探讨早期康复护理干预对创伤性颅脑损伤患者神经运动及认知功能的影响

目的:分析早期康复护理干预对创伤性颅脑损伤患者神经运动及认知功能的影响。方法:选择创伤性颅脑损伤患者64例,分为对照组与研究组,每组32例,给予对照组患者常规护理,研究组在对照组护理基础上进行早期康复护理干预,并对两组患者临床资料进行回顾性分析。结果:护理干预后,研究组神经运动功能总有效率为84.37%,明显优于对照组的71.88%;且研究组改善后的总有效率为93.75%,明显优于对照组的78.12%,差异有统计学意义(P<0.05)。结论:早期康复护理干预可以显著提升创伤性颅脑损伤患者的神经运动及认知功能,值得在临床中推广应用。     

早期护理干预对颅脑损伤后运动性失语患者康复的影响

目的在优质护理工作模式下,探索早期护理干预对重型颅脑损伤后运动性失语患者康复的影响。方法选择颅脑损伤后24h内入院,GCS评分≤8分,颅脑损伤后运动性失语症患者95例,随机分两组,观察组48例和对照组47例,观察组由管床护士实施早期护理干预措施。即在患者意识障碍减轻,病情稳定时尽早对患者进行语言评估,根据语言障碍评估结果,有计划地实施发音功能训练。对照组按重型颅脑损伤常规综合治疗、护士及家属随意训练。将两组患者康复效果进行比较,并进行统计学分析。结果观察组语言的恢复效果明显优于对照组(χ2=32.993,P<0.001)。结论早期护理干预能有效的促进重型颅脑损伤后运动性失语患者康复。     

早期康复护理在颅脑损伤患者中的应用

目的：探讨早期康复护理对颅脑损伤患者的影响。方法：选取颅脑损伤患者86例为研究对象,随机分为研究组与对照组各43例,对照组给予常规护理干预,研究组在对照组基础上增加早期康复护理,对比两组肢体运动功能、自理能力、功能状态、神经功能及护理满意度。结果：护理6个月后,研究组上肢运动功能评分、下肢运动功能评分高于对照组,差异有统计学意义(P<0.05),研究组自理能力评分均高于对照组,差异有统计学意义(P<0.05),护理后3个月,研究组营养评估评分以及吞咽功能评分均高于对照组,差异有统计学意义(P<0.05),护理后6个月,数据显示研究组营养状态评分高于对照组,但组间比较差异无统计学意义(P>0.05),研究组吞咽功能评分高于对照组,差异有统计学意义(P<0.05);组间护理前,神经功能缺损评分比较差异无统计学意义(P>0.05),护理3个月、6个月以及1年后,研究组神经功能缺损评分均低于对照组,差异有统计学意义(P<0.05),研究组护理满意度高于对照组,差异有统计学意义(P<0.05)。结论：将早期康复护理应用于颅脑损伤的治疗中,能够有效改...     

早期护理干预对重型颅脑损伤患者综合功能及生存质量的影响

目的:探讨早期护理干预对重型颅脑损伤患者综合功能及生存质量的影响。方法:选取2013年10月-2017年10月期间在本院住院的重型颅脑损伤患者90例作为研究对象,按照随机数字表法将其分为试验组和对照组,各45例。对照组进行常规化护理,试验组在对照组的基础上开展早期护理干预。比较两组的护理服务满意度、平均住院时间、重型颅脑损伤知识掌握度、康复训练依从性,护理前后患者的综合功能及生存质量评分,以及后遗症发生情况。结果:试验组患者对护理服务满意度为100%,明显高于对照组的80.00%,差异有统计学意义(χ~2=10.000,P=0.002)。试验组平均住院时间、重型颅脑损伤知识掌握度和康复训练依从性评分均明显优于对照组,差异均有统计学意义(P0.05)。护理前两组综合功能及生存质量评分比较,差异均无统计学意义(P0.05);护理后,试验组综合功能及生存质量评分均明显优于对照组,差异均有统计学意义(P0.05)。试验组后遗症发生情况明显低于对照组,差异有统计学意义(χ~2=5.074 8,P=0.024 3)。结论:早期护理干预在重型颅脑损伤患者护理中的应用效果确切,可提高患者重型颅脑损伤知识掌握度和康复训练依从性,改善神经、肢体等相关功能和生存质量,缩短住院时间,降低后遗症发生率,患者对护理服务满意度高。     

早期康复护理对重型颅脑损伤患者生存质量的影响

目的 探讨早期康复护理干预对重型颅脑损伤患者生存质量的影响.方法 78例重型颅脑损伤患者随机分为康复组40例,对照组38例.对照组采用神经外科常规护理,康复组在此基础上给予早期康复护理干预.将两组的治疗效果进行对比.结果 出院时两组患者根据Glasgow预后标准比较,康复组明显优于对照组.Glasgow预后差异有显著性( P＜0.05).结论 早期康复护理干预有利于促进重型颅脑损伤患者神经功能恢复,降低患者伤残率,提高生存质量.     

