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摘 要：偏瘫患者因肌力下降极易发生压疮，而翻身可间歇性减轻身体局部压力的压迫，是临床上最经济、有效的预防压疮的方法，故该文结合近年来护理人员帮助偏瘫患者翻身预防压疮的护理研究，从翻身的方法、翻身角度、翻身间隔时间及翻身辅助用具的使用等角度做出综述，为临床护理人员在有效预防压疮的基础上减轻翻身操作带来的职业性腰背痛提供一定的参考。
关键词：压力性损伤 偏瘫 护理 翻身
【摘 要】 目的 观察脉复生联合杏芎氯化钠注射液治疗下肢动脉硬化闭塞症患者的临床疗效。方法 将 206 例下肢动脉硬化闭塞症患者随机分为治疗组和对照组各 103 例。两组均在常规治疗基础上给予杏芎氯化钠注射液
( 100 mL 静滴，qd) ，治疗组加服用脉复生( 30 mL，bid) ，治疗 15 d 后，观察治疗前后患者创面愈合率、疼痛程度 VAS 评分、血脂水平、血液流变学、患肢经皮氧负压( TcPO2 ) 、踝肱指数( ABI) 的变化。结果 治疗组总有效率为 96. 11% ，显著高于对照组的 77. 1% ( P ＜ 0. 05) ; 治疗组疼痛减轻程度大于对照组( P ＜ 0. 05) ，经皮氧负压高于对照组( P ＜ 0. 05) 。结论 脉复生联合杏芎氯化钠注射液治疗下肢动脉硬化闭塞症患者有显著疗效，有助于减轻患者溃疡疼痛、提高患肢经皮氧分压、促进患肢溃疡愈合。
【关键词】 下肢动脉硬化闭塞症; 脉复生; 杏芎氯化钠注射液; 下肢溃疡; 经皮氧分压 ABI
【摘 要】目的: 调查肠造口患者病耻感与出院准备度现状，并探讨两者相关性。方法: 选取北京协和医院结直肠外科行肠造口术住院患者 124 例，采用出院准备度量表 ( RHDS) 评价出院准备度状况，用社会影响量表 ( SIS) 评价病耻感状况。结果: 居住在农村的患者 SIS 得分高于居住在城市的患者，家庭月均收入≤3000 元的患者 SIS 高于家庭月均收入 ＞ 3000 元的患者 ( 均 P ＜ 0. 05) 。患者 SIS 总分及各维度得分均与 RHDS 总分呈负相关 ( r = － 0. 35、 － 0. 31、 － 0. 26、 － 0. 32、 － 0. 36，均 P ＜ 0. 01) 。多重回归分析显示 SIS 的内在羞耻感维度得分与 RHDS 总分负向关联 ( β = － 3. 33，P ＜ 0. 05) 。结论: 肠造口患者病耻感与出院准备度密切相关。
【关键词】肠造口; 病耻感; 出院准备度
Background: Glycolysis dysfunction is an important pathogenesis of podocyte injury in diabetic kidney disease (DKD). Foot process fusion of podocytes and increased albuminuria are markers of early DKD. Moreover, cytoskeletal remodeling has been found to be involved in the foot process fusion of podocytes. However, the connections between cytoskeletal remodeling and alterations of glycolysis in podocytes in DKD have not been clarifified.
Methods: mRNA sequencing of glomeruli obtained from db/db and db/m mice with albuminuria was performed to analyze the expression profifiling of genes in glucose metabolism. Expressions of phosphofructokinase platelet type (PFKP) in the glomeruli of DKD patients were detected. Clotrimazole (CTZ) was used to explore the renal effects of PFKP inhibition in diabetic mice. Using Pfkp siRNA or recombinant plasmid to manipulate PFKP expression, the effects of PFKP on high glucose (HG) induced podocyte damage were assessed in vitro. The levels of fructose-1,6-bisphosphate (FBP) were measured. Targeted metabolomics was performed to observe the alterations of the metabolites in glucose metabolism after HG stimulation. Furthermore, aldolase type b (Aldob) siRNA or recombinant plasmid were applied to evaluate the inflfluence of FBP level alteration on podocytes. FBP was directly added to podocyte culture media. Db/db mice were treated with FBP to investigate its effects on their kidney.
Results: mRNA sequencing showed that glycolysis enzyme genes were altered, characterized by upregulation of upstream genes (Hk1, and Pfkp) and down-regulation of downstream genes of glycolysis (Pkm, and Ldha). Moreover, the expression of PFKP was increased in glomeruli of DKD patients. The CTZ group presented more severe renal damage In vitro, the Pfkp siRNA group and ALDOB overexpression group showed much more induced cytoskeletal remodeling in podocytes, while overexpression of PFKP and suppression of ALDOB in vitro rescued podocytes from cytoskeletal remodeling through regulation of FBP levels and inhibition of the RhoA/ROCK1 pathway. Furthermore, targeted metabolomics showed FBP level was signifificantly increased in HG group compared with the control group. Exogenous FBP addition reduced podocyte cytoskeletal remodeling and renal damage of db/db mice.
Conclusions: These fifindings provide evidence that PFKP may be a potential target for podocyte injury in DN and provide a rationale for applying podocyte glycolysis enhancing agents in patients with DKD.
Keywords: PFKP, diabetic kidney diseases, glycolysis, podocyte injury, cytoskeletal remodeling, FBP
