优质护理在预防ICU脑出血患者肺部感染中的应用效果观察

目的:观察给予ICU脑出血患者优质护理干预预防肺部感染发生的临床效果。方法:选取160位曾经于2016年5月～2017年5月来某院ICU进行过治疗的脑出血患者,并按照入院的顺序将他们依次编号,从0～160号,试验组人员为单号,对照组人员为双号,采用常规的护理方法护理对照组人员,采用优质干预护理的方式护理试验组人员,对比两组人员肺部感染几率。结果:两组患者在经过不同的护理方法护理后,试验组患者的肺部感染率(3.75%)、住院时间(17.89±3.45)d以及死亡率(2.50%)都低于对照组患者,差异具有统计学意义(P0.05)。结论:实施优质护理干预能够有效抑制ICU脑出血患者肺部感染的发生,降低患者的死亡率,具有临床应用的意义。     

集束化护理预防人工气道患者肺部感染的研究

目的探讨集束化护理预防人工气道患者肺部感染的效果。方法在ICU病房选择建立人工气道患者116例,随机分为实验组和对照组各58例,实验组在常规护理的基础上给予集束化综合护理干预,对照组仅给予常规护理。比较两组患者住院期间肺部感染的发生率及住ICU时间。结果与对照组相比,实验组肺部感染发生率明显下降,住ICU时间缩短,差异均有统计学意义(P<0.05)。结论对ICU建立人工气道患者进行集束化护理干预,能有效预防肺部感染的发生。     

护理干预对ICU脑出血患者预防肺部感染的效果观察

目的观察护理干预对ICU脑出血患者预防肺部感染的效果。方法选择入住ICU未并发肺部感染的脑出血患者120例,随机分为护理干预组和对照组,各60例,对照组按常规护理,护理干预组按《护理干预方案》护理。结果护理干预组患者肺部感染率明显低于对照组(P<0.01),住院时间和伤口感染明显低于对照组(均P<0.05),其他观察指标虽然差异无显著性(P>0.05),但实际数字均小于对照组,因数字太小,导致统计学误差增大有关。结论系统性护理干预能够有效减少ICU患者的肺部感染率,减少病死率,缩短住院时间,降低不良情况发生率。     

层级护理模式应用于ICU重症肺炎患者的护理价值评价

目的探究对ICU重症肺炎患者实施层级护理模式的效果。方法以2016年2月13日至2018年1月21日我院88例ICU重症肺炎患者作为观察对象,随机将88例患者分为实验组(44例,应用层级护理模式)、对照组(44例,应用基础护理)。研究对比实验组和对照组患者的感染发生率、住院时间及满意度评分。结果实验组患者感染发生率(4.55%)相比对照组(22.73%)明显更低,P <0.05;实验组患者住院时间[(5.24±1.23)d]相比对照组[(8.37±1.32)d]明显更短,P <0.05,且满意度评分[(87.27±3.25)分]相比对照组[(80.20±2.23)分]明显更高,P <0.05。结论对ICU重症肺炎患者实施层级护理模式的效果更佳。     

结构化护理干预对ICU颅脑损伤患者肺部感染的预防作用探讨

目的:探讨在重症监护室(ICU)颅脑损伤患者中采用结构化护理干预对肺部感染的预防效果。方法:选择2015年1月至2017年12月商丘市第一人民医院ICU收治颅脑损伤患者60例,随机将其分为观察组与对照组,每组各30例。观察组采用结构化护理干预,对照组采用常规护理干预。比较两组肺部感染率、死亡率、并发症与住院时间。结果:观察组患者肺部感染率、死亡率、并发症发生率均较对照组低,住院时间较对照组短,差异有统计学意义(P0.05)。结论:在ICU颅脑损伤患者中采用结构化护理干预能降低肺部感染发生率,缩短患者住院时间,提高临床疗效,改善其生存质量。     

系统性护理干预对ICU患者肺部感染的影响分析

目的：分析系统性护理干预对ICU脑出血患者肺部感染发生率的影响。方法研究对象为2013年2月～2014年2月收治的80例ICU脑出血患者，采用随机原则，分为两组，试验组（40例）对患者进行系统性护理干预，对照组（40例）对患者仅进行常规护理，观察比较两组患者的肺部感染发生率和感染发生时间。结果试验组患者的肺部感染发生率为45%，感染时间为23～27 d，平均（25±2.64）d。对照组患者的肺部感染发生率为80%，感染时间为17～22 d，平均（20±2.85）d。两组比较差异有统计学意义（P＜0.05）。结论对ICU脑出血患者进行系统性护理干预操作相对于常规护理措施能够明显降低患者肺部感染的发生率。     

