目的 探讨规范二级预防下老老年人轻型卒中复发的危险因素。方法 收集我院80岁及以上、既往有轻型卒中病史、并进行规范二级预防半年以上的老老年患者的临床资料:一般资料、既往病史及用药情况、入院时血压及基础生化指标、影像学资料、缺血性卒中复发情况。根据有无复发缺血性卒中将患者分为复发组和无复发组两组,分析以上因素在两组间的差异。结果 80例患者中复发缺血性脑卒中共26例,复发率32.5%。统计结果显示,轻型卒中复发组与合并高血压病、入院时收缩压、D二聚体水平呈正相关,其相关系数分别为0.265(P=0.018)、0.232(P=0.038)和0.222(P=0.048)。复发组收缩压升高比例高于无复发组(χ²=6.919,P=0.031)。非条件Logistic多因素分析显示:合并高血压病[OR 95%CI=(1.162,10.230)]、收缩压升高[OR 95%CI=(0.997,68.840)]与轻型缺血性卒中复发相关。结论 合并高血压病、收缩压升高是老老年人轻型卒中规范二级预防下复发独立危险因素。

Objective To analyze the recurrence risk factors of aged patients with minor ischemic stroke under standardized secondary prevention. Methods Patients over 80 years old and with minor ischemic stroke history were enrolled, and the following data were collected: demographic characteristics, medical history, current medicine, blood test, imaging findings and recurrence of ischemic strokes. Patients were divided into two groups: the recurrence group and the non-recurrence group. Chi-square test,logistic regression models were performed to assess correlations between baseline variables and recurrence of minor stroke events. Results In our study, 26 patients had recurrent minor ischemic stroke(32.5%). The prevalence of recurrence of minor stroke was positively correlated with hypertension(CI 0.265, P 0.018), SBP(CI 0.232,P 0.038), d-2-dimer(CI 0.232,P 0.048). Patients in recurrence group are more likely to presented with SBP elevation compared to non-recurrence group(χ²=6.919, P=0.031). Unconditional logistic regression analysis showed that hypertension, especially high SBP significantly related to minor ischemic stroke recurrence. Conclusion Hypertension,especially elevated SBP, were considered as an independent risk factors for aged old patients with minor ischemic stroke who received standardized secondary prevention.

目的 观察以“五物甘草生摩膏”为介质的膏摩法对小儿外感咳嗽的疗效及其社区应用价值。方法 90例符合纳入、诊断标准的患儿随机分观察组与对照组,观察组以“五物甘草生摩膏”为介质膏摩法干预;对照组服用玉屏风颗粒;疗程均为2个月,观察服药后1个月(治疗)以及停药后1年内(预防)的疗效。结果 不论是从近期疗效还是远期疗效观察,观察组的疗效更显著;观察组儿童外感咳嗽症状的发生率也明显低于对照组。结论 “五物甘草生摩膏”为介质的膏摩法对小儿外感咳嗽的疗效影响显著,值得在家庭和基层医疗机构中推广应用。

目的 探讨联合运用透明质酸钠及雌激素预防人工流产术后子宫内膜炎的临床疗效。方法 选择2015年1月—2015年6月在我院接受人工流产术者97例,随机分为观察组48例及对照组49例。对照组术后服用雌激素,观察组同时服用雌激素及透明质酸钠。于术后1周、3周时检测两组患者子宫内膜炎症状评分及宫颈分泌物炎症指标。结果 经过21天的干预之后,两组患者子宫内膜炎症状相比较,观察组患者下腹疼痛、白带增多及发热得分都低于观察组(P<0.05)。宫颈分泌物的CRP、IL-6、IL-9水平检测,术前两组患者之间差异不显著;治疗1周时,两组炎症因子水平均升高,但对照组变化更为明显;干预3周后,两组炎症因子水平较之1周时有所下降,但观察组基本降至正常水平,与对照组相比,差异有统计学意义(P<0.05)。结论 透明质酸钠联合雌激素预防人工流产术后子宫内膜炎效果明显,值得临床推广。

