护理干预对腰椎间盘突出症患者术后尿潴留的预防作用

目的:探讨护理干预对腰椎间盘突出症患者术后尿潴留的预防作用。方法:选取于我院行腰椎间盘髓核摘除术患者198例,将其随机分为观察组和对照组各99例,观察组给予系统的护理干预,对照组采用传统常规护理,比较两组患者护理后尿潴留的发生率及导尿率。结果:观察组护理后尿潴留的发生率及导尿率分别为12.1%、7.1%,对照组护理后尿潴留的发生率及导尿率分别为42.4%、27.3%,两组比较差异显著P<0.01。结论:系统的护理干预可明显降低腰椎间盘突出症患者术后尿潴留的发生率及导尿率,对盘突出症患者术后尿潴留有良好的预防作用。     

术前膀胱功能训练对腰椎间盘脱出症术后尿潴留的影响

目的 评估术前膀胱功能训练对预防腰椎间盘切除术后尿潴留发生的效果.方法 将273例腰椎间盘突出症行间盘切除术患者随机分为试验组和对照组,试验组采用术前膀胱功能训练,对照组采用常规护理.比较两组预防术后尿潴留的效果.结果 术后第1次排尿时间,试验组和对照组分别为(3.15±4.68)min和(14.44±6.27)min,试验组第1次排尿时间短于对照组(P＜0.01).试验组与对照组术后尿潴留、导尿的发生率分别为12.9%、8.2%,试验组尿潴留导尿发生率高于对照组(P均＜0.01).结论 术前膀胱功能训练能有效预防腰椎间盘摘除术术后尿潴留的发生率和导尿率.     

护理干预对痔、瘘术后尿潴留的影响

目的探讨护理干预对痔、瘘术后尿潴留发生率和导尿率的影响,为预防术后尿潴留提出可行的护理措施.方法 将84例患者按住院时间分为对照组和实验组:对照组37例,采用传统的护理方法,实验组47例,采取系统的护理干预措施,包括术前健康教育、卧床排尿训练、术后加强心理支持、协助早排尿、发生尿潴留及时采取诱导措施等.结果 两组患者术后尿潴留发生率和导尿率有显著性差异(P<0.01).结论痔、瘘术后尿潴留发生率高,为病人采取系统的护理干预措施,可明显降低其发生率,减轻病人的痛苦.     

系统化护理干预对痔上黏膜环切术(PPH)术后尿潴留的预防效果

目的:探讨系统化护理干预对痔上黏膜环切术(PPH)术后尿潴留的预防效果。方法:将240例行PPH术后患者依随机数字法分为两组,各120例。干预组实施系统化护理干预方案,对照组为常规护理。比较两组患者术后的尿潴留发生率及导尿率。结果:对照组120例中发生尿潴留46例,经常规护理后自行排尿18例,行导尿术28例;干预组120例,发生尿潴留者12例,8例自行排尿,行导尿术者4例。结论:系统化护理干预可以有效预防及降低PPH术后尿潴留的发生,降低导尿率。     

护理干预对预防骨科术后镇痛泵所致尿潴留的效果评价

目的 分析护理干预对预防骨科术后镇痛泵所致尿潴留的效果.方法 本研究选取96例骨科手术患者为对象,术后均应用镇痛泵,将其随机分为对照组和实验组,各48例.对照组患者接受常规护理,实验组患者接受预防性护理.对比分析2组患者尿潴留发生率、导尿率和护理满意率.结果 对照组患者的术后尿潴留发生率为37.50％,导尿率为12.50％,护理满意率为85.42％;实验组术后尿潴留发生率为10.42％,导尿率为2.08％,护理满意率为100.00％.实验组患者术后尿潴留发生率、导尿率明显低于对照组,实验组患者护理满意率明显高于对照组,差异有统计学意义(P＜0.05).结论 预防性护理干预可有效预防骨科术后镇痛泵所致的尿潴留,减轻患者的痛苦,并有助于增进护患关系.     

