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find Author "张学军" 6 results
  • Study on the Effect of Orem's Self-care Model in School-age Children with Asthma

    ObjectiveTo investigate the efficacy of Orem's self-care model in school-age children with asthma. MethodsSeventy-four children with asthma treated between March 2012 and June 2014 were divided into observation group (n=37) and control group (n=37) randomly. Orem's self-care model was applied in the observation group, while routine nursing was carried out in the control group. We observed the pulmonary function, therapeutic compliance and quality of life in children of both the two groups before and one year after treatment. ResultsOne year after treatment, forced expiratory volume in one second and peak expiratory flow increased significantly (P<0.05), and increase in the observation group was significantly more than that in the control group (P<0.05). Compared with the control group, the observation group showed significant increased treatment compliance rate (P<0.05). Pediatric asthma quality of life questionare scale results showed that one year after treatment, the two groups got significantly increased scores in the dimensions of emotion, symptom and activity (P<0.05), and the scores were significantly higher in the observation group (P<0.05). ConclusionOrem's self-care model has a significant curative effect for the improvement of lung function in school-age children with asthma, which can promot the treatment compliance and quality of life of the patients.

    Release date:2016-10-02 04:54 Export PDF Favorites Scan
  • 前瞻性护理应用于学龄前儿童静脉输液中的经验及效果评价

    目的探讨前瞻性护理对学龄前患儿静脉输液的治疗依从率、一次穿刺成功率和家长满意度的影响。 方法选择2014年6月-2015年3月进行静脉输液治疗的学龄前患儿435例,采用随机数字表法将患儿随机分为研究组216例和对照组219例,对照组采取常规护理,研究组在对照组的基础上给予前瞻性护理,比较两组患儿的治疗依从率、一次穿刺成功率和家长满意度。 结果研究组患儿的治疗依从率(95.37%)、一次穿刺成功率(94.44%)和家长满意度(97.22%)均明显高于对照组患儿(79.91%、78.08%、82.19%),组间差异有统计学意义(χ2=23.910、24.484、26.488,P<0.001)。 结论前瞻性护理能够有效提高学龄前患儿静脉输液的治疗依从率及一次穿刺成功率,从而提高家长满意度。

    Release date:2016-12-27 11:09 Export PDF Favorites Scan
  • Exploration of the postgraduate stage medical humanities training courses planning and practicing based on instructional system design model

    Objective To optimize the medical humanities training course in postgraduate medical education. Methods From 2018 to 2020, based on instructional system design (ISD) model of the “analyze-design-exploit-implement-assess” 5 steps, the current situation and existing problems were analyzed through literature review, and the postgraduate trainees’ cognitions and demands for the training course were surveyed. According to the content of the questionnaire, the curriculum was designed and implemented, and the curriculum satisfaction survey was conducted. Results A total of 532 postgraduate trainees participated in the cognitions and demands questionnaire survey, and the postgraduate trainees had high demands for humanistic training courses (88.53%). A total of 827 postgraduate trainees participated in the curriculum satisfaction survey. The trainees’ satisfaction to the training courses was more than 90%. Conclusion The medical humanities training courses based on ISD model get good results, which can provide a useful reference for the curriculum design of medical humanities education in each stage.

    Release date:2022-04-25 03:47 Export PDF Favorites Scan
  • Clinical Practice Analysis of Type 2 Diabetes Patients with Premixed Insulin Switched to Basic Insulin plus Oral Antidiabetic Drugs

    ObjectiveTo explore the efficacy and safety of basal insulin plus oral antidiabetic drugs (OADs) treatment switched from premixed insulin therapy in type 2 diabetes patients. MethodsPatients with type 2 diabetes with glycosylated hemoglobin (A1C) lower than 10%, taking stable dose of premixed insulin twice daily for at least 12 weeks, and treated between February 2010 and August 2011 were identified from our outpatient service, and their treatment was switched to glargine plus OADs. After 24 weeks of treatment, we analyzed the changes of the patients' weight, fasting and postprandial blood glucose (FBG and PBG), A1C, hypoglycemic events and insulin dose. ResultsA total of 36 patients were followed up and received glargine plus OADs. After glargine treatment, the patients' weight[(63.77±10.34) vs. (62.31±9.98)kg, P=0.002] and total insulin dose[(23.56±6.15) vs. (10.28±4.04)kg, P=0.000] were declined obviously. The A1C level had further declined in the group of premixed insulin therapy with A1C approaching or reaching 7% from start to end point (6.70±0.81)% vs.(6.34±0.55)kg, P=0.007], and the insulin dose was (0.16±0.06) U/(kg·d). However, no significant difference of the incidence of hypoglycemic events was discovered compared with non-standard group (33.33% vs. 55.56%, P=0.267). Compared with premixed insulin group, glargine group usually had 1 or 2 kinds of OADs, and the most widely used drug was glucophage (17/36). ConclusionIn type 2 diabetes patients whose A1C level approaches or reaches 7%, switching premixed insulin therapy to glargine plus OADs is associated with significant improvement in glycemic control, as well as sound safety and other benefits.

