护理干预在肝硬化并发上消化道出血患者中的应用效果

目的 探讨综合护理干预在肝硬化并发上消化道出血患者治疗中的临床效果.方法 选择本院收治90例肝硬化并发上消化道出血患者为观察对象,随机分为观察组48例和对照组42例,对照组给予常规护理干预,观察组在对照组的基础上给予综合护理干预,包括心理护理、饮食指导干预以及预见性护理干预.比较2组患者止血时间、出血复发率和死亡率.结果 观察组止血时间明显短于对照组,观察组出血复发率明显低于对照组,2组比较差异显著(P＜0.05).结论 综合护理干预能够缩短肝硬化并发上消化道出血患者的止血时间,同时降低出血复发率,可在一定程度上提高患者生存质量,值得临床推广应用.     

护理干预在难治性产后出血介入治疗后的有效性

目的：探讨难产性产后出血介入治疗的护理方法及其效果。方法选取难产性产后出血介入治疗患者60例,随机分为实验组和对照组,每组30例。两组患者均给予介入治疗,实验组和对照组分别给予有针对性的个性化护理和常规护理。结果实验组患者手术时间、止血时间、住院时间和复发率均明显低于对照组（均P＜0．05）,治愈率明显高于对照组（P＜0．05）。患者心律明显降低（P＜0．05）、收缩压、舒张压及血红蛋白水平均明显提高（均P＜0．05）。结论对于难产性产后出血患者按照临床路径实施有针对性的个性化护理能够有效提高止血效果和患者的恢复效果。     

难治性产后出血介入治疗的护理干预

目的探讨难治性产后出血介入治疗护理干预的要点。方法总结25例难治性产后出血介入治疗患者的心理护理,术前急救配合、物品准备,术中患者卧位选择、病情观察,术后并发症预防及出院指导要点。结果通过积极治疗和护理干预,25例患者均一次性栓塞成功,手术成功率100%,术后5~20 min止血,1~7 d血性恶露逐渐减少,未再出现异常的阴道出血。平均住院11.5 d,治愈率100%。随访患者子宫按期复旧,均恢复正常月经及排卵。结论对难治性产后出血介入治疗患者进行综合护理干预,是保证手术安全、避免术后并发症、促使患者术后早日康复的重要举措。     

超早期显微手术治疗高血压基底节区脑出血患者的护理

目的 探讨对高血压基底节区脑出血患者采用超早期显微手术治疗的临床护理要点.方法 选择我院2009年5月至2011年5月收治的高血压基底节区脑出血患者80例,随机分为对照组和观察组各40例,对照组采用常规护理,观察组在此基础上实施有针对性的护理干预,就2组临床结果进行回顾性分析.结果 观察组术前平均准备时间为32 min,对照组为55 min.观察组优良率为65.0％,明显高于对照组的37.5％,2组术前准备时间及临床优良率比较差异显著.结论 采取全面针对性的护理干预,明显提高了临床效果,改善了患者生存质量,降低了并发症的发生率,值得临床推广应用.     

护理干预对宫缩乏力性产后出血产妇产后康复的影响观察

目的 分析讨论针对性护理干预对宫缩乏力性产后出血产妇产后康复的影响。方法 选取我 148 例 2021 年 2 月至 2023 年 2 月进行宫缩乏力性产后出血治疗的患者为研究对象。以抽签法将患者分为对照组（74 例）和观察组（74 例）。对照组患者进 行常规护理,观察组患者采用针对性护理。对两组的生理指标、心理指标、生活质量评分、康复总有效率进行比较。结果 观 察组产妇的止血时间明显短于对照组（P<0.05）。在 24 小时之内,观察组产妇的出血量明显比对照组少（P<0.05）。观察组产妇 的焦虑情绪和抑郁情绪以及生活质量较对照组均有显著改善（P<0.05）。结论 针对性护理能够有效促进宫缩乏力性产后出血产 妇产后的康复。     

护理干预对肝硬化上消化道出血疗效的影响

目的 观察护理干预对奥曲肽联合奥美拉唑治疗肝硬化上消化道出血患者疗效的影响.方法 选择奥曲肽联合奥美拉唑治疗肝硬化上消化道出血的患者90例,随机分为观察组与对照组各45例,观察组给予精心护理干预,对照组给予常规护理,观察2组的护理效果及并发症情况.结果 观察组总有效率为95.56%,对照组总有效率为51.55%;观察组出血的例数明显少于对照组;止血后再出血复发率、死亡率均明显低于对照组.结论 运用奥曲肽联合奥美拉唑治疗肝硬化上消化道出血治疗的基础上给予护理干预可以显著提高临床治疗效果,减少并发症的发生.     

