目的:探讨基于行为转变模式的护理干预对慢性肾衰竭患者依从性、自我效能及生活质量的影响.方法:选取2018年9月1日～2019年9月1日肾内科收治的慢性肾衰竭患者96例为研究对象,根据随机数字表法分为观察组和对照组各48例.对照组实施常规健康指导,观察组实施基于行为转变模式的护理干预.比较两组干预前和干预3个月后治疗依从性、自我效能及生活质量[采用肾脏病疾病特异性调查表(KDQ)].结果:干预3个月后,观察组肾病患者治疗依从性量表中饮食、合理用药、运动锻炼、血液透析、定期复查方面依从性评分和总评分高于对照组(P<0.01),慢病自我效能量表中疾病共性管理、情绪控制、角色功能、疲劳控制、疼痛控制、与医生沟通评分及总评分高于对照组(P<0.01),KDQ中躯体症状、与他人关系、抑郁、疲劳、挫折评分及总评分高于对照组(P<0.01).结论:基于行为转变模式的护理干预能有效提高慢性肾衰竭患者治疗依从性及自我效能,从而改善患者生活质量.

抽取2017年1月-2018年8月82例糖尿病肾病维持性血液透析患者,根据血液净化方式不同分为2组,其中对照组采取血液透析治疗,研究组采取血液透析和血液灌流联合疗法.结果治疗后研究组微炎症状态的改善,生化指标的改善明显优于对照组,P ＜0.05.结论针对糖尿病肾病维持性血液透析患者可采取血液透析与血液灌流联合疗法,患者微炎症状态可明显改善,毒素清除效果较好.

选择140例于2017.5 ～2017.11期间70例糖尿病(T2DM)作为观察组,70例体检的正常人作为对照组.结果 观察组尿糖、尿微量白蛋白检验数值分别为(3.76±1.23)、(27.48±10.34),均显著高于对照组(2.17±0.62)、(16.19±7.64),P＜0.05,且观察组尿糖、尿微量白蛋白检验阳性率分别为84.29％、58.57％,同样均显著高于对照组0.04％、0.01％,P＜0.05.结论 尿糖、尿微量白蛋白检验对于T2 DM早期肾损伤诊断具有较好的临床应用价值.

目的 探讨心血管疾病患者并发抑郁焦虑精神心理障碍的情况以及针对性治疗的效果.方法 选取2016年3月至2016年8月入住本院心内科120例重症心血管疾病患者作为研究对象,同时选取同期120例非心血管疾病重症患者作为对照,采取Hamilton抑郁量表(HAMD)与Hamilton焦虑量表(HAMA)对两组患者的心理状况进行调查,同时对心血管疾病并发焦虑、抑郁的患者给予抗焦虑、抗抑郁药物治疗,并采取相应的心理干预措施,治疗前后评估患者的抑郁、焦虑程度变化情况.结果 心血管疾病患者单纯抑郁、单纯焦虑、抑郁合并焦虑发生率及总发病率分别为15.00%、22.50%、10.83%、48.33%,均明显高于非心血管疾病患者(P<0.05);心血管疾病合并抑郁患者治疗后HAMD评分较治疗前明显下降,GAS评分明显上升,与治疗前比较,差异具有统计学意义,(P<0.01);心血管疾病合并焦虑患者治疗后HAMA评分较治疗前明显下降,GAS评分明显上升,与治疗前比较,差异具有统计学意义(P<0.01).结论 重症心血管疾病患者并发精神心理障碍较为多见,在常规心血管疾病治疗基础上联合给予针对精神心理障碍的药物并联合心理干预治疗可取得满意效果.

Objective To observe the effect of gingerol on the isolated thoracic aorta ring of rabbits and investigate its underlying mechanisms.Methods The thoracic aortic ring muscle strips with intact and denuded endothelium were prepared and placed in an organ chamber containing physiological salt solution (PSS).Every strip was connected to the tension transducer and the change of the vascular ring tension was recorded and analyzed by the biological signal collection and analysis computer system.Th isotonic tension of thoracic aortic tings with intact and denuded endothelium precontracted by norepinephrine (NE,1 × 10-5 mol/L) or KCl (20 mmol/L) was recorded before and after administrating gingerol.Meanwhile,we also observed the effects of N-nitro-L-arginine methyl ester (L-NAME,1 × 10-4 mol/L) and indomethacin (1 × 10-8 mol/L) on the action of gingerol in the rings.Results (1) Administration of 1 × 10-5 mol/L NE or 20 mmol/L KCl could produce the contraction effect in the thoracic aortic rings with intact endothelium.gingerol induced the muscle relaxation of aorta in both intact and denuded endothelium groups in a dose-dependant manner,meanwhile,the relaxation effect of gingerol was stronger in intact endothelium group than that in denuded endothelium group (P ＜ 0.05).(2) L-NAME could inhibit the vasodilative role caused by gingerol in intact endothelium group (％,94.83 ±3.63 vs.96.83 ± 1.82,91.17 ± 2.89 vs.94.83 ± 2.68,83.83 ± 2.23 vs.94.67 ± 2.7,78.00 ± 3.54 vs.92.33 ± 2.91,67.83 ± 2.37 vs.90.83 ±3.77,62.83 ±3.42 vs.89.67 ±3.15 respectively in NE-treated group and 90.33 ± 8.33 vs.98.17±7.56,80.83 ±7.24 vs.96.83 ±7.28,70.83±7.57 vs.92.17±7.31,67.83 ±7.68 vs.89.83 ± 7.23,62.83 ± 7.49 vs.90.33 ± 8.87,57.33 ± 8.32 vs.87.67 ± 8.97 respectively in KCl-treated group,P ＜ 0.05).(3) Indomethacin could inhibit the vasodilative role caused by gingerol in intact endothelium group (％,93.83 ± 7.61 vs.97.83 ± 7.45,92.50 ± 10.13 vs.95.33 ± 8.36,86.67 ± 8.24 vs.93.83 ± 7.28,79.83 ± 7.36 vs.89.83 ± 7.63,67.83 ± 7.46 vs.85.33 ± 8.94,61.83 ± 7.55 vs.81.83 ±7.25 respectively in NE-treated group and 90.17 ±7.77 vs.96.17 ±7.31,79.67 ±8.65 vs.91.33 ±8.62,72.17 ±7.48 vs.85.67 ±8.76,70.83 ±7.78 vs.83.17 ±7.79,56.83 ±7.62 vs.77.83 ±7.29,54.17 ±7.68 vs.74.83 ±7.34 respectively in KCl-treated group,P＜0.05).Conclusion (1) Gingero preferentially antagonized the contraction effect induced by NE or KCl in a dose-dependent manner.(2) The vasorelaxation effect of gingerol on the thoracic aortic ring muscle strips was relevant to the production of NO and prostacyclin.

目的:评价我院2011-2013年抗肿瘤药及其辅助用药的应用特点,指导临床合理用药.方法:对我院2011-2013年抗肿瘤药及其辅助用药的使用金额、用药频度(DDDs)、日均费用(DDC)等按照药品类型和品种进行统计、分析.结果:细胞毒类的抗肿瘤药应用最多,其中多西他赛注射液的用药金额最大,吉西他滨注射液的DDDs最高.在抗肿瘤辅助用药中,保肝类的辅助用药应用最多.结论:我院抗肿瘤药及其辅助用药具有自己的特点,总体趋势与国内抗肿瘤药的使用基本一致.