同感心护理对初产妇心理状况及分娩结局的影响

目的:探讨同感心护理对初产妇的心理健康状况及分娩结局的影响。方法:将150例初产妇随机分为观察组75例和对照组75例。对观察组实施同感心护理,对照组实行传统护理。采用90项症状清单(SCL-90)评估心理健康状况。比较2组的心理健康状况和分娩结局(包括分娩方式、总产程时间、产后2 h出血量及新生儿1min Apgar评分)。结果:1观察组抑郁、焦虑因子分低于对照组(t=-2.127、-2.116,P<0.05);2观察组阴道分娩率高于对照组(χ~2=72.516,P<0.05);观察组的总产程时间短于对照组(t=-2.454,P<0.05)。结论:同感心护理有利于减轻分娩初产妇的负性情绪,在一定程度上改善分娩结局。     

同感心护理在初产妇自然分娩中的应用价值

目的分析同感心护理对足月、单胎、头位初产妇自然分娩产程及护理前后负面情绪的影响。方法选取2017年4月至2018年5月于临颍县人民医院分娩的104例足月、单胎、头位初产妇,采用随机数表法分为两组,每组52例。对照组产妇接受常规产时护理,观察组接受同感心护理干预。比较两组护理前后抑郁自评量表(SDS)、焦虑自评量表(SAS)得分及产程时间。结果护理后,两组产妇SAS、SDS评分均较护理前降低,观察组SAS、SDS评分均低于对照组,差异有统计学意义(均P<0.05)。观察组第一、二、三产程及总产程时间均短于对照组,差异有统计学意义(均P<0.05)。结论同感心护理干预可有效缓解初产妇负面情绪,缩短产程时间。     

孕期有备分娩培训对初产妇分娩过程及母婴结局的影响

目的探讨孕期有备分娩培训课程对初产妇自然分娩及母婴结局的影响,为提高初产妇临床护理质量提供依据。方法选择2014年7月~2015年6月本院426例初产妇,按照随机数字表法分为对照组210例和观察组216例。对照组由助产士进行常规的健康教育,观察组则在常规的健康教育的基础上加用孕期有备分娩培训课程进行干预。分别比较两组的分娩方式,分娩过程中各产程时间及总产程时间,状态焦虑量表(STAI)、视觉模拟焦虑评分表(VAAS)得分情况以及分娩后2小时出血量,新生儿窒息状况,新生儿Apgar评分等妊娠结局指标。结果 (1)观察组自然分娩率高于对照组,差异具有统计学意义(P<0.01);(2)观察组自然分娩第一、第二、第三产程以及总产程的时间要明显短于对照组,差异具有统计学意义(均P<0.05);(3)分娩后观察组的STAI和VAAS得分均低于对照组,差异具有统计学意义(均P<0.05);(4)观察组自然分娩产妇分娩后2小时出血量、新生儿窒息发生率均低于对照组,差异具有统计学意义(均P<0.05),观察组新生儿Apgar评分高于对照组,差异具有统计学意义(P<0.05)。结论对初产妇进行孕期有备分娩培训能够提高初产妇自然分娩率,缩短各产程时间,提高新生儿质量,并可显著改善初产妇心理状态,值得临床推广。     

时机理论指导的配偶全程陪伴式护理在初产妇分娩中的应用效果

目的:观察时机理论指导的配偶全程陪伴式护理在初产妇分娩中的应用效果。方法:选取2021年1月至2021年7月该院收治的140例初产妇进行前瞻性研究,按照抽签法将其分为对照组和观察组各70例。对照组采用常规护理,观察组采用时机理论指导的配偶全程陪伴式护理。比较两组产妇分娩恐惧、分娩体验评分,第一产程、第二产程、第三产程时间,母婴不良结局发生率和产妇母亲角色适应评分。结果:护理后,两组分娩恐惧评分均低于护理前,且观察组低于对照组,差异有统计学意义(P<0.05);分娩后,观察组分娩体验评分高于对照组,差异有统计学意义(P<0.05);观察组第一产程、第二产程及第三产程时间均短于对照组,差异有统计学意义(P<0.05);观察组不良分娩结局发生率为2.86%(2/70),明显低于对照组的11.43%(8/70),差异有统计学意义(P<0.05);观察组角色认知、照顾行为、亲子依附等母亲角色适应评分均高于对照组,差异有统计学意义(P<0.05)。结论:时机理论指导的配偶全程陪伴式护理应用于初产妇分娩可降低分娩恐惧评分和母婴不良结局发生率,缩短产程时间,提高分娩体验评分和母亲角色适应评分,效果优于常规护理。     

导乐分娩对初产妇分娩方式和产程的影响

目的探讨导乐分娩对初产妇分娩方式和产程的影响。方法 60例初产妇随机分为两组,各30例。观察组采用导乐分娩,对照组采用普通陪护。对比两组产妇的分娩方式和产程时间。结果观察组顺产率高于对照组,剖宫产率低于对照组,差异具有统计学意义(P<0.05);观察组第一、二产程时间较对照组不同程度缩短,总产程时间显著减少(P<0.05)。结论导乐分娩能够提高初产妇的顺产率,缩短产程,值得推广。     

