妇科腹腔镜术后患者早期护理干预对腹胀的影响

目的探讨早期护理干预对妇科腹腔镜患者术后腹胀的影响.方法选择2009年1月~2012年1月妇科腹腔镜手术患者176例分为对照组(n=88)与观察组(n=88),对照组给予常规护理,观察组给予心理、饮食、体位、早期锻练等护理干预,观察比较两组患者术后腹胀发生率、肠鸣音恢复时间、肛门排气时间.结果观察组患者腹胀发生率明显低于对照组,两组比较差异有统计学意义(P<0.05).观察组肠鸣音恢复时间、肛门排气时间均短于对照组,两组比较差异有统计学意义(P<0.05).结论护理干预对妇科腹腔镜患者可有效减轻术后腹胀症状,促进患者尽快恢复.     

围手术期护理策略对妇科手术后腹胀的影响研究

目的 探讨针对妇科手术后采取不同围术期护理方法对术后腹胀情况的影响.方法 选取我院妇产科收治的100例需做妇科手术的患者,将其按照随机数字表法分为两组,对照组50例患者采取常规护理模式,观察组50例患者采取综合护理模式.观察两组患者经不同护理方式后的排气情况、腹胀程度以及腹胀发生率.结果 观察组患者在术后48～72 h内排气的人数较对照组高28.00％,差异有统计学意义(P＜0.05).对照组患者无腹胀的人数较观察组少36.00％,差异有统计学意义(P＜0.05).观察组患者的腹胀发生率(24.00％)明显低于对照组患者的腹胀发生率(60.00％),差异有统计学意义(P＜0.05).结论 对妇科术后腹胀采取临床综合护理的方法能有效地促进妇科手术后患者胃肠功能恢复,缩短首次肛门排气时间,减轻腹胀,促进伤口愈合,减轻患者痛苦,促进康复,值得推广和应用.     

综合护理干预减轻妇科腹部手术后腹胀的效果观察

目的 探讨综合护理干预对减轻妇科手术后腹胀的临床效果.方法 以我院收治的92例妇科开腹手术患者为研究对象,随机分为干预组和对照组各46例,观察2组术后肛门排气、腹胀发生情况.结果 干预组平均术后下床活动时间(14.2±2.7)h,肛门排气时间(24.4±3.2)h,均明显短于对照组,组间比较差异有统计学意义(P＜0.01).干预组术后腹胀发生率21.7％(10/46),明显低于对照组(56.5％,26/46),发生腹胀患者的腹胀严重程度轻于对照组(P＜0.05).结论 对妇科开腹手术患者实施综合护理干预措施,能有效降低腹胀发生率以及腹胀程度,利于患者术后恢复.     

80例妇科腹腔镜手术患者术后观察护理

目的探讨妇科腹腔镜手术患者的术后观察护理干预效果。方法选取80例妇科腹腔镜手术患者,随机分成观察组和对照组,两组患者针对病情进行对症治疗,对照组采取常规护理方法,观察组在采用常规护理方法的基础上针对个体化差异进行护理干预。结果通过两组的数据比较分析,观察组患者护理满意度、和康复情况均好于对照组,观察组患者腹胀率明显小于对照组,差异均有统计学意义（P〈0.05）。结论通过针对性、个体化护理干预患者术后生存质量明显提高,并发症明显减少,并且效果显著,值得护理相关人员推广应用。     

急性胆囊炎患者腹腔镜胆囊手术整体护理干预体会

目的 探讨急性胆囊炎患者腹腔镜胆囊手术的整体护理干预措施.方法 选取我院2014年3月-2015年3月间收治的急性胆囊炎腹腔镜胆囊手术患者60例,随机均分为观察组与对照组,对照组患者实施常规护理干预,观察组患者实施整体护理干预.对比2组患者的护理满意度与各项并发症发生率.结果 观察组与对照组患者的护理满意度分别为96.67％,76.67％,比较差异有统计学意义(P＜0.05);并且观察组患者的平均住院时间与术后并发症的发生率明显低于对照组,比较差异有统计学意义(P＜0.05).结论 在急性胆囊炎患者开展腹腔镜胆囊手术治疗的过程中,为患者实施整体护理干预,能够有效提升患者的护理满意度,降低术后并发症发生率,值得在临床中推广应用.     

