目的 探讨低强度卧位体操训练对维持性血液透析患者营养状态的影响.方法 将2020年2-11月期间赣南医学院第二附属医院收治的 92 例维持性血液透析患者作为研究对象,按照随机数字表法分为对照组和观察组,每组各 46 例.对照组采用常规血透护理干预,观察组在常规血透护理的基础上采取低强度卧位体操训练干预,观察 2 组血透充分性、血脂水平及营养状况.结果 干预后,观察组尿素氮水平低于对照组,尿素清除指数(KT/V)、尿素下降率(urea reduction rate,URR)均高于对照组(P＜0.05);观察组低密度脂蛋白(low-density lipoproteins cholesterol,LDL-C)、总胆固醇及心钠素(atrial natriuretic polypeptide,ANP)水平均低于对照组(P＜0.05);观察组血红蛋白、总蛋白、前白蛋白、白蛋白及转铁蛋白水平均高于对照组(P＜0.05).结论 低强度卧位体操训练应用于维持性血液透析患者可显著提高透析充分性,改善血脂水平及营养状况.

目的 探讨子宫内膜增生并发子宫内膜癌发病机制与血浆中炎症细胞因子含量的相关性.方法 收集门诊及住院患者138例,经诊断性刮宫病理诊断分为子宫内膜癌组(47例)和良性病变组(91例),平均年龄(55±8)岁,同时选取血站献血健康女性40例为对照组,平均年龄(52±7)岁,应用酶联免疫吸附试验(ELISA)双抗体夹心法检测各组血浆中转化生长因子(TGF)-β、肿瘤坏死因子(TNF)-α,白细胞介素(IL)-1β 和IL-6的含量.结果 与对照组相比,良性病变组与子宫内膜癌组血浆中TGF-β、TNF-α、IL-1β、IL-6含量明显升高(P<0.01),且随着炎症细胞因子含量水平升高,发生子宫内膜癌的风险显著升高.结论 子宫内膜良性病变与子宫内膜癌患者血浆中炎症细胞因子含量表达水平与疾病的发生发展密切相关.临床通过阻断细胞因子的生物学效应,为子宫内膜良恶性病变的预防和治疗开辟新途径.

目的 分析知信行(KAP)护理模式对人工髋关节置换术患者肢体功能的改善作用.方法 以随机数表法将2019年3月-2021年2月我院收治的62例人工髋关节置换术患者分为观察组和对照组,每组各31例.对照组采用常规护理,观察组在此基础上实施KAP护理模式.比较两组护理前后哈里斯髋关节功能评分(HHS)、日常生活活动量表(ADL)、KAP评分.结果 与护理前相比,两组Harris及ADL评分均上升,且观察组评分上升幅度高于对照组(P<0.05).与对照组比较,观察组知识、态度、行为评分呈上升趋势(P<0.05).结论 在人工髋关节置换术患者中应用KAP护理模式,可改善髋关节功能,提高患者的治疗信心,临床应用价值高.

目的 观察快速康复外科护理联合心理干预对老年粗隆间骨折PFNA内固定术治疗效果影响.方法 选取2020年1月-2021年1月在我院实施PFNA内固定术的80例老年粗隆间骨折患者为研究对象,随机分为观察组(n=40例)和对照组(n=40例),对照组进行常规基础护理,观察组在对照组基础上应用快速康复外科联合心理护理干预,观察比较两组生活质量水平、焦虑和抑郁评分、疼痛评分、髋关节(Harris)评分以及护理满意度.结果 观察组情绪角色、身体健康、认知能力、社会功能生活质量各维度评分均高于对照组(P<0.05);干预后,2组焦虑、抑郁评分均低于干预前,且观察组低于对照组(P<0.05);干预后,2组疼痛评分均低于对照组,且观察组低于对照组(P<0.05);干预后,2组Harris评分均高于干预前,且观察组高于对照组(P<0.05);观察组护理满意度97.50％高于对照组87.50％(P<0.05).结论 快速康复外科护理联合心理护理干预可促进老年粗隆间骨折PFNA内固定术治疗患者康复,提高护理满意度和髋关节功能评分,改善生活质量水平,降低抑郁和焦虑评分,减轻患者疼痛度,具有显著的应用效果.

