心理护理在老年支气管哮喘中的应用体会

目的：研究心理护理干预用于老年支气管哮喘患者中的护理价值,探讨其改善患者心理情绪的影响。方法选择2014年2—11月我院收治的老年支气管哮喘患者160例,按照不同的护理方法分成观察组（ n＝80）与对照组（n＝80）,对照组运用常规护理,观察组在对照组的基础上加用心理护理干预措施,比较分析两组患者心理状况。结果观察组与对照组护理前抑郁自评量表（ SDS）与焦虑自评量表（ SAS）评分差异无统计学意义（P＞0.05）;护理干预后,观察组SDS与SAS评分均明显低于对照组（P＜0.05）。观察组对护理工作非常满意及满意的人数均明显高于对照组（P＜0.05）。结论在常规护理的基础上加用心理护理干预措施可以有效改善患者心理抑郁情绪,降低焦虑程度,提高护理满意度,值得推广及应用。     

优质护理干预对功能性便秘患者不良心理的影响分析

目的：分析优质护理干预对功能性便秘患者不良心理的影响。方法选择60例功能性便秘患者（FC）患者作为研究对象。将60例患者分为观察组和对照组,每组30例。对照组给予常规护理干预。观察组在常规护理干预基础上实施优质护理干预。干预4周后,比较2组患者干预前后焦虑自评量表（SAS）及抑郁自评量表（SDS）评分变化。结果干预前2组患者SAS评分及SDS评分差异无统计学意义。干预后,2组患者的SAS评分及SDS评分相比干预前均有所下降,但观察组患者下降幅度比对照组明显,2组患者SAS评分及SDS评分差异具有统计学意义（P＜0.05）。观察组患者干预前后SAS评分及SDS评分差异有统计学意义（P＜0.05）。结论优质护理能显著改善FC患者抑郁、焦虑等不良心理情绪,有助于FC治疗。     

心理干预对冠心病患者负性情绪及临床疗效的影响

目的探讨心理干预治疗对冠心病患者抑郁、焦虑情绪的效果及对临床疗效的影响。方法采用焦虑自评量表（SAS）和抑郁自评量表（SDS）对106例冠心病患者问卷调查，对伴有抑郁情绪者51例（48．3％）随机分为干预组及对照组，均给予常规心内科治疗，干预组同时配合心理干预，比较两组疗效；结果干预组第4周SDS及SAS评分均显著低于对照组，差异有统计学意义（P〈0．01）；两组SDS、SAS差值比较差异有统计学意义（P〈0．01）；针对抑郁情绪的心理干预能显著降低抑郁评分，明显改善患者症状，缩短住院时间。结论心理治疗能显著降低冠心病患者抑郁、焦虑情绪的严重程度，有效的心理干预能提高临床疗效，促进患者的康复。     

尿毒症患者血液透析期的心理干预护理

目的：探讨心理干预护理对尿毒症血液透析患者的临床应用价值,为尿毒症血液透析的临床护理提供参考.方法：选取我院血液透析治疗的患者70例随机分为2组,对照组接受常规护理,观察组在对照组的基础上接受心理干预护理.比较两组抑郁自评量表评分（SAS）及焦虑自评量表评分（SDS）及治疗依从性.结果：心理干预后,观察组SAS及SDS评分均低于对照组,差异有统计学意义（P＜0.05）.心理干预期间,观察组依从性高于对照组,差异有统计学意义（P＜0.05）.结论：尿毒症血液透析治疗患者实施心理干预护理可有效改善患者的抑郁焦虑情绪,提高患者治疗的依从性.     

