超声心动图对主动脉瓣替换术后康复期患者

Background: Rheumatic aortic valve disease is one of factors which cause serious left ventricular(LV) functions insufficiency. Aortic valve replacement(AVR) is a therapy's method of treating aortic valve disease,and the echocardiography is an important method of evaluating curative effect of it. Objective: To evaluate the effect of AVR on left ventricular functions by echocardiography. Unit:Service Force Hospital of 61398 Army of PLA,Shanghai Subject: There were 33 patients with rheumatic aortic valve disease(insufficiency or stenosis) and accepting AVR in Changhai Hospital from 1997 to 1999,7 females and 26 males,aged range 13～ 69 years(mean age 39.5± 13.2 years).3 cases of II degree,25 of III degree,5 of IV degree for left ventricular functions by NYHA.     

二尖瓣环收缩期最大位移达峰时间评价扩张型心肌病患者左心室长轴收缩功能的超声心动图研究

Objective To evaluate the value of peak time(PT) and corrected peak time(PTc) in the assessment of left ventricular long axis systolic function in patients with dilated cardiomyopathy(DCM).Methods Thirty-one DCM cases and thirty-six healthy cases were investigated using echocardiography.To obtain image of apical four-chamber view and apical two-chamber view, PT was measured by the technique of tissue motion annular displacement.The value of PTc was corrected by R-R interval.The critical value of PT and PTc was obtained by ROC curves.Results Compared with the PT of control group, the PT of DCM group at the site of septal and lateral were significantly increased ( P ＜0.05), but the PT at the site of anterior and inferior were no significantly increased ( P ＞0.05).The PTc at the four sites were significantly increased compared with control group ( P ＜0.05).The areas of under the ROC curve of PTc was 0.849 (95 % CI 0.699～0.929, P = 0.000), sensitivity and specificity of diagnosis cardiac dysfunction were 80.6 % and 66.7% respectively.Conclusions The PTc was significantly increased in patients with DCM.PTc was useful to evaluate left ventricular dysfunction in DCM patients.     

二尖瓣环收缩期最大位移达峰时间评价扩张型心肌病患者左心室长轴收缩功能的超声心动图研究

Objective To evaluate the value of peak time(PT) and corrected peak time(PTc) in the assessment of left ventricular long axis systolic function in patients with dilated cardiomyopathy(DCM).Methods Thirty-one DCM cases and thirty-six healthy cases were investigated using echocardiography.To obtain image of apical four-chamber view and apical two-chamber view, PT was measured by the technique of tissue motion annular displacement.The value of PTc was corrected by R-R interval.The critical value of PT and PTc was obtained by ROC curves.Results Compared with the PT of control group, the PT of DCM group at the site of septal and lateral were significantly increased ( P ＜0.05), but the PT at the site of anterior and inferior were no significantly increased ( P ＞0.05).The PTc at the four sites were significantly increased compared with control group ( P ＜0.05).The areas of under the ROC curve of PTc was 0.849 (95 % CI 0.699～0.929, P = 0.000), sensitivity and specificity of diagnosis cardiac dysfunction were 80.6 % and 66.7% respectively.Conclusions The PTc was significantly increased in patients with DCM.PTc was useful to evaluate left ventricular dysfunction in DCM patients.     

速度向量成像技术评价急性心肌梗死患者左心室不同步运动的临床研究

Objective To assess the left ventricular contraction asynchrony in patients with acute myocardial infarction(AMI) by velocity vector imaging(VVI).Methods Sixty AMI patients and 40 healthy volunteers were included.Using VVI,the time to peak longitudinal systolic velocity (TL-V) was measured in the left ventricular long axis views,the time to peak radial systolic velocity (TR-V) was measured in parasternal short axis views.The deviation of the earliest and the latest TL-V and TR-V (Ts max-min) was measured,and the standard deviation of TL-V and TR-V (TS-SD) was also measured.Results ①TL-V ,TR-V of the infarcted and non-infarcted segments in patients with acute myocardial infarction were longer than those of the normal segments (P ＜0.05).②The longitudinal Tsmax-min,Ts-SD and the radial Tsmax-min,Ts-SD in infarcted patients were increased compared with the healthy volunteers (P ＜0.001).③Ts of the infarcted segments was increased in turn from the class Ⅰ to class Ⅳ of the cardiac function (P ＜0.001).Conclusions VVI could be used to assess the left ventricular contraction asynchrony in patients with AMI.VVI is a new useful method to determine the infarcted segments.     

