心理干预对择期手术患者心理问题的影响

目的探讨术前心理干预对择期手术患者心理问题的影响。方法86例择期手术患者随机分为干预组和非干预组，干预组术前实施访视，讲解麻醉和手术相关知识，给予心理辅导和卫生宣教等心理干预措施。非干预组按术前常规护理。结果比较分析显示2组患者在担心手术疼痛、感到紧张、恐惧、焦虑、失眠、孤独无助等观察指标之间存在显著性差异。结论术前心理干预对减少择期手术患者心理问题具有重要的辅助作用。     

妇科门诊手术患者64例心理护理体会

目的：探究心理护理对妇科门诊手术患者预后的影响.方法：将我院拟行妇科门诊手术患者126例分为两组.常规对照组62例,进行常规术前处理.心理护理组64例,在常规术前处理的基础上进行心理干预护理,包括术前、术中及术后心理护理.分别观察两组患者焦虑恐惧、生命体征及疼痛程度.结果：心理护理组术前焦虑及恐惧发生率明显小于常规对照组,术中收缩压和舒张压均低于常规对照组,围术期平均心率和呼吸次数也低于常规对照组,术后无痛率明显大于常规对照组;轻度和中度疼痛率小于常规对照组.结论：科学的心理护理可有效缓解妇科门诊手术患者焦虑、恐惧情绪,有利于手术的顺利进行.     

心理干预对乳腺癌患者术后的影响

目的探讨术前心理干预对乳腺癌患者术后的影响。方法将62例拟行乳腺癌根治手术的患者随机分成试验组和对照组,试验组术前进行心理干预,对照组术前实施常规护理。观察2组患者护理前后焦虑、抑郁评分及疼痛情况。结果试验组患者较对照组患者对手术焦虑、恐惧情绪轻,术后对疼痛的耐受性好,能积极配合治疗。结论术前心理干预能降低患者焦虑、抑郁等紧张情绪,使其处于接受治疗的最佳状态,可以减少术后并发症的发生,利于患者康复。     

脑胶质瘤患者术前心理分析及护理干预体会

目的:术前对患者加强心理分析及护理干预,减少病人忧虑和痛苦,帮助他们建立起有利于治疗的最佳心理状态。方法:将61例胶质瘤往往伴有焦虑情绪使患者随机分为两组,包括干预组(30名)、对照组(31名)观察患者心理变化、焦虑、恐惧程度的改善。结果:护理干预组术前对不同心理状态的患者进行了心理分析及护理干预,患者的情绪稳定,消除了恐惧紧张心理。结论:采取有效的术前心理干预能及时调整患者的各种不良心态,使脑胶质瘤患者以良好的心理素质、健康的心理状态和平稳的生命体征迎接手术,对提高手术成功率有很大帮助。     

心理护理干预在急诊面部损伤清创缝合中的应用

目的:探讨心理护理干预在面部损伤清创缝合中的应用效果。方法:选择2009年12月-2010年12月急诊面部损伤患者67例,随机分为对照组26例和干预组41例,对照组采用一般急诊手术护理,干预组在对照组护理基础上应用心理护理干预。观察比较两组术前心态、术中身心反应及焦虑状态。结果:面部损伤急诊手术患者术前普遍存在焦虑、恐惧等心理问题。通过实施心理干预,干预组患者术前心态和术中身心反应调查结果及术前、术后焦虑自评量表评分结果均显著优于对照组。结论:心理护理干预可以缓解面部损伤急诊手术患者的焦虑、恐惧心理,有利于面部损伤急诊手术顺利进行。     

