整体护理对新生儿及婴幼儿磁共振检查的效果观察

目的：研究新生儿及婴幼儿磁共振检查的护理效果。方法选取2011年7月至2013年7月我院接受磁共振检查的新生儿及婴幼儿120例，将其随机分为观察组和对照组，两组各有患儿60例，对照组给予常规护理，观察组在检查前、中、后给予整体护理。结果观察组中54例患儿一次磁共振检查图像清晰，有3例患儿检查图像基本符合要求，有3例患儿在检查过程中醒后不配合检查，通过进行催眠后对其检查成功，一次性取得磁共振图像成功率为95．00％；观察组中39例患儿一次磁共振检查图像清晰，有11例患儿检查图像基本符合要求，有13例患儿在检查过程中醒后不配合检查，通过进行催眠后对其检查成功，一次性取得磁共振图像成功率为81．67％。结论整体护理的应用对新生儿及婴幼儿磁共振检查有显著效果，且磁共振室内的护士要有较为全面的护理知识，还要了解影像学方面知识，只有医生、护士、患者三方相互协调，才能使磁共振检查顺利完成。     

MRI在小儿脊髓栓系综合征的应用

目的：探讨磁共振在小儿脊髓栓系综合征诊断中的价值。方法：对我院2000年至2003年13例脊髓栓系综合征患儿在多平面上行磁共振扫描,对检查经验进行总结。结果：13例患儿的结果直观、可靠、清晰。结论：磁共振是脊髓栓系综合征最可靠的诊断方法。     

口腔专科患者的MRI检查安全和护理配合

目的：探讨口腔专科患者的磁共振检查安全风险及护理配合。方法回顾性分析2012年1月-2013年12月我科施行磁共振口咽部检查的90例口腔专科患者的临床资料,探讨磁共振检查的安全风险和护理配合的必要性。结果90例患者均顺利进行磁共振检查,经及时有效的护理,患者均顺利且安全地完成扫描,并获得清晰图像。结论切实强化口腔专科患者的磁共振知识宣传讲解和护理服务,能有效规避磁共振检查风险和提高检查结果的准确性。     

高压注射器在磁共振检查中的应用与护理

目的：总结应用高压注射器作磁共振血管成像（CE MRA）和磁共振增强扫描的应用和护理体会。方法：252例患者均使用高压注射器推注对比剂,先询问药物及对比剂过敏史。正确设置流速、流量及注射时间,做好血管的选择,防止药液渗漏。结果：251例患者顺利完成检查,1例患者出现药液渗漏。结论：高压注射器的应用和护理是磁共振血管成像（CE MRA）和磁共振增强扫描检查成功的关键之一。     

新生儿缺氧缺血性脑病患儿磁共振检查的护理体会

目的:研究新生儿缺氧缺血性脑病(HIE)进行磁共振检查中的有效护理方法。方法:分析我院2010年以来对46例HIE患儿进行磁共振检查中的护理过程,总结护理方法。结果:46例HIE患儿均顺利完成磁共振检查,获得满意图像。结论:认真仔细地做好每一项护理工作,就能够确保磁共振检查的顺利完成,为临床诊断和治疗提供有效服务。     

针对肝脏磁共振动态增强扫描患者的心理指导和护理措施研究

目的:研究分析肝脏磁共振动态增强扫描患者的心理护理以及护理方式。方法:以我院接收的120例肝脏磁共振动态增强扫描接受患者作为研究对象,在他们进行检查期间的护理资料进行回顾分析。结果:在经过护理后,此次研究的患者均取得了良好的检查效果,心理状态平稳,绝大部分患者都能够顺利的完成检查,有6例患者在第二次接受训练后也能完成检查。结论:心理护理和护理干预可以提高肝脏磁共振动态增强扫描的成功率。     

中低场强磁共振MRCP临床运用价值的评价

目的：探讨利用中低场强磁共振仪进行MRCP检查临床应用价值。方法：利用0.5T磁共振仪对52例梗阻性黄疸，1例慢性胰腺炎，1例胆总管囊肿和12名健康志愿者进行MRCP检查，分析其影像表现，与临床及病理对照分析。结果：52例梗阻性黄疸及1例胆总管囊肿病人，均可显示胆道扩张，12名健康志愿者胆管及胰管均未见显示，所有病例均经一次扫描，基本能够满足诊断要求，结合常规T1WI及T2WI图像，诊断符合率为90.38%。结论：利用中低场强磁共振进行MRCP检查有无创，安全，简单易行，可显示梗阻部位，判断引起梗阻原因等优点；有扫描时间长，细小胰胆管显示不满意等缺点，但同样能够满足临床诊断需要。     

小儿患者在MRI检查中的护理体会

磁共振成像(MRI)是一种安全又比较先进的影像学检查方法,因其具有鲜明的软组织对比、多参数、多方位成像的优势,以及无骨骼伪影干扰和血管流空效应等特性,特别是没有放射线对人体没有损害,所以对于小儿患者来说是尤为重要的。特别是在小儿中枢系统疾病的诊断中,已经成为不可忽视的临床检查方法。1资料和方法我科自2001年6月至2007年6月,对679例8岁以下的小儿进行头颅的检查,其中男性435例,女性244例。诊断脑发育不良、脑肿瘤、脑炎等疾病的占79%,正常约为15%,其他疾病约占6%。使用美国GE公司S igna 1.5 T超导扫描仪,在所检查的部位常规进行T1W I、T2W I轴位扫描,部分患者进行增强扫描,用Gd-DTPA对患者进行静脉推注,一般速率为2m l/s~3 m l/s,在根据不同部位分别进行Cor T1W I,Sag T1W I,AX T1W I扫描。2护理2.1一般护理尽管磁共振检查已经成为临床检查的重要手段,然而检查时间较长,患者身体全部进入磁体中心,且检查过程中噪音较大,一般患儿不能够很好的合作。为了能够顺利的完成检查,应针对不同的患儿给予不同的护理。首先应向患儿及陪同的家长介绍患者的准备及注...     

手足口病婴幼儿磁共振检查的护理

磁共振(MRI)是一种安全先进的影像学检查方法,因其具有鲜明的软组织对比性、多方位成像、无痛无害、可重复性强等优势,逐渐成为小儿中枢神经系统疾病的首选检查方法.但MRI扫描时间长,噪声大,扫描部位细微移动也会使图像出现扭曲[1],影响检查结果.因此,如何护理使患儿积极地配合检查,提高扫描成功率是关键.现总结我院2011年4月至2012年6月78例手足口患儿的MRI检查护理体会,报告如下.     

小儿神经母细胞瘤的MRI诊断

目的：探讨小儿神经母细胞瘤的核磁共振检查的影像学特点及应用价值.方法：收集20例经手术和病理学检查证实为神经母细胞瘤的患儿,结合病史及病理分型分析其MRI图像特点,包括病灶所在部位、大小、数量、密度或信号.结果：20例患儿磁共振平扫均有阳性发现,其中,发生于腹膜后的有12例,左侧肾上腺区有4例,左颈部有2例,后纵隔区有2例.T1WI扫描主要表现为腹部、纵隔或颈部实性占位性病变,边缘可见包膜,并向周围压迫临近器官,T2WI表现为等、高信号,以稍长T2信号为主,内可见多发结节样改变,使用增强扫描大部分病例瘤体内见不均匀明显强化.结论：MRI有助于神经母细胞瘤患儿的早期诊断及患儿预后的评估,并制定相应的治疗措施.     

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.