危象预见性护理在重症肌无力术后患者中应用

目的:探讨危象预见性护理在重症肌无力术后患者中的应用效果。方法将64例重症肌无力术后患者随机分成观察组和对照组各32例,对照组实施常规护理,观察组在此基础上加以危象预见性护理,根据评分的不同给予个体护理,观察患者术后咳嗽效果、肺部感染及肌无力危象的发生率。结果观察组较对照组术后咳嗽效果好,肺部感染及无力危象并发症的发生率低,,差异有统计学意义(P相似文献   

老年人医院内下呼吸道感染的调查分析及预防

在我国医院感染的首位感染比例为23 3%~42 0%,〔1〕在我院老年人下呼吸道医院内感染发病率也居首位,在治疗上较棘手,死亡率高,所以预防和控制下呼吸道感染是降低医院内感染的重要工作,为此,我们对78例老年人下呼吸道医院内感染患者的情况进行了调查与分析,现报告如下:1材料与方法1.1调查对象及方法调查对象来源于我院2004年10月-2005年9月住院的全部医院内感染病例。1.2诊断标准医院感染病例的诊断参照卫生部医政司编印的《医院感染诊断标准》。2一般资料78例医院内下呼吸道感染的老年患者,男69例,女9例,年龄最大88岁,最小70岁,住院天数最长…     

高渗盐水联合复方异丙托溴铵治疗毛细支气管炎30例临床观察

目的：观察高渗盐水联合复方异丙托溴铵治疗毛细支气管炎患儿的临床疗效。方法：选取毛细支气管炎患儿共60例，随机分为观察组与对照组各30例，对照组患儿给予生理盐水联合沙丁胺醇雾化吸入治疗，观察组给予高渗盐水联合复方异丙托溴铵雾化治疗，观察两组患儿的临床疗效。结果：观察组患儿总有效率明显优于对照组，肺部哮鸣音消失时间及住院时间明显少于对照组，差异均具有统计学意义（P＜0.05）。结论：高渗盐水联合复方异丙托溴铵治疗毛细支气管炎患儿疗效较好，能有效改善患儿气道高反应性和肺功能，缩短住院时间，值得临床推广应用。     

支气管哮喘患者治疗依从性的护理干预

支气管哮喘(简称哮喘)是由于过敏或非过敏因素刺激机体引起的一种气管—支气管反应性过度增高的疾病。美国的心肺血液研究对哮喘的最新定义为"可逆性的气道阻塞、气管炎症、气管对各种刺激的反应增强"[1]。哮喘是一个全球性的影响人类健康的常见病。在我国发病率在0.5%～2%之间[2]。近年来发现世界多数国家的支气管哮喘发病率在不断升高[3]。同时,哮喘患者具有病情迁延不愈、     

气压治疗预防昏迷病人下肢深静脉血栓的效果观察

目的：探讨气压治疗预防昏迷病人下肢深静脉血栓的临床效果。方法：择取我科于2014年1月～2014年12月收治的住院时间超过一周的昏迷病人50例，随机分为人数相同的实验组和对照组，各25人。其中实验组采用气压治疗方法进行治疗，每天两次，每次半小时，半个月一个疗程。对照组则采用传统人工按摩方式进行治疗，每天两次，每次半小时，并辅用相关药物进行预防。对比两种治疗方法在防治深静脉血栓形成方面的不同。结果：两组患者的下肢肿胀情况均有所改善，但行以气压疗法的实验组，其患者恢复情况要明显优于对照组，P＜0.05，差异具有统计学意义；对两组患者治疗前后股静脉和腘静脉的血液流速变化，治疗前两组患者股静脉和腘静脉的血液流速无明显差异，P＞0.05，差异无统计学意义；治疗后两组患者股静脉和腘静脉的血液流速差异明显，实验组股静脉和腘静脉的血液流速明显快于对照组，P＜0.05，差异具有统计学意义。结论：气压治疗具有安全性较高、操作性简便的优越性，病人在治疗过程中不会感到痛苦，副作用极小，且气压疗法的价格也可以被大众所接受。气压疗法有效防治深静脉血栓，为患者生命安全提供安全保障，在减轻患者的痛苦的同时，更是节约了治疗费用和医疗资源，给广大患者和医学工作者带来了福音。     

