综合护理干预在乳腺癌患者围手术期护理中的临床应用

目的探讨综合护理干预在乳腺癌患者围手术期护理中的临床应用。方法选择我院于2015年6月~2016年6月收治的乳腺癌患者60例,按照随机数字表法分为干预组与对照组,每组各30例。对照组患者给予常规对症护理,干预组在对照组基础上采取综合护理干预,对两组患者的焦虑、抑郁负性心理进行评价,并比较两组患者干预前后的生活质量QOL评分。结果干预组患者干预前SAS、SDS评分分别为(52.1±11.3)分、(51.3±15.2)分,干预后SAS、SDS评分分别为(32.5±11.5)分、(33.6±12.7)分,对照组患者干预前SAS、SDS评分分别为(53.2±12.7)分、(52.5±11.6)分,干预后SAS、SDS评分分别为(42.3±12.5)分、(41.3±13.8)分;干预组干预后的SAS、SDS评分均显著低于对照组,两组比较差异有统计学意义(P0.05)。两组患者干预前生活质量QOL评分比较,无统计学差异(P0.05);两组干预后生活质量QOL评分显著增加,与干预前比较均有统计学差异(P0.05);干预组干预后生活质量QOL评分显著高于对照组,差异有统计学意义(P0.05)。结论对乳腺癌患者围术期实施综合护理干预措施尤其心理护理干预,有利于缓解患者的焦虑、抑郁等负性心理,提高患者的生活质量。     

脑血栓患者护理中优质护理干预的应用研究

目的探究脑血栓患者护理中优质护理干预的应用效果。方法选取本院2017年2月至2019年2月治疗的脑血栓患者94例,其中47例采用常规护理干预,为对照组;另外47例采用优质护理干预,为观察组。比较分析两组患者的神经功能缺损症状(NIHSS评分)、日常生活能力(Barthel指数)、心理状态(焦虑评分SAS和抑郁评分SDS)和护理满意度。结果经护理后,观察组NIHSS评分[(10.58±2.12)分]、SAS评分[(36.65±5.48)分]和SDS评分[(38.21±5.43)分]低于对照组[(13.21±2.32)分,(42.13±6.22)分,(45.72±6.15)分],Barthel指数[(82.13±6.05)分]和护理满意率(95.74%)高于对照组[(75.24±6.19)分,(82.98%)],差异有统计学意义(P0.05)。结论对脑血栓患者实施优质护理干预有利于减轻其焦虑、抑郁情绪,改善其神经功能缺损症状,提高日常生活能力和护理满意度。     

心理行为干预对剖宫产产妇心理状态及产后疼痛的影响

目的探讨心理行为干预对剖宫产产妇心理状态及产后疼痛的影响。方法选取2017年4月至2018年4月汝南县人民医院收治的行剖宫产手术的126例产妇,按照随机数表法分成对照组和观察组,每组63例。对照组产妇接受常规护理,观察组接受心理行为干预护理,比较两组产妇心理状态及产后疼痛程度。结果观察组产妇产后疼痛程度轻于对照组,差异有统计学意义(P<0.05);观察组SAS评分[(39.23±3.64)分]、SDS评分[(40.65±3.27)分]均低于对照组[(46.26±4.15)、(49.28±4.76)分],差异有统计学意义(均P<0.05)。结论心理行为干预可有效改善剖宫产产妇的心理状态,降低产妇产后疼痛感,利于预后。     

心理护理干预对老年慢性心力衰竭患者治疗依从性及SAS、SDS评分的影响

目的探讨和分析心理护理干预对老年慢性心力衰竭患者治疗依从性及SAS、SDS评分的影响。方法选取2015年12月~2016年12月100例老年慢性心力衰竭患者作为研究对象,年龄≥60岁。根据护理方法不同随机分为干预组、对照组,每组各50例。对照组应用常规护理,干预组在对照组的基础上采取心理护理干预,比较两组患者的治疗依从率、两组患者干预前后的SAS、SDS评分变化、两组患者对护理人员工作的护理满意度。结果干预组患者的治疗依从率达96%,显著高于对照组的76%,差异有统计学意义(P0.05)。干预组与对照组患者干预后的SAS评分分别为(32.5±8.1)分、(42.8±6.2)分,差异有统计学意义(P0.05)。干预组与对照组患者干预后的SDS评分分别为(31.3±9.2)分、(41.2±6.5)分,差异有统计学意义(P0.05)。干预组患者对护理人员工作的护理满意度达98%,显著高于对照组的76%,两组患者对护理人员工作的护理满意度比较,差异有统计学意义(P0.05)。结论心理护理干预能显著提高老年慢性心力衰竭患者的治疗依从性,降低SAS、SDS评分,减轻患者的焦虑、紧张、抑郁等负性心理,提高对护理人员工作的护理满意度。     