目的 探讨雷公藤甲素防治大鼠青光眼术后滤过泡纤维化的可行性。方法 选取Wistar大鼠100只分为两组,对照组和观察组各50例。采用房水释放联合激光房角光凝法建立青光眼大鼠模型,然后所有大鼠均进行青光眼手术。手术后,观察组大鼠使用雷公藤甲素预防治疗青光眼术后滤过泡纤维化,对照组大鼠使用5-氟尿嘧啶预防治疗青光眼术后滤过泡纤维化。观察比较防治滤过泡纤维化效果。结果 观察组大鼠的眼压在手术后第1天与对照组相比无差异(P＞0.05),在第6天、14天低于对照组(P＜0.05),观察组大鼠滤过泡面积在手术后第1天、6天、14天均小于对照组大鼠(P＜0.05);观察组大鼠的治疗后滤过泡分型Ⅰ型和Ⅱ型均优于对照组,Ⅲ型和Ⅳ型均低于对照组(P＜0.05);观察组术后不良反应发生率为12.16%,低于对照组22.86%(P＞0.05)。结论 雷公藤甲素防治大鼠青光眼术后滤过泡纤维化效果明显,且安全性较高,值得临床广泛运用推广。

Objective To investigate the feasibility of triptolide in prevention and cure rats glaucoma surgery fibrosis. Methods 100 cases of Wistar rats were divided into two groups, with 50 cases in the control group and the observation group.Glaucoma rat model were built by aqueous release combined with laser photocoagulation, and all rats underwent glaucoma surgery. After surgery, the rats in the observation group were observed their triptolide preventive treatment in glaucoma surgery fibrosis, the control rats were observed their 5-fluorouracil preventive treatment in glaucoma surgery fibrosis.The effects of prevention and treatment of bleb fibrosis were compared. Results The intraocular pressure of rats in observation group in the first day after surgery compared with the control group has no significant difference (P>0.05), on the 6th、 14th day it was lower than the control group rats(P<0.05). Filtration area in the observation group on first, 6th day, 14th days after surgery, was less than the control rats(P<0.05); In the observation group, the type Ⅰ and type Ⅱ of filtering bleb were better than those of the control group, the type Ⅲ and type Ⅳ were lower than those of the control group (P<0.05);The adverse reaction rate was 12.16% in observation group, it was lower than the control group 22.86% (P<0.05). Conclusion Triptolide in prevention and cure of rats glaucoma surgery fibrosis is obvious, and high security. It is worthy of promotion.

目的 研究地佐辛复合丙泊酚对腹式子宫切除术牵拉反应的预防作用。方法 选择择期行腹式子宫切除术患者60例(ASA I ~Ⅱ级),随机分成三组。所有患者给予腰麻,麻醉平面调节并固定于T₆后,给予A组患者0.1 mg/kg地佐辛,静脉注射;B组静脉注射0.1 mg/kg地佐辛后丙泊酚持续泵注2~4 mg/(kg·h);C组单次静注丙泊酚1.5 mg/kg后持续泵注2~4mg/(kg·h)。记录麻醉前(T₀)、腰麻平面固定后(T₁)、静注药物后5min(T₂)、切皮(T₃)、牵拉子宫时(T₄)、术毕(T₅)患者的HR、MAP及Ramesay镇静评分;评价肌松效果、牵拉反应、患者舒适度及满意度。结果 三组患者一般情况无差异(P＞0.05);与T₀相比,Ⅲ组T₂及T₅时刻MAP与T₀相比差异有统计学意义(P＜0.05),T₂、 T₃ 、T₄及T₅时刻HR与T₀相比差异有统计学意义(P＜0.05);与T₀相比,Ⅱ组及Ⅲ组Ramesay镇静评分在T₂、 T₃及T₄时刻均升高,差异有统计学意义(P＜0.05);Ⅱ组及Ⅲ组Ramesay镇静评分在T₂、T₃及T₄时刻高于I组,差异有统计学意义(P＜0.05)。牵拉反应评价I组评为优的患者个数明显少于II组及III组,评为良及差的患者个数多于II组及III组,此差异有统计学意义(P＜0.05);II组及III组舒适度及满意度评定为优的患者个数明显多余I组,差异有统计学意义(P＜0.05)。结论 0.1 mg/kg地佐辛复合丙泊酚可以很好预防腹式子宫切除手术中的牵拉反应,提高患者舒适度和满意度。

