摘要
Objective:To investigate the application effect of production-oriented approach (POA) for consulting ability teaching in general practice standardized residency training.Methods:Eighteen third-year general practice residents in the Second Affiliated Hospital of Harbin Medical University received a special training course on the consulting ability based on POA with the situational simulation teaching from September 2021 to March 2022. The consulting ability of residents was evaluated with Objective Structured Clinical Examination (OSCE) and Leichester Assessment Package (LAP) before and after the training, and the results were compared. Meanwhile, a questionnaire survey and semi-structured interviews were conducted to assess residents′ satisfaction with the course.Results:All 18 resident trainees (11 females and 7 males) aged 25 to 34 (27.3±2.4) years successfully completed the training. Both OSCE scores and LAP scores after the training were significantly higher than those before training (66.25±5.84 vs. 44.44±12.80, t=8.46, P<0.001; 65.78±7.05 vs. 38.33±14.2, t=1.47, P<0.001, respectively). The ability of medical history collection, physical examination, patient management, problem solving, doctor-patient relationship, preventive care and medical record writing were all significantly improved after the training compared with those before training ( t=2.464, 4.278, 8.997, 2.385, 10.35, 5.212, 7.578, all P<0.05). The questionnaire survey showed that all the 18 residents were satisfied with the reasonableness of the teaching content, the class time arrangement, the teaching progress arrangement and the instructors. In the dimension of training effectiveness, 18 participants all believed that the course was helpful to improve their humanistic quality and confidence in reception. In terms of self-promotion, all respondents believed that this course was able to promote their reflection ability and stimulate their learning interest. By coding and analyzing the contents of the semi-structured interviews with the residents, nine main themes were constructed, namely course deficiencies, course characteristics, course advantages, course suggestions, trainees′ deficiencies, trainees′ gains, trainees′ goals, previous teaching deficiencies, and instructor′s role. The results showed that all residents had a high degree of satisfaction with the course, and they thought the course was vivid and interesting and it is able to mobilize the enthusiasm of learning, promote learner to reflect. The residents also suggested to increase the teaching hours and to enrich teaching cases. Conclusion:The consulting ability training of general practice based on POA can effectively improve consulting ability, stimulate learning interest and improve independent learning ability of residents, which gains recognition from both faculty and trainees.
摘要
Objective:To investigate the status quo of multi-level pre-job training for clinical nursing teachers and analyze their training needs, so as to provide reference for the design of pre-job training for clinical nursing teachers.Methods:A cross-sectional survey method was used to investigate 172 clinical nursing teachers in a tertiary general hospital in Harbin from April 2020 to June 2020 with multi-level pre-job training mode. The status quo of pre-job training and the training needs of teachers were analyzed. SPSS 17.0 was used to process the original data statistically.Results:Among the 172 respondents, 138 teachers (80.2%) were under 35 years old, and 133 teachers (77.3%) had a bachelor's degree or less; 89 teachers (51.7%) confirmed that hospitals or departments would carry out pre-job training in a planned and organized way, 10 teachers (5.8%) said that hospitals or departments had never organized training, 41 teachers (23.8%) had never participated in pre-job training, and 80 teachers (46.5%) had participated in pre-job training 1-3 times. There were 5 duplicates in the first 8 training contents of in-hospital training and in-department training, including knowledge of common diseases, nursing procedures, communication skills, hospital rules and regulations, and teaching methods. The total score of training demand was (154.51± 40.35) points, and the overall demand rate was 81.3%, which was at the high level. The dimensions with the highest scoring rate were legal system and humanistic literacy, with a scoring rate of 83.0%. The dimension with the lowest score was teaching management, with a score of 74.9%. The scoring rate of training needs with the highest points won nine items respectively on students' basic quality (self-supervision, willingness to learn, professional quality, etc.) (84.7%), training of legal knowledge (84.4%), incompatibility of drugs commonly used in department (84.3%), nurse etiquette (83.3%), nursing risk prevention (83.1%), evaluation methods of student education (83.1%), nurse-patient communication skills (83.0%), nurses and patients medication observation points of commonly used drugs in the department (83.0%), and effects of commonly used drugs in department (82.9%). Among the top three training forms, 84 students (48.8%) received online learning, 74 students (43.0%) received lectures from experienced teachers in hospitals, and 72 students (41.9%) received experience exchange and sharing seminars.Conclusion:The talent structure of clinical nursing teachers in this hospital is relatively young, and the first education level is low. Therefore, the pre-job training of clinical nursing teachers should be strengthened vigorously. The awareness rate and participation rate of pre-job training are average, so we should strengthen the release of training information from various channels, improve the awareness rate of training activities, clarify the encouragement or reward measures to participate in pre-job training activities, and improve the participation rate of training activities. Pre-job training content is repeated at every level, with a gap between the training needs of teachers in clinical nursing teaching. It's suggested that the teaching hospitals combine with their training objects of training needs, take the online-offline mixed mode of training, reasonably plan training contents as a whole at all levels, avoid training content repetition and waste of teachers, and organize teachers to timely exchange and share experiences.
