目的 探讨精神分裂症患者载脂蛋白E基因多态性与血清ApoE浓度、血脂、心血管疾病发生风险的相关性。方法 收集住院精神分裂症患者116例,记录一般资料和测定患者载脂蛋白E基因(APOE)、载脂蛋白E(ApoE)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、心血管疾病发生风险评分(Framingham risk score,FRS)等指标。结果 ①APOEε2、ε3、ε4不同等位基因组精神分裂症患者TC、载脂蛋白E、FRS评分差异有统计学意义(P=0.01,P=0.005,P=0.012)。②载脂蛋白E与TC、FRS评分存在负相关关系(r_s=-0.48,P=0.02;r_s=-0.52,P=0.04),APOE ε4等位基因组载脂蛋白E与TC、FRS评分存在更高的相关关系(r_s=-0.55,P<0.001;r_s=-0.63,P=0.04)。结论 精神分裂症患者ApoE基因多态性与载脂蛋白E、胆固醇、FRS评分存在关联,ApoE基因-载脂蛋白E-胆固醇代谢通路可能是精神分裂症患者心血管疾病的致病机制之一。

目的 从生物力学应力调控角度,探讨组织间质液压升高诱发肝纤维化的分子细胞机制。方法 人肝星状细胞随机分为3组,模型组:将其置于压力箱中施加恒定的高于大气压50 mmHg压力;实验组:加入ROCK抑制剂Y-27632(浓度10 μmol)置于与实验组相同条件;对照组:不加压置于相同培养箱中。应用RC-PCR检测其α-SMA、RhoA、ROCK mRNA的表达量,并应用免疫荧光染色分析其α-SMA、ROCK1、ROCK2蛋白表达情况。结果 间质液压变化对人肝星状细胞中α-SMAmRNA的表达量比对照组表达量增加,RhoA mRNA的表达先上升后下降,只对早期压力有变化,而 ROCK mRNA的表达量无明显变化。抑制剂组和压力组α-SMA 、ROCK1荧光强度较对照组增强,ROCK2荧光强度无明显变化,其中模型变化更显著。结论 细胞间质液压升高能通过RhoA/ROCK1信号通路引起肝星状细胞的活化。

目的 对比中成药镇痛活络酊和非甾体抗炎药(Nonsteroidal Anti-inflammatory Drugs,NSAIDs)治疗肱骨外上髁炎(lateral epicondylitis,LE)的短期临床疗效差异。方法 筛选后符合纳入标准的LE患者60例,随机分为镇痛活络酊组(n=30)和NSAIDs组(n=30)。镇痛活络酊组外用镇痛活络酊,NSAIDs组外用法斯通凝胶(酮洛芬),两组均连续用药3周,3次/d。用药后3 周、6 周和12 周连续随访,主要观测指标包括视觉模拟评分(visual analog scale,VAS);肩、肘和手的功能评分(Disabilities of the arm, Shoulder And Hand,DASH);无痛握力(Pain-free grip strength,PFGS)。VAS评分分别测量患者1周前用力活动时的VAS评分和正常休息时的VAS评分,记为VAS(活动时)和VAS(休息时)。运用统计学方法对比分析两组患者在VAS评分(活动时)、VAS评分(休息时)、DASH评分和PFGS上的差异。结果 两组患者在VAS评分(活动时)、VAS评分(休息时)和DASH评分上均未见组间差异(P>0.05)。两组患者在用药前、用药后3周、用药后6周的PGFS对比同样无组间差异(P=0.91,P=0.42,P=0.13)。但是,在用药后12周,镇痛活络酊组的PFGS高于NSAIDs组(P=0.02)。结论 镇痛活络酊缓解LE疼痛的效果与外用NSAIDs相当,对提升伸肌力效果则更优。

