针对性护理干预对中晚期肿瘤化疗患者毒副反应及疗效的影响

目的探讨针对性护理干预对中晚期肿瘤化疗患者毒副反应和生活质量的影响。方法将我院收治的中晚期肿瘤化疗患者随机分为两组,对照组化疗期间予常规护理,观察组予针对性护理,比较两组化疗期间毒副反应发生率、生活质量评分。结果观察组化疗期间毒副反应发生率低于对照组,SF-36量表评分高于对照组,两组差异有统计学意义(P0.05)。结论针对性护理干预能有效降低毒副反应发生率,改善生活质量,提高化疗效果,在中晚期肿癌患者化疗中有较高应用价值。     

老年妇科恶性肿瘤化疗毒副反应的临床研究

目的:对老年妇科恶性肿瘤患者化疗的毒副反应进行临床观察和分析。方法:选取2012年10月~2014年10月在我院接受妇科恶性肿瘤老年患者48例为观察组,选取同期妇科恶性肿瘤中青年患者48例为对照组,两组患者给予相同的化疗方法,对两组患者毒副反应的发生情况进行对比分析。结果:两组患者血液和消化道毒副作用无明显差异,不具有统计学意义(P0.05);观察组患者心血管系统、肝功能、肾功能以及泌尿系统等化疗毒副反应发生情况明显优于对照组,差异具有统计学意义(P0.05)。结论:在对老年妇科恶性肿瘤患者实施化疗的过程中,其部分类型毒副作用的发生率远远高于中青年患者,在治疗过程中应该选择合适的化疗方法,对可能出现的毒副作用进行防治,进而提高临床治疗的有效率。     

协同护理模式对化疗联合TACE治疗胃癌伴肝转移患者毒副反应的影响

目的 研究协同护理模式对化疗联合TACE治疗胃癌伴肝转移患者毒副反应的影响,以提高晚期胃癌患者的生存质量。 方法 选取2014年1月-2016年3月入住哈尔滨医科大学附属肿瘤医院普外科治疗的明确诊断为胃癌伴有肝转移的患者80例,所有患者给予统一化疗和TACE治疗方案。随机将患者分为观察组(40例)和对照组(40例),观察组采用协同护理模式,对照组给予常规护理。采用SPSS 22.0统计学软件对2组患者治疗前后抑郁心理、治疗发生的毒副反应组间比较采用t检验、对护理工作的满意度进行秩和检验,综合评价协同护理模式对肝癌患者毒副反应发生的影响。 结果 观察组的患者在治疗14 d后抑郁状态评分与入院前比较差异有统计学意义(P<0.05);观察组患者治疗14 d后与对照组治疗14 d后抑郁状态评分比较差异有统计学意义(P<0.05);协同护理模式组与常规护理组比较,恶心呕吐、口腔黏膜炎、肾功能损害、感染、骨髓抑制发生率均较低,差异均有统计学意义(均P<0.05);观察组满意度[36例(90.0%)]显著高于对照组[29例(72.0%)],差异有统计学意义(P<0.05)。 结论 对化疗联合TACE治疗胃癌伴肝转移的患者实施协同护理模式,能够明显减轻患者的不良情绪,降低毒副反应的发生率,提高患者的依从性,有利于帮助患者顺利完成治疗,提升患者生活质量。      

针对性护理干预对恶性淋巴瘤患者化疗疗效及生活质量的影响

目的探讨恶性淋巴瘤患者实施针对性护理干预对化疗效果和生活质量的影响。方法选取2016年1月—2018年4月广州市第一人民医院收治的恶性淋巴瘤患者80例为研究对象,按照随机数字表将患者分为对照组与观察组,每组各40例。两组均予以常规化疗方案,化疗期间对照组实施常规护理,观察组在常规护理的基础上采用针对性护理干预,比较两组的化疗疗效、化疗期间的毒副反应和两组护理前后的生存质量。结果观察组化疗有效率高于对照组(P<0.05);两组患者的血液系统毒性、神经系统毒性发生率比较差异无统计学意义(P>0.05),观察组骨髓抑制和消化道反应发生率低于对照组(P<0.05);护理后两组癌症患者生活功能指标量表(FILC)评分均提高(P<0.05),且观察组提高更显著(P<0.05)。结论对恶性淋巴瘤化疗患者实施针对性护理干预可以提高化疗效果,减少化疗毒副反应,并可改善患者的生活质量。     

针对性护理干预在行TP化疗方案治疗的卵巢癌患者护理中的应用

目的探讨针对性护理干预在行TP化疗方案治疗的卵巢癌患者护理中的应用效果。方法选取新乡市中心医院2015年2月至2016年2月行TP化疗方案的卵巢癌患者62例,按照随机数表法分为对照组和观察组,各31例,对照组接受常规护理,观察组在对照组基础上接受TPB的针对性护理干预。统计对比两组护理前后生活质量评分及不良反应发生率。结果护理后,观察组不良反应发生率[16.13%(5/31)]低于对照组[45.16%(14/31)],差异有统计学意义(P<0.05);观察组生活质量评分高于对照组,差异有统计学意义(P<0.05)。结论 TPB的针对性护理干预应用于行TP化疗方案卵巢癌患者中,可降低其不良反应发生率,提高生活质量。     

