精细化护理在新生儿重症监护病房中的应用效果

目的探讨精细化护理在新生儿重症监护病房中的应用价值。方法选取2018年1—12月安阳市妇幼保健院新生儿重症监护病房患儿100例作为研究对象,根据入院顺序分为对照组和研究组,各50例。对照组接受常规护理,研究组接受精细化护理,比较两组救治效果、住院时间、并发症发生率及护理满意度。结果对照组救治成功率[92.00%(46/50)]与研究组[96.00%(48/50)]比较,差异无统计学意义(P>0.05);研究组住院时间[(8.1±2.2)d]短于对照组[(12.5±3.6)d],差异有统计学意义(P<0.05)。研究组并发症发生率低于对照组,差异有统计学意义(P<0.05)。研究组家长护理满意度高于对照组,差异有统计学意义(P<0.05)。结论精细化护理在新生儿重症监护病房中的应用效果显著,可减少并发症的发生,缩短患儿住院时间,提升患儿家长护理满意度。     

新生儿重症监护室的临床护理分析

目的:探讨程序化护理管理模式在新生儿重症监护病房的应用效果.方法:本次研究中随机选择该院2013年6月至2014年6月收治的80例重症监护病房的新生儿作为研究对象,随机的分为对照组与实验组两组;在实验组中对重症监护病房的新生儿实施改进后的程序化的护理管理模式护理,对对照组中重症监护病房的新生儿则采取常规管理模式护理,护理1个月后对两组新生儿的救治成功率、院内感染率、护理满意度进行比较分析.结果:在本次研究中发现观察组新生儿感染率为8.78%,对照组新生儿感染率为14.25%,对比差异显著(P<0.05).结论:在新生儿重症监护病房中应用程序化护理管理模式,建立有效的护理管理流程,可以降低新生儿的感染率,提高救治成功率,增强护理满意度,在临床上具有十分重要的意义,值得进一步推广.     

护理安全管理在NICU护理工作中的应用效果分析

目的：综合分析护理安全管理在新生儿重症监护病房（NICU）护理工作中的应用效果,为治疗新生儿重症监护病房患者提供科学的数据参考。方法：选取本院在2014年6月～2015年6月收治的NICU患者临床资料66例,按照不同的护理干预方法随机分为观察组与对照组,每组皆为33例。观察组应用护理安全的护理方法,对照组应用基础护理的方法。结果：观察组的护理风险发生率为6.06%,对照组的护理风险发生率为33.3%,对照组的护理风险发生率远远高于观察组（P＜0.05）;观察组家属的总满意度为（96.25±2.11）分,对照组家属的总满意度为（89.21±2.02）分,观察组的家属总满意度显著优于对照组（P＜0.05）。结论：护理安全管理在NICU护理工作中的应用效果比较显著。     

新生儿重症监护室的临床护理分析

目的:探讨程序化护理管理模式在新生儿重症监护病房的应用效果。方法:本次研究中随机选择该院2013年6月至2014年6月收治的80例重症监护病房的新生儿作为研究对象,随机的分为对照组与实验组两组;在实验组中对重症监护病房的新生儿实施改进后的程序化的护理管理模式护理,对对照组中重症监护病房的新生儿则采取常规管理模式护理,护理1个月后对两组新生儿的救治成功率、院内感染率、护理满意度进行比较分析。结果:在本次研究中发现观察组新生儿感染率为8.78%,对照组新生儿感染率为14.25%,对比差异显著(P0.05)。结论:在新生儿重症监护病房中应用程序化护理管理模式,建立有效的护理管理流程,可以降低新生儿的感染率,提高救治成功率,增强护理满意度,在临床上具有十分重要的意义,值得进一步推广。     

镇静护理干预在儿科重症监护病房中的应用价值

目的分析在儿科重症监护病房中镇静护理的应用价值。方法选取于2015年11月至2016年10月在驻马店市第一人民医院接受治疗并入住重症监护病房的50例患儿进行分析,所有患儿均按照随机数字表达法分为对照组与观察组,其中对照组予以常规护理,观察组予以镇静护理,对比分析两组患儿的护理效果(镇痛评分)。结果对照组患儿的镇痛评分(3.78±0.23)分明显低于观察组(4.39±0.31)分,差异有统计学意义(P<0.05)。结论在儿科重症监护病房中应用镇静护理可以有效地提高患儿的镇静效果,提高救治质量,值得推广。     

