点滴式保留灌肠法用于放射性肠炎的临床观察

目的:探讨点滴式保留灌肠法用于放射性肠炎的护理效果.方法:将160例放射性肠炎且需保留灌肠的患者随机分为实验组和对照组,每组80例.对照组采用传统保留灌肠法,实验组采用点滴式保留灌肠法,观察两组患者灌肠液保留时间、灌肠液是否外溢、临床疗效及灌肠过程中患者的满意度.结果:与对照组比较,实验组灌肠液保留时间长(P<0.01),灌肠液外溢明显减少(P<0.01),临床疗效及患者满意度显著优于对照组(P<0.01).结论:点滴保留灌肠法可以提高灌肠效果,减轻患者在灌肠中的不适,减少药液外溢,延长药物的肠内保留时间,提高治疗及护理效果,具有较好的临床推广价值.     

两种灌肠模式治疗老年人便秘的疗效比较

目的:探讨改变灌肠模式提高解决老年患者便秘的护理效果.方法:将60例需要灌肠患者随机分为实验组和对照组各30例.实验组采用传统小剂量保留灌肠方式加开塞露生理盐水点滴式灌肠法,对照组采用传统小剂量保留灌肠法.结果:与对照组比较,实验组的有效率、护士的接受程度明显优于对照组,两组比较差异有统计学意义(P<0.05).结论:改变灌肠模式可以提高治疗老年患者便秘的疗效.     

静点式中药保留灌肠法的临床应用

目的探讨静点式中药保留灌肠法在临床应用的效果。方法将80例需要中药保留灌肠患者按入院先后顺序随机分成2组,实验组和对照组各40例。对照组采用传统保留灌肠方法,实验组采用静点式保留灌肠法,观察2组患者灌肠液保留时间、患者满意度及药液是否外溢和临床疗效。结果与对照组比较,实验组灌肠液保留时间长(P<0.05)、灌肠液外溢明显减少(P<0.05)。结论静点式保留灌肠法可以提高灌肠效果,减轻患者灌肠中的不适,减少药液外溢,延长药物在肠内保留时间,提高治疗效果,具有较好的临床推广价值。     

应用改良中药保留灌肠法与传统灌肠法的效果比较

目的比较两种保留灌肠法的临床效果。方法选择需保留灌肠患者60例，随机分为实验组和对照组各30例，对照组使用传统保留灌肠法，实验组应用输液式保留灌肠法比较两组灌肠后药液在肠内存留时间、药物外溢情况、患者满意度、临床效果。结果药液在肠内存留时间，实验组高于对照组；药液外溢：对照组高于实验组；患者满意度：实验组100％，对照组60％；治愈率：实验组80％，对照组16．7％。结论输液式中药保留灌肠法，能够使中药药液在肠内存留时间延长，药液外溢减少，患者满意度提高，临床效果较高。     

改进保留灌肠方法对提高溃疡性结肠炎疗效的临床价值

目的：探讨改进后的保留灌肠方法对提高溃疡性结肠炎疗效的临床价值。方法：将156例溃疡性结肠炎患者按住院先后顺序分为对照组和实验组,各组均为78例。对照组采用常规保留灌肠方法,实验组采用改进后的保留灌肠方法,治疗15 d为1个疗程。第1个疗程结束后,回顾性比较两组平均每次灌肠液保留时间、平均每次灌肠液外溢例数及治疗效果。结果：平均每次灌肠液保留时间实验组明显长于对照组（P〈0.01）,平均每次灌肠液外溢例数实验组明显少于对照组（P〈0.01）,完全缓解率、总有效率实验组均明显高于对照组（P〈0.05或P〈0.01）。结论：对溃疡性结肠炎患者在常规保留灌肠方法基础上,改进灌肠液量及灌肠液温度、肛管插入深度,并采取先清洁灌肠后保留灌肠,能明显延长灌肠液保留时间、减少灌肠液外溢,从而提高保留灌肠效果。     

