Objective:To investigate the brain regions with abnormal neural activity in the patients with obstructive sleep apnea hypopnea syndrome(OSAHS),using regional homogeneity(ReHo)and fractional amplitude of low-frequency fluctuation(fALFF)of the rest-state functional magnetic resonance imaging(rs-fMRI)technique.Materials and Methods:A total of 30 male patients with OSAHS who were initially diagnosed and untreated by polysomnography(PSG)in the Department of Respiratory of Shiyan Renmin Hospital were collected,and 30 volunteers with normal sleep,similar age and education level monitored by PSG during the same period were selected as the normal control(NC)group.Rs-fMRI examination was performed to obtain blood oxygen level dependent(BOLD)signals.ReHo,fALFF are used to compare the OSAHS group with the NC group to find out the brain regions with significant differences.Results:Compared with the NC group,the OSAHS group has significant differences between ReHo and fALFF(P＜0.001).The brain regions with increased ReHo value included left pons(t=3.94,P＜0.001),left anterior cerebellar lobe(t=4.68,P＜0.001)and right anterior cerebellar lobe(t=4.94,P＜0.001).The brain region with decreased ReHo value is none.The brain regions with increased fALFF value are left posterior lobe of the cerebellum(t= 6.20,P＜0.001),left superior temporal gyrus(t=5.49,P＜0.001),and left fusiform gyrus(t=4.35,P＜0.001).The brain region with decreased fALFF value is left paracentral lobule(t=-4.12,P＜0.001).Conclusions:In patients with OSAHS,the ReHo value and the fALFF value in multiple brain regions were changed.The ReHo value of some brain regions in OSAHS patients increased,and the brain regions that fALFF value changed were mostly concentrated in the left cerebral hemisphere.

目的:分析感觉统合训练联合心理行为干预对注意缺陷多动障碍患儿的治疗效果.方法:选择2018年1月—2020年4月本院收治的110例注意缺陷多动障碍患儿.依据随机分组法分为实验组和对照组.对照组采用药物治疗+心理干预,实验组采用药物治疗+心理干预+感觉统合训练治疗,对比两组患儿的治疗效果、Conners父母评定量表(Conners Parents SymPtom Questionnaire,PSQ)评分.结果:对比两组患儿治疗效果,实验组总有效率(95.55％)高于对照组(81.82％),差异显著(P<0.05);干预前两组PSQ各项评分对比差异无统计学意义(P>0.05);干预后,实验组P S Q评分均低于对照组,差异显著(P<0.05).结论:对注意缺陷多动障碍患儿加入进行感觉统合训练联合心理行为干预,具有显著的临床疗效,使患儿的注意力更加集中,并且多动症状也得到了纠正.

目的 讨论EMMPRIN在宫颈鳞状细胞癌组织中的表达及其对癌细胞迁移、侵袭能力的影响.方法 选择2017-01-2019-12我院67例宫颈鳞状细胞癌,术后留取癌组织及癌旁组织,采用免疫组化染色的方法检测两组患者EMMPRIN的表达情况,分析EMMPRIN的表达与病理因素的关系,并通过沉默EMMPRIN,讨论EMMPRIN对宫颈鳞状细胞癌细胞的迁移、侵袭能力的影响.结果 EMMPRIN在宫颈鳞状细胞癌组织中的表达呈阳性,阳性率明显高于癌旁组织,EMMPRIN阳性表达与盆腔淋巴结转移存在一定关系(P＜0.05),沉默EMMPRIN的宫颈鳞状细胞癌细胞迁移数目、细胞侵袭数目均明显低于未沉默EMMPRIN的宫颈鳞状细胞癌细胞(P＜0.05).结论 EMMPRIN在宫颈鳞状细胞癌中呈高表达,且其高表达与宫颈鳞状细胞癌的迁移和侵袭呈相关性,可能成为宫颈鳞状细胞癌治疗的新靶点.