目的 探讨改良密闭排烟气法应用于腹腔镜下胆囊切除手术中的效果.方法 选择2019年10月—2021年2月于赣南医学院第二附属医院行腹腔镜下胆囊切术的102例患者,将其随机分为对照组和观察组,各51例.对照组患者采用传统开放间断的排烟气法,观察组患者采用改良密闭排烟气法,对比2组术中情况及手术时间,血液性缺氧及一氧化碳(CO)中毒情况,手术烟雾中CO、CO2、PM2.5、PM10浓度.结果 观察组的排气孔放气次数、目镜擦拭次数少于对照组,手术时间短于对照组(P<0.05);观察组的碳氧血红蛋白(COHb)水平低于对照组,发生CO轻度中毒患者的例数少于对照组(P<0.05).观察组第一、二次测量手术烟雾中的CO、CO2、PM2.5、PM10浓度低于对照组,差异均有统计学意义(P<0.05).结论 改良密闭排烟气法可减少腹腔镜下胆囊切除手术术中的排气孔放气次数和目镜擦拭次数,并降低手术室空气中有害气体及物质的浓度,同时减少患者发生血液性缺氧和CO轻度中毒情况.

本文对移动医疗在孕期体质量管理中的应用进行综述,阐述了具体的实施方案,论述了移动医疗的优缺点,并对其有效性以及安全性进行了分析和总结,以期为移动医疗在国内孕期体质量管理领域中的应用推广提供参考.

目的 探讨三维护理模式在院前急救血栓栓塞患者中的护理效果.方法 选取2016年1月至2016年12月我院行院前急救护理的血栓栓塞患者68例作为活动对象,按随机数字表法将其分为对照组和观察组,每组各34例,对照组患者采取常规护理联合血栓栓塞患者院前急救,观察组患者在对照组的基础上给予三维护理模式联合血栓栓塞患者院前急救.观察两组患者院前急救期间抢救成功率、患者及家属对院前急救护理的满意度.结果 观察组抢救成功率(94.12％)明显高于对照组(79.41％)(P<0.05);观察组患者及家属对急救医护人员的急救知识评分、快速反应能力评分以及医护配合评分均高于对照组(P<0.05);两组患者护理后aPTT、PT、TT均明显上升,Fbg下降(P<0.05).结论 三维护理模式在提高院前急救血栓栓塞患者抢救成功率.

对妊娠期妇女身体活动自评式测评工具进行综述, 主要包括体力活动日记、自填式体力活动量表 (PAS) 、Baecke身体活动问卷、凯氏体力活动问卷 (KPAS) 、Godin-Shephard休闲体育活动问卷 (GSLTPAQ) 、国际体力活动问卷 (IPAQ) 、全球全面体力活动问卷 (GPAQ) 、孕期体力活动问卷 (PPAQ) .比较各量表在评估孕期身体活动类别、时间、强度等特点的利弊, 同时提出量表使用时的建议, 以期为国内学者开展孕期身体活动干预的相关研究提供参考, 为医务人员测评孕期身体活动提供依据, 进而提高孕期身体活动水平, 促进孕妇及新生儿健康.

[目的]探讨品管圈在提高院前急救出诊箱规范率中的应用效果.[方法]成立品管圈,以"提高院前急救出诊箱规范率"为主题,寻找真因并制定对策进行质量改进.[结果]院前急救出诊箱规范率由62.5％ 提高至98.1％;无形成果的品管圈圈员评分由5.5分提高至7.6分,圈员和谐度评分由5.8分提高至8.0分;附加效益:将品管圈中安瓿保护方法用到抢救车的药品管理,并推广至全院;将品管圈该活动的管理方法在全市机动库护士培训中进行推广;以《改良出诊包在院前急救中的应用研究》为题申请院级科研一项;拟申请改良出诊包专利.[结论]急诊科院前急救医护人员通过品管圈活动,规范了院前急救出诊箱的管理,有效提高了急诊科的院前急救质量.