慢性肺源性心脏病的护理体会

慢性肺源性心脏病是由于支气管、肺、胸廓或肺动脉血管的慢性病变导致肺动脉高压,右心负荷加重,进而造成右心室肥厚、扩大,甚至发生右心衰竭的心脏病。本病为中老年人的常见病。急性发作以冬春季多见。急性呼吸道感染是急性发作的主要诱因,常导致肺、心功能衰竭。重症肺心病的病死率仍较高。临床资料:1.一般资料:本科2004年1月—2005年1月间,共收治82例慢性肺源性心脏病的病人。其中男性70例,女性12例,年龄78-94岁。均有进行性呼吸困难、干咳等症状。其中75例患者继发肺部感染,25例患者合并呼吸衰竭,2例患者死亡。2.治疗方案:肺心病源于慢性…     

哮喘的病理机制及治疗药物

治疗的重心已由缓解气道平滑肌痉挛(气管扩张剂)转向预防和治疗气道炎症,糖皮质激素是目前临床治疗哮喘最有效的抗炎药物。近年来,白三烯(LT)抑制剂和白介素拮抗剂的出现成为新型治疗哮喘的抗炎药物。     

快速康复外科理念在腹腔镜直肠癌手术治疗中的临床应用及可行性分析

目的 探讨快速康复外科理念在腹腔镜直肠癌手术治疗中的临床效果。方法 选择甘肃省定西市人民医院100例直肠癌手术患者进行腹腔镜手术治疗后分组干预,对照组进行常规干预,实验组在对照组基础上进行快速康复外科理念。观察两组患者的临床数据。结果 实验组的临床疗效及患者满意度均高于对照组（P<0.05）,且手术时长、术中出血量、切口长度、住院时间及并发症发生率均少于对照组（P<0.05）。结论 在腹腔镜直肠癌手术治疗中进行快速康复外科理念的疗效显著,可有效降低并发症发生率,提高患者满意度。     

二甲双胍对多囊卵巢综合征患者疗效、代谢特征及激素水平的改善作用分析

目的 探讨应用二甲双胍对多囊卵巢综合征患者进行治疗的效果;方法 将甘肃省兰州市安宁区人民医院2019年3月至2020年3月作为研究时段,将该时段录入数据库资料登记有效的确诊为多囊卵巢综合征不孕患者22名作为研究对象,按照随机均分法,分为对照组与实验组,组内样本量设置为11。对照组患者选择炔雌醇环丙孕酮片进行治疗,实验组患者则在此基础上增加二甲双胍进行用药,对比两组患者治疗后睾酮、垂体分泌卵泡雌激素以及多囊卵巢综合征不孕治疗总有效率;结果 在实验结果中发现,相较于对照组来说,实验组患者的治疗总有效率明显更优,数据对比分析差异显著（P<0.05）,而在治疗完成后对两组患者的各项指标进行分析,发现实验组患者激素水平明显优于对照组,组间差异显著（P<0.05）;结论 选择二甲双胍对多囊卵巢综合征患者进行治疗,效果良好。     

小骨窗血肿清除术与微创穿刺血肿引流术治疗高血压脑出血患者的临床效果比较

目的 探讨并分析小骨窗血肿清除术与微创穿刺血肿引流术两种治疗方式对高血压脑出血患者的临床治疗效果。方法 选取我院2017年1月到2022年3月期间的60例高血压脑出血患者为本次研究对象,采取计算机表法对并其进行研究,分为研究组和对照组,每组30例患者,研究组高血压脑出血患者采取微创穿刺血肿引流术治疗方式,对照组患者采用常规小骨窗血肿清除术方式。结果 研究组高血压脑出血患者手术情况,主要包括术中出血量、手术时间以及术后住院时间明显少于对照组,研究组高血压脑出血患者的临床治疗总有效率（90.00%）明显高于对照组（66.67%）。研究组高血压脑出血患者的并发症发生情况,主要包括肺部感染、再出血以及颅内感染等情况的总发生率（6.67%）明显低于对照组（26.67%）,差异有统计学意义（P<0.05）。结论 将小骨窗血肿清除术与微创穿刺血肿引流术应用于高血压脑出血患者中,二者治疗方式均有效果,但是微创穿刺血肿引流术治疗效果更为显著,对患者的创伤较小,明显缩短患者的治疗时间,有效降低并发症的发生率,值得在目前临床中推广应用。     