急诊剖宫产患者术前心理护理的临床效果研究

目的:研究与分析急诊剖宫产患者术前心理护理的临床效果。方法:选取本院收治的急诊剖宫产患者80例为研究对象,按照随机数字表法将其分为对照组与观察组,各40例。对照组实施术前常规护理,观察组在对照组基础上实施术前心理护理。比较两组术前1 d、入手术室10 min时的心理状态(恐惧、焦虑、紧张、怀疑)、收缩压及心率水平。结果:术前1 d,两组患者心理状态(恐惧、焦虑、紧张、怀疑)、收缩压及心率水平比较,差异均无统计学意义(P0.05);入手术室10 min时,观察组恐惧、焦虑、紧张、怀疑等心理状态均较对照组改善(P0.05),且观察组收缩压、心率水平均低于对照组(P0.05)。结论:急诊剖宫产患者术前心理护理的临床效果显著,既能显著减轻患者恐惧、焦虑、紧张、怀疑等心理状态,同时还能改善其生命体征,值得临床推广应用。     

心理干预在门诊手术患者中的应用

目的：探讨心理干预的作用，预防或减轻门诊手术患者的焦虑、恐惧等紧张情绪的影响。方法：对106例门诊手术患者随机分为对照组和干预组各53例，对照组仅按常规进行宣教，干预组在常规基础上，整个过程进行心理干预。采用Zung焦虑自评量表测量患者心理状态，用视觉模拟镇痛法（VAS）评估患者镇痛效果。结果：心理干预后干预组的焦虑值、疼痛程度显著低于对照组；干预组患者的血压、心率值也显著低于对照组。结论心理干预在一定程度上预防或减轻门诊手术患者的焦虑、恐惧等紧张情绪，减少不良反应，对促进健康有积极作用。     

术前心理干预对全麻患者麻醉前及麻醉苏醒期的影响

目的：观察术前访视采取心理干预对全麻患者麻醉前及苏醒期配合的效果。方法：60例全麻患者随机分成对照组和心理干预组各30例。对照组患者常规术前访视,测量记录患者术前1 d和麻醉诱导前血压、心率及麻醉苏醒期配合情况。心理干预组患者除常规术前访视外还给予心理干预：介绍麻醉、手术相关信息及麻醉苏醒期不适等。测量记录项目同对照组。结果：2组患者术前1 d血压和心率差异均无统计学意义（P〉0.05）,心理干预组麻醉诱导前血压和心率均较对照组显著降低（P〈0.01）,2组麻醉诱导前配合率差异无统计学意义（P〉0.05）。心理干预组麻醉苏醒期配合率明显高于对照组（P〈0.01）。结论：术前心理干预可降低患者心理应激反应和焦虑程度,缓解紧张心理,使患者平稳渡过围手术期。     

护理干预对肝活检患者焦虑状态的影响

目的:探讨和研究综合护理干预对肝活检患者焦虑的影响。方法:选择158例肝活检术患者,分为观察组和对照组各79例。对照组仅给予常规护理干预,观察组在常规护理干预基础上给予心理干预和行为干预为主的综合护理干预。结果:经过综合护理干预后,观察组患者的焦虑评分明显低于对照组。结论:综合护理干预能够有效改善患者的心理状况,减轻焦虑、紧张、恐惧和烦躁等负面情绪的影响,有利于患者配合手术,确保手术能够顺利进行。     

手术室患者术前心理干预及效果评价

目的探讨手术室患者术前心理干预方式及临床效果。方法选取我院2009年12月~2010年12月其间进行椎管内麻醉手术的142例患者为研究对象,随机分为观察组和对照组,观察组采用术前心理干预护理（心理支持、音乐疗法、渐进性肌肉放松疗法等）,对照组采用常规护理,比较两组患者术前的焦虑和抑郁程度及术前一天与麻醉前的血压和心率变化。结果观察组的术前的焦虑抑郁程度显著低于对照组,P〈0.05;两组患者术前一天血压及心率无显著性差异,P〉0.05;麻醉前观察组要显著优于对照组,P〈0.05。结论通过心理干预可以帮助患者改善应对方式,可有效消除或缓解患者术前焦虑状况。     

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.