全程优质护理干预对脑梗死偏瘫患者ADL评分的影响

目的探讨全程优质护理干预对脑梗死偏瘫患者ADL评分的影响。方法选取延津县人民医院2016年9月至2018年3月收治的102例脑梗死偏瘫患者,按照随机数表法分为对照组与观察组,各51例。给予对照组常规护理干预,给予观察组全程优质护理干预。比较两组干预前后日常生活能力量表(ADL)、生活质量调查表(SF-36)、焦虑自评量表(SAS)、抑郁自评量表(SDS)评分。结果干预后观察组ADL[(63.29±19.86)分]、SF-36评分[(78.26±9.03)分]较对照组[(50.87±14.62)、(65.06±7.15)分]高,差异有统计学意义(均P<0.05);干预后观察组SAS[(33.74±10.86)分]、SDS评分[(33.72±11.13)分]较对照组[(41.08±11.95)、(42.31±12.42)分]低,差异有统计学意义(均P<0.05)。结论将全程优质护理干预应用于脑梗死偏瘫患者,能缓解患者焦虑、抑郁等不良情绪,提高日常生活能力及生活质量。     

叙事护理对慢性乙型肝炎患者不良情绪、健康信念及心理弹性的影响

目的 探讨叙事护理对慢性乙型肝炎患者不良情绪、健康信念及心理弹性的影响。方法 选取2021年3—8月新乡医学院第一附属医院收治的40例慢性乙型肝炎患者设为对照组，治疗期间实施常规护理干预，选取2021年10月至2022年3月新乡医学院第一附属医院收治的40例慢性乙型肝炎患者设为观察组，治疗期间在常规护理基础上增加叙事护理干预，比较两组患者干预前后不良情绪、健康信念、心理弹性状况变化以及干预后治疗依从性与生活质量差异。结果 干预后两组患者焦虑自评量表(SAS)与抑郁自评量表(SDS)分数均降低，且观察组患者SAS评分[(42.44±4.58)分]、SDS评分[(43.13±4.11)分]比对照组SAS评分[(51.56±4.96)分]、SDS评分[(51.72±4.84)分]低(P<0.05);干预后两组患者健康信念及心理弹性量表(CD-RISC)分数均升高(P<0.05),且观察组患者健康信念[(184.64±16.75)分]、CD-RISC[(83.52±6.43)分]均比对照组健康信念[(168.47±16.86)分]、CD-RISC[(71.89±6.66)分]高(P...     

路径化护理干预措施对冠心病PCI患者的护理效果及预后的影响分析

目的 分析路径化护理干预措施对冠心病PCI患者护理效果及预后的影响。方法选取2015年1月~2016年11月于我院接受冠心病PCI患者90例作为本次研究对象,随机将其分为观察组和对照组。观察组采用路径化护理干预措施,对照组采用常规护理措施。比较两组患者的手术时间、住院时间、SAS评分和SDS评分、并发症情况及生活质量评分。结果观察组手术时间和住院时间[(36.19±10.25)min、(9.17±1.26)d]明显少于对照组的(48.75±13.02)min、(15.49±2.04)d,差异有统计学意义(P0.05);护理后观察组SDS、SAS评分[(32.23±5.60)分、(30.23±2.07)分]均显著低于对照组[(49.87±5.21)分、(48.91±4.32)分],差异有统计学意义(P0.05);观察组血管并发症、腰酸腰痛、尿潴留、低血压、迷走反射、失眠、腹胀等非血管并发症发生率均明显低于对照组,差异有统计学意义(P0.05);观察组出院时生活质量评分为(80.29±8.65)分,显著高于对照组的(74.36±7.93)分,差异具有统计学意义(P0.05)。结论路径化护理干预措施可有效的缩减冠心病PCI患者的手术时间和住院时间,缓解患者焦虑、抑郁情绪,减少并发症的发生,提高患者生活质量,值得临床推广应用。     

