中医情志护理在黄褐斑患者中的应用效果

目的:观察中医情志护理在黄褐斑患者中的应用效果。方法:选取100例黄褐斑患者为研究对象,按照随机数字表法分为对照组与观察组各50例。对照组给予常规护理,观察组在对照组基础上给予中医情志护理,比较两组治疗时间、汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分和护理满意度。结果:观察组治疗时间为(1.12±0.33)个月,明显短于对照组的(2.70±0.39)个月,差异有统计学意义(P<0.05);护理后,两组HAMA、HAMD评分均低于护理前,且观察组明显低于对照组,差异有统计学意义(P<0.05);观察组护理满意度为96.00%,明显高于对照组的84.00%,差异有统计学意义(P<0.05)。结论:在常规护理基础上采用中医情志护理可缩短黄褐斑患者治疗时间,降低HAMA评分和HAMD评分,以及提高护理满意度,其效果优于单纯采用常规护理。     

综合性护理干预措施对创伤失血性休克患者救治的效果及护理质量分析

目的分析综合性护理干预措施对创伤失血性休克患者救治的效果及护理质量分析。方法选择2014年12月~2016年12月期间来我院接受治疗的创伤失血性休克患者112例进行研究,并按随机数字表法分为观察组(56例)和对照组(56例)。观察组采用综合护理干预措施,对照组采用常规护理的方案。记录患者的对护理的满意度、汉密顿焦虑量表(HAMA)、临床疗效、汉密顿抑郁量表(HAMD)及抑郁亚综合征(SDS)评分情况。结果观察组患者的救治总有效率91.07%明显高于对照组患者救治的总有效率76.79%,差异有统计学意义(P0.05)。观察组患者的HAMA评分(6.53±1.37)分、SDS评分(54.82±8.03)分、HAMD评分(6.46±1.46)分,明显优于对照组患者的HAMA评分(9.21±2.29分)、SDS评分(61.27±7.96)分、HAMD评分(9.16±2.33)分,差异有统计学意义(P0.05)。观察组患者对护理的满意度92.86%明显高于对照组患者对护理的满意度78.57%,差异具有统计学意义(P0.05)。结论采用综合护理干预对创伤性失血患者进行护理,提高患者的临床治疗效果,增加患者对护理的满意度,建立和谐的医患关系。     

早期康复护理在老年脑梗死患者中的应用效果观察

目的:观察早期康复护理在老年脑梗死患者中的应用效果。方法:选取116例老年脑梗死患者作为研究对象,按随机数字表法将其分为对照组和观察组各58例,对照组患者实施常规护理,观察组患者在对照组基础上实施早期康复护理,比较两组护理效果。结果:观察组护理满意度为96.55%(56/58),明显高于对照组的81.04%(47/58),差异有统计学意义(P<0.05)。护理前,两组肢体运动功能障碍评分比较,差异无统计学意义(P>0.05);护理后,观察组肢体运动功能障碍评分显著高于对照组,差异有统计学意义(P<0.05)。护理前两组生命质量量表(SF-36)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评分比较,差异无统计学意义(P>0.05);护理后两组SF-36评分明显高于护理前,HAMA、HAMD评分明显低于护理前,且观察组SF-36评分高于对照组、HAMA、HAMD评分均明显低于对照组,差异均有统计学意义(P<0.05)。观察组并发症发生率为8.62%,显著低于对照组的25.86%,差异有统计学意义(P<0.05)。结论:在常规护理的基础上实施早期康复护理,有利于老年脑梗死患者偏瘫肢体运动功能的恢复,能明显提高其生命质量,改善不良情绪,减轻并发症发生风险,且能提高护理满意度。     