Objective To compare the short-term clinical effects difference between analgesic tincture and topical nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment of lateral epicondylitis (LE). Methods 60 cases of LE patients were randomly divided into an analgesic tincture group (n=30) and a NSAIDs group (n=30). Analgesic tincture was chosen for the analgesic tincture group and topical ketoprofen gel for the NSAIDs group to treat LE. Two groups were treated continuously for 3w, 3 times/day. Clinical results of each drug were followed-up at the time point of 3w, 6w and 12w after usage. Observational indexes included the visual analogue scale (VAS), disabilities of the arm, shoulder and hand questionnaire (DASH) and pain-free grip strength (PFGS). The inter-group difference of VAS (at activity), VAS (at rest), DASH score and PFGS were compared subsequently. Results No difference of the VAS (at activity), VAS (at rest), DASH score were ascertained (P> 0.05) between groups. Inter-group difference of PGFS was also not discerned at the time points of pre-treatment and 3 weeks and 6 weeks (P=0.91, P=0.42, P=0.13) post-treatment. However, PFGS of the analgesic tincture group was found to be higher than that of the NSAIDs group (P=0.02) after 12 weeks post-treatment. Conclusion Effect of analgesic tincture in releasing pain is almost the same to that of tropical NSAIDs, but a better effect in improving muscle strength.

目的 分析AngioJet血栓抽吸联合髂静脉支架在下肢深静脉血栓合并髂静脉压迫的临床疗效。方法 2016年1月—2019年6月在揭阳市人民医院普外一科收治的首发髂股DVT并在AngioJet吸栓或联合导管溶栓后置入支架的患者,比较吸栓后直接支架置入和溶栓再分期支架置入的治疗效果。结果 本研究共纳入50例接受支架手术的DVT患者,其中治疗组29例,分期置入组21例。治疗组临床症状缓解率和住院时间优于对照组,差异有统计学意义(P＜0.05),且出血风险更低。 而置入支架长度和直径无差异,治疗组的3个月、6个月和12个月的通畅率、静脉返流时间和 Villalta评分均无差异(P＞0.05)。结论 AngioJet血栓清除后直接支架置入术是治疗合并髂静脉压迫的下肢深静脉血栓的有效方法,临床改善更快,住院时间显著缩短。

Objective To analyze the clinical effect of AngioJet thrombus aspiration combined with iliac vein stent in deep vein thrombosis of the lower extremity with iliac vein compression. Methods From January 2016 to June 2019, patients with first iliofemoral DVT and stent implantation after AngioJet thrombolysis or combined catheter thrombolysis were treated in the first department of general surgery, Jieyang People's Hospital. The therapeutic effects of direct stent implantation and stent implantation after thrombolysis were compared. Results A total of 50 patients with DVT who underwent stent surgery were included in this study, including 29 in the treatment group and 21 in the staging group. The clinical symptom relief rate and length of stay in the treatment group were better than those in the control group, the difference was statistically significant (P<0.05), and the risk of bleeding was lower. There was no significant difference in stent length and diameter. There were no significant differences in patency rate, venous reflux time, and Villalta score in the treatment group at 3 months, 6 months, and 12 months (P>0.05). Conclusion Direct stent placement after AngioJet thrombectomy is an effective method for treating deep venous thrombosis of lower limbs with iliac vein compression. The clinical improvement is faster and the length of hospital stay is significantly shortened.

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 探究分析基于互联网平台的健康管理模式对2型糖尿病患者血糖管理的效果及其临床价值。方法 选择2018年3月—2019年3月期间到我院进行治疗的120例2型糖尿病患者作为研究对象,用电脑随机法分为对照组和实验组各60例,对照组患者对其进行常规的护理干预,实验组患者给予基于互联网平台的健康管理模式,测试他们接受护理管理前后的血糖情况,邀请所有患者填写焦虑、抑郁自评量表评分并比较两组患者的心理状态评分,比较两组患者的生活质量和护理满意度。分析它们的护理要点及其结果。结果 实验组患者的护理后的血糖低于对照组;实验组患者焦虑自评量表(SAS)、抑郁自评量(SDS)表得分分别为(45.2±4.3)分和(42.8±6.3)分,这两个表均低于对照组的(56.3±7.5)分、(58.1±3.9)分;实验组患者的生活质量高于对照组;护理满意度高于对照组,差异有统计学意义(P＜0.05)。结论 应用基于互联网平台的健康管理模式有利于提高糖尿病患者血糖控制效果,对改善患者负面情绪、提高其生活质量及维持良好的护患关系也具有积极意义。

