PDCA循环联合运动干预对老年骨质疏松患者焦虑抑郁情绪、自我管理水平的影响

目的探究戴明循环管理法（PDCA）联合运动干预对老年骨质疏松患者焦虑抑郁情绪、自我管理水平的影响。方法选取100例老年骨质疏松患者,依据入院时间分为对照组与观察组,各50例。对照组予以常规护理干预,观察组予以PDCA循环联合运动干预。统计对比两组遵医行为率、骨折发生率、干预满意度及干预前后焦虑、抑郁、自我管理评分、骨密度。结果干预后,观察组焦虑、抑郁评分较对照组低（t=6.525、8.746,P＜0.001）;观察组遵医行为率（94.00% vs 80.00%）高于对照组（2=4.332,P＜0.05）;干预后,观察组摄钙效能、运动效能评分较对照组高（t=4.157、4.813,P＜0.001）;观察组骨折发生率（4.00% vs 18.00%）低于对照组（2=5.005,P=0.025）;干预后,观察组骨密度高于对照组（t=13.413,P＜0.001）;观察组干预满意度优于对照组（Z=2.778,P=0.006）。结论PDCA循环联合运动干预应用于老年骨质疏松患者中,可明显减轻患者焦虑、抑郁情绪,提高自我管理水平及遵医行为率,增强骨密度,降低骨折发生率,且患者满意度较高。     

多种护理形式延续护理模式在输尿管皮肤造口术后患者中的应用研究

目的探讨多种护理形式延续护理在输尿管皮肤造口术后患者中的应用的重要性。方法 2016 年10 月～2018 年12 月在本院抽取接受输尿管皮肤造口的膀胱癌患者50 例作为研究对象,按随机分为对照组和干预组,每组各25 例,对照组采取常规出院指导,干预组采取多种形式的延续护理干预,术后6 个月评价两组患者在护理自我能力、生活质量、焦虑、抑郁、并发症等方面的差异。结果 延续护理干预组患者的自我护理能力总分和生活质量各项评分显著高于对照组（P＜0.05）;延续护理干预组的焦虑、抑郁评分明显低于对照组（P＜0.05）;延续护理干预组的并发症发生率（12.00%）明显低于对照组（44.00%）（P＜0.05）。结论 多种护理形式延续护理提高了输尿管造口患者的自我护理能力和生活质量,改善了患者心理状态,有利于患者的身心健康。     

Snyder希望理论联合网络平台延续心理干预在肠造口患者中的应用效果

目的 探讨Snyder希望理论联合网络平台延续心理干预在肠造口患者中的应用效果。方法 选取2021年9月至2022年9月驻马店市中心医院收治的114例肠造口患者,按随机数字表法分为对照组和研究组,各57例。对照组患者接受常规护理干预,研究组患者接受Snyder希望理论联合网络平台延续心理干预。对比两组干预前后自护能力、心理状态、自我感受负担及希望水平等评分,比较两组不良反应发生率。结果 两组患者干预前自护能力、希望水平、生活质量等评分差异无统计学意义(P>0.05),经4个月干预后,两组患者自护能力、希望水平、生活质量等评分均升高,研究组高于对照组(P<0.05)。两组患者干预前焦虑、抑郁、自我感受负担等评分差异无统计学意义(P>0.05),经4个月干预后,两组患者焦虑、抑郁、自我感受负担等评分均降低,研究组低于对照组(P<0.05)。研究组并发症总发生率(17.54%)低于对照组(38.60%)(P<0.05)。结论 Snyder希望理论联合网络平台延续心理干预可改善患者心理状态,减轻自我感受负担,提高希望水平、自护能力,降低并发症发生率,改善生活质量。     

延续护理对直肠癌造口患者心理状态及自我护理能力的影响

目的：评价延续护理对直肠癌造口患者心理状态及自我护理能力的影响。方法观察组56例Miles术患者,对照组30例Miles术患者,分别给予延续护理和常规护理,出院3个月对比两组患者抑郁、焦虑、自我护理能力、生活质量及并发症发生率。结果出院后3个月观察组的SDS评分和抑郁程度均显著低于对照组（P＜0.05）,观察组的SAS评分显著低于对照组（P＜0.05）,中度及轻度抑郁率均显著低于对照组（P＜0.05）,观察组的ESCA量表总分、技能、责任感、自我概念及健康知识评分均显著高于对照组（P＜0.05）,观察组的SF-36量表生理职能、社会功能、情感功能、精神健康、精力、整体健康评分均显著高于对照组（P＜0.05）,观察组的造口并发症发生率显著低于对照组（P＜0.05）。结论延续护理有效改善直肠癌造口患者的心理状态,提高其造口自我护理能力,从而改善生活质量,降低造口并发症发生率。     

延续护理在肾移植受者自我管理能力中的应用效果

目的探讨延续护理在肾移植受者自我管理能力中的应用效果。方法选择2015年1月～2017年12月在我院行肾移植的患者60例为研究对象,随机分为观察组与对照组,各30例。对照组给予常规护理与术后随访,观察组在常规护理基础上实施延续护理。比较两组干预前后自我效能、自我管理能力、生活质量评分。结果干预后,观察组自我效能、自我管理各维度得分及总分均显著高于干预前(P0.05),且观察组自我效能、自我管理各维度得分及总分均显著高于对照组,差异有统计学意义(P0.05);对照组患者干预前后自我效能、自我管理各维度得分及总分比较,差异无统计学意义(P0.05)。干预后,观察组生活质量总分以及各维度得分显著高于干预前(P0.05),且观察组生活治疗总分及各维度得分显著高于对照组,差异有统计学意义(P0.05);干预后,对照组生活质量总分及各维度得分显著高于干预前,差异有统计学意义(P0.05)。结论对肾移植受者实施延续护理能够显著改善患者自我管理效能与自我管理能力,提高患者生活质量。     

