移植肾功能延迟恢复患者的心理问题及护理干预

目的　对移植肾功能延迟恢复 (DGF)患者的心理障碍进行分析 ,以制定合理的护理干预措施。　方法　 4 2例接受同种异体肾移植后发生DGF患者 (观察组 )进行护理干预和干预前后采用临床症状自评量表 (SCL 90 )、ZUNG抑郁自评量表 (SDS) ,ZUNG焦虑自评量表 (SAS)作心理测评 ,同时选择接受肾移植后肾功能恢复良好的患者 5 0例 (对照组 ) ,比较两组的心理测评情况。　结果　DGF的患者主要存在焦虑、抑郁等心理症状 ,3个量表总因子分与对照组相比差异有非常显著意义 (P <0 .0 1)。观察组在心理干预后焦虑、抑郁心理障碍较治疗前有所缓解 ,差异有非常显著意义 (P <0 .0 1)。　结论　DGF患者存在明显的心理障碍 ;对DGF患者实施心理干预可缓解心理障碍 ,提高患者的治疗信心和承受力 ,有利于提高肾移植成功率     

高龄肾移植围手术期患者心理障碍特点

目的　观察高龄肾移植患者围手术期心理障碍的特点。方法　对 36例高龄 ( >5 0岁 )肾移植患者于术前、术后 10d行心理评估 ,包括汉米顿焦虑量表 (HAMA)和抑郁量表 (HAMD)评分。同期接受肾移植手术的 5 5例非高龄患者作为对照组。所有患者均接受针对性护理心理干预治疗。结果　高龄肾移植手术患者术前焦虑、抑郁症患病率明显高于对照组 ,其HAMA和HAMD评分显著高于对照组。术后 10d两组患者的HAMA和HAMD评分均有明显下降 ,但高龄组仍高于对照组。高龄组中躯体性焦虑和抑郁表现相对突出。结论　高龄肾脏移植患者围手术期焦虑、抑郁均较非高龄患者发生率高、且更为严重。     

肾移植和血液透析患者抑郁焦虑心理的比较分析

目的对肾移植和血液透析患者抑郁焦虑心理进行比较。方法采用ZUNG抑郁自评量表（SDS）和焦虑自评量表（SAS）分别对宁夏地区50例肾移植术后患者和50例血液透析患者的心理状况进行调查。结果血液透析组抑郁、焦虑总分均数均高于肾移植组，两组抑郁总分均数存在显著性差异。结论根据肾移植和血液透析患者抑郁焦虑程度，针对性地进行心理干预，以缓解患者抑郁焦虑情绪，提高尿毒症患者的生存质量。     

肾移植术后患者肾功能延迟恢复的护理体会

目的着重阐述DGF患者区别于普通肾移植患者的护理方法,为确保DGF患者顺利渡过此阶段提供可靠护理依据,最终改善护理效果。方法对42例肾移植术后肾功能延迟恢复患者进行回顾性研究。通过临床观察与实践,总结DGF患者术后的护理要点。结果本组42例DGF患者,均出现不同程度的心理问题,通过护理方法的干预,最终42例患者都心境平和地配合了治疗和护理。本组共39例痊愈出院,2例移植肾功能完全丧失,行移植肾摘除术。1例发生严重感染合并肺功能衰竭导致死亡。结论及早发现并正确识别DGF,加强患者的心理护理,对DGF患者顺利渡过此期,至关重要。DGF发生并发症的潜在性较高,因此应重视并区别对待DGF患者与普通肾移植患者的并发症问题。     

移植肾功能延迟恢复的护理

目的探讨加强肾移植术后早期常见并发症的观察与护理，对DGF预后的影响。方法对我院ll例DGF患者的早期临床症状、护理特点及预后进行总结和综合分析。结果9例DGF患者经治疗，移植肾功能恢复，1例因并发脑出血死亡，1例移植肾功能丧失。在护理工作中尽早发现DGF早期表现加强护理，并及时通知医生采取正确的预防措施及尽快做出明确诊断并制定合理的治疗方案，能够缩短DGF时间促进移植肾功能恢复。结论加强对肾移植护理工作者的培养，掌握肾移植术后并发症的临床特点和病理进程，加强对DGF病人的全位护理，有利于缩短DGF时间和移植肾功能的恢复。     

