甲氨喋呤保守治疗异位妊娠的临床护理研究

目的：探讨异位妊娠保守治疗过程中的护理措施及经验。方法：对我院收治的45例异位妊娠患者采取保守治疗，并做好相应的护理工作。结果：本组患者的治愈率达到86．7％，失败的6例均经手术治疗痊愈。结论：做好异位妊娠保守治疗患者的护理工作，对治疗与恢复都有重要的意义。     

异位妊娠发病状况及保守治疗的护理

目的 分析异位妊娠的发病状况及探讨其保守治疗的护理措施.方法 分析126例异位妊娠患者的年龄、婚姻状况、生育史,采用药物保守治疗时的综合护理方法.结果 126例异位妊娠患者中,发病年龄26～32岁80例(63.49%),未生育85例(67.46%),经保守治疗治愈103例(81.75%),23例(18.25%)保守治疗失败后改为手术治疗.结论 针对患者的发病状况,加强对异位妊娠保守治疗患者的综合护理,是保守治疗成功的重要因素.     

异位妊娠保守治疗的临床护理

目的：探讨异位妊娠患者保守治疗的临床护理方法。方法对63例异位妊娠患者保守治疗的病历资料进行回顾性分析。结果本组保守治疗成功47例（74.6%）,1例为输卵管妊娠,2例自动出院,13例患者自动放弃保守治疗而改手术治疗。治愈60例,未愈3例。住院时间1 d~32 d,平均10.27 d。结论在异位妊娠保守治疗过程中护理工作极为重要,正确的心理护理及健康指导对患者早日康复十分有益。     

甲氨喋呤治疗异位妊娠的疗效观察及护理对策

目的 探讨使用甲氨喋呤保守治疗异位妊娠的临床疗效和护理对策.方法 对35例异位妊娠采取甲氨喋呤保守治疗的患者,予以病情观察、心理护理、活动指导、药物监护和出院指导等综合护理.结果 本组 35例患者,33例治愈,2例转为手术治疗,治愈率为94.28%.结论 合理的疗效观察及护理对策是异位妊娠保守治疗的重要保证.     

异位妊娠保守治疗的临床观察及护理

目的探讨异位妊娠保守治疗有效的临床护理措施.方法回顾性分析我院2010~2011年间收治的54例行保守治疗的异位妊娠患者的临床资料,所有患者均给予心理护理、基础护理、用药护理以及健康指导等综合护理措施.结果本组54例行保守治疗的异位妊娠患者中,治疗成功51例,治疗成功率为94.4%,治疗后患者的临床症状有显著改善,B超检查提示包块明显缩小,β-HCG水平显著降低,3例保守治疗失败的患者均行外科手术治疗.结论对异位妊娠患者行保守治疗临床疗效确切,对患者的损伤小,患者痛苦小,能够显著缩短平均住院时间,且操作较为简便,患者可接受性较高.对异位妊娠患者采取有效的综合护理措施,对于提高保守治疗效果,降低不良反应发生率,保证患者的安全用中药的意义.     

异位妊娠保守治疗38例护理体会

目的探讨异位妊娠保守治疗的护理措施与效果。方法分析38例异位妊娠保守治疗患者的临床资料，制订护理措施。结果38例患者保守治疗成功34例，失败后手术4例，成功率为90％．结论护理工作中，认真落实各项护理措施，密切观察病情变化和做好心理护理，及时处理用药后不良反应，严密观察异位妊娠症状缓解情况十分重要。     

异位妊娠保守治疗的临床护理

目的探讨异位妊娠保守治疗的临床护理方法,提高护理质量。方法回顾性分析78例异位妊娠患者采取保守治疗过程中的临床护理情况。结果经积极护理治疗69例患者保守治疗成功;3例因血β-H C G反弹行手术治疗;6例因自动放弃保守治疗而行手术治疗。结论在异位妊娠保守治疗过程中,临床护理尤为重要,正确的护理指导对患者的康复十分有益。     

异位妊娠286例临床分析

目的：探讨异位妊娠的发生原因及治疗效果。方法：回顾分析我院286例异位妊娠患者的临床资料。结果：286例患者均治愈，手术保守治疗及药物保守治疗的共为78例，术后45例通液通畅，术后妊娠有23例。结论：异位妊娠的发生与流产有密切的关系；异位妊娠的进展主要在保守治疗方面。药物保守治疗及手术保守治疗是必要的，也是有效的。     

35例异位妊娠保守治疗的护理

３５例异位妊娠保守治疗的护理黎玉芬（广西桂林医学院附属医院妇计科桂林市５４１００１）关键词异位妊娠；氨甲蝶呤；米非司酮；护理近年来，异位妊娠发病率逐年增多。手术是以往治疗异位妊娠的主要方法。但对于迫切要求生育的妇女来说，手术可减少将来妊娠的机会，保守...     

MTX用于异位妊娠临床治疗的观察及护理

目的:应用MTX治疗异位妊娠,探讨和总结异位妊娠保守治疗的效果和护理方法。方法:38例异位妊娠患者采用MTX保守治疗,并对患者制定科学合理的护理方案。结果:通过保守治疗及合理的护理措施,治愈35例,成功率达92%。结论:异位妊娠患者通过MTX治疗并结合科学合理的护理方法,效果良好,提高了治愈成功率。     

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.