老年痴呆患者个性化护理及效果评价

目的观察老年痴呆患者个性化护理的临床效果。方法选择112例老年痴呆患者,随机分为对照组56例和研究组56例。对照组进行常规护理,研究组进行个性化护理。以简易智能状态检查量表(MMSE)、日常生活能力量表(ADL)、老年痴呆患者生活质量量表(QOL-AD)等评分作为主要评价指标,比较2组患者在治疗前及治疗12个月后的认知能力、精神状况、日常生活能力和生活质量的改善情况。结果治疗12个月后,研究组患者MMSE、ADL、QOL-AD等评分优于对照组,差异有统计学意义(P<0.01)。结论个性化护理可明显改善老年痴呆患者的认知能力、精神行为症状和生活质量。     

针对性护理对老年血管性痴呆患者认知功能及生活质量的影响

目的:观察针对性护理对老年血管性痴呆患者认知功能及生活质量的影响。方法:选取69例老年血管性痴呆患者,按照随机数字表法分组,对照组34例给予常规护理,观察组35例给予针对性护理干预,比较两组护理前后MMSE评分和治疗依从性、护理满意度评分及生活质量(QOL-AD)评分。结果:护理后观察组MMSE、治疗依从性和护理满意度、QOL-AD评分均高于对照组,差异具有统计学意义(P<0.01)。结论:针对性护理可改善老年血管性痴呆患者生活质量和认知功能及提高护理满意度,郊果优于常规护理。     

老年痴呆HABILITATION护理模式的临床效果评价

目的研究老年痴呆HABILITATION护理模式的临床效果。方法选择2010年4月-2012年10月间就诊的252例老年痴呆患者,将其随机分为观察组和对照组,各126例。对照组患者运用多奈哌齐等常规治疗方法和护理模式,观察组患者在以上治疗和护理的基础上实施老年痴呆HABILITATION护理模式。对两组患者进行干预前以及干预1年后的认知能力、日常生活能力、精神状况以及生活质量等改善情况进行比较。结果观察组老年痴呆患者实施1年的HABILITATION护理模式后,日常生活能力量表(ADL)、简易智能状态检查量表(MMSE)、神经精神科问卷(NPI)、老年痴呆患者生活质量量表(QOL-AD)、总体衰退量表(GDS)评分均高于对照组,差异有统计学意义(P<0.05或P<0.01)。结论对老年痴呆患者实施HABILITATION护理模式后可显著改善其认知能力、生活质量以及精神行为症状。     

康复护理对老年高血压脑出血术后痴呆患者日常生活能力及认知功能的影响

目的探讨康复护理对老年高血压脑出血术后痴呆患者日常生活能力及认知功能的影响。方法选取2012年10月-2017年6月收治的78例老年高血压脑出血术后痴呆患者,按照随机数字表法入组患者分为对照组和观察组,两组例数均等,对照组给予常规护理,观察组常规护理基础上给予康复护理,比较两组患者的日常生活能力及认知功能。结果干预后观察组ADL评分明显低于对照组,QOL-AD和MMSE评分明显高于对照组,分别比较差异有统计学意义(P<0.05)。结论康复护理可显著改善老年高血压脑出血术后痴呆患者的日常生活能力,提高其认知功能,对延缓疾病进展提高患者生活质量有重要价值。     

盐酸多奈哌齐治疗阿尔茨海默病的疗效及其对患者认知功能与生活质量的影响

目的:探讨盐酸多奈哌齐治疗阿尔茨海默病的疗效及其对患者认知功能与生活质量的影响。方法:观察对象为我院2013年5月—2016年5月收治的80例阿尔茨海默病患者,采取随机数字表将其分成两组,每组40例。观察组给予盐酸多奈哌齐治疗,对照组给予吡拉西坦片治疗,采用AD评定量表认知量表(ADAS-Cog)、简易精神状态检查评分(MMSE)以及老年性痴呆生活质量量表(QOL-AD)进行疗效评估。结果:观察组治疗后ADAS-Cog评分明显下降,MMSE、QOL-AD评分明显上升(P<0.01),对照组治疗前、后各项量表评分无明显变化(P>0.05),观察组治疗后ADAS-Cog评分显著低于对照组,MMSE、QOL-AD评分显著高于对照组(P<0.01)。结论:盐酸多奈哌齐治疗阿尔茨海默病可取得满意的疗效,患者的认知功能有明显改善,生活质量明显提高,值得推广应用。     

