2511份儿科归档病案住院首次护理记录单缺陷分析与对策

目的分析儿科归档病案住院首次护理记录单存在缺陷，探讨提高儿科住院首次护理记录单质量的方法。方法回顾性分析我院儿科（包括小儿内科和小儿外科）2006年7月～12月归档病案2511份中的住院首次护理记录单的书写质量，对存在的缺陷进行总结、归纳、分析。结果检查的2511份护理病历中，共有96份住院首次护理记录单存在缺陷问题，占病案数的3．8％，共出现缺陷次数164次。结论应加强护理人员依法维权意识、增强护士的工作责任心、加强医护沟通及病历书写的标准化意识，以保证医疗护理活动中，护患双方的合法权益。     

提高护理记录书写质量的细节管理

目的探讨提高护士书写护理记录质量的细节管理。方法随机抽查2008年2月—2009年6月住院患者护理记录200份,分别记录其缺陷。结果2009年护理记录中的缺陷率较2008年显著降低。结论通过规范化的培训,重视环节质量、终末质量和重视护理记录质量的持续改进,加强自控、科控、院控三级质控,加强医护、护护沟通,可最大限度地减少护理记录缺陷,提高护理质量。     

在举证责任倒置下如何提高转科护理文书的相符性

目的探讨在举证责任倒置下如何提高转科护理文书的相符性。方法随机抽查2007年5～6月归档病案中115份转科病人的护理病历，对书写存在的缺陷进行了分析。结果转科护理文书的相符性较差。检查的115份转科护理病案中，存在缺陷病历18份，占检查病案数的15．6％，共出现缺陷次数37次。结论在举证责任倒置下，加强法律的学习和自我保护意识、加强病历书写的规范化教育、加强工作责任心、加强医护间、护护间的密切合作和沟通、加强护理文书的质量检查是提高转科护理文书相符性的良好对策。     

300份护理记录缺陷原因分析及干预措施

护理记录是由国家注册护士根据医嘱和病情从人院到出院护理过程的客观记录，是评估病人健康状况，制定护理计划，监督检查护理质量，进行护理科研教育的重要资料。护理记录作为病历的重要组成部分，病人有权对护理记录复印，即可以作为护患双方举证的法律依据，为了减少病历缺陷引起的纠纷，本文通过对300份护理记录的缺陷原因分析，提出干预措施。     

提高护理记录质量的探讨

目的分析护理记录存在的缺陷，探讨提高护理记录质量。方法检查我院10个护理单元3036份出科病历，对存在的缺陷进行总结归类分析。结果体温单存在的缺陷共计198份，医嘱单存在的缺陷87份，护理记录单存在的缺陷336份。结论加强护理病历质量的管理，提高护理记录的质量，更好地为医院患者和社会服务。     

2682份体温记录单缺陷分析与对策

目的分析体温记录单中常见缺陷,提高体温记录单的质量。方法对2,682份体温记录单缺陷进行统计分析。结果182份体温记录单中存在缺陷,占6．8％,出现缺陷次数271次。结论加强护理人员的法律意识和自我保护意识,强化病历书写标准,以确保医疗护理活动中护患双方的合法权益。     

115份精神科护理文书书写质量分析

目的：提高精神科护理文书书写质量，减少护理记录缺陷。方法：通过对115份精神科护理病历进行检查，发现存在的问题，进行原因分析，制定干预对策。结果：115份护理病历中，护理记录单存在的缺陷较多。结论：提高护理文件文书质量，减少记录缺陷，应加强护理记录的书写的规范性     

探析消毒供应中心护理缺陷原因与策略

目的：总结消毒供应中心护理缺陷原因与策略。方法：随机筛选2015年10月至2016年10月该院消毒供应中心的工作记录总共500份，分析消毒供应中心护理缺陷原因与策略。结果：消毒供应中心的工作记录总共500份，有30份记录显示为护理缺陷，具体护理缺陷发生原因有护理人员缺乏责任心、未按照标准要求完成护理操作、护理监管机制不够深入、护理人员的护理服务水平差等。结论：为了提升消毒供应中心的护理水平及质量，消毒供应中心管理人员需要从各个方面分析护理缺陷，并制定相应的解决对策，提升护理质量。     

门诊护患沟通影响因素及护理对策

目的:探讨门诊输液室护患沟通中存在的缺陷,找出影响护患沟通的薄弱之处,为进一步提高护患沟通做出努力.方法:采用调查问卷的方法在门诊输液室发放自行设计的问卷表50份,向25例患者和25名护士进行问卷调查.对护患沟通的时间、技巧、内容等进行分析.结果:回收有效问卷46份,其中护士25份,患者21份.影响门诊护患沟通的因素为护士与患者沟通交流的时间过短,护士对沟通技巧在护患沟通中的重要性的认识不足及对患者的称呼不够尊重等因素.结论:护士应提高护理专业水平,改进沟通技巧提高护理质量,提高患者满意度.     

门诊护患沟通影响因素及护理对策

目的:探讨门诊输液室护患沟通中存在的缺陷,找出影响护患沟通的薄弱之处,为进一步提高护患沟通做出努力.方法:采用调查问卷的方法在门诊输液室发放自行设计的问卷表50份,向25例患者和25名护士进行问卷调查.对护患沟通的时间、技巧、内容等进行分析.结果:回收有效问卷46份,其中护士25份,患者21份.影响门诊护患沟通的因素为护士与患者沟通交流的时间过短,护士对沟通技巧在护患沟通中的重要性的认识不足及对患者的称呼不够尊重等因素.结论:护士应提高护理专业水平,改进沟通技巧提高护理质量,提高患者满意度.     

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.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

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.