高血压患者自我效能提升对血栓前状态的影响

目的高血压患者自我效能提升对血栓前状态的影响。方法病例选取门诊高血压患者110例,随机将患者分为对照组和观察组,各55例,对照组给予常规护理,观察组在对照组基础上给予自我效能干预,干预前后发放《高血压病人自我效能量表》、《高血压病人自我管理能力量表》、日常生活能力量表ADL表(Barthel指数),评估两组治疗依从性和血压变化,检测血浆血管性学友病因子(v WF)、血小板α-颗粒膜蛋白(GMP-140)、组织型纤溶酶原激活剂(t-PA)、血浆纤维蛋白原(Fbg)。结果观察组干预后舒张压和收缩压显著低于对照组(P0.05);观察组干预后症状自我效能、疾病自我管理效能评分、ADL评分显著高于对照组(P0.05);观察组干预后饮食控制、运动管理、社会心理管理、治疗依从显著低于对照组(P0.05);观察组干预后vWF、GMP-140显著低于对照组,t-PA显著高于对照组(P0.05);观察组按时服药、合理饮食、按时运动、血压监测、合理生活的依从率分别为96.36%、94.55%、90.91%、90.91%、92.73%显著高于对照组(P0.05)。结论高血压患者自我效能提升能够改善其自我行为管理能力,提高治疗依从性,改善血栓前状态。     

基于时机理论的家庭护理在肺结核患者护理中的应用观察

目的观察基于时机理论的家庭护理在肺结核患者护理中的应用。方法选取我院2017年01月~2017年12月收治的200例肺结核患者为对象,按照入院单双顺序分为对照组(n=100)和观察组(n=100),对照组给予常规护理,观察组给予基于时机理论的家庭护理,比较两组治疗依从率、心理状态[汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD)]及生活质量(SF-36)评分的变化。结果干预后观察组患者治疗依从率为93.0%,显著高于对照组的79.0%(P<0.05);干预后观察组患者HAMA与HAMD评分均显著低于对照组(P<0.05);干预后观察组患者总体健康、生理职能、机体功能、躯体疼痛、活力、社会功能、情感职能、精神健康评分均显著高于对照组(P<0.05);观察组患者1年复发率为8.0%,显著高于对照组的20.0%(P<0.05)。结论基于时机理论的家庭护理可有效提高肺结核患者的治疗依从率和护理质量,降低其不良情绪。     

综合护理干预对精神分裂症患者服药依从性及生活质量的影响研究

目的探讨实施综合护理干预对精神分裂症患者服药依从性及生活质量的影响。方法选择2014年1月~2016年1月我院收治的精神分裂症患者76例作为研究对象。所有患者根据护理方法不同分为干预组、对照组,每组38例。对照组采取常规护理,干预组采取心理干预、药物指导、社会技能训练、健康教育等综合性护理干预措施,比较两组患者干预后的服药依从率及干预前后生活质量的躯体功能、心理功能、社会功能、物质生活状态各项评分的变化情况。结果干预后,干预组患者的服药依从率达92.1%,显著高于对照组的服药依从率76.3%,差异有统计学意义(P0.05)。干预后干预组患者生活质量评分较对照组比较明显升高,差异有统计学意义(P0.05)。结论精神分裂症患者实施综合护理干预有利于提高服药依从性,改善患者的生活质量,从而促进疾病的恢复。     

心理干预与健康教育对孕妇焦虑情绪及生活质量的影响

目的:探讨心理干预与健康教育对孕妇焦虑情绪及生活质量的影响.方法:选取2014年1月至2015年1月在该院住院时在常规护理服务基础上采取心理干预和健康宣教的56例产妇作为观察组,同时选取采用常规护理服务的45例产妇作为对照组,并比较两组患者焦虑情绪和生活质量改善情况.结果:护理前,对照组和观测组患者SAS评分比较,差异无统计学意义(P＞0.05),护理后,对照组和观测组患者SAS评分比较,差异具有统计学意义(P＜0.05);观察组患者生理功能、社会功能、生理职能、活力、精神健康、情感职能以及总体健康等SF-36评分均明显高于对照组(P＜0.05);观察组患者对护理服务满意度明显高于对照(P＜0.05).结论:在常规护理基础上实施心理干预和健康宣教服务不仅可明显改善患者抑郁和焦虑等负面心理情绪,还能显著提高患者预后生活质量,该方法值得推广应用.     

心理护理及健康教育在糖尿病肾病患者中的效果观察

目的观察心理护理及健康教育在糖尿病肾病患者中的效果。方法选择2017年1月～2018年1月在我院住院治疗的糖尿病肾病患者60例作为观察对象,随机分为观察组和对照组,每组30例,对照组采取常规护理,观察组在对照组治疗的基础上同时联合心理护理及健康教育,比较两组患者干预前后的焦虑心理及抑郁心理评分、生活质量各项评分、护理满意度。结果观察组与对照组患者干预前的SAS评分比较,差异不显著(P0.05),干预后,观察组与对照组患者的SAS评分显著降低。观察组与对照组患者干预前的SDS评分比较,差异不显著(P0.05),干预后,观察组与对照组患者的SDS评分显著降低。同时对比分析两组患者干预后的SAS评分、SDS评分,结果显示,观察组患者干预后的SAS评分、SDS评分分别显著低于对照组,组间比较差异具有统计学意义(P0.05)。观察组与对照组患者干预前的心理功能、躯体功能、物质生活状态、社会功能各项评分比较,差异不显著(P0.05),干预后,观察组与对照组患者的心理功能、躯体功能、物质生活状态、社会功能各项评分明显升高,且显著高于对照组,组间比较差异具有统计学意义(P0.05)。观察组的护理满意率为96.67%,对照组的护理满意率为70.00%,两组对比,组间差异有统计学意义(P0.05)。结论对糖尿病肾病患者在积极对症治疗的同时采取心理护理及健康教育干预措施,有利于减轻患者的焦虑抑郁心理,改善生活质量,提高护理满意度。     

