目的 探讨家庭药师与药物治疗管理对签约患者用药依从性及不合理用药干预效果。方法 选取2017年3月—2021年3月我院收治的慢性病患者100例作为前瞻性研究对象,按照随机余数法分为对照组和研究组各50例。其中,对照组实施首次随访调查,收集患者健康信息建立用药档案,末次随访评价。研究组采用收集患者健康信息,建立用药档案,填写调查表,对在用的药物治疗方案进行评价,家庭药师与家庭医生协作共同干预或直接干预,制定具体的解决方案,帮助患者达到治疗目标。比较2组患者干预前后的药物依从性、生活质量及用药情况的变化。结果 干预前,2组患者的药物依从性评分比较无统计学意义(P ＞0.05),干预后,2组患者药物依从性评分比较随时间增加而改善,而研究组的药物依从性评分显著高于对照组,统计学显示差异有统计学意义(P＜0.05)。2组患者的选择合理、给药频率合理、滴定合理、换药合理、联合用药合理均有明显改善且研究组多于对照组,比较差异有统计学意义(P＜0.05)。结论 家庭药师及药物治疗管理干预能够有效提高患者用药依从性及生活质量,改善用药情况,对慢性病患者干预具有一定参考价值。

Objective To explore intervention the effect of family pharmacist and medication management on medication compliance and unreasonable drug use in contracted patients. Methods A total of 100 patients with chronic diseases from March 2017 to March 2021 in our hospital were selected as prospective study subjects. According to the random remainder method,they were divided into control group and research group with 50 cases in each group. Among them,the control group was surveyed in the first followed-up,and the health information of patients was collected to establish drug use files,and evaluation was performed in the final follow-up. Family pharmacists and family physicians intervened together or directly to formulate specific solutions to help patients achieve the treatment goals and explain the treatment goals. The changes of medication compliance,quality of life and drug use before and after intervention were compared between the two groups. Results Before the intervention,the medication compliance scores of the two groups were not significantly different (P>0.05).After the intervention,the medication compliance scores of the two groups improved with time,while the medication compliance scores of the research group were significantly higher than the control group,statistics analysis showed that the difference was significant (P<0.05).The reasonable selection,the reasonable frequency,the reasonable titration,the reasonable drug change,and the reasonable combined medication in research group were significantly more than the control group,and the differences were statistically significant (P<0.05).Conclusions Family pharmacist and medication management intervention could effectively improve medication compliance and quality of life of patients,improve drug use,had a certain reference value for chronic disease patients.

目的 探讨延续性健康指导联合预见性干预对慢性脑卒中患者脑功能影响。方法 选取2019年6月—2020年6月我院收治的慢性脑卒中患者118例,使用随机数字表法将其分为两组,对照组进行预见性干预,研究组进行延续性健康指导联合预见性干预。比较两组效果、神经运动功能、不良反应。结果 研究组效果大于对照组(P＜0.05);研究组神经运动功能大于对照组(P＜0.05);研究组不良反应少于对照组(P＜0.05)。结论 慢性脑卒中护理中,延续性健康指导联合预见性干预效果较好,值得应用。

Objective To investigate the effects of continuous health guidance and combined predictive intervention on cerebral function in patients with chronic stroke. Methods A total of 118 patients with chronic stroke admitted to our hospital from June 2019 to June 2020 were selected and divided into two groups using the random number table method. The control group received predictive intervention, and the study group received continuous health guidance combined predictive intervention. The effects, neuromotor functions and adverse reactions of the two groups were compared. Results The effect of the study group was greater than that of the control group (P<0.05). The neuromotor function of the study group was higher than that of the control group (P<0.05). The adverse reactions in the study group were less than those in the control group (P<0.05). Conclusion In the nursing of chronic stroke, the effect of continuous health guidance combined with predictive intervention is good, and it is worth applying.

