高压氧治疗患者的心理护理

主要通过观察高压氧治疗患者的心理变化，根据不同类型的心理表现，给予相应的心理护理，使各种疾病患者均顺利完成高压氧治疗，产取得显著的疗效。因此，心理护理在高压氧治疗过程中起到了主要的作用。     

早期护理干预在新生儿黄疸治疗效果的影响

目的探讨早期护理干预对新生儿黄疸治疗效果的影响。方法对照组患儿采取常规护理,实验组患儿采取早期护理干预。观察患儿胎便初排时间和胎便转黄时间;观察患儿干预前后血清胆红素、体质量变化情况。结果实验组患儿胎便初排时间和胎便转黄时间均低于对照组,差异有统计学意义(P0.05),实验组患儿干预后血清胆红素、体质量均优于干预前和对照组,差异有统计学意义(P0.05),对照组患儿干预后血清胆红素优于干预前,差异有统计学意义(P0.05)。结论早期护理干预对新生儿黄疸治疗效果有积极的影响,能够缩短患儿胎便初排时间和胎便转黄时间,改善患儿血清胆红素、体质量水平。     

抚触护理对新生儿高胆红素血症的影响

目的探讨抚触护理对新生儿高胆红素血症的影响。方法选取江西省萍乡湘雅萍矿医院2012年8月至2015年1月收治的96例高胆红素血症患儿作为研究对象。按照入院顺序随机均分为实验组和对照组,对照组患儿进行常规护理,实验组患儿在对照组护理的基础上进行抚触护理。观察患儿经皮胆红素指数、住院时间、黄疸持续时间。结果护理干预前,两组患儿经皮胆红素指数水平对比,差异无统计学意义(P0.05);护理干预后,两组患儿经皮胆红素指数水平均低于护理干预前,差异有统计学意义(P0.05);护理干预后,实验组患儿经皮胆红素指数水平低于对照组,差异有统计学意义(P0.05)。实验组患儿住院时间、黄疸持续时间均低于对照组,差异有统计学意义(P0.05)。结论抚触护理对新生儿高胆红素血症有积极的影响,能够改善患儿经皮胆红素指数水平,缩短患儿住院时间、黄疸持续时间,临床应用价值较高。     

早期多药联合干预对早产儿脑白质软化的治疗效果观察

目的分析并研究早期多药联合干预对早产儿脑白质软化的治疗效果。方法将珠海市妇幼保健院收治的早产儿脑白质软化患儿68例作为研究对象,随机将患儿分为两组,每组各34例,其中对对照组患儿实施常规治疗方式,给予观察组患儿在常规治疗的基础上实施早期多药(神经节苷脂、1,6-二磷酸果糖和鼠神经生长因子)联合干预治疗,同时分别给予两组患儿脑白质损伤程度比较,并于患儿1岁时进行智力发育指数和心理运动发育指数的评价比较。结果观察组患儿脑白质损伤轻度显著高于对照组患儿,脑白质损伤重度显著低于对照组患儿,数据比较差异具有统计学意义(P0.05);观察组患儿智力发育指数与心理运动发育指数均显著高于对照组患儿,数据比较差异具有统计学意义(P0.05)。结论对早产儿脑白质软化患儿采用神经节苷脂、1,6-二磷酸果糖和鼠神经生长因子等多药早期治疗能够明显缓解患儿脑白质软化持续性病变的发展,治疗效果显著。     

儿科住院患儿家长对护理工作

为了解护士所提供的护理服务是否适合住院患儿的需要,采用本院护理部设计的护理满意度调查表,对住院的100例患儿家长进行了满意度调查。结果表明,住院患儿家长对护理服务的满意度均在85%以上,其中最好的是护士的服务态度95%,最低的是对患儿的健康教育为86%。提示加强对患儿家长的健康教育,改善护士的服务态度,提高儿科护士静脉穿刺技术及加强专业知识学习是提高家长对护理工作满意度的重要措施。     

采用不同剂量重组人生长激素治疗特发性矮小症的效果分析

目的探讨和分析采用不同剂量重组人生长激素治疗特发性矮小症的效果。方法选取2013年11月至2015年11月期间在佛山市第一人民医院接受临床治疗的60例特发性矮小症患儿作为研究对象,按照重组人生长激素的使用剂量不同分为3组,每组分别有20例患儿,对实验1组患儿每周给予0.26 mg/kg,对实验2组患儿每周给予0.35 mg/kg,对实验3组患儿每周给予0.41 mg/kg,分析3组患儿的效果。结果实验2组、实验3组治疗之后的ΔHt SDS、GV、IGF-1、IGFBP-3及患儿家长对治疗效果的总满意度与实验1组相比较,组间差异明显(P0.05)。结论每周应用O.35 mg/kg和0.41 mg/kg的重组人生长激素治疗特发性矮小症患儿的临床效果较佳。     