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  • Effect Observation of Rosiglitazone Plus Metformin in Treating Type 2 Diabetes Mellitus

    【摘要】 目的 观察罗格列酮加二甲双胍联合治疗对2型糖尿病患者的降糖作用和安全性以及对胰岛素抵抗的影响。 方法 对2007年8月-2008年5月收治的2型糖尿病患者53例采用自身前后对照研究,48例符合入选条件的患者,接受罗格列酮加二甲双胍为期12周治疗。试验开始和结束日测定患者空腹血糖(fast plasma glucose,FPG)、血清胰岛素(serum insulin,FINS)、总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)和糖化血红蛋白(glycosylated hemoblobin,HbA1c)以及标准餐后2 h血糖(postprandial 2 hours blood glucose,2hPPG)和胰岛素(postprandial 2 hours insulin,2hPINS)。胰岛素敏感性采用HOMA2模型公式评价。 结果 12周时FPG、FINS、2hPINS、 HbA1c均较治疗前基线时下降,分别为(8.16±2.37) mmol/L与(6.57±1.90) mmol/L,(8.84±8.07) mU/L与(7.28±6.84) mU/L,(26.87±3.13) mU/L与(20.18±13.25) mU/L,7.60%±1.71%与6.79%±1.82%,差异有统计学意义(Plt;0.05)。胰岛素抵抗指数显著低于治疗前(2.77±0.90与3.74±1.61,Plt;0.05)。其余代谢参数变化差异无统计学意义(Pgt;0.05)。 结论 罗格列酮加双胍类药物联合治疗2型糖尿病能有效降2型糖尿病患者的血糖水平,提高胰岛素敏感性,不增加体重,无低血糖发生,是一种安全有效的治疗方案。【Abstract】 Objective To observe the effect and security of rosiglitazone plus metformin in patients with type 2 diabetes mellitus, and the effect on insulin resistance. Methods Forty-eight cases suitable for this study were accepted and compared from August 2007 to May 2008. Patients accepted rosiglitazone plus metformin for 12 weeks. Fasting plasma glucose (FPG), serum insulin (FINS), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), glycosylated hemoglobin (HbA1c), postprandial 2 hours blood glucose and postprandial 2 hours insulin were determined at the first and last day of this study. HOMA 2 model formula evaluation was used in testing insulin sensitivity. Results After a 12-weeks’ treatment, FPG, FINS, 2hPINS, and HbA1c of patients were lower than those before treatment [(8.16±2.37) mmol/L vs (6.57±1.90) mmol/L; (8.84±8.07) mU/L vs (7.28±6.84) mU/L; (26.87±19.31) mU/L vs (20.18±13.25) mU/L; 7.60%±1.71% vs 6.79%±1.82%; Plt;0.05)]. Insulin resistance index was lower than that after treatment (2.77±0.90 vs 3.74±1.61, Plt;0.05). Other metabolic related parameter had no statistical difference (Pgt;0.05). Conclusion Rosiglitazone plus metformin treatment of type 2 diabetes mellitus is effective both in reducing in blood glucose levels and improving insulin sensitivity, and without gain weight, incidence of hypoglycemia. It is a safe and effective option.

    Release date:2016-09-08 09:50 Export PDF Favorites Scan
  • Therapeutic Effect of Recombinant Human Parathyroid Hormone(1-34) on Primary Osteoporosis

    【摘要】 目的 观察重组人甲状旁腺激素(1-34)[rhPTH(1-34)]治疗骨质疏松症患者骨密度的疗效和安全性。 方法 采用自身前后对照临床研究,纳入2008年3-5月就诊的原发性骨质疏松症患者共39例,予rhPTH(1-34) 20 μg 1次/d皮下注射,疗程18个月。治疗期间均同时口服钙制剂600 mg/d及维生素D3 125 U/d作为基础治疗。患者治疗前采用双能X线检测腰2~4椎体(L2~4)和股骨颈骨密度(BMD)、肝肾功能、血钙、血磷,治疗后6、12、18个月复查BMD和上述生化指标改变,记录患者不良事件,对患者治疗前后L2~4、股骨颈BMD变化进行对比分析。 结果 35例患者完成全疗程治疗,其中男2例,女33例;平均年龄65岁,平均病程6.5年;治疗6、12、18个月时L2~4 BMD均较治疗前明显提高(Plt;0.01),而股骨颈BMD在治疗6、12个月时改善不明显(Pgt;0.05),18个月时表现出较治疗前明显增加(Plt;0.01);腰椎平均BMD增长率为12.27%,股骨颈BMD增长率为4.11%;治疗期间不良反应少,均不需特殊处理而自行好转。 结论 rhPTH(1-34)治疗原发性骨质疏松症安全有效,对改善椎体BMD疗效迅速明显,对改善股骨颈BMD起效慢;适用于绝经后骨质疏松和老年性骨质疏松症患者。【Abstract】 Objective To observe the therapeutic effect of recombinant human parathyroid hormone (1-34) [rhPTH(1-34)] on the improvement of bone mineral density (BMD) in patients with primary osteoporosis. Methods A before and after self control study was performed on 39 patients with primary osteoporosis from March to May 2008. The patients underwent the subcutaneous injection with rhPTH (1-34) 20 μg/d for 18 months. All patients were given oral calcium (Ca 600 mg+Vit D3 125 U per day) as primary drug treatment. BMD of lumbar spine (L2-L4) and femur neck, serum calcium, and serum phosphate were measured before and 6, 12, and 18 months after the treatment. All of the adverse reactions were recorded. Results A total of 35 patients finished the trial,including two males and 33 females with the average age of 65 years and the course of disease of (6.54±4.30) years. BMD of lumbar spine (L2-L4) significantly increased 6, 12, and 18 months after treatment (Plt;0.01). There was no significant difference of femur neck BMD 6 and 12 months after treatment (Pgt;0.05), whereas by the end of the treatment, it improved significantly (Plt;0.01). The average increase rate was 12.27% in lumbar spine (L2-L4) and was 4.11% in femur neck BMD. There were a few adverse reactions during the therapeutic process, most of which were tolerable and self-restored. Conclusion rhPTH(1-34) is an effective and safe drug in treating primary osteoporosis. It can increase lumbar spine BMD rapidly and raise femur neck BMD gradually. It is applicable for postmenopausal osteoporosis and senile osteoporosis.

    Release date:2016-09-08 09:51 Export PDF Favorites Scan
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