摘要
Multiple myeloma is one type of hematological malignancy, characterized by the proliferation and accumulation of monoclonal plasma cells in bone marrow. Bone marrow microenvironment plays a key supporting role in the proliferation and survival of myeloma cells, where a large number of immune cells exist but are functionally suppressed. Based on the studies of myeloma immune microenvironment in recent years, we summarize the recent advances and existing problems in the treatment of multiple myeloma and put forward some considerations and suggestions, to provide references for researchers in this field.
摘要
From the perspective of social work, this article shares the experiences of medical social workers of Shanxi Bethune Hospital providing service in general practice clinic, hospital wards, and related communities; and explores the multiple roles of social workers as care giver, coordinator, counselor and educator in prevention and control of COVID-19 at the grassroots level. The article also summaries their work in Balingqiao Community Health Service Center, and proposes suggestions for community welfare service and organizing volunteer team in community epidemic prevention and control.
摘要
@#Objective To study the clinical characteristics and prognostic factors of different areas of medulla oblongata infarction. Methods From April 2019 to November 2019,63 patients with acute medullary infarction in the Department of Neurology,the First Affiliated Hospital of Harbin Medical University were selected as the research objects. The clinical information of the patients was collected,including general information,clinical symptoms and signs,complications,imaging characteristics. NIHSS score was used to evaluate the severity of the disease,and mRS score was used to evaluate the prognosis. Results (1) The incidence rate of male patients with medullary infarction was higher than that of females. The most common sites of medullary infarction were lateral,head and left. The lateral infarction of medulla oblongata is more common in the middle of medulla oblongata,while the medial infarction is more common in the head of medulla oblongata. The peak age was 61~70 years old. Among them,the incidence rate of male at 51~60 is higher than that of female,and the incidence rate of female is higher than that of male at 61~70 years old. (2) In a single factor analysis,dysphagia and abnormal pharyngeal reflex were higher than the poor prognosis group in the 30-day good prognosis group,dizziness or dizziness,nausea and vomiting in the 90-day good prognosis group were higher than the poor-prognosis group,and quadriplegia in the 90-day poor prognosis group was higher than the good prognosis group,and the differences between the groups are statistically significant. In lateral infarction,the good prognosis group was higher than the poor prognosis group at 90 days,and the difference between the groups was statistically significant. The dyspnea in the 90-day poor prognosis group was higher than that in the good prognosis group,and the difference between the groups was statistically significant. Progressive stroke in the 30-day and 90-day poor prognosis group was higher than the good prognosis group,the difference between the groups was statistically significant. (3) In multivariate logistic regression analysis,dysphagia is negatively correlated with a 30-day poor prognosis,and lateral infarction,nausea,and vomiting are negatively correlated with a 90-day poor prognosis. Central facial paralysis is an independent risk factor for a poor prognosis at 30 days. Progressive stroke is an independent risk factor for a poor prognosis at 30 and 90 days. Conclusion (1) The incidence of medullary infarction is higher in men than women,and the peak age of women is higher than men. (2) The incidence of medullary cephalic infarction is higher than that of the middle and tail,and the incidence of lateral infarction is higher than that of medial infarction. Lateral medullary infarction has a better prognosis than other regions. (3) Central facial paralysis is an independent risk factor for poor prognosis of medullary infarction within 30 days. Progressive stroke is an independent risk factor for poor prognosis of bulbar infarction.
