【摘要】 目的 對腦梗死患者施行靜脈溶栓治療前后的相關狀況和指標進行評價分析。 方法 2003年1月-2010年11月對神經內科收治的29例腦梗死患者予以靜脈溶栓治療及護理，并就治療前后各相關時間點血壓監測及美國國立衛生研究院卒中量表（National Institute of Health stroke scale，NIHSS）評分情況進行分析。 結果 溶栓前后血壓對比顯示:溶栓后2 h收縮壓相對于溶栓前和溶栓后24 h升高（Plt;0.05）；溶栓前后NIHSS評分差異有統計學意義（Plt;0.05）。 結論 溶栓后患者收縮壓出現升高，護理上應該加強血壓監控，為臨床治療提供支持。【Abstract】 Objective To investigate the correlated condition and clinical index changes before and after the intravenous thrombolysis of the cerebral infarction patients. Methods The blood pressure and the National Institutes of Health stroke scale (NIHSS) score of 29 cerebral infarction patients with the intravenous thrombolysis treatment between January 2003 and November 2010 were measured and analyzed. Results Two hours after the thrombolysis, the systolic blood pressure significantly increased compared with those before the intravenous thrombolysis and 24 hours after intravenous thrombolysis （P＜0.05）. NIHSS score was significantly decreased after the thrombolysis （P＜0.05）. Conclusions Systolic blood pressure significantly increases after the intravenous thrombolysis. Intensive blood pressure monitoring and controlling may be beneficial to the treatment and prognosis.
Objective To explore the current situation and influencing factors of self-management behavior in patients with primary glaucoma, so as to provide a theoretical basis for formulating intervention strategies to improve patients’ self-management ability. Methods Using convenient sampling method, 400 patients with primary glaucoma visiting the Outpatient Department of Ophthalmology, West China Hospital of Sichuan University between September 2019 and March 2020 were selected. Their current situation of self-management behavior was investigated by self-management behavior questionnaire, and the influencing factors of self-management behavior were analyzed. Results A total of 381 valid questionnaires were recovered. The total score of self-management behavior of patients with primary glaucoma was 51.11±6.22, and the mean scores of life debugging dimension, functional health care dimension, and medical management dimension were 2.66±0.67, 3.02±0.81, and 3.13±0.60, respectively. The results of multiple linear regression analysis showed that age [40-59 vs. <40 years old: unstandardized partial regression coefficient (b)=–2.830, 95% confidence interval (CI) (–4.813, –0.847), P=0.005; ≥60 vs. <40 years old: b=–2.660, 95%CI (–4.820, –0.498), P=0.016], occupation [in-service vs. farmers: b=2.639, 95%CI (0.303, 4.976), P=0.027; unemployed or retired vs. farmers: b=2.913, 95%CI (0.995, 4.831), P=0.003], smoking [smoking vs. non-smoking: b=–3.135, 95%CI (–5.196, –1.075), P=0.003], disease type [primary open-angle glaucoma vs. primary angle-closure glaucoma: b=–2.119, 95%CI (–3.317, –0.921), P=0.001], number of follow-up visits [≤2 vs. >2: b=–1.071, 95%CI (–2.118, –0.024), P=0.045], whether fixed doctor follow-up [unfixed vs. fixed: b=–2.619, 95%CI (–3.632, –1.605), P<0.001] were correlated with the total score of self-management behavior of patients with primary glaucoma. Conclusions The self-management behavior of patients with primary glaucoma is in the middle level. The main factors affecting the self-management behavior level of primary glaucoma patients include age, occupation, smoking, disease type, follow-up times, and fixed doctor’s follow-up. Ophthalmologists should pay attention to the current situation and influencing factors of self-management behavior and take feasible intervention measures to improve the self-management behavior of patients with primary glaucoma.
