健康教育对胆囊切除患者的心理影响

目的 探讨健康教育对胆囊切除病人的心理影响.方法 将80例胆囊切除病人随机分为干预组(接受健康教育),对照组(接受一般心理护理),两组均接受常规的手术治疗,并测定术前焦虑、心率收缩压及与术后恢复有关的各项指标.结果 健康教育之前,两组患者焦虑评分(SAS),抑郁评分(SDS)心率,收缩压的差别均无统计学意义(P＞0.05),健康教育后,干预组患者术前1d和术后3d的焦虑值,抑郁值,心率以及术前1d的收缩压均明显低于对照组(P＜0.05).结论 健康教育可降低胆囊切除患者的焦虑和抑郁情绪,促进胆囊切除患者顺利康复.     

子宫肌瘤不同术式对卵巢功能影响的临床研究

目的 探讨手术治疗子宫肌瘤不同术式对卵巢功能的影响.方法 回顾性分析83例手术治疗的子宫肌瘤患者.按术式分为子宫肌瘤剔除术组(D组)、子宫切除+保留附件组(E组)、全子宫切除术+双侧附件切除术组(F组),比较三组手术前后围绝经期综合征发生率的差异,以及术后 E2、FSH的变化.结果 三组术前围绝经期综合征症状发生率差异无统计学意义(P＞0.05),术后F组发生率(24.8%)显著高于D、E两组(8.7%,12.9%)( P＜0.05),E组发生率高于D组(P＜0.05).D组E2、FSH术前与术后比较差异均无统计学意义(P＞0.05),E、F两组术后2周E2下降,FSH升高,与术前相比差异均有统计学意义(P＜0.05);术后6个月E2、FSH与术前相比差异均无统计学意义 (P＞0.05).结论 卵巢和子宫对妇女的内分泌十分重要,子宫肌瘤患者行子宫和卵巢切除应慎重考虑.     

疼痛护理干预路径对宫颈癌患者围手术期疼痛及负性情绪影响

目的对宫颈癌患者围手术期采用疼痛护理干预路径护理,观察患者围手术期疼痛及负性情绪改善情况。方法选取2016年3月~2017年8月入院后确诊为宫颈癌患者133例;采取双盲法,根据患者确诊后病床单双号分为对照组66例与观察组67例;对照组予常规围手术期护理措施,观察组在对照组基础上加行疼痛护理干预路径;比较两组患者术前1 d与术后5 d、10 d NRS疼痛评分、简明疼痛评估量表评分,两组患者术前1 d与术后10 d焦虑自评量表评分(SAS)、抑郁自评量表评分(SDS),两组患者围手术期护理依从性评分。结果两组患者术前NRS、简明疼痛评估量表评分均无统计学差异(P0.05),术后5 d评分均存在统计学意义,且观察组优于对照组(P0.05),术后10 d简明疼痛评估量表评分存在统计学意义,观察组优于对照组(P0.05);两组患者术前SAS、SDS评分无统计学差异(P0.05),术后5 d、10 d评分存在统计学意义,观察组优于对照组(P0.05);术后10 d调查发现围手术期观察组护理依从性明显优于对照组,差异均有统计学意义(P0.05)。结论对宫颈癌患者围手术期采用疼痛护理干预路径能够有效降低患者负性情绪,提升患者护理依从性,且能够有效减轻患者围手术期疼痛程度,值得临床应用与推广。     

全面护理对宫腔镜、腹腔镜联合治疗不孕症围术期的影响

目的探讨宫腔镜、腹腔镜联合手术治疗不孕症的护理效果。方法选择2014年1月~2016年4月我院收治的75例不孕症患者,根据护理方式的差异分为常规组和全面组。两组患者均采用宫腔镜、腹腔镜联合手术治疗,常规组辅以常规护理,全面组辅以围术期全面护理。比较两组患者对宫腔镜、腹腔镜联合手术护理的满意度;护理前后焦虑情绪、抑郁情绪;宫腔镜、腹腔镜联合手术并发症发生率。结果全面组患者对宫腔镜、腹腔镜联合手术护理的满意度显著高于常规组(P0.05);干预前两组焦虑情绪、抑郁情绪差异无统计学意义(P0.05);干预后全面组较常规组焦虑情绪、抑郁情绪改善更显著(P0.05);全面组宫腔镜、腹腔镜联合手术并发症发生率显著低于常规组(P0.05)。结论宫腔镜、腹腔镜联合手术治疗不孕症患者辅以围术期全面护理效果确切,可有效减少手术并发症的发生,缓解患者不良情绪,提升患者满意度,值得推广。     

专科化术前访视在手术室优质护理服务中的 应用效果

目的 研究专科化术前访视在手术室优质护理服务中的应用效果.方法 选择手术室患者88例,将其随机分两组,各44例.常规访视组实施手术室常规护理方法,专科化访视组在手术室优质护理服务中给予专科化术前访视.比较两组患者手术室护理服务满意度;手术知识认知度、手术配合度、术后康复训练依从性;入院时和手术前5分钟患者焦虑情绪、抑郁情绪的差异;并发症发生率.结果 专科化访视组患者手术室护理服务满意度高于常规访视组(P<0.05);专科化访视组手术知识认知度、手术配合度、术后康复训练依从性高于常规访视组(P<0.05);入院时两组焦虑情绪、抑郁情绪比较差异无统计学意义;手术前5分钟专科化访视组焦虑情绪、抑郁情绪改善幅度更大(P<0.05).专科化访视组患者并发症发生率显著低于常规访视组(P<0.05).结论 专科化术前访视在手术室优质护理服务中的应用效果确切,可有效减轻患者术前焦虑抑郁情绪,提高其手术认知和配合度,并提升术后康复训练的依从性,减少术后并发症的发生,有利于提升患者对护理服务的满意度,值得推广应用.     

