快速康复外科理念预防子宫全切术后下肢深静脉血栓的效果

目的探析快速康复外科理念预防子宫全切术后下肢深静脉血栓的临床效果。方法选取2014年7月至2016年7月我院行子宫全切术的120例患者为研究对象,根据硬币法分为参照组(n=60)、观察组(n=60)。参照组给予常规护理,观察组给予快速康复外科理念护理,观察对比2组患者术后下肢深静脉血栓的发生率及下床活动时间。结果观察组患者术后下肢深静脉血栓发生率为1.7%,同参照组患者的13.3%进行对比,存在明显差异(P0.05);观察组患者下床活动时间明显短于参照组患者,对比存在明显差异(P0.05)。结论对行子宫全切术患者施行快速康复外科理念护理,可以有效减少术后下肢深静脉血栓的发生,缩短下床活动时间,临床应用效果较好,值得全面应用推广。     

快速康复外科理念对子宫全切术后患者下肢深静脉血栓形成的影响研究

目的 探讨快速康复外科理念对降低子宫全切术后患者下肢深静脉血栓形成的应用效果. 方法 采用方便抽样的方法,将185例子宫全切术后患者分为观察组(95例)和对照组(90例).观察组实施快速康复外科护理路径,对照组实施常规护理路径. 结果 两组患者术后的下肢深静脉血栓发生率、D-二聚体水平、日常生活活动能力评分的比较差异均有统计学意义(P<0.05);观察组下肢深静脉血栓形成的发生率和D-二聚体水平低于对照组(P<0. 01),观察组日常生活活动能力评分低于对照组(P<0.05). 结论 快速康复外科理念应用于子宫全切术后患者,可降低患者下肢深静脉血栓的发生率,提高患者自理能力,使患者尽快恢复健康水平.     

快速康复外科理念在腹腔镜下子宫肌瘤剔除术患者的临床应用

目的:探讨快速康复外科理念在子宫肌瘤围手术期应用的价值。方法:107例子宫肌瘤术患者随机分为实验组和对照组,在围手术期实验组(n=54)应用快速康复外科理念,对照组(n=53)采用传统治疗方案,比较两组患者的术后肠道排气时间、下床活动时间、住院时间,以及手术前、后血清C反应蛋白(CRP)的差异。结果:实验组较对照组术后排气时间、下床活动时间、住院时间明显缩短,CRP浓度明显降低(P<0.05)。结论:对于子宫肌瘤患者在围手术期中应用快速康复外科理念,能降低手术风险、缩短住院时间、减少手术并发症、减轻机体应激和炎症反应,加速患者康复。     

快速康复外科在腹腔镜无张力疝修补术患者中的临床应用

目的:探讨快速康复外科在腹腔镜无张力疝修补术患者中的临床应用效果。方法:对80例腹股沟疝患者随机分为实验组和对照组各40例,实验组患者应用快速康复外科理念行腹腔镜下无张力疝修补术和围手术期护理,对照组患者采用传统的开腹手术和术后常规护理。对两组患者术后进食时间、下床活动时间、肛门排气时间和并发症情况进行对比。结果:实验组患者术后进食时间、下床活动时间、肛门排气时间均早于对照组,比较差异有统计学意义(P<0.05);并发症发生例数少于对照组,但差异无统计学意义(P>0.05)。结论:应用快速康复外科理念行腹腔镜下无张力疝修补术的患者,术后进食时间和下床活动时间早,肠蠕动恢复快,肛门排气时间早,能缩短住院日,减少医疗费用,而术后患者并发症并没有明显增加,值得临床推广应用。     

加速康复外科理念在全髋关节置换围手术期患者中的应用

目的:探讨加速康复外科理念在全髋关节置换围手术期患者中的应用。方法:选取我院81例老年股骨颈骨折患者按抽签法分两组,对照组40例予围术期传统干预方案,观察组41例在此基础上增加加速康复外科理念。采用髋关节Harris评分评价患者髋关节功能,对比患者下肢深静脉血栓发生率。结果:对照组下肢深静脉血栓发生率22. 50%高于观察组的4. 88%,且髋关节Harris评分低于观察组(P<0. 05)。结论:全髋关节置换围手术期患者应用加速康复外科理念,可有效减少患者下肢深静脉血栓发生率,促进其髋关节功能恢复。     