【摘要】 目的 分析總結妊娠合并結核性腦膜炎患者的相關特征及護理經驗。 方法 對2010年1-12月收治的8例妊娠合并結核性腦膜炎患者的相關資料進行回顧性分析，并就疾病特點所采取的有效護理措施進行表述。 結果 6例患者好轉出院繼續治療（均于出院后1周內終止妊娠），1例經搶救后轉院行引產手術，1例因經濟原因自動出院。 結論 應大力普及妊娠期結核性腦膜炎相關知識，重視首發癥狀及腰椎穿刺檢查結果，做到早發現，早診斷，早治療，并采取相應的護理措施，減少并發癥和致死率。【Abstract】 Objective To summarize the characteristics of pregnant women with tuberculous meningitis and the nursing measures for these patients. Methods The clinical data of 8 pregnant patients with tuberculous meningitis diagnosed between January 2010 and December 2010 were retrospectively analyzed. The characteristics of race, admitting diagnosis, basis diseases, premiers symptoms, and course of disease were analyzed, and the nursing measures were summarized. Results Six patients recovered and left the hospital (all had terminationed pregnancy after discharge within one week), one was transferred to another hospital for induction of labor after emergency rescue, one left the hospital for economical reason. Conclusions The propagation of the knowledge of tuberculous meningitis is very important. We should pay more attention to its early symptoms, corning′s puncture examination and give suitable nursing care as soon as possible.
Angiotensin converting enzyme inhibitor (ACEI) is an important type of antihypertensive drug. Much evidence shows that ACEI not only decreases the blood pressure but also has the protective effect on the cardiac and cerebral vessels. ACEI may prevent the stroke. To provide the best evidence for the clinical practice, we electronically searched RCTs and systematic reviews from MEDLINE and The Cochrane Library to evaluate the mechanisms and the effects of ACEI in stroke treatment and prevention.
Objective To investigate the value of back propagation (BP) neural network for recognizing gastric cancer cell. Methods A total of 510 cells was selected from 308 patients. There were 210 gastric adenocarcinoma cells and 300 non-cancer gastric cells. Ten morphological parameters were measured for each cell. These data were randomly divided into two groups: training dataset (A) and test dataset (B). A three-layer BP neural network was built and trained by using dataset A. The network was then tested with dataset A and B.Results For data A, the sensitivity of network was 99%, specificity 99%, positive predictive value 98%, negative predictive value 99%, and accuracy 99%. For data B, the sensitivity of network was 99%, specificity 97%, positive predictive value 96%, negative predictive value 99%, the accuracy 98%. With receiver operator characteristic (ROC) curve evaluation, the area under ROC curve was 0.99.Conclusion The model based on BP neural network is very effective. A BP neural network can be used for effectively recognizing gastric cancer cell.
In recent years, the incidence rate of ischemic stroke in people living with HIV/AIDS (PLWHA) is increasing, attracting wide attention from scholars at home and abroad. In addition to traditional risk factors of stroke, the secondary ischemic stroke in PLWHA is also affected by HIV infection. This study reviews the incidence rate and risk factors of secondary ischemic stroke in PLWHA, in order to provide a theoretical basis for preventing and reducing the incidence of ischemic stroke in PLWHA.
目的 觀察對比卒中單元早期康復護理對卒中偏癱患者肢體功能恢復的效果。 方法 將2011年6月－12月期間住院的腦卒中偏癱患者88例，按照發病時間分為試驗組和對照組，發病5 d以內急性期入院者為試驗組，5 d以上入院的超過急性期者為對照組。在規范治療基礎上予以相同的康復護理干預，對其日常生活活動能力采用改良的Rakin量表MRS評分來進行功能評定。 結果 試驗組和對照組生活能自理人數分別占25%、13.6%，能部分自理的人數分別占56.8%、40.9%，試驗組肢體功能恢復明顯高于對照組（P＜0.05）。 結論 卒中單元早期康復護理對腦卒中偏癱患者肢體功能恢復有重要意義。
Objective To investigate the current status of randomized controlled trials (RCTs) and clinical controlled trials (CCTs) on pressure sore in China. Methods We searched Chinese Journal of Nursing, Chinese Journal of Practical Nursing and Journal of Nurses Training in CNKI and VIP (January 2000 to December 2005) for Chinese articles on pressure sore, using "pressure sore", "bed sore", "nursing", "treatment", "prevention", "evaluation" and "management" as search terms. The retrieved articles were summarized. Results We identified 16 reports (10 RCTs and 6 CCTs). The studies were judged to be of low quality.There was one study on the evaluation, two on the prevention, and 13 on the treatment of pressure sores. Conclusion The current studies on pressure sore in China are focusing on treatment. Randomized controlled trials of large sample size of pressure sore are needed to improve nursing quality.
