肝癌患者经肝动脉化疗栓塞术治疗后肝区疼痛的护理对策探析

目的:探析肝癌患者经肝动脉化疗栓塞术治疗后肝区疼痛的护理对策。方法:将实施常规护理的64例肝癌患者设为对照组,另将实施常规护理联合针对性疼痛护理的64例肝癌患者设为观察组;比较两组患者疼痛评分、疼痛分级及护理满意度。结果:观察组护理后疼痛评分低于对照组(P<0.05);观察组疼痛分级0度、Ⅰ度及Ⅱ度多于对照组,Ⅲ度、Ⅳ度少于对照组;观察组护理满意度高于对照组(P<0.05)。结论:对经肝动脉化疗栓塞术治疗后肝区疼痛的肝癌患者实施疼痛护理效果理想,能够有效减轻患者疼痛,提升患者满意度,建议使用。     

优质护理服务对肝动脉化疗灌注栓塞术后疼痛的影响

目的探讨优质护理服务对肝动脉化疗灌注栓塞术后疼痛的影响.方法 将90例肝动脉化疗灌注栓塞术后的肝癌患者随机分成2组,观察组45例在给予常规护理的基础上,给予心理护理、环境的干预及合理的止痛等优质护理服务,对照组给予常规护理.结果 观察组的疼痛程度评分低于对照组(P<0.05).结论 优质护理服务能有效减轻肝动脉化疗灌注栓塞术后患者的疼痛程度.     

原发性肝癌患者肝动脉化疗栓塞术后肝区疼痛护理效果观察

目的探讨原发性肝癌患者肝动脉化疗栓塞术后肝区疼痛护理效果。方法选择该院2009年4月—2011年4月间收治的原发性肝癌行肝动脉化疗栓塞术的患者60例,随机分为两组,对照组30例行常规护理,观察组30例针对疼痛进行观察并行针对性干预,就两组临床资料进行回顾性分析。结果观察组Ⅰ、Ⅱ级疼痛率显著高于对照组,Ⅲ、Ⅳ度疼痛率显著低于对照组,差异有统计学意义（P〈0.05）。观察组护理满意度为96.7%,对照组为80%,差异有统计学意义（P〈0.05）。结论原发性肝癌患者肝动脉化疗栓塞术后肝区疼痛实施针对性护理干预,可显著降低疼痛程度,确保手术顺利进行。     

耳穴压豆在肝癌肝动脉化疗栓塞术后便秘患者中的应用

目的 探讨耳穴压豆在肝癌肝动脉化疗栓塞术后便秘患者中的应用。方法 选取2018 年6 月～2019 年5 月我科拟行经肝动脉化疗栓塞的原发性肝癌患者,随机分为试验组和对照组,每组各40 例;两组患者均给予常规治疗护理方案,试验组在对照组基础上于患者行动脉化疗栓塞术后当日给予耳穴压豆,观察两组患者术后肛门首次排便时间及第0、2、4、6 天患者便秘症状评分。结果 试验组及对照组肝动脉化疗栓塞术后肛门首次排便时间分别为（29.83±4.01）h、（48.23±7.11）h（t=-8.151,P=0.000）,两组差异有统计学意义（P＜0.05）,试验组便秘症状评分显著优于对照组（P＜0.05）。结论 耳穴压豆可以有效预防肝动脉化疗栓塞术后便秘的发生,值得临床推广。     

血府逐瘀汤治疗原发性肝癌TACE术后气滞血瘀型疼痛30例

目的 观察血府逐瘀汤治疗原发性肝癌经导管动脉化疗栓塞（transcatheter arteriachemoembolization, TACE）术后气滞血瘀型疼痛的临床疗效。 方法 将60例原发性肝癌TACE术后气滞血瘀型疼痛患者随机分为治疗组和对照组,每组30例。治疗组给予血府逐瘀汤口服,对照组予以中药汤剂安慰剂口服。治疗前后比较两组患者疼痛数字分级评分（numerical rating scale, NRS）及Karnofsky功能状态评分（karnofsky performance status, KPS）的变化。 结果 治疗后两组NRS评分均显著下降,治疗组治疗前后NRS评分差值显著大于对照组（P＜0.05）。治疗后对照组KPS评分显著降低,而治疗组显著升高,两组治疗前后差值比较,差异具有统计学意义（P＜0.05）。治疗组NRS及KPS评分改善情况均显著优于对照组（P＜0.05）。 结论 血府逐瘀汤能有效减轻原发性肝癌TACE术后气滞血瘀型疼痛,提高患者生活质量。     

