综合护理干预对纯母乳喂养的影响

目的：探讨实施综合护理干预对纯母乳喂养的影响。方法前期接受常规产后访视护理的305名产妇为对照组,实施综合护理干预的316名产妇为观察组。观察两组产妇第1次访视、第2次访视、婴儿4个月龄时的纯母乳喂养率。于4个月龄时调查产后访视的满意度。结果观察组产妇第2次访视、婴儿4个月龄的纯母乳喂养率分别为50．0％（158／316）、62．3％（197／316）,均高于对照组的40．0％（122／305）、33．1％（101／305）（P均＜0．05）。观察组产后满意率为99．1％（313／316）,明显高于对照组的90．5％（276／305）（P＜0．05）。结论产后访视实施综合护理干预,对提高纯母乳喂养率有积极作用。     

产后访视对母乳喂养的影响

目的了解产后访视干预对母乳喂养的影响。方法对2007年3月-2009年3月在我院分娩的市区内产妇自愿接受产后访视的586例,于产后第14天、第28天进行家庭访视。了解母乳喂养情况,并针对存在的问题具体宣教指导。结果医院内纯母乳喂养率为93．68％,一访时下降为76．11％,二访时回升到83．38％。结论产后访视可提高母乳喂养的成功率。     

心理护理干预对母婴分离产妇负性情绪的影响

目的探讨心理护理干预对产后母婴分离产妇负性情绪及产后42d纯母乳喂养率的影响及实施方法。方法将76例产后母婴分离产妇随机分为干预组及对照组,每组36例,对照组采用传统护理方法,干预组在此基础上给予个体化心理护理干预,分析比较两组患者产后第1、5天焦虑自评量表（SAS）和抑郁自评量表（SDS）分值及产后42d纯母乳喂养率。结果产后第1天两组产妇焦虑、抑郁情况比较差异无统计学意义（P〉0．05）;产后第5天产妇焦虑、抑郁情况及产后第42天纯母乳喂养率情况干预组明显优于对照组,组间比较差异有统计学意义（P〈0．05）。结论有效的心理护理干预可促进产后母婴分离产妇生理、心理康复及母亲角色的适应和转换,提高产后第42天纯母乳喂养率,提高了患者对护理服务的满意度。     

社区产后访视对促进母婴健康作用的调查

为了解社区产后访视对母婴健康的影响，于产后42d对访视组（90例）和非访视组（95例）的产妇进行产褥期卫生、母乳喂养、脐部护理、预防接种等知识获知程度、母婴患病情况、母乳喂养率的调查，并对其出生后42d的婴儿进行身高和体重测量。结果表明，访视组纯母乳喂养率为86．7％，非访视组纯母乳喂养率为62．1％；访视组产妇对相关健康知识的知晓率高于非访视组；访视组产妇及婴儿的患病率明显低于非访视组；访视组42d婴儿的身高、体重均显著超过非访视组。     

影响母乳喂养因素的分析

目的 了解母乳喂养的的现状及其影响因素,采取有效的干预措施.方法 对2011年1月至12月在我院新城接受产后42天复查的产妇为为调查对象,共调查1141例,采用统一问卷,对影响母乳喂养的因素进行分析.结果 在1141例产妇中,纯母乳喂养率为69.9%,混合喂养率为24.8%,人工喂养率5.3%.剖宫产\阴道难产,孕产期有合并症或并发症,孕期及产后是否有健康宣教都影响母乳喂养.结论 提高纯母乳喂养率需要加强孕期及产后健康教育,同时要提高产科质量,发挥社区母乳喂养支持组织的作用.     

早期产后访视对母乳喂养的促进作用

目的：通过产后访视增加产妇对母乳喂养的信心，提高纯母乳喂养率。方法：对2012年1月至2013年1月社区休产假的母婴在产后进行早期访视，观察访视前后纯母乳喂养率的变化。结果：母乳喂养率由出院后第一次访视时的73.0%提高至第二次访视时87.3%。结论：早期产后访视可以提高纯母乳喂养率。     

孕期健康教育对母乳喂养成功实施的影响

目的：探讨孕期健康教育对产后42天母乳喂养成功实施的影响。方法：选择我院住院分娩符合研究标准的孕妇共289例,其中孕期参加孕妇学校系统健康教育培训的144例为干预组,孕期未参加孕妇学校健康教育培训,来院分娩的145例为对照组。观察两组产妇产后42天母乳喂养情况。结果：干预组纯母乳喂养率83．33％,对照组纯母乳喂养率71．72％,两组差异有统计学意义（P＜0．05）。结论：孕期健康教育可有效提高母乳喂养率。     

产后访视对纯母乳喂养的影响

目的了解入户产后访视指导对4个月内纯母乳喂养的影响。方法对2010年12月至2013年5月产后居住在本辖区内自愿接受我中心产后访视的759名产妇,于出院3天电话访视,出院1周内一般为产后10天左右和产后28天进行入户访视,了解母乳喂养的情况,针对出现的问题进行指导。结果住院期间纯母乳喂养率为89.46%,入户一访时为74.84%,二访时为85.24%,产后4个月为85.90%。结论入户产后访视不仅可以提高1个月内的纯母乳喂养率,而且对提升巩固4个月内纯母乳喂养有帮助和促进作用。     

社区卫生服务中心实施社区产后访视的临床价值

目的 探讨社区卫生服务中心实施社区产后访视的临床价值.方法 选择我社区2015年1月-3月87名产妇作为研究对象,随机分为产后访视(n=44)和未访视(n=43)2组,比较2组产妇健康知识知晓情况、母婴健康水平及母乳喂养率.结果 访视组产妇在产褥期卫生知识、产后保健知识、新生儿喂养知识及计划免疫知识四项评分均高于采访视组(P＜0.05);访视组产妇和婴儿发病率均低于未访视组(P＜0.05);访视组纯母乳喂养率为84.09％,明显高于未访视组(P＜0.05).结论 社区卫生服务中心开展产后访视可提高产妇自我保健知识和婴儿喂养知识,对促进母乳喂养、减少母婴患病率具有积极的意义.     

护理干预对提高产后母乳喂养成功率的影响

目的探讨护理干预对提高剖宫产后早期母乳喂养成功率的影响。方法住院分娩的剖宫产产妇120例随机分为干预组和对照组各60例,对照组产妇产后予以常规护理,在此基础上,干预组同时采取心理疏导、示范指导正确的喂奶体位与婴儿含接姿势、饮食护理及睡眠质量护理等护理措施。结果自第2天起,干预组产妇纯母乳喂养显著高于对照组（P〈0．01）;自第3天起,干预组产妇泌乳量显著多于对照组（P〈0．01）。结论对产妇积极施行产后护理干预,可提高母乳喂养成功率．值得临床推广应用。     

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.