护理干预对肝硬化上消化道出血疗效的影响

目的 观察护理干预对奥曲肽联合奥美拉唑治疗肝硬化上消化道出血患者疗效的影响.方法 选择奥曲肽联合奥美拉唑治疗肝硬化上消化道出血的患者90例,随机分为观察组与对照组各45例,观察组给予精心护理干预,对照组给予常规护理,观察2组的护理效果及并发症情况.结果 观察组总有效率为95.56%,对照组总有效率为51.55%;观察组出血的例数明显少于对照组;止血后再出血复发率、死亡率均明显低于对照组.结论 运用奥曲肽联合奥美拉唑治疗肝硬化上消化道出血治疗的基础上给予护理干预可以显著提高临床治疗效果,减少并发症的发生.     

内镜下不同方法治疗上消化道出血的疗效观察与护理

目的探索内镜下不同方法治疗上消化道出血的临床效果及护理方法。方法选取2016年5月至2017年5月上消化道出血患者100例为研究对象,随机将其等分为观察组和对照组,对照组采用内镜下喷洒止血药物治疗,观察组采用内镜下金属钛夹治疗,并给予相应护理干预。结果观察组患者并发症发生率、住院时间、引流液变清时间、呕血消失时间、潜血转阴时间、1周内再出血率、即时止血率、出血量均优于对照组(P0.05)。结论内镜下金属钛夹治疗上消化道出血患者临床效果显著,加强护理干预,有利于患者康复。     

产后出血应用阶段性护理干预的效果评价

目的:对产后出血应用阶段性护理干预的效果进行研究。方法:以2017年5月至2018年5月在本院妇产科就诊治疗60例产后出血患者为研究对象,之后随机将60例产后出血患者分为对照组与观察组两个组别,每组各30人。在治疗期间,对对照组的产后出血患者主要实施常规的护理方法,而对观察组的产后出血患者则实施阶段性护理干预。在护理完成后,比较对照组产后出血患者与观察组产后出血患者的临床护理效果与护理满意度。结果:在临床护理效果及护理满意度两个指标方面,观察组明显优于对照组(P<0.05),具有统计学意义。结论:产后出血应用阶段性护理干预具备良好的效果,可提升患者满意度与护理效果。     

子宫动脉栓塞介入治疗难治性产后出血的临床观察

目的探讨子宫动脉栓塞介入治疗难治性产后出血的临床价值。方法回顾分析2009年10月至2012年10月解放军空军总医院采用子宫动脉栓塞介入治疗(观察组)和子宫切除术治疗(对照组)难治性产后出血患者各40例,比较分析两组临床资料。结果观察组患者均一次性栓塞成功,止血有效率为97.50%(39/40),对照组止血有效率95.00%(38/40),两组差异无统计学意义(P>0.05)。观察组患者手术时间、术后下床活动时间和术后平均住院天数等均优于对照组,差异有统计学意义(P<0.05)。观察组患者术后发热、疼痛、感染及继发性贫血等方面均低于对照组,差异有统计学意义(P<0.05)。结论子宫动脉栓塞介入治疗难治性产后出血的止血率与子宫切除术效果相似,但是子宫动脉栓塞介入治疗手术时间短、创伤小、痛苦少和患者恢复快,有利于患者术后康复,值得临床推广应用。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Modified micro-superior percutaneously-assisted total hip: early experiences & case reports

Because of the extensile nature and familiarity of the standard posterior-lateral approach to the hip, a family of "micro-posterior" approaches has been developed. This family includes the Percutaneously-Assisted Total Hip (PATH) approach, the Supercapsular (SuperCap) approach and a newer hybrid approach, the Supercapsular Percutaneously-Assisted Total Hip (SuperPATH) approach. Such approaches should ideally provide a continuum for the surgeon: from a "micro" (external rotator sparing) posterior approach, to a "mini" (external rotator sacrificing) posterior approach, to a standard posterior approach. This could keep a surgeon within his comfort zone during the learning curve of the procedure, while leaving options for complicated reconstructions for the more practiced micro-posterior surgeons. This paper details one author's experiences utilizing this combined approach, as well as permutations of this entire micro-posterior family of approaches as applied to more complex hip reconstructions.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Structure and function of "metalloantibiotics"

Although most antibiotics do not need metal ions for their biological activities, there are a number of antibiotics that require metal ions to function properly, such as bleomycin (BLM), streptonigrin (SN), and bacitracin. The coordinated metal ions in these antibiotics play an important role in maintaining proper structure and/or function of these antibiotics. Removal of the metal ions from these antibiotics can cause changes in structure and/or function of these antibiotics. Similar to the case of "metalloproteins," these antibiotics are dubbed "metalloantibiotics" which are the title subjects of this review. Metalloantibiotics can interact with several different kinds of biomolecules, including DNA, RNA, proteins, receptors, and lipids, rendering their unique and specific bioactivities. In addition to the microbial-originated metalloantibiotics, many metalloantibiotic derivatives and metal complexes of synthetic ligands also show antibacterial, antiviral, and anti-neoplastic activities which are also briefly discussed to provide a broad sense of the term "metalloantibiotics."