复方丹参注射液治疗急性高血压性脑出血的临床观察

目的：观察复方丹参注射液治疗急性高血压性脑出血的疗效。方法：60例急性高血压性脑出血随机分为复方丹参组30例，对照组（西药常规治疗）30例。复方丹参治疗组在西药常规治疗基础上加用复方丹参注射液16ml加入5％葡萄糖500ml静滴，1次／d，连续14天，观察28天，评定疗效。结果：复方丹参组总有效率为96．67％，优于对照组73．33％（P＜0．05）；复方丹参组治疗14天CT复查血肿平均吸收率为62．96％，优于对照组44．96％，优于对照组44．96％。结论：复方丹参注射液治疗急性高血压性脑出血有较好疗效，安全，值得临床应用。     

全程护理干预对高血压脑出血患者术后康复效果的影响

目的探讨系统化、个体化全程护理干预对高血压脑出血患者术后康复效果的影响。方法将120例高血压脑出血术后患者随机分为干预组与对照组,对照组给予常规护理;干预组在常规护理的基础上给予系统化、个体化全程护理干预。在术后第12周,对两组病员进行日常生活活动能力评分（ADL）比较;观察并发症的发生情况。结果干预组病人ADL评分比对照组高,差异有统计学意义（P〈0．01）;干预组并发症发生率显著低于对照组（P〈0．05）。结论系统化、个体化全程护理干预能明显提高高血压脑出血患者术后的康复效果。     

护理干预模式在高血压脑出血患者中的应用探究

目的：探讨护理干预模式在高血压脑出血患者中的疗效。方法：选取2013年1月至2014年1月期间来我院就诊的50例高血压脑出血患者随机分为观察组和对照组,各25例。对照组采用常规护理措施;观察组采用综合护理措施,即在常规护理的基础上增加心理护理、并发症预防及出院指导。然后比较两者患者的疗效。结果：观察组的致残率为5例（20．0％）及病死率为2例（8．0％）均低于对照组的致残率10例（40．0％）及病死率5例（20．0％）;观察组患者满意为24例（96．0％）要高于对照组的20例（80．0）。两组比较差异有统计学意义（P＜0．05）。结论：综合护理干预模式的实施能够改善高血压脑出血患者的病情,减少因脑出血而引起的致残情况和病死情况的发生,进而保证了患者的生命质量。     

护理干预对减少鼻咽癌放疗并发症的观察

目的研究护理干预对鼻咽癌放疗后并发症的影响，探讨减少并发症的有效途径。方法60例鼻咽癌放疗后患者，分为干预组及对照组各30例，干预组采取有计划、系统的护理于预措施，对照组按常规护理，观察两组放疗后并发症发生情况。结果干预组并发症发生率骨髓抑制53．3％（16／30）、口腔白膜10．0％（3／30）、Ⅲ级皮肤反应6．7％（2／30），对照组三项指标均为83．3％（25／30），差异有统计学意义（P=0．000）。结论有计划、系统的护理干预可减少鼻咽癌放疗后的并发症。     

颅内血肿微创穿刺清除术加亚低温治疗高血压脑出血的临床研究

目的探讨颅内血肿微创穿刺清除术联合亚低温治疗高血压脑出血的临床疗效。方法将120例高血压脑出血患者根据随机数字表法分为观察组和对照组。对照组在常规对症治疗后行微创颅内血肿清除术,观察组在此基础上加亚低温治疗。比较2组疗效、神经功能缺损情况及生存质量。结果观察组治疗总有效率为83．3％（50／60）,显著高于对照组的48．3％（29／60）,差异具有统计学意义（P〈0．05）。观察组病死率为6．7％,低于对照组的26．7％（P〈0．05）。治疗30d后,观察组神经功能缺损评分明显低于对照组,2组比较差异有统计学意义（P〈0．05）。术后30d、90d后患者的BI指数比较,观察组明显高于对照组,2组比较差异有统计学意义（P〈0．05）。结论微创颅内血肿清除术联合亚低温疗法对高血压脑出血患者的治疗效果明显,并可以显著降低患者的病死率和致残率,有利于患者神经功能恢复和生存质量的提高,具有十分重要的临床应用价值。     

