肝病合并糖尿病患者人性化护理干预

目的：探讨肝病合并糖尿病患者人性化护理干预效果。方法：选取2011年6月-2013年5月我院收治的肝病合并糖尿病患者78例进行分析,按照护理方法分成人性化护理组和常规护理组,每组39例,人性化护理组采用人性化护理干预,常规护理组采用常规护理干预,观察两组干预前后血糖水平变化、患者依从性、护理满意度和舒适度。结果：两组干预后血糖水平均有显著降低（P＜0．05）,且人性化护理组降低水平明显优于常规护理组（P＜0．05）;人性化护理组患者依从性明显高于常规护理组（P＜0．05）,护理满意度和舒适度明显高于常规护理组（P＜0．05）。结论：对肝病合并糖尿病患者采取人性化护理干预能够有效控制患者的血糖水平,提高患者依从性,提高患者满意度和舒适度,效果显著,值得临床推广。     

个性化护理干预对妊娠合并糖尿病孕妇的影响

目的研究分析个性化护理干预对妊娠合并糖尿病孕妇的影响。方法选取该院60例妊娠合并糖尿病孕妇为研究对象,将其分为对照组和观察组,每组患者各30例。对照组采用常规护理;观察组在常规护理的基础上给予个性化护理。统计比较患者护理前后血糖水平、妊娠结局以及并发症的发生情况。结果护理前两组患者血糖水平差异不大(P0.05);护理后两组患者血糖水平均有所下降,且观察组血糖水平低于对照组(P0.05);观察组自然分娩成功率高于对照组(P0.05);观察组患者剖宫产率、早产率和晚期流产率均低于对照组患者(P0.05);观察组产后并发症发生率低于对照组(P0.05)。结论个性化护理干预应用于妊娠合并糖尿病孕妇可以有效降低血糖和并发症,提高自然分娩成功率,效果明显。     

甲状腺功能亢进合并2型糖尿病的护理要点研究

目的：探讨甲状腺功能亢进合并2型糖尿病的护理要点。方法：本次入选患者为我院收治的甲状腺功能亢进合并2型糖尿病的患者150例,随机将患者分为对照组和观察组,每组患者75例,对照组患者进行常规临床护理,观察组患者给予综合护理干预。结果：观察组甲状腺功能恢复正常的比例高于对照组患者,且P＜0．05统计学差异显著;两组患者在护理前后的空腹血糖均有所下降,观察组患者的空腹血糖下降优于对照组患者,且P＜0．05统计学差异显著;观察组患者的满意度明显高于对照组患者的满意度,且P＜0．05统计学差异显著。结论：采用综合护理干预措施对甲状腺功能亢进合并2型糖尿病患者进行护理,有效提高患者甲状腺功能水平,降低患者空腹血糖,患者临床满意度较高,值得广泛推广。     

优质护理服务对妊娠期糖尿病的临床价值分析

目的：对妊娠期糖尿病患者实施优质护理服务的临床价值进行分析。方法：将67例妊娠期糖尿病患者随机分为观察组（34例）和对照组（33例）,观察组实施优质护理服务,对照组实施传统护理,对比两组患者护理效果。结果：观察组血糖控制情况明显优于对照组,焦虑、抑郁情绪比对照组轻（P＜0．05）。观察组并发症发生率17．6％明显低于对照组并发症发生率47．1％,两组对比（P＜0．01）。结论：对妊娠期糖尿病患者实施优质护理服务,可明显控制孕妇血糖水平,减少糖尿病并发生的发生,临床价值确切。     

急性化脓性胆管炎合并 T2DM 患者围手术期护理干预

目的探讨急性化脓性胆管炎（AOSC）合并2型糖尿病（T2DM）患者在围手术期的护理干预措施。方法将78例急性化脓性胆管炎合并糖尿病患者,均采用血糖控制、补液、控制并发症等对症治疗。按照数字表法随机分为两组,对照组39例采用常规护理方法,观察组39例对患者则在不同阶段的病情特点和体征进行针对性围手术期的优质护理干预措施。结果观察组患者住院时间为（21．6±6．3） d、并发症发生率为2例占5．13％（2／39）;对照组分别为（32．9±5．4）d、7例占17．95％（7／39）,两组相比较差异有显著性（P均＜0．05）。观察组的总有效率为92．31％明显高于对照组的79．49％（P＜0．05）,观察组的护理满意度为97．44％显著地高于对照组的84．62％（P＜0．05）。结论加强AOSC合并T2DM患者临床观察及围手术期护理干预措施,可有利于患者的治疗和早日迅速康复,并提高护理满意度。     