护理干预在腰椎间盘突出症患者接受射频靶点消融术后的运用

目的 探讨射频靶点消融术后行护理干预对腰椎间盘突出症患者的康复效果.方法 选取2011年1月～2012年8月在重庆三峡中心医院百安分院疼痛科行射频靶点消融术治疗的腰椎间盘突出症患者48例,随机分成干预组和对照组,每组各24例.干预组给予术后系统护理干预,对照组术后仅接受常规护理和常规药物消炎止痛.调查出院时患者的满意度及随访1年后的复发率.结果 出院时调查显示,干预组满意度达100.00％,对照组满意度为70.83％,两组满意度比较,差异有统计学意义（P＜0.05）;随访1年,随访率均为100％,随访结果干预组有2例复发腰椎间盘突出症,远低于对照组的10例,复发率分别为8.33％和41.67％,两组复发率比较,差异有统计学意义（P＜0.05）.结论 科学、系统的护理干预能提高患者满意度,降低患者复发率,有利于提高患者的生活质量.     

护理干预对腰椎间盘脱出症术后尿潴留影响的效果观察

探讨护理干预对腰椎间盘切除术后尿潴留发生的影响。实验组102例入院后即开始进行护理干预。对病人进行心理护理、健康教育、训练床上排尿。术后发生尿潴留时厦时采取诱导措施，对照组129例采用常规护理措施。实验组术前的首次和末次排尿时间差异显著（P〈0．05）。两组术后首次排尿时间及尿潴留的发生率和导尿率差异十分显著（P〈0．01）。系统的护理干预可明显降低术后尿潴留的发生。     

护理干预对腰椎间盘突出症患者术后疗效的影响

目的探讨实施一系列护理干预措施对采用椎间盘镜治疗腰椎间盘突出症患者术后疗效的影响。方法选择采用椎间盘镜手术治疗腰椎间盘突出症患者80例,随机分为护理干预组(常规护理+心理护理)与对照组(常规护理)各40例,观察比较两组的护理效果、手术效果及并发症情况。结果护理干预组的总有效率为95.0%(38/40),明显高于对照组,两组总有效率比较差异有统计学意义(P0.05);护理干预组的术后神经根水肿、神经根粘连、椎间隙感染的发生率明显低于对照组(P0.05);护理干预组的手术时间及住院时间均明显短于对照组,而术中出血量明显少于对照组(均P0.05)。结论采取一系列精心的护理干预措施,尤其是心理干预措施,可以明显提高椎间盘镜手术治疗腰椎间盘突出症的疗效、降低并发症的发生率、提高患者生活质量。     

护理干预对无痛分娩后发生产后尿潴留的效果评价

目的探讨护理干预对无痛分娩后产生产后尿潴留的效果评价。方法将2008年12月至2009年11月124例无痛分娩的产妇列为对照组,2009年12月至2010年11月间136例无痛分娩的产妇列为实验组,对照组进行常规护理,实验组在进行常规护理同时给予系统的护理干预。观察2组产后尿潴留发生率及导尿率。结果实验组的产后尿潴留的发生率明显低于对照组（χ2=10.079,P〈0.01）,实验组的导尿率明显低于对照组（χ2=6.660,P〈0.05）。结论按整体护理模式对无痛分娩的产妇进行系统的护理干预,能有效降低产后尿潴留及导尿率的发生率。     

人性化护理在肛肠病术后预防尿潴留的研究

目的探讨人性化护理服务在肛肠疾病术后预防尿潴留临床效果观察.方法选择320例肛肠病患者者随机分为两组,160例患者实施人性化护理服务(治疗组),160例患者实施常规护理(对照组),观察两组患者术后尿潴留发生率及导尿率.结果两组患者入选时的病情无统计学差异(P>0.05),治疗组术后尿潴留发生率、导尿率、尿路感染明显低于对照组,有统计学差异(P<0.05).结论人性化护理对肛肠疾病术后患者明显降低尿潴留发生率及导尿率.     

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.     

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.