母婴床护理在初产妇分娩后的应用

目的探讨母婴床护理在初产妇分娩后的应用。方法选取清丰县人民医院产科2015年1—6月收治的120例分娩后初产妇为研究对象,按随机数表法分为观察组(60例)和对照组(60例)。对照组接受传统母婴护理方式,观察组接受母婴床护理,两组均护理至出院。比较两组初产妇分娩后的角色适应性、新生儿护理技能以及不良情绪。结果观察组产妇角色适应性优于对照组(P<0.05)。观察组母乳喂养、新生儿沐浴、新生儿抚摸、脐部护理、臀部护理等各项新生儿护理技能评分均高于对照组(P<0.05)。护理后,两组SAS及SDS评分均下降,观察组低于对照组(P<0.05)。结论对初产妇分娩后开展母婴床护理可有效提高其角色适应性及新生儿护理技能,并改善心理状态。     

护理干预对初产妇分娩方式及母乳喂养的影响

目的：：探讨护理干预对初产妇分娩方式及母乳喂养的影响。方法：选择符合标准的初产妇100例,随机分为观察组和对照组各50例,对照组实施常规护理,观察组给予个性化护理干预,比较二者护理效果。结果：观察组产妇经产道分娩率86.00％,高于对照组的58.00％,差异有统计学意义(P<0.05)。观察组产妇产后24h 出血量(259.03±33.47) mL,对照组产妇产后24h 出血量(378.14±39.05) mL,差异有统计学意义(P<0.05)。观察组产妇产后泌乳始动时间早于对照组,泌乳量多于对照组,产后均随访3个月观察组纯母乳喂养优于对照组,差异有统计学意义(P <0.05)。结论：护理干预有助于降低初产妇剖宫产率、减少产妇产后出血量、改善泌乳功能、提高纯母乳喂养率,有助于母婴健康。     

助产士引导全程心理干预在初产妇自然分娩中的应用

目的观察助产士引导全程心理干预在初产妇自然分娩中的应用。方法选取2016年1月至2017年7月漯河市召陵区人民医院收治的184例初产妇为研究对象,采用随机数表法将患者分为A、B两组,每组92例。A组产妇接受常规护理,B组接受助产士引导全程心理干预。采用视觉模拟疼痛评分法(VAS)评价患者产后疼痛感;采用焦虑自评量表(SAS)和抑郁自评量表(SDS)评价产妇围产期干预前后精神状态。对两组产妇分娩方式、产程时间和产后2 h出血量进行比较,并采用Apgar评分评价新生儿健康状况。结果 B组产妇SAS评分和SDS评分均低于A组,差异有统计学意义(均P<0.05);A组产后VAS评分[(6.32±0.54)分]高于B组[(4.17±0.48)分],差异有统计学意义(P<0.05);与A组比较,B组产妇阴道顺产成功比例较高,产程时间较短,产后出血量较少,差异有统计学意义(均P<0.05);A组新生儿Apgar评分[(6.95±0.56)分]低于B组[(8.47±0.71)分],差异有统计学意义(P<0.05)。结论助产士引导全程心理干预对促进初产妇自然分娩具有积极意义,可有效改善产妇负性不良情绪,缩短产程,具有临床推广价值。     

集束化护理干预对初产妇分娩方式及质量的影响

目的:探讨集束化护理干预对初产妇分娩过程及质量的影响。方法:选择52例足月初产妇作为观察对象,按照分娩时间顺序将产妇分为集束化护理干预组(观察组)27例和常规护理组(对照组)25例,观察两组产妇经产道分娩率、剖宫产率、新生儿窒息及并发症情况。结果:观察组27例孕妇经产道分娩23例,经产道分娩率85.2%,对照组25例孕妇经产道分娩14例,经产道分娩率56%,差异有统计学意义(P<0.05)。两组经产道分娩产妇出血量观察组(163.58±56.18)ml低于对照组(218.28±58.49)ml,差异有统计学意义(P<0.05)。两组产妇均无严重并发症发生,两组新生儿阿氏评分无统计学意义。结论:集束化护理干预可提高初产妇的经产道分娩率,提高产妇分娩质量。     

家庭式分娩模式的临床应用

目的 探讨待产、分娩和恢复三位一体的家庭式分娩模式的临床应用效果.方法 选择采用家庭式分娩模式的初产妇130例为研究组,同期在普通产房阴道试产的初产妇150例为对照组,比较两组产妇的分娩情况和母乳喂养成功卒.结果 研究组产妇的第一、二产程和总产程较对照组缩短,产时出血量较对照组减少(P<0.05);自然分娩率高于对照组,阴道助产、产时剖宫产率低于对照组(P<0.05);新生儿窒息率低于对照组(P<0.05);研究组产妇产后母乳喂养率高于对照组(P<0.05),泌乳始动时间、24h哺乳次数明显优于对照组(P<0.01).结论 家庭式分娩模式对缩短产程,减少难产、产时出血,促进母乳喂养和提高产科质量均有积极作用.     

