老年人绞窄性肠梗阻围手术期的护理

对 10 5例老年人绞窄性肠梗阻病人的护理 ,认为老年病人术前并存病多 ,临床症状和体征不典型 ,休克发生率高 ,提出加强术前病情的观察 ,做好各重要器官的监护 ,做好心理护理及术后精心细致的观察和护理 ,是减少手术并发症 ,提高临床治愈率的关键。     

听神经瘤病人手术前后颅内高压的护理

目的 探讨听神经瘤病人手术前后颅内高压的护理.方法 我院报告12例听神经瘤病人手术前后颅内高压的观察与护理.对术前颅内高压的9例病人严密观察生命体征、意识和瞳孔变化,缩短观察、记录的间隔时间,做好心理护理和各种术前准备.术后发生颅内高压5例,护理措施为采取正确的卧位,密切观察生命体征,保持呼吸道通畅,做好引流管护理、呼吸道及后组颅神经损伤护理、眼部护理.结果 本组10例痊愈,2例死于术后恶性颅内压增高导致的枕骨大孔疝.结论 分析了对听神经瘤手术前后颅内高压的护理,认为术前颅内高压的观察与护理是保证手术成功的重要因素,而术后及时发现和处理颅内高压是降低病死率与并发症的关键.     

腭裂修复术的围手术期护理

目的探讨腭裂病人术前护理及术后并发症的观察护理。方法我科2002年3月～2006年12月共行腭裂修复术224例。结果术后观察12～18天,214例手术成功,5例伤口内渗血,10例不同程度伤口裂开。结论良好的围手术期护理对提高疗效,减少并发症具有重要意义。     

颈动脉内膜剥脱术的护理（附49例报告）

目的 为了介绍颈动脉内膜剥脱术的护理经验。方法 对49例颈动脉内膜剥脱术后病人进行了术前及术后的护理，主要对并发症进行了严密观察。结果 1例于术后第10天突发“心肌梗死”死亡，有5例颈部血肿，得以及时处理。其他病人恢复良好，对护理满意。结论 围手术期的护理是颈动脉内膜剥脱术后病人康复的重要保证。     

经尿道电切术治疗前列腺增生症病人护理

目的:研究术前术后护理对前列腺气化电切术病人的影响。方法:对110例接受前列腺气化电切病人进行术前、术后护理和观察。结果:术后发生膀胱痉孪5例,其他患者均取得了满意的治疗效果。结论:经尿道电切术治疗前列腺增生逐年增加,正确掌握手术适应证,良好的术前术后护理对疾病能否成功治愈起关键作用。     

腹腔镜下子宫肌瘤手术病人的护理

目的对子宫肌瘤患者行腹腔镜下手术治疗，策划护理重点具体术前术后护理，减轻病人痛苦，使病人尽早康复，从而提高疗效。方法总结103例腹腔镜下子宫肌瘤手术病人的术前术后护理体会。术前做好心理护理、饮食护理、脐部护理，术后做好病情观察、预防并发症发生。本着术前术后相结合的原则进行护理。结果经术后回访103例腹腔镜下子宫肌瘤手术患者，对术前、术后护理满意率达99％，生活工作恢复正常。结论通过科学的心理护理及规范的术前准备和耐心的术后护理，可增强病人的自信心，确保手术顺利进行，使病人早日恢复健康，从而提高治疗效果。     

腓骨肌皮瓣修复下颌骨缺损术的护理措施

目的:总结腓骨肌皮瓣修复下颌骨缺损术病人的资料。方法:密切观察5例病人的病情变化并采取有效的护理措施。结果:5例病人手术全部成功,经细致有效的护理无1例出现并发症,均痊愈出院。结论:应用腓骨肌皮瓣修复下颌骨缺损是一种新的手术方法,术前认真做好准备,术后严密观察皮瓣情况,采取相应的预防措施是手术成功的重要环节。     

带皮岛游离腓骨骨皮瓣修复上颌骨缺损术的配合

介绍带皮岛游离腓骨骨皮辩修复上颌骨缺损术的手术护理配合。方法:术前做好器械仪器设备的准备和性能检查。术中与麻醉医生和手术医生密切配合,同时密切观察病情变化,及时处理。结果:自2003年2月至2007年5月共完成10例。术后效果满意。结论:手术护士做好病人术前,术中护理,熟练配合,并保证手术器械仪器设备的齐备和性能良好,是手术顺利完成和病人安全的重要保证。     

术前访视对骨科手术病人术后焦虑的影响

目的探讨术前访视对骨科手术病人焦虑的影响。方法将60例病人随机分为观察组和对照组,每组30例,对照组为常规术前护理,观察组为常规术前护理加术前访视,均进行术前STAI和术后SAI问卷调查。结果1)术前观察组和对照组病人的中、重度焦虑程度比较,P>0.05,差异无统计学意义,说明手术前病人均存在焦虑状态,两组病人具有可比性。2)术后两组病人中、重度焦虑程度比较,P<0.01,差异具有统计学意义。结论术前访视能降低骨科手术病人术后的焦虑,还可以减轻或消除病人的疼痛。     

白内障超声乳化+人工晶体植入术致角膜水肿的观察和护理

目的 探讨白内障超声乳化术后角膜水肿的原因、治疗和护理,减少术后并发症.方法 对659例白内障手术病人加强术前心理护理和宣教,术中配合,术后角膜观察,做好专科护理及出院指导.结果 659例白内障超声乳化病人有179例出现角膜水肿.其中,轻度角膜水肿80眼,2天内恢复透明.中度角膜水肿71眼,6-10天消退恢复透明.重度角膜水肿28眼,10-25天消退恢复透明.结论 晶体核硬度、超声能量、手术技巧、手术时间与角膜水肿的轻重有关,做好术前护理、术中配合、术后做好裂隙灯观察及护理,有利于手术后视力的提高,可防止角膜内皮失代偿的发生.     

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.