无痛护理在跟骨骨折术后夜间痛患者中的应用价值

目的探讨无痛护理在跟骨骨折术后夜间痛患者中的应用价值。方法将2015年2月1日~2016年12月31日期间80例接受手术治疗的跟骨骨折患者随机分成两组,每组40例,对照组实施常规护理,观察组采取无痛护理。对比两组患者术后患肢肿胀情况、夜间痛程度以及睡眠质量。结果两组患者术前患肢肿胀程度对比无明显差异(P0.05),术后3 d两组虽都有好转,但观察组优于对照组(P0.05)。观察组患者术后夜间痛程度明显较对照组患者更轻微(P0.05)。观察组患者术后睡眠质量评分为(18.62±1.02)分,对照组为(13.25±1.25)分,两组对比存在明显差异(P0.05)。结论无痛护理在跟骨骨折术后夜间痛患者中具有较高的应用价值。     

无痛病房管理应用于骨折患者疼痛护理的疗效观察

目的:探讨无痛病房管理应用于骨折患者疼痛护理的临床疗效。方法:选取2018年6月-2019年4月期间在我院自愿接受治疗的140例骨折患者作为观察对象,应用随机分组原则将其分为观察组与对照组,其中对照组患者70例,给予常规疼痛护理措施,观察组患者70例,在对照组基础上,给予无痛病房管理措施,通过分析2组患者不同时期的疼痛评分、护士护理工作质量评分、患者夜间睡眠时间及护理满意度等指标之间的差异,继而探讨无痛病房管理应用于骨折患者疼痛护理的临床疗效。结果:观察组患者不同时期的疼痛评分均显著优于对照组,护士护理工作质量评分、患者夜间睡眠时间及护理满意度均显著高于对照组,P<0.05,有统计学意义。结论:无痛病房管理应用于骨折患者的术后恢复阶段效果显著,能够有效缓解其疼痛反应,保障其夜间睡眠质量,促进患者早日康复,满意度高,值得推广。     

疼痛管理在骨科常见疼痛护理中的作用

目的 探讨疼痛管理对骨科患者术后疼痛及睡眠状况的影响.方法 将本科收治的并需要手术治疗的80例骨折患者随机分为疼痛管理组(实验组)和传统对照组(对照组),各40例.实验组患者给予疼痛管理模式治疗术后疼痛,对照组按传统疼痛管理模式护理.采用长海疼痛评分标准对照评估两组患者术后疼痛程度,对照分析两组患者术后镇痛效果及住院情况.结果 实验组患者术后疼痛评估得分明显低于对照组,住院时间及住院费用无明显增加.结论 实施疼痛管理模式护理,能显著减轻患者术后疼痛,改善患者生活质量,有利于患者术后康复.     

抗焦虑联合放松疗法对腰椎间盘突出症患者手术焦虑的影响

目的 探讨抗焦虑联合放松疗法治疗腰椎间盘突出症患者手术焦虑的效果.方法 将120例行腰椎间盘突出症手术患者随机分为实验组和对照组各60例,对照组实施常规护理,实验组在常规护理基础上实施放松疗法,观察两组患者手术前后焦虑情况、腰腿疼痛程度、心率、血压以及术后睡眠和排尿情况等.结果 实验组患者焦虑程度和术后疼痛程度明显低于对照组,睡眠和排尿情况优于对照组(P<0.05).结论 抗焦虑治疗联合放松训练可有效减轻腰椎间盘突出症患者焦虑情绪,缓解疼痛,改善睡眠.     

个性化护理干预对下肢骨折患者术后疼痛治疗的影响

目的探讨个性化护理干预对下肢骨折患者术后疼痛的影响。方法将298例骨科手术患者随机分为个性化护理组（实验组）和常规护理组（对照组）,每组各149例。两组均接受常规的治疗和护理,实验组同时增加个性化护理干预。观察比较两组患者术后疼痛、睡眠、活动等情况。结果术后3 d实验组患者的疼痛评分、疼痛认知程度、睡眠质量及身体恢复情况均优于对照组（P〈0.05或P〈0.01）。结论个性化护理明显减轻了患者的术后疼痛,改善患者睡眠质量,提高其生活质量,促进患者的康复。     