综合护理高血压脑出血患者预防肺部感染的临床探讨

目的通过综合护理对高血压脑出血患者进行肺部疾病的预防,旨在提高高血压脑出血患者的护理质量降低肺部感染的发生情况。方法选择2013年1月至2014年1月在我院接受治疗的高血压脑出血患者82例,随机平均分成研究组和对照组每组41例患者,研究组给予患者心理护理、呼吸护理、口腔护理、误吸护理、交叉感染护理等综合护理方式,对照组给予常规护理,统计两组患者肺部感染情况及住院时间。结果研究组通过综合护理有4例患者感染发生率为9.76%,住院时间为20 d;对照组肺部感染11例发生率为26.82%,住院时间为34 d,研究组护理疗效显著优于对照组,且P<0.05差异显著有统计学意义。结论综合护理能显著降低高血压脑出血患者肺部感染的发生率,缩短住院时间,提高患者生活质量。     

多学科护理在ICU重度颅脑损伤合并肺部感染患者中的应用效果

目的 探讨多学科护理在ICU重度颅脑损伤合并肺部感染患者中的应用效果。方法 将我院2020年1月至2021年1月68例ICU重度颅脑损伤合并肺部感染患者,按照住院号（单、双号）随机法分两组。对照组给予常规护理,多学科护理组实施多学科护理干预。比较护理前后患者的神经功能缺损程度、超敏C反应蛋白、降钙素原、ICU住院时间和护理满意度。通过两组不同结果的比较,判断多学科护理在ICU重度颅脑损伤合并肺部感染当中的护理价值,并对其能否在临床推广进行判定。结果 多学科护理组的护理满意度比对照组高（P <0.05）。多学科护理组的护理满意度是100.00%(34/34),而对照组的护理满意度是70.59%(24/34)。通过比较护理1周后的神经功能缺损程度、超敏C反应蛋白、降钙素原,结果显示,多学科护理组护理1周后神经功能缺损程度、超敏C反应蛋白、降钙素原均低于对照组,P <0.05。两组ICU住院时间比较结果显示,多学科护理组ICU住院时间（12.21±1.51）d显著低于对照组（17.12±2.12）d,P <0.05。结论 ICU重度颅脑损伤合并肺部感染患者实施多学科护理干预...     

集束化护理对ICU多重耐药菌感染发生率影响分析

目的:分析集束化护理对ICU多重耐药菌感染发生率影响。方法:选取本院收治的100例ICU患者,所有ICU患者的收取时间(2016年5月10日-2017年5月10日),电脑随机分为观察组一组(50例ICU患者)、对照组一组(50例ICU患者),分别实施集束化护理以及常规护理。结果:观察组ICU患者的ICU多重耐药菌感染发生率10.00%低于对照组患者20.00%(P0.05);观察组ICU患者的住院时间(10.25±1.01)d与对照组住院时间(15.15±0.26)d具有显著差异(P0.05)。结论:通过对ICU患者实施集束化护理后,取得显著效果,能预防ICU多重耐药菌感染发生,保障患者生命安全,促进患者康复。     

脑出血术后早期护理干预对防止患者肺部感染形成的作用观察

目的探讨脑出血患者术后早期进行护理干预对防止患者肺部感染形成的作用,分析这种护理干预对预防肺部感染是否具有临床的可行性,科学性,以及安全性。方法将2010年3月至2012年2月在我院接受治疗的脑出血患者80例作为研究对象,在患者及患者家属知情同意的情况下随机分成对照组和观察组各40例,对照组给予常规护理,观察组在对照组基础上实施护理干预,对结果做回顾性分析。结果观察组治疗期间肺部感染率明显低于对照组(P<0.05);观察组住院时间为(16±10.7)d,对照组为(28±15.5)d,差异均有统计学意义(P<0.05)。结论采取针对性的干预护理,提高了临床治疗效果、缩小了肺部感染几率、促进预后,临床意义显着,值得临床推广。     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg x kg(-1)) or i.p. (50 mg x kg(-1)) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) 1 x h(-1) x kg(-1) in the male rat and 10.6 (95% CI: 7.5, 15.0) 1 x h(-1) x kg(-1) in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was approximately 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p < 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p < 0.001) in plasma obtained from the male (8.8 +/- 2.0%) compared with the female rat (11.7 +/- 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Changes in angiopoietin expression in glomeruli involved in glomerulosclerosis in rats with daunorubicin-induced nephrosis

