妇科化疗病人的需求调查与护理

恶性肿瘤严重威胁着人类健康，在我国居死亡原因第二位。为了延缓生命及提高生存质量，据我科临床统计约一半以上的恶性肿瘤病人在不同时期需进行化疗，力求巩固治疗效果，增加治愈率。但由于化疗药物的应用会产生一定的毒副作用，患者在治疗期间往往会出现各种心理及生理方面的需求。面对这一状况，护理人员如何对化疗患者实施整体护理，已不容忽视，倍受大家关注。本文在调查分析妇科化疗病人的身心需求时，旨在了解与临床护理工作有无冲突，以便今后更好地促进对妇科化疗病人的身心整体护理。现将调查情况分析如下．     

妇科化疗病人的需求调查与护理

恶性肿瘤严重威胁着人类健康,在我国居死亡原因第二位。为了延缓生命及提高生存质量,据我科临床统计约一半以上的恶性肿瘤病人在不同时期需进行化疗,力求巩固治疗效果,增加治愈率。但由于化疗药物的应用会产生一定的毒副作用,患者在治疗期间往往会出现各种心理及生理方面的需求。面对这一状况,护理人员如何对化疗患者实施整体护理,已不容忽视,倍受大家关注。本文在调查分析妇科化疗病人的身心需求时,旨在了解与临床护理工作有无冲突,以便今后更好地促进对妇科化疗病人的身心整体护理。现将调查情况分析如下。1临床资料与调查方法1.1临床资料…     

妇科肿瘤化疗患者心理护理体会

目的：探讨妇科肿瘤患者化疗期的心理状态及相应的护理对策。方法：分析患者的不同心理状态,实施相应的心理护理措施。结果：通过采取有效的心理护理措施,78例化疗患者均能积极配合完成化疗。结论：加强心理护理在妇科肿瘤化疗中具有重要意义。     

白血病患者化疗的药物毒副反应观察和护理对策

目的:探索白血病常用化疗方案出现的毒性反应,对患者采取有效的护理措施。方法:对59例施行化疗白血病患者毒副反应进行观察及护理。结果:本组患者化疗副作用出现较少。结论:运用护理程序从生理、心理、社会等方面对患者实施整体护理,可有效减少化疗副作用发生率。     

个性化护理对妇科肿瘤化疗患者的作用

目的探讨妇科肿瘤化疗患者个性化的护理方法。方法根据患者不同的病情、不同的化疗方案、不同的药物副反应及妇科肿瘤化疗患者的心理特点,采取有针对性的护理措施。结果通过护理满足患者身心两方面的需求。结论对妇科肿瘤化疗患者实施个性化护理,可以提高患者的满意度及生活质量。     

临床路径护理对妇科肿瘤化疗中的效果评价

目的探讨临床路径护理干预对妇科恶性肿瘤术后化疗患者生理指标的影响。方法将360例妇科恶性肿瘤化疗患者随机分为观察组和对照组,各180例,对照组接受常规治疗和护理,干预组实施临床路径护理干预。比较两组患者干预前后采用SCL-90因子得分,毒性反应以及KPS得分。结果干预组出院时抑郁、焦虑、偏执、敌对和入院时差值与对照组差值比较显著性降低（P〈0.01）,并且干预组恶心呕吐、白细胞（WBC）和血红蛋白（Hb）与对照组相比有显著改善（P〈0.01）。KPS得分中干预组改善显著性多于对照组。结论临床路径护理干预有助于妇科恶性肿瘤患者化疗期间的生理、心理以及减轻化疗不良反应,从而最终提高患者的生命质量。     

葡萄胎患者的健康教育方法初探

整体护理是指对患者生理心理护理、健康教育及院外指导为一体的护理模式，健康教育是完成整体护理的重要环节。如何开展高质量的健康教育，普及科普知识及宣教卫生科学知识，满足患者康复需求，减少疾病并发症以及缩短恶性肿瘤患者的化疗疗程，在现今社会愈来愈受到重视。我科通过对2000年度葡萄胎患者实施健康教育，受到了良好的临床效果，现将具体做法和体会报告如下。     

妇科恶性肿瘤化疗期间的心理干预与护理方法

目的对妇科恶性肿瘤化疗期间的心理干预与护理方法进行研究。方法选取2015年1月至2016年1月来本院进行妇科恶性肿瘤化疗的60例患者作为本次的研究对象,将其随机的进行组别的划分,对照组实施常规的护理方式,观察组在常规护理的基础上实施心理护理的方式,对比两组患者心理状态的发生情况以及对相关护理人员的满意度评价。结果观察组的心理状态以及对相关护理人员的满意度调查要明显的高于对照组的患者,结论对妇科恶性肿瘤需要进行化疗治疗的患者实施心理护理的方式,能够有效的缓解患者的负面心理,增加其治疗效果以及护理效果,提升对相关医护人员的满意度,故而,能够广泛的应用于类似疾病的临床治疗中。     

谈手术患者的心理护理

心理护理是以病人的健康为中心，以护理程序为核心，对病人实施全面的整体护理，从而满足患者心理、生理、社会的需求。     

妇科恶性肿瘤化疗期间的心理干预与护理分析

目的探讨心理护理在妇科恶性肿瘤患者化疗期间的应用效果。方法采取方便抽样法抽取100例于2015年6月至2016年5月期间在我门诊实施化疗治疗的各类妇科恶性肿瘤疾病患者,以随机数字表法分为两组,观察组和对照组,各组均为50例患者。观察组患者在常规肿瘤化疗护理基础上给予全面的心理护理干预,对照组患者仅给予常规肿瘤化疗护理。结果护理后HAMA评分和HAMD评分,观察组患者显著优于对照组,比较差异存在统计学意义P0.05。护理后MHLC评分,观察组患者显著优于对照组,比较差异存在统计学意义P0.05。临床护理满意度,观察组患者显著高于对照组,比较差异存在统计学意义P0.05。结论在常规化疗护理基础上对妇科恶性肿瘤患者实施心理护理干预,能够显著的改善患者的不良心理状况,从而显著提高患者的护理满意度,具有较高的临床应用价值。     

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.