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        west china medical publishers
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        find Author "周敏" 36 results
        • 血友病的治療進展

          血友病是一組X連鎖隱形遺傳性出血性疾病,主要表現為自發性出血或外傷、手術后出血,反復關節肌肉出血可以致殘,危險部位出血甚至威脅生命。替代治療是血友病唯一有效的治療方法,同時需要康復、理療、護理、心理關懷等綜合治療。治療理念已從出血后按需治療發展為預防治療,未來的發展方向將是基因檢測阻斷患者出生,長效凝血因子的輸注以及基因治療等,從而使患者徹底擺脫疾病的困擾。

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        • The awareness and satisfaction of medical aid policy among the poor population in Sichuan province: a cross-sectional survey

          ObjectivesTo explore the poor population’s cognition and satisfaction on medical assistance policies in Sichuan province, so as to provide evidence for improving health poverty alleviation policies.Methods A telephone survey was conducted between October and December 2017 among 1 280 poor individuals in Sichuan Province, with multi-stage stratified random sampling. The contents of the survey included general demographics of the poor population, and knowledge and satisfaction of health poverty alleviation policies.ResultsThe awareness rate of medical assistance policy was 91.80%, and the satisfaction rate was 91.88%. Poor individuals from non-poor counties, who had been out of poverty, and who reported that they had not signed up for family doctors, had low awareness of poverty alleviation policies. Poor individuals from non-poor counties, who usually went to the municipal hospital, who reported that they have not signed up for family doctors, and who do not know about health policies for poverty alleviation had a lower satisfaction rate.ConclusionsThe overall awareness rate and satisfaction rate of medical assistance policies in Sichuan province are relatively high, however, there are still some shortage. In the future, more attention should be paid to strengthen the promotion of health poverty alleviation policies for non-poor areas and those who had been lifted out of poverty, speeding up the contract service of family doctors and exploring ways to further alleviate the burden of medical expense of patients with serious diseases.

          Release date:2019-03-21 10:45 Export PDF Favorites Scan
        • Influence of Different Pressures and Time of CO2 Pneumoperitoneum on Adhesive and Invasive Ability of Gastric Cancer Cells

          Objective To investigate the influence of different pressures and duration of CO2 pneumoperitoneum on the adhesive and invasive ability of gastric cancer cells based on the expressions of adhesive and invasive molecules. Methods With an artificial CO2 pneumoperitoneum model in vitro, human gastric cancer cell lines including MKN-45, SGC-7901, and MKN-28 were exposed to CO2 in different environments: 0 mm Hg (1 mm Hg=0.133 kPa), 9 mm Hg (2 h, 4 h), and 15 mm Hg (2 h, 4 h). The expressions of mRNA of E-cadherin, intercellular adhesion molecule-1 (ICAM-1), matrix metalloproteinase-2 (MMP-2), and vascular endothelial growth factor-A (VEGF-A) in the different environments were measured by RT-PCR. The expressions of protein of E-cadherin and ICAM-1 in the environments of 0 mm Hg and 15 mm Hg (4 h) were measured by FCM. Results With the increase of duration or pressure, RT-PCR showed that there was a downward trend in the expression of E-cadherin mRNA as well as there were upward trends in the expressions of ICAM-1, MMP-2, and VEGF-A mRNA; FCM showed that there was a downward trend in the expression of E-cadherin protein while the expression of ICAM-1 protein showed the opposite change. But there were no obvious differences under different environment (P>0.05). Conclusions Under low pressure (≤15 mm Hg) and short time (≤4 h) of CO2 pneumoperitoneum, the adhesive and invasive ability of gastric cancer cells could not be affected, which means that under this environment, CO2 pneumoperitoneum will not increase the possibility of neoplasm metastasis.

          Release date:2016-09-08 10:54 Export PDF Favorites Scan
        • BIOLOGICAL FEATURES AND IDENTIFICATION OF ENDOTHELIAL PROGENITOR CELLS FROM PERIPHERAL BLOOD

          ObjectiveTo compare the biological features of early and late endothelial progenitor cells (EPCs) by isolating and culturing early and late EPCs from the human peripheral blood so as to find some unique properties of EPCs and to propose a suitable strategy for EPCs identification. MethodsMononuclear cells were isolated from the human peripheral blood using density gradient centrifugation. Then, the cells were inoculated in human fibronectin-coated culture flasks and cultured in endothelial cell basal medium 2. After 4-7 days and 2-3 weeks culture, early and late EPCs were obtained respectively. The morphology, proliferation potential, surface markers, cytokine secretion, angiogenic ability, and nitric oxide (NO) release were compared between 2 types of EPCs. Meanwhile, the human aortic endothelial cells (HAECs) were used as positive control. ResultsThe morphology of early and late EPCs was different:early EPCs formed a cell cluster with a spindle shape after 4-7 days of culture, and late EPCs showed a cobblestone appearance. Late EPCs were characterized by high proliferation potential and were able to form capillary tubes on Matrigel, but early EPCs did not have this feature. Both types EPCs could ingest acetylated low density lipoprotein and combine with ulex europaeus Ⅰ. Flow cytometry analysis showed that early EPCs did not express CD34 and CD133, but expressed the CD14 and CD45 of the hematopoietic stem cell markers;however, late EPCs expressed CD31 and CD34 of the endothelial cell markers, but did not express CD14, CD45, and CD133. By RT-PCR analysis, the expressions of vascular endothelial growth receptor 2 and vascular endothelial cadherin in early EPCs were significantly lower than those in the late EPCs and HAECs (P<0.05), but no significant difference was found in the expression of von Willebrand factor and endothelial nitric oxide synthase (eNOS) between 2 type EPCs (P>0.05). The concentrations of vascular endothelial growth factor, granulocyte colony-stimulating factor, and interleukin 8 were significantly higher in the supernatant of early EPCs than late EPCs (P<0.05). Western blot assay indicated eNOS expressed in both types EPCs, while the expression of eNOS in late EPCs was significantly higher than early EPCs at 5 weeks (P<0.05). Both cell types could produce similar amount of NO (P>0.05). ConclusionThe expression of eNOS and the production of NO could be used as common biological features to identify EPCs, and the strategy of a combination of multiple methods for EPCs identification is more feasible.

