目的 分析基于中医针灸的康复训练对小儿脑瘫的临床疗效。方法 选择我院2016年2月—2017年3月接受治疗的脑瘫患儿88例,根据患儿入院接受疗法不同分为研究组(n=45)和对照组(n=43)。对照组给予康复训练治疗,研究组给予康复训练联合中医针灸治疗。比较两组患者治疗3个月后的临床效果,以及治疗前后粗大运动功能、生活质量评分变化。结果 治疗3个月后,研究组总有效率95.56 %明显高于对照组69.76 %(P<0.05);两组患儿粗大运动功能、生活质量、认知功能及自理动作评分均有提高,但研究组以上指标评分明显高于对照组(P<0.05)。结论 基于康复训练联合针灸干预脑瘫患儿可改善患儿粗大运动功能,提高患儿生活质量,效果显著。

目的 探究以临床护理路径为主的健康教育在二胎异位妊娠患者中的应用效果。方法 选取2016年1月—2017年6月收治的80例二胎异位妊娠患者,随机分为实验组40例和对照组40例,实验组:实施以临床护理路径为主的健康教育,对照组以常规指导,比较两组临床效果。结果 实验组患者在健康教育知晓率、护理满意率方面与对照组比较,有差异(P<0.05);实验组在住院时间、住院费用及并发症发生率方面与对照组比较(P<0.05),观察组焦虑评分与抑郁评分均低于对照组(P<0.05)。结论 二胎异位妊娠患者运用临床护理路径进行健康教育,可有效提高患者对于异位妊娠疾病的了解程度,提高治疗护理依从性,促进患者早日康复出院,提高护理满意度,值得推广普及。

Objective To study the effect of applying clinical nursing pathway on health education of second womb ectopic pregnancy and explore more effective health education modes. Methods 80 patients with second-trimester ectopic pregnancy were randomly divided into experimental group (40 cases) and control group (40 cases). The experimental group was given health education through clinical nursing pathway. The control group was given routine guidance. We compared the effects of health education in two groups. Results 40 patients in the experimental group were compared with the 40 patients in the control group in terms of awareness rate of health education and satisfaction rate of care, P<0.05; the experimental group was compared with the control group in terms of length of stay, hospitalization costs, and complication rate, P<0.05 The anxiety scores and depression scores in the observation group were lower than those in the control group, P<0.05. There was a statistical difference between the two groups. Conclusions Applying clinical nursing pathway on health education of second womb ectopic pregnancy patients may effectively improve patients' understanding of ectopic pregnancy diseases, improve compliance of nursing care, facilitate patients to be discharged and improve satisfaction of nursing satisfaction, clinical care services in the popularization.

目的 对临床护士实施预防住院患者误吸教育干预,评价干预措施对护士预防误吸知识及护理行为的影响。方法 选取我院神经系统相关科室的110名护士为研究对象,通过一系列教育干预,对比干预前后护士在预防误吸知识及护理行为等方面的改变,评估干预措施的效果。结果 110名护士均对培训满意;培训前护士预防误吸知识的平均得分为(65.6±9.6)分,培训后平均得分为(92.5±6.5)分,培训前后得分的差异有统计学意义(P<0.05)。培训后89份(89%)跟踪调查卷明确表示护士在工作中运用了培训所学的知识。结论 对护士进行有组织、有计划的教育干预能提高护士预防与处理患者误吸的知识水平,并能对护士预防和处理患者误吸的行为产生积极影响。

Objective To evaluate the effect of educating nurses on how to prevent and reduce aspiration rate of patients. Methods 110 nurses were recruited from neurological department in our hospital and were trained systematically about the prevention and nursing of aspiration. We compared the scores they had before and after training. Results 110 nurses were all satisfied with the training. The pre-education test score about the aspiration knowledge was 65.6±9.6 while the post-education test score was 92.5±6.5. The difference of the score before and after training was statistically significant difference (P<0.05). The follow-up study indicated that 89% nurses are applying the knowledge gained from the training to their clinical work. Conclusion It's suggested that well-organized educational training may improve nurses' performance of preventing patients from aspiration and treating patients when they had aspiration, which left a positive effect on nurses' behavior.