心理护理干预对复方樟柳碱治疗缺血性视神经病变患者SAS、SDS评分的影响

目的探讨心理护理干预对复方樟柳碱治疗缺血性视神经病变患者SAS、SDS评分的影响及效果观察。方法选择2016年1月~2017年1月我院收治的60例缺血性视神经病变患者为研究对象,根据随机数字表法随机分为心理护理干预组和对照组,每组各30例。两组均予复方樟柳碱注射液2 mL,每天1次,于患眼侧颞浅动脉旁皮下注射,疗程20 d。对照组予以对症护理,干预组在对照组治疗的基础上予以心理护理干预,干预20 d后,应用统计学方法对比分析两组的临床疗效、两组患者治疗前后SAS、SDS评分的变化、护理满意度。结果心理护理干预和对照组患者的SAS评分、SDS评分治疗后分别显著下降,其中,心理护理干预组、对照组患者的SAS评分分别为(31.16±7.09)分、(42.27±9.03)分,两组比较差异具有统计学意义(P0.05)。心理护理干预组、对照组患者的SDS评分分别为(32.06±8.57)、(41.52±7.43)分,两组比较差异具有统计学意义(P0.05)。心理护理干预和对照组患者治疗后的总有效率分别为93.3%、70.0%,两组比较差异具有统计学意义(P0.05)。心理护理干预和对照组患者的护理满意率分别为96.7%、70.0%,两组护理满意度比较差异具有统计学意义(P0.05)。结论心理护理干预有利于提高复方樟柳碱治疗缺血性视神经病变患者的临床疗效及护理满意度,缓解患者的焦虑、抑郁等负性心理,对于促进缺血性视神经病变患者病情的恢复发挥了重要作用。     

晚期肺腺癌患者65例循证护理干预对患者心理及疼痛状况的影响分析

目的 探讨循证护理干预对晚期肺腺癌患者心理及疼痛状况的影响。方法选取2015年8月~2016年7月在我院接受治疗的晚期肺腺癌患者130例,采用随机数字表法将所有入选患者分为两组,观察组65例,给予循证护理干预,对照组65例,给予常规护理干预,观察两组患者护理后生活质量、VAS、SDS、SAS及生活活动能力改善情况,同时比较两组患者护理后并发症发生率及患者对护理工作的满意度评价。结果护理后,观察组患者的生理、心理、社会、日常及总分都显著高于对照组,差异有统计学意义(P0.05);护理后,两组患者的VAS、SAS及SDS评分均有所下降,观察组[(3.12±1.02)分、(30.45±5.78)分和(32.02±6.12)分]低于对照组[(4.23±1.10)分、(36.12±8.12分)和(39.12±7.45)分],差异显著(P0.05);护理后,两组患者的生活活动能力均有所提高,观察组[(84.12±5.12)分]高于对照组[(77.12±6.89)分],两组比较差异显著(P0.05);观察组总发生率为9.23%,低于对照组27.69%,两组比较差异显著(P0.05);观察组患者护理后的总满意率为93.85%,高于对照组78.46%,两组比较差异显著(P0.05)。结论对晚期肺腺癌患者采用循证护理干预,能够有效缓解患者的疼痛,改善患者的生活质量和心理状态,效果显著。     

优质护理干预在胃癌患者围手术期的应用价值

目的观察优质护理干预对胃癌患者负性情绪和术后生活质量的影响。方法将2017年1月至2018年8月沈丘县人民医院收治的84例胃癌患者按照随机数表法分成对照组和观察组,各42例。对照组接受常规护理,观察组接受优质护理干预。使用焦虑自评量表(SAS)和抑郁自评量表(SDS)评估两组患者护理干预前后负性情绪;使用世界卫生组织生存质量测定量表简表(WHOQOL-BREF)评估两组患者出院时的生活质量;比较两组患者护理满意度评分。结果护理干预后观察组患者SAS和SDS评分[(28.94±5.62)分,(24.85±5.57)分]均低于对照组[(40.75±5.59)分,(38.39±5.36)分],差异有统计学意义(均P<0.05);观察组患者出院时WHOQOL-BREF评分[(95.17±5.81)分]高于对照组[(83.26±5.43)分],差异有统计学意义(P<0.05);观察组患者护理满意度评分[(96.21±4.16)分]高于对照组[(86.94±4.63)分],差异有统计学意义(P<0.05)。结论优质护理干预可有效缓解胃癌患者负性情绪,提高患者术后生活质量,具有较高的临床推广价值。     

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.     

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.