摘要
Objective@#To development a comfort scale for the patients after enterostomy,test its reliability and validity and to provide a tool for nursing staff to measure the comfort level of patients with enterostomy.@*Methods@#Pre-test scales were formed based on literature research methods, group meetings and expert consultation. A total of 310 patients after enterostomy were investigated in a top three hospital in Tianjin Union Medical Center, and the scale was tested by project analysis, validity analysis and reliability analysis.@*Results@#Exploratory factor analysis identified four principal factors which explained 52.584%, and the scale determined 4 dimensions, including 35 items. The Cronbach′s α coefficient of the scale was 0.937, the test-retest reliability was 0.846, and the half-fold reliability was 0.926.@*Conclusion@#The comfort scale for patients after enterostomy in this study has good reliability and validity. It can be used to evaluate the comfort of patients after enterostomy.
摘要
Objective To development a comfort scale for the patients after enterostomy,test its reliability and validity and to provide a tool for nursing staff to measure the comfort level of patients with enterostomy. Methods Pre-test scales were formed based on literature research methods, group meetings and expert consultation. A total of 310 patients after enterostomy were investigated in a top three hospital in Tianjin Union Medical Center, and the scale was tested by project analysis, validity analysis and reliability analysis. Results Exploratory factor analysis identified four principal factors which explained 52.584% , and the scale determined 4 dimensions, including 35 items. The Cronbach′s α coefficient of the scale was 0.937, the test-retest reliability was 0.846, and the half-fold reliability was 0.926. Conclusion The comfort scale for patients after enterostomy in this study has good reliability and validity. It can be used to evaluate the comfort of patients after enterostomy.
摘要
Objective To explore the effect of acupuncture plus neuromuscular electrical stimulation and cold stimulation on children with swallowing disorders caused by viral encephalitis.Methods A total of 322 chil dren with dysphagia subsequent to viral encephalitis were randomly divided into an acupuncture + cold stimulation group (group A,n=107),an electrical stimulation + cold stimulation group (group E,n=107) and an acupuncture + electric stimulation + cold stimulation group (group C,n=108) using a random number table.The treatments were applied in two courses each of 14 days with an interval of two days between the courses.Before and after the treatment,the total effectiveness rates and the incidence of aspiration pneumonia and malnutrition were ana lyzed.The children's swallowing function was evaluated using a standardized swallowing assessment (SSA),while the severity of dysphagia was assessed using dysphagia outcome and severity scale (DOSS) based on videofluorescopic imaging.Results There were no significant differences in any of the outcome measures before the treatment.Afterward the total effectiveness rate in group A was 76%,significantly higher than in group E (62%) but significantly lower than in group C (91%).There was significant improvement in the average SSA and DOSS scores of all 3 groups.Compared with group A,the average SSA score of group E was higher while the average DOSS score was lower.For group C the relationship was the opposite,with the average SSA score significantly higher and the average DOSS score significantly lower.After the treatment there were no significant differences between groups A and E in the incidence of aspiration pneumonia or malnutrition,but the incidence of both in group C was significantly lower than in groups A and E.Conclusion Acupuncture administered together with electrical and cold stimulation can significantly improve dysphagia and lower the incidence of aspiration pneumonia and malnutrition for children with viral encephalitis.
摘要
Objective To study the radioprotective effects of ultra-small carbon quantum dots (CQDs) in mice in vivo,and to reveal the protective mechanism,as well as to study the body immune response to CQDs and the toxicity in vivo.Methods Mice were injected with different concentrations of CQDs solution.Mice models of systemic radiation injury were constructed by high dose gamma rays radiation.The 30-days survival rate,bone marrow DNA,femoral bone marrow nucleated cells (BMNC),tissue superoxide dismutase (SOD) and malondialdehyde (MDA) were measured to evaluate the radioprotective effects of CQDs,and to investigate the possible protective mechanism.The toxicity of CQDs in vivo was studied by measuring the changes of body weight,liver index and spleen index before and after injections of CQDs in mice.Results CQDs showed obvious radioprotective effects on mice in vivo.Compared with the control group,the 30-days survival rate of irradiated mice treated with CQDs increased from 0% to 40%.CQDs could effectively reduce the hematopoietic system damages caused by radiation,and increase the level of bone marrow DNA,femur BMNC,liver and lung SOD,as well as reduce the production of MDA in liver and lung.The results of immunological reaction tests showed that CQDs had less toxicity in vivo and did not trigger the body immune response.Conclusions CQDs has tremendous application prospects in the field of radiation protection.This study can provide new ideas for the application of new nano-materials in medical field.
