重组人脑钠肽在治疗急性心肌梗死伴发急性左心衰中的可行性分析

目的：分析探讨重组人脑钠肽（rhBNP）治疗急性心肌梗死伴急性左心衰的临床疗效及其临床适用性。方法：选择2013年5月－2014年9月于我院接受治疗的40例急性心肌梗死伴急性左心衰患者作为观察对象,随机分为实验组和对照组。两组患者均进行卧床休息、低盐低脂饮食、吸氧、强心利尿等基础治疗。在此基础上,对照组给予硝酸甘油进行治疗,实验组给予 rhBN P进行治疗。观察两组患者治疗后临床体征以及不良反应。结果：实验组和对照组在接受治疗后总有效率分别为90％和65％,两组之间比较差异具有统计学意义（P＜0．05）。其中,两组患者临床症状均得到改善,实验组疗效显著优于对照组,未观察到明显不良反应。结论：rhBNP治疗急性心肌梗死伴发急性左心衰疗效较硝酸甘油好,能明显降低收缩压（SBP）,提高心脏排血指数（CI）,改善心肌细胞功能,值得进行推广。     

急性颅脑损伤患者院前急救与护理效果分析

目的研究急性颅脑外伤患者的院前急救及护理方法。方法采用病例对照研究的方法，对院前急救组与对照组进行比较，分析死亡率及预后情况。结果对照组院前死亡率为13．26％，而急救组仅为4．67％，二者比较差异存在统计学意义（X^2=4．72，P〈0．05）；急救组的恢复情况明显好于对照组，二者比较差异存在统计学意义（X^2=5．00，P〈0．05）。结论院前急救和护理对提高急性颅脑损伤患者的治疗和康复具有重要意义。     

高血压病患者与正常人血清胶原代谢的对比研究

目的　测定高血压病 (EH)患者血清Ⅰ型前胶原羧基端肽 (PⅠP)、Ⅲ型前胶原氨基端肽 (PⅢP)和Ⅰ型胶原羧端交联肽 (ICTP)水平的改变 ,探讨其在高血压性心肌纤维化中的诊断价值。方法　采用放射免疫法测定 4 2例EH患者、30例正常对照者血清PⅠP、PⅢP及ICTP浓度 ,并对结果进行统计学分析。结果　EH患者血清PⅠP、PⅢP的含量分别为 (12 1 2± 2 0 8) μg/L和 (5 2± 3 2 ) μg/L ,明显高于正常对照组 (分别为 92 8μg/L± 13 3μg/L和 3 8μg/L±1 5 μg/L) ,P <0 0 5 ;ICTP的含量EH组虽有增加的趋势 (4 4± 1 7) μg/L ,但与正常组 (4 1± 1 5 )μg/L相比 ,P >0 0 5。有左心室肥厚 (LVH)的EH患者血清PⅠP水平高于无左心室肥厚 (无LVH)组 (12 7 6 μg/L± 18 5 μg/Lvs 10 5 3μg/L±12 4 μg/L,P <0 0 5 ) ,有LVH组血清ICTP水平低于无LVH组 (4 2 μg/L± 1 1μg/Lvs 5 0 μg/L± 1 2 μg/L ,P <0 0 5 ) ,而PⅢP水平两组无统计学差异 (P >0 0 5 )。结论　EH患者可能有Ⅰ型胶原及Ⅲ型胶原的合成增加 ,降解相对不足 ,测定PⅠP、PⅢP及ICTP可作为了解EH患者心肌纤维化的间接指标     

复方丹参滴丸改善心肌缺血再灌注损伤研究进展

血运重建是治疗心肌梗死最重要的措施之一.然而心肌缺血再灌注后氧自由基生成增加、钙超载、炎症反应、线粒体损伤、细胞凋亡、内皮细胞活化和损伤以及自噬等机制激活,对心肌细胞造成损伤.现代临床研究表明复方丹参滴丸在缓解心绞痛发作、改善心肌缺血、提高运动耐受时间以及改善缺血再灌注心肌有确切的疗效.     

