目的 探究间充质干细胞来源的胞外囊泡通过装载miR-375 对结直肠癌发生的影响机制.方法 分离培养并鉴定结直肠癌组织中间充质干细胞,从间充质干细胞中分离并鉴定胞外囊泡.将胞外囊泡装载miR-375 过表达模拟物,qRT-聚合酶链反应(PCR)检测细胞中miR-375 的表达情况.培养结直肠癌细胞系SW480,将胞外囊泡和SW480 细胞共培养.双荧光素酶报告分析miR-375 和同源框蛋白(HOX)A3 的靶向关系.qRT-PCR检测共培养后,细胞中 miR-375 和HOXA3 mRNA的表达情况.Western印迹检测HOXA3 蛋白的表达情况.对细胞分别进行miR-375 和HOXA3 过表达处理,CCK-8 法、Transwell实验分别检测各组细胞增殖和侵袭能力变化情况.流式细胞术检测细胞凋亡情况.结果 成功分离间充质干细胞来源的胞外囊泡,并将miR-375 过表达模拟物装载至胞外囊泡.miR-375 可靶向负调控HOXA3 的表达.过表达miR-375 后抑制SW480 细胞增殖、侵袭,促进细胞凋亡,而过表达HOXA3 则会促进SW480 细胞增殖、侵袭,抑制细胞凋亡,且过表达HOXA3 后,会阻断miR-375 对SW480 细胞增殖和侵袭的抑制作用及对细胞凋亡的促进作用.结论 间充质干细胞来源的胞外囊泡通过装载miR-375,进入结直肠癌细胞后,通过靶向抑制HOXA3 的表达,进而抑制结直肠癌细胞增殖、侵袭,并促进细胞凋亡.

手术室是一个专业性强,技术性高,无菌要求非常严格,环境布局有别于病房的特殊科室,使初次进入手术室的学生由此产生较大的心理压力[1].随着护理事业的不断发展,传统的临床带教方法 和体系已经不能满足当今社会的带教要求.教学医院手术室的护理临床教学工作日益繁重,鉴于手术室环境、工作及管理制度的特殊性,尝试将微信公众平台及翻转课堂的教学模式应用于手术室临床教学.报告如下.

目的:探讨并分析腰椎康复练功术在腰椎间孔镜髓核摘除术后患者中的康复效果.方法:选取 2018年 8月至 2019年 8月我院骨二科住院的 66例腰椎间孔镜髓核摘除术后患者,随机分为对照组与观察组,每组 33例.对照组患者采取骨科常规护理与康复治疗,观察组在骨科常规护理与治疗基础上联合腰椎康复练功术治疗.于术前、术后一周、术后四周、术后八周比较两组 VAS评分、JOA评分、ADL评分以及患者满意度.结果:两组间一般资料如年龄、性别、BMI 指数、住院天数等比较,差异无统计学意义(P＞0.05);两组患者 VAS 评分、JOA 评分术前、术后一周比较,差异无统计学意义(P＞0.05),术后四周、术后八周观察组的 VAS 评分、JOA 评分高于对照组,差异有统计意义(P＜0.05);两组患者 ADL评分术前比较无统计学意义(P＞0.05),观察组术后一周、术后四周、术后八周的 ADL 评分高于对照组,差异有统计学意义(P＜0.05);观察组的患者满意度(87.59±9.95)高于对照组(67.56±10.74),差异有统计学意义(P＜0.05).结论:腰椎康复练功术通过加强腰背部核心肌群力量,能够促进腰部肌肉的血液循环,缓解肌肉痉挛,增强脊柱稳定性,对腰椎间孔镜髓核摘除术后患者具有良好的疗效,可在临床推广.

目的:探究Roy适应模式对鼻综合整形患者术后睡眠水平的影响.方法:选取2016年1月-2017年1月笔者医院收治的鼻综合整形手术患者91例,依据随机数字表法随机分为观察组45例和对照组46例.对照组给予常规心理护理及健康教育,观察组在对照组基础上给予Roy适应模式干预.对两组患者PSQI评分及护理满意度进行比较.结果:观察组住院时间、平均干预次数均低于对照组,差异具有统计学意义(P<0.05).干预后,两组患者除入睡时间无明显差异,观察组其他指标优于对照组,差异均有统计学意义(P<0.05);观察组护理满意度明显高于对照组,差异有统计学意义(P<0.05).结论:Roy适应模式可有效改善鼻综合整形患者术后睡眠质量,缩短患者住院时间,提高患者护理满意度.

Objective To explore the effect of surgical nursing cooperation for PFNA in the treatment of elderly pa-tients with femoral intertrochanteric fracture. Methods 68 elderly patients with intertrochanteric fracture were randomly divid-ed into observation group and control group with 34 cases in each group. All the patients were treated with PFNA internal fixa-tion,and the observation group were treated with meticulous operation nursing,and the control group were treated with routine operation nursing. The operation time,intraoperative blood loss,incidence of adverse events and satisfaction of operation doctor and patient in operation room in the two groups were observed and compared. Results The average operation time of observa-tion group was shorter than the control group,the mean blood loss of observation group was less than that of the control group, the differences were statistically significant(P ﹤ 0. 05). The total incidence rate of intraoperative device failure,surgical instru-ments transfer failure,infection and other adverse events in observation group(5. 88% )was lower than that in control group (20. 59% ),the difference was statistically significant(P ﹤ 0. 05). In the observation group,the satisfaction degree of the oper-ation doctor and the patient to the operation room nurses was 100. 00% ,94. 12% ,and the control group was 81. 82% , 79. 41% ,the difference was statistically significant(P ﹤ 0. 05). Conclusion In femoral coarse intertrochanteric fracture PF-NA internal fixation for the treatment of implementation of meticulous surgical nursing can effectively improve the effect of sur-gical treatment,shorten the operation time,reduce intraoperative blood loss,reduce the adverse event incidence and better pro-mote the smooth operation.

Objective To investigate the impact of anesthesia nurse perioperative pain management on the patient-controlled analgesia after cesarean section. Methods Selected intending to perform cesarean section,willing to accept postop-erative analgesia,single live births maternal 120 cases,randomly divided into anesthesia nurses to assist management group( N group)and anesthesiologist responsible group( A group),each of 60 cases. N group was given with pain education,intraopera-tive anesthesia care and postoperative follow-up,assisted by anesthesia nurse for physician. A group was given with periopera-tive pain panagement by anesthesiologists. Anesthesia methods was spinal anesthesia. Received intravenous electronics analgesi-a pump after surgery of two groups. Pain was assessed using a visual analog scale( VAS),observed maternal demographic data of two groups,24h follow-up VAS and maternal satisfaction scores. Results Two groups completed postoperative analgesia,no respiratory depression and movement disorder serious complications,no exit cases. General difference between the two groups were not statistically significant(P>0. 05). The VAS score 4h,8h of N Group after surgery was significantly lower than that in A group,the difference was statistically significant(P<0. 05),the remaining point of two groups had no significant difference in VAS score(P>0. 05). The maternal satisfaction of N group was significantly higher than A group,the difference was statisti-cally significant(P<0. 05). Conclusion The perioperative actively participated in pain management by anesthesia nurses can contribute to maternal early postoperative pain therapy,and higher maternal satisfaction postoperative analgesia.