目的 分析广州北部区域某胸痛中心不同性别的急性ST段抬高型心肌梗死患者直接经皮冠状动脉介入治疗的结果。方法 纳入广州市花都区人民医院2016年12月—2020年1月期间接受直接经皮冠状动脉介入治疗的急性ST段抬高型心肌梗死患者。按照不同的性别,评估患者的危险因素、治疗时限性和主要心血管不良事件情况。结果 入选389名患者,73名(18.8%)为女性。和男性患者对比,女性患者年龄更大(69.3±10.8岁vs 55.8±13.1 岁,P＜0.05),具有更高比例的2型糖尿病(26.0% vs 17.7%,P＜0.05)、高血压病(58.9.0% vs 43.0%,P＜0.05)病史。女性患者的症状-首次医疗接触时间和总缺血时间均长于男性患者(分别为229.2 min vs 174.5 min,P＜0.05;424.9 min vs 317.4 min,P＜0.05),PCI术中出现慢血流/无复流的比例更高(26.0% vs 16.5%,P＜0.05)。女性患者主要住院心血管事件风险更高(11.0% vs 4.4%, P＜0.05),其中院内死亡率(4.1% vs 1.6%, P＜0.05)。女性患者在院期间发生心衰及心源性休克的比例更高(分别为34.2% vs 21.2%,P＜0.05; 30.1% vs 18.7%,P＜0.05)。结论 在行急诊介入治疗的急性ST段抬高型心肌梗死患者中,女性患者预后差于男性,具有更高的心血管事件风险,死亡率更高。

Objective We investigated sex-based outcomes after primary percutaneous coronary intervention (PPCI) in patients with acute ST-segment elevation myocardial infarction (STEMI) in a chest pain center of northern Guangzhou. Methods From December 2016 to January 2020, consecutive STEMI patients who underwent PPCI in Guangzhou Huadu District People's Hospital were recruited. Risk factors, time variables, and major cardiovascular adverse events (MACE) were assessed according to gender. Results A total of 389 patients were enrolled,with 73(18.8%)women. Compared to men, women patients presented higher risk profiles with old age(69.3±10.8 years vs 55.8±13.1 years,P＜0.05),diabetes (26.0% vs 17.7%,P＜0.05), hypertension (58.9.0% vs 43.0%,P＜0.05).Women had longer symptom onset to first medical contact time and total ischemic time than men had(229.2min vs 174.5min,P＜0.05;424.9min vs 317.4min,P＜0.05).During PCI procedure,women presented higher ratio of slow flow/no reflow(26.0% vs 16.5%,P＜0.05).Women had increased major adverse events(11.0% vs 4.4%, P＜0.05), and higher in-hospital mortality(4.1% vs 1.6%, P＜0.05).Women presented more heart failure incidence (34.2% vs 21.2%,P＜0.05),and cardiac shock incidence(30.1% vs 18.7%,P＜0.05). Conclusion Women with acute STEMI who underwent PPCI had worse outcomes compared to men.They had higher MACE and in-hospital mortality.

目的 观察紧密连接蛋白在高尿酸血症致大鼠肾损害模型中的表达变化以及非布司他的干预疗效。方法 将SD大鼠分为正常组,高尿酸血症组(模型组),非布司他组(干预组);氧嗪酸联合尿酸诱导制作高尿酸血症大鼠模型,给予非布司他进行干预,分别于6周后检测各组大鼠血中尿素氮(BUN)、血肌酐(Scr)、尿酸(UA)水平,免疫组化及RT-PCR方法检测紧密连接蛋白包括膜周蛋白-1(ZO-1)、跨膜蛋白(occludin) 的表达变化,采用Masson染色检测大鼠肾间质病理改变。结果 6周时,模型组、干预组ZO-1、occludin表达较正常组降低(均P<0.05);干预组ZO-1、occludin表达较模型组增加,差异有统计学意义(均P<0.05),与正常组相比,模型组、干预组RIF指数均增高(均P<0.05),干预组RIF指数低于模型组,高于正常组(均P<0.05)。结论 紧密连接蛋白表达的降低在高尿酸血症肾间质纤维化发展过程中起着举足轻重的作用,并与血尿酸水平及肾功能损害密切相关。非布司他通过降低血尿酸水平,能改善紧密连接蛋白的表达,延缓肾功能损害,起到肾保护作用。

