对人工流产的患者实施计划生育服务指导教育的临床效果分析

目的 探讨分析对进行人工流产手术的患者实施计划生育服务指导教育的临床效果。 方法 选取2014年1月-2016年10月行人工流产手术的110例患者作为研究对象,按照随机数字法分为对照组和观察组,对照组进行常规的术后健康指导,观察组在此基础上进行计划生育服务的指导教育。比较2组患者在来院复查时避孕节育知识掌握情况及主动避孕率,随访1年后患者术后意外妊娠的发生率及再次进行人工流产手术的比率。 结果 患者手术前,观察组与对照组在避孕节育知识掌握情况、主动避孕率差异无统计学意义。实施计划生育技术服务指导教育后,来院复查时观察组避孕节育知识掌握的平均得分为9.12±1.06,远高于对照组的6.03±2.15;观察组的主动避孕率为94.5%,对照组为76.4%;随访1年后观察组术后意外妊娠的发生率及再次进行人工流产手术的比率分别为2.1%、0.0%,远低于对照组的16.0%、12.0%。2组间比较差异均具有统计学意义。 结论 临床上对于人工流产的患者实施计划生育技术服务的指导教育效果显著,不仅普及了患者的避孕节育知识,提供了患者正确的主动避孕方法,还能降低术后意外妊娠的发生率和再次进行人工流产手术的比率,大大提高了患者的生殖健康水平,值得临床推广应用。      

改进流产后服务模式效果研究

目的针对人工流产后服务模式进行对比研究,探讨改进流产后服务(post abortion care,PAC)效果。方法选取在门诊行人工流产术的妇女共200例,将其随机分为对照组及干预组,其中干预组采用改进服务模式,对照组采用常规服务模式。分析研究对象的一般资料及避孕相关情况,并对比两组服务模式的效果。结果干预组人工流产并发症发生率及再次意外妊娠率或人流率低于对照组,而对避孕措施的正确掌握情况则明显高于对照组,差异有统计学意义(P<0.05),且干预组的妇女对于改进PAC模式更满意,差异有统计学意义(P<0.05)。结论 PAC模式更能提升妇女对避孕相关知识的知晓程度。通过咨询服务指导群众科学避孕,从而远离人工流产,保护女性生殖健康。     

流产后健康教育对重复流产的控制及避孕依从性的影响

目的探讨人工流产后开展健康教育在降低重复流产及提高避孕依从性中的作用。方法选择行人工流产术者234例,随机分为观察组和对照组,每组117例。对照组接受人工流产术后常规健康教育及自行阅读《流产后生殖健康宣传手册》;观察组在此基础上进行开展咨询与健康教育服务。术后1个月、3个月、6个月、1年了解两组妇女生殖健康知识认知情况、避孕依从性及意外妊娠情况。结果观察组妇女对生殖健康知识认知程度,避孕依从性及意外妊娠率明显优于对照组(P<0.05)。结论开展人工流产后健康教育与咨询服务能满足患者的保健需要,对降低重复流产率是有效的。     

人工流产后计划生育服务干预临床效果观察

目的:探讨人工流产后计划生育服务干预临床效果观察。方法:将2015年7月-2016年7月在我院计划生育科行人工流产的260例患者随机分为两组,对照组未行计划生育服务,观察组采用计划生育服务,比较两组患者的避孕节育知识知晓情况、避孕措施实施情况以及非意愿妊娠情况。结果:观察组避孕节育知识得分明显高于对照组,差异有统计学意义(P0.05);观察组主动避孕率明显高于对照组,差异有统计学意义(P0.05);观察组非意愿妊娠率明显低于对照组,差异有统计学意义(P0.05)。结论:人工流产后实施计划生育服务干预能够显著提高患者的避孕节育知识水平,减少意外妊娠及人工流产,保护妇女生殖健康。     

健康教育人流术后健康宣教对患者避孕知晓率、计划外妊娠重复流产的影响分析

目的探究人流术后健康宣教对患者避孕知晓率、计划外妊娠重复流产的影响。方法随机抽取我院于2018年1月-12月3期间收治的人流患者386例,386例患者分组方法为抽签法,平均分为观察组193例以及对照组193例,护理模式分别为健康宣教以及基础护理,对比两组患者避孕知晓率、计划外妊娠重复流产情况。结果①观察组患者经过健康宣教后避孕知识知晓率为94.82%,对照组患者经过健康宣教后避孕知识知晓率为87.04%,组间数据通过对比P0.05;②观察组患者再次意外妊娠率(7.77%)低于对照组患者再次意外妊娠率(15.54%),两组数据经对比P0.05。结论人流患者经过健康宣教后可提升避孕知晓率,可将计划外妊娠重复流产率降低。     

关爱服务对人流术后再次流产率的影响

目的:探讨在人工流产术后实施关爱服务,对其再次流产率的控制效果.方法:选取该院人工流产术妇女64例,随机分为两组,对照组32例行人流术后常规指导,观察组32例行人流术后关爱服务,观察两组干预前后相关知识掌握情况以及避孕依从性、再次妊娠情况.结果:干预后观察组妇女相关知识测评结果显著高于对照组(P＜0.05);对照组避孕依从率为65.63％,主动依从率为31.25％;观察组避孕依从率为93.75％,主动依从率为65.63％,(P＜0.05);对照组再次妊娠率为25.00％,再次人流率为18.75％;观察组再次妊娠率为6.25％,再次人流率为6.25％,(P＜0.05).结论:通过关爱服务的实施,可有效提高人流术后妇女相关知识掌握程度,提升避孕依从性率,从而实现对再次妊娠、流产的控制.     