AIM: To study the potential pathological role of endogenous angiopoietins in daunorubicin-induced progressive glomerulosclerosis in rats. METHODS: Seventy male Wistar rats were allocated randomly into a daunorubicin group (DRB; n=40) or a control group (n=30). The rats in the DRB group were injected with DRB (15 mg/kg), in their tails. Subsequently, at intervals of 1, 2, 4, 6, 8, and 12 weeks, 5 male Wistar rats in each group were chosen randomly for 24 h urinary protein quantitative measurements (24 h UPQM), and determination of plasma tumor necrosis factor alpha (TNF-alpha), angiopoietin-1 (Ang1), and angiopoietin-2 (Ang2) levels. Kidney sections were examined by electron microscopy, Periodic Acid Schiff (PAS) staining, immunohistochemical staining and in situ hybridization histochemistry. RESULTS: As glomerulosclerosis progressed in the DRB group, expression of Ang1 mRNA and protein in glomeruli decreased and expression of TNF-alpha protein, Ang2 mRNA and protein in glomeruli increased. Expression of Ang1 mRNA and protein in glomeruli were negatively correlated with 24 h UPQM, Fn protein expression, and mean area of extracellular matrix (MAECM). In comparison, expression of Ang2 mRNA and protein in glomeruli were positively correlated with 24 h UPQM, Fn protein expression and MAECM; furthermore, there was a positive correlation between plasma Ang2 and 24 h UPQM. Plasma TNF-alpha and expression of TNF-alpha in glomeruli were positively correlated with expression of Ang2 mRNA and protein in glomeruli. There was a negative correlation between Ang1 protein expression and Ang2 protein expression in glomeruli. CONCLUSION: During DRB-induced glomerulosclerosis, podocyte injury led to a shift in the balance of Ang1 and Ang2 in glomeruli. Increased TNF-alpha in plasma and glomeruli may upregulate Ang2 expression in glomeruli. Elevated Ang2 in both plasma and glomeruli may mediate protein permeability through the glomerular filtration barrier. Moreover, local expression of Ang2 may facilitate the progress of glomerulosclerosis by upregulating a component expression of extracellular matrix.     

Hyperkalaemia in patients in hospital

A survey of all laboratory blood specimens with a plasma potassium concentration greater than or equal to 5.5 mmol/L was conducted over a three month period. Of 331 specimens with hyperkalaemia, 71 were excluded because the specimens was haemolysed, old or contaminated. The laboratory served a population of 348,561 and during this time measured the plasma potassium on 25,016 occasions. Sixty-six outpatients and 20 neonates were not evaluated. The survey was undertaken on 86 of 102 inpatients (46 males), 48 of whom were over 66 years of age. Fifty-seven patients were admitted under a medical service and 29 under a surgical service. Fifty-nine had a single episode of hyperkalaemia. Thirty-two underwent a surgical procedure. The commonest contributing factor was impaired renal function which was present in 71 (83%) patients. Although a definitive causative role for drugs could be identified in only five patients, in 52 (60%) patients drugs were a contributing factor (potassium supplements 24, ACE inhibitors 16, nonsteroidal antiinflammatory drugs 12). Thirty-five of the 86 (41%) patients died during their hospital admission. Nineteen of the 35 deaths occurred within three days of the hyperkalaemia being recorded. A normal plasma potassium was eventually documented in 50 of the 86 patients. Of the remaining 36 patients, 25 (69%) subsequently died. In general the treatment of patients with hyperkalaemia focused on identifying and treating the underlying cause. Hyperkalaemia must always be considered seriously and regard given to the overall clinical status of the patient, with particular attention to drug therapy, renal and cardiac function, acid base status and the possibility of sepsis.