个性化护理对中青年高血压患者服药依从性对照研究

目的:观察个性化护理对中青年高血压患者服药依从的干预效果.方法:将78例原发性高血压患者随机分为心理干预组38例和对照组40例,两组均给予内科常规抗高血压治疗及常规高血压护理.干预组在上述基础上给予个性化心理干预.结果:治疗前到治疗1周后,心理干预和对照组血压水平无显著差异(P＞0.05),而治疗2周后干预组和对照组血...     

健康教育在高血压患者中的应用效果

目的:观察健康教育在高血压患者中的应用效果。方法:选取86例高血压患者为研究对象,按照随机数字表法分为观察组和对照组,每组43例。对照组接受常规门诊指导,观察组组接受健康教育。比较两组护理前后简明健康状况调查表(SF-36)各维度评分,以及护理后的服药依从率。结果:护理前,两组SF-36量表各维度评分比较,差异均无统计学意义(P>0.05);护理后,两组SF-36量表各维度评分均高于护理前,且观察组高于对照组,差异有统计学意义(P<0.05)。观察组服药依从率为95.3%(41/43),高于对照组的81.4%(35/43),差异有统计学意义(P<0.05)。结论:健康教育应用于高血压患者可提高生命质量评分和服药依从率,优于常规门诊指导效果。     

“互联网+”模式下健康信息传播需求满足对中青年冠心病患者术后认知情况和服药依从度的影响

目的 研究“互联网+”模式下健康信息传播需求满足对中青年冠心病(CHD)患者术后认知情况和服药依从度的影响。方法 选择2018年1月到2020年1月本院诊治的110例CHD患者进行研究,将上述110例CHD患者采用随机数表法分为对照组(n=55)和观察组(n=55),对照组采取常规健康教育干预,观察组采取“互联网+”模式下健康信息传播干预,干预12个月后,比较两组患者的术后认知情况、服药依从性、生活行为、自我管理能力、生存质量。结果 观察组干预后二级预防知识、危险因素、治疗方式、药物知识及临床表现评分均高于对照组(P＜0.05);观察组干预1个月、3个月、6个月、9个月、12个月的Morisky服药依从性量表评分均高于对照组(P＜0.05);观察组干预1个月、3个月、6个月、9个月、12个月的生活行为评分均高于对照组(P＜0.05);观察组干预后CHD自我管理行为量表(CSMS)中各维度评分均显著高于对照组(P＜0.05);观察组干预后西雅图心绞痛量表(SAQ)中各维度评分均显著高于对照组(P＜0.05)。结论 “互联网+”模式下健康教育可改善中青年CDH患者PCI术后认知情况及服药依从度。     

快速康复护理路径对胃肠疾病手术患者术后锻炼依从性及心理状态的影响

目的：探讨快速康复护理路径对胃肠疾病手术患者术后锻炼依从性及心理状态的影响。方法选取我院2012年1月-2015年1月期间进行胃肠疾病手术的患者61例,随机分为观察组和对照组,观察组30例,对照组31例。术后对观察组实施快速康复护理路径进行干预,给予对照组实施常规护理干预,比较两组患者术后胃肠功能恢复时间、康复进程情况、锻炼依从性及心理状态评估结果。结果与对照组比较,观察组胃肠功能各指标恢复时间显著较短(P＜0.05);观察组患者康复进程各指标显著短于对照组,其中总住院时间(21.23±6.56)d显著短于对照组(37.33±8.96)d(P＜0.05);术后锻炼依从性方面观察组患者完全依从率为56.67%,高于对照组的32.26%,不完全依从率为3.33%,低于对照组的32.26%,两组完全依从率和不完全依从率相比均有显著差异(P＜0.05);术后锻炼两组在恐惧、悲观心理状态均存在显著差异(P＜0.05),康复进程状况与术后锻炼依从性、心理状态呈正相关。结论快速康复护理路径对胃肠疾病手术患者术后锻炼依从性及心理状态有积极影响,有利于患者完全依从术后护理康复计划,调整心理状况,尽快恢复胃肠功能,从而利于患者尽快康复。     

基于弗洛伊德人格理论的心理护理干预对产褥期抑郁症患者遵医行为及生活质量的影响

目的:探讨基于弗洛伊德人格理论的心理护理干预对产褥期抑郁症患者遵医行为及生活质量的影响。方法:选取89例产褥期抑郁症患者,按照随机数字表法分组,对照组44例实施常规护理干预,观察组45例于常规护理基础上实施基于弗洛伊德人格理论的心理护理干预,比较两组治疗依从性、生活质量(QOL)评分及护理满意度。结果:观察组总依从率(95.56%)显著高于对照组总依从率(68.18%);干预后观察组QOL评分显著高于对照组(P<0.05);护理满意度(97.78%)显著高于对照组护理满意度(75.00%)(P<0.05)。结论:基于弗洛伊德人格理论的心理护理干预可改善产褥期抑郁症患者遵医行为,提高其生活质量及护理满意度。     

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.     

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.