Objective To observe the expression of tight junction protein in hyperuricemia induced renal damage model in rats and the intervention effect of febuxostat. Methods SD rats were randomly divided into three groups: normal control group, model control group, febuxostat treatment group. Hyperuricemia was induced in rats with oxonic acid per time for three times per day, by gavage and combined with uric acid added in drinking water, while febuxostat were administered by gavage in febuxostat treatment group.The blood of rats were collected to analyse the differences of control, model and treatment group on changes of blood urea nitrogen (BUN), creatinine (Cr), uric acid (UA). Immunohistochemistry was used to assay ZO-1 and occludin protein expression and quantitive real time PCR to detect the expression of ZO-1 and occludin in renal tissue of renal interstitial fibrosis model rats induced by hyperuricemia. Paraffin section of kidney was maked and then performed Masson staining to make sure the model is successful. Results At 6 weeks, the expressions of ZO-1 and occludin in the model group and treatment group were lower than those in the normal group (all P<0.05). The expressions of ZO-1 and occludin in the treatment group were higher than those in the model group (all P<0.05). Compared with the normal group, the RIF index in the model group and treatment group were higher (all P<0.05), and the RIF index in the treatment group was lower than that in the model group and higher than that in the normal group (all P<0.05). Conclusion The downregulated expression of ZO-1 and occludin plays a crucial role during the development of hyperuricemia in renal interstitial fibrosis, and are closely related to UA level and renal function impairment. Febuxostat may improve the expression of tight junction by downregurating UA, reduce renal fuction impairment and play a role in renal protection.

目的 研究在新型冠状病毒COVID-19疫情期间,政府采取的干预措施对医院检测的流行性感冒(简称流感)阳性率的影响,为制定流感预防措施提供依据,也为间接评价新型冠状病毒的预防效果提供参考。方法 回顾性收集广州市第一人民医院总院2018—2020年年廿三至正月十五期间的流感抗原检测数据,对政府干预前后的流感抗原检测阳性率进行分析比较。结果 在春节前后,2018年和2019年的流感检测阳性率总体上维持稳定。其中,2018年春节前后,流感阳性率在15.6%～46.5%范围内波动,2019年春节前后,流感阳性率在11.9%～30.4%范围内波动。2020年同期的流感阳性率变化曲线与前两年不同,在正月初四前曲线变化较为稳定,维持在20.0%～44.1%范围内。在正月初四后曲线呈现显著下降趋势,在正月十二和正月十五,流感检测阳性率变为0。进一步的分析表明,政府干预对流感阳性率的影响无性别差异,对5～64岁人群效果最佳。结论 当前针对新型冠状病毒COVID-19的政府干预措施能显著降低流感阳性率,预防流感的发生,也为预防同样以呼吸道传播为主的新型冠状病毒的传播提供了间接证据。

Objective The aim of the study was to study the effect of government interventions on the positive rate of influenza detected in Guangzhou First People's Hospital during the outbreak of COVID-19, and to provide a basis to develop prevention measures against influenza and a reference for the indirect evaluation of the preventive effect of COVID-19. Methods Influenza antigen detection data of Guangzhou First People's Hospital were collected retrospectively from 23rd of the 12th lunar month to 15th of the 1st lunar month in 2018—2020, and the positive rates of influenza antigen detection before and after the government intervention were analyzed and compared. Results The positive rates of influenza were generally stable in 2018 and 2019 before and after the Spring Festival, where the positive rate fluctuated in the range of 15.6%～46.5% in 2018, and the positive rate fluctuates in the range of 11.9%～30.4% in 2019. The temporal change of the positive rate in 2020 was different from that of the previous two years. The positive rate curve was relatively stable before the fourth day of the first lunar month, maintaining a range of 20.0%～44.1% in 2020. After the fourth day of the first lunar month, the curve showed a significant downward trend. On the 12th and 15th day of the first lunar month, the positive rate of influenza became 0. Furthermore, the effect of government intervention on the positive rate of influenza showed no gender difference, and the effect was significant for people aged 5～64 years. Conclusion The current government intervention measures against COVID-19 could significantly reduce the positive rate of influenza, prevent the occurrence of influenza, and provide indirect evidence for the prevention of the spread of COVID-19, which was also mainly spread by respiratory tract.