快速康复外科理念在肝胆外科围手术期护理中的应用

目的:探讨快速康复外科理念在肝胆外科围手术期护理中的应用。方法:选择在我院接受肝胆外科手术的患者160例,将其随机分成观察组80例和对照组80例,观察组患者行快速康复外科理念护理,对照组患者行常规护理,观察两组患者的术后情况。结果:观察组患者术后下床活动早、进食时间和肛门排气时间大大缩短,且住院时间短,为患者家属减轻经济负担。结论:肝胆外科围手术期护理中采用快速康复外科理念帮助患者术后快速恢复且治疗费用少,值得推广。     

营养风险筛查和预防性肠内营养支持在胃癌快速康复外科治疗中的应用

目的 提高胃癌患者术后的营养状况与胃肠道免疫功能,加快康复速度,减少并发症发生率.方法 在快速康复外科(F T S)治疗理念的指导下,引入术前营养风险筛查和预防性肠内营养支持,随后行胃癌根治术,术后早期少量肠内营养支持、早期下床活动、围手术期护理等一系列措施,观察患者术后营养状况与胃肠道免疫功能,及术后肛门排气时间,并发症发生率、术后恢复时间上的差异.结果 进行预防性肠内营养支持后,实验组术后血清白蛋白及免疫球蛋白I g A水平明显高于对照组(P<0.01);术后肛门排气早;并发症发生率更低.结论 通过营养筛查后对存在营养风险的患者进行预防性肠内营养支持,同时结合快速康复外科的营养及护理理念应用于胃癌围手术期治疗,可以在不增加手术风险的前提下,降低并发症发生率,缩短住院时间、从而增强胃癌快速康复治疗的效果.     

快速外科康复理念在腹腔镜子宫次全切除术中的运用

目的：研究在腹腔镜子宫次全切除术中运用快速外科康复理念的安全性和可行性。方法选择2011年3月-2013年2月期间于该院行腹腔镜子宫次全切除术患者398例,分别采用FTS理念和传统处理原则管理围手术期,比较两组患者术后住院时间、住院费用、恶心呕吐、术后进食时间、术后肛门排气时间、术后并发症的发生率等。结果研究组患者住院天数为（4.0±1.2） d,对照组为（6.7±1.3） d,研究组住院费用为（5684.4±213.7）,对照组为（6754.6±179.9）,研究组术后进食时间（6.0±0.9） h,对照组为（9.4±2.6） h;研究组术后肛门排气时间为（14.5±3.8） h,对照组为（22.3±3.3） h;研究组和对照组术后并发症均为0例,研究组较传统组住院时间短,住院费用低,术后进食时间、术后肛门排气时间明显提前,术后并发症少,康复快,差异有统计学意义（P＜0.05）。结论将快速外科康复理念应用在腹腔镜子宫次全切除术患者的围手术期处理,有利于患者快速康复。     

快速康复外科联合中医康复护理在胆囊切除术围手术期中的应用

目的 将快速康复外科理念融入中医康复护理,观察其在胆囊切除术患者围手术期间的应用价值.方法 将我院行胆囊切除术的患者50例,根据入院病历号,采用数字单双号的模式,分为对照组(25例)和观察组(25例),对照组给予围手术期规范化常规护理,观察组在对照组常规护理措施基础上给予快速康复外科护理联合中医康复护理内容.比较2组术后下床时间、肛门排气时间、术后进餐时间及平均住院天数.同时记录术后是否发生不良反应及术后并发症事件.结果 观察组术后下床时间、肛门排气时间、术后进餐时间较对照组显著提前(P＜0.05),平均住院天数短于对照组(P＜0.05).2组均未发生术后不良反应及并发症事件.结论 快速康复外科理念融入中医康复护理,能够提高胆囊切除术患者围手术期间的术后康复质量,且安全有效.     

中西医结合快速康复外科在妇科腹腔镜围手术期的应用

【目的】观察中西医结合快速康复外科（FTS）在妇科腹腔镜围手术期的作用。【方法】将226例行腹腔镜手术患者随机分为试验组（即中西医结合FTS组）和对照组（即传统治疗组）各113例。观察2组术后首次肛门排气时间、下床活动时间、住院时间及术后并发症的发生率。【结果】试验组术后首次肛门排气时间和下床活动时间较对照组早,住院时间较对照组显著缩短（P＜0.05）;试验组术后并发症发生率为0.9%,显著低于对照组的4.4%（P＜0.05）。【结论】中西医结合快速康复外科治疗能促进肠蠕动,缩短肛门排气时间,有效地促进妇科腹腔镜术后胃肠功能的恢复,减少患者术后并发症,加快术后康复进程。     

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.