综合护理干预对肠梗阻患者心理状态的影响

目的:探讨综合护理干预对肠梗阻患者心理状态的影响。方法:选取我院收治的80例肠梗阻患者的临床资料,分为两组各40例,对照组患者进行常规护理,观察组患者进行综合性护理干预,对两组患者心理状态等方面进行评价。结果:观察组患者术后排气时间早、复发率低,与对照组患者比较差异有统计学意义(P<0.05);观察组患者SAS、SDS评分低,护理满意度高,与对照组患者比较差异有统计学意义(P<0.05)。结论:对肠梗阻患者进行综合护理,并进行个性化护理干预,能改善患者心理状态,效果满意,值得推广。     

内源性一氧化碳对培养的肺动脉平滑肌细胞增殖与凋亡的调节

目的 探讨内源性一氧化碳（CO）对低氧性肺血管平滑肌细胞（PASMC）增殖与凋亡的影响及机制。方法 体外培养Wistar大鼠PASMC,进行低氧并予以血红素氧合酶抑制剂卟啉锌－9（zinc protoporphyrin IX,ZnPP-9)处理,分为常氧12h组（N1组）、常氧24h组（N2组）、低氧12h组（H1组）、低氧24h组（H2组）、低氧12h ZnPP组（H1＋ZnPP组）、低氧24h ZnPP组（H2＋ZnPP组）,采用流式细胞术、免疫细胞化学方法检测PASMC增殖与凋亡情况。结果 1．碳氧血红蛋白（HbCO)检测：采用双波长法测定细胞培养液中HbCO的吸光度,用以代替培养液中CO的相对含量。低氧12h培养液中HbCO较常氧时显著增高（P＜0．01）,至24h恢复至常氧水平（P＞0．05）;而低氧同时进行干预,H1＋ZnPP及H2＋ZnPP两组HbCO水平均下降,且明显低于单纯低氧组（P＜0．01）,两组与常氧组相比亦有差异（P＜0．001）。2．流式细胞仪检测PASMC增殖指数（PI）与凋亡指数（AI）：H1组PI较N1组下降（P＜0．01）,H2组则较N2组增高（P＜0．001）;H1＋ZnPP组较H1组PI显著增高（P＜0．001）,H2＋ZnPP组与H2组比则无明显变化（P＞0．05）;H1组AI低于H2组（P＜0．01）,H1＋ZnPP组AI高于H1组（P＜0．001）,H2＋ZnPP组则低于H2组（P＜0．001）。3．PCNA免疫细胞化学染色,H1组及H2组PASMC细胞核阳性反应颗粒分别按N1及N2组明显增加（P分别＜0．01及P＜0．001）,H1＋ZnPP组及H2＋ZnPP组分别较H1及H2组增强（P＜0．01）。4．Caspase 3免疫细胞化学：H2组与H1组比胞浆着色增强（P＜0．05）,ZnPP处理12h及24h分别较H1及H2减弱（P＜0．05）。5．NF－κK免疫细胞化学：H1及H2组核染色分别较N1及N2组增强（P＜0．001）,而H1＋ZnPP组及H2＋ZnPP组则又分别较H1、H2组阳性核表达增多（P＜0．01）。结论 1．低氧12h内源性CO对PASMC增殖抑制作用显著,对凋亡可能无直接影响;低氧24h CO促进PASMC凋亡作用明显,而对增殖的影响不显著。2．NF－κB可能参与了内源性CO抑制PASMC增殖的调控机制。     

子宫内膜异位症患者盆腔粘连与疼痛的相关性

Objective To study the incidence of pelvic adhesions in endometriosis(EM) and the relationship between pelvic adhesions and pain symptoms. Methods The incidence of pelvic adhesions, dysmenorrhea, chronic pelvic pain, dyspareunia, dyschizia in 480 patients with EM were studied retrospectively to evaluate the correlation between pelvic adhesions and the degree of pain symptoms. In accordance with the revised American Fertility Society classification (r-AFS), it was observed that 155 cases were in Stage Ⅰ,33 cases were in stage Ⅱ,108 cases were in stage Ⅲ and 184 were cases in stage Ⅳ. Results (1) Among 480 cases with EM, 72.3% (347/480) of patients have pelvic adhesions simultaneously, of which 25.2% (39/155) patients were in Stage Ⅰ, 78.8% (26/33) patients were in Stage Ⅱ, 90.7% (98/108) patients were in Stage Ⅲ and 100.0% (184/184) patients were in Stage Ⅳ. It was found that positive correlation existed between the degree of pelvic adhesions and clinical staging of EM(rs=0.870,P<0.01).(2) 61.0%(293/480) of patients presented dysmenorrhoea, of which the percentages of mild, moderate and severe dysmenorrhea were 52.2%(153/293), 26.6%(78/293), 21.2% (62/293), respectively. The rate of patients presenting chronic pelvic pain (CPP), dyspareunia and dyschezia were 23.8% (114/480), 15.4% (74/480) and 7.1% (34/480), respectively. (3) Ovarian adhesions was positively correlated with dysmenorrhea and CPP(rs=0.367 and 0.267,P<0.01). Adhesion of the bottom and posterior wall of uterus was positively correlated with dysmenorrhea and CPP (rs=0.336, 0.164,P<0.01); adhesions of fallopian tubes were positively correlated with dysmenorrhea, CPP and dyschezia (rs=0.283, 0.225 and 0.159, P<0.01). Adhesions of rectum was positively correlated with dysmenorrhea (rs=0.101,P<0.05). In addition to dyspareunia, the degree of pelvic adhesions was positively correlated with dysmenorrhea, CPP and dyschezia (rs=0.470, 0.273, 0.132, P<0.01). Conclusion Pelvic adhesions are characteristic lesions of endometriosis, the site and degree pelvic adhesions are closely correlated with pain symptoms.     