目的 观察实施微信式延续护理干预对真菌性外耳道炎患者心理状态及治疗效果的影响。方法 选取我院2018 年12月—2019年12 月期间门诊治疗的110例真菌性外耳道炎患者为观察对象,将所选患者随机分为常规组和干预组,常规组55例,采取常规护理;干预组55例,在常规护理的基础上实施微信式延续护理干预。观察两组患者的心理状态及治疗依从性、治疗效果的变化。结果 干预组患者心理状态的改善、治疗依从性、治疗效果均优于常规组,差异有统计学意义(P＜0.05)。结论 在给予真菌性外耳道炎患者实施护理干预的过程中,加入微信式延续护理干预,患者的心理状态得到改善、治疗依从率增加及患者治疗的总有效率提高。因此微信式延续护理干预值得在临床护理中进一步推广。

Objective To observe WeChat continuous nursing intervention on mental state and therapeutic efficacy of fungal external auditory meatus. Methods 110 cases of fungal external auditory meatus treated in our hospital from December 2018 to December 2019 were selected as the observation objects,The selected patients were randomly divided into the conventional group and the intervention group,There were 55 cases in the conventional group,taking regular care; there were 55 cases in the intervention group,on the basis of routine nursing,WeChat continuous nursing intervention was implemented. The psychological status and treatment compliance of the two groups were observed,also changes in treatment outcomes. Results The improvement of psychological state,treatment compliance and treatment effect in the intervention group were better than that in the conventional group.The difference was statistically significant(P＜0.05). Conclusion In the course of nursing intervention for patients with fungal external auditory meatus,WeChat continuous nursing intervention was added.The psychological state of the patients has been improved,the rate of treatment compliance is increased and the total effective rate of treatment is increased greatly.Therefore,WeChat continuous nursing intervention is worthy of further promotion in clinical nursing.

目的 探讨循证护理干预在肺功能检查中对检查准确性的影响。方法 选取行肺功能检查患者80例,随机分为2组,分别记录为观察组40例和对照组40例,分别实施循证护理干预和常规护理干预,比较两组患者肺功能检查时间、肺功能检查结果及护理满意度。结果 观察组患者平均肺功能检查时间短于对照组(P<0.05);观察组患者肺功能检查正常率高于对照组;且观察组患者对护理服务的满意度高于对照组,组间对比差异有统计学意义(P<0.05)。结论 对行肺功能检查的患者实施循证护理干预效果显著,有利于缩短患者肺功能检查时间,并可提高检查的准确率,且有利于改善护患关系,值得在临床上推广应用。

Objective To investigate the influence of evidence-based nursing intervention on the accuracy of the examination in pulmonary function test. Methods 80 cases of patients with lung function examination, were randomly divided into 2 groups, were recorded in 40 cases of observation group and control group 40 cases, respectively. The implementation of evidence-based nursing intervention and routine nursing intervention were taken, to compare times of patients with pulmonary function test, pulmonary function test results and nursing satisfaction in two groups. Results In the observation group the average lung function examination time was shorter than that of the control group (P<0.05); normal pulmonary function tests was higher than that of the control group; satisfaction with nursing service was higher than the control group, there was statistical significance the differences between the two groups (P<0.05). Conclusion The pulmonary function test for patients with the implementation of evidence-based nursing intervention has significant effect. It can shorten the time in patients with pulmonary function examination, improve the inspection accuracy, and improve the relationship between nurses and patients, it is worthy of clinical application.

目的 总结预防接种认知干预对儿童预防接种效果的影响。方法 对2018年5—9月在东莞企石镇接种百白破疫苗的儿童家属按接种时间顺序分为对照组254名、实验组248名,对照组家属按常规方法进行预防接种,实验组在常规接种基础上,结合不按时接种、延迟接种等问题对幼儿家属开展多种多样的百白破疫苗预防知识、不良反应观察处理、接种注意事项等知识宣教和培训干预,总结两组儿童在按时接种、延迟接种、疫苗接种知识、不良反应表现与处理、接种注意事项知识的掌握、服务满意度等情况。结果 实验组幼儿按时接种率比对照组高,延迟接种率比对照组低,结果有差异(P＜0.05);家属对疫苗接种知识、不良反应表现和处理、接种注意事项等知识的掌握比对照组高,结果有差异(P＜0.05)。结论 实施家属预防接种认知干预管理能提高家属掌握预防接种知识和不良反应护理知识;提高儿童疫苗接种率和及时接种率,提高预防接种服务管理效果。