摘要
Objective To observe the effect of Gongxuening for the women placing the IUDafter cesarean section, and to analyze the effect and value of Gongxuening on intrauterine device placement after cesarean section. Methods 156 women who received voluntary intrauterine device after cesarean sectionin theShengzhou Maternal and Child Health Hospital of Shaoxing, Zhejiang were as the observation object. According to whether the application of Gongxuening, they were divided into two groupsafter treatment, the Gongxuening group of 75 cases (using Gongxuening + Nifloxacin) and the control group of 81 cases (using norfloxacin). The changes of serum inflammatory indexes were compared between the two groups before and after operation, and the uterine bleeding was compared between the two groups. Results After operation, the levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and interleukin-10 (IL-10) were with a significantfluctuation, and at the same time, Gongxuening group TNF-α, IL-6, IL-10, 24hours after surgery, postoperative 7d was significantly lower than the control group, the difference was statistically significant (P< 0.05). After treatment, the WBC of Gongxuening group 24hours after surgery, postoperative 7d was significantly lower than the control group, but the Hb 24 hours after surgey was significantly higher than the control group, the difference was statistically significant (P<0.05). The bleeding volume2h, 24h, bleeding stop time and puerperium duration in the Gongxuening group were significantlylower than the control group, the difference was statistically significant (P<0.05). Conclusion After cesarean section maternal IUD use Gongxuening capsule treatment, not only can effectively inhibit the expression of serum inflammatory markers, and can shorten the time of uterine bleeding, reduce bleeding, prevent postoperative anemia. It is suggested to pay more attention to clinical treatment.
摘要
<p><b>OBJECTIVE</b>To observe the impacts of electroacupuncture (EA) on microgliacytes and astrocytes of cervical spinal cord in rats with thyroid incisional pain and explore the mechanism of acupuncture anesthesia in thyroid surgery.</p><p><b>METHODS</b>Sixty Wistar male rats were randomized into a normal group, a model group, a Futu (LI 18) group, a Hegu (LI 4)-Neiguan (PC 6) group and a Zusanli (ST 36)-Yanglingquan (GB 34) group, 12 rats in each one. Except the normal group, a longitudinal incision, about 1.5 cm in length was done along the neck midline in the rats of the rest groups to prepare the model of thyroid incisional pain. In the Futu (LI 18) group, the Hegu (LI 4)-Neiguan (PC 6) group and the Zusanli (ST 36)-Yanglingquan (GB 34) group, after modeling for 4 h, 24 h and 48 h, EA was applied to bilateral "Futu" (LI 18), "Hegu" (LI 4) "Neiguan" (PC 6) and"Zusanli" (ST 36) "Yanglingquan" (GB 34) separately, once a day, continuously for 3 days. In the normal group and the model group, no any intervention was applied. The thermal radiant apparatus was used to detect the thermal pain threshold (PT). The fluorescence quantitative RT-PCR and the Western blotting (WB) were used to determine the expressions of protein and gene of microglia activation markers Iba1 and CD11b and the astrocyte specific protein marker, glial fibrillary acid protein (GFAP) in cervical spinal cord (Cto C) after intervention in the rats of each group.</p><p><b>RESULTS</b>After intervention, as compared with the normal group, in the model group, the neck PT was reduced apparently (<0.05), the expressions of Iba1 and CD11b and GFAP mRNA as well as the protein expressions in the spinal cord of Cto Cwere up-regulated apparently (<0.05,<0.01). As compared with the model group, in the Futu (LI 18) and the Hegu (LI 4)-Neiguan (PC 6) group, PT was increased significantly (both<0.05) and that did not change apparently in the Zusanli (ST 36)-Yanglingquan (GB 34) group (>0.05). In the Futu (LI 18) group, the protein and gene expressions of Iba1, CD11b and GFAP were lower than those in the model group (all<0.05). In the Hegu (LI 4)-Neiguan (PC 6) group, the expressions of Iba1 mRNA, CD11b protein, GFAP mRNA and protein were all lower apparently than those in the model group (all<0.05). In the Zusanli (ST 36)-Yanglingquan (GB 34) group, the expressions of Iba1, CD11b and GFAP proteins were not different significantly as compared with the model group (all>0.05). In the Zusanli (ST 36)-Yanglingquan (GB 34) group, the expressions of Iba1 mRNA and CD11b mRNA and protein expressions in the spinal cord of Cto Cwere higher apparently than those in the Futu (LI 18) group (<0.01,<0.05); the expressions of Iba1 mRNA and CD11b protein expressions were higher than those in the Hegu (LI 4)-Neiguan (PC 6) group (all<0.05); GFAP mRNA and protein expressions were higher apparently than those in the Futu (LI 18) group and the Hegu (LI 4)-Neiguan (PC 6) group (all<0.05).</p><p><b>CONCLUSIONS</b>EA at "Futu" (LI 18) or "Hegu" (LI 4), "Neiguan" (PC 6) relieves the acute neck incisional pain in the rats and its effect may be closely relevant with the down-regulation of the activities of microgliacytes and astrocytes in the spinal cords.</p>