家庭护理对减少学龄前儿童哮喘再入院发生率的影响

目的家庭护理对减少学龄前儿童哮喘再入院发生率的影响进行分析。方法选取南昌市第三医院哮喘患儿52例为此次研究对象,均分成观察组以及对照组,对照组患儿采用传统护理;观察组患儿给予家庭护理,对两组患儿的哮喘发作情况进行比较分析。结果观察组患儿的哮喘发作情况明显少于对照组(P0.05),组间比较差异具有统计学意义。结论给予家庭护理能够有效改善哮喘患儿的病情,缩短住院天数,临床中可推广使用。     

血清微量元素缺乏哮喘患儿的治疗观察

目的探究吸入丙酸氟替卡松治疗血清微量元素铁、锌缺乏的咳嗽变异性哮喘患儿的临床效果观察。方法选取佛山市第一人民医院过往72例咳嗽变异性哮喘患儿作为研究对象,随机分配为每组36例,观察组和对照组两组形式。对照组患儿是从血清微量元素铁、锌缺乏的患儿中随机抽取的,观察组是从血清微量元素铁、锌正常的患儿中抽取的,同时给予吸入丙酸氟替卡松治疗。随访时间是1年,持续的吸入治疗6个月的时间,对两组患儿的治疗效果进行对比观察研究。结果两组患儿在出现喘息、咳嗽消失时间、发展成为哮喘、复发例数等方面进行对比,差异具有统计学的意义(P0.05)。结论血清微量元素铁、锌缺乏的咳嗽变异性哮喘患儿,会致使气道高反应机会增高,容易发生反复呼吸道感染,增加了发展成为哮喘的风险,影响到丙酸氟替卡松治疗的效果。     

多巴胺持续头皮静脉输液的局部皮肤变化临床观察及护理

新生儿缺血缺氧性脑病是围产期窒息后严重的脑损伤并发症，是新生儿致残和死亡的主要原因之一。临床上在常规治疗的同时加用多巴胺持续静脉输液，以改善缺血缺氧情况；做好穿刺部位的护理，是顺利执行医嘱，防止发生新的机体损伤，避免增加患儿痛苦的关键。     

探讨鼻塞式持续正压通气对小儿重症肺炎并发呼吸衰竭的治疗效果

目的探讨鼻塞式持续正压通气(NCPAP)对小儿重症肺炎并发呼吸衰竭的治疗效果。方法将2012年11月到2015年10月来华中科技大学同济医学院附属孝感医院接受治疗的小儿重症肺炎并发呼吸衰竭患者82例,按照试验治疗方式的不同,将82例患儿随机分为试验组和对照组两组,每组41例。两组患儿在采用吸痰、平喘、抗生素等治疗的基础上,对照组采用面罩供氧方式,试验组采用鼻塞式持续正压通气供氧的治疗方式。比较两组患儿治疗总有效率、血气分析指标:血氧分压(Pa O2)、二氧化碳分压(Pa CO2)转变情况、两组患儿治疗前后主要临床症状缓解情况。结果 1试验组患儿的心率恢复正常时间、发绀消失时间、呼吸困难缓解时间、肺部啰音消失时间和临床症状体征消失时间,较对照组明显缩短(P0.05);2试验组治疗有效率(92.68%,n=41)高于对照组的治疗有效率(75.61%,n=41),差异有统计学意义(χ2=4.48,P0.05);3两组患儿在治疗前30 min血气分析指标比较无显著差异性(P0.05),但治疗前后两组患儿的血气分析指标均得到明显改善(P0.05),且试验组改善幅度优于对照组(P0.05)。结论鼻塞式持续正压通气对小儿重症肺炎并发呼吸衰竭的治疗效果显著,快速缓解临床症状,改善血气分析指标,值得临床推广。     