Objective To explore the effect and clinical value of health management model based on internet platform on blood glucose management in patients with type 2 diabetes(T2DM). Methods 120 patients with T2DM who came to our hospital for treatment from March 2018 to March 2019 were selected and they were randomly divided into the control group and the experimental group with 60 cases each. The patients in the control group were given routine nursing intervention. The patients in the experimental group were given health management mode based on the internet platform to test their blood glucose before and after receiving nursing management. All patients were invited to filled in the self-rating anxiety scale (SAS) and self-rating depression scale (SDS).The blood glucose level, the psychological state, the self-rating scales and nursing points in the two groups were investigated and compared after intervention. Results The blood glucose of the experimental group was lower than that of the control group, the scores of SAS and SDS were (45.2 ± 4.3) (42.8 ± 6.3) respectively, both of which were lower than those of the control group (56.3 ± 7.5) and (58.1 ± 3.9); the quality of life of patients in the experimental group was higher than that in the control group; nursing satisfaction was higher than that in the control group, the difference was statistically significant (P<0.05). Conclusion The application of health management model based on internet platform is conducive to improving the effect of blood glucose control in diabetes patients, relieving their negative emotions, improving their quality of life and maintaining a good nurse-patient relationship.

目的 探讨实习前护理知识技能评价与实习教学目标相结合的临床护理实习培训效果。方法 选择2018年在我科实习的护理本科实习生40名为对照组,采取传统的带班实习带教方法进行临床带教;2019年在我科实习的40名护理本科实习生为实验组,对实习生在实习前进行护理知识和护理操作能力评估,根据实习生专业知识与护理技术的评估结果,结合实习教学目标进行针对性的临床带教;实习结束对两组同学掌握的护理理论知识、护理操作技术、服务满意度进行评价。结果 实验组掌握的护理知识、护理操作技术得分均高于对照组,两组结果比较差异有统计学意义(P<0.001);服务满意度评价实验组高于对照组,两组结果比较差异有统计学意义(P<0.05);结论 开展实习前护理专业能力评价与教学目标相结合的护理临床实习培训模式管理,有助于带教老师掌握实习生存在的护理知识缺乏和护理技术薄弱问题,利于带教老师制定合理的实习带教计划和带教重点,提高学生临床实习效果和老师的带教质量。

Objective To explore the effect of clinical nursing practice training combined with the evaluation of nursing knowledge and skills and teaching objectives before practice. Methods 40 nursing undergraduates who practiced in our department in 2018 were selected as the control group, and the traditional method of clinical teaching was adopted; 40 nursing undergraduates who practiced in 2019 were selected as the experimental group to evaluate the nursing knowledge and nursing operation ability of the interns before the practice, according to the evaluation results of professional knowledge and nursing technology of the interns, combined with the practice teaching at the end of the internship. The students in the two groups were evaluated on their theoretical knowledge, nursing operation technology and service satisfaction. Results The scores of nursing knowledge and nursing operation technology in the experimental group were higher than those in the control group, and the results of the two groups were statistically significance (P<0.001); the evaluation of service satisfaction in the experimental group was higher than that in the control group, and the results of the two groups were statistically significance (P<0.05); Conclusion To carry out the management of nursing clinical practice training mode combining the evaluation of nursing professional ability with teaching objectives before practice is helpful for the teachers to find out problems of lack of nursing knowledge and weak nursing technology existing in the interns. It helps the teachers to formulate reasonable practice teaching plan and key points, and improves the effect of students' clinical practice and the quality of teaching.

目的 调查口腔专科医院门诊不同层级护士急救能力的现状,进一步探讨优化口腔门诊护士急救培训模式。方法 选取2019年1月—2020年1月我院口腔门诊护士97名,采用自设问卷调查及现场操作技能评估对护士进行考核,调查护士的急救能力。结果 口腔科门诊不同层级护士的急救能力(包括相关知识与操作能力)差异有统计学意义(P＜0.05)。其中,N1级(工作1~＜3年)的护理人员急救能力低于N2级(工作3~5年)的护理人员。N3级(工作6~10年)的急救知识考核分、操作考核分略低于工作N2级护士,但差异无统计学意义。而不同年龄、学历、职称、科室的护士急救能力的差异无统计学意义。结论 口腔门诊护士急救培训应分层级进行,特别应加强N1级以下护理人员的急救技能培训,保证护士急救培训效果同质化,对口腔门诊诊疗中提高医疗安全及护理质量具有重要意义。