摘要
[ ABSTRACT] AIM: To study the protective effect of ischemia preconditioning ( IPC ) on ischemia/reperfusion ( IR)-damaged myocardium in young and old rats .METHODS: Male Wistar rats aged at 3 months ( young ) and 20 months ( old) were used to establish myocardial IPC model and IR model with the method of Langendorff heart perfusion . The rats were divided into young ischemia/reperfusion ( YIR) group, young ischemic preconditioning ( YPC) group, old ischemia/reperfusion ( OIR) group and old ischemic preconditioning ( OPC) group.Transmission electron microscopy was used to observe the ultrastructural changes of myocardial tissue and myocardial mitochondria .The myocardial infarction area was determined by TTC staining .The lactate dehydrogenase ( LDH) content in coronary effluent fluid and the levels of su-peroxide dismutase ( SOD) and malondialdehyde ( MDA) in myocardial tissues were detected by the method of colorimetry . The levels of nitrated and carbonylated proteins in myocardial tissue were measured by ELISA .The myocardial cell apopto-sis was analyzed by TUNEL assay .The mitochondrial respiratory function and mitochondrial permeability transition pore o-pening induced by calcium load were evaluated by oxygen electrode method .RESULTS: Compared with YIR group , the myocardial infarction area in YPC group was obviously smaller , SOD activity in myocardial tissues increased , LDH activity in coronary effluent fluid and the content of MDA decreased , and the levels of nitrated and carbonylated proteins in the car-diac tissues reduced .In YPC group, the mitochondrial membrane structure appeared intact , cristae of the mitochondria showed close arrangement , and the matrix was compressed under the electron microscope .Myocardial mitochondrial respir-atory control rate , state Ⅲoxygen consumption and the P/O ratio in YIR group all significantly increased , proton leak de-creased, mitochondrial swelling induced by calcium distinctly reduced , and myocardial apoptosis rate declined .No signifi-cant difference of the above indexes between OIR group and OPC group was observed .Compared with YPC group , myocar-dial ultrastructural damage increased clearly , cardiac oxidative stress increased , mitochondrial respiratory function de-clined, and cell apoptosis and necrosis increased in OPC group .CONCLUSION:Ischemic preconditioning has protective effect against myocardial IR injury in young rat hearts , while old rat hearts were less sensitive to ischemic preconditioning , leading to bluntness of cardioprotection with IPC in aging hearts .This may be related to mitochondrial injury and severe cel-lular apoptosis caused by increase of cardiac oxidative stress levels in the aging ischemic preconditioning heart .
摘要
Objective To investigate the effects of glutathione protected gold nanoclusters (GSH-Au NCs) on HeLa cytotoxity.Methods Fluorescence intensity were measured on GSH-Au NCs containing medium treated cells using fluorescence spectrophotometer at different time points.GSH-Au NCs uptake by HeLa cells at 1,2,6,12 and 24 h were investigated through fluorescent spectrophotometer.In vivo tumor uptake was also investigated on BALB/c tumor-bearing mice through inductively coupled plasma mass spectrometry (ICP-MS) at 24 h after intraperitoneal injection of 0.2 ml GSH-Au NCs (3 mmol/L) and distilled water (control group) respectively.The cytotoxicity of GSH-Au NCs at different doses (0.003-0.3 mmol/L) was tested at 24 and 48 h using MTT assay after interaction with HeLa cells.Results The uptake efficiency of GSH-Au NCs by HeLa cells kept increasing and reached maximum of 73.13% at 24 h.The results of tumor-bearing mice indicated that the tumor tissue had higher uptake efficiency after 24 h (320±15) ng/g than that of control group (intraperitoneal injection of distilled water),and the difference was stastically significant (P<0.05).HeLa cells were treated with different concentrations of GSH-Au NCs for 24 h,and GSHAu NCs had a slight effect on cell viability.With the increase of GSH-Au NCs dose,the inhibition effects on growth of HeLa cells enhanced.The cell activity of HeLa cells treated with 0.3 mmol/L GSH-Au NCs for 24 h reduced to 86%compared with that of control group (the concentration of GSH-Au NCs was 0) (P<0.05),while there was no significant difference between the survival rate of different concentrations of GSH-Au NCs group and the control group for 48 h.Conclusions GSH-Au NCs have neglectable cytotoxity on HeLa cells even though both in vitro and in vivo uptake are high.GSH-Au NCs are suitable for biomedical application such as imaging,drug loading and targeted drug delivery.
