社区脑卒中患者居家护理需求及影响因素分析

目的：探讨社区脑卒中患者居家护理需求情况及其影响因素。方法：采用一般情况调查表、生活自理能力量表(ADL)、脑卒中患者与家属居家护理需求问卷、社会支持评定量表对367例社区脑卒中患者进行问卷调查。结果：社区脑卒中患者居家护理需求总分为(3.04±0.23)分，其中为健康教育需求(3.65±0.40)分、医疗康复护理需求(3.17±0.65)分、心理护理需求(2.79±0.47)分、生活护理需求(2.17±0.43)分。多元线性回归分析显示，ADL评分、社会支持、文化程度、慢性病数量、人均月收入是社区脑卒中患者居家护理需求的独立影响因素。结论：社区脑卒中患者的居家护理需求程度较高，医护人员应重点关注ADL评分低、社会支持水平低、文化程度低、慢性病数量多、人均月收入高的患者。     

脑卒中患者社区护理要求调查及其影响因素分析

目的:分析脑卒中患者社区护理要求调查及其影响因素临床应用效果.方法:在2014年5月至2015年5月选取五个社区共100例脑卒中患者作为具体的研究对象,分析他们对护理要求及其影响因素.结果:经过调查统计后得出,100例脑卒中患者在健康教育需求维度得分为(88.5±3.8)分,心理需求维度得分为(71.4±4.2分,社会支持维度得分为(61.3±2.5)分,提高自我护理能力维度得分为(85.3±2.6)分.患者对于健康教育得分最高,其次是提高自我护理能力,结果表明对于健康教育的需求最大.组间数据对比存在明显差异,(P＜0.05)具有统计学意义.结论:社区的脑卒中患者对于护理的要求较高,尤其是在健康教育方面.经济、职业、脑卒中类型以及年龄等因素都会对护理要求产生影响.     

脑卒中患者社区护理要求调查及其影响因素分析

目的:分析脑卒中患者社区护理要求调查及其影响因素临床应用效果。方法:在2014年5月至2015年5月选取五个社区共100例脑卒中患者作为具体的研究对象,分析他们对护理要求及其影响因素。结果:经过调查统计后得出,100例脑卒中患者在健康教育需求维度得分为(88.5±3.8)分,心理需求维度得分为(71.4±4.2分,社会支持维度得分为(61.3±2.5)分,提高自我护理能力维度得分为(85.3±2.6)分。患者对于健康教育得分最高,其次是提高自我护理能力,结果表明对于健康教育的需求最大。组间数据对比存在明显差异,(P0.05)具有统计学意义。结论:社区的脑卒中患者对于护理的要求较高,尤其是在健康教育方面。经济、职业、脑卒中类型以及年龄等因素都会对护理要求产生影响。     

社区缺血性脑卒中患者中医康复护理需求调查报告

目的:研究社区缺血性脑卒中患者中医康复护理需求及影响因素,为提高中医康复护理质量提供依据。方法:整群抽取我院2013年1月~2014年4月确诊为缺血性脑卒中,经入院治疗好转出院后社区康复阶段的患者312人,采用自行设计的中医康复护理需求调查问卷及Barthel指数评定、FuglMeyer评分进行随访调查。结果:57.42%患者没有听说过中医康复护理需求;文化程度、收入情况、中医康复护理需求知晓情况、Barthel指数评定、Fugl-Meyer评分是中医康复护理需求的影响因素。结论:应加强社区缺血性脑卒中患者对中医康复护理需求的健康教育。     

脑卒中社区康复简易适宜技术在社区脑卒中患者中的应用及效果分析

目的应用脑卒中社区康复简易适宜技术指导回归社区的脑卒中存活患者开展康复训练,并评价其应用效果。方法 2008年9月—2009年8月,永外社区卫生服务中心的5名社区医师接受脑卒中社区康复简易适宜技术培训后,社区医师应用简易适宜技术,对辖区内征集的70例脑卒中患者,以8～12人为一组,分7组先后开展为期3个月的集体康复训练和指导,比较康复训练前后患者的运动功能、日常生活活动能力和社会活动能力变化。结果经过3个月的集体康复训练,入组的70例社区脑卒中患者的简化Fugl-Meyer运动功能量表评分从(51.9±25.0)分提高到(62.1±25.2)分,差异有统计学意义(t=-14.056,P<0.0001);Barthel指数量表中位数评分从82.5分(25分位分值到75分位分值:70～95分)提高到90.0分(25分位分值到75分位分值:75～100分),差异有统计学意义(Z=-4.728,P<0.0001);社会功能活动问卷评分从(11.0±7.8)分降低到(9.6±7.4)分,差异有统计学意义(t=4.051,P<0.0001)。结论符合现代康复理念的脑卒中社区康复简易适宜技术易于社区脑卒中患者掌握,能很好地...     