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        • 預見性護理在重度燒傷患者并發應激性潰瘍中的應用及效果觀察

          目的探討預見性護理在重度燒傷患者并發應激性潰瘍中的應用及效果觀察。 方法將2012年 1月-12月收治的96例患者隨機分為對照組與干預組,對照組采取常規護理措施,干預組實施預見性護理措施,觀察兩組患者并發應激性潰瘍的發生率。 結果對照組發生應激性潰瘍16例,發生率為33.3%,干預組發生應激性潰瘍7例,發生率為14.6%,兩組發生率差異有統計學意義(χ2=4.631,P=0.031)。 結論對重度燒傷患者實施綜合預見性護理,結合必要的藥物治療,可有效降低應激性潰瘍的發生,提高患者及家屬的滿意度。

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        • 人工鼻在燒傷合并吸入性損傷氣管切開術中的應用及護理

          目的探討人工鼻在燒傷合并吸入性損傷氣管切開術中的應用效果及護理方法。 方法對2012年3月-10月16例燒傷合并吸入性損傷氣管切開患者,通過氣管導管口接人工鼻吸氧的護理方法及應用效果進行回顧性總結。 結果16例燒傷合并吸入性損傷氣管切開患者,15例使用人工鼻,均無氣管導管堵塞及肺部感染等并發癥的發生,于傷后14~22 d拔除氣管導管;1例因傷后15 d轉入醫院時已患多重細菌肺部感染,予積極控制感染、營養支持及同時使用人工鼻等治療,于傷后38 d拔除氣管導管。 結論人工鼻用于燒傷合并吸入性損傷氣管切開術中,能使開放式的人工氣道處于封閉狀態,溫熱濕化氣道,過濾空氣中的灰塵,達到氧療效果,有效預防氣管導管堵塞及肺部感染,縮短帶管時間,值得臨床應用。

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        • 大面積燒傷患者營養護理

          【摘要】 目的 探討大面積燒傷患者營養護理的有效方法。 方法 對2005年1月-2009年12月收治的79例重度燒傷患者以口服及靜脈營養支持為主,并輔以鼻飼管補充。 結果 72例患者各項營養監測指標改善,全身營養狀況良好,保證了內環境的平衡,僅7例因傷勢嚴重死亡。 結論 營養護理關系到營養支持的成敗,大面積燒傷的營養支持宜采用胃腸道內、外營養相結合的原則。

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        • 改良的一次性濕熱交換器用于氣管切開堵管的效果觀察

          目的探討使用一次性套管的氣管切開患者堵管的最優方法。 方法對2012年8月-2013年3月間收治的18例吸入性損傷行氣管切開患者,在堵管期間采用改良后的一次性濕熱交換器進行堵管。具體方法是將一次性濕熱交換器上蓋掀開,填塞數層凡士林油紗,然后回蓋,并可連接封閉式吸痰管及吸氧管,接于一次性氣管套管,達到堵管目的。 結果一次性濕熱交換器材料易備,使用方便,無菌材料無需另行消毒,無咳出及誤吸風險,13例患者堵管效果滿意,順利拔管。 結論改良后的一次性濕熱交換器用于氣管切開堵管效果好,連接封閉式吸痰管方便吸氧、吸痰,患者舒適。

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        • 隆乳術后使用靜脈自控鎮痛泵的鎮痛效果調查分析

          目的對靜脈自控鎮痛泵(PCIA)用于隆乳術后疼痛的鎮痛效果進行調查分析,為更好地選用PCIA提供參考。 方法從2013年1月-11月收治的隆乳術患者中隨機抽取62例患者,根據患者是否同意使用鎮痛泵,將患者分為觀察組及對照組,采用視覺模擬評分(VAS)方法,對觀察組及對照組的鎮痛效果分別進行評分。 結果觀察組術后各時點VAS評分均低于對照組,差異均有統計學意義(P<0.05),觀察組各時段鎮痛效果均優于對照組;觀察組不良反應多于對照組,兩組間不良反應發生率差異無統計學意義(P>0.05)。 結論鎮痛泵對隆乳術后疼痛治療相比傳統止痛方法值得臨床推廣。

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        • 重度燒傷并發下肢深靜脈血栓開線的原因及護理對策

          目的探討重度燒傷康復期深靜脈血栓形成(DVT)的原因及護理對策,降低重度燒傷患者住院期間DVT的發生率,提高其治愈率。 方法對2012年1月-2013年2月發生重度燒傷且并發DVT的5例患者,予以制動、防止腹壓增加及藥物治療,并采取積極有效的護理措施,促進下肢靜脈回流,改變血液濃縮及高凝狀態,保護血管內膜不受損傷,以預防深靜脈血栓的發生。 結果64例患者僅5例發生DVT,經積極處置和護理全部治愈。 結論重度燒傷患者住院時間長,臥床時間久,極易發生下肢DVT,故重在預防,一旦發生,及時采取制動、溶栓等措施是保證患者康復的關鍵。

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