永久性肠造口患者的心理护理

目的:探讨永久性肠造口患者常见的心理问题以及心理护理方法,为永久性肠造口患者的护理提供参考。方法:回顾性总结分析我院在2010年1月至2012年12月期间收治的60例永久性肠造口患者临床病例资料,按照不同入院时期将患者分为观察组和对照组,对照组患者进行常规护理,观察组患者在常规护理的基础上进行心理护理干预,总结两组患者的心理状态以及治疗效果。结果:两组患者护理前焦虑和抑郁评分差异无统计学意义(P0.05);两组患者护理前后焦虑和抑郁评分相比,差异具有统计学意义(P0.05);心理护理干预1个月后,观察组患者焦虑和抑郁评分低于对照组,差异具有统计学意义(P0.05)。结论:在常规护理的基础上进行心理护理干预能够有效缓解患者的焦虑、抑郁等不良负面情绪,能够有效改善患者治疗后生活质量,提高治疗效果。     

基于行为改变模式的健康教育在白血病化疗患者中的应用

目的 探讨白血病化疗患者护理实施基于行为改变模式的健康教育的临床效果。 方法 选择2020年3月至2023年2月安徽省滁州市第一人民医院血液科收治的100例白血病化疗患者,采用随机数字表将其分为对照组和观察组。化疗期间给予对照组（50例）常规医学护理,给予观察组（50例）常规护理联合基于行为改变模式健康教育。干预3个月后,观察两组负面情绪、自我管理能力及生存质量的变化情况。 结果 干预后,两组焦虑、抑郁评分均低于干预前,且观察组低于对照组,差异有统计学意义（P＜0.05）。干预后,两组自我管理能力测评量表及生活质量核心问卷-30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（P＜0.05）。 结论 基于行为改变模式的健康教育用于白血病化疗患者,能够有效缓解其负面情绪,增强其自我管理能力,在生存质量改善方面发挥积极作用。     

延续性健康教育对PCI术后患者 自我管理水平及预后的影响

目的 探讨延续性健康教育对经皮冠状动脉介入治疗（PCI）术后患者自我管理水平及预后的影响。 方法 选择 2021年3月至2022年3月在温州市中心医院行PCI术并顺利出院的100例患者为研究对象，根据出院后健康教育方案不同分为对 照组及观察组，各50例。对照组行常规健康教育，观察组在常规教育基础上行双轨延续性健康教育，评价指标包括：患者自我效能感 评分、自我管理能力评分、治疗依从性、不良心血管事件、再入院率以及满意度评分。 结果 两组患者干预后自我效能感、自我管理 能力评分均优于干预前（均P＜0.05），观察组在行延续健康教育后，自我效能感评分、自我管理能力评分、治疗依从性均优于对照组 （均P＜0.05）。观察组不良心血管事件、再入院率均低于对照组，健康教育总满意率高于对照组（均P＜0.05）。 结论 延续性健康教 育可有效增强PCI术后患者的自我效能感和自我管理能力，提高患者治疗依从性、预后康复水平及健康教育满意度。     

慢性病轨迹模式的护理干预在老年慢性心力衰竭患者中的应用效果

目的 探究在老年慢性心力衰竭患者中实施慢性病轨迹模式护理干预的效果。方法 纳入2019年12月至2021年1月新乡市第一人民医院收治的178例老年慢性心力衰竭患者,按随机数表法分为两组,各89例。对照组接受常规干预,观察组接受慢性病轨迹模式护理。比较两组心理状态、自我效能、生活质量及自我管理能力。结果 护理前,两组心理状态、自我效能、生活质量及自我管理能力比较,差异无统计学意义(P>0.05);护理后,观察组汉密斯顿抑郁量表(HAMD)及汉密斯顿焦虑量表(HAMA)评分较对照组低(P<0.05),自我管理能力测定量表(ESCA)中各维度评分均较对照组高(P<0.05),一般自我效能感量表(GSES)评分高于对照组(P<0.05),明尼苏达心力衰竭生活质量问卷表(LiHFe)评分低于对照组(P<0.05)。结论 慢性病轨迹模式的护理干预能够缓解老年慢性心力衰竭患者焦虑、抑郁等不良情绪,增强自我效能,提高自我管理能力,提高生活质量,促进患者病情稳定,值得临床进一步推广应用。     

基于慢性疾病轨迹模式的护理干预在胸腔镜食管癌患者中的效果

目的：探讨基于慢性疾病轨迹模式的护理干预在胸腔镜食管癌患者中的效果。方法：选择2018年1月-2021年5月在河西学院附属张掖人民医院心胸肿瘤外科接受胸腔镜手术的120例食管癌患者,采用随机数字的方法,将患者分对照组60例和观察组60例。对照组患者实施常规护理干预,观察组患者在对照组的基础上实施基于慢性疾病轨迹模式的护理干预。比较两组患者干预前后的负性情绪情况[汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）]、自我管理效能[中文版癌症自我管理效能量表（SUPPH）]、生活质量[生命质量测定量表（EORTCQOL-C30）]、疾病知识知晓情况。比较两组的遵医行为情况、术后并发症情况。结果：干预前,两组HAMA评分、HAMD评分、自我管理效能评分生活质量评分、疾病知识知晓评分比较,差异均无统计学意义（P>0.05）。干预后,两组HAMA评分、HAMD评分均低于干预前,自我管理效能评分、生活质量评分、疾病知识知晓评分均高于干预前（P<0.05）。干预后,观察组HAMA评分、HAMD评分均低于对照组,自我管理效能评分、生活质量评分、疾病知识知晓评分均高于对照组（P<...     

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.