脑卒中患者延续性护理需求的现状及影响因素分析

目的:调查脑卒中患者出院后对延续性护理服务的需求情况,分析其影响因素。方法:采用自行设计的《脑卒中患者延续性护理需求量表》对2014年9月-2017年9月在罗定市红十字会医院和罗定市船步镇卫生院就诊住院的184例脑卒中患者进行延续性护理需求调查,并应用Likert 5级评分和多因素Logistic回归分析进行评价。结果:(1)脑卒中患者延续性护理需求情况分析显示:脑卒中患者延续性护理服务的总需求率均在70%以上,其各维度得分:生活护理(3.57±0.48)分、康复指导护理(3.82±0.62)分、心理护理(3.26±0.33)分、健康教育护理(3.42±0.44)分、专业护理(3.46±0.59)分、并发症预防护理(3.12±0.25)分及自我护理(3.39±0.47)分。(2)多因素Logistic回归分析结果显示:年龄、文化程度、婚姻状况及月收入情况是脑卒中患者延续性护理需求的重要影响因素。结论:罗定地区脑卒中患者对出院后的延续性护理需求较高,且也非常迫切。基层医院或社区医院应提供多渠道的社会支持,以满足脑卒中患者对延续性护理需求,有利于促进患者早日康复,提高其生活质量。     

脑卒中患者自我护理能力与健康状况调查分析

目的:调查了解脑卒中患者自我护理能力和身心健康状况,探讨两者间的关系,为促进患者康复提供干预依据。方法:采用自编一般情况问卷、自我护理能力测定量表(ESCA)、自测健康状况评定量表(SRHMS)对120例社区脑卒中患者进行评定,并进行相关性分析。结果:脑卒中患者中ESCA高等水平占有率为22.5%,中等水平占有率为68.33%,低等水平占有率为9.17%。不同ESCA水平的脑卒中患者SRHMS评分具有显著性差异(P<0.01)。SRHMS分值与ESCA分值呈显著正相关(P<0.05或P<0.01)。结论:脑卒中患者自我护理能力和健康状况不佳,自我护理能力是影响脑卒中患者身心健康的重要因素,提高自我护理能力有助于提高健康水平和生存质量。     

银川市4个社区老年人自我护理能力现状调查

目的研究银川市4个社区老年人的自我护理能力的状况及其影响因素。方法采用自我护理能力测量量表(ESCAS)对银川市4个社区的老年人进行自我护理能力及其影响因素的调查。结果银川市4个社区老年人的自我护理能力得分为(109.69±15.97)分。老年人自我护理能力与性别、文化程度、以前职业、经济收入、健康状况、自我保健有关(P<0.05)。经多元线性回归分析,影响银川市4个社区老年人自我护理能力的主要因素是文化程度、自我保健和健康状况。结论针对影响老年人自我护理能力的因素,采取有效措施,进一步提高老年人的自我护理能力。     

三级医院脑卒中专科护士循证护理能力现状与影响因素的调查分析

目的 了解脑卒中专科护士的循证护理能力现状,分析其影响因素。方法 采用便利抽样的方法,于2021年2月选取上海、江苏、浙江19家三级医院在神经内科病区工作的155名脑卒中专科护士作为调查对象。采用一般资料调查问卷、循证护理能力评定量表对其进行调查并分析影响因素。结果 循证护理能力评定量表总分为(49.22±22.07)分,证据传播能力各维度均分最高,为(2.50±0.85)分,证据整合能力各维度均分最低,为(1.74±1.31)分。单因素分析结果显示,学历、职务、文献检索能力、对循证重要性的认识、对循证应用时机了解程度等因素对脑卒中专科护士循证护理能力有影响(P<0.05)。其中,接受过系统的循证护理培训、文献检索能力、循证应用时机了解进入多重线性回归方程,是脑卒中专科护士循证护理能力的主要影响因素(P<0.05)。结论 脑卒中专科护士循证护理能力亟待提高。     

循证护理对改善脑卒中患者预后的影响

目的观察循证护理干预对改善脑卒中患者预后的影响。方法 120例脑卒中患者,按随机数字表法分为实验组和对照组,每组60例,实验组患者采用循证护理方法,对照组患者采用传统护理方法。比较两组患者的住院费用、住院时间及患者日常生活活动功能Barthel积分的差异。结果实验组住院费用少于对照组(P<0.01),住院时间短于对照组(P<0.01),出院时实验组Barthel积分为(68.4±7.0)分,明显高于对照组的(39.7±6.8)分(P<0.01)。结论循证护理可以改善脑卒中患者预后。     

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.     

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.     

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.