心理干预对子宫全切术患者的应激激素的作用

目的探讨心理干预对45岁以下经腹子宫全切术患者的应激激素的作用。方法半随机选取符合入组标准的40例≤45岁经腹子宫全切术患者，对干预组20例进行术前心理干预。在两组入院第2天（T1）、手术前即干预后（T2）、术后第2天（T3）分别测定血清皮质醇和白介素-6浓度。结果心理干预组血清皮质醇T2、T3明显降低，较对照组T2血清皮质醇达显著性差异，P=0．05。白介素-6组内组间比较差异均未达到统计学意义。结论应重视并了解子宫全切术患者存在的心理问题，积极进行心理干预，能降低围术期心理应激水平。     

强化心理干预在腹式子宫全切术患者中的应用

目的 探讨子宫肌瘤患者在腹式子宫全切术前后实施心理干预的最佳方案.方法 以住院患者为研究对象,采用分组对照设计及自身前后对照设计的实验方法对子宫肌瘤患者在腹式子宫全切术前后实施不同的心理干预,比较其护理效果.结果 干预前两组患者在焦虑程度方面无统计学差异(P>0.05),干预后实验组焦虑程度明显低于对照组.干预前两组患者在生活质量方面无统计学差异(P>0.05),干预后实验组与对照组之间各项指标均有显著性差异(P<0.05).结论 强化心理干预不仅能减轻患者的焦虑程度,提高生活质量,帮助患者尽快恢复今后的正常生活.     

护理干预改善腹式子宫切除术患者不良情绪及生活质量的研究

目的：观察子宫全切术患者的心理状态以及护理干预对其心理状态、生活质量的影响。方法：选择我院2006年1月至2008年12月行全子宫切除的病人180例,随机分为干预组和对照组各90例,对照组按照护理程序常规进行术前健康教育,干预组在此基础上实施护理干预,两组患者皆于入院时、术前1d、术后3个月填写SAS、SDS测量表,于入院时、术后7d、术后3个月填写WHO-QOL-100测量表,观察两组在手术前、后的情绪及生活质量变化。结果：干预组在术前1d、术后3个月的焦虑、抑郁状况明显轻于对照组,差异有显著性（P〈0.01）。焦虑以两组在术前的差异最大,提示护理干预改善焦虑于术前效果最明显,抑郁状况以两组在术后3个月的差异最大,护理干预改善抑郁于术后效果最明显。干预组和对照组手术前、后生活质量评分比较,术前、术后7d各项评分接近（P〈0.05）,没有显著性差异,术后3个月干预组与对照组之间各项指标均有显著性差异（P〈0.05）。结论：有效地护理干预可以明显的缓解子宫全切患者的焦虑、抑郁状态,提高生活质量,尤以手术后期愈显著。     

心理护理对子宫全切术患者生活质量的影响

目的：探讨心理护理对子宫全切术患者生活质量的影响。方法：将220例子宫全切术患者随机分为实验组和对照组，对实验组进行常规护理的同时进行心理干预，对照组采用常规护理,观察两组患者焦虑、忧郁及病情恢复的程度。结果：实验组患者的焦虑、抑郁与对照组比较具有显著性差异（均P〈0.05）。结论：心理护理能有效地减轻子宫全切术患者的心理压力，减少患者术后抑郁的发生，提高其生活质量。     

术前焦虑对腹式子宫次全切手术患者术后疼痛的影响及护理对策

目的：探讨与分析术前焦虑对行腹式子宫次全切手术患者术后疼痛造成的影响及护理对策。方法：将我院于2011年2月至2014年2月收治的80例行腹式子宫次全切手术并伴有术前焦虑的患者,随机分为对照组和观察组,每组40例,对照组给予常规护理,观察组在常规护理的基础上给予术前强化护理干预。观察并比较术前不同程度的焦虑状态对术后疼痛的影响,以及不同的护理强度及方式对术前焦虑的改善作用。结果：研究表明,高焦虑患者在术后6、24h的VAS评分显著高于低焦虑患者（ P＜0．01）,而在术后48h,两组患者评分比较不存在显著性差异（ P＞0．05）;护理后,观察组与对照组患者的焦虑得分均有所下降,其中,观察组得分下降更加显著（ P＜0．01）。结论：对行腹式子宫次全切手术并伴有术前焦虑的患者进行术前强化护理干预,即心理干预、活动干预以及饮食干预,并配合家属的鼓励与支持,能够有效缓解患者焦虑,减轻术后疼痛,对术后康复有极大的帮助,值得临床推广并应用。     

