护理干预对剖宫产术后留置导尿患者膀胱功能的影响

目的研究护理干预对剖宫产术后留置导尿患者膀胱功能的影响。方法选取2015年1月至2015年12月行剖宫产的170例患者进行研究,将这170例患者随机分为观察组与对照组,每组85例。对照组患者接受个体化导尿护理,观察组患者在个体化导尿的基础上结合定时导尿方法,对比观察组和对照组患者拔管后自行排尿成功率。结果对照组自行排尿成功率为80.00%,观察组自行排尿成功率为98.82%,两组相比,观察组患者拔除尿管后自行排尿成功率更高,差异具有统计学意义(P0.05)。结论在个体化导尿护理的基础上结合定时导尿的护理干预,能够有效训练产妇的膀胱功能而促进膀胱的恢复,使得拔除导尿管后自行排尿成功率明显提高,值得临床推广应用。     

剖宫产术后留置导尿的护理干预对膀胱功能的影响

目的探讨剖宫产术后留置导尿的护理干预对膀胱功能的影响。方法选择200例剖宫产留置导尿的产妇，将其随机分成试验组和对照组各100例。对照组予以常规护理，试验组在常规护理的基础上给予护理干预措施，分别观察拔除尿管后第一次排尿情况。结果两种护理方法对膀胱功能的影响差异无统计学意义（P〈0．01），试验组自行排尿成功率明显高于对照组。结论剖宫产术后留置导尿的护理干预对膀胱功能恢复有良好影响，提高了拔管后的排尿成功率。     

膀胱冲洗加护理干预对留置尿管拔管后快速排尿的影响

目的:探讨膀胱冲洗加护理干预对留置尿管拔管后快速排尿的影响。方法:将94例留置尿管患者分成对照组和观察组,对照组41例,留置尿管后第1天即行膀胱冲洗,定时开放夹管,训练膀胱功能,拔管当天不进行膀胱冲洗;观察组53例,在对照组基础上拔管当天进行膀胱冲洗,冲洗完半小时后拔管,同时给予患者心理和行为护理干预。结果:观察组拔管后1 h、2 h、4 h、6 h内排尿率和尿道口疼痛率与对照组比较,差异均有统计学意义(P<0.05)。结论:膀胱冲洗加护理干预可提高留置尿管患者拔管后第1次排尿的成功率。     

糖尿病膀胱功能障碍患者留置导尿管拔管时机的探讨

目的探讨糖尿病膀胱功能障碍患者留置导尿管拔管时机对膀胱功能的影响。方法对37例行留置导尿管的糖尿病膀胱功能障碍患者随机分组,采用两种不同拔管时机拔除尿管,实验组19例在膀胱空虚时拔管,对照组18例在膀胱充盈时拔管,观察拔管后患者是否能自行排尿和拔管后的残余尿量。结果实验组残余尿量少于对照组(P<0·05),实验组自行排尿成功率高于对照组(P<0·05)。结论糖尿病膀胱功能障碍患者膀胱空虚时拔除尿管比膀胱充盈时拔除尿管优越。     

适宜温度下膀胱冲洗预防剖宫产留置导尿患者尿路感染的护理研究

目的:观察不同温度下膀胱冲洗预防留置导尿患者尿路感染的护理效果。方法:将99例留置导尿患者随机分为观察组(冲洗液温度30~38℃)、对照1组(冲洗液温度20~30℃)、对照2组(冲洗液温度10~20℃)、对照3组(冲洗液温度为室温),每组均进行膀胱冲洗,观察各组不同留置导尿时间菌尿发生率情况。结果:在留置导尿第1天、第2天、拔管前、拔管后各个时间点,观察组菌尿发生率与各对照组比较,差异有统计学意义(P<0.05或P<0.01),观察组菌尿发生率低于各对照组。结论:在适宜温度下(30~38℃)进行膀胱冲洗能较好地预防留置导尿患者尿路感染。     

