循证护理在ICU压疮高危因素患者中的应用效果

目的:探究循证护理在ICU压疮高危因素患者中的应用效果。方法:选取2016年1月至2017年3月我院ICU收治的评估后具有压疮高危风险的患者共80例,随机分为实验组和对照组,每组均含40例患者;对实验组患者采取循证护理模式,对照组患者采取常规护理模式,比较两组患者的压疮发生状况。结果:实验组患者的压疮发生率明显低于对照组,且压疮分期较低,差异具有统计学意义(P0.05)。结论:对ICU压疮高危因素的患者采取循证护理措施,可以有效减少压疮的发生,值得不断完善,并进一步推广。     

ICU高危压疮病人监控管理及护理干预

本文通过探讨ICU压疮高危病人护理质量监控管理方法,降低压疮发生率,得出结论:对ICU压疮高危患者进行监控及护理干预,提高了护士压疮管理的风险预测能力,有效降低了压疮发生率.     

护理专案对降低ICU高危压疮患者压疮发生率的作用

目的:分析护理专案对降低ICU高危压疮患者压疮发生率的临床作用。方法:选择2012年7月-2013年6月本院收治的ICU高危压疮患者54例为对照组,进行常规护理,选择2013年7月-2014年6月就诊的ICU高危压疮患者54例为观察组,采用护理专案进行护理,比较两组的压疮发生率、压疮风险评估准确率与护理满意度。结果:观察组压疮发生率低于对照组,风险评估准确率及护理满意度均高于对照组,比较差异均有统计学意义(P<0.05)。结论:护理专案有利于降低ICU高危压疮患者发生压疮的风险,还能够更为准确地对ICU高危压疮患者加以评估,具有较高的临床推广意义。     

集束化护理在ICU压疮高危病人护理管理中的应用研究

目的探讨集束化护理在ICU压疮高危病人护理管理中的应用效果。方法抽取我院2015年5月至2017年5月接收的120例ICU压疮高危病人为研究对象,随机均分为对照组与实验组,对照组实施传统的压疮预防护理,实验组则实施集束化护理干预,比较两组病人压疮发生情况。结果集束化护理干预后,实验组的压疮发生率为86.7%,对照组为60.0%,差异经比较,P=0.000。结论对ICU压疮高危病人在常规压疮护理的同时实施集束化护理干预,可以明显控制压疮的发生,保证住院期间的安全。     

探讨预见性压疮预防护理在ICU患者中应用的效果

目的探讨预见性压疮预防护理在ICU患者中应用的效果。方法随机性的抽取2016年7月至2018年7月在我院ICU病房进行疾病治疗的80例患者作为临床实验研究的观察对象,并按照平均性原则将患者划分为实验组和对照组两组,每组患者各40例。对对照组患者应用常规护理方法,对实验组患者应用预见性压疮预防护理,对两组患者在两种不同护理模式下的压疮发生率进行比较和分析。结果实验组压疮发生率(20%)明显低于对照组(45%),且实验组患者的压疮程度均显著低于对照组。两组实验结果比较差异明显,具有统计学意义(P0.05)。结论预见性压疮预防护理在ICU患者中应用,降低患者压疮发生率,减轻患者压疮严重程度,临床护理效果明显,值得推广应用。     

优质护理用于神经内科预防患者压疮的效果分析

目的对优质护理用于神经内科预防患者压疮的效果进行分析。方法本文选取2015年8月至2016年8月在我院神经内科接受治疗的180例压疮高危患者,将其作为研究对象,并且采取随机的方法将180例患者分为两组,对照组和实验组。对照组采取常规方法进行护理,实验组采取优质护理,随后对神经内科两组住院患者压疮发生率和患者的满意度进行比较。结果进行优质护理之后,与对照组相比较,实验组的患者压疮发生率有了非常显著的降低,患者的满意度有了显著的提高。结论在神经内科,采用优质护理干预措施对压疮高危患者进行治疗,主要对患者进行压疮教育以及对患者的实际病情进行密切的观察和防范,就促使院内压疮的发生率明显降低,也很大程度提高了患者对诊断治疗服务的满意度。     

伤口造口护理小组对压疮预防与治疗的应用探讨

目的建立伤口造口护理小组对压疮预防与治疗的应用探讨。方法以本院2016年6月至2017年6月诊治的有高压疮风险的患者88例为研究对象,划分到由伤口造口小组护理的实验组以及临床常规护理的对照组。比较两组压疮高危患者的压疮发生率、护理人员对压疮的认知程度以及患者对护理的满意度。结果实验组由伤口造口护理小组负责管理的患者44例中,压疮患者1例,占比2.27%。常规护理患者压疮8例,占比18.18%(P0.05),组间差异显著。负责实验组患者的护理人员对压疮的认知评分(在压疮的病因、压疮的风险评估、压疮的预防和治疗措施方面)普遍较常规组护理人员高,且该组患者对护理质量的满意度显著高于对照组患者(P0.05),以上指标组间差异有统计意义。结论在院内成立专门的伤口造口护理小组对于高危压疮患者起到显著的预防和治疗效果,一方面护理人员对压疮的认知掌握更全面,另一方面患者的压疮发生率显著降低,对护理工作的满意度更高。提高了治疗和护理的效果,对患者预后有积极意义。     

压疮管理流程在骨科截瘫患者中的运用

目的:探讨压疮管理流程在骨科截瘫患者中的运用效果。方法:建立压疮管理流程,从截瘫患者入院后即进入压疮管理流程程序直至出院,进行规范的管理。结果:14例截瘫患者入院至出院压疮发生率为零。结论:压疮管理流程在骨科截瘫患者中的运用,可以有效的帮助护理人员完成对截瘫等高危压疮好发人群的评估、预防护理措施、审核监控一体化管理,有效的降低了压疮的发生率。     

重症监护室患者压疮预警机制的应用效果

目的:运用 Braden评估表评估重症监护室(ICU)重症患者压疮发生的危险程度,探讨由其建立的压疮预警机制的应用效果。方法:收集无压疮病史,Braden评分<17分,APACHEⅡ评分>15分的重症患者为研究对象。将2012年收治的105例作为对照组,将2013年收治的113例作为观察组。根据Braden评估量表将2组患者又分为高危患者和低危患者。对照组施行常规的压疮护理模式,观察组在对照组基础上实施预警干预措施。比较2组重症患者压疮发生率及不同危险等级压疮发生率。结果:观察组重症患者压疮发生率低于对照组(P<0.05)。观察组高危患者压疮发生率亦低于对照组高危患者(P<0.05)。结论:ICU压疮预警机制的建立能够强化护士预防为主的理念,降低ICU重症患者压疮发生率,保障护理安全。     

护理会诊在压疮管理中的应用

目的通过护理会诊,规范压疮管理,降低压疮发生率,提高已发生压疮的治愈率。方法建立会诊制度,成立以护理部主任为组长的压疮管理小组,追踪考评压疮管理质量。结果会诊实施后,武威肿瘤医院住院患者压疮发生率显著下降,压疮治愈率明显提高。结论护理会诊在压疮管理中的应用能提高压疮管理质量,有效降低住院患者压疮发生率,提高已发生压疮的治愈率。     

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.