简介：【摘要】目的 ：研究 6s 管理模式在门诊护理服务中的应用价值，为进一步提高门诊护理服务质量奠定基础。 方法 ：我院门诊于 2019 年 4 月开始实施 6S 管理模式，分别选择 2018 年 3 月 -2019 年 3 月与 2019 年 4 月 -2020 年 4 月间各收治的 970 例患者为研究对象，通过比较两组患者对护理工作满意度以及各项护理质量考核结果，分析 6S 管理模式的应用价值。 结果： 比较患者对门诊护理工作的满意度情况，实施后显著优于实施前（ P ＜ 0.05 ）；比较实施前后科室护理质量考核结果，发现实施后门诊护理人员的劳动纪律评分、环境管理评分、职业形象评分与分诊候诊评分等显著优于实施前，组间数据差异显著（ P ＜ 0.05 ）。 结论 ：在门诊护理服务中，应用 6S 管理模式能够显著提高护理服务质量，推动门诊护理模式变革，具有满意效果。

简介：【摘要】目的：探讨 8S管理模式在消毒供应中心外来器械全流程管理中的应用效果。方法：本课题选取 2019.01到 2019.11时段内收取的外来器械共 600件，以随机抓阄法纳入参照组（ 300例）、管理组（ 300例）。即参照组为传统器械管理，管理组为器械 8S管理模式，比较器械质量合格率、消毒供应中心员工自我评价和满意度评分。结果：参照组器械质量合格率较低于管理组，即 91.67%＜ 96.67%，数据间比较有意义（ P＜ 0.05）。管理组消毒供应中心员工自我评价、满意度评分均优于参照组，数据间比较有意义（ P＜ 0.05）。结论：在消毒供应中心外来器械全流程管理过程中， 8S管理模式的选择不仅可提高器械质量合格率，还可增强消毒供应中心员工自我评价和满意度，应引起重视。

简介：【摘要】回顾性分析 5例 Madelung’s病病人资料，探讨此病病因、临床表现及治疗方法。该病病因尚不清，常见于中年男性，肿块主要对称分布于头颈部及上躯干部，呈典型“牛颈”或“驼峰”样外观。手术切除为主要治疗方法。该病恶变率低、预后良好。

简介：AbstractObjective:To review indications and techniques for the endoscopic endonasal approach to the craniovertebral junction (CVJ), analyze postoperative outcomes, and discuss important technical considerations.Methods:A retrospective analysis was performed on all patients undergoing endonasal endoscopic approaches to the CVJ from May 2007 to June 2017. Demographic information, presenting symptoms, imaging results, treatment course, postoperative functional status, and follow-up were recorded.Results:There was a total of 30 patients in this series, with a mean follow-up of 11.7 months. The average age was 33.6 years (range, 5-75 years), with 18 females and 12 males. The majority of patients (n = 22, 73.3%) had Chiari malformation type 1 with basilar invagination and symptomatic cervicomedullary compression as the indication for surgery. Intraoperative cerebrospinal fluid leak (CSF) was noted in 3 cases of odontoid resection and a single case of skull base resection. There were no postoperative CSF leaks. Overall, 81% of patients resumed regular diet by post-operative day 2 (range, 0-8 days). Severe postoperative dysphagia occurred in two cases with one requiring gastrostomy tube placement and another utilizing total parenteral nutrition for support prior to eventual gastrostomy. On average, patients were extubated by postoperative day 0.93 (range 0-3 days), with 85% extubated by postoperative day 1. A tracheotomy was required in one patient.Conclusion:The endonasal endoscopic approach is a valuable technique for access to the CVJ with minimal disruption of respiratory and alimentary function.

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简介：AbstractPeyronie’s disease (PD) is a benign, progressive fibrotic disorder characterized by scar or plaques within the tunica albuginea (TA) of the penis. This study provides new insights into the pathogenesis of PD based on data from different studies regarding the roles of cytokines, cell signaling pathways, biochemical mechanisms, genetic factors responsible for fibrogenesis. A growing body of literature has shown that PD is a chronically impaired, localized, wound healing process within the TA and the Smith space. It is caused by the influence of different pathological stimuli, most often the effects of mechanical stress during sexual intercourse in genetically sensitive individuals with unusual anatomical TA features, imbalanced matrix metalloproteinase/tissue inhibitor of metalloproteinase (MMP/TIMP), and suppressed antioxidant systems during chronic inflammation. Other intracellular signal cascades are activated during fibrosis along with low expression levels of their negative regulators and transforming growth factor-β1 signaling. The development of multikinase agents with minimal side effects that can block several signal cell pathways would significantly improve fibrosis in PD tissues by acting on common downstream mediators.