Association between ventricular repolarization variables and cardiac diastolic function: A cross-sectional study of a healthy Chinese population

BACKGROUND Diastolic electromechanical couple, a well-described phenomenon in symptomatic heart failure, has not been well studied in healthy people. We hypothesized that ventricular repolarization variables, such as the QT interval,Tpeak-to-Tend(Tpe) interval and Tpe/QT ratio, are associated with cardiac diastolic function in the healthy Chinese population.AIM To assess the relationship between ventricular repolarization variables and cardiac diastolic function in apparently healthy Chinese individuals.METHODS This was a community-based cross-sectional study conducted in Shenyang,China. A total of 414 healthy subjects aged 35-91 years were enrolled. All subjects underwent standard 12-lead electrocardiography(ECG) and comprehensive echocardiography. ECG enabled the measurement of QT and Tpe intervals and Tpe/QT ratio. echocardiographic parameters, such as the ratio of mitral early diastolic inflow velocity(E) and late diastolic inflow velocity(A), E-wave deceleration time, left atrial volume(LAV) and LAV index, were measured to assess diastolic function. E/A < 0.75 was considered to indicate reduced diastolic function. ECG and echocardiography results were analyzed separately and in a blinded fashion. Correlation and regression analyses were applied to determine associations.RESULTS Ventricular repolarization variables, such as the QTc interval(393.59 ± 26.74 vs403.86 ± 33.56; P < 0.001), Tpe interval(72.68 ± 12.41 vs 77.26 ± 17.86; P < 0.01),Tpec interval(76.36 ± 13.53 vs 83.32 ± 21.25; P < 0.001) and Tpe/QT ratio(0.19 ±0.03 vs 0.20 ± 0.04; P < 0.01), were significantly different between the normal diastolic function group and the reduced diastolic function group. Significant associations were found between repolarization variables and diastolic function.After adjusting for all other possible confounders, the QTc and Tpe_c intervals were significantly associated with the E/A ratio(P = 0.008; P = 0.010). In men, the QTc interval was associated with abnormal diastolic function, and compared to the third QTc tertile, in the second QTc tertile, the odds ratio was 0.257(95%CI:0.102–0.649; P = 0.004).CONCLUSION Repolarization variables are associated with cardiac diastolic function even in healthy people. Moderate levels of the QTc interval exert a protective effect on diastolic dysfunction in men.     

冠状动脉慢血流现象的冠状动脉血流成像分析

Objective To non-invasive assess coronary blood flow velocity changes of patients with slow coronary flow phenomenon (SCFP) by coronary blood flow imaging (CFI).Methods Twenty-one patients who had no significant coronary artery stenosis but had thrombolysis in myocardial infarction (TIMI) slow-flow phenomenon were the experimental group,nine patients who has no significant coronary stenosis and TIMI flow normal were the control group.Using corrected TIMI frame count(CTFC) assess velocity of coronary artery.The left ventricular end diastolic diameter,end systolic diameter,ejection fraction,E peak velocity,A peak velocity,E/A ratio were measured by conventional echocardiography.The distal anterior descending coronary artery diastolic peak flow velocity(Vmax),mean velocity(Vmean) and blood flow velocity time integral(VTI) were measured by CFI.Results The corrected TIMI frame count (CTFC) of left anterior descending artery blood flow in slow blood group was (45.37 ± 8.62)frame,that in control group was (15.94± 4.66)frame,the difference was statistically significant (t = -9.596,P =0.000).The conventional echocardiographic measurements of two groups were not significantly different.The left anterior descending artery Vmax was (22.86 ± 3.04)cm/s,Vmean was (17.62 ± 2.89)cm/s,VTIwas (8.49± 2.01)cm in the slow blood flow group,the left anterior descending artery Vmax was (31.78 ± 9.28) cm/s,Vmean was (23.67 ± 7.60) cm/s,VTI was (10.91 ± 4.47) cm in the control group.The difference was statistically significant.The left anterior descending artery CTFC with Vmax and Vmean was negative correlation in the control group and the slow blood flow group.The left anterior descending artery CTFC was negatively correlated with VTI in the control group,there was no correlation between left anterior descending artery CTFC and VTI in the slow blood flow group.Conclusions Coronary artery flow velocity in the left anterior descending artery was declined.CFI can reflect changes in coronary TIMI flow,but in the diagnosis of coronary slow flow phenomenon CFI has limitations.     