Objective To observe whether dezocine combined with propofol can prevent intra operative dragging reaction during hysterectomy or not. Methods Sixty patients(ASAⅠ~Ⅱ)which through hysterectomy surgery were randomly arranged to 3 groups. All the patients were under spinal anesthesia, adjusted the anesthesia plane to T6. Group l: dezocine 0.1 mg/kg were intravenous injected, Group ll: dezocine 0.1 mg/kg were intravenous injected and then propofol 2~4 mg/kg/h were intravenous pumped, Group lll: propofol 1.5 mg/kg were intravenous injected and then propofol 2~4 mg/kg/h intravenous were pumped. HR、MAP and Ramesay scale were recorded at the time points of pre-anesthesia(T₀)、pre-injection(T₁)、5 min after injection(T₂)、skin incision(T₃)、dragging uterus(T₄)、after surgery(T₅),the effect of muscle relaxation and the reaction of patients were recorded in the mean time, comfort degree and satisfaction degree of patients were evaluated after surgery. Results There was no significant difference of general condition between the three groups (P>0.05). At the time point of T₂ and T₅, MAP of Group lll patients were significant lower than the base value(P<0.05). At the time point of T₂、T₃、T₄ and T₅, HR of Group lll patients were significant lower then base value(P<0.05). Dragging reaction during the surgery were significant reduced in Group ll and Group lll but not in Group l(P<0.05). Group ll and Group lll patients felt more comfortable and more satisfied than Group l patients(P<0.05). Conclusion 0.1 mg/kg dezocine combined with propofol can prevent intra operative dragging reaction and make patient feel more comfortable during hysterectomy.

目的 探讨拉米夫定治疗对乙肝活动的肺结核病人抗结核治疗中的临床价值。方法 通过回顾性分析159例初治肺结核乙肝表面抗原(HBsAg)阳性、HBV-DNA定量阳性病人,所有病例在抗结核前查肝功能均正常,分为两组,治疗组:在抗结核及护肝治疗过程中,加用拉米夫定抗乙肝病毒治疗;对照组:没用任何抗乙肝病毒药物;分别在抗结核治疗前、治疗2周、4周及8周复查肝功能,对比两组间肝损发生率,及肝损发生时间及严重程度。抗结核治疗4周后复查HBV-DNA定量,对比两组间HBV-DNA定量下降例数。结果 治疗组的肝损发生率仅20.5%,对照组病人抗结核治疗后肝损的发生率为53.1%,两者间差异有统计学意义。治疗组肝损出现时间多为大于4周,而且多数是轻度肝损。治疗组出现肝损中断抗结核治疗的病例数低于对照组。抗乙肝病毒治疗后复查HBV-DNA定量降低例数高于对照组。结论 拉米夫定抗乙肝病毒治疗,能抑制乙肝病毒复制,降低乙肝合并肺结核病人的肝损发生率并减轻肝损严重程度,提高病人对抗结核药物的耐受性。

       无创正压通气的使用是患者发生鼻面部压力性损伤的重要原因之一，随着我国防控政策的放开，新增老年新冠感染患者急剧增加。文章对使用无创正压通气发生相关压力性损伤现状进行综述，介绍老年患者使用无创正压通气发生鼻面部压力性损伤的主要影响因素、评估方法以及预防措施现状，旨在为临床医务人员预防其相关压力性损伤提供参考。

