新生儿脐部感染的原因分析及护理对策

目的 探讨新生儿脐部感染的原因及护理对策.方法 对我院产科分娩的足月新生儿共2 848例中的45例（1.58%）新生儿脐部出现不同程度感染的情况进行分析.结果 脐部感染与脐粗大、脐带结扎位置过高、剪脐不净、脐断端处理及护理不当有关.加之新生儿抵抗力低,缺乏抗细菌定植能力,个别护理人员对脐部处理重视不够,使细菌经脐部残端侵入繁殖而引起脐炎.结论 正确掌握断脐的方法 和技巧,严格执行无菌操作原则,加强脐部的观察、护理和宣教,保持局部清洁干燥,并针对脐端不同临床表现采用不同的护理方法,是预防、避免新生儿脐部感染的有效措施.     

新生儿脐部暴露的不同时机对新生儿的影响比较

目的：研究分析新生儿脐部暴露的不同时机对于新生儿的影响情况。方法选择该院2012年12月—2013年12月期间出生的320例新生儿作为研究对象，将所有新生儿按照随机数字法分为A、B、C、D 4组，每组各80例。A组新生儿在断脐即刻暴露脐部残端，B组新生儿在断脐12 h后暴露脐部残端，C组新生儿在断脐24 h后暴露脐部残端，D组新生儿在断脐48 h后暴露脐部残端。观察对比4组新生儿在10 d内脐部出血和感染发生率情况，并且观察比较脐带残端脱落时间和脐部愈合时间。结果 A组新生儿的脐部出血发生率和脐部感染率均明显低于B组、C组和D组，差异有统计学意义（P<0.05）。 A组新生儿的脐带残端脱落时间和脐部愈合时间均明显低于B组、C组和D组，差异有统计学意义（P<0.05）。结论新生儿脐部暴露的最佳时间为断脐即刻，能够有效缩短脐部愈合时间和脐部残端脱落时间，降低出血率和感染发生率。     

两种新生儿护脐贴的应用效果比较

新生儿脐部护理是产科护理的重点之一。新生儿发生脐炎的主要原因是断脐时或出生后处理不当，脐部残端被细菌入侵、繁殖而引起炎症。脐部残端若护理不当，轻者可致局部渗血、感染，重者将引起败血症，危及新生儿生命。有资料表明，在1200例新生儿败血症中，脐部感染者占66．0％～87．5％，且多为厌氧菌感染。因此，新生儿脐带脱落时间越早越好，既可避免脐部并发症的发生，又有利于家庭护理。为观察新生儿脐部护理的效果，我们选择了2种不同的护脐用品进行比较，现报道如下。     

新生儿脐带两种护理方法的比较

新生儿脐带的护理很重要，如护理不当造成感染可引起脐炎及败血症。我们对新生儿脐带的护理采取了早期干预措施，取得了良好的效果，报告如下。1方法本组共500例，分观察组和对照组。观察组250例采取早期干预措施即在胎儿娩出后用线绳结扎脐带，断端用2％碘酒消毒加压包扎，12～24h。沐浴后将残喘消毒剪去，再次消毒，用脐绷带包扎24h。对照组250例采用传统方法，即用气门芯结扎脐带，断端用15％锰酸钾消毒，脐绷带加压包扎什，每天淋浴时保护好脐部不要进水，防腐干燥，促进其干性坏死早日脱落愈合[1]。2结果2．1新生儿脐部的分泌物比较见…     

两种不同脐部护理方法对预防新生儿感染的效果观察

目的比较不同脐部护理干预对预防新生儿脐部感染的效果。方法我院新生儿科自2018年3月开始落实新式脐带护理方法,选择该方法实施前(2017年3月—2018年2月)在本院分娩的160例新生儿作为对照组,另选择该脐带护理方法实施后(2018年3月—2019年2月)在本院分娩的160例新生儿作为观察组。对照组新生儿采用常规酒精脐部护理方法,观察采用新式脐部护理(1.0%活力碘)方法,对比两组脐带残端脱落时间和感染性疾病发生率。结果观察组新生儿脐带残端脱落时间为(8.69±2.68)d,对照组为(13.03±4.69)d,组间比较差异具有统计学意义(P<0.05)。观察组新生儿轻度脐炎、中度脐炎、重度脐炎发生率均低于对照组,但无显著差异(P>0.05)。观察组新生儿脐炎发生率(1.25%)显著低于对照组(10.63%),差异具有统计学意义(P<0.05)。两组新生儿仅出现了脐部感染发生,未见其他感染及全身性感染。结论新式脐部护理(1.0%活力碘)方法可有效提升新生儿脐部护理效果,促进断端尽快脱落,降低脐部感染风险,临床应用安全可靠。     

新生儿脐炎脐部敷药的探讨

新生儿脐炎脐部敷药的探讨附属医院护理部张维智附属医院儿科孙亚华新生儿脐炎是由于断脐时消毒不严或出生后脐残端被细菌污染所致。脐部病菌可通过脐动、静脉进入血液生长繁殖或产生毒素引起全身感染。对如何改进新生儿脐炎的护理，我院新生儿室护理人员自１９９２年４月...     

