健康教育对外伤患者的护理观察

目的探讨我院收治的外伤患者护理效果进行分析。方法采用回顾性分析的方法,分析我院收治的外伤患者的护理资料进行分析。结果观察组疼痛评分、一般自我效能感明显优于对照组,P<0.05;观察组护理工作满意度明显高于对照组,(P<0.05),差异有统计学意义。结论健康教育对外伤患者实施护理,疼痛、一般自我效能感明显改善,护理工作满意度明显提高,值得临床推广应用。     

重症胸外伤的急救护理

目的探讨重症胸外伤的急救措施,提高护理质量。方法通过总结104例重症胸外伤的病例,对其密切的病情观察,急救施护及心理护理。结果通过急救护理,抢救成功率达91.3%。结论熟练的应急措施是取得成功的关键,对提高抢救成功率具有重要作用。     

护理干预在预防脊柱外伤及术后患者深静脉栓的效果观察

目的探索预防脊柱外伤及术后患者发生深静脉栓应采取的护理干预措施及其临床效果。方法于我科实施护理干预前后分别选取235例患者纳入对照组予以常规护理,271例患者纳入实验组,对实验组患者在常规护理的基础上予以系统护理干预措施,对比2组DVT的发生率。结果实验组发生DVT2例,占0.73%;对照组发生DVT13例,占5.53%;2组发生率比较,P<0.01,差异具有统计学意义。结论对脊柱外伤及术后患者存在的深静脉栓因素应予以高度警惕,并进行系统的护理干预,可有效降低深静脉栓的发生率,促进患者早日康复。     

外伤患者的院前急救护理

目的探讨外伤患者院前急救护理的重要性。方法对我院2003年5月～2007年5月收治外伤患者480例进行院前急救护理的。结果院前及时急救使病人的死亡率及伤残率明显下降。结论快速而有效的院前急救对保全病人的生命,减少医院前期病人的死亡率及伤残率至关重要。     

医院颅脑外伤患者的护理

通过回顾性总结2007年1月-2009年7月期间雅江县人民医院接收救治的49例颅脑外伤患者的急救与护理经验,探讨颅脑外伤患者的护理方法,达到有效减轻患者病情,减少并发症的发生,提高治愈率的目的。     

外伤患者的院前急救与护理

通过对我院2006年救治外伤患者136例时回顾性分析,总结外伤的急救与护理的经验和不足,尽量避免和减少因护理措施不当而引发的一切不良后果。     

穴位点按用于手指外伤并骨折术后患者疼痛护理的效果研究

目的通过穴位点按的方法对手指外伤并骨折后患者疼痛症状的疗法。方法将手指外伤并骨折术后患者疼痛的80例随机分为2组,实验组和对照组,各40例,实验组患者点按合谷,支沟,内关,人中穴,每穴点按3～5min,2h后重复1次,点按时嘱患者活动患指;对照组以肌肉注射盐酸曲马多100mg。2组均在治疗完毕后每15分钟记录1次,连续记录4h。采用数字分级法(NRS)来评估疼痛程度。结果治疗痊愈32例(80%),显效4例(10%),好转2例(5%),无效2例(5%),总有效率95%,高于对照组的75%。结论运用穴位点按法对手指外伤并骨折术后患者疼痛进行护理治疗,具有见效快、疗法安全、无副作用、不易复发等优点,临床上建议推广使用。     

酸氧化电位水对病原微生物的消毒效果分析

目的:分析酸性氧化电位水对金黄色葡萄球菌和铜绿假单胞菌临床分离的影响,及15株真菌的杀菌效果。方法:采用微生物实验室方法对各种消毒剂进行鉴定。结果:用酸性氧化电位水溶液处理耐甲氧西林金。金黄色葡萄球菌和非甲氧西林耐药金黄色葡萄球菌对铜绿假单胞菌的杀菌效果分别为99.9、99.9、99.9和99.9。对念珠菌的杀灭率在240s达到99.9。结论:酸性氧化电位水是一种理想的临床细菌和真菌消毒剂。杀菌时间随细菌种类和真菌种类而不同,但对有机物的影响较大。     