摘要
Objective To investigate the value of contrast -enhanced ultrasound combined with serum homocysteine in determining the stability of atherosclerotic plaques.Methods 96 cases with cerebrovascular disease accompanied by carotid atherosclerotic plaques were selected.All patients were taken ultrasonography and contrast -enhanced ultrasound.Semi -quantitative grading was used for plaque according to the reinforced.The serum homocys-teine levels were detected.Results A total of 146 plaques of 96 cases were found out.Hard plaques were 13(8.9%),soft plaques were 71(48.6%)and mixed plaques were 62(42.5%).All cases were divided into three groups according to the plaque ultrasound contrast semiquantitative grading.24 cases were in Ⅰ grade group,46 cases were in Ⅱ grade group,26 cases were in Ⅲ grade group.The differences of serum homocysteine levels among the three groups were statistically significant(F =59.942,P <0.05),pairwise compared,the differences were statistically significant(t =16.837,20.682 and 15.416,all P <0.05).Pearson linear correlation analysis showed that contrast -enhanced ultrasound plaque classifications were positively correlated with serum homocysteine levels(r =0.709,P =0.000).Conclusion Contrast -enhanced ultrasound could accurately assess the neovascularization in the plaque. Semi -quantitative grading of ultrasound contrast are positively correlated with serum homocysteine levels.Combined the two could provides scientific basis for early and accurate prediction the stability of plaque.
摘要
Cancer has become the second largest life-threatening disease nowadays.Radiotherapy and chemotherapy are still important treatments for cancer.However, they tend to produce a lot of serious adverse effects including bone damage and bone marrow fat, etc.Based on recent research, the research progress on canonical Wnt pathway and its impact on stromal stem cells differentiation into osteoblasts and adipocytes are reviewed.Radiochemotherapy-induced bone damage and bone marrow fat is closely related to canonical Wnt pathway.In experimental assay and clinical application, Wnt pathway antagonists, such as Dickkopf-1 (DKK-1), sclerostin, and secreted frizzled-related protein 1 (sFRP-1) are used to relieve bone damage.Wnt pathway is expected to become a potential target for the therapy of bone damage and bone marrow fat induced by raidochemotherapy.
摘要
OBJECTIVE@#To explore the related factors of tonsil postoperative pain.@*METHOD@#After founding databank a statistic analysis was performed on 90 cases with tonsillectomy who admitted in our hospital. Chi-square test were used to investigate the related factors for postoperative pain in those patients.@*RESULT@#After Chi-square test, the important effect factors in the postoperative pain were gender, age, surgical methods, preemptive analgesia, physical analgesia and preoperative anxiety level.@*CONCLUSION@#The pain after tonsillectomy is influenced by not only surgery itself, but also by preemptive analgesia, preoperative anxiety level and so on.
Subject(s)
Humans , Pain Measurement , Pain, Postoperative , Palatine Tonsil , General Surgery , Tonsillectomy摘要
Objective To investigate the effect of alprostadil combined irbesartan in treatment of early diabetic nephropathy. Methods Randomly selected 200 cases of early diabetic nephropathy patients from February 2013 to Au-gust 2014 in our hospital treated, they were divided into the study group and the control group, the study group was treated with alprostadil combined with irbesartan treatment, the control group was treated with irbesartan alone. After a period of treatment, compared two groups of patients with blood glucose, blood rheology, urinary protein excretion, renal function and so on, and the clinical efficacy of the two groups of patients after treatment were analyzed. Results The total effective rate of study group was obviously higher than that in control group, the difference was significant (χ2=6.23,P<0.05), After treatment, blood rheology, the study group of patients with renal function were significantly im-proved, better than the control group, the urinary albumin excretion rate, the study group was significantly lower than the control group, the difference was statistically significant (P<0.05). Conclusion Alprostadil and irbesartan in treatment of early diabetic nephropathy, can effectively improve the patient's condition, improve renal function in pa-tients, improve quality of life, has positive significance for early diabetic nephropathy, it is worth to promote the use in clinical.