护理干预对减少留置气囊导尿管术并发症效果观察

目的探讨加强护理干预对减少留置气囊导尿管术并发症效果观察。方法将130例留置气囊导尿管男性患者随机分为对照组和实验组各65例,对照组给予常规无菌导尿术及护理,实验组在此基础上给予加大插管深度及低压慢速膀胱冲洗,比较两组患者导尿时不良反应及术后并发症等情况。结果两组患者血尿、膀胱冲洗出血发生率比较,差异无统计学意义（P〉0.05）;实验组导尿时不良反应及术后下尿路感染等发生率明显低于对照组,经统计学分析,差异具有统计学意义（均P〈0.01）。结论气囊导尿管留置导尿时加大插管深度与并行低压慢速膀胱冲洗可提高插管成功率,减少导尿时不良反应及术后并发症。     

间歇性导尿及护理在脊髓损伤患者康复中的应用效果观察

目的:探讨间歇性导尿及护理在脊髓损伤患者康复中的应用效果.方法:选取该院康复科2014年5月至2016年5月所收治的100例脊髓损伤患者,随机分为观察组(行间歇导尿术)和对照组(行常规留置导尿术),每组50例,两组患者均要求治疗、护理,为期2个月,比较观察两组的临床效果和患者满意度.结果:治疗后,观察组的插管成功率、膀胱功能恢复情况明显高于对照组(P<0.05).观察组的导尿时间、尿道感染率要明显低于对照组(P<0.05).观察组的满意度为100%,对照组的满意度为90%,两组相较有统计学意义(P<0.05).结论:脊髓损伤患者在早期行间歇导尿具有显著的临床疗效,既可以促进膀胱功能恢复,又可以降低尿道感染率,提高患者满意度,值得临床推广应用.     

早期活动对广泛性子宫切除术后膀胱功能恢复的影响

目的探讨早期活动对广泛性子宫全切加盆腔淋巴清扫术患者膀胱功能恢复的影响。方法将广泛性子宫全切加盆腔淋巴清扫术患者90例随机分为观察组(45例)和对照组(45例),对照组给予常规护理,拔管前3天夹管训练膀胱反射性排尿功能。观察组给予常规护理,拔管前3天夹管训练膀胱反射性排尿功能和手术后早期活动,比较两组术后膀胱残余尿量和留置导尿管时间。结果观察组患者膀胱残余尿量>100ml和留置导尿时间较对照组少,差异有显著性(P<0.05)。结论早期活动可促进广泛子宫全切加盆腔淋巴清扫术患者的膀胱功能恢复,减少膀胱残余尿量,缩短留置导尿管的时间,减少尿潴留的发生。     

留置导尿管拔管时机对腹腔镜术后患者排尿的影响

目的探讨腹腔镜术后留置导尿管患者拔管时机对排尿功能的影响。方法对40例腹腔镜术后留置导尿管的患者随机分组采用两种不同时机拔除尿管实验组20例在膀胱充盈时拔管对照组20例在膀胱空虚是拔管观察拔管后患者是否能自行排尿。结果实验组继发尿潴留及排尿障碍的发生率明显低于对照组(P<0.05)。结论选择膀胱充盈时拔除尿管可有效地预防尿潴留。     

选择拔除尿管时机对减少拔管后再发尿潴留的观察

目的探讨选择不同拔除尿管时机对减少拔管后再发尿潴留的影响。方法将112例留置尿管的病人分为实验组62例和对照组50例,实验组膀胱充盈自感有尿意时拔尿管,对照组膀胱充盈先排空尿液待膀胱空虚时拔尿管。结果实验组拔除尿管后能顺利自行排尿的成功率95.16%(59/62)明显高于对照组80.00%(40/50),χ2=6.20,P<0.05。结论膀胱充盈有尿意时拔管比膀胱充盈先排空尿液待膀胱空虚时拔管能明显减少拔管后再发尿潴留。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.