护理干预对乳腺癌术后放疗皮肤的影响研究

目的:分析护理干预对乳腺癌术后放疗皮肤的影响。方法:选取本院2009年6月-2010年6月门诊及住院收治的乳腺癌患者126例,均采取手术根治性治疗+术后放疗的治疗模式,随机分为观察组与对照组各63例。对照组使用乳腺癌放疗常规皮肤护理方法,观察组患者采用放射性治疗皮肤的针对性护理干预,比较两组患者的皮肤损伤程度与放疗中断率的差异。结果:观察组患者放疗后皮肤损伤程度明显低于对照组(P0.05),放疗后因皮肤损伤而导致治疗中断的百分率明显低于对照组(P0.05)。结论:护理干预可以有效减轻乳腺癌术后放疗患者的皮肤损伤程度,减少治疗中断率,值得推广应用。     

伯格曼喷剂对乳腺癌术后放疗患者放射性皮肤损伤发生的影响

目的：探讨伯格曼对乳腺癌术后放疗患者放射性皮肤损伤的预防作用。方法：按照随机数字表法将2020年1月～2021年6月在厦门大学附属第一医院接受放疗的乳腺癌术后患者80例分为两组，各40例，对照组采用康复新液外喷，观察组采用伯格曼外喷，对两组治疗后放射性皮肤损伤情况进行统计，比较两组治疗前、治疗后的生活质量，评估两组治疗满意度。结果：与对照组[25.00%(10/40)]相比，观察组治疗后放射性皮肤损伤发生率[7.50%(3/40)]较低(P<0.05);两组治疗后简明健康状况调查表(SF-36)中社会功能、躯体功能、精力状态、生理功能、生理职能、健康状况、情感职能及精神健康评分均较治疗前升高，且观察组比对照组高，差异有统计学意义(P<0.05);观察组整体治疗满意度优于对照组，且治疗总满意度高于对照组，差异有统计学意义(P<0.05)。结论：乳腺癌术后放疗患者采用伯格曼喷剂可有效预防放射性皮肤损伤，有效提高治疗满意度，改善生活质量。     

疮疡灵治疗乳腺癌放疗所致放射性皮炎临床研究

目的:观察疮疡灵治疗乳腺癌放疗所致放射性皮炎的临床疗效。方法:选取126例乳腺癌放疗患者作为研究对象,随机分为试验组和对照组,其中试验组给予疮疡灵防治放射性皮炎,对照组予以复方醋酸地塞米松软膏防治放射性皮炎,疗程结束后比较两组患者放射性皮炎的发生率及损伤程度,评价临床效果及生存质量。结果:试验组放射性皮炎的发生率明显低于对照组,且损伤程度较轻,两组比较,差异有统计学意义(P0.05);试验组有效率为90.5%,对照组有效率为65.1%,且试验组患者生存质量明显优于对照组,差异有统计学意义(P0.05)。结论:疮疡灵可降低乳腺癌放射性皮炎的发生率及严重程度,改善患者生存质量,临床疗效明显。     

奥克喷联合喷氧预防及治疗乳腺癌放射性皮炎的效果观察

目的 探讨医用射线防护剂奥克喷联合喷氧对乳腺癌放射性皮肤损伤的预防及治疗效果;方法将接受放射治疗的55例乳腺癌病人随机分组:观察组27例,放疗前后对照射区皮肤采用奥克喷外喷,出现放射性皮炎后采用换药联合高流量喷氧.对照组28例,放疗前后常规给予常规指导,未采用特殊保护措施,出现放射性皮炎后单纯换药.比较两组不同程度皮肤损伤的发生率及转归时间;结果观察组放射性皮肤损伤的发生率较对照组明显降低,差异有统计学意义(P<0.05);观察组放射性皮肤损伤的转归时间低于对照组,差异有统计学意义(P<0.05);结论奥克喷联合喷氧能有效防治及治疗乳腺癌患者皮肤放射性损伤.     

土黄连溶液喷涂预防乳腺癌放射性皮炎的效果观察

目的:探讨中药土黄连溶液对乳腺癌放射性皮肤损伤的预防效果。方法:将接受放射治疗的126例乳腺癌术后病人随机分组:观察组63例,放疗前后对照射区皮肤采用我院制剂土黄连溶液外喷。对照组63例,放疗前后常规给予常规指导,未采用特殊保护措施。比较两组不同程度皮肤损伤的发生率。结果:观察组放射性皮肤损伤的发生率较对照组明显降低,差异有统计学意义(P0.05)。结论:土黄连溶液能有效预防乳腺癌患者皮肤放射性损伤。     

益气化浊法治疗三阴乳腺癌临床观察

目的:观察益气化浊法对三阴乳腺癌术后患者临床疗效及生存质量的影响。方法:将62例三阴乳腺癌术后患者随机分为治疗组31例和对照组31例,治疗组以益气化浊法为治则,给予自拟慈菇平岩方汤剂口服,对照组不予治疗单纯进行定期复查。观察两组患者临床疗效、生存质量及体质量变化情况。结果:治疗组有效率为90.3%,对照组有效率为64.5%,治疗组优于对照组(P0.05);在生存质量及体质量改善方面,治疗组均优于对照组,两组比较差异有统计学意义(P0.05)。结论:益气化浊法对于延长三阴乳腺癌术后患者生存时间,提高生存率,改善生存质量方面疗效肯定。     