目的:基于静息态功能磁共振成像(rs-fMRI)度中心度(DC)法探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者脑功能异常及其神经病理学机制.方法:受试者包括在本院呼吸内科经多导睡眠监测(PSG)初次诊断且未经过治疗的30例男性OSA HS患者(患者组)及同时间段经PSG监测为睡眠正常且年龄、受教育程度相匹配的30例健康志愿者(对照组).采用蒙特利尔认知评估量表(MoCA)对所有受试者的认知功能进行评分,然后进行rs-fMRI检查,获取脑组织的血氧水平依赖(BOLD)信号,将OSAHS组与对照组间BOLD信号有显著差异的脑区作为感兴趣区域(ROI),提取每个ROI的DC值,将其与MoCA评分以及PSG监测的睡眠指标[呼吸紊乱指数(AHI)、微觉醒指数(AI)、最低血氧饱和度(Mini-SaO2)]进行相关性分析.结果:与对照组比较,患者组中DC值增加的脑区有左侧脑桥、右侧边缘叶、左侧颞上回、右侧额下回、左侧额上回和右侧额上回;DC值减低的脑区有右侧小脑后叶和左侧楔叶.右侧小脑后叶的DC值与MoCA评分呈显著正相关(r=0.656,P<0.001),左侧楔叶的DC值与Mini-SaO2(r=0.519,P=0.003)呈显著正相关.结论:OSAHS患者多个脑区的度中心度发生了改变,右侧小脑后叶度中心度减低可能与认知功能的减低有关,左侧楔叶的度中心度减低可能与缺氧密切相关.

目的 探讨整体性护理管理模式在急诊科危重患者抢救中的应用效果.方法 选取2017年4月～2019年4月于郧阳区中医医院急诊科收治的92例急诊科危重病症的患者作为研究对象,采用随机数字表法将其分组,分别应用整体性护理管理模式(实验组)进行护理干预及常规护理干预方式(对照组)进行干预,比较护理效果.结果 实验组抢救成功率显著高于对照组,实验组的护理满意度显著高于对照组,且实验组的护理质量评分显著高于对照组,差异有统计学意义(P＜0.05).结论 对急诊科危重症患者进行抢救的过程中,采用整体性护理管理模式进行干预,有利于提升护理质量,提升抢救的成功率.

原发性鼻腔鼻窦血管肉瘤( sinonasal angiosarco-mas,SNA)是一种非常罕见的鼻窦鼻腔恶性肿瘤,由于其发病率低(约占鼻咽鼻腔恶性肿瘤的 0. 1％)[1],临床表现无特异性,SAN 的诊断及治疗尚缺乏循证医学的证据.本文报道了1例SNA的CT及MR表现,旨在提高对该病的认识,为SNA早期诊断及治疗提供有价值的信息.

阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)是一种常见的慢性多系统损害的疾病.OSAHS的中枢神经系统(central nervous system,CNS)损害主要表现为认知障碍及神经精神异常,严重影响患者的生存质量及生命安全,但其神经病理机制尚未完全阐明.近年来,静息态功能磁共振成像(resting state functional magnetic resonance imaging,rs-fMRI)及其先进的数据处理方法 为OSAHS神经影像学的研究开辟了新道路.作者对其进行综述,旨在探究OSAHS患者CNS损害潜在的神经病理机制并为其早期诊断及治疗提供有价值的方法 及证据.

膝骨关节炎是以膝关节软骨变性和丢失及关节边缘和软骨下骨骨质再生后为特征的慢性关节炎疾病[1]. 多发于中老年人群,临床主要症状为骨关节肿痛、弹响、僵硬发冷等,病情严重者可有关节畸形或肌肉萎缩. 其发病原因与多种因素有关,包括年龄、体质量、膝关节损伤、关节受凉受寒等. 目前治疗方法主要以保守治疗为主,如服用软骨保护药物、注射局部"封闭"等镇痛药物、针灸理疗等,以缓解疼痛,逐步改善软骨功能. 近年来临床逐渐采用多种手段综合进行治疗,并不断优化治疗方法,以提高治疗效果.

