对老年糖尿病患者实施社区护理服务的效果观察

目的:探讨对老年糖尿病患者实施社区护理服务的效果观察。方法:将两组患者进行对比研究,对照组患者实施日常护理手段,实验组患者在对照组的基础上实施社区护理干预服务措施。结果:通过研究表明,实验组的各项指标均优于对照组,且患者的满意度均高于对照组,具有显著差异(P0.05),具有临床意义。结论:糖尿病患者采取积极的饮食控制和合理的药物治疗,能够将血糖维持在相对稳定的水平内,可以大大降低和延缓并发症的发生,提高患者的生活质量。     

在老年公寓与家居生活老年人的生活质量比较研究

目的：对在老年公寓与家居生活老年人生活质量进行比较，了解两种养老方式的特点。方法：采用整群抽样的方法，随机抽取城市社区和老年公寓60岁以上老人200例，用总体幸福感量表、生活质量综合评定问卷进行调查。结果：居住于社区家庭的老年人个人和家庭的人均住房面积明显高于老年公寓的老人；老年公寓老人的精神紧张度和情绪波动明显高于居住于社区者；生活质量总体评价、总体幸福感等方面两者无显著性差异。结论：老年公寓是一种可取的社会化养老方式，但还需进～步完善。     

社区护士在老年疼痛管理中的作用

目的针对社区护士在老年疼痛管理中的作用进行研究分析。方法将收治的100例重度老年疼痛患者按照随机的方式分为实验组和对照组,每组各50例患者。结果经过护理后,疼痛患者的疼痛情况获得明显好转,其中实验组患者的疼痛缓解率明显高于对照组,差异有统计学意义(P<0.05)。结论在社区老年疼痛患者的护理管理当中,设立专门的社区护士,能够有效的降低老人的疼痛感,缓解老人精神压力,提升其生活质量。因此值得推广和采用。     

社区护理干预在老年高血压患者中的效果

目的本次实验课题主要探讨老年高血压患者应用社区护理干预的临床效果。方法通过随机的分组方法将本院2016年3月至2017年3月在院治疗的68例老年高血压患者分配到实验组和对照组,对照组34例患者采用基础护理干预,实验组34例采用社区护理干预,对比两组患者生活质量评分与血压情况。结果实验组老年高血压患者生活质量评分高于对照组,血压低于对照组,均具有统计学差异(P0.05)。结论老年高血压患者的血压情况和生活质量能够通过社区护理干预明显改善。     

慢性心力衰竭患者实施从医院到社区无缝隙护理管理模式的效果

探讨对慢性心力衰竭患者实施从医院到社区无缝隙护理管理模式的效果。将220例患者随机分为实验组和对照组,每组110例。对实验组采用从医院到社区无缝隙护理管理模式,对对照组实施常规的健康教育。实验组患者躯体功能、社会能力、总生活质量、情绪功能等生活质量均明显高于对照患者(P0.05);实验组患者治疗依从性明显高于对照组患者,抑郁、焦虑评分明显低于对照组患者(P0.05);实验组患者心功能指标较对照组患者明显改善(P0.05)。针对慢性心力衰竭患者采用从医院到社区无缝隙护理管理模式,提高患者生活质量和质量依从性,改善患者焦虑、抑郁状况及心功能指标,临床值得推广应用。     

护理干预对癫痫患者生活质量及负性情绪的管理效果

目的探究护理干预对癫痫患者生活质量及负性情绪护理效果。方法将2016年8月至2018年8月的60例癫痫患者应用掷骰子的方式平均分为实验组与对照组,分别采用综合性护理干预和常规护理干预方式进行护理,对比管理效果。结果经护理,实验组的生活质量主要包括生活机能、生理职能、社会职能和情感职能均显著优于对照组,且实验组的焦虑与抑郁程度显著低于对照组,差异显著,P0.05。结论采用综合性护理措施对癫痫患者进行管理,有利于改善患者的负性情绪,提高患者生活质量,有利于提高患者自我管理能力,提升患者康复速度。     

护理干预对老年高血压患者生活质量的影响

目的探讨个性化护理干预对社区老年高血压患者血压和生活质量的影响。方法随机抽取某社区高血压患者120名作为研究对象,随机分为实验组（60例）与对照组（60例）。实验组患者采取个性化的护理干预,对照组给予社区综合健康教育,干预时间均为3个月。干预前、干预中和干预后均测量两组患者血压,同时干预前、后用WHOQOL-100量表测量两组患者的生活质量。结果与干预前血压相比,两组干预方式均能有效降低患者收缩压、舒张压（P〈0.05）,总体生活质量也得到提高（P〈0.05）;干预后两组患者比较,实验组患者的血压明显低于干预后对照组,且随着干预时间的延长,血压逐渐趋于平稳;实验组患者干预后的总体生活质量以及生理、心理、社会、环境和生活信念5个领域得分也显著高于对照组（P〈0.05）,但两组患者独立性领域得分比较无显著差异（P〉0.05）。结论个性化护理干预能有效降低社区老年高血压患者血压,并在一定程度上改善其生活质量。     

构建社区“医养结合”服务模式下的老年人健康管理的效果分析

目的研究社区构建"医养结合"服务模式对老年人健康管理的实际效果。方法将社区中的60例2-糖尿病合并高血压老年患者按照随机数表法分为实验组和对照组,对照组(30例)采用常规社区护理和服务,实验组(30例)在对照组基础上实施医养结合的服务模式,比较两组患者健康管理状况。结果实验组躯体健康风险、日常活动能力、精神健康、社会支持情况均明显优于对照组,组间比较均形成统计学价值(P0.05)。结论 "医养结合"服务模式能够提升社区老年的健康,提升其生活质量,应该在社区中进行推广。     

护理干预对社区高血脂患者的医治和身体健康的影响

目的分析护理干预对社区高血脂患者的医治和身体健康的影响;方法选择2013年1月至2015年1月在体检期间发现的血脂高并合并脂肪肝的社区居民80例,根据数字随机原则将全部患者分成实验组和对照组各40例;对照组患者在规定的时间内测量血脂指标,实验组患者在此基础上给予有效的护理干预;结果护理干预后实验组患者的不良生活方式改善情况显著优于对照组患者,两者比较差异有统计学意义(P0.05);护理干预后实验组患者的治疗依从性评分显著优于对照组患者,两者比较差异有统计学意义(P0.05)。结论在社区高血脂患者中加强护理干预,能有效改善患者的不良生活方式,并提高患者的治疗依从性,提高患者生活质量。     

社区护理干预在糖尿病患者中的应用效果

目的探讨社区护理干预在糖尿病患者中的应用效果。方法将100例糖尿病患者分成对照组和实验组进行对比研究。对照组采用常规的糖尿病护理方法;实验组则在此基础上融入了社区护理干预内容。结果护理干预后,实验组遵医嘱情况、血糖控制情况均明显优于对照组(P0.05),比较差异有统计学意义。结论社区护理干预可有效提高糖尿病患者的生活质量和健康意识。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.