人工股骨头置换术的护理

目的 探讨股骨颈骨折实施人工股骨头置换术的疗效及护理要点。方法 总结和分析33例股骨颈骨折行人工股骨头置换术患者的康复护理体会。结果 33例经人工股骨头置换术的患者无一例发生并发症，均取得满意的治疗效果。结论 术前做好病人的心理、饮食护理，术后做好病情观察及预防并发症的护理，指导功能锻炼是防止并发症发生，促进病情早日康复的关键。     

术前护理干预在行人工股骨头置换术患者康复中的作用

目的：探讨术前护理干预对人工股骨头置换术后老年患者康复的影响。方法：对42例行人工股骨头置换术患者的临床资料进行回顾性分析,按是否给予术前护理干预分为干预组和对照组,对两组患者术后的疼痛耐受性及并发症情况进行对比研究。结果：两组患者术后疼痛耐受性及并发症发生率比较,有显著性差异（P〈0.05）。结论：术前护理干预能帮助减轻患者痛苦,并能有效的预防手术后并发症的发生,有利于人工股骨头置换术后患者的康复。     

高龄患者人工股骨头置换术的护理

目的:探讨高龄患者人工股骨头置换术的护理,预防术后并发症的发生,促进早日康复。方法:对28例高龄患者行人工股骨头置换术进行全方位的护理。结果:28例高龄患者人工股骨头置换术均获得成功。结论:术前、术后精心正确的护理,不但提高手术疗效,预防并发症,并对患者肢体功能的恢复,生活自理能力的恢复,生活质量的提高起到了关键作用。     

人工股骨头置换术的护理

人工股骨头置换术的护理罗宝凤（广西桂林医学院附属医院骨科桂林市５４１００１）关键词股骨头；置换术；人工；护理自从１９８８年以来，我科采用人工股骨头置换术治疗股骨颈骨折，由于注意了术前、术后方面的护理，故未出现并发症，现将护理体会总结如下。１临床资料本...     

人工股骨头置换术治疗股骨颈骨折的康复护理

目的探讨人工股骨头置换术治疗老年股骨颈骨折的康复护理。方法回顾性分析2008年1月—2010年12月在我科治疗的48例人工股骨头置换术患者的康复护理情况。结果除1例术后并发肺栓塞死亡外,其他患者均痊愈出院。结论对人工股骨头置换术治疗股骨颈骨折患者进行术前、术后康复护理,可明显减少各种并发症的发生,提高患者生活质量。     

人工股骨头置换术围手术期护理

目的：总结人工股骨头置换术围手术期护理要点。方法：对102例行人工股骨头置换术的患者术前充分准备和术后精心护理。结果：102例患者3周左右均顺利出院，无一例发生并发症。结论：做好体位、切口及引流管护理，预防并发症的发生，指导患者正确进行功能锻炼是保证手术成功的关键。     

术前护理干预对人工股骨头置换术后患者的影响

目的 探讨术前护理干预对人工股骨头置换术后患者的影响.方法 将68例行人工股骨头置换术的患者随机分成干预组和对照组,在年龄、文化程度、心理素质、经济状况、术后诊断等基本相同的情况下,对两组患者对疼痛的耐受性、术后患肢功能锻炼时间及并发症情况对比研究.结果 各项指标均有明显差异(P<0.05).结论 术前护理干预对人工股骨头置换术后患者有着较大的影响,减轻了患者的痛苦,有利于促进手术后患者的康复,并可预防手术后并发症的发生.     

21例无柄人工全髋关节置换术围手术期的护理

目的:总结无柄人工全髋关节置换术围手术期的护理对策及体会。方法:回顾性分析21例使用无柄人工全髋关节置换术治疗晚期股骨头缺血坏死病例临床及护理资料,总结护理经验。结果:本组21例患者术后住院14～21 d,平均16 d;均顺利通过手术,未出现术后并发症,术后患肢功能恢复良好。结论:充分的术前准备、心理护理、术后的正确护理及早期功能锻炼,能有效预防无柄人工全髋关节置换术后关节脱位、下肢深静脉血栓形成、肺部感染、压疮等并发症,促进患者术后早日康复。     

老年人工股骨头置换围术期护理体会

目的探讨老年人工股骨头置换围术期的护理措施。方法对50例人工股骨头置换术患者进行全方位的护理。术前予解除患者心理顾虑,做好各种术前准备,术后密切观察病情变化并预防并发症的发生,注意体位护理,重视术后功能锻炼。结果术后平均住院日15d,患者恢复顺利,无1例发生护理并发症,均痊愈出院。结论做好老年人工股骨头置换围术期护理,是保证手术成功和减少术后并发症的重要环节,对患者肢体功能的恢复,提高其生活质量起着十分关键的作用。     

人工股骨头置换术围手术期护理

目的总结人工股骨头置换术围手术期护理要点。方法对52例行人工股骨头置换术的患者术前充分准备和术后精心护理。结果52例患者3周左右均顺利出院,无一例发生并发症。结论做好体位、切口及引流管护理,预防并发症的发生,指导患者正确进行功能锻炼是保证手术成功的关键。     

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.