目的 探讨病案导入—情景模拟培训法在护士分层专科急救技能培训中的作用.方法 将湖北医药学院附属人民医院144名护士分成两组,即对照组组与实验组.对照组采用病案传统理论示教法,观察组采用病案导入—情景模拟培训法,培训完后对两组护士分别进行专科急救技能综合考核及专科理论考核.结果 实验组考核成绩明显高于对照组,两组间比较差异有统计学意义(P<0.05).结论 病案导入—情景模拟演练培训法既能发挥各级护士的主观能动性,增加科室团队意识,又能保障护理安全,激发护士的学习热情.

目的:探究健康教育在酚妥拉明多巴酚丁胺佐治婴儿肺炎合并心衰护理中的应用.方法:选取2018年2月-2019年2月来笔者所在医院就诊并采用酚妥拉明、多巴酚丁胺佐治的肺炎合并心衰患儿104例,根据护理方式不同分组,对照组52例采用常规护理,研究组52例患儿在对照组基础上采用健康教育.统计护理前后患儿的心率(HR)、呼吸率(RR)、心衰纠正时间.统计两组患儿的治疗有效率、并发症发生率与满意度.结果:研究组患儿心衰纠正时间显著短于对照组,差异有统计学意义(P<0.05);护理后,两组HR、RR均明显降低,且研究组患儿HR、RR降低程度显著大于对照组,对照组家属对婴儿肺炎合并心衰的认知度显著低于研究组,差异均有统计学意义(P<0.05);研究组患儿的治疗有效率、护理满意度显著高于对照组,且对照组患儿的并发症发生率显著高于研究组,差异均有统计学意义(P<0.05).结论:在酚妥拉明多巴酚丁胺佐治婴儿肺炎合并心衰护理中,应用健康教育能保证对患儿的护理质量,加速患儿的恢复进程.

目的:观察对重症患儿实施呼吸道护理管理干预措施的效果.方法:选取本院2014年5月至2016年6月收治的重症患儿70例,随机分为两组,对照组及观察组,各35例.对照组给予常规呼吸道护理干预,观察组给予呼吸道护理管理干预.观察两组患儿护理干预后并发症发生情况及家属护理满意度.结果: 观察组并发症总发生率(8.57%)低于对照组(28.57%),差异显著(P<0.05);观察组家属护理总满意率(94.29%)高于对照组(68.57%),差异显著(P<0.05).结论: 对重症患儿给予呼吸道护理管理干预,患儿并发症发生情况少,家属护理满意度高,临床护理管理效果显著.

Objective To analyze the effect of empathy nursing on negative emotion,self-efficacy and quality of life of patients with irritable bowel syndrome (IBS).Methods From February 2013 to March 2016,88 patients with IBS in our hospital were randomly assigned to the control group and the treatment group,with 44 cases in each group.The control group was given routine nursing and the treatment group was given empathy nursing in addition to routine nursing.The relief of negative emotion,improvement of self-efficacy and quality of life were compared between the two groups.Results Before the intervention,there were no significant differences in the scores of anxiety and depression scale,self-efficacy and quality of life between the two groups (P ＞ 0.05).After 4 weeks of intervention,the scores of anxiety and depression were decreased,and the scores of self-efficacy and quality of life were increased (P ＜ 0.05).After 4 weeks of intervention,the scores of anxiety and depression in the treatment group were significantly lower and the scores of self-efficacy and quality of life higher than those in the control group(P ＜ 0.05).Conclusion Empathy nursing can relieve negative emotions of patients with IBS,improve their self-efficacy,and optimize their quality of life.