“治未病”理论干预在肝硬化患者防治中的应用

目的通过对肝硬化患者进行“治未病”理论宣教干预,观察证实“治未病”理论在肝硬化患者治疗中的必要性,并总结出肝硬化患者行之有效的理论宣教方法以运用于临床。方法以本院80例肝硬化患者为观察对象。将80例肝硬化患者随机分为对照组和试验组。对照组采取传统宣教方案,试验组采取传统宣教方案加“治未病”理论干预宣教方案,观察2组患者并发症发生率、患者满意度及健康宣教合格率及患者住院平均总天数的差异。结果试验组患者的并发症发生率、健康宣教合格率、满意度与对照组比较差异均有显著性意义（P〈0．01）。结论对肝硬化患者进行“治未病”理论宣教干预,可明显降低患者并发症发生率、提高健康宣教合格率、提高患者满意度,值得推广应用。     

健康行为管理对住院慢性心力衰竭病人生活质量的影响

[目的]探讨健康行为管理对住院慢性心力衰竭病人生活质量的影响.[方法]将在本院心内科住院的心力衰竭病人107例作为研究对象,一病区57例作为观察组,二病区50例作为对照组.观察组采用健康行为管理方法,包括健康教育、技能培训和行为监控;对照组采用常规健康教育方法.2周后调查两组病人生活质量水平.[结果]观察组生活质量4个维度得分和总分低于对照组（P＜0.01）.[结论]健康行为管理能改善住院慢性心力衰竭病人健康行为,提高生活质量.     

Effects of pioglitazone on arteriosclerotic-related factors and short term prognosis in patients with coronary disease and diabetes

Background Thiazolidinediones (TZDs) not only improve insulin resistance, lowering blood sugar, also has anti-atherosclerotic effect. However, whether the protective effect on cardiovascular pioglitazone is still controversial. Methods Totally 98 patients with coronary disease and diabetes mellitus were randomly divided into pioglitazone group (n = 48) receiving conventional therapy and pioglitazone (15 mg/day), and control group (n = 50) merely receiving conventional therapy. The patients were followed up for 12 months. The plasma level of Plasminogen activator Inhibitor 1 (PAI-1) and P-selectin were detected at baseline and after treatment for 12 months by ELISA, and major adverse cardiac events (MACE) were studied. Results Pioglitazone therapy for 12 months was associated with a significant decrease of PAI-1 [(7.9 ± 1.4 vs 4.2 ± 0.5)ng/mL, P < 0.05] and P-selectin[(16.6 ± 6.8 vs 12.4 ± 3.6)ng/mL, P < 0.05], MACE was significantly lower in the pioglitazone group than in the control group [acute coronary syndrome (ACS): 32.0% vs 10.4%, P < 0.05; target vessel revascularization:22.0% vs 6.3%, P < 0.05]. Conclusions Pioglitazone can effectively reduce the plasma level of PAI-1, P-selectin and the occurrence of MACE in patients with coronary heart disease and diabetes mellitus.     

The Contrast Study on Serum Collagen Metabolism between Essential Hypertension and Normal Control

Objectives To investigate serum concentration of procollagen type Icarboxyterminal peptide (PⅠP), type Ⅲ aminopeptide (PⅢP) and type Icollagen telopeptide (ICTP) in essential hypertension (EH). Methods Serum levels of PⅠP, PⅢP and ICTP in 42 EH patients and 30 healthy control were measured by radioimmunoassays. Results In EH patients, serum concentration of PⅠP, PⅢP was significantly higher than that in 30 healthy control. Although EH patients did tend to exhibit a higher serum ICTP concentration than normal control subjects, the difference was not statistically significant. EH patients with left ventricular hypertrophy exhibited higher values of PⅠP (P < 0. 05) and lower values of ICTP (P < 0. 05) than EH patients without left ventricular hypertrophy. No significant difference was noted between the serum PⅢP of the EH patients with and without left ventricular hypertrophy (P > 0.05 ). Conclusions The results suggest that PⅠP and PⅢP are sensitive serum markers of myocardial collagen synthesi     

臂丛神经改良切口全程松解术患者的术后护理

目的总结胸廓出口综合征行改良切口全程松解术患者的术后护理经验。方法对77侧胸廓出口综合征患者行改良切口全程松解术后患者,给予周密细致的体位护理、生活护理、疼痛护理,严密观察并发症,做好常规及专科护理,重视康复训练指导。结果患者手术均顺利,术后48h症状明显改善者68例,3例改善不明显,1例自觉症状加重。手术切口均一期愈合,无1例感染。患者平均住院11.8d。6个月有效随访49侧,功能优良率为87.76%。结论实施全面、系统的术后护理,注重心理护理及康复指导护理,可减少并发症的发生,保证手术效果。