优质护理模式对重型颅脑损伤患者开颅术后综合生存质量的影响研究

目的 探讨研究优质护理模式对重型颅脑损伤患者开颅术后综合生存质量的影响.方法 选取2012年1月～2013年1月于河北省兴隆县人民医院采用开颅术进行治疗的70例重型颅脑损伤患者为研究对象,将70例患者遵循随机数字表法分为对照组35例和观察组35例,对照组根据常规护理程序进行干预,观察组则以优质护理模式进行干预,然后分别于护理干预前和护理干预后第2、4周采用颅脑损伤患者生活质量量表（QOLIBRI）量表、康奈尔医学指数（CMI）量表和焦虑抑郁他评量表对两组患者进行评估.结果 护理干预后第2、4周观察组的QOLIBRI量表、CMI量表和焦虑抑郁他评量表评估结果均显著优于护理干预前,并且明显地优于对照组,差异均有统计学意义（均P＜ 0.05）.结论 优质护理模式可有效改善重型颅脑损伤患者开颅术后的综合生存质量,有利于患者的术后康复.     

高压氧综合护理模式对早期重型颅脑损伤的影响及护理对策

目的 探讨高压氧综合护理对重型颅脑损伤患者的疗效.方法 对于高压氧综合护理的早期重型颅脑损伤患者进行回顾性研究,对照组给予高压氧常规护理,研究组给予高压氧综合护理,包括制定护理重点,康复计划及预见性护理措施.对比不同护理的两组患者在治疗过程中并发症发生率及因并发症中断高压氧治疗时间的差异,并比较两组高压氧不良反应发生率的差别.采用GCS评分行近期疗效评定.采用远期生活质量评估量表（KPS）行远期生活质量评定.结果 高压氧治疗及高压氧综合护理3个疗程后,研究组消化道出血发生（4/42）较对照组（14/41）减少,因并发症中断高压氧治疗的时间f（13.64±2.78）d]比对照组[（20.90±8.96）d]缩短,高压氧不良反应的发生（0/42）比对照组（4/41）显著下降,治疗前后GCS评分及治疗后KPS评分均明显优于对照组,差异均有统计学意义（均P＜ 0.05）.结论 高压氧综合护理对早期重型颅脑损伤患者具有更佳的临床效果和更大的安全性.     

早期康复对脊髓损伤患者功能恢复及并发症的影响

目的探究对脊髓损伤患者行早期康复对其功能恢复及并发症影响。方法选取2015年11月至2016年11月本院收治63例脊髓损伤患者临床资料,根据治疗方式不同分两组,对照组31例患者进行常规干预,研究组32例患者在其基础上行早期康复干预,对比分析两组功能恢复、并发症情况以及生活质量评分。结果研究组FIM、Barthel、ASIA评分比对照组高,比较差异均有统计学意义(P0.05);且研究组异位骨化、体位性低血压者比对照组少,总的并发症发生率研究组为15.63%远优于对照组的45.16%,比较具统计学意义(P0.05);研究组早期康复后的躯体疼痛、情感功能和精神状况等生活质量指标评分均高于对照组,差异有统计学意义(P0.05)。结论脊髓损伤患者接受早期康复干预不仅有助于降低并发症几率,而且有利于促进机体功能恢复和生活质量提升,因此具备实际临床应用价值。     

早期康复护理干预对重型颅脑损伤术后偏瘫肢体康复效果的影响

目的：探讨早期康复护理干预对重型颅脑损伤术后偏瘫肢体康复效果的影响。方法：选取我院自2008年5月至2010年3月收治的130例重型颅脑损伤术后偏瘫患者作为研究对象,知情同意前提下按照随机数字表法随机分为干预组和对照组各65例,两组患者均给予常规术后护理,干预组在此基础上给予早期康复干预性护理措施,比较两组患者肢体康复效果及并发症情况。结果：两组患者总有效率、术后并发症、术后生活质量评分比较均有统计学差异（P〈0．05）。结论：早期康复护理干预可以提高患者肢体功能水平、改善生活质量、降低术后并发症。     

社区护理干预对康复期重型颅脑损伤患者的意义

目的通过社区护理干预对重型颅脑损伤患者康复的影响,了解社区护理的意义。方法将某院2006年3～10月好转出院的重型颅脑损伤患者60例随机分为对照组和干预组各30例,干预组采用护理干预方法,对照组采用一般护理措施。采用自制问卷调查评估两组患者的康复情况。结果干预组患者在心理状况、语言功能改善、肢体功能改善、压疮等并发症发生情况、康复满意度等方面要优于对照组。两组差异显著(P值分别为P<0.01、<0.05、<0.01、<0.05、<0.01)。结论对重型颅脑损伤患者的社区护理干预能促进患者的康复。     

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.