系统性护理在急性缺血性脑卒中患者中的应用

目的分析系统性护理在急性缺血性脑卒中患者中的应用效果。方法选取2016年9月至2017年9月在襄城县人民医院进行静脉溶栓治疗的82例急性缺血性脑卒中患者,按照随机数表法将其分为对照组和观察组,每组41例。给予对照组常规护理,观察组在对照组基础上接受系统性护理干预。采用美国国立卫生研究院卒中量表(NIHSS)评估患者神经系统功能,采用Barthel指数评估患者日常生活活动能力,采用健康状况调查量表(SF-36)评估患者生活质量。结果干预后,两组NIHSS评分均较干预前降低,Barthel指数和SF-36评分均较干预前升高,且观察组NIHSS评分低于对照组,Barthel指数和SF-36评分均高于对照组,差异有统计学意义(均P<0.05)。结论对急性缺血性脑卒中患者中实施系统性护理干预,可有效改善患者神经功能,提高其日常生活活动能力及生活质量。     

康复护理干预对老年性痴呆患者生活质量的影响

目的 探讨康复护理干预对老年性痴呆(AD)患者生活质量的影响. 方法 将40例轻、中度老年性痴呆患者随机分为实验组和对照组各20例,对照组进行常规治疗和护理;实验组除常规治疗和护理外,根据病情制定综合康复训练计划,并按计划实施康复训练,对两组患者进行护理干预前后简易精神状态量表(MMSE)和改良巴氏指数(MBI)量表评定其日常生活能力(ADL). 结果 康复训练后实验组与对照组MMSE、MBI得分差异有显著性(P<0.01). 结论 综合康复训练可提高老年性痴呆患者日常生活能力,改善认知功能,提高生活质量.     

基于“互联网+”延续护理干预模式对阿尔茨海默病患者康复效果的影响

目的:探讨基于“互联网+”延续性护理干预模式对阿尔茨海默病(AD)患者康复效果的影响。方法:选取2018年5月—2020年5月遂溪县人民医院收治的86例AD患者作为研究对象,按随机数表法分为对照组和观察组,每组各43例。对照组给予常规护理,观察组采取“互联网+”延续护理干预模式。比较两组患者干预前后心智功能[简易智能精神状态检查量表(MMSE)、阿尔茨海默病认知功能评定量表(ADAS-cog)]评分、生活能力[基本生活活动能力量表(BADL)]评分、生命质量[阿尔茨海默病生命质量测定量表(QOL-AD)]评分及不良事件发生率。结果：干预后,两组患者MMSE评分均高于干预前,且观察组高于对照组,两组患者ADAS-cog评分均低于干预前,且观察组低于对照组,差异有统计学意义(t=6.864、6.627,P<0.05)。干预后,两组患者BADL、QOL-AD评分均高于干预前,且观察组高于对照组,差异有统计学意义(t=8.497、13.027,P<0.05)。两组患者不良事件发生率比较,观察组低于对照组,差异有统计学意义(χ²=7.679,P<0.05)...     

CGA评分导向的针对性护理模式在老年轻中度认知功能障碍患者中的应用观察

目的：探究老年综合评估工具(CGA)指导下的针对性护理在轻中度老年认知功能障碍(MMCIE)患者中的应用效果。方法：选取我院2019年12月—2021年12月收治的MMCIE患者186例，以入院顺序不同分为对照组、观察组，各93例。对照组给予常规护理干预，观察组在对照组基础上给予CGA评分为导向的针对性护理。对比2组蒙特利尔认知功能评估量表(MoCA)、简易智能精神状态检查量表(MMSE)、日常生活功能指数评定量表(ADL)、生活质量综合评定问卷-74(GQOL-74)、护理满意度。结果：干预后观察组MMSE、MoCA、GQOL-74评分较对照组高(P<0.05),ADL评分低于对照组(P<0.05);观察组护理总满意度高于对照组(P<0.05)。结论：CGA评分导向的针对性护理可减轻MMCIE患者认知功能障碍，增强自我活动能力，从而促进生活质量的改善，获得患者及家属认可。     

康复护理干预对老年血管性痴呆患者认知功能及日常生活能力的影响

目的观察分析康复护理干预对老年血管性痴呆患者认知功能及日常生活能力的影响。方法选取2015年5月至2017年1月鄢陵县中医院收治的老年血管性痴呆患者90例,根据就诊顺序分为对照组和观察组,各45例。对照组接受常规护理,观察组在常规护理基础上接受康复护理干预。观察两组患者的认知功能(MMSE评分)及日常生活能力(ADL评分)。结果护理前,两组患者MMSE评分和ADL评分比较,差异均无统计学意义(P>0.05);护理后,观察组MMSE评分和ADL评分均高于对照组,差异有统计学意义(P均<0.05)。结论康复护理干预应用于老年血管性痴呆患者效果显著,可改善患者认知功能,提高其日常生活能力,值得临床推广应用。     

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.