Cervical cancer is a deadly gynecological malignancy in need of innovative treatment strategies. Emerging preclinical data has suggested the benefits of nanocarriers over the traditional chemotherapy for cancer treatment. In particular, gold nanoparticles are gaining popularity due to gold's inert nature, limited side effects, good cytocompatibility, and flexibility in preparation/modification. We conjugated polyethylene glycol (PEG) with hollow gold nanospheres (HGNs) and loaded the pegylated HGNs with an anticancer drug, cisplatin to target cervical cancer. HGNs were irradiated with noninfrared laser to increase the penetration of drug into tumor tissue and improve the delivery of cisplatin. We investigated the comparative characterization studies of prepared cisplatin loaded pegylated HGNs (cis PEG-HGNs), free cisplatin, cisplatin loaded HGNs (cis-HGNs), cis PEG-HGNs without laser, and cis PEG-HGNs with laser and its effects over cervical cancer cells. Transmission electron microscopy photomicrographs confirmed the integrity of prepared HGNs. While no significant difference was observed between encapsulation efficiency and drug loading of cis-HGNs (84.6%) and cis PEG-HGNs (86.7%), the encapsulation efficiency increased almost twice in HGNs, compared with control gold nanoparticles (GNs) because of the hollow cavity in HGNs. In-vitro cytotoxicity was measured by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay using HeLa cells. With irradiation, HGNs induced much elevated cytotoxicity. Not only HGNs were internalized by HeLa cells, they were retained in the cellular compartment. We also tested formulations in vivo and observed that the irradiated cis-HGNs and cis PEG-HGNs were most effective in regressing tumors in mice.

Abstract This study sought to investigate the effects of placental laterality on the measurements of uterine artery (UtA) Doppler velocimetry and their application in predicting early-onset preeclampsia (PE). We conducted a prospective cohort study on all women with singleton, uncomplicated pregnancies scheduled for first-trimester nuchal translucency at our institution. Pulsatility index (PI) for both UtAs was measured by Doppler velocimetry, and placental laterality was determined. Additionally, pregnancy outcome data were abstracted from the medical records. Receiver operating characteristic curves (ROCs) were plotted. Of the 304 patients enrolled, 247 met the inclusion criteria. Among these patients, 240 had uncomplicated delivery, while 7 had early delivery at <34 weeks due to PE. For the uncomplicated pregnancies, PI measurements of the UtA ipsilateral to the placenta were similar (left versus right UtA: 1.06 ± 0.38 vs. 1.04 ± 0.40; P = .745). However, PI measurements of the UtA contralateral to the placenta differed significantly (left versus right UtA: 1.45 ± 0.51 vs. 1.3 ± 0.47; P = .027). In predicting early-onset PE, the ideal cut-off value for the placental side PI was 1.91, with sensitivity 100% and specificity 96.3%. For nonplacental side PI, the ideal cut-off value for PI was 1.975, with sensitivity 57.1% and specificity 79.2%. Using the mean of the left and right UtA PI, the ideal cut-off value was 1.63, with sensitivity 100% and specificity 74.2%. ROC analysis confirmed that PI measurements of the UtA on the placental side were significantly lower than those on the contralateral side, PI measurements of the UtA ipsilateral to the placenta were similar.

目的 对比分析血清降钙素原(PCT)与炎性因子C-反应蛋白(CRP)、白介素-6(IL-6)及血清淀粉样蛋白A(SAA)在脓毒症患者早期诊断中的应用价值.方法 分析2016年7月-2017年10月医院重症医学科接受诊治的42例脓毒症患者(观察组)的临床资料.另外选取同期在医院接受健康体检的46例健康者作为本次研究的对照组.比较两组患者的基线资料、血清PCT及CRP、IL-6、SAA的表达水平.分析血清PCT及炎性因子CRP、IL-6、SAA在脓毒症患者中的诊断价值.结果 两组研究对象的年龄、性别等基线资料差异无统计学意义.观察组患者的血清PCT、CRP、IL-6、SAA水平均明显高于对照组(P＜0.05).单独PCT与PCT联合CRP、IL-6、SAA对脓毒症的诊断价值差异无统计学意义,且均比传统炎性因子IL-6、CRP、SAA优秀.结论 与传统炎性因子CRP、IL-6、SAA相比,血清PCT对脓毒症患者的诊断价值更加突出,值得推广.