摘要
Objective To investigate the correlation between serum 25 hydroxyvitamin D[25 (OH) D] level and post-stroke depression in elderly patients with acute stroke.Methods Depression was assessed by Beck Depression Inventory (BDI),Burns Depression Checklist (BDC),and the Diagnostic and Statistical Manual of Mental Disorders Ⅳ in 231 elderly inpatients at 2-4 weeks after onset of acute cerebral infarction.According to the depression assessment,the patients were classified into four groups:normal group),depressive symptoms group,with mild depression group,and severe depression group.The cut-off point of 25 (OH) D level for post stroke depression was analyzed by receiver operating characteristic (ROC).Results The serum level of 25(OH)D was (23.0±1.6) nmol/L in all subjects,(25.0±1.7) nmol/L in normal group,(23.7± 1.6) nmol/L in depressive symptoms group,(22.4±1.5) nmol/L in mild depression group,(16.3± 1.5) nmol/L in severe depression group.Serum 25(OH) D level had significant differences between major depression groups and other three groups,while no significant differences were found between mild depression group,depressive symptoms group and normal group.Pearson correlation analysis showed that scores of BDI and BDC were inversely related to 25 (OH)D level (r=0.24 and-0.25,both P<0.01).ROC curve analysis showed that the cut off point of serum 25 (OH) D level for severe post-stroke depression was 21.6 nmol/L.Conclusions Serum 25 (OH)D level is inversely related to depression.Serum 25(OH) D level is reduced in patients with severe post stroke depression.
摘要
Objective To investigate the status quo of transformational leadership,psychological empowerment,team psychological safety and team effectiveness,and test whether the supposed structural equation is tenable.Methods Totally 380 nurses completed the Transformational Leadership Questionnaire,Psychological Empowerment Questionnaire,Team Psychological Safety Questionnaire and Team Effectiveness Questionnaire,structural equation model was used to verify the relationship of the above,Bootstrapping confidential interval and product of coefficient were used to test the mediating effect.Results Significant correlations were found between transformational leadership,psychological empowerment,team psychological safety and team effectiveness (P < 0.01),transformational leadership played indirect effect on team effectiveness (Z=6.195,P < 0.05),psychological empowerment and psychological safety had a totally mediation effect.Conclusions Healthcare workers should make psychological empowerment and team psychological safety as the breakthrough point,fully play the advantages of transformational leadership on team effectiveness in order to increase the working ability of nurses and make them complete the clinical work effectively and with high quality.
摘要
Objective To evaluate the rate of depression in adult rheumatoid arthritis (RA) patients in China.Methods Literature search was conducted to collect studies on the prevalence of depression in adult RA patients in Cochrane library, Medline, EMbase, China National Knowledge Internet (CNKI),China Biology Medicine (CBM), Chinese science & technology journal database (VIP) and Wanfang database.Data were analyzed by R 3.2.0 software after evaluating all data.Results A total of 25 studies, including a total size of 4 830 and 2 712 patients of depression, were eligible for inclusion in the review.The prevalence of depression by analyzing the effect size was 44.7% [95%CI (37.5%, 52.0%)], which was close to the median of 43.0% from all studies included and higher than the global rate 38.8% [95%CI (34%, 43%)].Eight studies, including the sample size of 1 028 cases, 311 cases of mild depressive disorders and 219 cases of moderate or severe depressive disorders, reported the prevalence levels of 30.2% [30.2%CI (22.1%, 40.0%)] and 16.5% [95%CI (9.6%,26.9%)], respectively.Subgroup analysis showed that the depression rate of female RA patients was higher than male, the depression rate in the central and western areas were higher than that of the eastern region, the prevalence level estimated by the Geriatric Depression Scale (GDS) was higher than estimated by other tools.Sensitivity analysis showed that the pooled effect size had good stability and reliability.Conclusion The prevalence rate of depression in adult RA patients is 44.7%, suggesting that medical staff should pay much attention to depression in adult RA patients.