护理干预对普外科患者术后疼痛的效果分析

目的 探讨护理干预对普外科患者术后疼痛的护理效果。方法 回顾性分析我院自2008年8月至2011年10月患者254例,随机分观察组128例(护理干预)和对照组126例(常规护理),对2组患者术后疼痛情况进行了比较。结果 2组患者术后24、72h的VAS评分相比差异具有显著性(P<0.05)。结论 护理干预可有效的减轻患者术后的疼痛,从而提高了普外科整体的护理质量。     

手术室实施舒适护理干预后的效果观察

目的观察比较手术室实施舒适护理干预后的效果情况。方法选择我院近年来收治的80例择期手术病人,随机分为干预组与对照组各40例,干预组采取舒适护理方法,对照组不给予舒适护理。结果2组患者经护理干预后的生命体征比较,经统计学处理,干预组较对照组有显著性差异,有统计学意义(P<0.05)。结论手术室实施舒适护理干预后,有助于维持患者生命体征的稳定,减少术后并发症的发生,提高了护理服务质量,降低了护患纠纷。     

Shock-Driven Endotheliopathy in Trauma Patients Is Associated with Leucocyte Derived Extracellular Vesicles

Endotheliopathy following trauma is associated with poor outcome, but the underlying mechanisms are unknown. This study hypothesized that an increased extracellular vesicle (EV) concentration is associated with endotheliopathy after trauma and that red blood cell (RBC) transfusion could further enhance endotheliopathy. In this post hoc sub study of a multicentre observational trial, 75 trauma patients were stratified into three groups based on injury severity score or shock. In patient plasma obtained at hospital admission and after transfusion of four RBC transfusions, markers for endotheliopathy were measured and EVs were labelled with anti CD41 (platelet EVs), anti CD235a (red blood cell EVs), anti CD45 (leucocyte EVs), anti CD144 (endothelial EVs) or anti CD62e (activated endothelial EVs) and EV concentrations were measured with flow cytometry. Statistical analysis was performed by a Kruskall Wallis test with Bonferroni correction or Wilcoxon rank test for paired data. In patients with shock, syndecan-1 and von Willebrand Factor (vWF) were increased compared to patients without shock. Additionally, patients with shock had increased red blood cell EV and leucocyte EV concentrations compared to patients without shock. Endotheliopathy markers correlated with leucocyte EVs (ρ = 0.263, p = 0.023), but not with EVs derived from other cells. Injury severity score had no relation with EV release. RBC transfusion increased circulating red blood cell EVs but did not impact endotheliopathy. In conclusion, shock is (weakly) associated with EVs from leucocytes, suggesting an immune driven pathway mediated (at least in part) by shock.     

Nutritional Interventions for Patients with Mitochondrial POLG-Related Diseases: A Systematic Review on Efficacy and Safety

Ketogenic diet is recommended as a treatment to reduce seizure frequency in patients with intractable epilepsy. The evidence and safety results are sparse for diet interventions in patients with pathogenic polymerase gamma (POLG) variants and intractable epilepsy. The aim of this systematic review is to summarize the efficacy of diet treatment on seizure frequency, clinical symptoms, and potential deleterious effect of liver involvement in patients with mitochondrial diseases caused by pathogenic POLG variants. Literature was searched in PubMed, Embase; and Cochrane in April 2022; no filter restrictions were imposed. The reference lists of retrieved studies were checked for additional literature. Eligibility criteria included verified pathogenic POLG variant and diet treatment. Overall, 880 studies were identified, providing eight case-reports representing nine patients eligible for inclusion. In eight of nine cases, clinical symptoms were improved; six out of nine cases reported improvements in seizure frequency. However, increasing levels of liver enzymes after initiating ketogenic diet were found in four of the nine cases, with one case revealing decreased levels of liver enzymes after initiating long-chain triglyceride restriction. Viewed together, the studies imply that ketogenic diet can have a positive impact on seizure frequency, but may induce progression of liver impairment in patients with pathogenic POLG variants.     