Auditory evoked potentials as a function of sleep deprivation

Event-related brain potentials (ERPs) were studied in subjects deprived of sleep over a 48-h test period to assess the effects of different durations of continuous wakefulness on ERP components and to determine whether changes in the ERP components were related to changes in performance. Forty subjects were randomly assigned to either an experimental (sleep deprived) group (n = 30) or a control (not sleep deprived) group (n = 10). For the experimental subjects, ERP and performance measures were obtained in four-h test blocks throughout the 48-h period. Performance was assessed using the Walter Reed performance assessment battery. The control subjects were tested at the same times except during designated sleep periods. Both performance and evoked potential measures showed systematic changes over the experimental test period in association with sleep deprivation, time of day, and repeated testing. The latency of the N2 component of the evoked potential covaried with throughput measures on the performance assessment battery across the 12 four-h test blocks of the experiment. These data suggest that ERPs reflect central processes that change across the sleep deprivation period and that ERP measures might be useful in assessment and prediction of performance degradation under adverse conditions such as sleep loss.     

A Comparison of the Effects of Incentive and Penalty Procedures on Work Performance: A Simulation

This study compared the effects of incentive and penalty on work performance. In Experiment 1, participants in the incentive group could earn 50 won (approximately 5 cents) for correctly completing each task and those in the penalty group could lose 50 won for incorrectly completing each task. The incentive and penalty did not exert differential impacts on work performance. In Experiment 2, participants were randomly assigned to one of six experimental groups: incentive, penalty, and no reward groups under two different consequence delivery schedules. Under the continuous condition, the payment was determined in the same way as in Experiment 1. Under the VR 5 condition, 250 won was either added or deducted based on a VR 5 schedule. The effects of the incentive and penalty were comparable under the continuous condition. However, the incentive was more effective than the penalty under the VR 5 condition.     

Morphometric Approaches for Evaluating Pulmonary Toxicity in Mammals: Implications for Risk Assessment

Recent advances in quantitative morphology provide all the tools necessary to obtain structural information in the lung that can be quantified and interpreted in the three-dimensional world of toxicology. Structural hierarchies of conducting airways and parenchyma of the lung provide: (1) numbers of cells per airway, lobe, or lung; (2) surface areas of cells, airways, and alveoli; (3) length of airways and vessels; and (4) volumes of cells, alveoli, airways, vessels, and individual lobes or the entire lung. Unbiased sampling of these subcompartments of the lung requires fractionation of lobes or individual airways. Individual airways of proximal and distal generations are obtained by airway microdissection along one axial pathway and comparisons made between airway generations. Vertical sections of selected airways are used to sample epithelium and interstitium. Using this unbiased approach of quantitative morphology, we have shown that inhalation of low ambient concentrations of ozone ([O₃]0.15 ppm) near or at the United States National Ambient Air Quality Standard (NAAQS) (0.12 ppm O₃) induces significant alterations in bronchiolar epithelium and interstitium in nonhuman primates but not rats. The alterations do not appear to be concentration- or time-dependent, thereby bringing into question the current NAAQS that may be at or above the threshold for distal airway injury in primates. Unbiased morphometric methods are critical in a quantitative evaluation of toxicological injury of mammalian tracheobronchial airways.     

Appropriate use of bright light promotes a durable adaptation to night-shifts and accelerates readjustment during recovery after a period of night-shifts