Objective To investigate the clinical effect of precise percutaneous radiofrequency ablation of semilunar ganglion through fo -ramen ovale under the three-dimensional CT for the treatment of trigeminal neuralgia .Methods A total of 80 patients with primary trigeminal&nbsp;neuralgia in our hospital from August 2013 to December 2015 were selected,and they were randomly divided into two groups with 40 cases in each group .The control group was implemented blind detective radiofrequency ablation ,while the observation group was carried out under the three-dimensional CT positioning radiofrequency ablation .All the patients were followed up for 3 months after treatment .Compared the overall clinical results , and recorded the time of targeting the trigeminal nerve and the complications within 1 week after treatment between the two groups.The pain condition at different time points (before treatment,1 week and 3 months after treatment) between the two groups were com-pared.Results The positioning time of observation group was shorter than that of the control group ,the difference was significant (P<0.05). The VAS score of the observation group 1 week and 3 months after surgery was lower than the control group ,the difference was significant (P<0.05).The ratio of masticatory muscle weakness ,hypoacusis,facial swelling and congestion and corneal anesthesia of the observation group within 1 week postoperatively were lower than those of the control group ,the difference was significant (P<0.05).The effective rate of the observation group was higher than that of the control group ,the difference was significant (P<0.05).Conclusion Percutaneous radiofre-quency ablation of semilunar ganglion through foramen ovale under the three -dimensional CT for the treatment of trigeminal neuralgia has the advantages of more accurate positioning of the foramen ovale ,shorter operation time , and less complications ,which can relieve the pain of pa-tients and improve the overall clinical effect .

目的 探讨显微手术治疗侵袭型垂体腺瘤对于患者远期日常生活活动能力的影响.方法 2012年4月到2015年2月选择在本院诊治的侵袭型垂体腺瘤患者78例,根据随机数字表法分为治疗组与对照组各39例,对照组给予传统经鼻蝶手术治疗,治疗组给予神经内镜下显微手术治疗.结果 所有患者都手术顺利,治疗组与对照组的肿瘤全切除率分别为72.0％(28/39)和48.7％(19/39),组间对比差异有统计学意义(P＜0.05).治疗组术后脑脊液漏、颅内感染、垂体功能下降、鼻腔黏膜黏连、颅内出血等并发症发生情况明显少于对照组(P＜0.05).术后3个月治疗组与对照组的日常生活活动能力评分分别为82.93±4.14分和65.28±5.33分,都明显高于术前的50.66±4.29分和50.18±4.87分,同时组间对比(P＜0.05).随访到2015年8月,治疗组的平均生存时间与无瘤生存时间分别为24.98±4.13个月和21.76±3.19个月,而对照组分别为19.34士3.98个月和17.33±4.11个月,组间对比(P＜0.05).结论 相对传统手术治疗,神经内镜下显微治疗侵袭性垂体腺瘤能提高肿瘤的全切率,具有更好的安全性,同时改善患者的远期日常生活活动能力,延长生存时间.

Objective: To discuss about the curative effect and mechanism of surgical treatment of acute cerebral infarction patient with the assistance of neuronavigation system. Methods: There were 78 acute cerebral infarction patients who selected to be treated in our hospital from July 2012 to February 2015. Those patients were divided into observation group and control group in accordance with random number table, 39 cases for each group. The control group adopted the traditional surgical treatment while the observation group was given surgical treatment with the assistance of Neuronavigation system. The prognosis conditions of the two groups were observed. Results: The effective rate after surgery of the observation group and the control group separately was 94.9% and 82.1%. The effective rate of the observation was significantly higher than that of the control group (P<0.05). NIHSS score of post-operation observation group and control group separately was (6.34±1.34) and (9.19±1.84), both of which were significantly lower than (14.24±1.56) and (14.29±1.87) before operation (P<0.05). Besides, the postoperative NIHSS score of the observation group was also significantly lower than that of control group (P<0.05). The occurrence conditions of re-hemorrhage, intracranial infection, tardive hydrocephalus and other complications 7 days after operation of the observation group were significantly less than that of the control group(P<0.05).The serum matrix metalloproteinase -9(MMP-9)content after operation of observation group and control group separately was (82.34±12.84)ng/ml and (182.34±11.45)ng/ml, both of which were significantly lower than (534.24±16.11)ng/ml and (531.29±21.24)ng/ml before operation (P<0.05). The contrast difference between the groups has the statistical significance (P<0.05). Conclusion: The surgical treatment of acute cerebral infarction with the assistance of neuronavigation system can accelerate the relieving of dysneuria and lower the occurrence of complications and thus can improve the curative effect. The function may be caused by the effective acceleration of lowering of serum MMP-9 content.

