健康教育在肺结核患者中的重要作用

目的了解肺结核患者对疾病的认知情况，分析健康教育对其的影响。方法采取SOL－90症状自评量表，对确诊为肺结核的68例患者进行分析，并采用发放肺结核知识问卷调查表和健康小册子、知识讲座、常规指导等方式进行调查和实施健康宣教。结果健康教育宣教前和宣教后相关知识掌握程度有了很大的提高。结论通过健康教育，可满足患者对肺结核知识的需求，使患者了解和掌握日常卫生保健知识，纠正不良饮食习惯，控制传染源，提高患者对治疗的耐心与信心，促进疾病早日康复。     

肺结核患者健康教育需求的调查

目的了解肺结核患者健康教育需求。方法采用自行设计的问卷调查表，对500例肺结核患者进行健康教育需求调查。结果肺结核患者的总体疾病知识需求较高，平均为95.1％，健康教育方法的需求平均为93.8％。结论医护人员应重视肺结核患者的健康教育，有针对性地进行宣教。     

健康教育对肺结核患者疾病认知的影响

目的 了解肺结核患者对疾病的认知情况,分析健康教育对其的影响.方法 自制"肺结核患者健康调查表",对我院门诊和住院153例患者健康教育前后对疾病认知情况结果进行分析.结果 健康教育宣教前和宣教后相关知识掌握程度有了很大的提高.结论 健康教育为患者提供了正确的饮食、服药、休息,预防并发症等指导,满足了患者对肺结核知识的需求,提高了患者对治疗的耐心与信心.     

健康教育对肺结核患者的影响

目的：探讨健康教育对肺结核患者的心理影响与护理效果。方法：采取SCL-90症状自评量表,对确诊为肺结核的68例患者进行分析,并采用发放肺结核知识问卷调查表和健康小册子、知识讲座、常规指导等方式进行调查和实施健康宣教。结果：通过健康宣教后,肺结核患者对疾病知识的知晓率明显提高,患者了解和掌握了日常卫生保健知识,纠正了不良饮食习惯,控制了传染源,促进了疾病的早日康复。肺结核患者的阳性项目、阳性症状、躯体化、强迫、抑郁、焦虑和恐惧因子等均无显著性差异（P〈0．05）。结论：对肺结核患者强化健康教育,可提高肺结核患者对疾病的知晓率,达到促进疗效和疾病康复之目的,而且还可明显改善肺结核患者的心理状况及对知识的认知程度,从而提高治疗和护理效果。     

健康教育在肺结核病人中的应用对策

通过对肺结核病人的健康宣教，使其了解有关肺结核的特点、消毒隔离、传播途径等知识，使病人知道必须坚持规律用药、巩固疗效，才有治愈的机会。通过宣教使之改变不良生活习惯，自觉采用有利于健康的行为。     

肺结核患者健康教育效果分析

为探讨肺结核患者健康教育的护理效果,我科对确诊为肺结核的患者通过发放肺结核知识问卷调查表和健康小册子、知识讲座、常规指导等方式,制订健康教育计划并实施健康宣教。健康教育不仅可以提高患者对肺结核病知识的认知程度,达到促进疗效和疾病康复的目的,还能提高患者的遵医行为,而且还可以明显改善肺结核患者的心理状况,从而提高治疗和护理效果。     

健康意识模型对肺结核患者健康意识及规范服药的影响研究

目的了解肺结核患者的健康意识和健康行为之间的关系，尤其是对规范服药的影响。方法根据“健康意识模型”（HBM），自行研制了肺结核患者调查表，对25例结核病患者进行定性问卷调查。结果规范服药和不规范服药的患者均未意识到肺结核的易患性。不规范服药的患者患病时症状严重，但担心的事情较少，认为规范服药的收益只有能尽快恢复健康，在治疗过程中意识到的障碍较少，在治疗前后信心指数没有增加。而规范服药的患者有更多的担心，说明意识到肺结核的严重性会导致规范服药。他们意识到规范服药的收益也多于不规范服药的患者。他们意识到的障碍多，能更好的面对长期的治疗，有更多的思想准备。在治疗的前后规范服药的惠者信心的指数随着服药时间越来越多。结论文中成功地运用HBM中部分内容研究了肺结核患者健康意识和DOTS治疗的关系，并提示医护人员应该特别注意接待患者的态度，让患者了解疾病相关知识，并注重健康教育及其方法。     

心理干预在肺结核患者康复中的作用

目的探讨分析肺结核患者不同年龄,不同性别,不同文化背景的患者的心理情况及因素,总结针对性护理措施。方法将该院2011年1月—2012年12月收治的90例肺结核患者在治疗过程中,进行心理问题分析,实施心理干预。结果 68例患者会产生紧张,恐惧,焦虑,孤独,自卑,悲观,失望等许多心理上的问题。其主要原因有:担心治疗效果,不适应医院生活,担心治疗费用,担心家庭及子女,担心传染家人,缺乏医学有关知识了解等,使病情加重,形成心理生理之间的恶性循环,直接影响到患者的治疗和康复,因而,护理对策主要从患者的心理,家庭,健康教育,治疗与护理等方面着手,并根据患者的不同心理特点给予针对性护理。结论通过了解患者康复过程中的心理问题原因,从问题的根源实施有效护理干预,使护理作用有效发挥,促进疾病康复。     

健康教育路径对耐多药肺结核患者遵医行为的影响

目的:探讨健康教育路径对耐多药肺结核患者遵医行为的影响。方法:将72例住院耐多药肺结核患者随机分为研究组和对照组,对照组采用常规宣教指导,研究组实施健康教育路径。在入组前及入组后2个月对两组患者的依从性、健康知识知晓率、满意度进行问卷测评。结果:研究组患者依从性、健康知识知晓率、满意度均高于对照组,两组比较差异有统计学意义(P<0.05)。结论:健康教育路径实施能提高住院耐多药肺结核患者的依从性、健康知识知晓程度及满意度。     

肺结核患者的心理护理

目的探讨肺结核患者心理护理对康复效果的影响。方法通过临床观察剖析肺结核患者心理状态。结果通过临床观察,绝大部分肺结核患者存在不同程度的心理问题,怀疑诊断,担心传染给家人及同事,中断治疗,不能科学合理的治疗,经过心理护理,病人消除顾虑,积极配合治疗。结论针对大部分肺结核患者的心理问题给予相应的心理干预及护理对策,改善患者的心理状况,提高了患者对疾病的认识及治疗效果。     

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.