妇科腹腔镜手术患者的配合及护理干预探讨

目的研讨妇科病患者行腹腔镜手术的配合与护理干预效果。方法从我院妇科2014年4月至2015年10月收集的腹腔镜手术病例中抽取82例并随机分组,在常规手术配合的基础上,对照组41例接受一般性护理,观察组41例接受针对性护理,评估两组的术后下地时间、排气时间、平均住院日及腹胀发生情况,同时对其护理配合满意情况进行问卷调查。结果经精心护理与配合,观察组的术后下地时间、排气时间及平均住院日相比对照组均显著缩短,术后腹胀发生率显著下降,有统计学意义(P0.05)。调查显示,观察组在总满意度上占97.6%,相比对照组的82.9%有显著提高,有统计学意义(P0.05)。结论在妇科腹腔镜手术患者的临床护理中,积极开展手术配合与针对性护理,对促进患者恢复、降低术后腹胀的发生均有良好效果,而且可提高护理质量,值得推荐。     

探讨舒适护理在普外腹腔镜手术中的临床应用效果

目的:探讨在普外科的腹腔镜手术中应用舒适护理的护理效果.方法:本研究选取2016年2月至2017年6月就诊该院普外科行腹腔镜手术患者70例作为研究对象,均分为观察组与对照组各35例.对照组行腹腔镜手术患者应用常规护理,观察组行腹腔镜手术患者应用舒适护理.比较两组的护理满意度、术后临床指标及并发症等情况.结果:观察组行腹腔镜手术患者的护理满意率(97.14％)明显高于对照组(82.86％),组间数据比较差异显著(P＜0.05);观察组行腹腔镜手术患者术后下床活动时间(8.55 +2.61)h、住院时间(4.58±1.65)d均明显短于对照组(13.52±Z38)h、(6.96±1.43)d,组间数据比较差异显著(P＜0.05);观察组行腹腔镜手术患者术后的并发症率(5.72％)明显低于对照组(22.86％),组间数据比较差异显著(P＜0.05).结论:普外科腹腔镜手术中的应用舒适护理效果显著,提高了护理满意度,促进术后康复,并降低并发症率,值得在临床上推广应用.     

探讨早期护理干预对妇科腹腔镜患者术后腹胀的影响

目的:探讨早期护理干预对妇科腹腔镜患者术后腹胀的影响。方法:将我院90例腹腔镜手术患者平均分为两组,对照组实施常规护理,观察组在对照组基础上实施早期护理干预。结果:观察组腹胀发生率为24.44%,对照组腹胀发生率为60.00%,组间比较具有统计学差异(x2=11.660,P=0.001);观察组患者的肛门排气时间与肠鸣音恢复时间要明显小于对照组,组间比较差异显著(P0.05)。结论:妇科腹腔镜患者早期进行护理干预能够显著改善患者术后腹胀发生情况,加快患者恢复,值得在临床上大力推广。     

早期预见性护理干预对妇科腹腔镜术后患者应用价值探讨

目的:研究和探讨早期预见性护理干预对妇科腹腔镜术后患者的应用价值.方法:收集行妇科腹腔镜手术的患者共102例,随机分为观察组与对照组,各51例,对照组患者进行常规护理,观察组进行早期预见性护理干预,将两组患者的术后并发症发生率、痊愈时间以及患者满意度进行观察和对比.结果:观察组患者的术后并发症发生率明显低于对照组,观察组患者的痊愈时间显著短于对照组,观察组患者的满意度显著高于对照组(P均＜0.05).结论:在行妇科腹腔镜手术患者的护理过程中使用早期预见性护理干预,能够有效降低患者术后的并发症发生率,促进患者痊愈,使患者更加满意,值得推广应用.     

妇科腹腔镜手术中全程优质护理服务模式的运用

目的:分析总结全程优质护理模式在妇科腹腔镜手术中的应用.方法:将该院2015年4月至2016年4月收治的76例妇科腹腔镜患者作为研究对象,将患者随机分为观察组和对照组,每组38例,分别采用常规护理及全程优质护理服务模式,对比两组护理效果.结果:相比于对照组,观察组术后肠功能恢复时间、下床活动时间、住院时间均明显较短,差异存在显著性(P＜0.05);观察组、对照组的护理满意度分别为94.7％(36/38)、71.7％ (27/38),两组间存在明显差异(P＜0.05).结论:针对妇科腹腔镜患者实施全程优质护理模式,有利于患者术后的恢复,提高护理质量,值得临床推广.     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.