产前护理教育对初产妇分娩认知及分娩方式的影响

目的:探讨产前护理教育对初产妇分娩认知和分娩方式的影响.方法:2015年8月～2016年10月定期来我院做产前检查的初产妇120例为研究对象,随机分为对照组(60例)和观察组(60例).对照组实施常规护理干预,观察组在常规护理干预的基础上给予产前护理教育.比较两组产妇对分娩的认知情况和分娩方式.结果:观察组产妇分娩态度、分娩知识和产时应对行为得分均明显高于对照组,组间比较差异具有统计学意义(P＜0.05).两组产妇分娩方式比较差异具有统计学意义,观察组阴道产率明显高于对照组(P＜0.05).观察组产妇社会因素剖宫产率明显低于对照组,组间比较差异具有统计学意义(P＜0.05).结论:产前护理教育有利于提高初产妇对分娩的认知,提高自然分娩率.     

心理干预对初产妇自然分娩的影响

目的:探讨心理护理对初产妇自然分娩的影响。方法:选择初产妇200例,随机分成观察组与对照组,每组100例,对照组采用传统的常规护理方法,观察组在常规护理的基础上给予心理护理。结果:观察组的焦虑评分、产痛程度、剖宫产、母婴并发症、产程时限明显低于对照组,而自然分娩率则明显高于对照组,差异有统计学意义(P<0.05)。结论:心理干预能显著改善产妇分娩时的焦虑和恐惧等不良情绪,减轻疼痛,缩短产程,提高自然分娩率,降低剖宫产率,减少母婴并发症,对促进母婴健康,提高人口素质具有重要意义。     

孕晚期心理干预对城镇和农村初产妇分娩情况影响的对比研究

目的:探求实施相同标准及内容的孕晚期心理干预对城镇与农村初产妇分娩情况(产程进展、产痛、分娩方式等)的影响的异同,促进自然分娩.方法:按初产妇日常生活居住地分为城镇和农村组,于孕晚期和入院待产后持续给予心理干预,观察两组的产程时间、产痛、分娩方式等情况;同时,随机选择上一年度未进行系统心理干预的常规分娩病案作为对照组.结果:接受心理干预的两组产妇第一产程、第二产程时间差异有显著意义(P<0.05),与常规分娩对照组比较差异存在非常明显意义(P<0.05);接受心理干预的农村组顺产率显著高于城镇组,剖腹产率显著低于城镇组(P<0.05),并且两组的顺产率均显著高于常规分娩对照组(P<0.01).结论:恰当的心理干预,对城镇和农村初产妇的分娩情况(产程进展,产痛、分娩方式等)的积极影响足一致的,并且对农村初产妇效果更好,能显著提高自然分娩率,降低剖宫产率.     

温馨护理对初产妇分娩结局和护理满意度的影响

目的 观察温馨护理对初产妇分娩结局和护理满意度的影响.方法 随机抽取116例初产妇,按照随机数字表法分为温馨组和对照组各58例,对照组给予常规产科护理,温馨组在常规产科护理的基础上给予产前、产时和产后全程人性化温馨护理措施,观察比较两组的剖宫产率,护理服务满意度,顺产产妇的第一、二、三、总产程时间及产后2h出血量.结果 温馨组顺产例数明显多于对照组,护理服务满意度优于对照组,顺产妇中温馨组第一产程和总产程短于对照组,两组比较差异有统计学意义(P＜0.05).结论 全程人性化温馨护理措施可以降低剖宫产率,提高自然分娩率,缩短顺产妇的第一产程及总产程,提高护理服务满意度.     

产前护理干预对自然分娩的影响

目的 探讨产前护理干预对促进产程进展、提高自然分娩率,减少母婴并发症的作用.方法 选择2006年1月～2009年1月单胎、头位、无高危因素的初产妇253例,随机分为观察组127例,对照组126例,进行临床观察.结果 两组产妇在产程进展时间、分娩方式、产后出血、新生儿窒息等方面均有显著性差异(P＜0.05).结论 产前护理干预可以缩短产程、降低剖宫产率、减少母婴并发症、提高自然分娩率.     

人性化护理在初产妇分娩中的效果分析

目的：探讨人性化护理干预对初产妇分娩的影响。方法：将170例待分娩的初产妇随机分为观察组和对照组,每组85例,对照组采用产科常规护理;观察组进行人性化的护理干预,密切观察两组产妇的产程和分娩方式的变化。结果：观察组第一、第二产程和总产程明显短于对照组,具有统计学意义（P〈0.05）,第三产程观察组略短于对照组,差异无统计学意义（P〉0.05）;观察组自然分娩率显著高于对照组,而阴道助产及剖宫产率显著低于对照组,差异具有统计学意义（P〈0.05）。结论：人性化护理干预在初产妇分娩过程中可缩短产程,提高自然分娩率,提高分娩质量。     

导乐分娩在促进初产妇自然分娩中的护理研究

目的:探讨导乐分娩在初产妇自然分娩中的应用效果。方法:将收治的200例初产妇采用随机对照的方法分为观察组和对照组,观察组采用导乐分娩护理,对照组采用常规护理,比较两组的护理效果。结果:观察组的总产程时间显著少于对照组,阴道分娩率显著高于对照组,剖宫产率显著低于对照组,产后出血量显著少于对照组,差异有统计学意义(P<0.05)。结论:导乐分娩能给给予初产妇产时有效的帮助,缩短产程,提高自然分娩率。     

认知行为干预对无痛分娩初产妇妊娠压力、自我效能及分娩结局的影响

目的探讨认知行为干预对无痛分娩初产妇妊娠压力、自我效能及分娩结局的影响。方法选择自愿要求分娩镇痛的初产妇280例,按随机数字表法分为观察组和对照组各140例。对照组给予常规产程护理,观察组在此基础上采用认知行为干预,比较两组产妇的妊娠压力（PPS）、自我效能感（GSES）及分娩结局。结果观察组PPS评分、视觉模拟评分和导尿率均低于对照组,GSES评分高于对照组,第一产程活跃期时间和第二产程时间均少于对照组,两组比较差异均有统计学意义（均P＜0.01）。两组自然分娩率、产后2h出血量和新生儿Apgar评分比较差异均无统计学意义（均P＞0.05）。结论对初产妇进行产前综合认知行为干预,可以明显降低产妇的妊娠压力、提高自我效能感,改善母婴分娩结局,值得临床推广应用。     

运用人性化护理提高产妇自然分娩率的效果观察

目的通过人性化护理服务模式的应用，提高产妇的自然分娩率，确保母婴安全。方法将240例产妇随机分为观察组和对照组各120例，观察组将人性化护理贯穿分娩全过程，对照组只按常规护理处理。比较两组产妇产程时间、自然分娩率、剖宫产率及母婴并发症的发生率。结果观察组产妇产程缩短，自然分娩率大大提高，剖宫产率及母婴并发症率明显降低。结论人性化护理可有效地提高自然分娩率，降低剖宫产率，促进健康分娩，提高产科工作质量。     

导乐陪产及行为干预对分娩的影响

目的:探讨导乐陪产及行为干预对分娩的影响.方法:将120例正常足月初产妇分为干预组和对照组各60例.干预组自愿要求行为干预,同时给予助产士一对一的专人陪伴;对照组按产科常规护理,观察并比较对分娩的影响.结果:干预组的产痛程度、产程时间、自然分娩率等方面均优于对照组.结论:导乐陪产及行为干预能减轻分娩引起的疼痛,缩短产程,降低剖宫产率.     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.