全程陪伴联合镇痛分娩在初产妇分娩中的应用效果分析

目的：分析全程陪伴联合镇痛分娩在初产妇分娩中的应用效果。方法：选取2022年1月—2023年12月于郴州市第一人民医院产科分娩的200例初产妇作为研究对象,经双盲法分为观察组与对照组,各100例。对照组采用常规护理,观察组采用全程陪伴联合分娩镇痛护理。比较两组产程时间、情绪状态、疼痛情况、不良妊娠结局发生情况、自我效能感、社会支持评分。结果：观察组第一产程、第二产程、第三产程及总产程时间短于对照组,差异有统计学意义(P<0.001)。观察组不良妊娠结局总发生率低于对照组,差异有统计学意义(P=0.009)。护理后,两组焦虑、抑郁、疼痛评分低于护理前,且观察组低于对照组,差异有统计学意义(P<0.05)。两组自我效能感、社会支持评分高于护理前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论：全程陪伴联合镇痛分娩在初产妇分娩中的应用效果较好,可缩短产程时间,缓解产妇负性情绪,减轻疼痛,降低不良妊娠结局发生率,提高产妇自我效能感和社会支持。     

Bn连续性助产护理对初产妇产程及分娩结局的影响

目的:探讨连续性助产护理对初产妇产程及分娩结局的影响。方法:选取2015年12月至2017年12月在我院分娩的初产妇110例,随机分为A组与B组,每组各55例。A组产妇实施连续性助产护理干预,B组产妇实施常规护理干预,比较两组产妇的产程及分娩结局。结果:A组产妇第一产程时间及总产程时间显著短于B组,差异有统计学意义(P0.05);第二产程及第三产程相比差异无统计学意义(P0.05)。A组产妇及新生儿并发症发生率显著低于B组,差异有统计学意义(P0.05)。结论:连续性助产护理有效的缩短了产妇分娩的第一产程及总产程,并降低了产妇及新生儿并发症发生率,改善了妊娠结局。     

导乐陪伴分娩对初产妇自然分娩率及产程时间的影响

目的研究导乐陪伴分娩对初产妇自然分娩率及产程时间的影响。方法选取2015年8月至2017年2月舞阳县中心医院收治的初产妇92例,依照入院时间分为对照组与观察组,各46例。对照组接受常规模式指导分娩,观察组接受导乐陪伴分娩。观察两组分娩结局,记录两组第一产程、第二产程及总产程时间。结果观察组自然分娩率[97.93%(45/46)]高于对照组[78.26%(36/46)],差异有统计学意义(χ~2=8.364,P<0.05);观察组第一产程、第二产程及总产程时间均短于对照组,差异有统计学意义(P<0.05)。结论导乐陪伴分娩能有效提高初产妇自然分娩率,缩短产程时间。     

经皮穴位电刺激联合全程导乐陪伴式护理对初产妇分娩疼痛及产程的影响

目的:探讨经皮穴位电刺激联合全程导乐陪伴式护理对初产妇的应用效果.方法:回顾性分析2018年6月—2020年2月于广昌县人民医院分娩的94例初产妇,按照护理方式的不同将其分为两组,对照组48例采取全程导乐陪伴式护理,观察组46例在对照组基础上加用经皮穴位电刺激.对比两组分娩疼痛、总产程时长及心理状态.结果:观察组分娩疼痛低于对照组,总产程时间短于对照组,差异有统计学意义(P<0.05);分娩前两组心理状态对比,差异无统计学意义(P>0.05);观察组分娩后焦虑、抑郁评分低于对照组,差异有统计学意义(P<0.05).结论:经皮穴位电刺激联合全程导乐陪伴式护理可减轻初产妇分娩疼痛,缩短产程,利于改善其心理状态,值得应用.     

硬膜外麻醉在初产妇分娩镇痛中的效果及对产程、分娩结局和新生儿的影响

目的 探讨初产妇分娩期间实施硬膜外麻醉对分娩镇痛的效果及对产程、分娩结局及新生儿结局的影响。方法 便利选取2021年5月—2023年5月于南京市六合区人民医院分娩的85例初产妇作为研究对象。按照手环编号单双数分为对照组（43例）观察组（42例）,对照组产妇实施常规分娩,观察组产妇实施硬膜外麻醉分娩镇痛;比较两组产妇分娩各个产程疼痛程度、分娩产程所用时间、分娩结局及新生儿结局情况。结果 观察组产妇第一、二、三产程疼痛评分均低于对照组,同时观察组产妇分娩第一、二、三及总产程所用时间均短于对照组,差异有统计学意义（P<0.05）;观察组产妇自然分娩率高于对照组,观察组剖宫产及术后产褥感染发生率均低于对照组,差异有统计学意义（P<0.05）;观察组分娩新生儿宫内窘迫、新生儿窒息的总发生率低于对照组,差异有统计学意义（P<0.05）。结论 初产妇分娩期间通过硬膜外麻醉分娩镇痛可有效减轻分娩期间痛感,促进产程进展,改善分娩及新生儿结局。     

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.