人文关怀在妇科恶性肿瘤化疗患者健康教育路径中的应用

目的探讨人文关怀在妇科恶性肿瘤化疗患者健康教育路径中的应用效果。方法按住院时间先后将妇科恶性肿瘤化疗患者分为两组,对照组实施常规健康教育路径,观察组将人文关怀融入健康教育,评价两组患者化疗前后的焦虑情绪评分、化疗依从性、化疗副反应发生情况、健康教育达标率及满意度差异。结果观察组患者的焦虑程度较对照组明显降低,有统计学差异(P0.05);观察组恶心呕吐、疲倦乏力等化疗副反应发生情况好于对照组,有统计学差异(P0.05),便秘腹泻发生无差异。观察组化疗依从性、健康教育达标率及满意度高于对照组,均具有统计学差异(P0.05),结论人文关怀应用于妇科恶性肿瘤化疗患者健康教育路径,可减轻患者焦虑程度,提高治疗依从性、健康教育达标率及满意度。     

胃癌患者化疗的医护一体化干预方法与干预效果评估

目的:探讨胃癌化疗患者的医护一体化干预方法及其干预效果。方法:选取本院2018年1-8月收治的胃癌化疗患者42例作为研究对象,按照随机数字表法将其分为对照组和观察组,各21例。对照组按照常规护理模式干预,观察组则采取医护一体化干预模式干预,比较两组护理前后焦虑自评量表(SAS)、抑郁自评量表(SDS)、癌症疲乏量表(CFS)评分,同时记录化疗副反应发生情况和住院时间,护理质量和患者对护理的满意度评分。结果:护理前两组SAS、SDS、CFS评分比较,差异均无统计学意义(P0.05);护理后,两组SAS、SDS、CFS评分与治疗前比较均明显降低,且观察组均明显低于对照组,差异均有统计学意义(P0.05)。观察组化疗副反应发生率明显低于对照组,住院时间明显短于对照组,差异均有统计学意义(P0.05)。观察组护理质量和患者对护理的满意度评分均明显高于对照组,差异均有统计学意义(P0.05)。结论:医护一体化护理干预应用在胃癌患者中不仅可以明显改善患者的焦虑、抑郁症状,而且还能更好地改善癌性疲乏症状,提高护士护理水平,减少化疗副反应,缩短住院时间,使得患者对护理更满意,值得借鉴。     

针对性护理在负压封闭引流糖尿病足患者中的应用效果

目的:观察针对性护理在负压封闭引流(VSD)糖尿病足患者中的应用效果。方法:选取2019年7月至2021年7月该院收治的88例行VSD的糖尿病足患者进行前瞻性研究,按照随机数字表法分为观察组与对照组各44例。对照组采取常规护理,观察组采取针对性护理,比较两组抗生素使用时间、创面愈合时间、视觉模拟评分法(VAS)评分、护理不良事件发生率和护理满意率。结果:观察组抗生素使用时间和创面愈合时间均短于对照组,差异有统计学意义(P<0.05);护理后,两组VAS评分均低于护理前,且观察组低于对照组,差异有统计学意义(P<0.05);观察组护理不良事件发生率为4.55%,低于对照组的20.45%,差异有统计学意义(P<0.05);观察组护理满意率为95.45%,高于对照组的81.82%,差异有统计学意义(P<0.05)。结论:针对性护理用于VSD糖尿病足患者可缩短抗生素使用时间和创面愈合时间,降低VAS评分和护理不良事件发生率,以及提高护理满意率,优于常规护理效果。     

整体护理干预对白血病化疗患者心理状态、并发症及生活质量影响

目的:探讨整体护理干预对白血病化疗患者心理状态、并发症及生活质量的影响。方法:选取2016年2月-2018年2月本院接受化疗的96例白血病患者作为研究对象,按随机数字表法分为观察组(n=48)和对照组(n=48)。对照组实施常规护理,观察组在常规护理的基础上实施整体护理。比较两组心理状态、并发症发生率及生活质量。结果:护理前,两组焦虑自评量表(SAS)和抑郁自评量表(SDS)评分比较,差异均无统计学意义(P0.05)。护理后,两组SAS与SDS评分明均明显优于护理前,且观察组SAS与SDS评分均明显优于对照组(P0.05);护理后,观察组并发症发生率(12.50%)明显低于对照组(41.67%),差异有统计学意义(P0.05)。护理后观察组各项生活质量评分明显高于对照组(P0.05)。结论:整体护理干预能有效改善患者心理状态,减少并发症发生风险,显著提高患者的生活质量,临床值得推广运用。     

妇科恶性肿瘤化疗期间的心理干预与护理方法

目的探究妇科恶性肿瘤化疗期间的心理干预与护理方法。方法将2014年5月至2015年8月间我院收治的妇科恶性肿瘤患者120例为研究对象,随机分成观察组与对照组,60例对照组患者给予常规护理,60例观察组给予心理护理干预,对比两组患者化疗后的心理状态和护理满意度。结果护理干预前,两组患者SDS评分比较,差异无统计学意义,P0.05;经过护理干预后,两组患者SDS评分均有明显下降,且观察组下降幅度明显优于对照组,差异显著,有统计学意义P0.05;观察组的护理满意度明显高于对照组,差异显著,有统计学意义P0.05。结论对妇科恶性肿瘤患者采用心理护理干预措施以及临床上常见并发症预见性的护理干预,能有效降低患者焦虑抑郁心情,提高护理满意度,效果显著。     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.     

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.