浅谈肝硬化患者的健康教育体会

目的:肝硬化是一种慢性疾病,并发症多,严重的会威胁生命,通过健康教育使肝硬化病人掌握有关健康知识,合理调养,减少并发症的发生,增进健康。方法:通过对病人进行心理、饮食、起居、用药等方面的指导,对病人进行有效的健康教育。结果:使病人从对疾病的焦虑忧郁到掌握知识后的坦然面对。结论:通过对肝硬化病人的有效健康教育,提高生活质量。     

腰椎间盘突出症术后健康指导

为了预防腰椎间盘突出症患者术后发生并发症，我们对患者实施有针对性的健康教育。结果表明：健康教育可以使患者掌握术后相关饮食、并发症预防及功能锻炼等方面知识，建立了有利健康的行为，预防和降低了并发症的发生，同时也提高了护理质量。     

对肝硬化患者进行健康教育的调查分析

目的 评价肝硬化患者健康教育效果,为预防控制肝硬化并发症的措施制订提供依据.方法 以住院的肝硬化患者268例为研究对象,对患者进行肝硬化相关知识的健康教育,采用自制调查问卷对调查对象住院期间、出院后或再住院时以直接询问和电话随访等方式完成问卷调查.结果 健康教育获得途径主要为医护人员.健康教育前后患者对肝硬化并发症知识知晓率差异有统计学意义（P＜0.05）,其中上消化道出血知晓率提高明显,为80.90%（教育前为8.1%）.健康教育前有不良饮食习惯的患者为213例,健康教育后有182例不同程度地改变了不良卫生习惯,希望获取健康教育材料的患者占98%.结论 健康教育能使肝硬化患者提高相关知识知晓率,改变不良饮食卫生习惯.应通过面对面讲解或发一些健康教育材料,以提高对肝硬化的认识程度,减少并发症的发生.     

对门诊病人实施健康教育的体会

医院开展健康教育是促进患者康复，提高医疗服务水平的重要手段。通过健康教育不但可以减轻病人的心理负担，指导病人配合治疗和护理以减少并发症的发生促进康复；而且还可以传播医疗保健知识，提高人们对疾病的预防以及维护健康的能力。近年来，笔者对门诊病人实施全程的健康教育，使患者和家属掌握自我保健知识和护理技能，促进了疾病的康复，减少了并发症，取得了较好的健康教育效果，     

对股骨干骨折患者及家属实施健康教育的效果观察

目的探讨健康教育对促进股骨干骨折愈合的作用。方法在治疗股骨干骨折的过程中，对32例患者及家属进行股骨颈骨折相关健康知识指导，将指导前后患者及家属对健康知识的知晓情况进行比较，并现场抽查知识的应用情况。结果教育后患者及家属对股骨干骨折相关健康知识知晓的人数大幅度增加。现场抽查应用较好，患者痛苦减轻p〈0．01，防治了并发症。结论对股骨干骨折患者及家属施以有效的健康教育，对促进骨折愈合、预防并发症有积极的意义。     

健康教育在肛肠疾病中的实施

我院于1998年起开展健康教育，向患者介绍肛肠疾病的原因、治疗及预防等知识，患者住院期间根据不同的时期进行阶段性的健康教育。通过健康教育，密切了护患之间的关系，患者对护理人员产生信任感，对肛肠疾病的知识有了一定的了解和掌握，解除焦虑情绪，主动配合治疗，手术后并发症明显减少，取得了良好的治疗效果。     

健康教育在预防心脑血管疾病中的效果

目的 通过对心脑血管病患者进行健康教育干预,分析和评价健康教育对于预防心脑血管疾病的效果。 方法 选取2014年2月—2015年3月河南省医学会辖区内的120例心脑血管疾病患者作为研究对象,随机分为对照组和实验组,每组60例,对照组给予一般治疗方法,并给予基础的健康教育;实验组在对照组的基础上,给予健康知识讲解、心理疏导、饮食健康教育、加强用药指导、运动治疗、家庭健康教育和合并症的治疗指导等全面的综合健康教育干预。治疗过程中对2组患者进行实时观察。 结果 通过对患者进行综合健康教育和干预,并对患者的治疗情况、知识掌握情况进行测试和观察得到相应结果。实验组患者健康知识掌握率为96.7%,并发症发生率为3.3%;对照组患者相关知识掌握率为71.7%,并发症发生率为21.7%,差异具有统计学意义(均P<0.05)。 结论 通过对患者进行知识培训、心理干预、饮食教育、用药指导、运动质量、家庭健康教育等综合性的健康教育干预措施,极大地提高了患者对心脑血管疾病的认识和健康知识的掌握,改变了错误的生活习惯,养成了健康的生活方式,特别是通过2组对照,充分地说明了健康教育对于心脑血管疾病的预防具有显著效果,值得在日常生活和干预中大力推广。      

糖尿病合并冠心病51例护理体会

目的:总结糖尿病合并冠心病患者的护理措施及注意事项。方法:从药物护理、饮食护理、生活护理等多方面指导,针对患者进行健康教育指导。结果:通过健康教育指导,患者掌握了糖尿病合并冠心病的知识及护理技术,达到了预防并发症及提高生活质量的护理目标。结论:正确的健康教育与细致入微的综合护理是糖尿病合并冠心病患者适应正常生活的重要保障。     

糖尿病患者的营养护理与健康教育干预

对住院糖尿病患者进行跟踪营养防治及健康教育干预,根据临床营养学对糖尿病患者进行日常生活指导及健康教育,3个月后进行干预效果评价:患者及家属了解相关知识,帮助患者更好地配合相关治疗,掌握自我管理及预防并发症发生的技巧,提高生活质量.     

126例创伤性截瘫病人健康教育的效果评价

本文通过对126例截瘫患者进行健康教育指导，如出入院指导，心理，营养，体位，膀胱机能与功能锻炼及并发症的预防等指导，并评价其效果。结果：126例截瘫病人的健康行为形成率低于指导健康教育内容知晓率，不同文化程度的患者在膀胱功能，并发症预防等方面的健康行为形成率存在统计学差异，病人对健康教育满意率为100％，提示今后的护理工作将重点探索如何在患者有正确的认识时如何转化为自觉的行为，并加强低学历患者在并发症预防与膀胱机能训练方面的健康教育。     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.