护理干预对降低人工流产患者术后意外妊娠率的效果观察

目的 分析护理干预对于人工流产患者术后意外妊娠率的影响效果.方法 选取2010年5月～2013年5月在广东省深圳市人民医院进行人工流产手术的患者4000例,分为实验组(n=2000)和对照组(n=2000),分别使用护理干预与普通护理,观察两组的意外妊娠发生率、避孕知识和生殖健康知识掌握程度.结果 实验组的术后意外妊娠发生率为10.35％,明显低于对照组的患者(36.45％),实验组的避孕套、避孕药、安全期避孕、紧急避孕药、宫内节育器、绝育术、阴道环、皮下埋植、女用避孕套和避孕药膜的知晓率分别为91.25％、90.60％、53.20％、47.95％、42.15％、24.70％、22.60％、15.45％、8.80％和7.65％,高于对照组患者(分别为84.05％、81.15％、37.35％、34.40％、31.95％、16.85％、15.95％、9.55％、5.30％、3.20％);实验组中经期知识、避孕及人工流产知识、生殖健康知识整体水平、性传播疾病知识和获得性免疫缺乏综合症(AIDS)知识得分分别为(21.29±4.89)、(25.62±6.19)、(98.79±12.15)、(11.63±2.43)分和(42.46±5.49)分,高于对照组,分别为(12.16±5.82)、(15.83±7.36)、(62.35±18.36)、(7.45±3.16)分和(26.39±8.69)分(P＜0.05).结论 护理干预能够有效地降低人工流产患者术后意外妊娠率,提高妇女的生殖健康.     

避孕知识健康教育对人工流产后妇女避孕行为的影响分析

目的 研究避孕知识健康教育对人工流产后妇女避孕行为的影响.方法 选择2015年2月~2015年12月江西省妇幼保健院收治的536例意外妊娠行人工流产患者进行研究.按照随机数表法,随机分为对照组和观察组,各268例.对照组给予常规人工流产术后教育,观察组在对照组的基础上给予避孕知识健康教育.结果 观察组患者人工流产后避孕措施正确使用率(87.69%)明显高于流产前(29.85%),差异有统计学意义(P<0.05);对照组患者人工流产后避孕措施正确使用率(64.93%)与流产前(29.85%)相比有所提高,差异有统计学意义(P<0.05);但人工流产后观察组患者避孕措施正确使用率(87.69%)明显高于对照组(64.93%),差异有统计学意义(P<0.05);人工流产前观察组和对照组患者避孕措施正确使用率都比较低,分别为29.85%和27.24%,差异无统计学意义.结论 避孕知识健康教育对人工流产后妇女避孕行为的影响显著,能有效提高避孕率,能有效减少再次意外妊娠情况和保护女性健康,值得广泛推广.     

人工流产后计划生育服务对避孕措施的影响

目的：分析人工流产后计划生育服务对避孕措施的影响。方法：选取2013年4月至2016年7月在该院进行人工流产术的患者172例作为观察目标，按照术后是否接受计划生育服务分为对照组（n＝86，未接受计划生育服务）和研究组（n＝86，接受计划生育服务），比较2组患者对避孕知识的知晓情况和避孕效果。结果：研究意外怀孕率和重复人工流产率显著低于对照组，其对避孕节育知识知晓率显著高于对照组（P＜0.05）。结论：人工流产后计划生育服务有利于提高患者对避孕节育知识的认知能力，降低意外妊娠发生率和重复人工流产情况，具有积极的临床使用和推广价值。     

流产后关爱对高危人工流产患者术后避孕方式选择的影响

目的：探讨流产后关爱对高危人工流产患者术后避孕方式选择的影响。方法：选取2021年1-10月赣州市妇幼保健院计划生育科收治的486例高危流产患者,按照随机数字法分成对照组242例,试验组244例。对照组给予常规的人工流产,试验组在对照组的基础上,流产后给予关爱服务。比较两组患者流产后6个月内通过口服短效避孕药、宫内节育器两种高效可逆避孕方式的使用情况、流产后6个月内的重复流产率及对生殖健康知识的掌握率。结果：试验组流产后6个月内选择口服短效避孕药、宫内节育器两种高效可逆避孕方式进行避孕占比高于对照组,6个月内的重复流产率低于对照组,试验组对生殖健康知识的总掌握率高于对照组,差异均有统计学意义（P<0.05）。结论：对流产后的患者实施关爱护理,可以提高高危人工流产患者的避孕意识和对生殖健康知识的掌握率,使其能够坚持使用高效避孕措施进行避孕,降低6个月内再次意外怀孕率,保障高危人工流产患者的生殖健康。     

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.     

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.     

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.