长期家庭氧疗对慢性阻塞性肺疾病患者心理情绪的影响

目的探讨长期家庭氧疗(LTOT)对慢性阻塞性肺疾病(COPD)低氧血症患者心理情绪的影响。方法 31例COPD低氧血症患者用医院焦虑和抑郁情绪表(HAD)进行心理情绪评分。然后分为LTOT组17例和对照组14例。LTOT组的氧流量0.5～2.5L/min,每日吸氧时间≥15h(包括睡眠时间);对照组除未进行LTOT外,其余治疗与氧疗组相同。两组年龄、性别、肺功能和动脉血气无明显差别。1年后分别复查HAD评分。结果 LTOT组焦虑评分由治疗前的14.35±3.81下降到1年后的9.65±3.83(P<0.01),抑郁评分由治疗前的13.18±4.50下降到1年后的9.06±2.79(P<0.01);对照组焦虑和抑郁评分均无明显变化。1年后LTOT组的焦虑及抑郁评分分别与对照组比较明显改善。1年后LTOT组除动脉血氧分压与对照组有显著差异外,动脉血二氧化碳分压、PH值及肺功能均无显著差异。结论 LTOT能改善COPD低氧血症患者的心理情绪。     

心理干预对慢性阻塞性肺病患者焦虑抑郁情绪的影响

目的　观察心理干预对慢性阻塞性肺病 (COPD)患者心理情绪的影响。方法　 10 0例 COPD患者分为心理干预组和对照组 ,两组均给予常规药物治疗 ,干预组增加心理干预 ,观察时间 1年 ,分别在干预前和 1年后应用医院焦虑抑郁(HAD)测评表评估患者心理情绪变化。结果　干预组焦虑评分由 9.88± 3.6 1降为 4.45± 3.38,抑郁评分由 10 .8± 4.0 3降为5 .36± 3.6 9。结论　心理干预能改善 COPD患者心理障碍 ,对 COPD的康复具有重要作用     

慢性阻塞性肺疾病患者长期家庭氧疗的临床观察

慢性阻塞性肺疾病(COPD)是可以引起劳动力丧失和死亡的常见慢性呼吸道疾病。严重COPD患者在缓解期仍存在低氧血症,长期家庭氧疗(LTOT)即每天在家里持续吸氧15h以上,使动脉血氧分压(PaO_2)>60 mm Hg(1 mm Hg=0.133 kPa)是COPD缓解期患者康复治疗的重要措施。本研究探讨LTOT对COPD患者生命质量(包括躯体功能、心理情绪)和肺功能的影响。     

慢性阻塞性肺疾病患者长期氧疗的疗效观察

目的观察慢性阻塞性肺疾病(COPD)患者长期氧疗(LTOT)的疗效.方法将64例COPD患者分成二组(非氧疗组和氧疗组),非氧疗组停止吸烟,常规给予抗感染、支气管扩张剂,祛痰药等治疗;氧疗组在以上常规治疗的基础上加长期氧疗,随访4年.结果LTOT可纠正低氧血压,减缓肺功能恶化,提高生活质量及降低死亡率.结论LTOT是COPD延长生命的重要途径.     

综合心理干预对慢性阻塞性肺疾病患者焦虑抑郁的应用研究

目的：探讨综合心理干预对慢性阻塞性肺疾病患者焦虑抑郁情绪的影响。方法：选取60例COPD患者,随机分为综合心理干预组和对照组,每组30例。两组给予常规抗炎、控制性氧疗、氨茶碱、祛痰及一般支持治疗;心理干预组在常规治疗基础上,由专业精神科医师团队进行专业心理干预。记录两组患者入院时及2周后心理量表及肺功能指标变化。结果：干预2周后综合心理干预组心理量表评分低于对照组（P＜0．05）,肺功能指标高于对照组（P＜0.05）。结论：综合心理干预能更好地改善COPD患者焦虑抑郁情绪,更利于肺功能的改善。     

CAT评分评价长期家庭氧疗在慢性阻塞性肺疾病并呼吸衰竭中的应用价值

目的应用慢性阻塞性肺疾病(COPD)评估测试量表(CAT)评分评价长期家庭氧疗(LTOT)在COPD并呼吸衰竭中的应用价值,并观察患者肺功能、动脉血气与CAT评分之间的相关性。方法将70例COPD患者随机分为对照组和氧疗组,每组35例,对照组予以常规治疗,氧疗组在常规治疗的基础上实施LTOT。对两组患者进行为期1 a随访,对比两组患者治疗前后肺功能、血气分析水平及与CAT评分的相关性。结果氧疗组患者肺功能FVC、FEV_1、FEV_1/FVC、动脉血气指标(SpO_2、PaO_2)显著高于治疗前及对照组,且其升高与CAT评分值成负相关,而PaCO_2下降与CAT评分值呈正相关。结论 LTOT可提高患者肺功能及血氧饱和度,显著降低患者CAT评分值,改善患者预后,提高生活质量;CAT评分可作为评价LTOT治疗效果的有效指标。     