Osmotic phenomena in application for hyperbaric oxygen treatment

Hyperbaric oxygen (HBO) treatment defines the medical procedure when the patient inhales pure oxygen at elevated pressure conditions. Many diseases and all injuries are associated with a lack of oxygen in tissues, known as hypoxia. HBO provides an effective method for fast oxygen delivery in medical practice. The exact mechanism of the oxygen transport under HBO conditions is not fully identified. The objective of this article is to extend the colloid and surface science basis for the oxygen transport in HBO conditions beyond the molecular diffusion transport mechanism. At a pressure in the hyperbaric chamber of two atmospheres, the partial pressure of oxygen in the blood plasma increases 10 times. The sharp increase of oxygen concentration in the blood plasma creates a considerable concentration gradient between the oxygen dissolved in the plasma and in the tissue. The concentration gradient of oxygen as a non-electrolyte solute causes an osmotic flow of blood plasma with dissolved oxygen. In other words, the molecular diffusion transport of oxygen is supplemented by the convective diffusion raised due to the osmotic flow, accelerating the oxygen delivery from blood to tissue. A non steady state equation for non-electrolyte osmosis is solved asymptotically. The solution clearly demonstrates two modes of osmotic flow: normal osmosis, directed from lower to higher solute concentrations, and anomalous osmosis, directed from higher to lower solute concentrations. The fast delivery of oxygen from blood to tissue is explained on the basis of the strong molecular interaction between the oxygen and the tissue, causing an influx of oxygen into the tissue by convective diffusion in the anomalous osmosis process. The transport of the second gas, nitrogen, dissolved in the blood plasma, is also taken into the consideration. As the patient does not inhale nitrogen during HBO treatment, but exhales it along with oxygen and carbon dioxide, the concentration of nitrogen in blood plasma drops and the nitrogen concentration gradient becomes directed from blood to tissue. On the assumption of weak interaction between the inert nitrogen and the human tissue, normal osmosis for the nitrogen transport takes place. Thus, the directions of anomalous osmotic flow caused by the oxygen concentration gradient coincide with the directions of normal osmotic flow, caused by the nitrogen concentration gradient. This leads to the conclusion that the presence of nitrogen in the human body promotes the oxygen delivery under HBO conditions, rendering the overall success of the hyperbaric oxygen treatment procedure.     

Revealing the ionization ability of binding site I of human serum albumin using 2-(2'-hydroxyphenyl)benzoxazole as a pH sensitive probe

The ability of site I of human serum albumin (HSA) to bind medium sized molecules is important for the distribution, metabolism, and efficacy of many drugs. Herein, we show that this binding site has the ionization ability that may alter the drug structure during the process of its delivery. We reveal this ability by employing 2-(2'-hydroxyphenyl)benzoxazole (HBO) as a pH sensitive probe. Binding of HBO in site I is studied here at physiological pH 7.2 using steady-state and lifetime spectroscopic measurements, molecular docking and molecular dynamics (MD) simulation methods. The complex photophysics of HBO and the unique fluorescence signature of its anionic form indicate that, upon binding with HSA, the molecule exists in equilibrium between the anionic and the syn-keto forms. The position of HBO inside the binding site was determined experimentally by measuring the fluorescence quenching of W214, the sole tryptophan residue in HSA. The ionization degree of HBO inside the binding site was estimated to be close to the ionization degree of HBO in an aqueous solution of pH 10. This was concluded by comparing the fluorescence behavior of bound HBO to that of HBO in different solvents and in aqueous solutions of different pH values. Molecular docking and MD simulations show that HBO binds in site I close to W214, confirming the experimental results, and pinpoint the dominant role of hydrophobic interactions in the binding site. The formation of the anionic form is proposed to be due to through-space interaction between the OH group of HBO and both R222 and I290 with a binding mode similar to that of warfarin in site I. Comparison of the results with those of HBO mixed with key amino acids in solution indicates the importance of through-space interaction in the formation of the anion, similar to enzymatic reactions.     

广州市花都区儿童保健服务现状与对策

目的通过对花都区儿童保健情况进行调查,了解该地区儿童保健服务现状,为提出建议及对策提供科学依据。方法通过问卷调查、定性访谈等对全区16家承担基本公共卫生服务的单位进行调查。结果全区16家社区卫生服务中心设有儿童保健门诊16家,共有儿保人员41名,大专及以上学历38人,占92.7%;专职31人,占75.6%;2011年至2014年儿童建档率、新生儿访视及集体儿童体检逐年递增。结论政府要合理配置医疗资源,加大对儿童保健服务的投入,社区卫生服务中心应重视儿保门诊的规范化建设,给予充足的人员配置,从而提高儿童保健综合服务能力。     

高压氧治疗糖尿病足的疗效分析

为观察高压氧(HBO)治疗糖尿病并发糖尿病足的临床疗效,HBO组36例患者在使用抗生素及局部换药等治疗的同时,采用HBO治疗;对照组34例患者仅使用抗生素及局部换药等治疗。结果表明,HBO组患者总的有效率为91.7%,而对照组总有效率为67.5%,两组的疗效有显著性差异(P<0.05)。HBO对糖尿病足有显著的疗效,值得临床进一步研究和应用。     