目的 探讨拔岗晋级结合激励机制在护士岗位管理的实践和体会。方法 在护士岗位管理中运用拔岗晋级结合激励机制,收集实施岗位管理前后1年护士满意度、患者满意度、护士职业获益感、护士职业投入、离职率资料,进行统计学分析。结果 实施后护士满意度、患者满意度、护士职业获益感、护士职业投入较实施前提高(P<0.05),离职率下降(P<0.05),差异有统计学意义。结论 建立在拔岗晋级及激励机制上的护士岗位管理能提高护士满意度,降低护士离职率,稳定护士队伍,能够提高护士职业获益感、护士职业投入,从而提高护士工作的主观能动性和工作积极性,为高质量护理服务和优质护理服务长效机制的建立奠定了基础,促进优质护理服务的可持续发展,提高护理管理效能。

Objective To explore the application and experience of job promotion combing with excitation mechanism in nurses position management. Methods We used job promotion combing with excitation mechanism in nurses position management to compare the satisfaction rate, perceived career benefit, work engagement and separation rate of nurses. Results After the application, the satisfaction rate, perceived career benefit and work engagement of nurses were increased, while separation rate of nurses was decreased(P<0.05), the difference has statistical significance. Conclusion The application may increase the satisfaction rate, perceived career benefit and work engagement of nurses, and decrease the separation rate of nurses, elevate the subjective initiative and work enthusiasm. Nursing quality is improved continuously. The management efficacy is promoted.

目的 分析超声检查前准备质量评价对超声检查效果的影响。方法 对进行泌尿科B超检查150例患者按数字表法随机分为对照组和实验组各75例,两组患者发放超声检查须知,按检查准备要求按预约时间前来完成超声检查;实验组在检查前对患者准备效果进行评价,及时落实检查须知事项。结果 检查前准备知识知晓、检查前准备质量、按时检查率对照组低于实验组(P＜0.05);检查前准备依从性、服务满意度对照组低于实验组(P＜0.05)。结论 开展检查前准备质量评价能促进患者落实超声检查前准备,提高准备依从性和准备知识知晓率,缩短检查等候时间,提高检查前准备质量和患者服务满意度。

Objective To analyze the influence of pre-preparation quality evaluation on the effect of ultrasound examination. Methods According to the digital table method, 150 patients were randomly divided into the control group and the experimental group, 75 cases in the control group and the experimental group each. The two groups were taken the ultrasound examination, and the ultrasound examination was completed according to the preparation requirements. The patients in the experimental group were evaluated before the examination, and the inspection notes were timely implemented. Results Knowledge of pre preparation, preparation quality before examination, and rate of check on time were lower in the control group than that in the experimental group(P<0.05). The control group was lower than the experimental group(P<0.05). Conclusion The preparation quality evaluation before examination may promote the patient's preparation before the ultrasonic examination, improve the preparation compliance and knowledge awareness, shorten the waiting time, and improve the quality of preparation and the satisfaction of patient service.

目的 探讨孕妇学校改革创新后,孕妇对孕妇学校授课的效果和满意度及影响因素分析。方法 2016年8月—2017年6月,通过师资授课比赛、课后孕妇满意度、对相关知识知晓率排名相结合方式竞争产生孕妇学校授课师资队伍,随机选取部分听课孕妇作为调查对象。结果 授课后,孕妇对相关知识的知晓得分提高约20分(P＜0.05),孕妇对核心知识点知晓率提高明显(P＜0.05),孕妇对课程讲授效果各方面满意度均在94%以上。对课程不满意的维度主要有授课PPT制作、教学计划、授课形式等,不满意比例分别为19.1%、18.0%和16.3%。对课程不满意组孕妇较满意组孕妇年龄偏大(P＜0.05),其余孕妇基本特征差异无统计学意义。结论 孕妇学校师资改革成效明显,行之有效,值得推广。

Objective To explore the effect of pregnant women's school after reform and innovation. Methods FromAugust 2016 to June 2017, teachers of pregnant women's school were produced by teaching competition and pregnant women's satisfaction and degree of knowledge. Survey objects were randomly selected. Results After teaching, knowledge degree of pregnant women improved about 20 points (P<0.05). The awareness rate of pregnant women on core knowledge points increased (P<0.05). Satisfaction degree of pregnant women on the course was over 94%. The main dimensions of dissatisfaction with the course included PPT production, teaching plan and teaching form. The proportions of dissatisfaction were 19.1%, 18.0% and 16.3% respectively. Unsatisfied women ages were older than satisfied women (P<0.05). Conclusion Reform and innovation is effective, and it is worth promoting.

