预见性护理在急性心肌梗死院前急救中的应用

目的:探讨预见性护理在急性心肌梗死患者院前急救中的应用效果.方法:选取急诊收治急性心肌梗死患者60例为观察组,采用预见性护理干预措施.选择不同时段急诊收治的急性心肌梗死患者60例为对照组,采用常规急救护理措施.比较两组患者抢救成功率及急救时间(包括病情评估时间、静脉通路建立时间、心电图时间及总急救时间).结果:与对照组比较,观察组抢救成功率明显提高,急救时间明显缩短(P＜0.05).结论:预见性护理干预缩短了急性心肌梗死患者院前急救的救治时间,提高了抢救成功率.     

急性心肌梗死患者院前急救护理对预后的影响

目的：分析急性心肌梗死患者院前急救护理对预后的影响。方法将81例急性心肌梗死患者分为常规就诊组和院前急救组,常规就诊组患者直接前来急诊科就诊,未接受院前急救护理;院前急救组实施院前急救护理。对比2组干预结果。结果与常规就诊组比较,院前急救组救治成功率更高,心源性休克、心力衰竭、心律失常等并发症发生率更低,发病至急救时间、住院时间更短,差异均有统计学意义（P<0.05）。结论急性心肌梗死患者院前急救护理对预后的影响大,可快速实现急救反应,为患者抢救争取时间,减少心源性休克、心力衰竭、心律失常等严重并发症的发生,提高患者救治成功率,值得推广。     

预见性护理在院前急救中的应用

目的 探讨预见性护理在院前急救中的应用.方法 将我科2011年9 12月200例院前急救患者随机分成对照组和观察组,对照组实施院前急救护理常规,观察组实行预见性护理,比较二组患者的有效抢救时间及抢救的成功率.结果 对照组的抢救时间及抢救成功率为(21.38±3.84) min和83.0％,观察组为(14.91±3.26)min和92.0％,二组比较差异均有统计学意义(P均＜0.05).结论 对院前急救患者实行准确、恰当的预见性护理,可以缩短抢救时间,提高了抢救成功率.     

AMI患者院前急救注意事项及急救护理对预后的影响

目的 探讨急性心肌梗死(AMI)患者院前急救注意事项及急救护理方法对预后影响.方法 对我中心2015年7月—2016年7收治的120例AMI患者进行观察,采用随机分组法将60例采用院前急救护理患者分为观察组,将60例常规护理患者分为对照组.记录2组患者急诊反应时间、住院时间、并发症发生率、病死率及对护理满意度情况.结果 观察组急诊反应时间、住院时间、并发症发生率、病死率均低于对照组(P<0.05);观察组护理满意度明显优于对照组(P<0.05).结论AMI患者病情危急,安全转运、稳定患者生命体征、保持呼吸通常是院前急救重点,配合急救护理可以缩短急救反应时间,提高急救效果,降低病死率和并发症发生,改善患者的预后.     

流程管理法在急性心肌梗死患者院前急救护理中的应用效果

目的探讨流程管理法在急性心肌梗死患者院前急救护理中的应用效果。方法将2015年3月至2017年3月我院收治的90例急性心肌梗死采用随机数表法分为观察组(n=45)和对照组(n=45),对照组予以常规护理,观察组在常规护理基础上加用流程管理法,比较两组患者时间指标(出诊反应时间、院前急救时间、急诊入院时间、住院时间)和临床结局指标(转运成功率、急救成功率、并发症发生率)。结果相比于对照组,观察组出诊反应时间、院前急救时间、急诊入院时间及住院时间显著缩短,转运成功率、急救成功率显著升高,并发症发生率降低,差异有统计学意义(P0.05)。结论将流程管理法用于急性心肌梗死患者院前急救护理可缩短急救时间,降低并发症发生率,提高急救工作效率。     

预见性及针对性护理对肝硬化合并上消化道出血患者的影响

目的探究预见性及针对性护理对肝硬化合并上消化道出血患者的护理效果。方法随机选取我院在2013年1月至2015年12月收治的1000例肝硬化合并上消化道出血患者作为研究对象,将其均匀分为观察组与对照组各500例,对照组患者实施常规护理模式,观察组患者在常规护理的基础上实施预见性和针对性护理干预措施,比较两组患者的临床护理效果。结果比较两组患者实验数据发现,观察组患者护理效果明显优于对照组,抢救成功率较高,并发症发生率较低,出血次数较少,患者满意度和患者治疗依从性较高。结论对肝硬化合并上消化道出血患者实施预见性和针对性护理干预措施,有利于提高临床护理效果,提高抢救成功率,在实际应用中具有较高指导意义。     

急救护理措施在骨科多发伤患者救治中的作用

目的研究急救护理措施在骨科多发伤患者救治中的作用。方法选取我院收治的骨科患者作为研究对象,共计184名,并随机分成两组,对其实施不同的护理措施。一组实施常规护理干预,另一组实施急救护理干预。结果研究发现,实施了急救护理干预的观察组患者的抢救成功率较高,手术时间较短,与对照组相比具有统计学意义(P0.05)。结论对骨科急救患者实施有效的抢救护理干预,可以提高抢救成功率,降低并发症发生率,适合大力推广。     

护理干预措施对救治急性心肌梗死患者的临床体会

目的探讨急性心肌梗死患者在救治过程中实施护理干预措施的临床疗效。方法将2010年2月～2012年2月在我院救治的56例急性心肌梗死患者在常规护理的基础上实施护理干预措施。结果56例AMI患者在积极的救治同时实施护理干预措施,抢救成功53例,抢救成功率为94.6%;3例患者因抢救无效而死亡。结论急性心肌梗死患者在急救过程中及时有效的实施护理干预措施,可提高抢救成功率,减少并发症的发生,对挽救患者生命具有重要的临床意义。     

院前急救护理路径在急性左心衰院前急救护理中的应用

目的:探讨院前急救护理路径在急性左心衰院前急救护理中的应用效果。方法:将158例急性左心衰接到患者随机分为观察组和对照组,对照组采用常规的急救护理流程,观察组运用自行拟定的急性左心衰院前急救护理路径对病人进行急救护理。观察并比较两组患者的急救反应时间、抢救成功率、满意度。结果:观察组急救反应时间短于对照组、成功率及满意度高于对照组(均P0.05)。结论:急救护理路径指导下的急救护理措施对急性左心衰患者应用效果显著,可缩短左心衰患者的院前急救反应时间,抢救成功率提高,满意度提高。     

120院前急救系统在急性心肌梗死患者中早期干预的临床意义

目的 评价120院前急救系统在急性心肌梗死(AMI)患者中的早期干预效果。方法 前瞻性选取2020年1月-2021年12月南京市江宁医院收治AMI患者80例,依据入院方式分组,自行来医院就诊的40例患者为对照组,由120出诊接回医院的40例患者为研究组,比较两组抢救成功率、急救时间、并发症发生率、心功能状况。结果 研究组抢救成功率明显高于对照组(χ²=3.914,P<0.05)。研究组分诊、就诊至心电图检查以及病情确诊和急诊停留等时间均明显短于对照组(P<0.05)。研究组常见并发症总发生率明显低于对照组(χ²=4.114,P<0.05)。出院时研究组左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)明显低于对照组,左室射血分数(LVEF)明显高于对照组(P<0.05)。结论 120院前急救系统能提升AMI患者抢救成功率、缩短急救时间、降低并发症发生率,值得临床大量推广。     

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.