综合护理干预对于高血压脑出血治疗依从性及生活质量的影响

目的：分析综合护理对于高血压脑出血治疗依从性及生活质量的影响。方法：2013年2月－2014年5月在我院住院治疗的高血压脑出血患者68例,随机分为综合护理干预组（34例）和常规护理组（34例）,观察分析综合护理干预组和常规护理组的治疗依从性及生活质量评分。结果：综合护理干预组治疗依从率显著高于常规护理组（p＜0．05）;护理后综合护理干预组的生活质量评分显著高于常规护理组（p＜0．05）。结论：综合护理干预能够显著提高高血压脑出血患者治疗依从性及生活质量。高血压脑出血是一种临床常见的心脑血管疾病,属于临床危重症,严重威胁患者的生命健康。护理是高血压脑出血治疗的重要组成部分,本文旨在观察综合护理对于高血压脑出血治疗依从性及生活质量的影响。     

社区高血压患者实施护理干预的效果评价

目的探讨对社区高血压患者实施护理干预的临床价值。方法将我院所辖社区高血压患者100例随机分为观察组和对照组各50例,对照组进行常规社区治疗,观察组在对照组的护理基础上进行护理干预,包括健康教育、心理护理、服药干预及定期随访。结果实施护理干预6个月～1年,平均（9．67±2．08）月,观察组依从性好占82．00％,血压达标占96．00％,高血压疾病知识知晓占86．00％,自我管理良好占86．00％,均高于对照组的50．00％,74．00％,64．00％和60．00％,差异有统计学意义（P〈0.01）。结论开展社区护理干预,能提高社区高血压患者对原发性高血压相关知识及并发症的认识,治疗效果明显。     

高血压脑出血患者颅内血肿穿刺引流术治疗围术期护理分析

目的：探讨高血压脑出血患者颅内血肿穿刺引流术治疗围术期护理。方法：研究该院2014年2月至2015年12月期间随机抽取的80例高血压脑出血颅内血肿穿刺引流术患者,分为对照组与观察组各40例,其中对照组运用常规护理,观察组运用针对性护理干预,分析两组患者护理效果差异。结果：在治疗有效率上,观察组为75％,显著高于对照组（42.5％,P ＜0.05）;在护理满意度上,观察组为92.5％,显著高于对照组（80％,P ＜0.05）。结论：高血压脑出血患者颅内血肿穿刺引流术治疗围术期护理干预可有效辅助治疗提升治疗疗效,提高患者护理满意度,达到护患和谐关系。     

脑出血伴精神障碍患者的临床护理效果探讨

目的分析临床护理路径在脑出血伴精神障碍患者中的应用价值,提高护理水平。方法：将我院2011年2月至2014年2月收治的60例脑出血伴精神障碍住院患者作为观察对象,根据入院顺序分为观察组和对照组各80例。在相同临床治疗的情况下,观察组采用临床护理路径,对照组行常规护理干预。出院前,比较两组患者护理干预后的住院时间、治疗效果、护理满意度。结果观察组治疗有效率为92．5％,对照组为81．25％,经比较,两组患者治疗效果差异有统计学意义（P＜0．05）;观察组住院时间较对照组短,差异有统计学意义（P＜0．05）;观察组护理满意度较对照组高,差异有统计学意义（P＜0．05）。结论临床护理路径可缩短脑出血伴精神障碍患者住院时间,提高治疗效果和护理满意度,值得借鉴。     

微创颅内血肿清除术治疗高血压脑出血的优质综合护理效果

目的：探讨微创颅内血肿清除术治疗高血压脑出血（ HICH ）的优质综合护理影响效果。方法将98例高血压脑出血后的患者,均经微创颅内血肿清除术治疗后按照数字表法随机分为两组,对照组49例给予神经外科常规护理;观察组49例患者在对照组基础上给予优质综合护理,并比较两组的护理效果。结果观察组的并发症总发生率为10．20％明显的低于对照组的36．73％（P＜0．05）,观察组患者的护理满意度为95．92％显著地高于对照组的77．55％（P＜0．05）。结论微创颅内血肿清除术是一种针钻一体切口小、创伤小、适应证宽的抢救HICH较为理想而有效血肿迅速清除治疗方法。术后的优质综合护理干预显著的降低了患者死亡率、并发症出现率,提高了患者对护理满意度及其生存质量。     

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.