鼻咽癌病人的心理护理

目的：针对鼻咽癌病人的心理问题进行心理护理以减少其焦虑心理，提高治疗效果。方法：将118例鼻咽癌病人随机分成两组，对照组作一般常规护理，观察组在常规护理的基础上加作系统的心理护理，比较两组住院1mo后心理状态。结果：两组治疗前后各自比较，均有显著性差异p〈0．05（x^2=7．869）和p〈0．01（x^2=40．109）：治疗后观察组更优于对照组p〈0．01（x^2=12．206）。结论：通过心理护理，减少病人的心理问题，提高了生存质量。     

母乳喂养与人工喂养对婴儿健康的影响

目的探讨母乳喂养与人工喂养对婴儿生长发育的影响。方法对怀化市出生体重2500—4000g的足月婴儿305例，其中母乳喂养儿168例，人工喂养儿137例，6mo龄时，用Gesell量表测量发育商。结果两组在婴儿体重、身高数值上母乳喂养组显著高于人工喂养组p〈0．01；患病情况母乳喂养组13．69％（23／168），低于人工喂养组46．71％（64／137）p〈0．01（x^2=40．368）；心理发育正常人数母乳喂养组为88．09％（148／168）高于人工喂养组75．99％（104／137）p〈0．01（x^2=7．801）。结论母乳是最理想的天然食品，母乳中的免疫物质是婴儿6mo内抗疾病的重要因素；母子交流是婴儿心理发展的首要条件。     

健康教育的效果评价及管理对策

目的为了评价健康教育实施的效果。方法对2005年住院患者中随机抽查536例（78．1％）作为调查对象，分别在入院和出院时进行观察、询问、交流和问卷调查等，分析患者知、信、行及其满意度，并与2004年调查结果比较。结果2005年患者健康教育前后知、信、行效果比较，健康教育后显著高于健康教育前p〈0．01；2005年满意度97．9％（525／536）显著高于2004年的85．1％（658／774）p〈0．01（x^2=59．053）。结论通过有计划、有目的健康教育活动，克服和改变了患者不良健康行为；实行健康管理，利于健康的知、信、行。     

吉他霉素与阿奇霉素治疗小儿肺炎的疗效与不良反应比较

目的比较吉他霉素与阿奇霉素治疗小儿肺炎的临床疗效与不良反应。方法将94例小儿肺炎住院患儿随机分为两组，分别给予吉他霉素与阿奇霉素序贯治疗。结果吉他霉素组（A组）48例，总有效率91．6％，阿奇毒素组（B组）46例，总有效率95．7％，两组总有效率比较无显著性差异p〉0．05（x^2=0．843）：不良反应总人数A组4／48例，B组12／46例，两组不良反应总人数比较有显著性差异p〈0．01（x^2=9．983）：〈3岁年龄段不良反应总人数A组3／48例，B组10／46例，两组比较有显著性差异p〈0．05（x^2=4．710）;≥3岁年龄段不良反应总人数A组1／48例，B组2／46例，两组比较无显著性差异p〉0．05。结论两组疗效相当，但从两组不良反应总人数及不同年龄段不良反应总人数比较看，吉他霉素宜于低年龄组，阿奇霉素宜于年长儿。     

医学院校大学生蠕形螨感染情况调查及相关因素分析

目的调查莆田学院医学院一年级大学生人体蠕形螨的感染情况及分析相关因素。方法对莆田学院医学院一年级1211名大学生的家庭背景、个人卫生习惯、皮肤类型及脸部疾病等相关因素作问卷调查，同时采用透明胶带单粘过夜法进行蠕形螨检查。结果在校一年级医学生蠕形螨总感染率为56.23％，男生感染率显著高于女生（x^2=7．18，P〈0.01）；面部皮肤有酒渣鼻、毛囊炎、痤疮或脂溢性皮炎等患者感染率也高于面部皮肤健康者（x^2=14．59，P〈0.01）；常混用他人日常用品者感染率也高于不常与他人混用者（x^2=17．51，P〈0.01）；春季蠕形螨感染率高于冬季（x^2=21.88，P〈0.01）；而来自于城市的与来自于乡村的学生感染率差异无显著性（x^2=0.35，P〉0．05）。结论蠕形螨感染在莆田学院一年级医学生中较为普遍，蠕形螨感染与性别、季节、个人卫生习惯有关，而与家庭背景无关，蠕形螨感染是引起酒渣鼻、毛囊炎、痤疮、脂溢性皮炎等面部皮肤疾患的因素之一。     