行气化湿治疗慢性萎缩性胃炎

目的 探讨湖北武汉及沿长江中游地域的自然环境特征对慢性萎缩性胃炎（ＣＡＧ）发病的影响。方法 立行气化湿法，制胃炎１号治疗ＣＡＧ３７８例。结果 ３２１例症状完全消失，占８５％。其中２０９例经纤维胃镜复查并活检，２０１例病灶修复，病理痊愈达９６％。结论 天热地湿是湖北地区居住的人群患ＣＡＧ的主要原因之一，气滞湿阻是其主要病理机制。     

慢性肾功能衰竭患者血清肌钙蛋白T/I的变化及其临床意义

大量研究表明 ,血清心脏肌钙蛋白T/I(cTnT/I)在心肌损害时升高 ,且cTnT/I可作为鉴别微小心肌损害的一个特异的生化指标。慢性肾功能衰竭患者几乎 10 0 %合并心血管疾病 ,研究发现慢性肾衰患者的cTnT/I升高。本文综述了cTnT/I的分布、结构、功能、表达特点、代谢特点、检测方法及其在慢性肾功能衰竭患者中的异常变化、发生机制以及对诊断和预后评估的价值。     

参麦注射液对晚期消化道癌临床应用的探讨

目的：探讨参麦注射液对晚期消化道癌的增效减毒作用。方法：恶性肿瘤病人肿瘤分期均为Ⅲ-Ⅳ期,用化疗方案治疗,治疗组72例常规化疗配合用参差注射液,对照组54例常规化疗。结果：治疗组有效率83．3％,对照组有效率62．9％,两组差异显著（P＜0．05）。结论：用参麦注射液配合化疗治疗中晚期消化道肿瘤病人能增加化疗药物疗效,减轻副作用,值得临床上进一步推广应用和探讨。     

用于生物人工肝的肝细胞组织化培养

肝细胞是生物人工肝支持系统的核心。组织化培养的肝细胞具有比常规培养肝细胞更好的功能。本文就近年来肝细胞组织化培养的发展作一综述 ,并归纳了肝细胞组织化研究的发展方向     

低氧对大鼠肺动脉平滑肌细胞血红素加氧酶-1 mRNA 表达及细胞增殖的影响

探讨血红素加氧酶－1（HO－1）mRNA在低氧大鼠肺动脉平滑肌细胞（PASMC0的表达及HO－1／一氧化碳（HO－1／CO）体系对PASMC增殖的影响。应用荧光定量RT－PCR法测定HO－1mRNA表达。用双波长法检测碳氧血红蛋白（HbCO)吸光值。应用免疫细胞化学方法检测细胞增殖核抗原（PCNA）及核转录因子－κB（NF-κB）的表达。发现HO－1 mRNA在常氧大鼠PASMC有低水平的表达，低氧12h HO-1mRNA水平是常氧时的1．5倍，且HbCO产量随之显著增高（P＜0．01）；低氧24h HO-1 mRNA表达呈回落趋势，HbCO产量亦有所减少，但两者仍高于常氧水平。低氧12h及24h PASMC PCNA核阳性反应颗粒表达较常氧时增强（P＜0．01，P＜0．001），使用HO抑制剂ZnPP-9，其PCNA该阳性反应颗粒表达较单纯低氧时增加更多（P＜0．001，P＜0．01）。低氧组核NF－κB阳性染色较常氧组增强（P＜0．001），使用ZnPP-9，其表达则比低氧时更多（P＜0．01）。低氧通过诱导大鼠PASMC的HO－1 mRNA基因表达，上调HO／CO体系活性，使内源性CO含量增高，抑制PASMC增殖；NF－κB参与了PASMC增殖的调控机制。     

关爱肾脏，警惕肾病偷袭

正沉默的肾脏,强大的功能每个人都有两个蚕豆状、拳头大小的肾脏。肾脏拥有强大生理功能,号称"水司令",单单一个泌尿功能,就包含着从生成尿液,到排除体内代谢废物和多余的水分以及平衡酸碱度的复杂过程。它不像心脏一般娇气,一点不适就让人心悸甚至心痛到昏厥。