综合性护理干预对2型糖尿病患者治疗依从性及血糖的影响

目的探讨对2型糖尿病患者实施综合性护理干预对血糖及治疗依从性的影响及临床意义。方法将确诊的70例2型糖尿病患者随机分为干预组（综合护理）和对照组（常规护理）各35例;对照组仅根据病情需要给予常规基础护理。观察组给予心理护理、饮食护理、运动护理、用药指导、定期随访等一系列的综合性护理干预措施,应用统计学方法对比分析两组患者治疗的依从性、血糖控制情况以及护理观察指标如护理满意度等。结果两组比较,干预组的依从性明显优于对照组（P〈0．01）;干预组的血糖指标控制效果明显优于对照组（P〈0．05）;干预组的护理满意度97．1％（34／35）,对照组的护理满意度74．2％（26／35）,两组比较差异有统计学意义（P〈0．05）。结论对2型糖尿病患者实施综合性护理干预后,其治疗依从性得到明显提高,血糖控制效果好,护理满意度也明显提高。     

58例妊娠合并糖尿病的临床观察

目的 探讨妊娠合并糖尿病对母儿所造成的影响以及治疗对妊娠结局的影响。方法 选择1994～2003年间妊娠合并糖尿病孕妇58例与同期65例正常孕妇进行比较;并根据血糖控制情况将55例妊娠合并糖尿病孕妇分为血糖控制满意组（A组）,共40例;血糖控制不良组（B组）．共15例,进行比较。结果 与正常孕妇组比较,妊娠合并糖尿病孕妇并发症（妊娠高血压疾病、羊水过多、胎膜早破、早产及剖宫产）显著升高（P〈0．05）,围产儿并发症（死胎、新生儿窒息、巨大儿及RDS和畸形）的发病率亦显著升高（P〈0．05）。B组妊娠高血压疾病、早产发生率和新生儿窒息率、死胎发生率均显著高于A组。结论 妊娠合并糖尿病对母儿造成严重危害,加强对其管理和合理治疗可明显减少孕产妇并发症及死亡率,改善母儿结局。     

护理干预在前置胎盘期待疗法中的效果探析

目的：探究护理在前置胎盘期待疗法中效果。方法：选取我院妇产科住院部在2014年2月至2015年2月期间收治的前置胎盘孕妇96例作为研究对象,按照随机数表法将这96例前置胎盘孕妇随机分为观察组48例和对照组48例。给予对照组前置胎盘孕妇常规护理,给予观察组前置胎盘孕妇常规护理基础上的干预护理。结果：观察组48例产妇产前出血和对照组相比（P ＞0．05）,观察组的产后出血和产褥感染明显低于对照组（P＜0．05）。观察组孕妇对护理的服务态度,责任心,业务熟练程度和满意度均高于对照组（P ＜0．05）。结论：在护理过程中进行干预护理可以有效改善妊娠结局以及提高对护理满意度,值得在临床推广。     

妊娠期糖尿病血糖水平与不良妊娠结局的临床分析

目的：总结分析妊娠期糖尿病血糖水平对不良妊娠结局的影响。方法：选择2010年6月至2012年11月期间我院收治的110例妊娠期糖尿病患者为研究对象,根据治疗后血糖水平控制情况分为血糖控制理想组60例、血糖控制不理想组50例,同时选择同期在我院产检的50例健康孕妇作为对照组,比较三组孕妇妊娠结局差异。结果：血糖控制不理想组母体并发症发生率51．7％明显高于血糖控制理想组与对照组并发症发生率,且差异具有统计学意义（ P＜0．05）;血糖控制不理想组新生儿患病率明显高于血糖控制理想组与对照组,且差异具有统计学意义（ P＜0．05）,但血糖控制理想组与对照组母体并发症发生率、新生儿患病率相比无统计学差异（ P＞0．05）。结论：妊娠期糖尿病患者在治疗后血糖控制满意时可以争取良好妊娠结局,临床要提高警惕,积极做好筛查和治疗工作。     

个性化护理干预心绞痛患者的临床效果体会

目的：探讨对心绞痛患者实施个性化护理干预的效果。方法：2015年4月至2016年4月收治的心绞痛患者162例,随机分为两组各81例,对照组给予常规护理,观察组实施个性化护理干预,对比两组心绞痛发作次数、心电图检查情况、生活质量及护理满意度。结果：干预后观察组心绞痛发作次数少于对照组,心电图 ST 段压低改善优于对照组（P ＜0．05）;观察组 SF －36评分高于对照组（P ＜0．05）;观察组护理满意率高于对照组（P ＜0．05）。结论：个性化护理能够有效缓解心绞痛病情,有利于改善患者生活质量和护理满意率。     

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.