目的 讨论生活护理级别对临床基础护理的指导作用和意义。 方法 2010年3月－2011年12月，由亚专业护理组长每日根据病情制定或修改患者生活护理级别，指导责任护士落实各级基础护理措施，用生活护理级别指导基础护理。 结果 采用生活护理级别指导基础护理，护士的工作量明显下降，患者满意度、护士满意度、基础护理、一级生活护理和整体护理水平明显提高。 结论 按生活护理级别实施基础护理不仅可以提高责任护士对基础护理的认知和实践能力，还能提高基础护理水平，提高护士的工作满意度。
Objective To study the effect of PBL teaching method which was applied in the clinical practice of diabetes nursing, and to analyze its advantages and shortages. Methods Seventy-seven undergraduates in major of nursing were randomly grouped into two: one as an experimental group was taught with PBL teaching method, while the other as a control group was taught with traditional teaching method. The questionnaire and final examination were adopted to analyze the teaching effect. Results The effect of PBL teaching method was better in the experimental group for stimulating learning motivation, helping students to closely combine the theory and practice, and promoting communication ability. However, there was no statistical difference in final examination between the two groups (Pgt;0.05). Conclusion PBL teaching method is much better than traditional teaching method in clinical nursing practice of internal medicine, for it can guide students to get the approaches for solving problems and cultivate their integrated diathesis and other abilities.
目的 了解接受胰岛素治疗的糖化血红蛋白＞7.5%的2型糖尿病患者自我血糖监测现状及存在的问题，为帮助患者建立健康行为提供理论依据。 方法 对2008年12月－2011年2月住院治疗的128例符合纳入标准的患者进行问卷调查。调查内容包括患者一般资料、血糖控制情况、自我监测相关知识及技能等内容。 结果 共发放问卷128份，收回128份，其中有效问卷122份。糖尿病患者血糖自我监测知识获取渠道单一，且相关知识匮乏；不能制定正确血糖自我监测方案，不能对检测结果进行正确记录和汇报；血糖检测操作不正确，检测频率达不到标准要求。 结论 接受胰岛素治疗的2型糖尿病患者自我监测现状并不容乐观，患者自我监测行为缺乏。为此，提高糖尿病患者健康教育水平，帮助其建立并维持健康行为，是糖尿病教育工作的重点和挑战。
Objective To evaluate the safety and efficacy of venlafaxine and carbamazepine on painful peripheral diabetic neuropathy. Methods This was a randomized, parallel-group, double-blind, double-dummy clinical trial. 132 patients a venlafaxine group (n=66) and a carbamazepine group (n=66) with painful peripheral diabetic neuropathy were recruited from 3 clinical centers. The venlafaxine group took venlafaxine 25 mg plus one dummy carbamazepine tablet twice a day and the carbamazepine group took carbamazepine 0.1 g plus one dummy venlafaxine tablet twice a day both for 2 weeks. The primary efficacy measurement consisted of a numeric pain intensity scale and the secondary measurement assessed quality of life. Results One hundred and nineteen patients completed the trial. Venlafaxine was superior to carbamazepine in improving mean pain intensity scores at 5,7,10 and 14 days by per-protocol analysis (P=0.02, P=0.03, P=0.003 and P=0.001 respectively). The effects of venlafaxine on the improvement in the total quality of life scores were better than those of carbamazepine at 10 and 14 days (P=0.02 and P=0.01 respectively). Sleep interference and mood were improved by both venlafaxine and carbamazepine, but the efficacy of venlafaxine was superior to that of carbamazepine. The common adverse events of venlafaxine included mild gastrointestinal discomfort, dizziness and somnolence. The frequency of adverse events in the venlafaxine group was about 43.9% (4 patients withdrew because of adverse events) and in the carbamazepine group about 25.76% (2 patients withdrew because of adverse events) (P =0.06). Conclusions Venlafaxine and carbamazepine are effective in the treatment of painful diabetic neuropathy, venlafaxine is superior to carbamazepine in improving pain and quality of life. Both drugs may be safe and well tolerated.