三乙醇胺乳膏在乳腺癌改良根治术后辅助放疗放射性皮肤损伤防治中作用的临床研究

目的观察三乙醇胺乳膏在乳腺癌患者术后辅助放疗放射性皮肤损伤的预防及治疗效果。方法 76例乳腺患者随机分为两组,每组38例,对照组采用常规放疗护理方法,治疗组除采用常规放疗护理方法之外,治疗期间照射区外涂三乙醇胺乳膏。结果在累积剂量为10 Gy及25 Gy时,治疗组放射性皮肤损伤发生率低于对照组。两组放射性损伤程度差别有统计学意义,治疗组放射性损伤程度低于对照组。结论三乙醇胺乳膏能有效地降低乳腺癌放疗患者放射性皮肤损伤的程度,适于在乳腺癌患者放疗中应用。     

沙榆油对急性放射性皮肤损伤模型大鼠皮损组织中bcl-2和bax基因表达的影响

目的:观察沙榆油对急性放射性皮肤损伤模型皮肤损伤的防治效果及对凋亡相关基因bcl-2和bax表达的影响。方法:雌性SD大鼠40只,均行臀部照射野皮肤脱毛,随机选取10只为空白组,不做特殊处理,其余30只进行急性放射性皮肤损伤造模后随机分为模型组、治疗组和对照组,每组10只。从造模次日起均以生理盐水清洁放射野皮肤,治疗组清洁后外施沙榆油,对照组清洁后外施湿润烧伤膏,模型组不做处理,每天1次。比较各组大鼠照射野皮肤变化,免疫组织化学检测bcl-2和bax的表达情况。结果:造模3组大鼠均发生急性放射性皮肤损伤,治疗组较轻,模型组最重,对照组较重。第14天,与空白组比较,其余3组大鼠皮损组织中bcl-2蛋白均呈低表达或阴性,差异均有统计学意义(P0.05)。第30天,与空白组比较,治疗组bcl-2蛋白表达明显升高,差异无统计学意义(P0.05);治疗组bcl-2蛋白表达显著高于模型组、对照组(P0.05);模型组、对照组bcl-2蛋白表达上升缓慢,均显著低于空白组(P0.05)。第14天,与空白组比较,其余3组bax蛋白均呈阳性(++)至强阳性,差异均有统计学意义(P0.05);治疗组与模型组比较,差异有统计学意义(P0.05)。第30天,治疗组bax蛋白表达进一步减弱,与模型组、对照组比较,差异均有统计学意义(P0.05);模型组、对照组bax蛋白的表达仍然较强,与空白组比较,差异有统计学意义(P0.05)。结论:沙榆油可以减轻放射性皮肤损伤的程度,促进放射性皮肤损伤的恢复;其机制可能与其增强皮损细胞中bcl-2蛋白的表达、降低bax基因的表达、抑制细胞凋亡的作用有关。     

探讨护理干预对乳腺癌术后放疗期间皮肤的影响

目的:研究对乳腺癌术后病患采取全面有效的皮肤护理措施的意义。方法:选取126例在我科进行治疗的乳腺癌病患,126例病患均接受手术治疗和术后放疗进行治疗,对其进行分析研究。将其随机平均分为两组,对照组和观察组每组63例。对对照组病患实施常规的皮肤护理措施,对观察组病患实施放射性有针对性的皮肤护理干预措施,对两组病患的放疗中断率及皮肤损伤程度进行比较。结果:采取护理措施后,比较两组病患的放疗中断率及皮肤损伤程度,观察组病患均比对照组病患好,(P0.05)存在显著性差异,在统计学上有意义。结论:对乳腺癌术后病患采取全面有效的皮肤护理措施,能够大大降低病患皮肤损害程度及治疗中断率,取得很好的临床效果,在临床上具有重大意义,值得广泛进行推广。     

复方榆树皮软膏的制备及对乳腺癌术后放射性皮肤损伤疗效观察

目的 探讨复方榆树皮软膏对皮肤刺激性大小及对临床乳腺癌术后因放疗所致放射性皮肤损伤的防治作用.方法 皮肤刺激性：采用家兔完整皮肤和破损皮肤进行实验,刺激性大小采用得分制,然后进行评价;放射性皮肤损伤的治疗作用：临床采用设观察组50例（复方榆树皮软膏）、阳性药物对照组46例（三乙醇胺乳膏）,两组治疗后,进行疗效的对比观察.结果 皮肤刺激性方面：复方榆树皮软膏对家兔完整皮肤和破损皮肤刺激性平均积分值分别为0、0.67;放射性皮肤损伤的防治疗效方面：①在两组患者皮肤损伤分级中,两组比较存在明显差异（P〈0.05）;②在两组相同放射剂量的皮肤损伤发生率中,20~30 Gy和〉40 Gy照射剂量组两组比较均存在明显差异（P〈0.05）;③在两组患者皮肤反应治疗效果中,观察组和对照组的总有效率分别为96%、87%,两组比较存在明显差异（P〈0.05）.结论 复方榆树皮软膏对家兔皮肤有轻度刺激性（轻度刺激性分值为：0.5~1.9）;对临床乳腺癌术后因放疗所致放射性皮肤损伤有较好的防治效果.     

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.