无痛病房护理在肿瘤患者护理中的临床应用

目的:探讨无痛病房护理在肿瘤患者护理中的护理疗效。方法:将本院在2011年2月~2013年11月收治的200例肿瘤患者平均分成两组,实验组与对照组,各100例。对照组患者给予一般常规护理,实验组患者实施无痛病房护理,比较两组患者疼痛缓解情况及满意度。结果:实验组患者实施无痛病房护理后,疼痛有效缓解率为94%,明显高于对照组患者疼痛有效缓解率;实验组患者对护理的满意度为96%,也明显高于对照组的满意度78%,两组比较存在显著性差异(P0.05)。结论:肿瘤患者实施无痛病房护理可以有效缓解患者的疼痛,减轻患者的痛苦,提高了患者的生存质量和满意度,具有好的临床应用价值,值得大力推广。     

快速康复外科护理对跟骨骨折患者围术期疼痛的干预效果

目的观察快速康复外科（FTS）护理对跟骨骨折患者围术期疼痛的干预效果。方法选取2016年9月至2017年2月收治的围术期采用常规护理跟骨骨折患者50例为对照组,2017年3至9月收治的采用FTS护理跟骨骨折患者50例为观察组。两组患者均行切开复位内固定术治疗。观察并比较两组患者入院时与术后1、2、3d疼痛评分（数字评估法）。结果两组患者入院时疼痛评分比较差异无统计学意义（P＞0.05）,观察组患者术后1、2、3d疼痛评分均低于对照组,差异均有统计学意义（均P＜0.05）。结论FTS护理可有效降低跟骨骨折患者围术期疼痛程度,值得临床推广应用。     

无痛病房护理在肿瘤患者护理中的临床应用

目的：探讨无痛病房护理在肿瘤患者护理中的护理疗效。方法：将本院在2011年2月～2013年11月收治的200例肿瘤患者平均分成两组,实验组与对照组,各100例。对照组患者给予一般常规护理,实验组患者实施无痛病房护理,比较两组患者疼痛缓解情况及满意度。结果：实验组患者实施无痛病房护理后,疼痛有效缓解率为94％,明显高于对照组患者疼痛有效缓解率;实验组患者对护理的满意度为96％,也明显高于对照组的满意度78％,两组比较存在显著性差异（P＜0．05）。结论：肿瘤患者实施无痛病房护理可以有效缓解患者的疼痛,减轻患者的痛苦,提高了患者的生存质量和满意度,具有好的临床应用价值,值得大力推广。     

穴位贴敷联合耳穴埋籽对上肢闭合性骨折疼痛护理疗效观察

目的:探讨穴位贴敷联合耳穴埋籽法对上肢闭合性骨折围手术期患者在疼痛护理中的疗效观察。方法:收集2013年8月—2015年7月因上肢闭合性骨折入院治疗患者120例,利用完全随机法分为对照组60例及观察组60例,所有患者均根据病情进行常规骨折治疗及基础护理干预。利用单盲法对观察组给予穴位贴敷联合耳穴埋籽法干预。围手术期间利用《骨科病人疼痛评估表》评估两组患者疼痛改善情况,利用匹兹堡睡眠质量指数量表评估患者失眠质量变化。结果:观察组患者术后切口痛、骨折痛及睡眠质量改善效果明显优于对照组,差异有统计学意义(P0.05)。结论:穴位贴敷联合耳穴埋籽法能够有效缓解上肢闭合性骨折患者术后疼痛,改善失眠质量。     

无痛病房管理在骨科围手术期患者中的应用

目的：探讨骨科实施无痛病房管理后围手术期患者对疼痛的自我感受及对护理服务的满意度。方法：选择骨折需行内固定治疗病例200例,其中入院后实施无痛病房管理100例为实验组,入院后按骨科传统常规管理100例为对照组。采用（NRS）和面部表情量表评分法（PRS-R）记录实验组和对照组的评分结果,发放患者对护理服务的满意度调查表,对结果进行分析比较。结果：实验组术前、术后疼痛评分明显低于对照组,比较差异有统计学意义（P〈0.05）。同时,实验组对护理服务的满意度明显高于对照组,比较差异有统计学意义（P〈0.05）。结论：骨科无痛病房的建立,以及对围手术期患者实施的规范化疼痛管理,对医疗护理质量的提高及病人满意度具有重要意义。     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.