社会心理因素对子宫全切术患者抑郁和焦虑的影响及护理干预

目的：探讨社会心理因素对行子宫全切除术患者的影响及护理干预方法。方法选取子宫全切术治疗患者100例,随机分为2组,对照组给予常规护理,观察组在常规护理基础上增强心理干预和社会支持。对比2组干预后焦虑抑郁状况及对护理工作满意度。结果术后患者焦虑抑郁状况比术前明显下降,干预后2组之间评分出现明显差异（P<0.05）,观察组焦虑与抑郁自评分明显低于对照组。观察组满意度评分（98.0±3.45）分,明显高于对照组的（89.40±5.69）分（P<0.05）。结论社会心理因素对子宫全切术患者抑郁和焦虑具有较大影响,实施心理干预和社会支持能够有效减轻患者的不良情绪,促进家人间的沟通以及增强护患关系,提高护理满意度。     

心理干预在子宫全切围手术期护理中的应用

目的研究子宫全切患者围手术期的心理干预效果。方法选择2010年6月至2011年12月期间在我科住院行子宫全切术的患者100例,随机分为观察组和对照组各50例,对照组术后给予妇科常规护理,观察组在此基础上还给予有针对性、系统性的心理护理干预。并对两组患者术后焦虑和抑郁的心理状态进行对比分析。结果与对照组比较,干预组患者的焦虑症状和抑郁情绪明显减轻,两组比较差异均有统计学意义(P<0.01)。结论在子宫全切围手术期中给予心理护理干预,有利于减轻甚至解除患者焦虑、抑郁的情绪,促进术后康复,提高患者术后生活质量。     

术前心理干预对经腹全子宫切除术患者焦虑的影响

目的探讨心理干预对经腹全子宫切除术患者焦虑心理的影响。方法将89例经腹全子宫切除术患者随机分为干预组45例,对照组44例。干预组接受有针对性、系统化的心理干预,对照组接受常规的心理护理,以焦虑、抑郁指数为指标分析其临床疗效。结果干预组的SAS、SDS评分均显著低于对照组。结论对经腹全子宫切除术患者采用系统连续性的心理干预,可有效减轻患者的焦虑与抑郁情绪。促进其心理状况向积极方向转变,提高手术耐受力。     

临床心理干预对子宫肌瘤手术患者心理状态的影响分析

目的:对临床心理干预对子宫肌瘤手术患者心理状态的影响进行分析和探讨。方法:选择子宫肌瘤患者60例,分为观察组与对照组,每组30例。在行子宫肌瘤手术治疗后均给予两组患者子宫肌瘤常规护理,观察组在此基础上给予包括入院时的心理护理、术前心理护理以及术后心理护理在内的心理干预,采用焦虑自评量表(SAS)和抑郁自评量表(SDS)对两组患者的心理状态进行评定,并观察患者对术中疼痛强度的反应。结果:在实施护理干预前,两组患者的焦虑、抑郁状态比较差异无统计学意义(P>0.05),实施干预后,两组患者的焦虑、抑郁状态均有了一定的改善,其中观察组患者的改善程度明显高于对照组,两组相比,差异有统计学意义(P<0.05)。结论:在子宫肌瘤手术患者的护理工作中增加心理护理干预,这对于提高护理效果,促进患者的早日康复具有重要意义。     

心理干预对子宫全切术患者焦虑状态及生理应激反应的影响

目的探讨心理干预对子宫全切术患者焦虑状态及生理应激反应的影响。方法选择2013年7月至2016年9月济源市人民医院子宫全切术患者84例,根据入院顺序分组,各42例。对照组行常规护理,观察组在此基础上加强心理干预。对比两组干预前后负性情绪(焦虑抑郁)评分及手术前后生理应激反应指标[促肾上腺皮质激素(ACTH)、皮质醇(Cor)]水平。结果干预前,两组负性情绪评分比较,差异无统计学意义(P>0.05),干预后观察组焦虑抑郁评分均低于对照组(P<0.05);术前,两组ACTH、Cor水平比较,差异无统计学意义(P>0.05),术后两组ACTH、Cor水平均有所上升,但观察组变化幅度小于对照组,差异有统计学意义(P<0.05)。结论加强子宫全切术患者心理护理干预,可有效缓解其焦虑等负性情绪,减轻术后生理应激反应。     

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.