【摘要】 目的 探讨开展优质护理服务对早期慢性肾功能衰竭患者治疗的影响。 方法 将2009年9月-2010年6月收治的80名早期慢性肾功能衰竭患者，随机分成对照组和试验组，每组各40例。试验组实施优质护理服务，对照组按常规护理，半年后采用自测健康评定量表（SRHMS V1.0）对患者进行问卷调查，从而了解和评判优质服务对早期慢性肾功能衰竭患者治疗的影响及效果。 结果 试验组在器官功能、日常生活功能、生理健康子量表总分3个维度，在负向情绪、正向情绪、认知功能、心理健康子量表总分4个维度，在角色活动、社会健康子量表总分2个维度与对照组比较，差异均有统计学意义（Plt;0.05），在社会支持和社会资源方面与对照组的差异无统计学意义（Pgt;0.05）。 结论 开展优质护理服务能明显提高患者治疗疾病的信心，对有效控制患者病情发展有一定的影响与作用。【Abstract】 Objective To investigate the impact of quality care on early chronic renal failure patients. Methods Eighty patients in early stages of chronic renal failure in our department between September 2009 and June 2010 were randomly divided into the control group and the experimental group with 40 patients in each group. Quality and Conventional care were implemented on the two groups respectively. Six months later, self-rated health measurement scale (SRHMS V1.0) was used to analyze the impact of quality care on the patients. Results The results of the measurement showed that there were significant differences between the two groups in organ function, daily life function, physiologic health, negative emotion, positive emotion, cognitive ability, psychological health, role activity and social health (Plt;0.05). There were no significant differences between them in social support and social resources. Conclusion Carrying out high-quality care can significantly improve the active treatment confidence of the patients and can effectively control the development of the disease.
Chronic disease is a major threat to human health. Fundus disease has become a major ophthalmic disease affecting daily life. Although great breakthroughs have been made in the treatment, compared with other chronic disease management, the management of patients with fundus disease is still in its infancy. To strengthen the management exploration of patients with fundus diseases, establish a management model of fundus diseases and strive to improve patients' awareness of fundus diseases and adherence to treatment and follow-up are the great challenges at present. All ophthalmic centers should strengthen patient education, establish a regional cooperation network, support the construction of grassroots medical capacity, cultivate talents, enhance training, promote the standardized treatment of fundus diseases, standardize fundus imaging inspection and diagnosis, and promote the homogeneous construction of diagnosis and treatment of chronic fundus diseases. We will accelerate the construction of a hierarchical diagnosis and treatment system and the ability to link consultation and referral. Through systematic management and intervention of fundus diseases, a large number of patients with fundus diseases will receive early screening, diagnosis, standardized continuous treatment and systematic management, and improve the quality of life of patients with fundus diseases.
目的:观察和探讨细胞角质素CK18慢性胆囊炎患者的胆囊组织和血清中的表达及其意义。方法:35例经腹腔镜胆囊切除的慢性结石性胆囊炎患者(27例女性患者,8例男性患者,年龄在55.65±13.48岁),将患者分为两个组,A组为患慢性非活动性结石性胆囊炎者(n=10),B组为患慢性活动性胆囊炎者(n=25),在细胞凋亡早期胱门蛋白酶分裂的CK18用M30细胞凋亡酶联免疫吸附测定,总细胞角蛋白18(从凋亡及坏死细胞中分离)用M65酶联免疫吸附测定。然后计算M30/M65结果:胱门蛋白酶分裂的CK18,特别是总CK18在胆汁中的表达远高于血清。在B组中,胱门蛋白酶分裂的CK18和总CK18的表达在胆囊组织和血清中表达差异相当大。在胆囊粘膜上皮细胞胱门蛋白酶分裂的CK18染色呈强阳性。结论:CK18在胆囊上皮细胞中表达。胱门蛋白酶分裂的CK18和总CK18在胆囊组织中的表达远高于血清中的表达。胱门蛋白酶分裂的CK18和总CK18的表达水平在活动性胆囊炎和非活动性胆囊炎中的表达并无明显差异。
Objective To analyse the content and structure of the health management policy text for chronic obstructive pulmonary disease (COPD) in China, and to provide a reference for the optimization and improvement of subsequent relevant policies. Methods We searched for relevant policy documents on COPD health management at the national level from January 2017 to December 2023, constructed a two-dimensional analysis framework for policy tools and chronic disease health management processes, coded and classified policy texts, and used content analysis method to analyze policy texts. Results Twenty-four policy texts were included. There were 183 codes for policy tool dimension, with supply based, environmental based, and demand based tools accounting for 43.72%, 47.54%, and 8.74%, respectively. There were 124 codes for the dimension of health management processes, with health information collection and management accounting for 12.10%, risk prediction accounting for 14.52%, intervention and treatment accounting for 66.13%, and follow-up and effectiveness evaluation accounting for 7.26%. Conclusions At present, the proportion of policy tools related to the management of COPD in China needs to be dynamically adjusted. Environmental tools should be appropriately reduced, the internal structure of supply tools should be optimized, the driving effect of demand tools should be comprehensively enhanced, the coupling of COPD health management processes should be strengthened, and the relevant policy system and overall quality should be continuously improved.
