重症监护室患者MRSA肺部感染的预防及护理

目的讨论护理方法预防重症监护病房患者耐甲氧西林金黄色葡萄球菌（MRSA）肺部感染的效果。方法选择我院自2010年12月至2012年12月于重症监护病房收治的1464例患者为研究对象,自2011年12月始采用综合性护理干预,对比观察2010年12至2011年12月（768例）患者和2011年12月至2012年12月（666例患者）两个时间段重症监护室发生MRSA肺部感染发生率情况。结果2011年12月至2012年12月MRSA肺部感染发生率为0.75%,明显低于2010年12至2011年12月发生率1.82%,差异具有统计学意义（P<0.05）.结论有效的综合性护理干预可能及时发现MRSA感染,并降低MRSA感染发生率,值得临床广泛推广。     

人文化护理管理在体检中心的应用

我院体检中心自2008年以来,开展以客人为中心,以健康教育为向导的人文化护理管理措施,收到良好的效果,总结如下。1对象与内容1.1调查对象收集本院体检中心2007年7-12月的体检者满意度调查问卷,共计600份,收集2008年7-12月、2009年7-12月体检者满意度调查表各600份。设2007年7-12月为对照组,2008年7-12月、2009年7～12月为观察组,     

妇科腹腔镜手术127例护理体会

我科2008年12月～2010年12月共行妇科腹腔镜手术127例,经过围术后精心护理,术后4～7天治愈出院,现将围手术期护理体会总结如下。1临床资料2008年12月～2010年12月应用腹腔镜技术治疗127例     

两种结膜瓣转移覆盖术治疗原发性翼状胬肉的比较

目的:比较两种结膜瓣转移覆盖术治疗原发性翼状胬肉的疗效.方法:回顾分析1999年12月～2009年12月原发性翼状胬肉患者242例284眼,将1999年12月～2009年12月行翼状胬肉切除+结膜瓣转移覆盖术¨5例136眼原发性翼状胬肉患者定为A组,将2003年12月～2009年12月行翼状胬肉切除+带自体角膜缘干细胞...     

20年间腹膜透析213例临床分析

[目的]分析20年来213例不卧床持续性腹膜透析（CAPD）患者的状况。[方法]横断面调查1988年12月～2008年12月期间213例CAPD≥3个月患者的状况。分组：①透析时间：前10年组（1988年12月～1998年12月）和近10年组（1998年12月～2008年12月）;②开始透析年龄：≥65岁组和〈65岁组;③病因：糖尿病组和非糖尿病组。[结果]①近10年组年龄明显大于前10年组（61.8±16.0岁和49.4±17.7岁,P〈0.001）,血肌酐水平明显低于前10年组（701.2±325.8     

新疆昌吉地区青光眼住院患者流行病学分析

目的了解原发性青光眼住院病人的病型构成、性别、年龄、民族分布以及手术情况,为制定青光眼防治的新策略提供依据。方法对我院眼科1998年1月至1999年12月以及2008年1月至2009年12月所有原发性青光眼住院病人进行统计分析。结果原发性开角型青光眼（Primary open angle glaucoma,POAG）在原发性青光眼的比例于1998年1月至1999年12月为28.24%,2008年1月至2009年12月为48.53%。经检验POAG构成比增大有统计学意义。原发性闭角型青光眼（Primary angle closure glaucoma,PACG）中位数年龄在1998年1月至1999年12月为60岁,在2008年1月至2009年12月为65岁;POAG则分别为43及47.5岁。女性患者在PACG与POAG分别占61.41%与44.09%。少数民族患青光眼比率在1998年1月至1999年12月为11.35%,2008年1月至2009年12月为18.38%,闭角型青光眼手术率在1998年1月至1999年12月为46.15%,2008年1月至2009年12月为31.11%。结论在青光眼住院病人中PACG仍占主要部分,但POAG的构成有增多的趋势,而闭角型青光眼手术比率下降,少数民族患闭角型青光眼比例增加,分析可能有诊断、屈光不正、全身情况、检查治疗手段增多增加以及社会因素等方面的原因。     

新生儿高胆红素血症病因分析

目的探讨引起新生儿高胆虹素血症的病因变化。方法对资料完整的1998年1月至2003年12月5年间（组1）与2004年1月至2008年12月5年间（组2）于我院分娩的新生儿高胆虹素血症患者,按病因构成比进行回顾性分析。结果1998年10月至2003年12月年间及2004年1月至2008年12月年间高胆虹素血症病例发病率分别为15．7％和13．4％,1998年10月至2003年12月引起新生儿高胆虹素血症病因依次是：新生儿溶血病27．7％,围生因素27．1％,感染19．8％,母乳喂养16．0％,其他因素9．4％;2004年1月至2008年12月年间引起新生儿高胆虹素血症病因依次是围产期因素37％,新生儿溶血病27．1％,母乳性喂养25．0％,感染15．2％,其他因素2．5%。结论高胆虹素血症发病率在2004年1月至2008年12月年间较1998年10月至2003年12月年问有所降低,病因构成比方面也有所不同。     

成人急性肠梗阻病因分析

1 临床资料 1.1一般资料为我院1998年12月～2006年12月住院的急性肠梗阻患者共140例，分为前4年组（A组）：1998年12月～2002年11月72例，其中男44例，女28例，年龄20～95（56．70&#177;5．88）岁；后4年组（B组）：2002年12月～2006年12月68例，其中男46例，女22例，     

因卡膦酸二钠对比帕米膦酸二钠治疗恶性肿瘤引起的骨转移疼痛的Meta分析

目的:系统评价因卡膦酸二钠对比帕米膦酸二钠治疗恶性肿瘤引起的骨转移疼痛方面的有效性和安全性.方法:检索数据库PubMed(1950年12月至2019年3月)、EMbase(1978年12月至2019年3月)、TheCochraneLibrary(2019年12月)、维普中文科技期刊数据库(2000年12月至2019年3...     

中西医结合治疗慢性前列腺炎42例体会

我科2005年12月-2006年12月采用中西医结合治疗慢性前列腺炎42例,效果显著,报告如下。     

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.