护理干预在结石性胆囊炎腹腔镜下胆囊切除术围手术期的应用价值分析

目的:探究护理干预应用于行腹腔镜下胆囊切除术的结石性胆囊炎患者围手术期的价值。方法:选取2016年5月16日—2017年12月31日我院收治的结石性胆囊炎60例,均接受腹腔镜下胆囊切除术,根据护理方法的差异分组:对照组患者实施常规围手术期护理,观察组实施围手术期护理干预,对比两组围手术期指标及护理满意度。结果:观察组患者的围手术期指标(手术时间、术中出血量、术后住院时间)均低于对照组,差异均有统计学意义(P<0.05);观察组对护理的满意度为96.7%,高于对照组的80%(P<0.05)。结论:护理干预的应用使结石性胆囊炎患者安全度过围手术期,术后早期恢复,缩短住院时间,值得推广。     

急性结石性胆囊炎腹腔镜胆囊切除术中转开腹的手术室护理措施分析

目的分析急性结石性胆囊炎腹腔镜胆囊切除术中转开腹手术室的临床护理措施。方法随机选取2012年10月至2016年2月我院收治的58例急性结石性胆囊炎腹腔镜胆囊切除术中转开腹手术患者临床资料,根据随机数字法,把58例患者分成对照组与观察组,各29例。对照组行常规护理,观察组行临床护理干预,对比两组护理满意度与信任度,术中出血量、手术时间及并发症情况。结果观察组护理满意度96.6%,信任度93.1%,对照组护理满意度75.8%,信任度72.4%,观察组护理满意度和信任度明显比对照组高,观察组手术时间(45.6±18.2)min,术中出血量(69.8±19.5)ml,对照组手术时间(61.5±20.2)min,术中出血量(130.5±26.8)ml,观察组手术时间与术中出血量明显比对照组少,观察组并发症发生率3.4%,对照组并发症发生率17.2%,观察组并发症发生率明显低于对照组,对比组间差异显著(P0.05)。结论急性结石性胆囊炎腹腔镜胆囊切除术中转开腹手术,在手术室加强临床护理干预,可以有效改善患者心理和生理,提高患者的护理满意度和信任度,减少并发症发生,具有重要作用,值得推广应用。     

老年急性结石性胆囊炎患者围手术期护理效果分析

目的研究老年急性结石性胆囊炎围手术期护理的效果。方法选取急性结石性胆囊炎患者96例,随机分为观察组和对照组,各48例。所有患者均给予腹腔镜下胆囊切除术,观察组在常规护理的基础上再给予围手术期护理干预。比较两组患者的首次排气时间、住院时间、并发症发生率及护理满意度。结果术后观察组首次排气时间及住院时间均明显低于对照组(P<0.05);观察组的护理满意度为91.67%,明显高于对照组的70.83%(P<0.05);观察组并发症发生率明显低于对照组(P<0.05)。结论围手术期护理干预能够有效缩短老年急性结石性胆囊炎患者的首次排气时间及住院时间,减少术后并发症的发生,提高患者的护理满意度,对促进患者康复具有较高价值。     

循证护理在结石性胆囊炎胆囊切除术围手术期患者护理中的实施效果

目的:探讨循证护理在结石性胆囊炎胆囊切除术围手术期患者护理的实施效果。方法:选取110例进行胆囊切除手术的结石性胆囊炎患者,将其随机分为观察组和对照组。对照组患者使用常规护理,观察组在此基础上采用用循证护理模式,对患者的手术状况和术后并发症等方面进行对比分析。结果:观察组患者的手术状况优于对照组,患者对治疗的满意度明显高于对照组,术后并发症的发生率也低于对照组,以上差异均有统计学意义(P<0.05)。结论:对进行胆囊切除术的结石性胆囊炎患者采用循证护理措施,能够有效缓解患者的心理压力,提升手术质量,减少并发症的发生。     

急性胆囊炎行腹腔镜胆囊切除术的围术期护理

目的探讨急性胆囊炎患者行腹腔镜胆囊切除术下的围术期护理。方法选取本院2015年1月至2016年1月收治的急性胆囊炎患者60例作为研究对象,随机分为对照组和观察组各30例。对照组给予基础性护理治疗,观察组给予综合性围术期护理治疗。比较两组患者术后并发症发生率和患者满意度。结果观察组并发症发生率明显低于对照组,患者满意度明显高于对照组;数据对比差异显著,具有统计学意义(P0.05)。结论良好的围手术期护理是胆囊炎腹腔镜胆囊切除术成功的重要保障。对于降低患者并发症发生率,提高对护理工作满意度而言意义重大。     