心理干预对冠心病介入治疗患者焦虑抑郁的影响

目的：探讨心理干预对冠心病介入治疗患者的影响。方法：将109例冠心病行介入治疗患者随机分为对照组和实验组。对照组仅常规治疗;实验组在常规治疗的同时,有计划地实施心理护理。采用焦虑自评量表（SAS）和抑郁自评量表（SDS）对患者于术前1d、术后1、3、5d进行调查,统计SAS、SDS评分。结果：实验组术后1、3、5d SAS、SDS评分及阳性率分别与术前1d比较,差异有统计学意义（P〈0.01）,与对照组同时段比较,差异有统计学意义（P〈0.01）。结论：冠心病介入治疗患者存在明显的焦虑、抑郁心理。心理护理干预可明显改善其焦虑、抑郁情绪。     

综合护理干预对冠心病患者心理状态的影响分析

目的：评价综合护理干预对冠心病患者心理状态的影响。方法将88例冠心病患者随机分为护理组和常规组各44例,给予常规组患者常规护理,并在此基础上给予护理组患者综合护理干预。对2组患者治疗前后焦虑自评量表（SAS）评分、抑郁自评量表（SDS）评分进行对比。结果2组患者干预前SAS评分、SDS评分比较均无显著性差异（P〉0.05）,干预后2组患者SAS评分、SDS评分均有所改善,但护理组明显优于常规组（P〈0.01）。结论给予冠心病患者综合护理干预可有效改善其焦虑及抑郁情绪,临床效果显著,值得推广和应用。     

临床护理路径对介入治疗冠心病患者心理影响的临床观察

目的观察临床护理路径（CNP）对介入治疗冠心病患者心理影响。方法选择介入治疗冠心病患者112例,随机均分为CNP组与常规组,CNP组给予CNP护理干预,常规组给予常规护理,比较两组患者治疗前后焦虑自评量表（SAS）及抑郁自评量表（SDS）评分。结果治疗2周后两组患者SAS评分和SDS评分比较,具有统计学意义（P〈0.05）。结论对介入治疗冠心病患者施行CNP护理干预,可减轻焦虑和抑郁的不良负面情绪。     

心理干预改善心内科住院患者焦虑抑郁情绪的效果研究

目的：探讨心理干预对心内科住院患者焦虑抑郁情绪的的改善效果,为促进患者的身心康复提供依据.方法：60例符合入组条件的心内科住院患者按抛硬币分组法被分为研究组（32例）和对照组（28例）,两组均按常规药物治疗和护理,对照组给予支持性心理护理,研究组在此基础上实施为期4周的心理干预,治疗前后采用焦虑自评量表（SAS）、抑郁自评量表（SDS）对两组患者的焦虑抑郁情绪程度进行评定.结果：两组间治疗前比较,SAS、SDS评分均无明显差异（P＞0.05）,治疗后两组间比较,研究组SAS、SDS评分值明显低于对照组（P〈0.01）.两组治疗前后自身比较,对照组SAS、SDS评分无明显改变（P＞0.05）,研究组SAS、SDS评分变化显著（P〈0.01）.结论：心理干预能够有效改善患者的焦虑抑郁情绪.     

冠心病患者运用心理护理干预后的情绪状态影响分析

目的：探讨冠心病患者运用心理护理干预后的情绪状态影响。方法：研究该院2014年3月至2016年1月期间随机抽取的80例冠心病患者，分为对照组与观察组各40例，其中对照组运用常规护理，观察组运用心理护理干预，分析两组患者在情绪状态方面的差异。结果：在SAS与SDS等焦虑抑郁评分上，观察组护理后改善幅度高于对照组（P＜0．05）。结论：冠心病患者运用心理护理干预后可以有效的改善不良焦虑抑郁心理状态，提升心理健康程度。     

心理干预对外伤性截瘫患者心理状况的效果探讨

目的：探讨心理干预对外伤性截瘫患者心理状况的作用效果。方法：将136例患者随机分为对照组（65例）和观察组（71例）,对照组采用常规临床护理,观察组在此基础上增加心理护理干预,比较两组患者2周后的焦虑自评量（SAS）评分和抑郁自评量（SDS）评分情况。结果：两组患者的SAS评分和SDS评分均有所降低,观察组的效果优于对照组,两组比较差异有统计学意义（P〈0．05）。结论：对外伤性截瘫患者实施有效的针对性心理护理干预措施,在一定程度上可以改善患者的焦虑、抑郁情绪,对患者的康复具有重要的积极意义。     

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.