基于网络互动平台的延伸护理在溃疡性结肠炎活动期患者中的效果观察

目的:观察基于网络互动平台的延伸护理在溃疡性结肠炎(UC)活动期患者中的应用效果。方法:选取90例UC活动期患者,根据入院顺序将其分为观察组与对照组各45例,对照组给予常规护理,观察组在实施常规护理基础上,给予基于网络互动平台的延伸护理,比较两组护理前后汉密尔顿焦虑、抑郁量表(HAMA、HAMD)评分、治疗依从性及护理后3个月复发率。结果:护理前两组HAMA、HAMD评分比较差异无统计学意义(P>0.05),护理后观察组HAMA评分为(10.11±3.29)分,低于对照组的(13.12±3.36)分,HAMD评分为(14.25±3.17)分,低于对照组的(19.82±2.87)分,差异均有统计学意义(P<0.05);观察组治疗依从率为100%,高于对照组的84.44%,差异有统计学意义(P<0.05);观察组复发率为4.44%,显著低于对照组的17.78%,差异有统计学意义(P<0.05)。结论:基于网络互动平台的延伸护理可提高UC活动期患者治疗依从率,改善患者心理状态,减少疾病的复发,应用价值较高。     

“5A”护理联合运动疗法在妇科肿瘤化疗患者中的应用效果分析

目的：探讨“5A”护理联合运动疗法在妇科肿瘤化疗患者中的应用效果。方法：选取2020年1月-2022年1月南京医科大学附属南京医院收治的100例妇科肿瘤化疗患者作为研究对象,以双盲随机法分为试验组和对照组,各50例。对照组实施常规护理,试验组在对照组基础上实施5A护理联合运动疗法。比较两组护理前后汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)评分、护理满意度、并发症发生率。结果：护理前,两组HAMA和HAMD评分比较,差异无统计学意义(P>0.05);护理后,试验组HAMA和HAMD评分均低于对照组,差异有统计学意义(P<0.05)。试验组护理满意度高于对照组,差异有统计学意义(P<0.05)。试验组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论：对妇科肿瘤化疗患者实施“5A”护理联合运动疗法的效果确切,可改善患者心理状态,提高满意度,降低并发症发生率,值得推广。     

综合干预在乳腺癌护理中的应用价值探讨

目的：探讨综合干预在乳腺癌护理中的应用价值。方法随机选取该院肿瘤科在2013年9月-2014年9月期间治疗的100例乳腺癌患者,随机进行分组;对照组接受常规护理,而观察组在常规护理的基础上,采取综合护理;对比两组患者护理前后的HAMA、HAMD及ADL评分,并发症发生率、护理依从率、护理满意度。结果两组患者护理前HAMA、HAMD及ADL评分差异无统计学意义(P>0.05),观察组患者护理后HAMA及HAMD评分显著下降,与治疗前及对照组护理后相比差异有统计学意义(P<0.05),观察组患者护理后ADL评分显著上升,与治疗前及对照组护理后相比差异有统计学意义(P<0.05);观察组患者并发症发生率24.00%、护理依从率90.00%、护理满意度94.00%;对照组患者并发症发生率52.00%、护理依从率72.00%、护理满意度76.00%;两组数据差异有统计学意义(P<0.05)。结论综合干预可改善乳腺癌患者的心理状态及预后,显著提高乳腺癌患者的护理效果,具有较高的应用价值,值得广泛推广。     

心理护理干预在急性髓系白血病化疗患者中的应用效果观察

目的 探讨心理护理干预在急性髓系白血病化疗患者中的应用效果。方法 选择我院2016年2月～2019年4月收治的急性髓系白血病化疗患者100例作为研究对象,按照随机数字法分为两组,每组50例。对照组采用传统基础护理方式,实验组采取传统基础护理方式+心理护理干预方式,比较两组的配合治疗率、遵循医嘱率、不依从率、化疗总缓解率。结果 实验组急性髓系白血病化疗患者配合治疗率、遵循医嘱率高于对照组,不依从率低于对照组,差异有统计学意义(P0.05);实验组化疗总缓解率(96.00%)高于对照组(66.00%),差异有统计学意义(P0.05);两组患者护理前的HAMA和HAMD评分比较,差异无统计学意义(P0.05),两组患者护理后HAMA和HAMD评分和护理前相比均显著降低,其中护理后对照组HAMA和HAMD评分均明显高于实验组,差异有统计学意义(P0.05)。与护理前相比较,实验组和对照组患者血清中的IL-1β、IL-6、IL-8、TNF-α、Hs-CRP等炎性因子水平均降低(P0.05),且实验组炎性因子水平较对照组降低更明显(P0.05)。另外,与护理前相比,两组患者血清中Hs-CRP水平亦降低,且实验组降低较明显(P0.05)。结论 心理护理干预不仅能够明显提高急性髓系白血病化疗患者的治疗率、遵循医嘱率和依从率,还能改善患者的负面情绪,值得在临床推广应用。     

