优质护理对子宫内膜息肉宫腔镜术后患者疾病认知及复发结局的影响

目的探究优质护理对子宫内膜息肉宫腔镜术后患者疾病认知及复发结局的影响。方法选择2015年01月至2017年01月期间在我院进行宫腔镜术治疗的子宫内膜息肉患者108例患者作为实验分析对象,将患者随机分为观察组和对照组各54例,给予对照组患者常规护理干预,观察组患者进行优质护理干预,比较两组患者疾病知识认知程度、临床护理满意度及术后不同时间段疾病复发率。结果观察组患者疾病知识认知优良率高于对照组,差异有统计学意义(P0.05);观察组患者临床护理满意度高于对照组,差异有统计学意义(P0.05);观察组患者术后6个月、12个月及24个月疾病复发率均低于对照组,差异有统计学意义(P0.05)。结论优质护理能够提高子宫内膜息肉宫腔镜术后患者疾病认知程度及临床护理满意度,降低患者疾病复发率,具有临床使用及推广价值。     

观察优质护理理念在子宫内膜息肉宫腔镜术后患者中的应用价值

目的观察优质护理理念在子宫内膜息肉宫腔镜术后患者中的应用价值。方法抽取60例子宫内膜息肉病人给予探讨,平均分组。对照组采取常规护理措施;实验组采取优质护理措施。观察两组治疗效果。结果经过分析,实验组远远强于对照组,差异较大,具有临床对比价值。结论针对子宫内膜息肉宫腔镜术后女性给予优质护理服务,可以改善病人满意度,降低并发症,减少复发率,促进身体康复,具有显著的临床效果。     

围手术期优质护理在子宫内膜息肉手术患者中的应用价值

目的探讨围手术期优质护理在子宫内膜息肉手术患者中的应用价值。方法选择于2015年6月至2016年8月泌阳县妇幼保健院妇产科收治的60例子宫内膜息肉患者为研究对象,随机分为观察组(优质护理干预,30例)和对照组(常规护理措施,30例),所有患者均行宫腔镜手术治疗。比较两组治疗效果及术后并发症发生情况。结果观察组患者住院时间、手术时间均短于对照组,差异有统计学意义(P<0.05);观察组患者术中出血量、术后并发症发生率均低于对照组,差异有统计学意义(P<0.05)。结论对宫腔镜下治疗子宫内膜息肉患者给予围手术期优质护理干预,临床应用更具优势,可有效缩短患者治疗周期,减少术中出血量,预防并减少术后并发症的发生,具有较高的应用价值。     

宫腔镜下电切术治疗子宫内膜息肉的护理体会

目的 探讨宫腔镜下电切术治疗子宫内膜息肉的护理方法 及效果.方法选择子宫内膜息肉患者100例,均行宫腔镜下电切术治疗,将其随机分为对照组和观察组,对照组患者采用常规护理,观察组在此基础上采用优质护理,对比2组患者的并发症发生率、复发率以及护理满意度.结果 观察组低钠血症、出血、切口感染发生率以及复发率均明显低于对照组(P<0.05);观察组护理满意度明显高于对照组(P<0.05).结论 优质护理应用于子宫内膜息肉行宫腔镜下电切术治疗患者中,可降低并发症发生率和复发率,提高护理质量和护理满意度.     

宫腔镜电切术与刮宫术对治疗子宫内膜息肉的临床对比研究

目的比较宫腔镜电切术与刮宫术治疗子宫内膜息肉的临床效果。方法选取阳江市阳东区人民医院从2015-05—2016-10间入院治疗的100例子宫内膜息肉患者作为研究对象。按照治疗方法的差异将患者分为观察组50例与对照组50例,对照组患者应用刮宫术治疗,观察组患者应用经宫腔镜子宫内膜息肉电切术治疗。比较两组患者的围术期临床指标、治疗前后患者月经量变化、近远期并发症发生情况及复发率。结果两组患者围术期临床指标接近,差异无统计学意义(P>0.05)。观察组患者术后1年月经量低于对照组患者;观察组患者的近远期并发症发生情况及复发率均显著优于对照组患者,差异有统计学意义(P<0.05)。结论临床应用宫腔镜下电切术治疗子宫内膜息肉,疗效确切,术中损伤小,术后恢复快,近远期并发症发生率及复发率低,值得临床广泛推广应用。     