积极护理干预对慢性阻塞性肺疾病患者抑郁情绪和生活质量的影响

目的:探讨积极护理干预对稳定期慢性阻塞性肺疾病(COPD)患者抑郁情绪和生活质量的影响。方法:选择2007年1月-2008年1月就诊确诊稳定期65例COPD患者,随机分为积极护理干预组(33例)和对照组(32例)。积极干预组随访1年,干预前和干预后1年分别采用抑郁自评量表和生活质量量表评估两组的抑郁情绪状态和生活质量。结果:积极护理干预后,COPD患者的抑郁情绪评分较对照组明显下降(39.6±7.9/59.6±8.9),生活质量总评分较对照组明显上升(78.8±4.5/62.1±10.4),P均<0.05。积极干预组患者1年后抑郁评分较干预前明显下降(55.6±15.2/39.6±7.9),生活质量总评分上升(63.9±14.7/78.8±4.5),P均<0.05。COPD患者抑郁情绪评分与生活质量评分呈负相关(r=-0.505,P<0.05)。结论:稳定期COPD患者存在着抑郁情绪障碍和生活质量下降,积极护理干预可以显著地改善患者的抑郁情绪状态,明显提高患者的生活质量。     

慢性阻塞性肺疾病患者伴焦虑抑郁的临床调查及治疗

目的:调查慢性阻塞性肺疾病(COPD)患者合并焦虑、抑郁的发生率,并探讨有效治疗COPD合并焦虑、抑郁患者的方案。方法:选择2018年1月-2019年1月在本院治疗的300例COPD患者,根据医院焦虑抑郁量表(HAD)评分统计COPD患者伴焦虑、抑郁的发生率;将COPD伴焦虑、抑郁患者按随机数字表法分为对照组和观察组。对照组采用COPD规范化治疗联合认知行为干预,观察组在对照组基础上给予草酸艾司西酞普兰治疗,比较两组治疗前后的HAD评分、肺功能、生活质量、呼吸困难评分及6分钟步行试验(6MWD)情况。结果:300例COPD患者中伴焦虑、抑郁60例,发病率为20.00%。治疗后,两组焦虑与抑郁评分均明显低于治疗前,且观察组均低于对照组(P0.05);治疗后,两组FEV1与FEV1/FVC%均高于治疗前,且观察组均高于对照组(P0.05)。治疗后,两组各项生活质量评分及总分均低于治疗前,且观察组均低于对照组(P0.05)。治疗后,观察组呼吸困难评分低于治疗前及对照组,且观察组6MWD情况优于治疗前与对照组(P0.05)。结论:COPD患者伴焦虑抑郁发生率较高,在COPD规范化治疗基础上应用草酸艾司西酞普兰联合认知行为干预能够有效改善COPD伴焦虑、抑郁患者的精神状态,有效改善患者的肺功能及生活质量,减轻呼吸困难程度,增强患者的运动能力。     

冠状动脉旁路移植患者术前心理状况对低氧血症发生的影响

目的 探讨冠状动脉旁路移植术（CABG）术后患者发生低氧血症的危险因素,以及术前心理状态对低氧血症发生的影响。方法 回顾性分析2018年6月至2021年10月入住本院心血管外科的成年患者,根据术后氧合指数将患者分为低氧血症组和非低氧血症组。采用医院焦虑抑郁量表评估患者的术前心理状态,当任一子量表评分大于7分时即认为存在焦虑抑郁状态,纳入心理障碍组,反之则纳入心理正常组。结果 本研究共纳入148例患者,其中45例术后出现低氧血症,发生率为30.4%。术前存在焦虑抑郁状态的患者共有70例,占47.3%。心理障碍组中低氧血症的发生率为40%(28/70),显著高于心理正常组的21.8%(17/78)(P<0.05)。术后24 h心理障碍组患者的氧合指数显著低于心理正常组（P<0.05）。年龄、术前合并慢性阻塞性肺病（COPD）、术前焦虑抑郁、手术时间被发现与低氧血症的发生密切相关（P<0.05）,而进一步通过logistics回归分析证实术前合并COPD、术前焦虑抑郁、手术时间是低氧血症发生的独立危险因素（P<0.05）。当CABG患者术前出现焦虑抑郁后,其机械通气时...     

长期家庭氧疗对慢性阻塞性肺疾病的治疗作用

目的　通过对一组伴严重低氧血症的COPD患者进行长期家庭氧疗 (LTOT) ,以了解该治疗的临床意义。方法　选择缓解期COPD患者 5 0例 (PaO2 <7 3kPa(5 5mmHg)或SaO2 <88% )进行家庭氧疗 2个月 ,氧疗前后进行血气分析和血细胞比容测定。结果　每日持续吸氧 >15h者的PaO2 升高同时不伴有PaCO2 的升高 ,血细胞比容较氧疗前明显下降 ,临床症状明显改善。结论　应对伴有严重低氧血症的COPD患者进行LTOT。     

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.