Objective To investigate the current status of the first-aid ability of nurses at different levels in outpatient clinics of stomatological hospitals, and to further explore the optimization of the training model of first-aid nurses in outpatient clinics. Methods A total of 97 nurses in our outpatient clinic from January 2019 to January 2020 were selected. The nurses were assessed by self-designed questionnaire surveys and on-site operation skills assessment to investigate the nurses' first aid ability. Results The difference in first aid ability (including relevant knowledge and operation ability) of nurses at different levels in the dental clinic was statistically significant (P<0.05). Among them, the first-aid ability of nursing staff of N1 grade (working 1 ~<3 years) is lower than that of nursing staff of N2 grade (working 3 ~ 5 years). The N3 level (working 6～10 years) first aid knowledge assessment and operation assessment scores are slightly lower than those of working N2 nurses, but the difference is not statistically significant. There was no statistically significant difference in the first aid ability in nurses of different ages, educational backgrounds, titles, and departments. Conclusion The first-aid training of nurses in oral clinics should be conducted in different levels, especially the first-aid skills training of nurses below N1 level. We should be strengthened to ensure the homogenization of nurse's first-aid training effect, which is of great significance to improve medical safety and quality of care in oral clinics.

目的 观察综合健康教育在门诊长期肌注黄体酮患者的应用效果。方法 选取2018年10月—2019年6月在本院门诊中心注射室进行黄体酮注射的先兆流产患者319例,按患者来门诊的注射顺序,采用随机分组方法,单数位为对照组,双数位为干预组。干预组在肌注黄体酮时实行综合健康教育,而对照组则进行基本指导。注射1个月后观察效果。结果 干预组发生硬结例数77例(48.4%),对照组147例(91.9%);而疼痛程度方面干预组为(1.34±2.125)分,而对照组则为(4.51±2.400)分;干预组的满意度平均分为(9.60±0.975)分,而对照组为(6.65±1.603)分,差异均有统计学意义(P<0.01)。结论 对门诊长期肌注黄体酮患者实行综合健康教育有助于减轻患者疼痛、降低硬结发生率,促进药物疗效,提高患者满意度。

Objective To observe the effect of comprehensive health education on outpatients with long-term intramuscular injection of progesterone. Methods 319 patients were enrolled from October 2018 to June 2019, and were divided into the observation group and control group according to the sequence of patients coming to the outpatient clinic. Comprehensive health education was applied in the intervention group, and general basic education was applied in the control group. Results There were 77 cases (48.4%) of callosity in the intervention group, 147 cases (91.9%) in the control group. In pain degree scores of (1.34±2.125) were in the intervention group, (4.51±2.400) in the control group. In degree of satisfaction, (9.60±0.975) were in the intervention group, and (6.65±1.603) in the control group, with statistically significant difference (P<0.01). Conclusion Comprehensive health education may alleviate pain and callosity in patients with long-term intramuscular injection of progesterone.

目的 开展卫生应急演练并总结经验,探讨演练在提高新发传染病应急处置能力中的作用。方法 以桌面演练和功能性演练为手段,在广州某三甲医疗机构开展演练活动,并对演练效果进行评价。结果 全院共51个科室开展新发传染病防控卫生应急演练,全院演练平均得分4.87。演练为新发传染病应急处置积累了实战经验,达到了锻炼队伍、提高能力的作用。结论 卫生应急演练是检验和提高新发传染病应急处置水平的重要手段,医疗机构通过推进演练活动的制度化、规范化和常态化,可促进新发传染病应急处置工作能力提升。

Objective To carry out health emergency exercises and summarize experiences, and to explore the role of exercises in improving emergency response capabilities for emerging infectious diseases. Methods Using tabletop exercises and functional exercises as means, the exercises were conducted in a tertiary class healthcare facilitie in Guangzhou, and the effects of the exercises were evaluated. Results A total of 51 departments in the hospital conducted health emergency exercises for the prevention and control of emerging infectious diseases, and the average score of the exercises was 4.87. The exercises accumulated actual combat experience for emergency treatment of emerging infectious diseases, and achieved the effect of training the team and improving the capabilities. Conclusion Health emergency exercise is an important mean to test and improve the emergency response capability of emerging infectious diseases. Healthcare facilities can promote the improvement of emergency response capabilities of emerging infectious diseases by promoting the institutionalization, standardization and normalization of exercise activities.