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简介：【摘要】目的：探讨外科护理管理中 6S管理模式的应用对患者满意度的影响。方法：将我院 80例外科患者，双盲随机法分二组。对照组给予常规外科护理管理，实验组实施外科 6S管理模式。比较两组护理前后负面情绪、患者满意度、各项护理质量评分。结果：实验组负面情绪低于对照组，患者满意度高于对照组，各项护理质量评分高于对照组，存在显著差异， P＜ 0.05。结论：外科患者实施外科 6S管理模式效果确切，可减轻患者的负面情绪，提高护理质量，提高患者的满意度，值得推广。

简介：［摘要］目的：探究导图式教学融入8s管理理念在护生教学管理中的应用效果。方法：选取2018年5月-2020年2月在我科实习的两届90名大专护生，同时选取10名具备资质认证老师作为一对一带教老师作为研究对象。将2019届45名护生作为观察组采用导图式教学融入8s管理理念进行入科教育、专科知识与技能培训、一对一清单教学计划。2018届45名护生作为对照组采用传统总-分教学模式。比较两届护生职业素养、专科知识技能考核成绩、沟通实践能力、10名一对一带教老师教学能力。结果：观察组职业素养、专科知识技能考核成绩、沟通实践能力、一对一带教老师教学能力得分均高于对照组（p＜0.05）。结论：导图式教学融入8s管理理念，教学活动更加计划性、规范性、导向鲜明。有助于学生准确把握学习的要点和记忆，学生更加规范自己的行为，在一定程度上提升了职业素养及沟通实践能力，同时提高了一对一带教老师教学能力，师生沟通交流。促进护生教学管理质量提升。

简介：摘要目的分析非小细胞肺癌(NSCLC)患者人S100钙结合蛋白A8/钙粒蛋白A(S100A8)、S100A9、基质金属蛋白酶9(MMP-9)的表达及意义。方法将2017年1月至2020年1月于四川省眉山市人民医院就诊的16例NSCLC患者纳入NSCLC组进行回顾性研究，将同期20例肺部良性疾病患者作为良性组，另选同期20名健康受试者作为对照组。通过酶联免疫吸附法法测定3组血清S100A8、S100A9、MMP-9水平，经受试者工作特征曲线分析3项指标对NSCLC的诊断价值，并分析其与NSCLC病理特征的关系。结果NSCLC组血清S100A8、S100A9及MMP-9水平均>良性组>健康组，差异均有统计学意义(P值均<0.05)；绘制受试者工作特征曲线结果显示，血清S100A8、S100A9预测NSCLC的曲线下面积(AUC)分别为0.953、0.977，诊断价值高；血清MMP-9预测NSCLC的AUC为0.846，诊断价值中等；经Spearman等级相关分析法发现，S100A8、S100A9、MMP-9表达均与组织分化程度呈负相关(P值均<0.05)，与TNM分期呈正相关(P值均<0.05)；且MMP-9表达与有无淋巴转移相关(r＝0.811，P<0.05)。结论NSCLC患者血清中S100A8、S100A9及MMP-9水平均呈高表达，且与组织分化程度、TNM分期等病理特征密切相关，可作为诊断NSCLC及评估预后的潜在分子标志物。

简介：摘要目的探讨"3S2E"护理管理模式在重症肺炎患者中的应用效果。方法采用便利抽样法，选取郑州大学第一附属医院2017年2月—2019年2月ICU收治的168例重症肺炎患者为研究对象，根据入院顺序编号，单号为观察组（n=84），双号为对照组（n=84）。对照组患者给予ICU常规护理方案干预，观察组患者在ICU常规护理基础上实行"3S2E"护理管理模式。比较两组患者干预前后呼吸功能、生命体征相关指标，焦虑自评量表（SAS）、抑郁自评量表（SDS）、匹兹堡睡眠指数量表（PSQI）得分，机械通气时间、住院时间。结果干预后，观察组每分钟通气量、呼吸频率、浅快呼吸指数、氧合指数、平均动脉压、中心动脉压和心率均低于对照组，两组比较差异有统计学意义（P<0.05）；观察组SAS、SDS、PSQI得分均低于对照组，两组比较差异有统计学意义（P<0.05）；观察组机械通气时间、住院时间均短于对照组（P<0.05），两组比较差异有统计学意义。结论重症肺炎患者采用"3S2E"护理管理模式干预，可有效改善患者呼吸功能，减轻患者焦虑、抑郁情绪，改善睡眠质量。