Bn连续性助产护理对初产妇产程及分娩结局的影响

目的:探讨连续性助产护理对初产妇产程及分娩结局的影响。方法:选取2015年12月至2017年12月在我院分娩的初产妇110例,随机分为A组与B组,每组各55例。A组产妇实施连续性助产护理干预,B组产妇实施常规护理干预,比较两组产妇的产程及分娩结局。结果:A组产妇第一产程时间及总产程时间显著短于B组,差异有统计学意义(P0.05);第二产程及第三产程相比差异无统计学意义(P0.05)。A组产妇及新生儿并发症发生率显著低于B组,差异有统计学意义(P0.05)。结论:连续性助产护理有效的缩短了产妇分娩的第一产程及总产程,并降低了产妇及新生儿并发症发生率,改善了妊娠结局。     

导乐分娩联合家庭式温馨护理环境对产妇及新生儿的影响

目的 探究导乐分娩联合家庭式温馨护理环境对产妇心理状态、新生儿评分及分娩结局的影响。方法 选取2017年10月至2019年10月于延安市宝塔区人民医院进行分娩的产妇156例为研究对象,按照随机数字表法分为护理组和对照组,各78例。护理组行导乐分娩联合家庭式温馨护理环境干预,对照组行常规护理干预。比较两组不同干预方式对产妇心理状态、新生儿评分及分娩结局的影响。结果 重复测量方差分析显示,两组产妇不同时间点SAS、VAS评分均有不同程度的降低(P＜0.05),且护理组在宫口扩张期、胎儿娩出期及产后6 h的SAS、VAS评分均低于对照组,差异具有统计学意义(P＜0.05)。但两组新生儿出生后1、5、10 min的Apgar评分比较差异均无统计学意义(P＞0.05)。同时护理组产妇阴道自然分娩者显著高于对照组(χ²=10.556,P＜0.05),而会阴侧切、剖宫产分娩低于对照组,差异具有统计学意义(χ²=4.924、4.019,P＜0.05)。结论 导乐分娩联合家庭式温馨护理环境干预可有效减少产妇分娩中紧张、焦虑等不良情绪,降低分娩时疼痛感及剖宫产率,为产妇顺利分娩提供良好环境。     

协同式待产心理护理模式对足月单胎初产妇的影响

目的观察协同式待产心理护理模式对足月单胎初产妇的影响。方法将2017年6月至2018年6月在清丰县人民医院分娩的114例初产妇按随机数表发分为A组(57例)和B组(57例),A组接受常规护理,B组接受协同式待产心理护理干预。采用焦虑自估量表(SAS)和抑郁自估量表(SDS)评估产妇护理干预前后心理状态,对两组产妇自然分娩率及产后大出血发生率进行比较,采用医院自拟护理满意度调查问卷统计两组产妇护理满意度。结果护理干预后B组产妇SAS和SDS评分均低于A组,差异有统计学意义(均P<0.05)。A组和B组产妇自然分娩率分别为70.17%(40/57)、89.47%(51/57),B组产妇自然分娩率高于A组(P<0.05)。A组和B组产妇产后出血发生率分别为17.54%(10/57)、5.26%(3/57),B组产妇产后出血发生率低于A组(P<0.05)。A组产妇护理满意度评分低于B组,差异有统计学意义(P<0.05)。结论协同式待产心理护理模式可有效缓解初产妇产前焦虑状态,提高自然分娩率。     

助产护理对提高高龄初产妇分娩质量的效果以及应用价值分析

目的研讨在高龄初产妇中开展助产护理对分娩质量的提升作用。方法选择我院收治于2016年1月至2018年1月的77例高龄初产妇作为课题研究对象,并利用计算机进行随机数表分组,A组(n=37)予以常规基础护理,B组(n=40)在A组条件下予以助产护理干预,对两组初产妇的分娩质量进行评估与比较。结果第一、二产程以及总产程对比显示,B组较A组均显著缩短,P0.05有统计学意义。B组的自然分娩率为77.5%,对比A组(62.2%)显著提升,P0.05有统计学意义;B组产后出血率为2.5%、新生儿窒息率为2.5%,对比A组的13.5%与16.2%均显著下降,P0.05有统计学意义。结论在高龄初产妇中开展助产护理干预,能够促进产程进展,显著改善分娩质量,值得推荐。     

产前护理干预对高危妊娠初产妇分娩结局的影响

目的分析产前护理干预应用于高危妊娠初产妇对其分娩结局的影响效果。方法研究对象为2018年1月至2019年1月在本院生产的1500例高危妊娠初产妇,随机均分为2组。对照组(n=750)予常规护理,观察组(n=750)予产前护理干预。观察比较产妇生存质量与焦虑程度,对比分析分娩结局。结果实施产前护理干预后,观察组产妇生存质量、SAS评分与对照组差异有统计学意义(P0.05);观察组顺产率(78.13%)显著高于对照组(52.27%),新生儿窒息率(2.67%)低于对照组(17.20%),组间差异均有统计学意义(P0.05)。结论高危妊娠初产妇实施产前护理干预能够有效提高其生存质量,缓解焦虑情绪,显著提高顺产率,减少新生儿窒息的发生,对改善分娩结局有重要作用。     

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.