目的 通过对未进行过商业基因检测(NCGT)社区居民和直接面向消费者的基因测试(DCGT)消费群体的调查,分析市场基因测试产品的消费构成和消费者社会特征与基因检测消费的相关因素。方法 采用分层随机抽样方法对广州市居民和直接面向消费者的基因检测非患者居民进行面访式调查,采用Logistics回归分析商业基因测试的相关社会学因素。结果 NCGT社区居民中其家庭成员进行过胎儿产前筛查基因检测的比例(26.3%)较高、DCGT人群因常规健康体检包含基因检测项目而进行基因测试的比例(44.8%)最高,儿童天赋基因的测试比例(23.3%)也相对较高,两个群体均认为基因检测的目的主要是预防疾病,信任的检测机构为医院。DCGT行为相关的社会学特征有婚姻(已婚vs未婚:OR=5.591,P<0.001)、学历(专科以上vs专科及以下:OR=0.071,P<0.001)、年龄(30～49岁组vs其他组:OR=0.223,P<0.001)、工作(全职vs其他:OR=4.660,P<0.001)、公费医疗(OR=1.183,P=0.021)和商业保险(OR=2.121,P=0.004)。结论 公众将基因测试看成是预防疾病和控制遗传性疾病的公共卫生手段,需要在医院将基因检测和个性化治疗对应起来。

Objective By investigating consumer groups that have no-commercial genetic testing (NCGT) community residents and direct-to-consumers genetic testing (DCGT), to analysze the consumer composition of market genetic testing products and the factors related to consumer social characteristics. Methods A stratified random sampling method was used to conduct a face-to-face survey of residents and non-patients of genetic testing in Guangzhou residents. The logistic regression analysis was used to analyze the sociological factors of commercial genetic testing. Results The proportion of children in the NCGT community who had prenatal screening for prenatal screening (26.3%) was higher, and the proportion of DCGT populations that were genetically tested for routine health checkups containing genetic testing (44.8%) was the highest. The proportion of test genes (23.3%) is also relatively high. Both groups believe that the purpose of genetic testing is mainly to prevent diseases, and the testing institutions for their trust are hospitals. The sociological characteristics associated with DCGT behavior are marriage (married vs unmarried: OR=5.591, P<0.001), education (specialist vs. specialist and below: OR=0.071, P<0.001), age (30~49 years vs others, OR=0.223, P<0.001), work (full-time vs other: OR=4.660, P<0.001), public medical care (OR=1.183, P=0.021) and commercial insurance (OR=2.121, P=0.004). Conclusion The public regards genetic testing as a public health tool for preventing diseases and controlling hereditary diseases, and it is necessary to correlate genetic testing with personalized treatment in hospitals.

目的 探讨结肠原发性腺鳞癌和鳞癌的临床病理特征、诊断、发病机制及预后。方法 分析2例结肠原发性腺鳞癌和鳞癌的临床特点、组织学、免疫组化及基因检测特点,并结合相关文献进行讨论。结果 2例患者均因右下腹隐痛入院,平均年龄69岁,肿瘤均位于右半结肠。腺鳞癌可见腺鳞两种成分随机混合在一起,鳞癌成分免疫组化结果示CK5/6,P63均阳性,基因检测结果(ARMS-PCR法):腺鳞癌KRAS 2号外显子突变,BRAF未突变,鳞癌KRAS和BRAF均未突变。腺鳞癌患者术后放弃治疗1个月后死亡,鳞癌患者5个月后死于肝转移。结论 结肠原发性腺鳞癌/鳞癌非常少见,其临床症状与腺癌相似,但临床过程却更具侵袭性,预后相对较差,所以在临床中需得到重视。

Objective To study the clinicopathologic features, diagnosis, pathogenesis and prognosis of primary colon adenosquamous carcinoma and squamous cell carcinoma. Methods We analyzed clinical features, histological morphology, immunohistochemical results and gene mutation. Besides, relevant literatures were also reviewed. Results The two patients with an average of 69 years were admitted to the hospital due to abnormal pain. The tumors were all located in the right hemicolon. Adenosquamous carcinoma contained both components that mixed haphazardly. Immunohistochemistry showed that both CK5/6 and P63 were positive in squamous cell carcinoma. KRAS exon 2 mutations and BRAF wide-type were found in adenosquamous carcinoma patient, while KRAS and BRAF wide-type were found in squamous cell carcinoma patient using ARMS-PCR method. Adenosquamous carcinoma patient abandoned treatment and died after one month and the other died of liver metastasis in five months after surgery. Conclusion Primary colon adenosquamous carcinoma and squamous cell carcinoma are very rare. They have the similar clinical symptoms, more invasive clinical processes and worse prognosis compared with adenocarcinoma, therefore should be valued in clinic.