       The use of non-invasive positive pressure ventilation is one of the important reasons for nasal and facial pressure injuries in patients．With the release of China's epidemic prevention policy，the number of new elderly patients with COVID-19 has increased dramatically．This paper summarizes the current situation of stress injuries caused by noninvasive positive pressure ventilation，introduces the main influencing factors，evaluation methods and prevention measures of nasal and facial stress injuries in elderly patients with noninvasive positive pressure ventilation，aiming to provide a reference for clinical medical personnel to prevent their related stress injuries．

       目的   探讨预防性风险管理在肌层浸润性膀胱癌根治术后的应用效果及对术后生活质量影响。方法   选取2020年6月—2023年10月安阳市肿瘤医院收治的66例肌层浸润性膀胱癌患者，应用抽签法分为观察组（n=33）与对照组（n=33）。所有患者均采取根治性全膀胱切除术与淋巴清扫术治疗，对照组患者术后实施常规护理，观察组在对照组基础上增加预防性风险管理。对比两组术后尿量、胃肠功能恢复时间、术后住院时间，干预前后病耻感及负面情绪、术后并发症发生率，最后对比两组干预前后生活质量变化。结果   两组患者术后尿量对比差异无统计学意义（P＞0.05），观察组术后胃肠功能恢复时间为（5.27±0.82）d，术后住院时间为（18.31±3.27）d，短于对照组的（7.25±1.12）（23.27±4.18）d，对比差异有统计学意义（t分别为8.194、5.369，P＜0.05）；干预后两组患者病耻感量表（SSCI）、抑郁自评量表（SDS）和焦虑自评量表（SAS）评分均降低，观察组分别为（35.67±7.45）（40.02±2.43）（45.36±4.17）分，低于对照组的（48.27±10.69）（54.54±3.54）（51.37±4.38）分，对比差异有统计学意义（t分别为5.555、19.426、5.709，P＜0.05）；观察组术后并发症发生率为9.09%，低于对照组的30.30%（χ ² =4.690，P=0.030）；干预后两组膀胱癌特异性模块、功能状况、精神状况、家庭/社会状况及躯体状况相关维度膀胱癌患者生活质量量表（FACT-BL）评分均升高，观察组分别为（34.27±3.26）（25.11±4.23）（21.51±4.23）（25.02±4.43）（20.56±3.11）分，高于对照组的（27.00±4.34）（21.11±3.24）（16.12±2.12）（21.54±5.54）（15.87±4.13）分，对比差异有统计学意义（t分别为7.694、4.313、6.544、2.818、5.211，P＜0.05）。结论   预防性风险管理在肌层浸润性膀胱癌根治术后的应用效果显著，可缩短患者术后胃肠功能恢复时间及住院时间，改善患者负面情绪，有助减少术后并发症，提升患者生活质量。

