褥疮护理进展

目的：探讨褥疮护理的进展。方法：通过褥疮护理认识其发病机制、诱因、易感人群及病理变化。结果：提高褥疮护理水平。结论：解决褥疮预防、治疗和临床护理。     

青黛散／生肌散联合外敷治疗老年压疮的护理体会

目的：探讨老年褥疮患者的临床处理，以提高临床褥疮治疗的效果。方法：将42例老年褥疮患者随机分为两组，实验组采用中药配合常规护理治疗，对照组仅常规护理治疗，比较两组治疗过程中褥疮面积变化、疼痛变化及褥疮治愈率。结果：与对照组相比，治疗1周实验组褥疮好转率明显提高，差异有统计学意义（P=0．036）；治疗2周，实验组褥疮面积明显缩小（P=0．043）；实验组褥疮总愈合时间较短，差异有统计学意义（P=0．038）。结论：青黛影生肌散联合常规护理有利于患者褥疮的愈合，是老年褥疮有效的辅助治疗手段。     

褥疮护理与治疗的新发现

目的：褥疮护理的新发现。方法：通过对46例卧床患者褥疮炎性浸润期及浅度溃疡期和3例坏死溃疡期褥疮患者采用碘伏-百多邦外用,持续加湿加温的氧气等治疗护理方法。结果：46例患者很快就痊愈了,对于3例坏死溃疡期患者褥疮也有了好转。结论：使用此方法对褥疮的治愈是行之有效的。     

褥疮的预防与护理

目的：通过了解褥疮发生的原因，易发人群，总结褥疮的防治方法，减少褥疮发生率，减轻患者痛苦。方法：阅读大量相关资料，联系临床实践，吸取经验。结果：褥疮的发生与患者年龄、营养状况及所患疾病，局部皮肤清洁及创口处理，医疗环境舒适程度，护理质量有极大关系。结论：褥疮的护理应以预防为主，治疗为辅，未病先防。     

臀大肌肌皮瓣修复骶尾部褥疮

目的：探讨用外科手术治疗骶尾部顽固褥疮的方法。方法：应用上半臀大肌肌皮瓣修复骶部褥疮缺损，应用下半臀大肌肌皮瓣修复尾部、坐骨部褥疮缺损。结果：12例12处褥疮用臀大肌肌皮瓣转移修复。肌皮瓣全部成活，随诊6月～2年，褥疮愈合良好，无复发。结论：臀大肌肌皮瓣由于有较可靠的血运和抗感染能力，可用来手术修复骶尾部褥疮缺损。     

ZT医用粘涂胶对褥疮的疗效

目的：探讨ZT医用粘涂胶（ZT胶）治疗褥疮的效果。方法：我院56例褥疮病人，按褥疮程度分为2组，分别行ZT胶治疗和传统方法治疗，对其疗效进行比较。结果：行ZT胶治疗的病例较传统方法治疗的病例，褥疮愈合良好，愈合时间缩短。结论：ZT胶用于褥疮治疗能加速褥疮面愈合，同时无需每日换药，值得临床推广。     

自制褥疮治疗液临床效果评价

目的：探讨褥疮治疗液治疗褥疮后的疗效，为临床治疗褥疮提供参考。方法：随机将40例褥疮患者分为实验组和对照组．实验组20例用自制褥疮治疗液湿敷治疗；对照组20例用常规法治疗，观察两组疗效。结果：实验组和对照组治愈率比较P〈0．05，治愈时间比较P〈0．01，两组疗效有显著差异。结论：褥疮治疗液治疗褥疮药源丰富，价格低廉，使用方便，治疗时间短，值得临床推广使用。     

外科骨折患者褥疮治疗及护理对策

目的：研究探讨护理干预结合本院研制的褥疮膏治疗Ⅲ度、Ⅳ度褥疮的疗效,并分析褥疮形成原因与护理对策。方法：将100例Ⅲ度、Ⅳ度褥疮患者随机分为实验组（50例）和对照组（50例）,两组均给予基础护理、营养支持护理及常规的褥疮防治方法,实验组加用褥疮膏治疗。比较两组疗效及褥疮愈合时间。结果：实验组总有效率达到100%,高于对照组的54.00%（P〈0.05）;对照组褥疮愈合时间（75.4±16.6）d,实验组为（43.7±13.4）d,两组比较差异具有统计学意义（P〈0.05）。结论：护理干预结合褥疮膏在治疗褥疮方面具有一定的临床使用价值,对各种程度的褥疮,尤其是重度褥疮效果确切、简单易行、安全实用、经济实惠,完全可避免手术植皮等,减轻患者各重负担,值得推广。     

褥疮膏治疗褥疮的临床效果研究

目的：探讨研究褥疮膏治疗褥疮的临床疗效。方法：选取2009年6月-2011年6月本院收治的合并褥疮患者68例,按随机数字表法将患者分为对照组34例和治疗组34例,对照组给予褥疮常规方法治疗,治疗组给予褥疮膏治疗,观察两组治疗后的近期临床疗效和褥疮的治愈时间。结果：治疗组治疗有效率为91．2％,对照组为67．6％,治疗组近期临床疗效优于对照组,差异有统计学意义（P〈0.05）;治疗组褥疮治愈时间明显短于对照组,差异有统计学意义（P〈0.05）。结论：褥疮膏治疗褥疮具有较好的临床疗效,且缩短了治愈时间,值得临床推广。     

橡胶气圈和自制海绵垫在褥疮预防中的临床效果观察

目的：探讨橡胶气圈和自制海绵垫在褥疮预防中的临床效果。方法：对我院60例长期卧床病人应用自制海绵垫（观察组）与60例长期卧床病人应用橡胶气圈（对照组）的资料与结果进行比较。结果：观察组60例病人中有3例皮肤出现程度较轻的红肿,褥疮的预防有效率为95．0％;对照组60例病人中有8例发生褥疮,褥疮的预防有效率为86．7％,观察组的褥疮预防临床效果优于对照组。结论：自制海绵垫在褥疮预防中的临床效果较好,可减少或杜绝褥疮的发生。     

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.