目的:探讨对哮喘患者进行全面护理的临床效果.方法:对2012年2月~2015年2月期间我院收治的80例哮喘患者的临床资料进行回顾性研究.我们将这些患者随机分为全面护理组和对照组,每组各有40例患者.对全面护理组患者进行全面护理,对对照组患者进行常规护理.治疗结束后,比较两组患者的治疗效果.结果:全面护理组患者的PaO2、FEV1水平均明显高于对照组患者,二者相比差异具有显著性(P<0.05).全面护理组患者的PaCO2的水平明显低于对照组患者,二者相比差异具有显著性(P<0.05).结论:对哮喘患者进行全面护理的效果显著.此护理方法 值得在临床上推广应用.

顽固性鼻出血是耳鼻喉科较严重的也是治疗非常棘手的急症之一。一般治疗是根据出血部位不同采取前后鼻孔填塞、射频治疗、局部微波烧灼，但对于严重的顽固性鼻出血的治疗效果欠佳，因此，介入栓塞技术被广泛应用于顽固性鼻出血的治疗［1］，我科在2008年2月至2015年2月收治的顽固性鼻出血57例行介入栓塞治疗，通过采取系统性护理干预，提高了治疗效果，减轻了患者的痛苦，改善了患者的生活质量。现将护理体会总结报告如下。

目的:探讨血浆置换联合连续性血液净化在救治重症蜂蜇伤致多器官功能不全患者中的应用效果.方法:用Baxter床旁血滤机对我科2012年8月～ 2015年12月共收治的15例重症蜂蜇伤致多器官功能不全患者进行血浆置换联合连续性血液净化治疗,在治疗过程中观察患者的生命体征、病情变化、生化指标、体外凝血状况及皮肤状况,并进行合理的液体管理.观察急性肾功能衰竭患者注意有无水肿、心表现象发生.有凝血功能异常的患者不宜进行全身肝素化,注意有无喉头水肿及休克的发生,并对治疗效果进行分析总结.结果:15例患者1 3例痊愈,1例死亡,1例转为慢性肾衰竭.治疗前后生命体征,各项生化指标逐渐降至正常范围;病情由危重转为稳定,神志转清;电解质及酸碱平衡失调逐渐恢复正常,治疗效果满意.结论:15例重度蜂蜇伤致多器官功能不全患者的观察及护理措施有效,效果满意,对我科以后重度蜂蜇伤致多器官功能不全患者的观察及护理方面提供了有效的指导,值得推广.

目的：探讨中西医结合护理干预对糖尿病患者血糖控制效果的影响。方法按随机数字表法将糖尿病患者160例分成2组，对照组仅予常规性护理干预，观察组在常规护理干预的基础上行中西医结合护理干预，对2组患者的血糖控制情况进行比较，比较2组生活方式、住院时间及费用、患者的满意度等情况。结果护理干预后，观察组患者的生活方式以及血糖控制情况均明显优于对照组（P均＜0．05），2组患者的满意度、住院时间以及费用比较差异均有统计学意义（P均＜0．05）。结论中西医结合护理干预能够有效地控制糖尿病患者血糖，并促进患者早期康复。

目的 探讨高通量血液透析(HFHD)对维持性血液透析(MHD)患者血清甲状旁腺激素(PTH)和β2-微球蛋白(β2-MG)的影响.方法 选择58例MHD患者为研究对象,随机将其分为两组,HD组予常规低通量透析,HFHD组予高通量透析HFHD治疗,比较两组患者治疗前及治疗6w后血清PTH、β2-MG的变化.结果 两组治疗开始时,透析前血清PTH、β2-MG比较差异无统计学意义(P＞0.05),HFHD组首次透析后血清PTH、β2-MG下降率明显大于HD组(P＜0.01);透析治疗6w后,HFHD组血清PTH、β2-MG均较治疗前明显降低,且均低于HD组水平(P＜0.01),而HD组血清β2-MG、PTH较治疗前无明显变化(P＞0.05).结论 HFHD可有效降低血液透析患者血清PTH、β2-MG水平,对防治MHD患者的远期并发症如肾性骨病、透析相关性淀粉样变、心血管并发症等具有重要作用.