Objective To explore the effect of peer mentor mode in the nursing operation skill practice for nursing undergraduates. Methods Nursing undergraduates were recruited from Grade 2015 and were divided into observation group with 228 cases and control group with 230 cases. Nursing undergraduates in the control group received conventional education but those in the observation group conventional education plus peer mentor mode. At the end of the course, practice knowledge examination and the self-efficiency evaluation were used to test the effect of the new practice teaching method. The independent- samples t-test was used to analyze the score of the practice knowledge test and the self-efficiency of nursing undergraduates in 2 groups. Results There was statistical difference between the two groups regarding students' performance in practice knowledge examination(P<0.05). The score of self-efficiency evaluation was improved in the observation group when compared with that in the control group(P<0.05). Conclusion Peer mentor mode with the combination of conventional practice teaching can meet nursing students' needs for personalized knowledge acquisition in practice and help students to have good self-efficiency.

目的 评价银质针配合艾灸治疗女大学生原发性痛经(以下简称“痛经”)的疗效.方法 选取吉林医药学院大学生创业项目“五艾堂”就诊的96例女大学生痛经患者,随机分为对照组和治疗1组、治疗2组,每组各32人.对照组采用普通不锈钢针针灸治疗;治疗1组在对照组的基础上配合艾灸治疗;治疗2组采用银质针针灸配合艾灸治疗.于患者每月月经来潮第1天开始,连续治疗3d,每天治疗1h,3个月为1个疗程,共治疗2个疗程.分别在第1、第2个疗程后采用数字疼痛强度量表NRS评估患者痛经程度.结果 第1个疗程后,各组均能不同程度地缓解女性月经期疼痛,提高患者的舒适感(P＜0.05),且治疗组的NRS得分与对照组比较差异有统计学意义(P＜0.05);第2个疗程后,各组NRS得分差异均有统计学意义(P＜0.05).结论 银质针配合艾灸治疗法可治疗女性原发性痛经.

正>卵巢癌死亡率居妇科恶性肿瘤之首。由于早期临床症状隐匿,缺乏有效的早期诊断方法,约70%的患者就诊时已是临床晚期[1]。因此早期诊断、早期治疗对卵巢癌患者尤为重要。目前,对卵巢癌的诊断尚无敏感性和特异性均高的肿瘤标志物。然而

目的 观察外源性榄香烯注射液对人卵巢癌SKOV3细胞株生物学行为影响.旨在为寻找卵巢癌治疗的特效药物提供理论依据.方法 应用MTT(四甲基偶氮唑蓝)比色法观察不同浓度的榄香烯注射液对SKOV3细胞的增殖抑制作用,流式细胞仪检测不同浓度的榄香烯注射液对SKOV3细胞增殖周期各时相变化及凋亡率.透射电子显微镜观察SKOV3亚细胞结构变化.结果 不同浓度的榄香烯注射液对SKOV3细胞增殖均有抑制作用.呈明显的剂量依赖性,流式细胞仪结果显示,G0/G1期细胞增多,S期细胞减少.G2/M期细胞相对增多,细胞凋亡率升高.结论 榄香烯注射液对SKOV3细胞有较强的敏感性和药物浓度依赖性,其机制可能与榄香烯注射液影响SK-OV3细胞周期进程并调节凋亡相关蛋白基因表达有关

Rationale:Autoimmune pancreatitis (AIP) is a special type of chronic pancreatitis, which is rarely associated with pseudocyst.Patient concerns:A 48-year-old man complained of a recurrent upper abdominal pain in our hospital.Diagnoses:A cystic mass of size 4x3cm in his pancreatic tail was found by computed tomography. The concentrations of serum carbohydrate antigen19-9 (81U/mL) and serum immunoglobulin G4 (181mg/dL) were elevated.Interventions:The patient received partial pancreatectomy with splenectomy and partial esophagectomy.Outcomes:Further histopathological examination revealed a pseudocyst, significant lymphoplasmatic infiltration, and fibrosis in the pancreas and esophagus. We report a rare case of AIP complicated with a pancreatic pseudocyst and invasion of lower esophagus.Lessons:Our study demonstrated that surgical therapy should be considered for the refractory AIP complicated with a pancreatic pseudocyst and invasion of lower esophagus.