Objective To summarize the effect of cognitive intervention on children's vaccination. Methods The family members of children vaccinated with DPT vaccine in Qishi Town of Dongguan City from May to September 2018 were divided into control group 254 and experimental group 248 according to the sequence of vaccination time. The family members of control group were vaccinated by routine methods. On the basis of routine vaccination, the experimental group carried out a variety of preventive knowledge and adverse reactions observation of DPT vaccine to the family members of children in combination with the problems of untimely vaccination and delayed vaccination. The knowledge propaganda and training intervention of treatment and vaccination precautions were summarized. The situation of two groups of children in timely vaccination, delayed vaccination, vaccination knowledge, adverse reaction performance and treatment, knowledge of vaccination precautions and service satisfaction were summarized. Results The vaccination rate of children in the experimental group was higher than that in the control group, and the delayed vaccination rate was lower than that in the control group. The results showed statistical difference (P＜0.05). The knowledge of vaccination, adverse reactions, treatment and matters needing attention of family members were higher than that in the control group, and the results showed statistical difference (P＜0.05). Conclusion Implementing cognitive intervention management of family vaccination may improve family members'knowledge of vaccination and nursing of adverse reactions, improve children's vaccination rates and timely vaccination rates, and improve the management effect of vaccination service.

目的 观察饮食干预管理和健康教育对糖尿病酮症酸中毒(DKA)患者的干预效果。方法 90例DKA患者根据数字表法随机分为2组,对照组(n=45)予以常规治疗及护理措施,观察组(n=45)在对照组治疗及护理基础上予以饮食干预管理和健康教育,比较两组患者干预后血糖控制时间、酸中毒纠正时间和住院治疗时间;采用相关效果量表调查两组患者干预前后相关知识知晓程度及健康饮食依从度;通过生活质量评分表和问卷表比较两组患者两组生活质量和护理满意度。结果 观察组干预后血糖控制时间、酸中毒纠正时间均早于对照组(P<0.05),而住院治疗时间少于对照组(P<0.05);两组干预前相关知识知晓程度比较无差异(P>0.05),观察组干预后相关知识知晓程度及健康饮食依从度均优于对照组(P<0.05);观察组干预后生活质量及护理满意度均优于对照组(P<0.05)。结论 饮食干预管理和健康教育可明显改善DKA患者症状及生活质量,提高相关知识知晓程度及健康饮食依从度。

目的 总结GuideLiner^®延长导管在复杂经皮冠状动脉介入治疗(PCI)中的初步经验,探讨其有效性及安全性。方法 选择2015年3月—2017年3月因冠心病于广州市第一人民医院行PCI的患者13例,因复杂病变需要更强支撑力而使用GuideLiner^®延长导管完成手术,总结手术成功率、并发症以及6个月随访主要不良心脏事件的发生情况。结果 13例患者在GuideLiner^®延长导管应用下均成功完成手术。使用延长导管的目的2例手术为辅助球囊通过,7例为辅助支架通过,4例为辅助支架及球囊通过。全部患者均未发生术中及住院期间死亡、急性心肌梗死,未发生急性支架内血栓形成、目标冠脉夹层或穿孔、心包填塞等并发症,6 个月随访均无不良心脏事件发生。结论 应用延长导管可提高支撑力,有效辅助球囊和/或支架到达冠状动脉病变部位,提高手术成功率,安全性较高。

Objective To evaluate the clinical efficacy and safety of GuideLiner^® guide extension catheter during complex coronary percutaneous coronary intervention(PCI) procedures. Methods Thirteen patients with coronary heart diseases performed PCI procedures were included in this study from March 2015 to March 2017. GuideLiner^® guide extension catheters were used in these complex cases. The PCI success rate,incidence of complications and 6-month follow up data were observed. Results Benefited from the stronger support produced by GuideLiner^®, PCI success rate was 100%. The guide extension catheters were used for the delivery of balloons in 2 cases, while 7 cases for stents, and 4 cases for both balloons and stents. No death were observed during the procedure or in hospital, and there were no dissection or acute myocardial infarction. During 6 months of follow-up,there was no major adverse cardiac events (MACE). Conclusion GuideLiner^® guide extension catheter may improve procedure success rate by ensuring the delivery of balloons and stents in complex PCI.