体位管理对老年髋部骨折患者术后髋关节功能恢复及并发症的影响

目的:探讨体位管理对老年髋部骨折患者术后髋关节功能恢复及并发症的影响。方法:选取我院于2015年5月-2017年5月收治的老年髋部骨折患者120例作为本次研究的主要对象,随机将其分为对照组和观察组,对照组采用常规护理管理,观察组在常规护理的基础上给予体位护理管理,观察两组患者术后并发症发生以及功能恢复情况。结果:观察组患者的术后并发症发生率以及功能恢复情况均优于对照组,组间对比差异明显具有统计学意义(P0.05)。结论:在老年髋部骨折患者治疗过程中,给予患者相应的体位护理管理,对于改善患者的术后以及降低并发症发生率效果显著,值得临床推广使用。     

老年髋部骨折围术期患者行优质护理的临床体会

目的探讨分析老年髋部骨折围术期患者行优质护理的临床价值。方法选取我院2012年12月至2013年12月收治的80例实施髋部骨折手术的老年患者为研究对象,将其随机平均分为两组,对照组40例患者给予常规护理,观察组40例患者给予优质护理,观察两组临床效果。结果观察组患者临床并发症发生率为5.0%,显著低于对照组55.0%,住院时间显著短于对照组,患者满意度明显高于对照组,差异均具有统计学意义(P<0.05)。结论在老年髋部骨折患者围术期实施优质护理能有效降低患者术后并发症发生率,缩短住院时间,提高患者生活质量及满意度,值得应用。     

优质护理在老年髋部骨折围术期的临床护理应用体会

目的:探讨优质护理在老年髋部骨折围术期的临床护理应用体会。方法:选取2011年10月~2014年10月某院收治的髋部骨折患者112例,以盲分法随机分为观察组和对照组各56例。对照组采取常规护理措施,观察组在对照组的基础上进行优质护理,将两组患者在术前术后的护理效果进行对比分析。结果:观察组患者并发症的发生率明显小于对照组,观察组的住院时间明显短于对照组,护理满意度明显高于对照组(P<0.05)。结论:优质护理应用于围术期老年髋部骨折患者,能够明显降低患者不适,使术后并发症发生率降低,患者生存质量提高,值得临床推广。     

老年髋部骨折围手术期并发症的防治

目的探究髋部骨折老年患者围手术期并发症的防治措施。方法选取2013年1月~2016年8月广东省信宜市人民医院收治的髋部骨折老年患者135例,随机分为对照组与观察组。对照组67例,实施常规护理与治疗。观察组68例,基于常规护理实施围手术期护理与治疗。比较两组患者并发症发生率及生活质量评分。结果观察组并发症发生率(7.35%)显著低于对照组(26.87%),差异具有统计学意义(P<0.05)。观察组生理功能、躯体疼痛、社会功能等生活质量评分显著高于对照组,差异具有统计学意义(P<0.05)。结论围手术期护理与治疗可降低髋部骨折老年患者并发症发生率,提高生活质量。     

髋关节置换术后老年股骨颈骨折患者的中医护理分析

目的分析髋关节置换术后老年股骨颈骨折患者的中医护理效果。方法 84例老年股骨颈骨折患者,随机分为实验组和对照组,各42例。所有患者均接受髋关节置换术治疗,对照组患者实施常规护理,实验组患者实施中医护理。对比两组术后并发症发生率的差异。结果实验组术后并发症发生率(2.38%)明显低于对照组(16.67%),差异有统计学意义(P<0.05)。结论对髋关节置换术后老年股骨颈骨折患者实施中医护理有助于减少并发症,促进康复进程。     

健康教育在老年骨质疏松性髋部骨折护理中的应用

目的分析研究不同健康教育方法对老年骨质疏松性髋部骨折患者的护理效果,为临床护理提供参考和依据。方法随机抽取2011年6月至2013年11月老年骨质疏松性髋部骨折患者共82例为本次实验的临床研究对象。使用随机数字表将患者分为两组。对照组共41例,临床护理使用常规语言健康教育;实验组41例,使用Orem自理模式护理,观察对比观察的护理效果。结果实验组患者护理后,患者对疾病掌握优良率更高,发生髋部骨折后并发症比例更低,各项指标与对照组患者比较,P<0.05,差异有统计学意义。实验组老年骨质疏松性髋部骨折患者术后生活质量为(81.87±6.08),高于对照组患者,P<0.05,差异有统计学意义。结论对老年骨质疏松性髋部骨折的患者给予Orem自理模式健康教育方法的效果更优秀,可以提高患者知识掌握水平,降低并发症,并提高生活质量。     

预见性护理干预预防髋部骨折患者术后DVT的临床价值分析

目的观察预见性护理干预在预防髋部骨折术后深静脉血栓形成的临床价值。方法选取我院骨科2011年3月-2013年3月收治的100例髋部骨折的患者,随机分为两组。实验组和对照组各50例。对照组给予常规护理,实验组在常规护理的基础上进行预见性护理干预,观察两组患者的护理效果。结果实验组术后DVT的发生率为2％,对照组术后DVT的发生率为14％,差异有统计学意义（P〈0．05）。实验组在住院时间、护理满意度、生化指标等方面均优于对照组,差异具有统计学意义（P〈0．05）。结论对髋部骨折患者实施预见性护理能有效降低DVT的发生率,提高患者对护理服务的满意度。     

