Utilidad y seguridad de los ingresos directos a una unidad hospitalaria de agudos de un servicio de geriatría valorados por atención geriátrica en residencias

Background and objectiveMore than half of institutionalized older people need a emergency department visit annually, with high resources consumption and higher risk of adverse events, due to high complexity. Direct admission to Acute Geriatric Unit (AGU), after geriatric consultant and nursing home medical team assessment, could be a safety and effective alternative to emergency department (ED) admission.MethodsRetrospective observational study of AGU patients admitted by Nursing Home Geriatric Team between January, 1st and December, 31st, 2021. Planned admissions and SARS-CoV-2 positive patients were excluded. Medical (sociodemographic, clinical, functional and cognitive) records and outcomes data (inpatient mortality, hospital and ED lenght of stay, transfer to ED and delirium within 48 h after admission, hospital discharge location) were collected.ResultsTwo hundred and six patients directly admitted, 101 through ED (N 307). 62.5% with Barthel index <40, 65% with dementia, 56.4% with Charlson index ≥3. Inpatient mortality was 14.6% in direct admission, 20.8% in ED referral group, p = 0.14. Hospital lenght of stay was 9.61 ± 6.01 days in direct admission, 11.22 ± 5.36 days in ED group, p = 0.02. 27.7% of patients with delirium in direct admission and 36.6% in ED group; only one patient was transferred to ED, within 48 h after admission.ConclusionsDirect admission is a safety and effective alternative to ED referral in institutionalized older people after geriatric assessment, due to no increased mortality, shorter length of stay and hospital cost reduction.     

家庭干预对喉癌患者术后生活质量的影响

目的:探讨家庭干预对喉癌术后患者生活质量的影响。方法:将66例喉癌术后患者随机分为干预组和时照组,两组病人均进行常规治疗和护理,干预组在此基础上对患者实施针对性家庭干预。采用Terrell生活质量调查表分别在实施干预前及实施干预后进行评估。结果:干预组患者干预后对健康知识掌握率显著高于对照组(P<0.05),生活质量明显高于对照组(P<0.05)。结论:对喉癌术后病人实施针对性家庭干预,可以提高喉癌术后病人生活质量。     

基于奥马哈理论的护理模式 对慢性阻塞性肺疾病患者肺功能及细菌感染率的影响

目的探讨基于奥马哈理论的护理模式对慢性阻塞性肺疾病(COPD)患者肺功能、症状控制、细菌感染率及生活质量的影响。方法选取2018年1月至2019年1月我院收治的134例COPD患者,采用随机数字表法将研究对象分为观察组(n=69)与对照组(n=65),对两组患者住院期间肺功能、症状控制情况、细菌感染率、睡眠情况以及生活质量进行评估和分析。结果观察组患者肺功能情况优于入院时(P0.05)。两组患者泌尿系统感染发生率最高,其次为褥疮创面感染和口腔感染。观察组患者泌尿系感染的发生率低于对照组(P0.05)。两组患者干预后PSQI量表评分和CAT评分均低于入院前,且观察组患者总分低于对照组(均P0.05)。干预后观察组患者SF-36评分均高于对照组(均P0.05)。结论在基于奥马哈理论的护理模式下,COPD患者的肺功能得到加强,继发感染的发生减少,生活质量得到提高。     

离子导入疗法对防治糖尿病视网膜病变及改善症状的临床研究

目的：探讨离子导入疗法对糖尿病视网膜病变患者进行护理的临床效果。方法：选取88例（122眼）糖尿病视网膜病变患者,随机分为照组和实验组,其中对照组44例（58眼）,给予常规护理治疗;实验组44例（64眼）,在对照组基础上采用离子导入疗法进行护理。观察患者视网膜改变、视力的改善及自觉症状改善情况。结果：实验组实施干预后,视网膜改变、视力的改善、自觉症状的改善显效率明显高于对照组,差异有统计学意义（P〈0．01）。结论：离子导入疗法有助于改善糖尿病视网膜病变患者眼底血液循环。促进出血点吸收、改善临床症状,操作简单易行,患者易于接受。     

结合分子生物学课程对大学生创新能力进行培养的尝试

大学教育应以建设创新型国家为己任,为培养创新型人才服务。根据分子生物学课程的特点,从课堂教学和实验教学两方面同时入手,结合教师的科研情况、学科的前沿动态以及引导学生进行课外阅读等几方面对学生的创新能力的培养进行尝试,取得良好效果。     

护理干预对骨科患者术后两种镇痛效果及满意度的影响

目的:探讨护理干预对骨科患者术后使用硬膜外持续微量注射镇痛及静脉自控微量注射镇痛效果的影响.方法:根据研究要求将患者按硬膜外持续微量注射镇痛及静脉自控微量注射镇痛方式分为实验组A、B组和对照组A、B组,实验组给予护理干预,对照组给予常规护理,然后对比两种术后镇痛方式护理干预组与常规护理组之间的镇痛满意度.结果:通过分析、比较,硬膜外持续微量注射镇痛患者及静脉自控微量注射镇痛患者镇痛满意度护理干预实验组均明显高于常规护理对照组.结论:常规的硬膜外持续微量注射镇痛及静脉自控微量注射镇痛使患者术后取得镇痛效果的过程中,系统的护理干预是提高镇痛满意度的重要因素.     