宫腔镜下子宫内膜息肉电切除术与子宫内膜息肉摘除加电凝术治疗子宫内膜息肉的疗效比较

目的比较宫腔镜下子宫内膜息肉电切除术与子宫内膜息肉摘除加电凝术治疗子宫内膜息肉(EMP)的疗效。方法选取2016年8月至2018年6月无锡市惠山区第二人民医院妇科收治的EMP患者112例,根据数字随机表法将患者分为观察组和对照组,每组各56例。对照组给予宫腔镜下子宫内膜息肉摘除加电凝术治疗,观察组给予宫腔镜下子宫内膜息肉电切除术治疗。比较两组患者围手术期指标和术后3个月的月经量、血管内皮生长因子(VEGF)水平、术后1年妊娠率及复发率情况。结果两组患者手术时间、术中出血量、住院时间比较,差异无统计学意义(P>0. 05);观察组患者术后3个月的月经量减少量和VEGF降低水平均高于对照组,差异有统计学意义(P <0. 05);观察组患者术后1年妊娠率高于对照组,复发率低于对照组,差异有统计学意义(P <0. 05)。结论子宫内膜息肉电切除术治疗EMP患者,能够减少患者月经量,降低VEGF水平及复发率,并提高患者妊娠率,值得推广。     

宫腔镜手术治疗子宫内膜息肉及术后复发预防对策分析

目的探讨子宫内膜息肉患者接受宫腔镜手术治疗的价值,并分析其术后复发的预防措施。方法选取2014年1月~2016年2月子宫内膜息肉患者60例,其均接受宫腔镜手术治疗,分为两组,其中对照组术后不给予激素干预,实验组术后给予曼月乐治疗,对比组疾病复发率、手术时间、术中出血、并发症的差异性。结果所有患者均手术治疗成功;两组子宫内膜患者手术时间、术中出血量相比,差异无统计学意义(P0.05);实验组子宫内膜息肉患者的疾病复发率(3.33%)明显低于对照组的疾病复发率(23.33%)(P0.05)。结论子宫内膜息肉患者接受宫腔镜手术治疗,可以取得较好的疗效,在患者术后给予其激素干预,可降低疾病复发率,改善预后。     

宫腔镜子宫内膜息肉电切术后联合妈富隆预防子宫内膜息肉复发效果分析

目的分析宫腔镜子宫内膜息肉电切术后联合妈富隆预防子宫内膜息肉复发的临床效果。方法选择2013年2月至2014年3月开封市妇幼保健院收治的106例子宫内膜息肉患者,随机分成对照组和治疗组,各53例。对照组单纯采用宫腔镜子宫内膜息肉电切术治疗,治疗组采用宫腔镜子宫内膜息肉电切术后联合妈富隆治疗,观察两组患者的复发情况。结果治疗组术后6个月复发率低于对照组,月经改善率高于对照组(P<0.05)。结论对子宫内膜息肉患者采用宫腔镜子宫内膜息肉电切术后联合妈富隆共同治疗效果明显,能有效降低复发率,提高月经改善率,可推广应用。     

宫腔镜电切术联合左炔诺孕酮宫内缓释系统治疗子宫内膜息肉临床观察

目的探讨宫腔镜电切术联合左炔诺孕酮宫内缓释系统治疗子宫内膜息肉临床效果。方法选择2016年2月‐2017年2月该院收治的子宫内膜息肉患者170例作为研究对象,将所有患者随机分为观察组与对照组,各85例。对照组行宫腔镜电切术治疗,观察组行宫腔镜电切术联合左炔诺孕酮宫内缓释系统治疗,比较两组患者子宫内膜厚度、血清雌二醇(E2)、孕酮(P)水平与月经量变化情况以及术后子宫内膜息肉复发率。结果术前与术后1个月两组患者子宫内膜厚度相比,差异无统计学意义(P0.05),观察组患者在术后3、6个月子宫内膜厚度均低于对照组,差异有统计学意义(P0.05);术前术后两组患者E2、P水平相比,差异均无统计学意义(P0.05);术前两组患者月经量相比,差异无统计学意义(P0.05),观察组患者在术后1、3、6个月月经量均少于对照组,差异有统计学意义(P0.05);术后观察组子宫息肉复发率低于对照组,差异有统计学意义(P0.05)。结论宫腔镜电切术联合左炔诺孕酮宫内缓释系统治疗子宫内膜息肉可有效减少患者子宫内膜厚度与月经量,降低术后内膜息肉复发率。     

宫腔镜下不同术式治疗子宫内膜息肉的疗效观察

目的:探讨宫腔镜下不同手术方式治疗子宫内膜息肉的临床疗效。方法:将86例子宫内膜息肉患者按照随机分为观察组和对照组,两组患者在宫腔镜下给予不同手术治疗方式。结果:观察组手术时间、术中吸液量、VAS评分等诊疗指标明显优于对照组;观察组术后1年的月经改善情况及子宫内膜厚度均优于对照组;两组12个月复发率差异有统计学意义(P<0.05)。结论:宫腔镜下电切除术能显著改善患者月经及子宫内膜厚度,降低术后复发率,在子宫内膜息肉治疗中具有重要的临床应用价值。     

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.