浅谈新生儿脐部感染的原因和护理对策

探讨新生儿发生脐部感染的原因，并针对病因提出护理对策。方法：对2011年1月～2012年9月期间在我院出生的2400名足月新生婴儿的临床资料进行了回顾性研究。我们对这2400例足月新生婴儿的脐部自身条件和处理情况进行统计分析，并通过统计分析，找出导致新生儿脐部感染的主要原因。根据这些导致新生儿脐部感染的主要原因，我们提出有针对性的护理对策。结果：经研究发现导致新生儿发生脐部感染的主要原因有：①对新生儿的脐部残端消毒不严和对断脐工具消毒不严；②对新生儿的脐部剪切不净；③新生儿的脐部粗大；④对新生儿脐部结扎的位置过高或其脐部下方存在血肿；⑤对新生儿的日常护理不当。结论：经过研究发现导致新生儿脐部感染的主要原因是对新生儿的脐端结扎不规范、对其脐部消毒不严和日常护理不当。针对这些原因，医护人员应严格按照规范的结扎方式为新生儿进行脐端结扎，加强对新生儿脐部的护理和对新生儿家属的宣教，从而防止新生儿出现脐部感染。     

新生儿不同断脐长度对减少脐部感染的影响及护理干预分析

目的探讨对新生儿脐部的护理干预措施以及不同断脐长度对于减少新生儿脐部感染的影响效果。方法选取2016年1月-2016年12月在本院出生的足月新生儿90例作为本次研究的对象,随机分为观察组与对照组,每组各45例,其中观察组新生儿在出生时从距离脐根部的3cm处进行断脐,对照组新生儿出生后从距离脐根部1cm处进行断脐。应用相同的护理干预措施对两组新生儿进行护理,对比分析两组新生儿的脐部渗血、潮红、脐带不完整脱落的发生情况以及新生儿家长对护理工作的满意度。结果观察组新生儿的脐部渗血、潮红以及脐带不完整脱落的发生率均低于对照组,两组比较具有显著的统计学意义(P0.05);观察组家长对护理工作的满意度为93.33%(42/45),对照组家长对护理工作的满意度为84.44%(38/45),两组比较具有显著的统计学意义(P0.05)。结论适宜的断脐长度可以降低新生儿脐部的不良事件发生率和脐部感染的发生率,从而保证新生儿的安全。     

新生儿二次断脐护理效果对比分析与对策

笔者对所在医院270例新生儿脐部护理进行分析总结,发现脐部轻微炎症与脐粗大、结扎位置过高、剪脐不净有关.提出正确把握三关,即出生时正确断脐;掌握剪脐的时间与技巧;加强脐带日常护理和宣教,保持局部清洁干燥,并对脐端不同临床表现采用不同护理方法.是避免脐部感染预防新生儿感染的有效措施.围产儿脐部是病原微生物入侵的特殊部门,极易发生局部感染,有资料表明在1200例新生儿败血症中,存在脐部感染者占66%～87.5%,且是脐部是厌氧菌的好发部位.笔者采取两次断脐的方法,缩短了脐部脱落的时间,使脐部残端在干枯脱落的过程中,减少炎性分泌物的渗出和脐周皮肤红肿,减少渗血,从而避免了脐部感染和并发症的发生.     

360例新生儿脐部护理的观察与分析

目的:探寻护理新生儿脐部的最佳方法。方法:将360例健康足月新生儿随机分成两组,其中一组为观察组(200例),观察组新生儿采用的脐部护理法是微波断脐联合护脐包扎法,另外一组为对照组(160例),对照组新生儿采用的脐部护理法是传统的断脐护理法。结果:与对照组相比,观察组新生儿的脐部并发症发生率更低、创面愈合时间更少,且两者间的差异具有显著性(P<0.01)。结论:微微波断脐联合护脐包扎法可有效地预防新生儿发生脐部感染。     

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.