Abstract

The present study examines the stability of bright light circadian readjustment during two consecutive dim light night-work periods and circadian synchronization during the recovery after a night-shift period. A sample of 10 subjects was divided into 2 groups (control group: 6 subjects; experimental group: 4 subjects). All subjects worked during 5 days, between 23:00 and 07:00 h and then went to sleep. Subjects received 2500-3000 lux between 02:00 and 05:00 h during 5 days for the control group and 3 days for the experimental group. During recovery after the night-shift periods, three cycles of bright light were administered at two different times: 12:00-15:00 h for two of six subjects from the control group and 10:00-13:00 h for all subjects (4) of the experimental group. By the fifth cycle of night-work the maximum of urinary aMT6s excretion that occurs at 05:00 h in the baseline condition was shifted to 12:00 h for the control and experimental groups (delay in hours: 7±1.6 (control); 7±1 (experimental)). This result suggests that three cycles of bright light are sufficient to induce a significant phase delay and that this delay remained stable when night-work proceeded under dim light. The phase delay of the circadian aMT6s excretion by exposure to bright light was accompanied by an improvement of the quality of day sleep and level of cognitive and psychomotor performances for control and experimental groups. No significant difference was observed in the two groups for daytime sleep and nocturnal performance. The two bright light periods used during the three days of recovery induced a complete synchronization in five of six subjects. One subject showed a partial synchronization probably because he remained at the laboratory under dim light during the day and had few family and social contacts.     

Efficacy of writing for recovery on traumatic grief symptoms of Afghani refugee bereaved adolescents: a randomized control trial

Effective evidence-based intervention for traumatic bereavement is one of the current major research issues in the field of Post Traumatic Stress Disorder (PTSD) in children and adolescents. The "Writing for Recovery" group intervention is a new treatment approach developed by the Children and War Foundation for traumatized and bereaved children and adolescents after disasters. The purpose of this project was an empirical examination of this intervention with 12- to 18-year-old war bereaved Afghani refugees. Eighty-eight war bereaved Afghani refugees were screened using the Traumatic Grief Inventory for Children (TGIC). From those with the highest total score, 61 were randomly assigned to either an experimental (n = 29) or control group (n = 32). The experimental group received six sessions of group training on 3 consecutive days in their school. The difference of TGIC scores between the experimental group in pretest and posttest was significant (p = 0.001). Results of analysis of covariance also showed a significant effect of Writing for Recovery on the experimental group (p < 0.001). It is concluded that "Writing for Recovery" is an effective group intervention for bereaved children and adolescents after disasters.     

Appropriate use of bright light promotes a durable adaptation to night-shifts and accelerates readjustment during recovery after a period of night-shifts

The present study examines the stability of bright light circadian readjustment during two consecutive dim light night-work periods and circadian synchronization during the recovery after a night-shift period. A sample of 10 subjects was divided into 2 groups (control group : 6 subjects; experimental group: 4 subjects). All subjects worked during 5 days, between 23:00 and 07:00 h and then went to sleep. Subjects received 2500-3000 lux between 02:00 and 05:00 h during 5 days for the control group and 3 days for the experimental group. During recovery after the night-shift periods, three cycles of bright light were administered at two different times: 12:00-15:00 h for two of six subjects from the control group and 10:00-13:00 h for all subjects (4) of the experimental group. By the fifth cycle of night-work the maximum of urinary aMT6s excretion that occurs at 05:00 h in the baseline condition was shifted to 12:00 h for the control and experimental groups (delay in hours: 7 +/- 1.6 (control); 7 +/- 1(experimental)). This result suggests that three cycles of bright light are sufficient to induce a significant phase delay and that this delay remained stable when night-work proceeded under dim light. The phase delay of the circadian aMT6s excretion by exposure to bright light was accompanied by an improvement of the quality of day sleep and level of cognitive and psychomotor performances for control and experimental groups. No significant difference was observed in the two groups for daytime sleep and nocturnal performance. The two bright light periods used during the three days of recovery induced a complete synchronization in five of six subjects. One subject showed a partial sychronization probably because he remained at the laboratory under dim light during the day and had few family and social contacts.     

Daily Inhalation Rate and Time‐Activity/Location Pattern in Japanese Preschool Children