全面优质护理干预对老年髋部骨折患者术后肢体功能恢复的效果分析

目的 探讨全面优质护理干预对老年髋部骨折患者术后肢体功能恢复的效果.方法 选取我院2010年7月至2013年6月收治的老年髋部骨折患者68例,随机分为实验组（全面优质护理）与对照组（常规护理）各34例.干预3个月后,比较两组病人Harris评分、Barthel指数评分情况.结果 实验组患者术后Harris评分、Barthel指数优于对照组,差异具有统计学意义（P＜0.05）.结论 全面优质护理干预对老年髋部骨折患者术后肢体功能恢复效果较好,值得临床推广应用.     

80例老年髋部骨折患者的围术期护理

目的探讨老年髋部骨折患者的围手术期护理措施。方法对80例老年髋部骨折患者进行疼痛评估管理、教授功能锻炼,术后加强病情观察、防止并发症、指导患者合理康复训练等围手术期护理。结果老年髋部骨折患者未发生深静脉血栓等并发症。结论加强老年髋部骨折患者围术期护理可显著提高护理质量,减少并发症,促进术后康复。     

综合护理干预在老年股骨颈骨折中的应用效果

目的探讨综合护理干预在老年股骨颈骨折中的应用效果。方法选取本院2010年3月~2013年4月收治的43例老年股骨颈骨折患者作为研究对象,随机分为实验组和对照组。对照组采用常规护理,实验组在对照组的基础上采用综合护理措施进行干预。比较两组的术后并发症发生率、髋关节功能评分、ADL评分、住院时间及护理满意度。结果实验组的术后并发症发生率显著低于对照组,差异有统计学意义(P<0.05)。实验组干预后的髋关节功能及ADL评分显著高于干预前及对照组,差异有统计学意义(P<0.05)。实验组的住院时间及护理满意度显著优于对照组,差异有统计学意义(P<0.05)。结论综合护理能够显著降低老年股骨颈骨折患者的术后并发症发生率,有助于患者术后髋关节功能以及日常生活能力的恢复,同时缩短了住院时间,提高了护理满意度。     

Pharmacological treatment of COVID-19: an opinion paper

The precocity and efficacy of the vaccines developed so far against COVID-19 has been the most significant and saving advance against the pandemic. The development of vaccines has not prevented, during the whole period of the pandemic, the constant search for therapeutic medicines, both among existing drugs with different indications and in the development of new drugs. The Scientific Committee of the COVID-19 of the Illustrious College of Physicians of Madrid wanted to offer an early, simplified and critical approach to these new drugs, to new developments in immunotherapy and to what has been learned from the immune response modulators already known and which have proven effective against the virus, in order to help understand the current situation.     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Lung disease and PKCs

The lung offers a rich opportunity for development of therapeutic strategies focused on isozymes of protein kinase C (PKCs). PKCs are important in many cellular responses in the lung, and existing therapies for pulmonary disorders are inadequate. The lung poses unique challenges as it interfaces with air and blood, contains a pulmonary and systemic circulation, and consists of many cell types. Key structures are bronchial and pulmonary vessels, branching airways, and distal air sacs defined by alveolar walls containing capillaries and interstitial space. The cellular composition of each vessel, airway, and alveolar wall is heterogeneous. Injurious environmental stimuli signal through PKCs and cause a variety of disorders. Edema formation and pulmonary hypertension (PHTN) result from derangements in endothelial, smooth muscle (SM), and/or adventitial fibroblast cell phenotype. Asthma, chronic obstructive pulmonary disease (COPD), and lung cancer are characterized by distinctive pathological changes in airway epithelial, SM, and mucous-generating cells. Acute and chronic pneumonitis and fibrosis occur in the alveolar space and interstitium with type 2 pneumocytes and interstitial fibroblasts/myofibroblasts playing a prominent role. At each site, inflammatory, immune, and vascular progenitor cells contribute to the injury and repair process. Many strategies have been used to investigate PKCs in lung injury. Isolated organ preparations and whole animal studies are powerful approaches especially when genetically engineered mice are used. More analysis of PKC isozymes in normal and diseased human lung tissue and cells is needed to complement this work. Since opposing or counter-regulatory effects of selected PKCs in the same cell or tissue have been found, it may be desirable to target more than one PKC isozyme and potentially in different directions. Because multiple signaling pathways contribute to the key cellular responses important in lung biology, therapeutic strategies targeting PKCs may be more effective if combined with inhibitors of other pathways for additive or synergistic effect. Mechanisms that regulate PKC activity, including phosphorylation and interaction with isozyme-specific binding proteins, are also potential therapeutic targets. Key isotypes of PKC involved in lung pathophysiology are summarized and current and evolving therapeutic approaches to target them are identified.