简介：AbstractIntroduction:Erosive adenomatosis of the nipple is a rare benign lesion involving nipple which can be easily misdiagnosed as more ominous entities such as Pagets disease.Here we reported a case of erosive adenomatosis on the nipple masquerading as paget’s disease.Case presentation:A 21-year-old woman presented with a 6-year history of breast erythema involving her left nipple with tenderness and mild itching. The nipple appeared rough and thickened with areas of erosion and fissuring. Physical examination of other areas of breast as well as imaging studies including ultrasound and mammography showed no abnormalities. The histological examination reveal adiagnosis of erosive adenomatosis of nipple (EAN). The patient was treated by a simple surgical excision without complications and recurrence during 9-month follow-up.Discussion:In the early stage, it can mimic eczema, but in the later stage, more serious diagnosis such as Pagets disease should be differential. It is diagnosed by histopathological examination. Surgical excision is an optimal choice for treament with or without plastic reconstruction.Conclusion:EAN should be considered in the diagnosis of erythema and erosion lesions involving nipple. The gold standard for diagnosis is histopathological examination. A prompt and correct diagnosis of EAN can avoid both unnecessary over treatment and patients emotional stress.

简介：摘要目的探讨S100A8和S100A9在H.pylori相关胃炎中的表达及其临床意义。方法选择2018年10月至2019年5月在山西医科大学第一医院确诊的慢性胃炎患者101例。采用免疫组织化学法检测101例慢性胃炎患者胃黏膜组织中S100A8和S100A9的表达(以吸光度表示)，同时采用RT-PCR法检测其中48例患者胃黏膜组织S100A8和S100A9的mRNA表达，并结合H-E染色病理诊断和临床H.pylori感染资料进行分析。统计学方法采用Mann-Whitney U检验、Kruskal-Wallis H检验和Spearman秩相关。结果101例患者中，慢性萎缩性胃炎(CAG)59例(CAG组)，慢性非萎缩性胃炎(NAG)42例(NAG组)；H.pylori阳性59例(H.pylori阳性组)，H.pylori阴性42例(H.pylori阴性组)。CAG组S100A8和S100A9的表达水平与NAG组比较[分别为0.10(0.07，0.13)比0.09(0.06，0.10)和0.13(0.08，0.15)比0.09(0.07，0.10)]，以及H.pylori阳性组S100A8和S100A9的表达水平与H.pylori阴性组比较[分别为0.11(0.10，0.13)比0.07(0.06，0.08)和0.13(0.10，0.15)比0.07(0.07，0.08)]，差异均有统计学意义(U＝754.00、602.00、5.00、40.00，P均<0.01)。CAG组中H.pylori阳性患者(34例)S100A8和S100A9的表达水平与阴性患者(25例)比较[分别为0.13(0.11，0.14)比0.07(0.07，0.08)和0.15(0.14，0.16)比0.08(0.08，0.09)]，以及NAG组中H.pylori阳性患者(25例)的S100A8和S100A9的表达水平与阴性患者(17例)比较[分别为0.10(0.09，0.10)比0.06(0.05，0.07)和0.10(0.10，0.11)比0.07(0.06，0.07)] ，差异均有统计学意义(U＝1.00、0.00、0.00、0.00，P均<0.01)。CAG合并H.pylori感染者的S100A8和S100A9的表达水平最高，NAG无H.pylori感染者的S100A8和S100A9表达水平最低，差异均有统计学意义(H＝84.78、89.64，P均<0.01)。CAG患者(24例)S100A8和S100A9的mRNA表达水平与NAG患者(24例)比较[分别为0.12(0.06，1.31)比0.05(0.03，0.08)和0.19(0.03，0.43)比0.03(0.01，0.09)]，以及H.pylori阳性患者(24例)S100A8和S100A9的mRNA表达水平与阴性患者(24例)比较[分别为0.45(0.10，1.90)比0.05(0.03，0.08)和0.36(0.24，0.81)比0.03(0.01，0.04)]，差异均有统计学意义(U＝55.00、74.00、19.00、2.00，P均<0.05)。CAG合并H.pylori阳性患者(12例)S100A8和S100A9的mRNA表达水平与阴性患者(12例)比较[分别为0.85(0.27，2.28)比0.06(0.03，0.09)和0.39(0.25，0.87)比0.03(0.02，0.05)]，以及NAG合并H.pylori阳性患者(12例)S100A8和S100A9的mRNA表达水平与阴性患者(12例)比较[分别为0.09(0.05，0.28)比0.04(0.03，0.07)和0.20(0.09，0.65)比0.01(0.01，0.03)，差异均有统计学意义(U＝5.00、2.00、0.00、0.00，P均<0.01)。CAG合并H.pylori感染者S100A8和S100A9的mRNA表达水平最高，NAG无H.pylori感染者的S100A8和S100A9的mRNA表达水平最低，差异均有统计学意义(H＝20.43、24.15，P均<0.01)。S100A8和S100A9无论在蛋白质水平还是在mRNA水平的表达均呈正相关(r＝0.899和0.903，P均<0.01)。结论S100A8和S100A9可能参与H.pylori感染胃黏膜的致炎过程并促使胃黏膜上皮细胞增殖紊乱的发生，是H.pylori导致胃黏膜固有腺体减少和CAG发生的可能机制之一。S100A8和S100A9有望作为CAG诊断、随访生物标志物和治疗的潜在靶点。