品管圈活动在新生儿重症监护病房机械通气患儿中的应用效果

目的：观察品管圈活动在新生儿重症监护病房（NICU）机械通气患儿中的应用效果。方法：选取2020年6月至2021年6月该院NICU收治的64例机械通气患儿设为对照组,实施常规护理;另选取2021年7月至2022年7月该院NICU收治的64例机械通气患儿设为观察组,实施品管圈活动。比较两组皮肤损伤发生率、住院时间、机械通气时间及家长护理满意度。结果：观察组皮肤损伤发生率为3.12%(2/64),低于对照组的14.06%(9/64),差异有统计学意义（P<0.05）;观察组机械通气、住院时间均短于对照组,差异有统计学意义（P<0.05）;观察组健康教育、沟通态度、操作技术、护理服务等各项家长护理满意度评分均高于对照组,差异有统计学意义（P<0.05）。结论：品管圈活动应用于NICU机械通气患儿,可降低其皮肤损伤发生率,缩短机械通气时间和住院时间,提高家长满意度,效果优于常规护理。     

风险防范式护理模式在儿科病房护理中的应用

目的:观察风险防范式护理模式在儿科病房护理中的应用效果。方法:选取儿科病房患儿84例,按照入院时间先后分为对照组和观察组各42例。对照组实施常规护理,观察组在对照组基础上实施风险防范式护理。比较两组风险事件发生情况和患儿家属护理满意度。结果:观察组风险事件总发生率明显低于对照组,护理满意度明显高于对照组,差异均有统计学意义(P<0.05)。结论:在常规护理基础上,风险防范式护理模式应用于儿科病房护理中可减少风险事件发生,提高患儿家属的护理满意度。     

新生儿重症监护室药物准备过程的护理风险与安全用药

目的探析新生儿重症监护室药物准备过程的护理风险与安全用药。方法选取2014年11月至2015年11月许昌市中心医院重症监护室收治的56例新生儿作为研究对象,随机分为观察组与对照组,各28例。给予观察组护理风险管理,给予对照组常规护理管理,对比两组患儿感染发生率与用药差错事件发生率。结果观察组新生儿的感染发生率为7.14%,对照组为28.57%,前者明显低于后者,观察组用药差错事件发生率明显低于对照组,差异具有统计学意义(P<0.05)。结论对护理人员进行定期用药安全教育、药物知识培训,掌握交流沟通的技巧,同时使用信息化技术,对降低新生儿重症监护室的用药差错事件发生率具有重要意义。     

发展性照顾在新生儿重症监护室早产儿护理中的应用效果

目的:探讨在新生儿重症监护室(NICU)早产儿护理中采用发展性照顾的应用效果。方法:选取收治的88例NICU早产儿为研究对象,按照随机数字表法将其分为对照组和观察组,每组44例。对照组予常规护理,观察组在常规护理基础上予发展性照顾。对比两组胎便完全排泄时间、达到全肠道喂养时间、体质量增至正常时间、NICU住院时间、并发症发生率及患儿家属护理满意度。结果:观察组胎便完全排泄时间、达到全肠道喂养时间、体质量增至正常时间、NICU住院时间均短于对照组,且并发症发生率低于对照组,差异均有统计学意义(P<0.05)。观察组患儿家属护理工作满意度为95.46%,高于对照组的75.00%,差异亦有统计学意义(P<0.05)。结论:发展性照顾用于NICU早产儿,可减少并发症,缩短康复进程,提升患儿家属护理工作满意度。     

CCU护理管理中的风险因素分析与安全防范措施

目的:探讨冠心病重症监护病房(CCU)护理管理中的风险因素与安全防范措施。方法:选取收治的100例重症冠心病患者依据不同护理方案分为对照组和试验组各50例,对两组患者的护理风险因素进行分析并采用的安全防范措施,对比两组护理效果。结果:试验组CCU患者护理风险事件发生率为6.00%明显低于对照组的28.00%,两组比较差异有统计学意义(P<0.05)。试验组患者临床护理满意度评分明显高于对照组患者,差异有统计学意义(P<0.05)。结论:在CCU护理管理中,在风险因素分析的基础上采取安全防范措施,有助于降低护理风险,提高患者的护理满意度。     

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.