Differential solvation and tautomer stability of a model base pair within the minor and major grooves of DNA

2-(2'-Hydroxyphenyl)benzoxazole (HBO) may be used as a model base pair to study solvation, duplex environment, and tautomerization within the major and minor groves of DNA duplexes. In its ground state, HBO possesses an enol moiety which may be oriented syn or anti relative to the imino nitrogen of the benzoxazole ring. In the absence of external hydrogen-bond donors and acceptors HBO exists as the internally hydrogen-bonded syn-enol, a mimic of the rare base pair tautomer found in DNA, which may be photoinduced to tautomerize and form the keto tautomer, a mimic of the dominant base pair tautomer. Previously, we demonstrated that when incorporated into DNA such that the enol moiety is positioned in the major groove, HBO is not solvated, exists exclusively as the internally hydrogen-bonded syn-enol which is efficiently photoinduced to tautomerize, and the corresponding keto tautomer is preferentially stabilized. In stark contrast, we now show that when HBO is incorporated in DNA such that the enol moiety is positioned in the minor groove, the enol tautomer is preferentially stabilized. Molecular dynamics simulations suggest that this results from the formation of a stable hydrogen-bond between the HBO enol and the O4' atom of an adjacent nucleotide, an H-bond acceptor that is only available in the minor groove. The differential stabilization of the enol and keto tautomers in the major and minor grooves may reflect the functions for which these environments evolved, including duplex replication, stability, and recognition.     

Rotational energy barrier of 2-(2',6'-dihydroxyphenyl)benzoxazole: a case study by NMR

2-(2'-Hydroxyphenyl)benzoxazole (HBO) derivatives represent an important class of luminescent materials, as they can undergo excited state intramolecular proton transfer (ESIPT). The material's ESIPT properties are dependent on the ratio of two different rotamers, whose interconversion is poorly understood. By using HBO derivative 4, the rotational energy barrier of 2- (2',6'-hydroxyphenyl)benzoxazole is determined to be 10.5 kcal/mol by variable-temperature NMR. Although a HBO derivative typically exhibits two rotamers with O···H-O (e.g., 1a) and N···H-O bonding (e.g., 1b), correlation of NMR with fluorescence data reveals that the rotamer with N···H-O bonding is predominant in the solution.     

Femtosecond fluorescence upconversion studies of excited-state proton-transfer dynamics in 2-(2′-hydroxyphenyl)benzoxazole (HBO) in liquid solution and DNA

A femtosecond fluorescence upconversion study is reported for HBO in solution, as well as for HBO incorporated in DNA. The typical time for the excited-state intramolecular proton-transfer reaction of the syn-enol tautomer in solution and in DNA has been determined to be 150 fs. In addition, the lifetimes of the keto, the anti-enol and the ‘solvated enol’ tautomer forms were determined in protic solvents, aprotic solvents and DNA. Picosecond rise and decay components in the fluorescence transients with characteristic times between 3 and 25 ps are also observed and attributed to the effects of vibrational cooling.     

A theoretical prediction about harnessing ESPT process for HBO derivatives

The different excited-state behaviors involved in excited-state proton transfer (ESPT) process of a series of 2-(2-hydroxyphenyl)benzoxazole (HBO) derivatives have been theoretically investigated. The primary bond lengths and bond angles were analyzed. Coupling with the infrared (IR) vibrational spectra, we confirmed that the intramolecular hydrogen bond O–H···N should be strengthened in the S₁ state, which might provide the possibility for ESPT reaction, whereas introducing the fused rings may weaken the hydrogen bond in excited state. By investigating the vertical excitation process, the charge redistribution was explored. It is found that the electron-accepting –NO₂ and –COOH would facilitate the ESPT reaction. With adding fused rings to HBO, less charge transfer exists in the transition process, which can reasonably explain the weakening hydrogen bond phenomenon in excited states. Via constructing the potential energy curves of both S₀ and S₁ states, we further confirm that electron-accepting substitutions could promote the ESPT process for HBO systems. And fused rings do inhibit ESPT reaction to a great extent. We believe this work not only elaborates the different excited-state proton transfer behaviors for a series of HBO derivatives but also presents a new harnessing ESPT process through substitutional effects.     

微量元素锌与小儿健康状况分析

对98例西安阎良一四一医院儿科门诊就诊的小儿发锌进行了测定，分析了锌与小儿健康的关系，并对低锌的小儿进行了治疗。通过治疗(药疗、食疗)症状明显好转，复查发锌正常者达85．7％。