护理干预对慢性鼻窦炎鼻内窥镜手术患者负性情绪及疼痛的影响

目的观察护理干预对行鼻内窥镜手术的慢性鼻窦炎患者负性情绪及疼痛的影响。方法将2015年6月至2016年6月方城县中医院收治的110例行鼻内窥镜手术的慢性鼻窦炎患者按随机数表法分为对照组与观察组,各55例。给予对照组患者常规护理措施,给予观察组患者护理干预措施。比较两组患者抑郁自评量表(SDS)、焦虑自评量表(SAS)以及视觉模拟量表(VAS)评分。结果两组患者术前1 d SAS、SDS评分比较,差异无统计学意义(P>0.05);观察组患者术前2 h、术后24 h SAS、SDS评分以及清醒后、术后24 h VAS评分均低于对照组,差异有统计学意义(P均<0.05)。结论护理干预应用于慢性鼻窦炎鼻内窥镜手术中可有效缓解患者的负性情绪,减轻疼痛程度。     

早期运动康复护理管理模式在老年骨折患者中的应用研究

目的:探讨早期运动康复护理管理模式在老年骨折患者中的应用价值.方法:选取100例老年骨折患者为研究对象,根据护理干预模式不同分为对照组和观察组,每组各50例.对照组患者接受常规护理干预;观察组患者在对照组基础上接受早期运动康复护理管理模式干预,时间6个月.比较两组患者肢体运动功能Fugel-Meyer量表(FMA)评分、生活自理能力优良率及焦虑自评量表(SAS)和抑郁自评量表(SDS)评分.结果:干预后,两组患者上、下肢FMA评分均升高(P＜0.05),且观察组高于对照组(P＜0.05);SAS评分及SDS评分均降低(P＜0.05),且观察组低于对照组(P＜0.05);观察组患者生活自理能力优良率高于对照组(P＜0.05).结论:老年骨折患者应用早期运动康复护理管理模式,可有效缓解负性情绪,改善肢体功能,促进自理能力的恢复.     

综合护理干预神经外科择期手术患者术前焦虑的临床观察

目的:观察综合护理干预神经外科择期手术患者术前焦摩情况。方法:将70例神经外科择期手术患者随机分为对照组和观察组,各35例。对照组采用神经外科常规护理,观察组在此基础上加用综合护理,比较两组的焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分及护理满意度。结果:两组护理后的焦虑自评量表(SAS)评分和抑郁自评量表(SDS)评分均低于护理前,差异均有统计学意义(P0.05),且护理后观察组低于对照组(P0.05)。观察组护理满意度为88.57%,高于对照组的74.29%,差异有统计学意义(P0.05)。结论:综合护理干预能减轻神经外科择期手术患者术前焦虑和抑郁状态,并且能提高患者护理满意度,值得临床推广应用。     

个性化护理干预对老年慢性前列腺增生患者负性情绪及护理满意度的影响

目的:探讨个性化护理干预对老年慢性前列腺增生(BPH)患者负性情绪及护理满意度的影响。方法:选取68例老年慢性BPH患者,随机数字表法分为对照组和观察组,每组各34例。对照组予以常规护理干预,观察组在对照组基础上予以个性化护理干预。比较两组干预前后抑郁自评量表(SDS)评分、焦虑自评量表(SAS)评分变化,统计对比护理满意度。结果:干预前比较两组SAS、SDS评分差异均无统计学意义(P>0.05);干预后观察组SAS、SDS评分均明显低于对照组(P<0.05);观察组护理满意度明显高于对照组(P<0.05)。结论:对于老年慢性BPH患者实施个性化护理干预,有利于改善其负性情绪及提高护理满意度。     

护理干预对老年冠心病患者负性情绪影响的临床观察

目的:分析心理护理对缓解老年冠心病患者负性情绪的价值。方法:将144例老年冠心病患者随机分为对照组和观察组,两组均给予常规护理,观察组同时给予相应的心理护理。采用SAS(焦虑自评量表)和SDS(抑郁自评量表)评价负性情绪的变化。结果:两组入院后24 h内的SAS和SDS评分比较,差异无统计学意义(P>0.05);观察组出院前1 d的SAS和SDS评分均显著低于干预前及对照组出院前,两者比较,差异均有统计学意义(P<0.05);而对照组入院后、出院前SAS和SDS评分比较,差异无统计学意义(P>0.05)。结论:老年冠心病患者给予相应的护理干预可明显缓解或消除其负性情绪,有助于其顺利康复。     

