延续护理对直肠癌造口患者心理状态及自我护理能力的影响

目的：评价延续护理对直肠癌造口患者心理状态及自我护理能力的影响。方法观察组56例Miles术患者,对照组30例Miles术患者,分别给予延续护理和常规护理,出院3个月对比两组患者抑郁、焦虑、自我护理能力、生活质量及并发症发生率。结果出院后3个月观察组的SDS评分和抑郁程度均显著低于对照组（P＜0.05）,观察组的SAS评分显著低于对照组（P＜0.05）,中度及轻度抑郁率均显著低于对照组（P＜0.05）,观察组的ESCA量表总分、技能、责任感、自我概念及健康知识评分均显著高于对照组（P＜0.05）,观察组的SF-36量表生理职能、社会功能、情感功能、精神健康、精力、整体健康评分均显著高于对照组（P＜0.05）,观察组的造口并发症发生率显著低于对照组（P＜0.05）。结论延续护理有效改善直肠癌造口患者的心理状态,提高其造口自我护理能力,从而改善生活质量,降低造口并发症发生率。     

自我效能模式对肠造口患者自我管理能力的影响

目的 探讨自我效能模式在提升肠造口患者自我管理能力中的应用效果。方法 选择2019 年1 月至2020年6 月于湖州市中心医院行手术治疗的肠造口患者120 例,根据对数表法将其分为两组,干预组和对照组各60 例。对照组患者给予常规护理,干预组在常规护理的基础上应用自我效能模式。比较两组患者自我管理能力、自我效能水平[造口自我效能量表（SSES）]、心理状态[焦虑、抑郁自评量表（SAS、SDS）]及生活质量（EORTCQLQC30）。结果 干预前,两组患者自我管理能力、自我效能水平心理状态及生活质量评分比较,差异无统计学意义（P＞0.05）;干预后,干预组患者我自我管理能力评分及自我效能水平评分显著高于对照组,差异有统计学意义（P＜0.05）;干预后,干预组患者焦虑、抑郁症状评分显著低于对照组,差异有统计学意义（P＜0.05）;干预后,干预组患者生活质量评分显著高于对照组,差异有统计学意义（P＜0.05）。结论 自我效能模式可有效提升肠造口患者的自我效能水平、自我管理能力及生活质量,同时可以缓解患者焦虑、抑郁症状,值得临床推广。     

协同护理对结肠造口患者自我护理能力和造口皮肤的影响

目的：研究协同护理模式对结肠造口患者自我护理能力和造口皮肤的影响。方法96例低位直肠癌行Miles手术患者随机分为干预组和对照组,每组各48例,对照组实施常规护理,干预组在对照组基础上开展协同护理,分别在不同时点采用一般情况调查表、自我护理能力实施量表（ ESCA）、造口自我护理能力量表和造口皮肤评估工具（ DET评分）,所得数据行统计学处理。结果干预组术后1周和出院后1月ESCA评分明显高于对照组（ P＜0．05）,术后1周和出院后1月干预组自我护理能力量表总分、自我护理知识以及自我护理技能评分均明显高于对照组（ P＜0．05）,而自我意愿评分两组比较差异不明显（ P＞0．05）,出院后1月干预组DET总分、变色以及侵蚀评分均明显低于对照组（ P＜0．05）,而组织增生评分两组比较差异不明显（ P＞0．05）。结论应用协同护理模式对结肠造口患者进行干预,可有效提高患者自我护理能力,改善造口周围皮肤状况。     

Snyder希望理论联合网络平台延续心理干预在肠造口患者中的应用效果

目的 探讨Snyder希望理论联合网络平台延续心理干预在肠造口患者中的应用效果。方法 选取2021年9月至2022年9月驻马店市中心医院收治的114例肠造口患者,按随机数字表法分为对照组和研究组,各57例。对照组患者接受常规护理干预,研究组患者接受Snyder希望理论联合网络平台延续心理干预。对比两组干预前后自护能力、心理状态、自我感受负担及希望水平等评分,比较两组不良反应发生率。结果 两组患者干预前自护能力、希望水平、生活质量等评分差异无统计学意义(P>0.05),经4个月干预后,两组患者自护能力、希望水平、生活质量等评分均升高,研究组高于对照组(P<0.05)。两组患者干预前焦虑、抑郁、自我感受负担等评分差异无统计学意义(P>0.05),经4个月干预后,两组患者焦虑、抑郁、自我感受负担等评分均降低,研究组低于对照组(P<0.05)。研究组并发症总发生率(17.54%)低于对照组(38.60%)(P<0.05)。结论 Snyder希望理论联合网络平台延续心理干预可改善患者心理状态,减轻自我感受负担,提高希望水平、自护能力,降低并发症发生率,改善生活质量。     

永久性肠造口患者的心理护理

目的:探讨永久性肠造口患者常见的心理问题以及心理护理方法,为永久性肠造口患者的护理提供参考。方法:回顾性总结分析我院在2010年1月至2012年12月期间收治的60例永久性肠造口患者临床病例资料,按照不同入院时期将患者分为观察组和对照组,对照组患者进行常规护理,观察组患者在常规护理的基础上进行心理护理干预,总结两组患者的心理状态以及治疗效果。结果:两组患者护理前焦虑和抑郁评分差异无统计学意义(P0.05);两组患者护理前后焦虑和抑郁评分相比,差异具有统计学意义(P0.05);心理护理干预1个月后,观察组患者焦虑和抑郁评分低于对照组,差异具有统计学意义(P0.05)。结论:在常规护理的基础上进行心理护理干预能够有效缓解患者的焦虑、抑郁等不良负面情绪,能够有效改善患者治疗后生活质量,提高治疗效果。     