简介：摘要目的观察S100A8、S100A9蛋白在比格犬健康及实验性牙周炎组织中的表达分布特点。方法将6只比格犬的一侧下颌第二磨牙通过拴线法诱导实验性牙周炎模型（结扎组），另一侧下颌第二磨牙保持口腔卫生（健康对照组），应用免疫组化法检测S100A8、S100A9在6只比格犬健康及实验性牙周炎组织中的表达；免疫细胞化学法检测两种蛋白亚基在人牙龈成纤维细胞（human gingival fibroblasts，hGF）（来自3例牙冠延长术切除的牙龈组织）、人牙周膜细胞（human periodontal ligament cells，hPDLC）（来自3例因正畸拔除的前磨牙或第三磨牙的牙周膜细胞）中的表达。结果实验性牙周炎诱导第12周，结扎组探诊深度[（3.86±0.14）mm]显著高于健康对照组[（2.11±0.28）mm，P<0.01]；比格犬健康牙周组织中S100A8、S100A9主要表达于牙龈上皮细胞、中性粒细胞，且在结合上皮处呈强阳性表达；实验性牙周炎组织中除牙龈上皮、中性粒细胞外，两种蛋白还诱导表达于牙龈成纤维细胞、牙周膜细胞、微血管内皮细胞及骨髓成纤维细胞；hGF及hPDLC中均可检测到S100A8、S100A9的表达。结论实验性牙周炎使S100A8、S100A9的表达范围更大，表达S100A8、S100A9的细胞类型更多。

简介：【摘要】目的：探究 5A模式在慢性肾脏病 (CKD)病人门诊随访管理中的应用价值分析。方法：笔者收集龙泉驿区第一人民医院慢性肾脏疾病管理门诊进行随访的慢性肾脏病 3-4期病人 90例为课题指标，依据随机抽签模式均分小组，试验组 45例予以 5A模式进行随访管理，对照组 45例予以传统的管理方式。结果：试验组患者经由以患者为中心 5A模式随访管理，其自我管理能力水平、服药、饮食依从性、肾小球滤过率、肌酐、血红蛋白达标率及满意度等指标均优于对照组指标（ P<0.05）。结论： 5A模式于随访管理应用中可显著提高门诊慢性肾脏病患者自我管理能力。

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简介：AbstractPurpose:To investigate the orthopedic injuries sustained while driving and using social media on cellular phones from an orthopedic resident's perspective.Methods:A total of 118 patients who presented with a history of road traffic accident secondary to social media usage and suffered from fractures were included in this cross-sectional study. These patients were reported from October 2018 to April 2019. We collected the data including the type of collision, type of social media usage during driving, location of injury, wearing of safety equipment's such as helmet and seat belt during driving.Results:The mean age of patients was (34.86 ± 12.73) (range 15-71) years. The common types of accident on the basis of collision of vehicles were: car versus motorbike 45 (38.1%), motorbike versus motorbike 28 (23.7%), and motorbike versus pedestrian 22 (18.6%). Most of the accidents (61, 51.7%) occurred due to mistake of motor-bikers. Out of them, 44 (37.3%) occurred on traffic signals, followed by 29 (24.6%) while driving on main roads. The common timing of accident was normal hours with frequency of 44 (37.3%), followed by 39 (33.1%) at late night. According to fracture type, closed injuries were 98 (83.1%) and open fractures were 20 (16.9%). The most common fracture was clavicular fracture (21, 22.5%) followed by soft tissue injury in 19 (16.1%) patients. The most common social media application usage during driving was Facebook 43 (36.4%), followed by Whatsapp 24 (20.3%), Google 19 (16.1%), and Instagram 15 (12.7%).Conclusion:This study provides evidence that social media usage while driving put the drivers and other road users' lives at high risk. The most common social media addiction while driving is Facebook and Whatsapp. So there is a need to make strict rules and penalties for using cell phone during driving so as to save the lives of drivers and other people using road.

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