Lack of data on daily inhalation rate and activity of children has been an issue in health risk assessment of air pollutants. This study aimed to obtain the daily inhalation rate and intensity and frequency of physical activity in relation to the environment in Japanese preschool children. Children aged four–six years (n= 138) in the suburbs of Tokyo participated in this study, which involved three days' continuous monitoring of physical activity using a tri‐axial accelerometer and parent's completion of a time/location diary during daily life. The estimated three‐day mean daily inhalation rate (body temperature, pressure, saturated with water vapor) was 9.9 ± 1.6 m³/day (0.52 ± 0.09 m³/kg/day). The current daily inhalation rate value of 0.580 m³/kg/day proposed for use in health risk assessment in Japan is confirmed to be valid to calculate central value of inhaled dose of air pollutants in five‐ to six‐year‐old children. However, the 95th percentile daily inhalation rate of 0.83 m³/kg/day based on measurement for five‐year‐old children is recommended to be used to provide an upper bound estimate of exposure that ensure the protection of all five‐ to six‐year‐old children from the health risk of air pollutants. Children spent the majority of their time in sedentary and light level of physical activity (LPA) when indoors, while 85% of their time when outdoors was spent in LPA and moderate‐to‐vigorous physical activity. The results suggest the need to consider variability of minute respiratory ventilation rate according to the environment for more refined short‐term health risk assessment.     

Effects of resident-oriented care on job characteristics of nursing caregivers

This study evaluates the effects of the implementation of resident-oriented care on the job characteristics (job autonomy, job demands and social support) of nursing caregivers in three Dutch nursing homes. In a quasi-experimental design, experimental and control groups in both general and psychogeriatric wards were followed for up to 22 months, using a pre-test and two post-tests by means of written questionnaires and semi-structured interviews. The results showed that the intervention appeared to be partly successful. Last post-test regression analyses revealed significant increases in a number of design characteristics of resident-oriented care. Significant increases were noticed on resident assignment, the two variables measuring the nursing process and, in the psychogeriatric experimental group, on resident-oriented tasks (p≤.01). The effects on job characteristics were limited. An indicative increase was shown in contextual job autonomy in the experimental group (p≤.05). The qualitative data derived from the interviews showed that there was still a partly task-oriented division of labour. Further, the delegation of co-ordination tasks to nursing caregivers had not yet been properly achieved. The study concludes with some theoretical and methodological reflections in the light of the findings.     

Effects of resident-oriented care on job characteristics of nursing caregivers

This study evaluates the effects of the implementation of resident-oriented care on the job characteristics (job autonomy, job demands and social support) of nursing caregivers in three Dutch nursing homes. In a quasi-experimental design, experimental and control groups in both general and psychogeriatric wards were followed for up to 22 months, using a pre-test and two post-tests by means of written questionnaires and semi-structured interviews. The results showed that the intervention appeared to be partly successful. Last post-test regression analyses revealed significant increases in a number of design characteristics of resident-oriented care. Significant increases were noticed on resident assignment, the two variables measuring the nursing process and, in the psychogeriatric experimental group, on resident-oriented tasks (p≤.01). The effects on job characteristics were limited. An indicative increase was shown in contextual job autonomy in the experimental group (p≤.05). The qualitative data derived from the interviews showed that there was still a partly task-oriented division of labour. Further, the delegation of co-ordination tasks to nursing caregivers had not yet been properly achieved. The study concludes with some theoretical and methodological reflections in the light of the findings.     

Assessing the Exacerbations Risk of Influenza‐Associated Chronic Occupational Asthma

The purpose of this article was to conduct a risk‐based study based on a linkage of experimental human influenza infections and fluctuation analysis of airway function to assess whether influenza viral infection was risk factor for exacerbations of chronic occupational asthma. Here we provided a comprehensive probabilistic analysis aimed at quantifying influenza‐associated exacerbations risk for occupational asthmatics, based on a combination of published distributions of viral shedding and symptoms scores and lung respiratory system properties characterized by long‐range peak expiratory flow (PEF) dynamics. Using a coupled detrended fluctuation analysis‐experimental human influenza approach, we estimated the conditional probability of moderate or severe lung airway obstruction and hence the exacerbations risk of influenza‐associated occupational asthma in individuals. The long‐range correlation exponent (α) was used as a predictor of future exacerbations risk of influenza‐associated asthma. For our illustrative distribution of PEF fluctuations and influenza‐induced asthma exacerbations risk relations, we found that the probability of exacerbations risk can be limited to below 50% by keeping α to below 0.53. This study also found that limiting wheeze scores to 0.56 yields a 75% probability of influenza‐associated asthma exacerbations risk and a limit of 0.34 yields a 50% probability that may give a representative estimate of the distribution of chronic respiratory system properties. This study implicates that influenza viral infection is an important risk factor for exacerbations of chronic occupational asthma.