肾移植患者手术前后心理状态的分析与研究

目的分析与研究肾移植患者手术前后的心理状态。方法应用状态自评表（SCI—90）、Zung焦虑自评量表（SAS）、抑郁自评量表（SDS）及纽芬兰纪念大学幸福量表（MUNSH）对26例肾移植患者分别于同种异体肾移植手术前、后1-2周进行两次心理状态调查分析。结果肾移植手术前受者均存在明显的焦虑、抑郁，总体幸福度低；肾移植术后经有效的心理干预，受者的焦虑、抑郁症状明显低于术前，总体幸福度明显提高。不同性别、年龄、文化程度的肾移植患者术后焦虑、抑郁的严重程度不同，其中以女性、高学历以及〉30岁的中年人表现最为明显；而经济状况和术后移植肾功能恢复情况对肾移植患者的心理状态有着显著的影响。结论肾移植患者手术前后均存在较严重的心理问题，分析和研究患者手术前后的心理状态，实施有针对性的心理干预，对于提高肾移植的成功率，改善患者心理状态，提高生活质量极其重要。     

移植肾功能延迟恢复的护理

目的探讨加强肾移植术后早期常见并发症的观察与护理,对DGF预后的影响。方法对我院11例DGF患者的早期临床症状、护理特点及预后进行总结和综合分析。结果9例DGF患者经治疗,移植肾功能恢复,1例因并发脑出血死亡,1例移植肾功能丧失。在护理工作中尽早发现DGF早期表现加强护理,并及时通知医生采取正确的预防措施及尽快做出明确诊断并制定合理的治疗方案,能够缩短DGF时间促进移植肾功能恢复。结论加强对肾移植护理工作者的培养,掌握肾移植术后并发症的临床特点和病理进程,加强对DGF病人的全位护理,有利于缩短DGF时间和移植肾功能的恢复。     

慢性肾脏病患者的焦虑抑郁心理状态的护理干预措施

目的:观察和探讨护理干预对慢性肾脏病(CKD)患者心理障碍干预的影响。方法:采用症状自评量表(SCL-90)对CKD患者入院时进行心理状态测定,对存在焦虑、抑郁情绪的72例患者按优质护理服务的标准开展心理疏导,出院时再次进行心理状态测定。结果:通过开展优质护理服务使患者焦虑抑郁情绪明显缓解,该组患者出院时(SCL-90)中抑郁与焦虑因子与入院时比较差异有统计学意义(P0.05)。结论:开展优质护理服务能明显的缓解CKD患者的焦虑抑郁情绪,提高患者的生活质量,值得临床推广应用。     

慢性肾脏病患者的焦虑抑郁心理状态的护理干预措施

目的:观察和探讨护理干预对慢性肾脏病(CKD)患者心理障碍干预的影响.方法:采用症状自评量表(SCL-90)对CKD患者入院时进行心理状态测定,对存在焦虑、抑郁情绪的72例患者按优质护理服务的标准开展心理疏导,出院时再次进行心理状态测定.结果:通过开展优质护理服务使患者焦虑抑郁情绪明显缓解,该组患者出院时(SCL-90)中抑郁与焦虑因子与入院时比较差异有统计学意义(P＜0.05).结论:开展优质护理服务能明显的缓解CKD患者的焦虑抑郁情绪,提高患者的生活质量,值得临床推广应用.     

38例同种异体肾移植患者心理分析与护理干预

目的　对接受同种异体肾移植患者的心理障碍因素进行分析和评定 ,以制定合理的护理干预计划。方法　对 38例接受同种异体肾移植患者在住院期间采取心理会谈方式 ,了解患者的心理障碍类型 ,分析其心理变化过程 ,采用临床症状自评量表 (SCL - 90 )、ZUNG抑郁自评量表 (SDS)、ZUNG焦虑自评量表(SAS)对该组 (观察组 ) 38例患者与 4 0例健康自愿者 (对照组 )进行比较 ,针对患者症状严重程度分别进行心理干预前后评分。结果　观察组患者心理障碍因素主要为焦虑、抑郁等心理特征。 3个量表总因子、单因子分别与对照组比较 ,差异有显著性 (P <0 .0 1)。心理干预后 ,SCL - 90总分及单因子评分结果 ,观察组在焦虑、抑郁心理方面与治疗前比较 ,差异有显著性 (P <0 .0 1)。结论　心理干预对于接受同种异体肾移植可提高患者的治疗信心、增强受者对异体肾的容受性 ,有利于提高生活质量     

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…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…