       Objective  To explore the effect of preventive risk management on postoperative application and quality of life of myometrial invasive bladder cancer patients after radical surgery．Methods  A total of 66 patients with myometrial invasive bladder cancer admitted to Anyang Cancer Hospital from June 2020 to October 2023 were selected as research objects，and were divided into observation group（n=33）and control group（n=33）by lot drawing．All patients were treated with  radical total cystectomy and lymph node dissection．The control group received routine nursing care after surgery，while the observation group received preventive risk management in addition to the control group．The postoperative urine output，recovery time of gastrointestinal function，and hospitalization time between two groups were compared，as well as the shame and negative emotions before and after intervention，the incidence of postoperative complications，and the changes in quality of life between the two groups before and after intervention．Results  There was no significant difference in postoperative urine volume between the two groups of patients（P＞0.05），and the postoperative gastrointestinal function recovery time（5.27±0.82）d，postoperative hospitalization time（18.31±3.27）d were shorter than the control group［（7.25±1.12）d，（23.27±4.18）d］，with statistical significantce（t=8.194，5.369，P＜0.05）．After intervention，the Stigma Scale of Chronic Illness（SSCI），Self Rating Depression Scale（SDS），and Self-Rating Anxiety Scale（SAS）in both groups of patients decreased，and the observation group［（35.67±7.45），（40.02±2.43），（45.36±4.17）］scored lower than the control group［（48.27±10.69），（54.54±3.54），（51.37±4.38）］，statistically significant（t=5.555，19.426，5.709，P＜0.05）．The incidence of postoperative complications in the observation group was significantly lower at 9.09% compared to the control group at 30.30%（χ ² =4.690，P=0.030，P＜0.05）．After intervention，the scores of bladder cancer specific module，functional status，mental status，family/social status and physical status  related dimensions of bladder cancer patients’ quality of life scale for bladder cancer patients（FACT-BL）in both groups increased，and the observation group［（34.27±3.26），（25.11±4.23），（21.51±4.23），（25.02±4.43），（20.56±3.11）］ scored higher than the control group［（27.00±4.34），（21.11±3.24），（16.12±2.12），（21.54±5.54），（15.87±4.13）］，the comparison was statistically significant（t=7.694，4.313，6.544，2.818，5.211，P＜0.05）．Conclusions  Preventive  risk management has a significant effect on the application of myometrial invasive bladder cancer after radical surgery，which can shorten the recovery time of gastrointestinal function and hospital stay，improve patients’ negative emotions，assist in preventing postoperative complications，and improve patients’ quality of life．

      目的   探讨在冠状动脉造影术后患者中应用风险防范护理干预对血管并发症的控制效果。方法   选择2022年1月—2023年6月于我院接受治疗的85例冠状动脉造影术后患者。按照随机数字表法分组，其中对照组42例给予常规护理干预，观察组43例给予风险防范护理干预，比较两组干预前后的心理状态、治疗依从性、血管并发症。结果   干预后，观察组正性情绪（PA）评分高于对照组PA评分（t=3.821，P＜0.001），观察组负性情绪（NA）评分低于对照组NA评分（t=5.380，P＜0.001）。与对照组比，观察组治疗依从性更好（Z=2.268，P=0.023）。观察组血管并发症总发生率低于对照组（9.30% vs 30.95%，χ ² =6.224，P=0.013）。结论   采用风险防范护理干预，能够改善冠状动脉造影术后患者的心理状态，提高治疗依从性，并降低血管并发症总发生率。

       Objective  To explore the effect of  risk prevention nursing intervention on controlling vascular complications in patients after coronary angiography．Methods  Eighty-five patients after coronary angiography in our hospital were selected from January 2022 to June 2023．They were grouped according to the random number table．And 42 cases were divided into the control group for routine nursing intervention，and 43 cases in the observation group were given risk prevention nursing intervention．Psychological status，treatment compliance and vascular complications of the two groups were observed．Results  After the intervention，the postive affect score of the observation group was higher than that of the control group（t=3.821，P＜0.001），and the negative affect score of the observation group（21.25±3.31）was lower than the score of the control group（25.35±3.70）（t=5.380，P＜0.001）．Compared with the control group the compliance of observation group was higher（Z=2.268，P=0.023）．The overall incidence of vascular complications in the observation group was lower than that in the control group（9.30% vs 30.95%，χ2=6.224，P=0.013）．Conclusions  Risk prevention nursing intervention can improve the psychological status of patients after coronary angiography，improve treatment compliance，and reduce the overall incidence of vascular complications．

       近几十年来，全球近视患病率不断上升，已成为全世界主要的公共卫生问题之一。众多研究表明户外活动能有效控制近视的发生和发展。本文综述了户外活动对近视防控作用的研究进展及其作用机制，以期为近视防控提供新的思路。

     In recent decades, the prevalence of myopia has been increasing globally, becoming one of the major public health issues worldwide. Numerous studies indicate that outdoor activities can effectively control the onset and progression of myopia. This article reviews the research progress on prevention and control effect and mechanism of outdoor activities on myopia, hoping to provide new insights for myopia prevention and control.