某技校学生乙肝病毒感染情况调查分析

目的：了解某技校学生人群中乙肝病毒感染情况及乙肝免疫水平。方法：对2006年到我站进行健康体检的技校学生进行静脉抽血检查乙肝两对半和肝功能。结果：共调查体检人员1049名，其中HB8他阳性73人，阳性率6．96％，HBsAb阳性171人，阳性率16．30％，肝功能（ALT）异常5例，最高为120单位；男、女学生HBsAg阳性率分别为5．85％和7．72％，两者比较，无显著性差异（x^2=1．18，p〉0．05），HBsAb阳性率分别为20．37％和13．50％，两者比较，差异显著（x^2=6．24，p〈0．05）；1049名受检者中，乙肝疫苗接种率为16．68％，已接种和未接种乙肝疫苗者的HBsAg阳性率分别为1．14％和8．12％，两者比较差异显著（x^2=9．91，p〈0．01），HBsAb阳性率分别为P4．29％和0．69％，两者比较差异显著（x^2=465．8，p〈0．01）；已接种乙肝疫苗者中单纯HBsAb阳性占的比例大，为52．00％。结论：被调查学生人群中乙肝疫苗接种率低，而接种乙肝疫苗能有效预防乙肝病毒感染，提示应加大预防接种的宣传力度。‘     

泮托拉唑治疗胃溃疡的疗效观察

目的观察泮托拉唑治疗胃溃疡的临床疗效。方法采用随机抽样，配对分组法将128例胃溃疡患者分为泮托拉唑组和雷尼替丁对照组。结果泮托拉唑对胃溃疡的8wk治愈率为92．19％，明显高于雷尼替丁组的68．75％，p〈0．01；（x^2=11．184）；且副作用少，总有效率分别为96．9%（62/64）和87．5（56／64），p〈0．05（x^2=3．905）。结论泮托拉唑治疗胃溃疡疗效显著。     

湖北省民族地区在校大学生吸烟状况调查分析

目的：了解民族地区大学生的吸烟状况，探讨控烟的有效措施。方法：以问卷形式调查湖北民族地区两所高校3500名在校大学生的吸烟状况。结果：在调查对象中，经常吸烟和吸烟成瘾人数高达25．48％，其中，男生高于女生，土家、苗族学生高于其它民族学生，二、三年级学生高于一、二年级学生，三者均有显著统计学差异（x^2=26．3，x^2=18．6，x^2=16．4，P均〈0．01）。上大学以后养成吸烟爿惯的高达68．03％，学生吸烟主要以社交为目的（64.04％）。结论：大学生吸烟率增加问题应引起高度关注，需要加大控烟宣传教育力度和强化干预措施加以控制。     

青少年DM患者的健康教育和心理护理

目的为了观察健康教育和心理护理对青少年糖尿病（DM）患者的治疗效果。方法对31例青少年DM患者采用健康教育、心理护理、营养治疗、体育锻炼和胰岛素治疗。结果通过健康教育和心理护理配合治疗，血糖控制较理想者25例（80．6％），较单用药物有显著差异p〈0．01（x^2=14．762）。结论随着心身医学的发展，健康教育和心理护理在DM患者的康复中作用越来越显得重要。     

后程立体定向γ射线放射治疗食管癌的临床研究

目的：评价后程大分割立体定向γ射线放射治疗食管癌的近期疗效和放射反应。方法：将2003—01～2005—03收集的61例完成治疗食管癌病人，分常规放射治疗组（CRT）30例和后程立体定向放射治疗组（LCHSRT）31例。CRT组，2Gy／次，5次／wk，总剂量为66～70Gy／6．5～7wk。LCHSRT组，先常规放射治疗到剂量36～40Gy／3．5～4wk，再进行大分割体部伽玛刀治疗，3．6～5Gy／次，3次／wk，20～32Gy／I．5～2．5wk，总剂量达到66～70Gy／5．5～6wk。结果：CRT组和LCHSRT组急性放射性气管炎、放射性肺炎发生率分别为40．0％和16．1％（x^2=4．322，P〈0．05）、26．7％和6．5％（x^2=4．546，P〈0．05），两组急性放射性气管炎、放射性肺炎差异有显著性意义；急性放射性食管炎的发生率分别为36．7％和48．4％（x^2=1．086，P〉0．05），两组急性放射性食管炎差异无显著性意义。CRT组和LCHSRT组疗后ImoCR率分别为33．3％和61．3％（x^2=4．788，P〈0．05）、局控率分别为90．0％和93．5％（x^2=0．218，P〉0．05）；3mo局控率分别为83．3％和90．0％（x^2=0．577，P〉0．05），两组差异无显著性意义；6mo局部控制率分别为56．7％和83．3％（x^2=5．079，P〈0．05），两组6mo局部控制率差异有显著性意义；1a局控率为45．8％和76．2％（x^2=4．301，P〈0．05），两组1a局部控制率差异有显著性意义。1a生存率分别为41．7％和76．2％（x^2=5．472，P〈0．05），两组1a生存率差异有显著性意义。结论：LCHSRT提高了食管癌的局部控制率、1a生存率，近期疗效高于CRT。LCHSRT的放射反应小。远期疗效及晚期并发症有待进一步随访。     

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.     

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.