Objective To investigate the histological origin, diagnosis, differential diagnosis and treatment of thyroid carcinoma showing thymus-like differentiation (CASTLE). Methods Five patients with thyroid CASTLE were adopted by surgical resection and postoperative radiotherapy, and the CD5, CD117, CK5/6, P63, thyroid transcription factor-1 (TTF-1), carcino-embryonic antigen (CEA), calcitonin (CT), Ki-67, chromogranin A (CgA), thyrobolulin (Tg), peroxisome proliferator activated receptorγ (PPAR-γ), sodium iodide symporter (NIS), and thyroid stimulating hormone receptor (TSHR) were detected in tumor tissues by immunohistochemistry S-P method and v-raf murine sarcoma viral oncogene homolog B1 (BRAF)V600E gene and telomerase reverse transcriptase (TERT) promoter mutations were detected by DNA sequencing. Eight cases of poorly differentiated thyroid carcinoma and 6 cases of anaplastic thyroid carcinoma were adopted by comprehensive comparative analysis. Results Thyroid CASTLE tumor cells showed the positive expression of CD5, CD117, CK5/6 and P63, and the negative expression of TTF-1, CT, CgA, Tg, PPAR-γ, NIS and TSHR. There were partly positive expression for CK5/6, P63, TTF-1, CgA, Tg, NIS and TSHR, and negative expression for CD5 and CD117 in the poorly differentiated thyroid carcinoma and anaplastic thyroid carcinoma. The BRAFV600E gene and TERT promoter mutations were not detected in thyroid CASTLE, and the BRAFV600E gene mutations were also not detected in the poorly differentiated thyroid carcinoma and anaplastic thyroid carcinoma. Four cases of poorly differentiated thyroid carcinoma showed the TERT promoter mutations (4/8) included 3 cases with C228T and 1 case with C250T. Two cases of anaplastic thyroid carcinoma showed the TERT promoter mutations (2/6) included 1 case with C228T and 1 case with C250T. There was no recurrence and metastasis after 3–47 months (an average of 25.6 months) of followed-up in thyroid CASTLE patients. Conclusions The histological origin of thyroid CASTLE may be not related to the thyroid. There is important clinical value to combined detection of CD5, CD117, P63, TTF-1, Tg, NIS, and TSHR for the diagnosis and differential diagnosis of thyroid CASTLE. The further study still need for the diagnosis and differential diagnosis of thyroid CASTLE according to the detection of BRAFV600E and TERT promoter mutations.
【摘要】 目的 分析床旁陪護行為對視頻腦電圖的影響，總結護理指導的意義。 方法 2008年7-9月對214例患者行24 h視頻腦電圖監測（video EEG，VEEG）監測，每例患者留一床旁陪護。重點觀察坐床沿或同睡、用手機、拍打及按摩行為，并比較初次及再次護理指導后上述行為發生情況。 結果 坐床沿或同睡、用手機、拍打、按摩均可影響VEEG，初次指導后以上行為出現率分別為62.6%、55.1%、30.4%、20.1%；再次指導后以上行為分別減少78.4%、75.4%、78.5%、79.1%，VEEG監測質量均有提高。 結論 應將規范床旁陪護行為的指導貫穿于VEEG監測的全過程。【Abstract】 Objective To assess the impacts of bedside accompany behavior on the quality of video-electroencephalography (VEEG). Methods A total of 214 patients underwent 24-hour VEEG monitoring from July to September 2008. Each patient had a bedside-accompany family member. The behaviors of accompany included sitting at the bed, using mobile phone, clapping, and kneading the patients, which were evaluated after the first and second nursing education. Results Sitting at the bed, using mobile phone, clapping, and kneading the patients influenced the quality of VEEG. After the first education, the occurrences of the above unfavorable behaviors were 62.3%, 55.1%, 30.4%, and 20.1%. After the second education, the unfavorable behaviors reduced 78.4%, 75.4%, 78.5%, and 79.1% respectively; the VEEG quality improved. Conclusion Proper bedside accompany behavior may improve the quality of VEEG monitoring.