静脉留置针置管改进技术对穿刺成功率的影响

目的 探讨静脉留置针的不同穿刺方法对静脉留置针穿刺成功率的影响.方法 将行静脉留置针穿刺的160例肺癌患者随机分为观察组80例和对照组80例.对照组按传统的静脉留置针的方法穿刺并固定,观察组采用改良的静脉留置针的方法穿刺并用贴膜固定,比较两组穿刺的成功率.结果 观察组的静脉留置针的一次性穿刺成功率为97.5%,对照组为77.5%,差异有统计学意义（P＜0.05）,且渗液渗血、发生静脉炎等并发症发生情况与对照组比较,差异无统计学意义（P＞0.05）.结论 采用改良的静脉留置针的穿刺方法可明显提高静脉留置针的穿刺成功率,节约护理操作时间,对穿刺局部并发症的发生无影响.     

静脉留置针在新生儿护理中的应用研究

目的:分析静脉留置针在新生儿护理中的临床应用效果。方法:对我院收治的新生儿进行抽样,选取80例随机分为对照组和观察组,各40例。对照组采取手背静脉留置针方法,观察组采取头皮静脉留置针方法,对两组患者穿刺成功率、并发症等进行对比分析。结果:观察组穿刺一次成功率为92.5%,留置时间(6.19±0.48)d;对照组穿刺一次成功率为82.5%,留置时间(3.50±0.30)d,两组差异有统计学意义,P0.05。结论:静脉留置针在新生儿护理中效果显著,且头皮静脉留置针相对手背静脉留置针效果更佳,值得进一步推广利用。     

静脉留置针在新生儿护理中的应用研究

目的分析静脉留置针在新生儿护理中的应用效果。方法以240例新生儿为研究对象,将患儿平均分为观察组和对照组,对照组患儿接受头皮静脉穿刺,观察组患儿采用腋下静脉穿刺,对比两组患儿的一次穿刺成功率、留置针堵塞率、平均留置时间、并发症发生率。结果观察组的一次穿刺成功率为95.8%、堵塞率为6.7%,并发症发生率为3.3%,平均留置时间为(5.5±0.7)d,对照组的一次穿刺成功率77.5%、堵塞率为12.5%,并发症发生率为9.2%,平均留置时间为(2.7±0.8)d,两组患者的一次穿刺成功率、留置针堵塞率、并发症发生率和留置时间差异有统计学意义(P0.05)。结论静脉留置针在新生儿护理中的应用效果显著,且腋下留置穿刺针的效果更好,可提高一次穿刺成功率,延长留置时间,降低不良反应发生。     

改良后的股静脉留置针穿刺方法在NICU中的临床应用

目的：探讨改良后的股静脉穿刺方法在NICU中的临床应用。方法：将108例新生儿随机分为观察组和对照组各54例。观察组采用改良后的股静脉留置针穿刺由两人协作边抽回血边穿刺的方法,对照组采用传统股静脉留置针穿刺方法,对2组不同方法置留置针的成功率进行比较分析。结果：观察组成功率明显高于对照组,具有统计学意义（P〈0.05）。结论：改良后的股静脉留置针穿刺方法比传统股静脉留置针穿刺方法成功率高,安全,并发症少,减少反复穿刺给患儿带来的痛苦,同时也减轻护士的护理工作量,提高了护理质量和家属满意度,值得推广。     

新生儿双侧股静脉交替留置套管针与PICC置管的效果比较

目的：分析新生儿双侧股静脉交替留置针的应用效果,比较新生儿双侧股静脉交替留置针与PICC置管的临床效果.方法：选取69例新生儿作为研究对象,将其按照随机数字表法分为观察组与对照组,观察组选择双侧股静脉交替留置针,对照组选择PICC置管,比较两组之间的置管时间、置管并发症发生率及医疗成本.结果：观察组患儿股静脉留置针留置时间短于对照组PICC的留置时间（P＜0.05）,但观察组置管并发症发生率及所耗费用较对照组低（P＜0.05）.结论：双侧股静脉交替留置针替代PICC置管安全可行,医疗成本低.     