综合护理干预对老年住院糖尿病患者影响的临床观察

目的：观察综合护理干预对老年住院糖尿病患者的临床影响,探讨改善老年住院糖尿病患者临床表现及预后的护理方式。方法：选择老年住院糖尿病患者160例,随机均分为对照组和观察组,对照组采取常规专科护理,观察组加行综合护理干预,治疗2周后比较两组患者焦虑自评量表（SAS）和抑郁自评量表（SDS）评分;出院3个月后比较两组患者自我管理和生活质量（GQOL-100）评分结果：治疗2周和出院3个月后,两组患者在上述方面比较,差异具有统计学意义（P〈0.01,P〈0.05）,观察组优于对照组。结论：对老年住院DM患者施行综合护理干预措施,具有积极的临床意义。     

基于CRISPR/Cas9基因编辑技术的本科教学实验体系的创建与实践

CRISPR/Cas9是新兴的基因编辑技术,在生命科学研究中发挥着重要的作用。将它引入本科生的实验教学,使本科生了解这项前沿科研技术很有意义。我们创建了一个基于CRISPR/ Cas9技术的本科教学实验体系。该实验体系侧重CRISPR/Cas9技术在哺乳动物细胞中的应用,选用一株基因组上被插入mCherry基因的小鼠胚胎成纤维细胞为实验材料,命名为STO-82。首先设计靶向mCherry的sgRNA,构建CRISPR-Cas9/sgRNA共表达质粒。经测序验证无误后,转染到STO-82细胞。采用流式细胞仪分析检测mCherry阴性和阳性两群细胞,分选出阴性单细胞并扩大培养。最后用测序检验单克隆细胞中靶标DNA序列的编辑情况。结果显示,靶位点有插入或缺失突变,说明体系创建成功。该实验体系将sgRNA设计、CRISPR-Cas9/sgRNA共表达质粒的构建、细胞转染、单细胞分选、单克隆细胞培养、测序序列分析等内容融合为一个综合实验,用于高年级本科生的实验教学。根据实际情况,将教学实践内容分解分块教学,也可以做完整性项目教学。本教学实践采用10人左右的小班分块教学,2人一组,经过3个班（共13组）的实践,绝大部分学生都能完成实验,得到预期结果。通过这个实验,学生加深了对CRISPR/Cas9技术的原理和实验流程的理解,锻炼了实验操作能力和严谨的科研思维,也使学生对该技术的医疗应用风险有了一些认识。     

Fine-scale distribution of treeline trees and the nurse plant facilitation on the eastern Tibetan Plateau

Above-average climate warming occurred during the 20th century in high altitude regions, and alpine treelines are believed to be an early indicator to respond to these warming-related changes. However, empirical investigations on treeline dynamics showed diverse results. The main objectives of this study are: (1) to investigate if treeline position shifted and if tree recruitment changed along with climate warming, and (2) to test if adult trees have “nursing effect” on tree establishment at treelines. We investigated two Balfour spruce (Picea balfouriana Rehd. et Wils.) treelines in Chang Niang (CNT) and Dang Dui (DDT), Dingqing county, Changdu prefecture, eastern Tibet. At each treeline site, three replicate plots with a size 30 m × 50 m were established. The coordinates of each tree within the plots were recorded and the age of each tree was identified by dendrochronological method. The changes in treeline position and tree recruitment were examined from spatially fine-scale distribution of trees and their age structure. The spatial patterns of individual trees were analyzed to infer the neighborhood effects. Results indicate that plots CNT2, CNT3, DDT1 and DDT2 showed stable treeline position during the last century, whereas plots CNT1 and DDT3 showed treeline advancing movement. Tree recruitments in all the six plots were enhanced during the 20th century, with two peaks occurring in the 1890–1910s and the 1950–1990s. Seedlings and saplings showed a general clustered distribution in all the six plots. The diverse pattern of treeline movement and episodic regeneration suggest that the treeline activity is not merely a result of climate change. “Nursing effects” from adult trees may play an important role in shaping the treeline activities on the eastern Tibetan Plateau. Our findings reveal diverse patterns in treeline dynamics at a local scale and highlight the importance of incorporating biotic interactions into species distribution modeling approaches.     

Undergraduate Music Program Alumni's Career Path,Retrospective Institutional Satisfaction,and Financial Status

The purpose of this study was to examine undergraduate music education and performance alumni's career path, retrospective institutional satisfaction, and financial status. Data for this study were drawn from respondents from the 2010 administration of the nationwide, multi-institutional survey conducted by the Strategic National Arts Alumni Project (SNAAP). Regarding career path, nearly half of the music performance degree graduates reported performing as their current job, and slightly more than half of the music education degree graduates reported working in K–12 schools. Participants were generally satisfied with their institutional experiences, although relatively low levels of satisfaction were reported for networking and career advising services. The respondents reported being most satisfied with aspects of their current jobs that reflected the intrinsic benefits of contributing to a greater good, satisfying personal interests and values, and opportunities to be creative. The majority of the sample reported accruing student loan debt ranging between $10,000 and $30,000; however, no significant differences were found between groups, and 40 percent of the participants reported having accrued no debt at all. The reported annual income of the participants varied significantly, with music educators reporting higher earnings than performers.