手术患者发生切口感染的手术室相关因素分析及护理对策

目的分析手术患者发生切口感染的手术室相关因素,探究护理措施。方法选取2014年2月至2015年4月我院手术室行手术患者900例患者临床资料行回顾性分析,采用单因素和多因素方法分析患者切口感染手术室相关因素,并针对性实施护理措施。结果 900例手术患者中42例患者发生切口感染,切口感染发生率为4.67%。单因素分析得出是否为层流手术室、手术时间、手术性质、参观人员、接台手术与患者切口发生感染密切相关,比较差异有统计学意义(P0.05)。经多因素Logistic回归分析得出,非层流手术室、手术时间、急诊手术、参观人员及接台手术为影响手术患者切口感染手术室相关危险因素。结论引起手术患者发生切口感染手术室相关危险因素有非层流手术室、手术时间、急诊手术、参观人员及接台手术。临床中实施针对性护理方法可降低手术患者切口感染发生风险。     

手术室切口感染的相关因素及预防护理对策研究

目的探讨手术室切口感染的相关因素及预防护理对策。方法选择2014年6月至2015年6月在驻马店市中医院手术室治疗的436例患者为对照组,总结分析引起其手术室切口感染有关因素,制定预防护理对策,并选择2015年7月至2016年7月手术室收治的441例患者为观察组,依据制定护理策略进行护理。统计比较两组手术切口感染率。结果经多因素分析显示,手术时间>3 h、急诊手术、非层流室、术中有参观人员、接台手术等是引发手术室切口感染的重要影响因素;实施预防护理后观察组手术切口感染率(2.27%)低于对照组(5.50%),差异具有统计学意义(P<0.05)。结论手术时间>3 h、急诊手术、非层流室、术中有参观人员、接台手术等是引发手术室切口感染的主要危险因素,针对上述因素制定预防护理对策并应用于手术室治疗中,可明显减少手术室切口感染发生情况。     

外科手术患者发生切口感染的手术室相关因素分析及护理措施

目的：探讨外科手术患者发生切口感染的手术室相关因素分析及护理措施。方法：回顾性分析我院2016年1月至2016年6月间收治的300例手术患者的临床资料,观察手术患者发生切口感染的手术室相关因素,并根据调查结果制定相应的护理措施。结果：通过对所选的300例手术患者进行分析,其中19例切口出现感染,感染发生率为6．33％。运用单因素分析得出,手术室温度、急诊手术、手术参观人数、接台手术等因素与患者切口感染发生率密切相关,差异有统计学意义（P＜0．05）。通过多因素 Logistic 分析得出,手术室温度、急诊手术、手术参观人数、层流手术室级别、接台手术等是对患者手术切口产生感染的相关因素。结论：导致患者手术出现切口感染的手术室相关因素与手术室温度、急诊手术、手术参观人数、层流手术室级别、无菌操作手术时间过长、接台手术相关,通过对其实施有针对性的护理措施能够降低切口出现感染的几率。     

手术室切口感染的相关因素及护理干预措施

目的探讨手术室切口感染的相关因素及护理干预措施。方法选取2017年1—12月于郑州大学附属郑州中心医院手术室治疗的患者400例作为对照组,采用手术室常规护理,回顾性分析其临床资料,通过单因素及多因素Logistic回归分析,总结手术室切口感染的相关因素,选取2018年1—12月于郑州大学附属郑州中心医院手术室治疗的400例患者作为观察组,实施针对性护理干预措施。比较干预前后感染率。结果急诊手术、手术时间≥3 h、有参观人员、接台手术是导致手术室切口感染发生的独立危险因素(均P<0.05)。观察组手术室切口感染率低于对照组(P<0.05)。结论通过实施手术室切口感染针对性干预措施,可有效减少手术室切口感染的发生,保障手术效果。     

手术患者发生切口感染的手术室因素分析及护理观察

目的 分析手术患者发生切口感染的手术室因素,为护理对策提供科学依据。方法 选取本院外科手术患者200例,回顾分析一般资料、手术流程,总结感染相关因素。制定针对性的护理措施,观察护理应用效果。结果 急诊手术、非层流室手术、手术用时≥3h、有参观人员、属于接台手术的患者感染发生率高;实施护理对策后感染率(1.5%)明显低于实施前(5.0%)。P0.05,差异有统计学意义。结论 影响手术患者切口感染的手术室因素较多,包括手术性质、地点、用时、参观人员、接台手术等。提示医护人员制定护理对策,以降低感染发生率、改善患者预后。     

