases of healthy children as control group.Carried out at different time heart-type fatty acid binding protein(H-FABP)and conventional test items creatine kinase isoenzyme(CK-MB)and troponin Ⅰ(CTnI)detection.RESULTS:Forty-two cases of HF in children with the CK-MB and CTnI at onset HF after 6-8 h start rising,24 h peaked;H-FABP at onset HF after 6-8 h peak.24 h after the rapidly declining.Three indicators of the peak value with simple pneumonia and two healthy children control group differences were statistically significant,simple pneumonia and healthy children two groups revealed no statistically significant difference.CONCLUSION:CK-MB and CTnI as poor indicators of early diagnosis,HFABP the early diagnosis of HF can be used as the best indicator.

Objective To Observe the effectiveness of psychological nursing for the patients with generalized neurodermatitis. Methods For 12 hospitalized patients with generalized neurodermatitis of my department in 2008 (1~12 month). We provided the psychological nursing to alleviate psychological stress and distract attention intensively,while strictly according to doctor's order for drug treatment and skin nursing,and compared with the same kind of patients of my department in 2007(1~12 month). Results Arnong 12 cases ,1 patient was cured and 11 patients were excellent effective. The average length of stay was 19 days,shorter than that of the patients only with drug therapy and routine nursing care in 2007(1-12)month (25 days). Conclusion The timely and effective psychological nursing can shorten the course of disease and improve clinical efficacy.

目的 探讨银屑病患者自我概念与社交回避及苦恼的关系.方法 运用自我概念量表(SCS)和社交回避及苦恼量表(SADS)对80例银屑病住院患者进行调查,并进行相关性分析.结果 银屑病患者的SCS得分为122.35±10.03.处于中度负性水平;SADS得分为16.32±6.13.显著高于正常人(P<0.01);银屑病患者的自我概念及各因子与社交回避及苦恼存在显著负相关(P<0.05,P<0.01).结论 银屑病患者的自我概念与社交回避及苦恼现象应引起护理人员高度重视,需提高患者的正性自我概念,以改善其社交回避及苦恼状况.

临床资料 1 一般资料 本组8例,其中男5例,女3例,年龄4个月至7岁,并发化脓性脑膜炎就诊者6例,其中表现反复发作4例, 1例发作4次,3例发作3次,2例发作1次,1例表现为脊髓脓肿.

目的:探讨既符合《医疗事故处理条例》要求,又充分体现整体护理内涵的护理记录方法。方法:深入研究功能制护理记录与PIO(PIO为整体护理病历中记录护理工作的形式。P:Problem即护理问题;I:Intervention即护理措施;O:Objective即评价。以下简称"PIO")记录的特点,将两者融合,制定新的护理记录书写规范,并应用于临床。结果:新的《护理记录书写规范》在临床应用三年多,结果显示该规范既充分体现护理程序的科学思维,又全面地体现了病人住院全过程的护理工作,使护理记录成为举证的有力依据。结论:新的《护理记录书写规范》符合临床护理工作实际,记录方法简便、易行、科学,达到了护士正确、规范书写护理记录的目的,使护理记录成为保护护患双方合法权益的有力证据。