Objective To explore the modified early warning scoring system (MEWS) for patients with chest pain and the clinical effect of triage.Methods A total of 381 cases using the modified early warning scoring system (MEWS) from August 2016 to February 2017 were as the observation group,and another 381 cases from January to July 2016 applied the routine examination were as the control group.Waiting time and triage accuracy rate and mortality data were recorded and statistical analyzed.Results The study found that the waiting time of patients in the observation group was (9.28 ± 2.39) min,which was significantly lower than (22.37 ± 5.48) min in the control group.Acute myocardial infarction (STEMI) patients with aortic dissection,the number of cases and non ST segment elevation myocardial infarction (NSTEAM) cases have little significant difference,and their accurate rate of the observation group were 244 cases (93.13％),78 cases (90.70％),21 cases (95.45％),respectively,which were higher than that of the control group (P ＜ 0.05).The mortality of patients with STEMI,aortic dissection and non ST segment elevation myocardial infarction (NSTEAM) in the observation group were 2.36％,0.52％ and 0,respectively,which were lower than that in the control group (P ＜ 0.05).Conclusion The triage effect of modified early warning scoring system (MEWS) for patients with chest pain is more significant compared with the conventional diagnosis,and it can effectively reduce the waiting time and the mortality rate.

The long non-coding RNAs (lncRNAs) regulating encoding transcripts/genes involved in Wnt signalling pathway in keloids is largely unclear. We used a pathway-focused lncRNA microarray to detect the differentiated expression profiles of both lncRNAs and genes involved in Wnt pathway, thus a total of 116 Wnt-targeted genes and 69 Wnt-related lncRNAs aberrantly expressed in keloids were initially identified. A stepwise bioinformatics was further performed to find skin-related lncRNA/gene pairs in Wnt pathway in keloids. Firstly, an lncRNA/gene co-expression network with clustered functional modules was constructed; simultaneously, 114 Wnt-genes regarding to dermis were online enriched using Phenotype Enrichment. Secondly, 17 skin-related keloid-aberrant Wnt-genes were acquired by overlapping the 114 skin-related Wnt-genes with the 116 keloid-aberrant Wnt-genes. Thirdly, after co-expression coefficient of each lncRNA/gene profile being ranked respectively, 11 top co-expressed lncRNAs characterized with the highest co-expression coefficients to the 17 genes were identified. Fourthly, seven of the 11 top co-expressed lncRNAs exhibiting array-detected aberrant expression in keloids, together with their 12 most interactive Wnt-genes, were selected to undergo in-pair intracellularly quantitative PCR validation in keloids. As a result, four lncRNAs including CACNA1G-AS1, HOXA11-AS, LINC00312 and RP11-91I11.1 with their six paired Wnt-genes undergoing both array-and-qPCR as well as lncRNA-and-gene double validation were finally identified as skin-related lncRNA/gene pairs that involved in Wnt signalling pathway in keloids. In conclusion, in-depth exploration on these easily-accessible lncRNAs in keloids might aid to find the novel target on how to maintain highly recurrent tumours benign via Wnt-involved network regulation.

目的 分析划片区组长负责制能级对应分层管理模式在急诊护理管理中的应用效果.方法 选取医院急诊科室A区21名、B区10名护理人员为观察对象,B区为对照组,A区为观察组,对照组实施常规新老搭配双班制综合护理,观察组实施划片区组长负责制能级对应分层管理模式,比较两组工作质量的差异.结果 观察组急救技术、危重患者护理落实、基础护理落实及护理文件书写、消毒隔离合格率均明显高于对照组,差异有统计学意义(P＜0.05).结论 急诊护理管理中应用划片区组长负责制能级对应分层管理模式对提高临床护理效果和护理服务质量具有重要意义,值得采纳和大力推广.