新型口服霍乱疫苗人体反应及效果

用工程菌产生的霍乱毒素 B 亚单位(BS)和灭活霍乱弧菌(WC)构建成新型 BSWC 口服霍乱疫苗,经志愿者口服免疫证实安全而且免疫原性良好,能刺激人体产生强的抗菌及抗毒免疫,其所引起的肠道免疫和血清抗体与用天然霍乱毒素纯化的 BS 构建成的同型疫苗效果相似,因此,可作为预防霍乱的候选苗。     

Antithrombotic Therapy in Patients with Peripheral Artery Disease: A Focused Review on Oral Anticoagulation

Peripheral artery disease (PAD) is a major cause of morbidity and mortality but it is usually underdiagnosed and undertreated. Patients with PAD present dysregulated procoagulant, anticoagulant, and fibrinolytic pathways leading to arterial and venous thrombosis. The risk of several ischemic-related complications could be mitigated with appropriate antithrombotic therapy, which plays a central role in all types of PAD. For years, antiplatelets have been indicated in patients with symptomatic PAD or those who have undergone revascularization. Unfortunately, a non-negligible proportion of patients with PAD will suffer from adverse events during the follow-up, even despite proper medical therapies for the prevention of PAD complications. Thus, there is room for improving clinical outcomes in these patients. Given the implication of both, primary and secondary hemostasis in arterial thrombosis and the pathophysiology of PAD, the combination of antiplatelets and anticoagulants has emerged as a potential antithrombotic alternative to antiplatelets alone. In this narrative review article, we have highlighted the most recent evidence about antithrombotic therapy in PAD patients, with a special focus on oral anticoagulation. Certainly, COMPASS and VOYAGER PAD trials have shown promising results. Thus, rivaroxaban in combination with aspirin seem to reduce cardiovascular outcomes with a similar bleeding risk compared to aspirin alone. Nevertheless, results from real-world studies are needed to confirm these observations, and other trials will provide novel evidence about the safety and efficacy of emerging anticoagulant agents.     

Therapeutic Efficacy and Outcomes of Remdesivir versus Remdesivir with Tocilizumab in Severe SARS-CoV-2 Infection

The infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) generated many challenges to find an effective drug combination for hospitalized patients with severe forms of coronavirus disease 2019 (COVID-19) pneumonia. We conducted a retrospective cohort study, including 182 patients with severe COVID-19 pneumonia hospitalized between March and October 2021 in a Pneumology Hospital from Cluj-Napoca, Romania. Among patients treated with standard of care, 100 patients received remdesivir (R group) and 82 patients received the combination of remdesivir plus tocilizumab (RT group). We compared the clinical outcomes, the inflammatory markers, superinfections, oxygen requirement, intensive care unit (ICU) admission and mortality rate before drug administration and 7 days after in R group and RT group. Borg score and oxygen support showed an improvement in the R group (p < 0.005). Neutrophiles, C-reactive protein (CRP) and serum ferritin levels decreased significantly in RT group but with a higher rate of superinfection in this group. ICU admission and death did not differ significantly between groups. The combination of remdesivir plus tocilizumab led to a significantly improvement in the inflammatory markers and a decrease in the oxygen requirement. Although the superinfection rate was higher in RT group than in R group, no significant difference was found in the ICU admission and mortality rate between the groups.     

Effect and Biocompatibility of a Cross-Linked Hyaluronic Acid and Polylactide-co-glycolide Microcapsule Vehicle in Intratympanic Drug Delivery for Treating Acute Acoustic Trauma

The treatment of acute hearing loss is clinically challenging due to the low efficacy of drug delivery into the inner ear. Local intratympanic administration of dexamethasone (D) and insulin-like growth factor 1 (IGF1) has been proposed for treatment, but they do not persist in the middle ear because they are typically delivered in fluid form. We developed a dual-vehicle drug delivery system consisting of cross-linked hyaluronic acid and polylactide-co-glycolide microcapsules. The effect and biocompatibility of the dual vehicle in delivering D and IGF1 were evaluated using an animal model of acute acoustic trauma. The dual vehicle persisted 10.9 times longer (8.7 days) in the middle ear compared with the control (standard-of-care vehicle, 0.8 days). The dual vehicle was able to sustain drug release over up to 1 to 2 months when indocyanine green was loaded as the drug. One-third of the animals experienced an inflammatory adverse reaction. However, it was transient with no sequelae, which was validated by micro CT findings, endoscopic examination, and histological assessment. Hearing restoration after acoustic trauma was satisfactory in both groups, which was further supported by comparable numbers of viable hair cells. Overall, the use of a dual vehicle for intratympanic D and IGF1 delivery may maximize the effect of drug delivery to the target organ because the residence time of the vehicle is prolonged.     