股骨骨折后应用人性化护理干预的效果观察

目的：探讨人性化护理干预模式在股骨骨折患者中的应用效果。方法：将120例股骨骨折患者根据随机数字表将其分为观察组及对照组，每组各60例患者，其中对照组实施常规性护理，观察组在对照组的基础上应用人性化护理，对比分析2组患者骨折愈合情况、并发症发生率、疼痛情况、护理满意度评分、住院时间、心理状况等方面的差异。结果：观察组患者骨折愈合率为93.33％，对照组骨折愈合率为80.00％，2组患者愈合率具有统计学意义（P〈0.05）。观察组术后并发症发生率为8.33％，对照组并发症发生率为20.00％，2组患者并发症发生率具有统计学意义（P〈0.05）。观察组VAS疼痛评分、住院时间、满意度评分优于对照组，差异有统计学意义（P〈0.05）。观察组干预后HAMA评分为（9.31±4.82），HAMD评分为10.91±2.82，对照组干预后HAMA评分为13.26±7.84，HAMD评分为16.31±3.81，差异有统计学意义（P〈0.05）。结论：对股骨骨折患者术后应用人性化护理干预能有效促进患者骨折愈合，降低患者并发症发生率，改善患者心理状况，提高患者满意度，避免医患纠纷的发生。     

喉癌手术患者围术期综合护理效果分析

目的探讨喉癌手术患者围术期综合护理的效果。方法收集自2015年12月~2016年12月我院住院治疗的喉癌患者60例,均为鳞状细胞癌。所有患者均行手术治疗,根据护理方法不同随机分为两组,每组各30例,其中对照组采取常规对症护理,观察组实施综合性护理干预,采用汉密尔顿焦虑量表(HAMA)及汉密尔顿抑郁量表(HAMD)对患者的负性心理进行评价,并观察和比较两组患者的护理满意度、知识掌握率。结果两组患者干预前HAMA评分、HAMD评分组间比较差异无统计学意义,干预后,观察组的HAMA评分、HAMD评分显著低于对照组,差异有统计学意义(P0.05)。观察组患者的护理满意度、知识掌握率显著高于对照组,差异有统计学意义(P0.05)。结论喉癌手术患者围术期综合护理能显著缓解患者的负性心理,提高护理满意度。     

舒适度量表在急性白血病化疗患者护理中的应用效果

目的探讨舒适度量表在急性白血病化疗患者中的应用效果。方法选择2016年9月～2017年12月在我院收治的急性白血病化疗患者80例,采用随机数字表法将患者分为观察组和对照组,每组40例,对照组实施常规护理措施,观察组在常规护理基础上给予舒适护理。采用GCQ、视觉模拟评分法(VAS)评分对两组患者术后舒适度和疼痛程度进行评价,比较两组患者对护理的满意度和术后并发症情况。结果护理干预前,两组舒适度和VAS评分比较,差异无统计学意义(P0.05),护理7 d两组舒适度明显升高,VAS评分明显降低,且与对照组比较,观察组舒适度更高,VAS评分更低,差异有统计学意义(P0.05)。观察组并发症发生率为45.0%,明显低于对照组并发症发生率82.5%,差异具有统计学意义(P0.05)。观察组患者对护理的总满意度为92.5%,明显高于对照组(72.5%),差异有统计学意义(χ2=7.127,P=0.010)。结论根据舒适度量表可明显显示急性白血病化疗患者的舒适状态,根据量表结果实施舒适护理,可明显改善患者舒适度,减轻患者疼痛,降低化疗并发症的发生,提高患者对护理的满意度。     

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.