术前情绪状态对患者术后睡眠状况的影响研究

目的研究腹式全子宫切除手术患者的术前情绪状态对术后睡眠状况的影响。方法选取行腹式全子宫切除手术的患者80例,根据术前焦虑自评量表的结果将患者分为情绪正常组（N组）和情绪焦虑组（A组）。在术后第7d,使用匹兹堡睡眠质量指数（PSQI）量表对患者进行睡眠状况调查。结果 46.25%的患者术前存在焦虑情绪。与情绪正常组相比,情绪焦虑组患者的睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、催眠药物、日间功能障碍和PSQI总分均显著升高,差异有统计学意义（P〈0.05）。结论接受子宫切除手术的患者常出现焦虑情绪,而术前的紧张情绪可影响患者的术后睡眠。     

成年重度烧伤患者康复期焦虑抑郁情绪分析

目的:调查分析成年重度烧伤患者康复期焦虑和抑郁情绪发生情况。方法:研究组为住院治疗或门诊复查的烧伤康复期成年患者42例,对照组为患者的健康配偶或成年兄弟姐妹42例。采用焦虑自测量表(SAS)及抑郁自测量表(SDS)比较两组焦虑和抑郁评分情况,并比较两组焦虑症状和抑郁症状发生率。结果:研究组的SAS及SDS评分显著高于对照组,差异有统计学意义(P<0.05),研究组焦虑症状的发生率为95.2%,高与对照组的16.7%,抑郁症状的发生率分别为59.5%和2.4%,差异均有统计学意义(P<0.05)。结论:成年重度烧伤患者康复期存在明显的焦虑和抑郁情绪,应采取综合康复治疗措施。     

聚焦解决模式改善围手术期乳腺癌患者焦虑抑郁症状效果观察

目的：：应用聚焦解决模式对围手术期乳腺癌患者进行干预,评估聚焦解决模式对围手术期乳腺癌患者焦虑、抑郁情绪的效果。方法：选取在我院住院治疗的乳腺癌围手术期伴有焦虑、抑郁情绪的患者60例,随机分为对照组和实验组,每组30例。对照组患者接受围术期乳腺癌患者的常规护理,实验组患者在常规护理的基础上接受聚焦解决模式干预。所有被试者均在术前1d及术后12d,应用焦虑及抑郁评价量表进行测试,对比分析两组患者焦虑抑郁情绪的变化。结果：干预后两组患者焦虑抑郁评分比较,差异有统计学意义(P＜0.05)。结论：聚焦解决模式可明显改善围手术期乳腺癌患者的焦虑、抑郁情况。     

整合式心理护理联合精细化饮食干预对食管癌术后患者营养状态及心理状态的影响

目的 探讨整合式心理护理联合精细化饮食干预对食管癌术后患者营养状态及心理状态的影响。方法 简单随机选取2022年4月—2023年4月福建省立医院接受根治性手术治疗的90例原发性食管癌患者作为研究对象,以随机数表法分为两组,各45例。对照组患者接受围术期常规护理,观察组患者在常规护理基础上加入整合式心理护理联合精细化饮食干预。对比两组患者的营养状态、心理状态及希望水平。结果术后24 h,两组患者的前白蛋白、白蛋白、转铁蛋白水平比较,差异无统计学意义（P均>0.05）;两组患者的症状自评量表中恐怖症状、抑郁情绪、敌对态度、焦虑情绪等评分比较,差异无统计学意义（P均>0.05）;两组患者的Herth希望量表中积极行为、保持与他人密切关系、目前与未来态度等维度评分比较,差异无统计学意义（P均>0.05）。出院当日,观察组患者的前白蛋白、白蛋白、转铁蛋白水平高于对照组,差异有统计学意义（P均<0.05）;观察组症状自评量表中恐怖症状、抑郁情绪、敌对态度、焦虑情绪等评分低于对照组,差异有统计学意义（P均<0.05）;观察组Herth希望量表中积极行为（14.05±1....     

心理护理对逆行胰胆管造影患者围手术期心理障碍的干预效果

目的:探讨内镜下逆行胰胆管造影(ERCP)患者围手术期精神心理特征,评价心理护理对ERCP患者围手术期心理障碍的干预作用,为制定ERCP患者围手术期心理护理方案提供科学依据.方法:将58例ERCP患者随机分为干预组30例和对照组28例,另选取24名健康者作为健康对照(健康组).干预组和对照组分别于术前及术后采用综合医院焦虑/抑郁情绪测定量表(HAD)、匹兹堡睡眠质量指数(PSQI)量表进行测评,并比较2组术后卧床时间和住院时间.健康组仅作心理状况评估.结果:ERCP组患者术前抑郁和焦虑评分均高于健康组(P<0.01和P<0.05);术前PSQI评分中,除催眠药物和日间功能障碍评分差异均无统计学意义外,其他各项评分均高于健康组(P<0.05~P<0.01).干预组与对照组术前HAD和PSQI评分差异均无统计学意义(P>0.05).术后,干预组焦虑及抑郁评分均低于对照组(P<0.05和P<0.01);PSQI评分除催眠药物、日间功能障碍因子评分与对照组差异均无统计学意义(P>0.05)外,其余各项评分差异均有统计学意义(P<0.05~ P<0.01).干预组术后卧床时间和住院时间均短于对照组(P<0.05).结论:行ERCP患者围手术期表现出焦虑、抑郁和睡眠障碍,心理护理可改善ERCP患者的心理障碍,并缩短卧床时间及住院时间.     

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.