优质护理在90例肺结核大咯血患者中的应用效果观察

目的:观察优质护理在肺结核大咯血患者中的应用效果。方法:选取90例肺结核大咯血患者作为研究对象,按照随机数表法分成观察组与对照组各45例。对照组患者接受常规护理,观察组患者在对照组基础上接受优质护理。采用焦虑自评量表(Self-rating anxiety scale,SAS)和抑郁自评量表(Self-rating depression scale,SDS)评价患者的心理状况,比较两组的健康知识知晓率及护理满意度。结果:护理后,观察组患者护理满意度明显高于对照组,差异均有统计学意义(P<0.05)。观察组患者咯血量、咯血停止时间及再次咯血率明显低于对照组,差异有统计学意义(P<0.05)。观察组患者并发症发生率明显高于对照组,差异有统计学意义(P<0.05)。结论:在常规护理基础上,实施优质护理可有效提高患者护理满意度,减少患者咯血量,缩短咯血停止时间,降低再次咯血率和并发症发生率。     

优质护理干预对降低鼻咽癌患者调强放疗后口腔黏膜反应的影响研究

目的:探究为鼻咽癌患者应用优质护理干预对其强调放疗后出现的口腔黏膜反应的临床干预效果。方法:将我院92例鼻咽癌患者纳入研究,随机分组法将46例患者归入研究组,另46例归入对照组,所有患者均接受基础护理,研究组加用优质护理干预,观察两组口腔黏膜反应情况,并比较两组疗效、不良反应。结果:护理后,研究组0级反应例数显著增多,Ⅱ级例数显著减少,差异有统计学意义(P<0.05),研究组Ⅰ、Ⅲ级例数及对照组各级反应例数有所改变,但差异无统计学意义(P>0.05)。研究组0级、Ⅱ级例数与对照组比较,差异有统计学意义(P<0.05);研究组疗效为95.65%;对照组为82.61%,两组比较差异有统计学意义(P<0.05);研究组不良反应发生率为6.52%;对照组为21.74%,两组比较差异有统计学意义(P<0.05)。结论:应用优质护理能够有效预防鼻咽癌患者采用强调放疗发生口腔黏膜反应,且可有效改善口腔黏膜反应患者病情,降低不良反应。     

体循环动脉中非支气管动脉在肺结核大咯血介入治疗中的价值

目的:探析体循环动脉中非支气管动脉在肺结核大咯血介入治疗中的临床价值。方法:选取接受治疗的84例肺结核大咯血患者为研究对象,随机分为对照组与观察组各42例。对照组实施常规内科综合治疗,观察组实施体循环动脉中非支气管动脉介入治疗,比较两组患者的临床治疗效果、不良反应发生率、复发率和治疗前后咯血量。结果:观察组的治疗总有效率显著高于对照组,两组比较差异有统计学意义(P<0.05);观察组患者治疗后的不良反应发生率明显低于对照组,差异有统计学意义(P<0.05);观察组患者治疗后1年的复发率显著低于对照组,差异有统计学意义(P<0.05);两组患者治疗前的咯血量比较差异无统计学意义(P>0.05);从治疗后3 d开始到治疗后7 d,观察组患者的咯血量明显少于对照组,两组比较差异有统计学意义(P<0.05)。结论:体循环动脉中非支气管动脉介入治疗肺结核大咯血的临床疗效显著,不良反应少、复发率低,且咯血量少,可提升患者的生存质量,值得临床进一步推广和应用。     

优质护理干预应用于肺结核咯血患者护理中的临床效果

目的探讨对肺结核合并咯血患者实施优质护理干预的临床效果。方法将我科2016年1月至2016年12月期间收治的52名肺结核合并咯血患者,设置为研究组,提供全程优质护理干预;另选取2015年1月至2015年12月接收的52例肺结核合并咯血患者进行对照研究,设置为对照组,仅提供临床常规护理服务,比较两组护理效果。结果研究组患者入院至咯血停止时间较对照组更短;在预后情况上,研究组咯血恢复情况明显优于对照组,且窒息及转ICU几率较对照组更低,差异对比有意义,P0.05。结论临床对肺结核合并咯血患者实施优质护理干预效果显著,可明显缩短患者咯血时间,改善其预后,对促进患者早日康复、提高生活质量具有重要意义。     

优质护理在宫腔镜联合腹腔镜手术中的应用效果

目的:观察优质护理在宫腔镜联合腹腔镜手术中的应用效果。方法:选取107例接受宫腔镜与腹腔镜联合手术的患者作为研究对象,依据入院顺序将其分为研究组54例和对照组53例,对照组给予常规护理,研究组在对照组基础上给予优质护理,比较两组一次手术痊愈率、手术配合度、手术前后焦虑自评量表(SAS)与抑郁自评量表(SDS)评分、满意度评分以及术后并发症发生率。结果:研究组一次手术痊愈率和手术配合率均明显高于对照组,差异有统计学意义(P<0.05);术前两组SAS评分、SDS评分及护理满意度评分差异无统计学意义(P>0.05),术后研究组的SAS评分、SDS评分及护理满意度评分均优于对照组,差异有统计学意义(P<0.05);研究组并发症发生率为11.11%,显著低于对照组的37.74%,差异有统计学意义(P<0.05)。结论:优质护理应用在宫腔镜联合腹腔镜手术护理中效果显著,可有效缓解患者焦虑及抑郁情绪,提高手术配合率及手术效果,降低并发症发生率,且能明显提高护理满意度。     