循证护理在结石性胆囊炎胆囊切除术围手术期的实施效果分析

目的：探讨结石性胆囊炎胆囊切除术围手术期实施循证护理的效果。方法选择2011年6月至2013年6月我院收治的结石性胆囊炎胆囊切除术患者134例作为研究对象,按照护理方法的不同分为循证护理组和对照组,每组各67例。观察两组患者的护理效果和患者满意度。结果循证护理组患者的住院时间、住院费用和成本效益比均低于对照组,患者满意度显著高于对照组,两组差异均具有统计学意义（P〈0.05）。循证护理组患者的并发症总发生率低于对照组,差异具有统计学意义（P〈0.05）。循证护理组患者在术后第3天和术后第5天的VAS评分低于对照组,差异具有统计学意义（P〈0.05）。结论在结石性胆囊炎胆囊切除术围手术期实施循证护理措施,能有效降低不良并发症的发生率,缓解患者的紧张焦虑情绪,提高患者满意度,促进患者的早日康复,值得在临床上推广应用。     

老年急性胆囊炎腹腔镜胆囊切除术的手术护理配合要点

目的探究老年急性胆囊炎腹腔镜胆囊切除术的手术护理配合要点。方法选取我科于2016年1月-2016年11月收治的老年急性胆囊炎患者126例作为对象进行研究,随机将其分成对照组和实验组,对照组患者实施常规基础护理方法,实验组患者采取有效的围手术期护理措施,对比两组患者的患者满意度以及术后并发症的发生率。结果实验组患者采取有效的围术期护理措施后,术后患者满意度、并发症发生率均明显优于对照组,差异明显(P0.05),具备临床统计学意义。结论在LC治疗老年急性胆囊炎疾病患者治疗期间实施综合有效的围手术期护理干预措施可以显著提高临床治疗效果,降低并发症的发生率,提高患者满意度。     

结石性胆囊炎胆囊切除术围手术期的护理

目的:探讨护理干预在结石性胆囊炎胆囊切除术围手术期的护理效果。方法:随机选取结石性胆囊炎患者80例,以上患者分为观察组和对照组。两组均手术治疗,对照组常规护理干预,观察组实施综合性护理干预,包括术前护理和术后护理。记录两组患者手术时间、术中出血量、术后首次肛门排气时间、住院时间等。结果:观察组手术时间、术中出血量、术后开始排气时间、住院时间分别与对照组比较,差异有统计学意义(P<0.05)。结论:护理干预能够改善结石性胆囊炎患者术中情况,促进患者术后恢复,提高手术治疗效果。     

高龄患者腹腔镜胆囊手术的围术期护理研究

目的：探讨高龄腹腔镜胆囊切除术患者的围术期护理。方法选取2009年1月—2014年5月我院行腹腔镜胆囊切除术老年患者40例,随机分为观察组和对照组各20例,对照组给予常规护理,观察组给予围术期护理干预。比较2组患者手术指标、并发症及满意度。结果观察组患者手术时间、术中出血量、术后排气时间及疼痛评分均显著优于对照组,差异有统计学意义（P＜0.05）;观察组并发症发生率显著低于对照组,满意度显著高于对照组,差异有统计学意义（P＜0.05）。结论高龄腹腔镜胆囊切除术患者围术期应用护理干预,能有效改善手术各项指标,降低术后并发症发生率,提高患者满意度,值得在临床上推广。     

特殊护理干预在腹腔镜胆囊切除术围手术期的应用价值

目的探讨特殊护理干预在腹腔镜胆囊切除术围手术期的应用价值。方法选取襄城县人民医院2016年4月至2017年4月收治的76例拟行腹腔镜胆囊切除术的急性胆囊炎患者,按照入院顺序分为两组,各38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特殊护理干预,比较两组患者术后胃肠功能恢复时间、并发症发生情况、生活质量以及护理满意度。结果观察组患者术后胃肠功能恢复时间短于对照组,术后并发症发生率低于对照组(13.16%比34.21%),护理满意度高于对照组(94.74%比71.05%),术后生活质量评分各指标均高于对照组,差异有统计学意义(P均<0.05)。结论将特殊护理干预应用于行腹腔镜胆囊切除术的急性胆囊炎患者的护理中,可促进患者胃肠功能恢复,降低术后并发症发生率,提高生活质量和护理满意度。     

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.