Successful treatment of systemic sclerosis complicated by ventricular tachycardia with a cardiac resynchronization therapydefibrillator: A case report

BACKGROUND Systemic sclerosis is a rare connective tissue disease characterized by localized ordiffuse skin thickening and fibrosis,which usually accumulates in various organsthroughout the body.Tachyarrhythmia is a common clinical manifestation ofcardiovascular damage in systemic sclerosis patients.However,few studies havereported the use of catheter ablation and an implantable cardioverter defibrillatorin patients with systemic sclerosis complicated by ventricular tachycardia.CASE SUMMARY A 39-year woman with an 11-year history of systemic sclerosis was referred toour hospital due to three syncopal episodes in the past 6 mo.The results of anelectrocardiogram and a transthoracic echocardiogram revealed ventriculartachycardia and left ventricular systolic and ventricular septum segmentalmotion abnormalities,respectively.The results of an electrocardiogram showed asinus rhythm with complete blockage of the left bundle branch.In light of theprogressive nature of systemic sclerosis,the presence of a left bundle branchblock,and the decreased ejection fraction,a cardiac resynchronization therapydefibrillatorwas implanted.The patient’s clinical conditions improved,and at the3-mo follow-up,the patient was free of ventricular tachycardia and all cardiacsymptoms.CONCLUSION We report the first case of systemic sclerosis complicated by ventriculartachycardia that was successfully treated with a cardiac resynchronizationtherapy-defibrillator.     

护理干预对老年复治肺结核病人预后的影响

Objectiye To enhance the therapy compliance and the cure rate of the relapse agedness patients with pulmonary tuberculosis by nursing intervention. Methods One hundred and six relapse agedness patients with pulmonary tuberculosis were divided into experimental (n=54) and control groups (n=52). The experimental group was given the whole course nursing intervention and the control group was given universality guidance when they left hospital. The therapy compliance, sputum negative conversion rate and absorbability instance of focus were investigated among the patients of the two groups. Results The therapy compliance,sputum negative conversion rate and absorbabilty instance of focus in the trial group were significant higher than those in the control group (P＜0.05). Conclusions The whole course nursing intervention can enhance the therapy compliance and the cure rate of the relapse agedness patients with pulmonary tuberculosis.     

护理干预对老年复治肺结核病人预后的影响

Objectiye To enhance the therapy compliance and the cure rate of the relapse agedness patients with pulmonary tuberculosis by nursing intervention. Methods One hundred and six relapse agedness patients with pulmonary tuberculosis were divided into experimental (n=54) and control groups (n=52). The experimental group was given the whole course nursing intervention and the control group was given universality guidance when they left hospital. The therapy compliance, sputum negative conversion rate and absorbability instance of focus were investigated among the patients of the two groups. Results The therapy compliance,sputum negative conversion rate and absorbabilty instance of focus in the trial group were significant higher than those in the control group (P＜0.05). Conclusions The whole course nursing intervention can enhance the therapy compliance and the cure rate of the relapse agedness patients with pulmonary tuberculosis.     