音乐疗法对肝癌TACE后急性腹痛的影响效果观察

目的观察在肝癌TACE(肝动脉介入化疗栓塞术)后急性腹痛中应用音乐疗法的效果。方法将选取的80肝动脉介入化疗栓塞术患者随机分为对照组和观察组,对照组患者对常规的护理方法进行使用,观察组患者在常规护理方法的基础上对音乐放松疗法进行使用。结果对照组患者的SAS评分要远远高于观察组患者的,两组间比较具有统计学意义(P0.05);对照组患者的VAS评分远远高于观察组患者的,两组间比较具有统计学意义(P0.05)。结论综上所述,在肝癌TACE患者术后的康复中应用音乐疗法,可以将患者的焦虑水平和疼痛程度大大降低,对患者具有较好的护理效果,所以在实际的临床工作中要将其推广力度不断加大。     

综合护理干预对TACE术后疼痛的影响观察

目的 探讨综合护理干预对肝动脉灌注化疗栓(TACE)术后疼痛的影响.方法 将60例接受TACE治疗的肝癌患者随机分成2组,对照组给予常规护理,干预组在常规护理的基础上给予综合护理,比较2组患者术后疼痛情况及睡眠情况.结果 干预组患者术后的疼痛评分明显低于对照组,干预组患者术后的睡眠质量明显高于对照组,差异均有统计学意义(P＜0.05).结论 综合护理干预能降低TACE术后疼痛,提高患者的睡眠质量.     

苦参素对原发性肝癌肝动脉栓塞及栓塞化疗术后综合征的疗效观察

目的探讨苦参素对原发性肝癌经导管及微导管肝动脉栓塞及动脉栓塞化疗（transcatheter arteral chemoembolization,TACE）后综合征的改善。方法回顾性分析选择纳入标准的原发性肝癌60例,定量资料,分为治疗组（TACE＋苦参素）30例,对照组30例,TACE术前一周、术后一周及一月检测肝功能,观察患者肝动脉栓塞化疗术后综合征及肝功能的情况。结果TACE术后治疗组、对照组的肝功能均升高,经过护肝治疗后均稍高于治疗前的水平,谷草转氨酶（AST）及总胆红素（TBIL）两组差异有统计学意义（P〈0．05）;两组的谷丙转氨酶（ALT）差异无统计学意义（p〉0．05）;治疗组较对照组病人术后栓塞综合征缓解较快,两组差异有统计学意义（P〈0.05）。术后一周、术后定期复查肝功能,栓塞化疗术后综合征症状均恢复和缓解。结论苦参素可缓解原发性肝癌TACE栓塞术后综合征症状。     

强化护理对中晚期肝癌患者TACE术后疼痛程度和生活质量的影响

目的探讨强化护理对中晚期肝癌患者肝动脉化疗栓塞术(TACE)术后疼痛程度和生活质量的影响。方法选取2016年11月至2018年10月郑州大学第一附属医院收治的76例经TACE治疗的中晚期肝癌患者,根据入院时间分为对照组和观察者,每组38例。对照组患者接受常规护理,观察组在常规护理的基础上接受强化护理。比较两组患者护理前后视觉模拟痛觉量表(VAS)评分。借助肝癌患者生活质量测定量表(QOL-LC)评估患者护理前后生活质量,包括躯体功能、社会功能、心理功能。结果护理后,两组患者VAS评分低于护理前,观察组患者VAS评分低于对照组,差异有统计学意义(均P<0.05)。护理后,两组患者躯体功能评分、社会功能评分、心理功能评分均高于护理前,观察组患者躯体功能评分、社会功能评分、心理功能评分均高于对照组,差异有统计学意义(均P<0.05)。结论强化护理有助于改善行TACE的中晚期肝癌患者的疼痛状况,提高生活质量。     

护理干预在原发性肝癌首次肝动脉化疗栓塞治疗患者中的应用

目的探讨护理干预在原发性肝癌首次肝动脉化疗栓塞治疗患者中的应用效果。方法以126例原发性肝癌首次肝动脉化疗栓塞治疗患者为研究对象,随机分为观察组和对照组,观察组采取常规护理+护理干预措施,对照组采取常规护理措施,比较两组患者术后并发症发生率、疼痛程度、可正常饮食的时间及患者满意度。结果观察组术后并发症发生率、疼痛程度、可正常饮食时间显著低于对照组,护理满意度显著高于对照组。结论在临床上对原发性肝癌首次肝动脉化疗栓塞治疗患者实施护理干预可以降低术后并发症发生率、减轻术后疼痛程度、减轻胃肠道反应及提高患者满意度,适合在临床推广应用。     

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.