不合作病员留置针置管成功率的探讨

目的探讨不合作患者静脉留置针穿刺置管的方法及留置针的穿刺成功率。方法选择住院患者120例,随机分为观察组与对照组,每组各60例。对照组采用传统静脉留置针操作方法;观察组在此基础上采用左手固定皮肤,右手食指后退针芯至套管内,根据血管情况决定送管长度进行静脉穿刺置管操作。结果观察组穿刺置管成功率97%,对照组为82%。观察组置管成功率显著高于对照组（P〈0.01）。结论单手置管可提高不合作病员静脉留置针的穿刺置管成功率。     

新生儿静脉留置针应用体会

目的 提高新生儿头皮静脉留置针穿刺成功率,减少并发症的发生.方法 将2 000例罹患不同疾病的新生儿随机分为观察组（1 000例）和对照组（1 000例）,对照组在静脉留置针操作中采用常规方法 ,观察组采用改进方法 .结果 观察组静脉留置针穿刺成功率显著高于对照组,留置针堵塞率明显低于对照组（P〈0.01）.结论 改进穿刺和封管方法 ,可提高留置针穿刺成功率,降低并发症发生率,减轻患儿痛苦和护士工作压力.     

探析静脉留置针置管改进技术

目的：探讨静脉留置针置管改进技术对穿刺成功率的影响。方法随机选取该院2013年1月-2014年2月期间行静脉留置针穿刺的患者110例,随机分为两组,各55例,对照组实施常规静脉留置针穿刺,观察组采用改进的静脉留置针穿刺。结果观察组的一次穿刺成功率为98.18%,对照组为87.27%;观察组的并发症发生率为11.11%,对照组为6.25%。结论采用改进的静脉留置针置管穿刺,能有效提高穿刺成功率,值得临床推广应用。     

基于外周中心静脉置管在新生儿输液中的应用研究

目的探讨PICC(外周中心静脉置管)在新生儿输液中的应用效果。方法将2015年3月~2017年11月我院新生儿科接诊的60例患儿纳入本研究,作为观察组。将2013年9月~2015年1月我院新生儿科接诊的60例患儿纳入本研究,作为对照组。对照组予常规外周静脉留置针输液,观察组予PICC输液。观察导管留置时间、穿刺成功率、并发症发生情况。结果观察组导管留置时间为(21.04±6.33)d,对照组为(3.14±1.47)d,观察组导管留置时间高于对照组(t=17.009,P0.05)。观察组穿刺成功率为98.33%(59/60),对照组为91.67%(55/60)。两组穿刺成功率对比,差异无统计学意义(χ~2=2.807,P=0.094,P0.05)。观察组并发症发生率低于对照组(P0.05)。结论PICC在新生儿输液中的应用效果较好,能够延长导管留置时间,降低并发症发生情况。     

静脉留置针在新生儿护理中的应用研究

目的:观察不同部位静脉留置针在新生儿护理中的作用,为临床工作提供参考。方法:选择收治的新生儿128例,随机分为对照组和观察组各64例,对照组患儿采用头皮静脉留置针,观察组采用腋静脉留置针。观察并比较两组患儿一次穿刺成功率、堵塞率和并发症发生率和留置时间的差异。结果:与对照组比较,观察组患儿一次穿刺成功率明显较高,并发症发生率明显降低,留置时间明显较长,差异有统计学意义(P<0.05)。两组患儿留置针堵塞率比较,差异无统计学意义(P>0.05)。结论:在新生儿临床护理工作中,选择腋静脉留置针可明显提高一次穿刺成功率,减少并发症,延长留置时间,有效减轻了患儿痛苦和护理人员的工作压力,值得临床推广应用。     

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.