支气管哮喘患者的夜间观察与护理

目的了解支气管哮喘患者病情及护理人员的夜间特点，加强临床观察，护理人员克服自身困难，采取有效的护理措施。方法3年内对46例支气管哮喘患者的病情及转归进行分析。结果支气管哮喘患者发病及死亡率在夜间较高，所以夜间观察和护理尤为重要。结论支气管哮喘病情急重，变化快，危及生命。加强夜间护理病情观察，可以及早发现病情变化，为抢救争取时间和防止意外事故的发生。     

急性心肌梗塞的夜间观察及护理研究

目的：探讨急性心肌梗塞患者的夜间观察及护理。方法：对78例急性心肌梗塞患者随机分为对照组和观察组，对照组37例，观察组41例，两组患者性别年龄无显著性差异，对照组给予常规护理，观察组在此护理基础上加强夜间观察，并对梗死部位，并发症以及住院病死率进行比较。结果：观察组与对照组两组患者在梗死部位，并发症以及住院病死率，都具有显著性差异（P〈0．05）。结论：急性心肌梗塞的夜间观察，可以及时发现病情的变化，给予及时的救治，有效地降低死亡率的发生。     

急性心肌梗塞病人的夜间观察与护理

急性心肌梗塞是冠脉急性闭塞引起梗死,相关血管所供区域的心肌细胞急性坏死的一组综合征。可并发心律失常、休克及心力衰竭等,是内科急症,严重威胁着病人的生命。其并发症多,病死率高,病情易变、多变,因此病情观察非常重要。早期发现病情变化,给予及时处理是抢救成功的关键。尤其是夜间,由于各种因素的影响,容易忽视护理观察的重要性。本文结合临床实践,根据急性心肌梗塞的临床特征及各种并发症的特点,通过对120例急性心肌梗塞病人的夜间观察与护理,取得良好效果,现结合文献报道如—Fa     

重视老年病区夜间护理查房

夜间查房是一项非常重要的护理工作，然而由于人体生物钟的影响，护士值夜班时生理功能多较低下，神经系统处于抑制状态，反应灵敏度下降。因此护士夜间巡视病区，观察病情时容易忽视一些问题，而老年病区病人多为心脑血管疾病及慢性病，病种多，疾病复杂，病情变化快，夜间睡眠状态下潜在许多危险因素，所以应重视和加强老年病区夜间护理查房。     

老年常见病的夜间观察及护理

观察病情是临床护理工作中的重要内容之一，尤其在夜间，由于夜间的病情变化不像白天那样容易被发现，有些病人的体征和症状在夜间也容易被掩盖而被忽视；同时危重病人夜间发生各种危象、功能衰竭及死亡的亦多；另外，夜间工作人员少，病房熄灯，患者多在睡眠中，这就给观察带来了一定的困难，也对我们的夜班护士提出了更高的要求。因此，这就需要夜间值班护士熟悉病情，     

夜间护理观察的特点及规律

夜间护理观察的特点及规律莫爱礼（广西医科大学第一附属医院南宁５３００２１）夜间值班人员少，危重病人病情变化大［１］。所以，做好夜间护理工作至关重要。针对夜间护理工作的特点及规律，现总结如下。１夜间护理观察的特点１．１独立性：很多医院的护士都是单独值夜...     

支气管哮喘患者的夜间观察与护理

目的了解支气管哮喘患者病情及护理人员的夜间特点,加强临床观察,护理人员克服自身困难,采取有效的护理措施。方法3年内对46例支气管哮喘患者的病情及转归进行分析。结果支气管哮喘患者发病及死亡率在夜间较高,所以夜间观察和护理尤为重要。结论支气管哮喘病情急重,变化快,危及生命。加强夜间护理病情观察,可以及早发现病情变化,为抢救争取时间和防止意外事故的发生。     

肺心病患者夜间护理体会

慢性肺源性心脏病简称肺心病，是由于支气管、肺、胸廓或肺动脉的慢性病变引起的肺动脉高压，使右心室肥厚、扩大，进而发展为右心衰竭的心脏病。其并发症多，病死率高，病情易变、多变，因此病情观察非常重要。早期发现病情变化，给予及时处理是抢救成功的关键。尤其是夜间，由于各种因素的影响容易忽视护理观察的重要性，现结合临床上肺心病的病理生理变化，通过23例肺心病患者的观察，谈谈护理体会。     

浅谈内科病房的夜间护理

我们是一所二级乙等医院,内科病房是一个综合的病区,主要收治的病例包括消化、呼吸、心血管、内分泌的内科疾病。病种多,病情复杂多变,因此病情观察非常重要,早期发现病情变化,给予及时护理是抢救成功的关键。尤其是夜间,由于各种因素导致夜间护理工作不到位,病情观察不及时,而影响疾病的治疗及预后。因此,夜间对患者的观察护理也是非常重要的一个方面。     

ICU病房体外循环术后的夜间护理

夜间严密观察病情是衡量护理质量的重要标志，夜间护理也越来越受到人们的重视，尤其在ICU病房手术大、病情重、病种杂、夜间又容易发生病情变化．由于特定的病房，特殊的环境及危重的病人．这就要求的护士，在夜间不仅要有全面知识、过硬的急救技术，而且还要有较强的责任心，敏感的观察力，切不可放松警惕和麻痹大意，否则会造成不可弥补的损失，只有这样，才能做好夜间护理工作，保证病人的健康和安全。下面就夜间的循环系统，呼吸系统、管道、皮肤及睡眠几方面来探讨夜间护理的重要性。     

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.