界面理论在骨折患者健康教育应用中的效果评价

目的 探讨应用界面理论指导临床护理工作,转变护理工作模式,对患者健康教育效果的影响。方法 将198例骨折手术患者随机分成实验组和对照组,实验组98例给于界面理论指导下的轴辐面健康教育方法,结合运用健康教育执行表;对照组100例给于横断面健康教育方法,2组患者分别在入院当天、出院前进行问卷调查,比较2组患者健康教育的效果、健康教育的满意度。结果 实验组患者对入院宣教、术前和术后指导、康复锻炼指导、出院复诊等知识掌握方面显著好于对照组（t=3.54、3.53、2.72、4.11、4.18,P〈0.01）,住院宣教方面明显好于对照组（t=2.44,P≤0.05）,健康教育满意度优于对照组（χ2=15.24,P〈0.01）。结论 应用界面理论转变护理模式,拉长了护患接触的纵向长度,有利于护患间信息交流与吸收,明显提高了健康教育的效果和患者的满意度。     

优质护理在爱婴区病房的实施与成效

目的:探讨优质护理在爱婴区病房施行的成效。方法:对1240例住院患者实施优质护理,并在患者出院前调查患者对护理服务的满意程度。结果:患者对住院环境、健康教育、技术水平、护患关系、出院指导满意度为98%。结论:优质护理对提高护理工作价值、患者满意度有着积极作用。     

对200例慢性心力衰竭患者实施出院前健康教育的研究

目的 探讨对慢性心力衰竭患者住院期间实施健康教育的方法,以减少患者的并发症,提高其生活质量.方法 选择200例慢性心力衰竭患者,分为加强组和对照组,两组在接受治疗和护理的同时均使用健康教育处方进行健康教育,而加强组在患者出院前增加出院健康教育处方,加强出院健康指导.结果 加强组患者经双重性健康知识强化后,患者对健康知识的获得,对生活的满意度明显高于对照组.结论 对慢性心力衰竭患者出院前积极实施出院健康教育,可提高其健康知识水平,提高自我保健能力,改善生活质量.     

出院患者满意度调查对护理服务质量的影响

目的 探讨以患者实际需求为导向,提高住院患者满意度.方法 对出院患者实行护理质量满意度问卷调查,对2008年第1季度的住院患者出院时采取问卷调查1次, 将调查结果 进行分析、讨论、改进,并进行比较.结果 找出护理服务与患者需要的差距,采取改变护理服务理念,变革护理行为、狠抓业务培训、强化健康教育一系列有效改进措施,从而使患者的平均满意度由 2008年1月的95%上升到2008年3月的98.5%.结论 通过对患者满意度调查、分析,发挥满意度调查作为护理服务工作的导向作用,为管理者提供决策参考,有效地促进了护理服务质量的改进.     

对冠心病患者实施个性化、系统化健康教育的效果评价

目的:了解个性化、系统化健康教育对冠心病患者的效果,从而强化护士的健康教育意识,提高患者的健康水平,进一步提高患者的生活质量.方法:将502例冠心病患者随机分为试验组和对照组(排除人为因素).对照组采取一般的常规指导,而对试验组则根据患者及家属的具体情况于入院后及出院前反复实施有目的、有计划、系统的健康教育.对两组患者均采用询问或问卷调查的形式于患者入院时及出院前分别进行调查评定,出院后半年内对两组患者再住院率进行比较.结果:两组患者在住院天数、再住院率、对护士的满意度三方面均有显著差异(P＜0.05或P＜0.01).结论:个性化、系统化的健康教育能明显提高患者对护士的满意度,缩短住院天数,降低再住院率;健康教育必须反复个性化、系统化实施.     