中医辨证施护在老年性肺炎患者中的应用研究

Objective To explore the effect of Chinese medical dialectic nursing on age-related pneumonia patients. Methods Tatally 128 age-related pneumonia patients were selected randomly, and they were divided into control and intervention groiips stochastical ly, each with 64 cases. The control group was given the routine nursing, while the intervention group was given the extra Chinese medical dialectic nursing. Results Significant functional recovery efficiency of 87. 5% was seen in the intervention group, and 75% in the control group (P＜0.05) . Conclusions Chinese medical dialectic nursing can improve the functional recovery in patients with age-related pneumonia.     

与气管切开病人的沟通

分析2000年5月－2001年7月气管切开30例患的各期心理变化，总结对气管切开患如何正确使用语言和非语言交流技巧，以促进护患之间心理沟通，根据患的体语和病情变化，及时了解气管切开患的心理需求，使病人增强战性疾病的信心，缩短住院时间，提高治愈率。     

Libyan family with beta-thalassemia trait associated with hypercholesterolemia with widespread xanthomas

We describe a Libyan family with beta-thalassemia trait associated with unusually high concentrations of hemoglobin A2 and hypercholesterolemia. The family consists of the father, mother, and three sons. The marriage was consanguineous. The concentrations of total cholesterol and low-density lipoprotein cholesterol in serum were very high in two sons who also had widespread xanthomas. The erythrocyte membranes showed a high cholesterol/phospholipid ratio, with no significant susceptibility to lipid peroxidation in vitro.     

Family work with people with dementia

Family interventions (FI) are used where there is a psychotic illness. This article argues for their use in dementia cases. It looks at the example of a family where the father had recently received a diagnosis of Lewy bodies with dementia. The focus is on the process of working with the patient and his close relatives using an adapted FI model.     

Medpor填充联合钛板及钛钉固定治疗眼眶爆裂性骨折病人的护理

[目的]总结多孔聚乙烯高分子合成材料(Medpor)填充联合钛板及钛钉固定治疗眼眶爆裂性骨折病人的护理。[方法]对40例眼眶爆裂性骨折病人行Medpor填充联合钛板及钛钉固定治疗,同时加强护理。[结果]术后所有患眼眼球内陷均得以矫正,双眼突出度基本一致,复视情况消失或得到明显改善,眼球各方向运动良好,效果满意。[结论]加强眼眶爆裂性骨折病人行Medpor填充联合钛板及钛钉固定治疗的护理有利于病人的术后康复。     

胺碘酮治疗心衰合并心律失常患者的护理

目的 分析胺碘酮在心力衰竭合并心律失常治疗中常见的不良反应,并总结护理经验.方法 选择我院急性心衰合并室性心律失常患者75例,所有患者均先经抗心力衰竭治疗,胺碘酮治疗过程全程实施精心护理,分析治疗后患者恢复情况.结果 75例急性心衰合并心律失常患者,经全程护理及相应治疗后,72例恢复窦性心律;3例经电除颤治疗后恢复窦性心律;胺碘酮注射治疗的并发症包括静脉炎、低血压及反复发作的心律失常;无死亡病例出现.结论 在静脉注射胺碘酮治疗心衰合并心律失常过程中,实施全程精心护理,严密监测患者生命体征的变化,精确合理用药,可取得较好的救治效果.     

左旋门冬酰胺酶在联合化疗中毒副反应的护理

目的观察长春新碱、柔红霉素、左旋门冬酰胺酶（L-ASP）、泼尼松联合方案（VDLP）治疗急性淋巴细胞白血病（ALL）中L-ASP的毒副作用及总结护理要点。方法2002年10月～2004年3月对18例初治ALL患者。采用VDLP方案化疗，观察其疗效及L-ASP的毒副作用，并给予治疗及护理。结果5例发生急性胰腺炎，10例发生肝功能损害。2例出现皮疹，1例发生继发性高血糖。治疗1疗程后完全缓解13例，部分缓解3例。死亡2例。结论L-ASP在治疗ALL联合化疗效好，但其毒性反应需引起临床的高度重视，护理人员除了严密监控L-ASP使用过程，还应加强其毒副反应的预防和治疗，早期发现、早期治疗及对症护理，可确保化疗顺利完成。