河南省实习护生手卫生状况调查分析

目的提高实习护生手卫生依从性,为降低医院感染发生率、改善手卫生提供科学依据。方法引用调查问卷,调查郑州市72名本科护生,了解实习护生手卫生执行情况。结果 75.76%的本科实习护生不了解《医务人员手卫生规范》,了解甚少占15.15%,9.09%的基本了解。结论郑州市本科实习护生手卫生重视度及认知不高,加强实习护生手卫生监督及管理。     

强化医院感染知识培训对护生手卫生依从性的影响

目的：探讨强化医院感染知识培训对提高护生手卫生依从性的效果。方法选取2014年5月在我院进入临床实习的护生38人为对照组,2014年6月在我院进入临床实习的护生42人为观察组。对照组护生在进入临床实习前进行护理核心制度、各专科护理特点、实习注意事项、基础护理知识,基本技能操作及医院感染防控基础知识培训;观察组护生除进行上述知识培训外,再由医院感染控制办公室专职人员进行8个学时的医院感染相关知识强化培训。比较两组护生手卫生的依从性。结果观察组护生手卫生的依从性高于对照组（ P ＜0．01）。结论强化医院感染知识培训,可以使护生掌握医院感染相关知识,有效提高其手卫生依从性。     

ICU护生手卫生认知现状及分析

目的 了解ICU护生对手卫生观念及相关知识的认知情况,提高正确洗手的卫生意识及指导正确洗手方法和手卫生知识等教育.方法 自行设计ICU护生手卫生认知情况调查表,对720名ICU护生进行相关调查.同时现场观察和考核护生的手卫生行为.结果 80.4%的护生对手卫生的必要性都有充分的认识,但相关知识不全面.本科护生对手卫生相关知识的认知程度及实际洗手操作的准确性及合格率都比大专护生高,差异有统计学意义(P<0.05).护生迫切要求临床带教老师进行手卫生的相关知识教育及洗手方法的正确引导.结论 护生对手卫生相关理论知识欠全面,手卫生执行力不强,加强手卫生知识培训及洗手行为的督促,能促使护生养成良好的职业习惯和行为,培养基本的职业道德素质,提高基本的护理技术水平,从而有效地控制医院感染.     

实习医护学生手卫生认知程度调查分析

目的探讨实习医、护生对手卫生知识的了解程度,培养实习生的安全防护、医院感染防治意识和良好职业习惯。方法采用自行设计问卷调查表,对2005年7月-2006年7月在本院实习的102名实习医护生进行问卷调查。结果102份问卷中,了解程度良好的有15份,占12.5%;一般的有58份,占56.86%;差的有29份,占28.43%。结论实习医护生手卫生知识比较缺乏,医学院校及医院管理者应重视医护生手卫生学教育,制定具体可行的培训计划及教育对策,培养医学生的基本职业素质、职业技能,使其形成良好的职业习惯和行为,更好的控制医院感染。     

品管圈(QCC)活动在提高实习护生洗手依从性中的应用

目的:探讨品管圈活动在提高实习护生洗手依从性中的应用效果。方法:通过开展品管圈活动,选定主题、拟定计划、设计调查表,分析影响实习护生洗手依从性的因素并采取相应的措施,进行持续改进结果:经过3个月的品管圈活动,护生在按要求洗手、用快速手消剂洗手、将手擦干等方面的依从性较开展QCC活动前明显提高(P0.05)。结论:品管圈活动在普及实习护生手卫生知识、强化洗手意识、提高其洗手依从性、防止医院交叉感染中效果显著,值得推广。     

临床护生使用速干手消毒剂与监测结果调查分析

目的了解临床护生使用速干手消毒剂后手的卫生状态。方法根据卫生部《医务人员手卫生规范》中的要求进行采样、监测,并实施干预措施。结果干预后的临床护生手卫生相关知识与细菌监测结果优于干预前,差异有统计学意义（P〈0.01）。结论加强临床护生带教、培训、提高认知和掌握正确的手消毒剂取用量与正确的洗手方法是手卫生消毒效果监测达标的关键,同时也是防止临床护生因手部卫生污染引发医院感染的重要措施。     

临床实习生对手卫生认识的现状调查与分析

目的 了解临床实习生对手卫生知识的认识现状.方法 采用自行设计的问卷调查对2006年来院实习的临床医护实习生进行手卫生知识及其执行洗手情况的调查.结果 临床医护实习生对手卫生知识的认识程度中不知道手卫生概念的占22.67%,学生从学校获得手卫生知识的仅占19.33%;从学校教学中获得正确洗手方法的占28.0%,而在医院早期教育中获得手卫生概念及正确洗手法的分别占44.0%、56.0%.结论 加强学校的手卫生知识教育和医院的早期教育显得非常重要.     

临床实习生对手卫生认识的现状调查与分析

目的 了解临床实习生对手卫生知识的认识现状.方法 采用自行设计的问卷调查对2006年来院实习的临床医护实习生进行手卫生知识及其执行洗手情况的调查.结果 临床医护实习生对手卫生知识的认识程度中不知道手卫生概念的占22.67%,学生从学校获得手卫生知识的仅占19.33%;从学校教学中获得正确洗手方法的占28.0%,而在医院早期教育中获得手卫生概念及正确洗手法的分别占44.0%、56.0%.结论 加强学校的手卫生知识教育和医院的早期教育显得非常重要.     

护生对医院感染管理与职业防护认知调查与分析

目的 了解院校护生对医院感染管理与职业防护的掌握情况,为制定实习前培训方案提供依据.方法 采用自行设计的调查问卷,对院校护生进行医院感染管理基本知识和职业防护知识问卷调查.结果 院校护生对医院感染管理的基本概念、职业暴露与防护、手卫生规范和医疗废物管理规范的相关知识掌握不理想,80％以上的护生知晓手卫生指征和搓手方法,11项指标护生知晓率在50％以上,9项指标护生知晓率在50％以下.结论 在院校护生进入临床实习前应结合医院特点、护理专业特点和医院感染管理相关法规的要求,对学生进行规范和系统的医院感染管理知识培训,以提高他们进入临床后的执行力和安全意识.     

实习护生护理操作中手卫生认知状况的调查分析与对策

目的：了解医院实习护士在护理操作中对手卫生的认知情况,为做好实习护士在护理操作中的手卫生培训工作提供依据。方法：采用自制问卷,对2011年7月至2012年5月在院实习的110名临床实习护生进行护理操作项目中手卫生认知情况的调查分析。结果：实习护生的学历对手卫生的知识获取途径（P〈0．01）及手卫生掌握的有效途径（P〈0．05）认识有统计学意义。实习护生对手卫生认知存在片面性,对一般性护理操作的洗手依从性较差。结论：应重视实习护生在各项护理操作中的手卫生认知及执行情况,规范实习期间的手卫生培训工作,严格临床实习带教,提高实习护生对手卫生认识和在执行护理操作中洗手的依从性。     

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.