目的 探讨乳腺癌原发病灶超声声像图特点及病理分子分型与腋窝淋巴结转移的相关性。方法 回顾性分析106例接受乳腺超声检查及腋窝淋巴结活检,病理确诊为乳腺癌的患者资料。超声观察乳腺癌原发病灶的位置、大小、有无钙化、纵横比、内部血流、腋窝淋巴结声像图特点,结合临床病理学特点,分析与腋窝淋巴结转移相关的因素。结果 超声诊断未见明显异常的腋窝淋巴结75例,可疑的腋窝淋巴结31例;病理证实腋窝淋巴结未转移70例,转移36例。灵敏度66.7%、特异度90%、阳性预测值77.4%、阴性预测值84%。单因素分析显示原发肿块的位置、最大径、腋窝淋巴结淋巴门消失、ER表达与腋窝淋巴结转移有关(P<0.05 )。多因素分析显示原发肿块的位置、腋窝淋巴结淋巴门消失与腋窝淋巴结转移有关(P<0.05)。结论 腋窝淋巴结常规超声检查结合乳腺癌原发病灶超声声像图及病理分子分型有助于评估腋窝淋巴结状态。

Objective To analyse the ultrasonographic features and pathological molecular typing of the primary lesions and axillary lymph node (ALN) of breast cancer related to axillary lymph node metasta-sis(ALNM). Methods The Grey-scale and color Doppler ultrasound and axillary lymph node biopsy were performed in 106 patients with breastcarcinomas. The observed features included the position,the most dimen-sion,inner calcification,aspect ratio,the type of blood supply of the primary tumor and axillary lymph node image. Combining with the clinicopathological features, we analyzed the factors associated with axillary lymph node metastasis. Results Ultrasound found normal axillary lymphnodes in 70 patients and abnormal in 31 patients. Pathology confirmed axillary lymph node metastasis in 36 patients, and no metastasis in 70 patients.The sensitivity, specificity, positive predictive value, negative predictive value were 66.7%, 90%, 77.4% and 84% r-espectively.Univariate analysis showed that the location, maximum diameter, lymphnode with disappearance hilus and ER expression were related to axillary lymph node metastasis (P< 0.05). Multivariate analysis showed that the location of primary mass and lymph node with disappearance hilus were related to axillary lymph node metastasis (P< 0.05). Conclusion Axillary lymph node routine ultrasound examination combined with ultrasonographic and pathological molecular typing of primary breast cancer is helpful to evaluate axillary lymph node status.

目的 探讨肺结核合并肺癌患者的CT影像特征,为临床疾病诊断提供参考依据。方法 选取2015年—2018年我院收治的肺结核合并肺癌患者50例作为观察组,另选取同期于我院治疗的单纯肺结核患者50例为对照组。观察两组患者临床症状及CT影像表现并作出对比分析。结果 两组患者临床症状及体征相比,差异无统计学意义(P>0.05);观察组患者分叶征、毛刺状结节比例高于对照组患者,差异有统计学意义(P<0.01),观察组患者实质内空洞比例低于对照组患者,差异有统计学意义(P＜0.01),两组患者肿物及条索影发生比例相比差异无统计学意义(P>0.05)。结论 肺结核合并肺癌患者的CT影像学特征主要在分叶征、毛刺状结节和空洞症,临床应根据这些特征并结合其他检查进行定性诊断。

Objective To investigate the CT images of patients with pulmonary tuberculosis complicated with lung cancer and provide reference for the diagnose. Methods 50 cases of pulmonary tuberculosis and lung cancer treated in our hospital in 2015~2018 in January were selected as observation group, and 50 cases of simple pulmonary tuberculosis treated in our hospital for the same period were selected as control group. The clinical symptoms and CT imaging findings of the two groups were observed and compared. Results There was no significant difference in clinical symptoms and signs between the two groups (P>0.05), and the proportion of lobular sign and burr nodular nodules in the observation group was higher than that of the control group (P<0.01), and the proportion of parenchymal cavities in the observation group was lower than that of the control group (P<0.01). There was no significant difference between the two groups in the incidence of tumor and streak shadow (P>0.05). Conclusion The CT imaging features of patients with pulmonary tuberculosis and lung cancer are mainly lobular sign, burr like nodules and cavities, which should be qualitatively diagnosed according to these features combined with other tests.