经腹腔镜精索静脉高位结扎术治疗精索静脉曲张临床观察及护理体会

目的探讨经腹腔镜精索静脉高位结扎术治疗精索静脉曲张的临床意义和护理方法。方法对经腹腔镜精索静脉高位结扎术治疗的63例精索静脉曲张患者进行分析,并与同期开放手术治疗的71例患者比较。结果腹腔镜组平均住院时间(3±1.2)d,对照组平均住院时间(8±1.3)d,有显著差异(P<0.01);术后两组患者的症状、精液性质均较术前有显著改善(P<0.01),但术前、术后两组间同一参数相比无显著差异(P>0.05)。结论腹腔镜治疗精索静脉曲张损伤小、恢复快、住院时间短、复发率低,疗效可靠,可同时处理双侧精索静脉曲张。术前、术后积极的护理配合,对患者术后顺利恢复具有重要的作用。     

The Potentiality of Plant-Derived Nanovesicles in Human Health—A Comparison with Human Exosomes and Artificial Nanoparticles

Research in science and medicine is witnessing a massive increases in literature concerning extracellular vesicles (EVs). From a morphological point of view, EVs include extracellular vesicles of a micro and nano sizes. However, this simplistic classification does not consider both the source of EVs, including the cells and the species from which Evs are obtained, and the microenvironmental condition during EV production. These two factors are of crucial importance for the potential use of Evs as therapeutic agents. In fact, the choice of the most suitable Evs for drug delivery remains an open debate, inasmuch as the use of Evs of human origin may have at least two major problems: (i) autologous Evs from a patient may deliver dangerous molecules; and (ii) the production of EVs is also limited to cell factory conditions for large-scale industrial use. Recent literature, while limited to only a few papers, when compared to the papers on the use of human EVs, suggests that plant-derived nanovesicles (PDNV) may represent a valuable tool for extensive use in health care.     

The Hexosamine Biosynthetic Pathway as a Therapeutic Target after Cartilage Trauma: Modification of Chondrocyte Survival and Metabolism by Glucosamine Derivatives and PUGNAc in an Ex Vivo Model

The hexosamine biosynthetic pathway (HBP) is essential for the production of uridine diphosphate N-acetylglucosamine (UDP-GlcNAc), the building block of glycosaminoglycans, thus playing a crucial role in cartilage anabolism. Although O-GlcNAcylation represents a protective regulatory mechanism in cellular processes, it has been associated with degenerative diseases, including osteoarthritis (OA). The present study focuses on HBP-related processes as potential therapeutic targets after cartilage trauma. Human cartilage explants were traumatized and treated with GlcNAc or glucosamine sulfate (GS); PUGNAc, an inhibitor of O-GlcNAcase; or azaserine (AZA), an inhibitor of GFAT-1. After 7 days, cell viability and gene expression analysis of anabolic and catabolic markers, as well as HBP-related enzymes, were performed. Moreover, expression of catabolic enzymes and type II collagen (COL2) biosynthesis were determined. Proteoglycan content was assessed after 14 days. Cartilage trauma led to a dysbalanced expression of different HBP-related enzymes, comparable to the situation in highly degenerated tissue. While GlcNAc and PUGNAc resulted in significant cell protection after trauma, only PUGNAc increased COL2 biosynthesis. Moreover, PUGNAc and both glucosamine derivatives had anti-catabolic effects. In contrast, AZA increased catabolic processes. Overall, “fueling” the HBP by means of glucosamine derivatives or inhibition of deglycosylation turned out as cells and chondroprotectives after cartilage trauma.     

深圳市医疗卫生机构医疗废物产污现状调查与分析

为了解深圳市医疗卫生机构医疗废物产污现状,调查分析了30家医院、4家妇幼保健院和8家社康中心医疗废物产生情况。结果表明,医院、妇幼保健院和社康中心医疗废物平均产污系数分别为0.97 kg/床/d、1.64 kg/床/d和0.06 kg/人次,妇幼保健院产污系数要高于医院(P0.05);三级医院、二级医院和一级医院产污系数分别为0.89 kg/床/d、0.91 kg/床/d和1.10 kg/床/d,三者间无统计学差异(P0.05);医院医疗废物产生量与病床数呈极显著正相关关系(P0.01)。深圳市医疗卫生机构医疗废物产污系数在国内外均处于较高水平,其中妇幼保健院产污系数最大,三级医院、二级医院和一级医院相近。