应用改良保留灌肠法与传统灌肠法的效果比较

目的：比较两种保留灌肠法的临床效果。方法：选择需保留灌肠患者80例,随机分为两组,实验组50例和对照组30例,对照组使用传统保留灌肠法,实验组应用输液式保留灌肠法。结果：药液在肠内存留时间,实验组高于对照组;对照组药液外溢高于实验组;实验组满意度、治愈率优于对照组,两组对比差异有统计学意义（P〈0．01）。结论：输液式保留灌肠法,能够使药液在肠内存留时间延长,药液外溢减少,患者满意度提高,临床效果较高。     

低张水灌肠螺旋CT扫描对大肠肿块性病变的应用价值

目的报告结肠的螺旋CT扫描方法，评估低张水灌肠螺旋CY扫描(WESCT)对大肠肿块性病变的诊断价值和限度。方法对58例已知或高度怀疑结肠病变的病人，行螺旋CT扫描。扫描前清洁肠道，扫描时应用肌肉松弛剂和温生理盐水保留灌肠。结果58例病人中有57例清晰显示病变，其中大肠癌45例，淋巴瘤4例，转移瘤3例，脓肿2例，炎性狭窄1例，结肠息肉2例。1例结肠息肉WESCT未检出。45例大肠癌WESCT正确分期40例，其中浆膜层浸润的准确率为91．4％(32／35)，对异常淋巴结检出的敏感度达95．1％(39／41)，淋巴结转移的特异性诊断正确率为83．3％(25／30)。3例转移瘤因清晰显示病变位于肠壁并向外生长及明确的病史而确诊。结论低张水灌肠螺旋CT扫描对大肠癌的分期非常有价值。     

保留灌肠操作中护理体会及效果评价

目的：进行保留灌肠操作中护理体会及效果评价。方法;选择保留灌肠治疗患者60例随机分为两组各30例,对照组用常规方法使用一次性灌肠桶法进行,实验组应用一次性50～100W一次性注射器接保留灌肠管将药液自肛门缓慢推注。结果：药液在体内保存时间实验组高于对照组,治愈率97%、舒适度满意度100%,对照组为73%、65%,药液外溢对照组高于实验组。结论：改进后保留灌肠法注重患者身心感受,将整体护理贯穿于操作过程始终,取得患者积极主动配合增加患者的舒适度满意度,提高了治愈率,增强了患者治疗信心,取得较好效果。     

进展期大肠癌T分期及新辅助化疗疗效的MSCT评价

目的探讨多层螺旋CT在进展期大肠癌T分期及新辅助化疗疗效评价上的应用价值。方法选自经手术治疗的进展期大肠癌患者165例,所有病例术前均行16层螺旋CT和纤维大肠镜检查。其中,42例经新辅助化疗后再次行16层螺旋CT检查并行手术治疗。阅读CT图像后,诊断病变的T分期、新辅助化疗疗效,并与术后病理对照。结果应用MSCT判定进展期大肠癌T分期的准确率为82.4%(P<0.05);判定新辅助化疗疗效准确率为88.1%(P<0.05)。结论MSCT影像因反映了进展期大肠癌的生物学行为,而与病理所见具有一致性。MSCT在诊断进展期大肠癌的T分期、新辅助化疗疗效上具有明显的价值。     

改良中药保留灌肠法在溃疡性结肠炎治疗中的应用

目的:观察分析改良中药保留灌肠法在治疗溃疡性结肠炎的疗效。方法:将194例溃疡性结肠炎患者分为两组,对照组用传统的中药保留灌肠方法。观察组于每晚灌肠前先用开塞露排便,再用注射器接吸痰管(代肛管)方法,灌肠后不断改变体位,观察其疗效及护理。结果:与对照组比较,观察组药液在肠道内保留的时间延长(P<0.01),灌肠药液外溢减少(P<0.01),总有效率明显增高(P<0.05)。结论:改良中药保留灌肠法治疗溃疡性结肠炎的疗效显著。     

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.