手术室巡回护士与病房护士协同合作术前访视的临床效果

目的:观察手术室巡回护士与病房护士协同合作术前访视的临床效果。方法:选取70例择期手术患者作为研究对象,依据入院时间将其分为对照组和研究组各35例,对照组选择常规术前访视模式,研究组在对照组基础上选择手术室巡回护士与病房护士协同合作的术前访视模式,比较访视前后两组心理状况及术前、麻醉即刻血压、心率的变化情况。结果:术前1 d研究组焦虑自评量表(SAS)、抑郁自评量表(SDS)评分均明显低于对照组,差异有统计学意义(P<0.05);麻醉即刻研究组收缩压(SBP)、舒张压(DBP)、心率(HR)均明显优于对照组,差异有统计学意义(P<0.05)。结论:手术室巡回护士与病房护士协同合作的术前访视模式,可以有效改善患者的负性情绪,维持患者在麻醉期间血压、心率稳定,具有良好的临床应用价值。     

社区老年轻中度高血压患者冥想干预效果研究

目的 探讨冥想干预对社区老年轻中度高血压患者血压水平的影响,分析其可能的发生机制.方法 选择2011年4-9月在南通市某街道卫生服务中心就诊的高血压患者80例,随机分为实验组(n=38)与对照组(n=42),分别进行为期8周的冥想与健康教育讲座.两组分别于干预前和每周一下午0.5 h的干预结束后测量血压.实验组与对照组分别在干预前后进行焦虑自评量表(SAS)和抑郁自评量表(SDS)的评分,同时检测肾上腺素与去甲肾上腺素的水平.结果 实验组干预后各个时间点的收缩压与舒张压均低于对照组,差异有统计学意义(P＜0.05).干预后,实验组SAS得分与干预前比较,差异均有统计学意义(P＜0.01);干预后实验组SAS得分低于对照组,差异有统计学意义(P＜0.01);两组干预后SDS得分间差异无统计学意义(P＞0.05).干预后,实验组的肾上腺素与去甲肾上腺素水平低于干预前,差异均有统计学意义(P＜0.05).实验组干预后的肾上腺素和去甲肾上腺素水平均低于对照组,差异有统计学意义(P＜0.05).结论 冥想干预对降低社区老年轻、中度高血压患者血压水平有效,这可能与其能降低焦虑、肾上腺素以及去甲肾上腺素水平有关.     

术前术后心理干预对慢性鼻-鼻窦炎患者行鼻内镜手术前后的负性情绪和生存质量的影响

目的:探讨术前术后心理干预对慢性鼻-鼻窦炎(CRS)患者行鼻内镜手术前后的生存质量和负性情绪的影响。方法:选取2016年3月-2017年9月本院行鼻内镜手术治疗的CRS患者80例。按照随机数字表法将其分为观察组(常规护理+术前术后心理干预)和对照组(常规护理),各40例。比较两组手术前后的焦虑自评量表评分(SAS)、抑郁自评量表评分(SDS)、鼻腔鼻窦结局测试量表-20评分(sNOT-20)、疼痛评分(VAS),住院时间及护理满意度。结果:手术日、术后2 d,观察组SDS、SAS评分均低于术前及对照组(P0.05);术后,观察组s NOT-20各项评分均低于对照组(P0.05);观察组术后1 h、2 d的VAS评分均低于对照组,住院时间短于对照组,差异均有统计学意义(P0.05);观察组护理总满意率为100%,高于对照组的90.00%(χ~2=4.211,P=0.040)。结论:对行鼻内镜手术治疗的CRS患者进行术前术后心理干预,能明显改善患者负性情绪及术后生存质量,减轻术后疼痛,缩短住院时间,提高护理满意度。     

优质护理服务在改善肾内科患者负性情绪中的应用

目的 观察在肾内科患者的护理过程中应用优质护理服务后对患者负性情绪的干预效果.方法 选取肾内科患者共83例,根据患者入院日期的单双号数分为对照组40例和观察组43例.对照组患者接受常规护理,观察组在此基础上结合优质护理服务,对2组患者的焦虑自评量表(SAS)和抑郁自评量表(SDS)评分进行对比.结果 观察组患者SAS和SDS评分明显低于对照组,差异均具有统计学意义(P＜0.05).结论 在肾内科患者的护理过程中,采用优质护理服务能够有效改善患者的负性情绪,提高患者对治疗和护理的依从性,值得推广应用.     

同伴教育对2型糖尿病患者负性情绪和生活质量的影响

目的：：探讨同伴教育对糖尿病患者负性情绪及生活质量的影响。方法：60例2型糖尿病患者随机分为观察组和对照组各30例,对照组进行常规健康教育,观察组同时对患者实施同伴教育8周。分别于教育前和教育后采用Zung焦虑自评量表(SAS)、抑郁自评量表(SDS)和生活质量指数评定量表(QOL)进行评分。结果：健康教育后,观察组患者的SAS评分、SDS评分和QOL评分均显著优于对照组(P＜0.05)。结论：对糖尿病患者实施同伴教育,可改善患者的负性情绪和生活质量。     

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.