ObjectiveTo investigate the role of mindfulness-based stress reduction in improving anxiety and depression in elderly patients with chronic heart failure.MethodsFrom August 2016 to August 2018, a total of 196 elderly patients with chronic heart failure were randomly divided into the treatment group and the control group, with 98 cases in each group. The control group received routine care. The treatment group received routine care plus mindfulness-based stress reduction in two 60-minute sessions a week for 8 weeks. The level of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) was detected by electrochemiluminescence immunoassay, and left ventricular ejection fraction (LVEF) was measured by echocardiography before intervention and at week 8 of intervention; the effective rate was calculated. Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), and General Well-Being scale (GWB) were used to assess the degree of anxiety, depression, and well-being of patients before intervention and at week 8 of intervention.ResultsThe serum NT-proBNP levels at week 8 of intervention in the two groups were lower than those before intervention, and the LVEFs were higher than those before intervention (P<0.05). The treatment group showed significant changes when compared with the control group (P<0.05). The effective rate of the treatment group was higher than that of the control group (89.80% vs. 69.39%, P<0.05). Before intervention, the SAS scores in the treatment group and the control group were 56.61±8.25 and 55.98±6.32, respectively, the SDS scores were 59.98±7.21 and 58.86±6.17, respectively, and the GWB scores were 53.19±12.38 and 54.06±10.93, respectively; at week 8 of intervention, the SAS scores in the treatment group and the control group were 40.56±8.17 and 46.25±5.43, respectively, the SDS scores were 42.85±5.77 and 48.34±8.01, respectively, and the GWB scores were 76.17±9.63 and 68.58±13.30, respectively. At week 8 of intervention, the SAS and SDS scores of the two groups were both lower than those before intervention, and the GWB scores were higher than those before intervention (P<0.05). The treatment group showed significant changes when compared with the control group (P<0.05).ConclusionMindfulness-based stress reduction can improve the anxiety and depression of elderly patients with chronic heart failure, improve their well-being and promote the recovery of heart function.
ObjectiveTo systematically review the prevalence and risk factors of the chronic post-cesarean section pain (CPCSP). MethodsPubMed, EMbase, The Cochrane Library, CINAHL, PsycInfo, CBM, WanFang Data, VIP, and CNKI databases were electronically searched to collect studies on the prevalence and risk factors of CPCSP from inception to August 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Meta-analysis was then performed using Stata 15.1 software. ResultsA total of 43 studies involving 12 435 participants were included. The results of meta-analysis showed that the prevalence of CPCSP for 2 to 5 months, 6 to 11 months, and at least 12 months were 19% (95%CI 15% to 23%), 13% (95%CI 9% to 17%), and 8% (95%CI 6% to 10%), respectively. The risk factors included preoperative pain present elsewhere, postoperative severe acute pain, low abdominal transverse incision, non-intrathecal administration of morphine, preoperative anxiety, postpartum depression, etc. ConclusionsThe current evidence shows that the overall prevalence of CPCSP is high. Preoperative pain presents elsewhere, postoperative severe acute pain, low abdominal transverse incision, non-intrathecal administration of morphine, preoperative anxiety and postpartum depression may increase the risk of CPCSP.
The patency of vascular access is of great significance to hemodialysis patients. Combining with guidelines and literature associated with vascular access for dialysis in recent years, the authors interpret the effectiveness and limitations of prophylactic drug strategies, including using fish oil, anticoagulation, anti-platelet, lipid-lowering agents, etc., in order to promote the proper use of these agents in clinical practice, and improve the effect of prophylaxis and treatment of vascular access dysfunction.
目的 评价健身气功八段锦对慢性阻塞性肺疾病（COPD）稳定期患者临床疗效及肺功能的影响。 方法 2011年6月－2012年5月将COPD稳定期患者随机分为试验组和对照组各40例。在两组均接受西医基础治疗基础上，试验组同时采用健身气功八段锦肺康复训练：每日下午练习气功八段锦1次，每次30 min，疗程90 d。观察两组患者的临床疗效及肺功能改善情况。 结果 观察期（两组各1例）患者不能坚持而弃之。试验组总疗效、肺功能改善情况优于对照组（P＜0.05）。 结论 通过健身气功八段锦训练可在一定程度上改善COPD稳定期患者的临床疗效及肺功能，值得推广。