延续护理对直肠癌术后永久性结肠造口患者自我护理能力及生活质量的影响

目的：探讨延续护理在改善直肠癌术后永久性结肠造口患者自我护理能力和生活质量中的效果。方法：选择直肠癌术后永久性结肠造口患者81例,随机分为观察组40例和对照组41例,对照组实施传统护理,观察组实施延续护理,入组时和半年后采用自我护理能力测定量表（ ESCA）及中文版健康调查简表（ SF－36）进行评价。结果：入组时,两组患者ESCA、SF－36各维度评分相似,差异无统计学意义（ P＞0．05）;半年后,两组患者ESCA、SF－36各维度评分高于本组入组时,但观察组较对照组改善幅度更大,差异有统计学意义（ P＜0．05）。结论：延续护理有利于改善直肠癌术后永久性结肠造口患者的生活质量,提高自我护理能力,值得临床推广应用。     

家属参与的综合护理对肠造口患者生活质量的影响

目的 探讨家属参与下的综合护理对肠造口患者生活质量的影响.方法 收集永久性肠造口患者128例,按随机化原则把患者分成试验组和对照组两组,对照组按胃肠外科的综合护理进行,包括术前、术后的健康教育和心理护理,以及出院后的院外持续护理.试验组在综合护理的基础上强调对家属的健康教育和心理干预.观察两组出院后1个月、3个月的复诊情况、并发症发生情况,以及两组患者的生活质量得分.结果 出院后3个月,试验组的复诊依从性高于对照组（P＜0.05）.出院后1个月、3个月,对照组并发症总数高于试验组（P＜0.05）,对照组中造口周围皮肤炎症高于试验组（P＜0.05）,试验组主要是和造口术后护理相关的并发症发生较少.出院后1个月、3个月,试验组生活质量总分及各维度得分均高于对照组（P＜0.05）,表明试验组患者在生理、心理、社会医患关系、婚姻关系和性关系上均比对照组好,各方面更健康.结论 对家属的健康教育和护理干预能有效提高肠造口患者的生理、心理上的康复,促进其参加社会活动,提高患者的生活质量.     

护理干预对根治性膀胱全切输尿管皮肤造口患者生活质量的影响

目的:探讨术后造口护理干预对根治膀胱全切输尿管皮肤造口患者生活质量的影响。方法:选取2012年6月至2013年5月我院收治的膀胱全切输尿管皮肤造口患者病人60例进行分析,按照护理方法分成观察组和对照组两组,每组30例,观察组在常规治疗基础上进行术后造口护理干预,对照组仅采用常规治疗,观察两组疼痛评分和治疗满意度。结果:观察组在治疗后的疼痛评分较干预前明显降低(P0.05),且观察组降低水平明显优于对照组(P0.05);观察组护理满意度明显高于对照组(P0.05)。结论:对膀胱全切输尿管皮肤造口病人采取术后造口护理干预,能够有效缓解患者的疼痛,提高患者对护理的满意度,效果显著,值得临床推广。     

延续护理在预防性末端回肠造口中的应用研究

目的:探讨出更好的提高末端回肠造口患者自我护理能力和生活质量的护理方法。方法:选择2014年6月-2016年9月在笔者所在医院行预防性末端回肠造口患者40例,按照随机数字表法分为观察组(延续护理组)和对照组(常规护理组)。观察组在围手术期常规护理基础上进行为期3个月的以电话访问、家庭访视等形式行延续护理干预,对照组行围手术期常规护理。观察并评价两组患者的自我护理能力、生活质量、造口并发症。结果:观察组自我护理能力和生活质量优于对照组(P0.05)。结论:延续护理应用于预防性末端回肠造口患者,可提高自我护理能力和生活质量。     

护理干预对脑出血非手术患者心理状态、并发症以及满意度的影响

［摘要］目的　评价护理干预对脑出血非手术患者心理状态、并发症以及满意度的影响．方法　选择攀枝花市第三人民医院2013年1月至2015年6月收治的脑出血非手术患者184例,随机分为观察组和对照组,每组92例,对照组采用常规内科护理措施,观察组在对照组的基础上实施护理干预措施．1个月后,采用焦虑自评量表（SAS）和抑郁自评量表（SDS）评价2组护理前后心理状态,比较2组并发症发生率以及满意度;采用生活活动能力评定（FIM）量表以及生活质量指数（QLI）评定2组护理前后生活自理能力以及生活质量．结果　与对照组比较,观察组干预后SAS以及SDS评分显著改善（P＜0.05）;观察组并发症发生率明显低于对照组,满意度明显高于对照组（P＜0.05）;干预后,观察组FIM以及QLI评分显著优于对照组（P＜0.05）．结论　护理干预应用于脑出血非手术患者可以明显地改善患者的心理状态和生活质量,减少并发症发生率,提高满意度,值得广泛推广.     

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.     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.