分析全程护理对肺结核并咯血患者疗效的影响

目的:为进一步提高对肺结核并咯血患者的治疗效果,探讨分析全程护理对肺结核并咯血患者的疗效的影响。方法:选择我院2013年1月至2014年1月期间接收治疗的60例肺结核并咯血患者,将患者随机分为观察组和对照组,两组患者各30例,护理期间两组都实行常规护理,观察组患者加行全程护理,对两组患者护理后的临床症状、咯血发生率及持续时间、住院时间进行观察和统计。结果:观察组发生大咯血、窒息发生率及复发例数均显著低于对照组,差异具有统计学意义(P0.05);观察组患者咯血发生率、持续时间及住院时间均显著短于对照组,差异具有统计学意义(P0.05)。结论:全程护理对肺结核合并咯血患者的疗效具有显著效果,对提高患者治愈率有重要意义,值得在临床上应用和推广。     

优质护理对脑梗死患者的影响分析

目的:通过对脑梗死患者实施优质护理观察护理后临床效果,旨在探讨出优质护理在脑梗死患者中的应用价值。方法:选取接受治疗的160例脑梗死患者,平均分成研究组和对照组两组,每组80例患者,对照组采用传统的常规护理,研究组在常规护理的基础上给予患者心理护理、康复期护理、饮食护理等综合方式,记录两组患者焦虑状态、生活自理能力及治疗的有效率。结果:研究组患者经优质护理后焦虑状态显著减轻且生活完全自理患者多,与对照组比较,差异有统计学意义(P<0.05);研究组患者治疗的总有效率为72.5%,显著高于对照组患者治疗总有效率47.5%,且差异有统计学意义(P<0.05)。结论:通过对脑梗死患者进行优质护理能显著提高患者的精神状态、改善患者生活自理能力、并提高治疗的总有效率,优质护理对脑梗死患者有着重要的意义,可以在临床广泛推广使用。     

垂体后叶素治疗肺结核咯血临床观察

目的:探讨垂体后叶素治疗肺结核咯血临床效果.方法:选取该院2014年9月至2016年1月接收的肺结核咯血患者50例为研究对象,采用随机数字表法划分为对照组与研究组,两组患者均行常规治疗,对照组采取常规对症治疗措施,研究组使用垂体后叶素治疗,对比两组患者治疗效果、咯血停止时间及治疗满意度情况.结果:对照组患者治疗总有效率80.00％显著低于研究组的96.00％差异存在统计学意义(P＜0.05);研究组患者咯血停止时间短于对照组差异有统计学意义(P＜0.05);研究组治疗总满意度高于对照组(P＜0.05).结论:肺结核咯血患者应用垂体后叶素治疗的效果较好,可缩短患者咯血时间,提高患者治疗满意度,具有临床推广应用价值.     

全程护理干预在肺结核并咯血患者护理中的应用

目的探讨全程护理干预在肺结核并咯血患者护理中的应用效果。方法选取商丘市第一人民医院分院2015年4月至2016年4月肺结核并咯血患者80例,按随机数表法分为观察组与对照组,各40例。给予对照组常规护理干预,观察组在对照组基础上接受全程护理干预。统计对比两组护理干预前后遵医行为及并发症发生率。结果干预后观察组并发症发生率(12.5%)低于对照组(32.50%),且观察组住院时间短于对照组,差异有统计学意义(P<0.05);干预后观察组遵医率(97.50%)高于对照组(77.50%),差异有统计学意义(P<0.05)。结论肺结核并咯血患者实施全程护理干预,可有效改善患者遵医行为,降低并发症发生率。     

消化内科护理管理引入优质护理的整体实施效果评价

目的研究在消化内科护理管理中引入优质护理的整体实施效果。方法选取2013年9月至2015年9月在南阳南石医院消化内科治疗的84例患者,随机分为对照组与研究组,各42例。对照组接受常规护理,研究组在对照组基础上引入优质护理,以患者心理状态、生活质量改善情况为标准对护理效果予以评析。结果两组护理前SAS、SDS评分差异无统计学意义(P>0.05),护理后两组的各评分均有所降低(P<0.05),且研究组低于对照组(P<0.05);护理后,研究组患者的生理功能、心理健康、精神以及人际关系等生活质量评分均显著高于对照组(P<0.05)。结论在消化内科护理管理中引入优质护理可显著改善患者的负性情绪,提升其生活质量,建议临床加以重视并推广应用。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.     

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.