糖尿病患者的自我管理

目的通过糖尿病的健康教育，让患者积极参与治疗，提高患者的自我管理能力和生活质量。方法从糖尿病患者自我管理的任务及护士如何帮助患者获得糖尿病各方面知识以及在教育过程中存在问题进行指导。结果护士改变了健康教育的方式，提高了患者自我管理的技能。结论糖尿病患者自我管理技能的提高，减少了并发症的发生。     

老年冠心病患者的健康教育

目的：探讨老年冠心病患者的健康教育方式及内容。方法：通过采用宣传栏、口头讲解、公休座谈会等健康教育形式，对老年冠心病患者重点进行基础知识、饮食、心理、运动、药物等方面的健康教育。结果：提高了患者医疗保健知识和自我保护能力，减少了疾病复发频率，促进了患者康复。对护士本身由于不断学习冠心痛新学说、新知识，有助于提高自身专业护理水平。结论：对老年冠心病患者实施正确的健康教育，对于降低冠心病的复发率、提高护士素质是有意义的。     

糖尿病患者的自我管理

目的 通过糖尿病的健康教育,让患者积极参与治疗,提高患者的自我管理能力和生活质量.方法 从糖尿病患者自我管理的任务及护士如何帮助患者获得糖尿病各方面知识以及在教育过程中存在问题进行指导.结果 护士改变了健康教育的方式,提高了患者自我管理的技能.结论 糖尿病患者自我管理技能的提高,减少了并发症的发生.     

指导糖尿病患者的社区健康教育

糖尿病是持续高血糖为基本生化指征的一种综合病症。糖尿病患者的健康教育应因人而异，根据患者的年龄、体质、个人生活习惯、文化背景、糖尿病情进展情况及有无并发症的发生，采用形式多样的教育方法来向患者传授在饮食、运动、生理、自我护理能力等方面的知识，并指导如何进行自我护理，以满足不同群体的需求。通过对糖尿病患者进行有针对性的健康教育，使患者对糖尿病的知识有一个基本的了解，改变态度和行为，心理上积极应对，有针对性的采用各种方法，从而提高自我护理能力。社区健康教育的效果最直接地表现在糖尿病患者健康行为的建立上。通过多样化教育形式，使患者建立健康的生活方式，提高自我保健能力，消除思想顾虑，避免许多并发症的发生，提高患者的生活质量和存活率，同时提高了护士的业务水平，增强了责任感。     

对糖尿病住院患者推行健康教育新模式的效果探讨

目的：探讨糖尿病健康教育新模式对患者疗效的影响。方法将2012年住院的糖尿病患者200例（设为非专职组）和2013年住院的患者320例（设为专职组）进行对照,前者采用传统教育模式,后者推行专职护士健康教育新模式,比较两组糖尿病知识掌握情况、患者自我管理能力、血糖控制情况及对服务满意度情况。结果专职组住院患者对疾病知识、服药指导、手术前后注意事项、饮食营养、锻炼与休息、预防保健、出院指导等方面知识都有明显提高,对健康教育的满意度远高于非专职组。结论糖尿病专职护士健康教育新模式是治疗措施的有益尝试,可明显提高患者知识水平和自我管理能力,改变不良生活方式,建立良好的健康行为,该模式可作为制度化措施,在临床中推广应用。     

便携式健康教育手册在糖尿病患者中的应用

目的：强化健康教育工作督导落实,提高健康教育效果,达到糖尿病患者对疾病的正确认识。方法：设计临床健康教育手册。结果：通过临床实践,提高了患者健康教育普及率、知晓率及护士健康教育能力。结论：临床健康教育手册的应用促进了健康教育工作规范化管理,提高了临床健康教育水平和糖尿病患者对疾病的正确认识。     

对外科护士健康教育能力培养的体会

在临床护理中,健康教育是一项有计划的系列过程,是以护理干预的手段促使人们自觉地采用有利于健康的行为和生活方式,使患者掌握增进健康的知识,改变患者不良的心理和情感,顺利地渡过手术关。外科护士健康教育意识、教育知识和教育能力直接影响到健康教育的水平和效果。如何提高外科护士的健康教育能力,现将几点体会介绍如下：     

浅议社区护士开展糖尿病健康教育的问题与对策

社区护士对社区患者及高危人群针对糖尿病的健康教育实施过程中暴露了一些问题,调查分析发现:社区护士知识老化缺乏、患者遵医率不理想、护士的职业素养和心理素质有待提高、欠缺沟通和协调能力是日常工作中遇到最突出的问题.通过加强继续教育和自主学习,社区护理干预提高患者遵医率,提升职业素养、心理素质,掌握沟通技巧等方法提高了服务质量,既满足社区人群对糖尿病防治健康知识的需求,又提升了社区护士的社会地位.     

糖尿病78例健康教育效果评价

目的：加强对糖尿病患者的健康教育,提高患者的自我管理能力,有效控制糖尿病,提高患者的生活质量。方法：运用护理知识对糖尿病患者进行饮食、用药、运动、自我监测的指导。结果：健康教育后的患者对糖尿病相关知识的掌握、饮食控制、按时服药、有氧运动、血糖控制方面有显著性提高。结论：科学的健康教育可提高糖尿病患者对疾病的认识水平和自我监护能力,有效控制糖尿病,预防和延缓急慢性并发症的发生。     

社区护士运用健康教育对糖尿病患者控制血糖的影响

目的:探讨社区护士有效的健康教育对糖尿病患者血糖控制的重要性。方法:通过对28例糖尿病患者定期接受糖尿病系列知识教育,饮食指导,运动指导,药物应用指导,血糖自我检测等健康教育。结果:通过合理、科学的糖尿病健康教育,糖尿病患者能主动配合,自我照顾和管理好饮食,血糖控制在理想水平,提高了糖尿病患者的生活质量。结论:社区护士的有效的健康教育对糖尿患者血糖的控制特别重要。     

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.