普外科ICU病人转移性焦虑状况的调查与分析

目的:本项研究旨在调查普外科ICU病人转移性焦虑状况及其相关因素,以便采取适当的心理干预,减轻病人转移性焦虑,有利于病人术后康复。方法:对120例普外科ICU病人进行焦虑状态测评,分2个测评时间即在病人病情稳定允许转出但未被告知前和在病人被告知转移至尚未转出之间,调查表主要包括:改良的状态～特质焦虑问卷(STAI)中的S-AI部分。结果:普外科ICU病人存在转移性焦虑,告知转移前后焦虑状态存在差异性(t=13.8492,P<0.05),告知转移前焦虑程度高于告知转移后焦虑程度。结论:普外科ICU病人转移性焦虑原因与国外ICU病人转移性焦虑产生的原因存在差异性,应根据实际情况,采取适当的护理措施。     

过渡期护理模式对“ICU后综合征”发生的干预研究

目的:观察分析过渡期护理模式对ICU转出患者及家属"ICU后综合征"发生率的研究。方法:选取收治的400例ICU转出患者和400例患者家属作为研究对象,根据随机数表法将所有患者分为对照组和观察组,每组200例。对照组患者给予常规护理模式,观察组患者给予过渡期护理模式。观察两组ICU转出患者及家属"ICU后综合征"发生情况。结果:观察组患者及家属焦虑发生率、抑郁发生率、焦虑评分及抑郁评分均显著低于对照组患者及家属,差异具有统计学意义(P<0.05)。结论:对ICU转出患者实施过渡期护理模式,可显著改善患者及家属心理状态,降低患者及家属焦虑和抑郁发生率。     

麻醉下人工流产术病人焦虑、抑郁情绪障碍的调查分析

目的 了解麻醉下人工流产术病人情绪障碍的发生率及相关情况。方法 对70例手术病人在手术前后进行SAS、SDS评定、分析。结果 麻醉下人工流产病人手术前后焦虑和抑郁的平均分无显著性差异，发生率无明显差异。无孕产史的病人焦虑和抑郁的发生率在手术前与有孕产史的病人比较存在显著差异，并且无孕产史的病人手术前后比较也有显著差异；手术前文化水平低的病人焦虑和抑郁发生率明显高于文化水平高的病人，手术前后比较低文化组存在显著性差异。结论 麻醉下人工流产术未引起病人明显的情绪障碍。孕产经历及文化可能与早期妊娠女性情绪障碍有关，对早期妊娠女性进行心理干预是非常必要的。     

ICU心脏手术病人的心理护理

目的研究ICU心脏手术病人心理问题的临床表现并对其进行心理护理。方法对体外循环心内直视手术500例病人在ICU的心理异常表现及护理干预进行归纳总结。结果在ICU期间256例出现焦虑、紧张心理,80例出现抑郁心理,17例出现谵妄,经加强心理护理后,异常的心理反应都得到减轻或解除,顺利度过复苏关。结论针对心脏术后ICU病人不同的心理反应采取相应的心理护理,是促进术后康复的关键之一。     

手术前后的心理反应及其护理

本文随机抽取头颈部、胸腹部、脊柱四肢及肿瘤等手术病人１２１名，用Ｚｕｎｇ编制的焦虑自评量表（ＳＡＳ）分别在手术前后进行检测。结果显示全部手术病人在手术前后的焦虑程度有显著差异，同时发现，术后过妥善的心理护理，其焦虑状态获明显改善。     

手术前后的心理反应及其护理

本文随机抽取头颈部、胸腹部、脊柱四肢及肿瘤等手术病人１２１名，用Ｚｕｎｇ编制的焦虑自评量表（ＳＡＳ）分别在手术前后进行检测。结果显示全部手术病人在手术前后的焦虑程度有显著差异，同时发现，术后经过妥善的心理护理，其焦虑状态获明显改善。     

心理干预对手术患者焦虑情绪的影响

目的 探讨手术与焦虑的联系及缓解或消除的方法。方法 随机抽取头颈部、胸腹部、脊柱四肢及肿瘤等手术病人121名，用Zung焦虑自评量表（SAS）分别在手术前一日评估焦虑水平后再进行心理干预，手术后3～5日再做焦虑评估。结果 各类手术患者术前焦虑程度明显高于全国常模水平比较，差异非常显著（P〈0．01）；与焦虑症患者比较，无显著性差异（P〉0．05）；各类手术患者在术后与焦虑症患者比较，则有显著性差异（p〈0．01）。各类手术患者之间差异无显著性（P〉0．05）。结论经过妥善的心理干预和积极完善的心理护理，其焦虑状态获明显改善。     

腹腔镜胆囊切除病人手术前后心理状态的调查及对策

目的 调查腹腔镜胆囊切除病人手术前后焦虑、抑郁状态。方珐采用问卷调查，用焦虑自评量表（SAS）和抑郁自评量表（SDS），对96例行腹腔镜胆囊切除病人手术前后焦虑和抑郁状态进行测评。结果腹腔镜胆囊切除病人手术前及术后短期内均存在明显焦虑、抑郁，术前明显重于术后，不同年龄、文化程度、性别，其术前焦虑、抑郁程度不同，而术后4周焦虑抑郁值与常模比较无差异（P〉0．05）。结论腹腔镜胆囊切除病人手术前、手术后短期内心理健康状况较差，应加强健康指导，作好病人心理护理，对缓解病人不良心理有积极作用，能提高病人生活质量。     

肝脏MRI检查的心理护理

目的研究心理护理在肝脏MRI检查中的应用。方法400例需行肝脏MRI检查的患者，随机分为对照组和治疗组各200例，治疗组在对照组常规护理的基础上加用心理辅导；记录两组检查前后的焦虑水平，统计检查成功率。结果治疗组检查后焦虑水平显著改善p〈0．01（u=24．507），对照组焦虑水平无改善。两组检查成功率无显著差异，但治疗组优于对照组。结论心理护理有利于肝脏MRI检查。     

持续性人文关怀理念对ICU病人的护理效果

目的:探讨在重症监护病房(ICU)病人护理中加入持续性人文关怀理念的干预效果.方法:选取ICU危重症病人96例,根据入院时间随机分为观察组和对照组,各48例.对照组进行ICU常规护理,观察组在常规护理基础上加入持续性人文关怀理念.比较2组病人的护理满意度和护理前后的焦虑自评量表(SAS)评分.结果:2组病人护理前SAS评分差异无统计学意义(P>0.05);对照组病人护理前后SAS评分差异无统计学意义(P>0.05),而观察组病人护理后SAS评分较护理前显著降低,亦明显低于对照组护理后的SAS评分(P<0.01).观察组病人护理满意度明显高于对照组(P<0.01).结论:在ICU病人常规护理中添加持续性人文关怀理念,有助于改善病人焦虑状态,提高病人护理满意度,促进护患和谐,值得临床推广.     

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.