临床健康教育路径在经皮腰椎间盘髓核化学溶核术患者中的应用

目的探讨临床护理路径在经皮腰椎间盘髓核化学溶核术患者中的实施效果。方法通过制定临床护理路径,将128例胶原酶手术患者分为观察组和对照组各64例,对照组采用传统健康教育方法,实验组采用临床健康教育路径对患者入院术前、术后、康复、出院前进行系统的健康教育,出院前对每位患者进行健康教育内容的掌握程度,教育达标率、对护士满意度等进行调查并比较。结果观察组患者健康知识达标率,对护士满意度均高于对照组,术后不良反应及并发症发生率低于对照组,住院时间则明显短于对照组。结论实施临床护理路径能克服部分护理人员知识上的缺陷,促进护患沟通,提高工作效率,明显提高护理质量。     

临床护理路径在子宫肌瘤腹腔镜手术患者中的应用

目的评价临床护理路径在子宫肌瘤腹腔镜手术中的应用效果。方法将2010年3月-2011年2月200例子宫肌瘤腹腔镜手术患者为观察组,2009年2月-2010年1月200例子宫肌瘤腹腔镜手术患者为对照组。观察组患者从入院指导、检查、治疗、用药、护理、饮食指导、健康教育到出院按临床护理路径,对照组在治疗、护理、检查项目、住院天数不作统一规定,比较两组患者在住院天数、住院费用、患者对健康教育的掌握程度和对护理工作的满意度。结果观察组的住院天数、住院费用少于对照组,对健康教育的掌握程度和满意度明显高于对照组（P〈0.05）。结论子宫肌瘤腹腔镜手术使用临床护理路径对护理人员和患者都有利,能提高患者满意度,缩短住院天数,减少住院费用。     

临床护理路径在肝硬化住院患者健康教育中的应用

目的:评价临床护理路径应用于肝硬化住院患者健康教育中的效果。方法:将114例住院肝硬化患者随机分为观察组和对照组各57例。对照组接受常规健康教育方法,观察组采用自制的肝硬化临床护理路径表实施健康教育。于出院时比较2组患者肝硬化相关健康教育知识达标率、患者满意度;出院2周电话回访比较2组患者健康行为执行程度。结果:观察组健康教育知识达标率92.98%高于对照组的61.40%(P0.01);观察组患者总满意度98.25%高于对照组的87.72%(P0.01);观察组健康行为执行率78.95%高于对照组的57.89%(P0.05)。结论:应用临床护理路径对肝硬化患者实施系统的健康教育,能有效提升患者对疾病的认知程度,改善患者的健康行为,提高患者对护士工作的满意度。     

神经内科住院患者对护理工作满意度现状及影响因素

目的:对神经内科住院患者对护理工作满意度的现状进行探讨,并分析对其护理工作满意度现状产生影响的主要因素。方法:选择420例神经内科住院患者为临床研究对象,对患者给予问卷调查的方式,对其对护理工作满意度进行调查统计,并分析影响护理工作满意度的影响因素。结果:神经内科护理工作满意度排名前三项为护士服务态度、护理操作技术、有固定护士;排名后三项为病房环境卫生管理和安静、出院指导、生活照顾;影响因素主要包括被调查人性别、年龄、文化层次、回答人身份、治疗效果等因素。结论:通过神经内科护士落实责任制护理、生活护理、出院患者的健康教育等方式,能够进一步提高患者对护理工作的满意度。     

个体化健康教育在急性白血病护理中的应用

目的:探讨个体化健康教育对住院急性白血病患者的治疗效果的影响.方法:将78例急性淋巴细胞白血病患者随机分为观察组40例,对照组38例. 从入院到出院过程中, 观察组针对急性淋巴细胞白血病特点给予个体化健康教育干预,对照组给予常规健康教育和护理指导.两组进行健康知识评估、心理测评、护理质量满意度调查,比较两组化疗后感染发生率.结果:观察组化疗后感染发生率降低(P＜0.05),出院时健康教育知识评估明显优于对照组(P＜0.005),护理质量满意度明显高于对照组(P＜0.05),心理焦虑值明显下降(P＜0.001).结论:个体化健康教育对住院急性白血病患者健康状况有良好的促进作用,可减少化疗后感染的发生,是提高患者满意度之有效的方法.     

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.