手术患者发生切口感染的手术室相关因素分析及护理措施

目的探讨分析手术患者发生切口感染的手术室相关因素,并讨论其护理措施。方法选取2016年1月至2016年12月在我院行手术治疗的120例患者作为研究对象,记录所有患者其手术时间、有无参观人员、手术性质、手术地点、引流管数量、是否接台手术等情况,并研究影响患者切口感染的危险因素。结果纳入本研究行手术治疗的患者共有120例,其中发生切口感染的患者有16例,感染率为13.33%。急诊手术患者切口感染率高于择期手术患者,非层流室手术患者切口感染率高于层流室手术患者,手术时间3 h的患者切口感染率高于≤3 h的患者,有参观人员、接台手术的患者切口感染率高于无参观人员、非接台手术的患者(P0.05)。引流管数量为1的患者于引流管数量≥2的患者切口感染率无明显差异(P0.05)。结论高度重视影响围手术期患者切口感染的因素,并加强围手术期患者护理,可有效降低患者切口感染风险。     

手术室切口感染的危险因素分析及护理对策

目的分析手术室切口感染的相关危险因素,并提出护理对策。方法将惠州市中心人民医院2012年1月~2013年12月发生手术室切口感染的104台手术作为感染组,抽取140台未发生手术室切口感染的手术作为对照组,比较手术者年龄、性别、手术部位、体重指数、是否机械通气、手术参观人数、手术室级别、围手术期抗菌药物使用情况、有无层流洁净系统、手术创面及手术时间情况。结果单因素分析表明感染组患者在年龄、体重指数、手术参观人数、有无层流洁净系统及手术时间与对照组比较差异有统计学意义(P<0.05);多元logistic分析表明体重指数(RR=1.562,95%CI:1.024-2.983)、手术参观人数(RR=1.985,95%CI:1.305-3.480)、层流洁净系统(RR=1.608,95%CI:1.243-3.108)及手术时间(RR=2.408,95%CI:1.679-5.804)是影响手术切口感染的危险性因素。结论影响我院手术室切口感染的危险因素有体重指数、手术参观人数、层流洁净系统及手术时间,护理人员可通过控制手术参观人数,尽可能采用层流洁净系统,协助医师控制手术时间及提升患者免疫力来降低医院切口感染率。     

手术室切口感染相关因素分析及护理对策

目的：探讨手术室切口感染的危险因素及相应的护理对策。方法：选择该院手术室自2015年12月至2016年2月收治的600例手术患者为研究对象,记录患者详细的临床资料,分析手术室切口感染发生的危险因素,并制定相应的护理策略。结果：急诊手术、非层流室手术、有参观人员、手术时间≥3 h 以及接台手术因素是手术室切口感染发生的主要危险因素。结论：手术室切口感染的危险因素较多,根据患者际情况制定相应的护理干预措施,对降低手术室切口感染的发生率,促进患者早日康复具有重要的意义。     

手术患者发生切口感染的手术室相关因素分析及护理对策

目的探讨手术患者发生切口感染的手术室相关因素分析及护理对策。方法选取2016年1~6月我院手术室收治的患者156例,平均分为两组,对照组予常规护理,研究组在分析切口感染相关因素的基础上应用针对性护理,对比两组患者出现切口感染的情况。结果研究组切口感染发生率明显低于对照组(P0.05),手术时间≥3 h以及有参观人员等因素是手术切口感染单因素的重要风险因素(P0.05)。结论通过分析切口感染相关因素,加强手术室护理干预,有利于避免这一问题的出现,改善手术患者的预后质量。     

手术患者发生切口感染的手术室相关因素分析及护理对策

目的:探讨手术切口感染的相关因素并提出相应的预防护理对策。方法:选取570例手术治疗的患者,对所有患者的临床资料进行回顾性分析,分析手术室切口感染的相关影响因素,并提出预防护理对策。结果:共29例患者发生切口感染,感染发生率为5.09%,单因素分析显示,手术切口感染发生与急诊手术、有无参观人员、手术地点、手术时间过长以及接台手术密切相关,多因素分析显示急诊手术、有无参观人员、手术地点、手术时间过长以及接台手术是影响手术切口感染发生的独立危险因素。结论:急诊手术、有无参观人员、手术地点、手术时间过长以及接台手术是影响手术切口感染的独立因素。     

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.     

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.     

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.