PICC标准化护理流程在肿瘤化疗置管患者中的应用效果观察

目的探讨分析PICC标准化护理流程在肿瘤化疗置管患者临床护理中的应用价值。方法从本院2017年3月至2018年3月接收的肿瘤化疗PICC置管患者中,随机抽取82例患者,将其按照入院顺序进行奇偶排序,41例奇数患者作为观察组,采用PICC标准化护理流出进行干预,41例偶数患者作为对照组,采用常规护理流程进行干预。观察两组患者护理满意度情况以及护理后静脉炎发生情况。结果观察组护理总满意率显著高于对照组,且静脉炎总发生率低于对照组,比较差异有统计学意义(P0.05)。结论肿瘤化疗置管患者采用PICC标准化护理流程进行干预效果较为理想,提高了患者置管治疗的效果,改善了患者的预后,并且降低了患者静脉炎的发生几率,临床价值较高,值得推广使用。     

问题导向的管道护理干预对乳腺癌术后 PICC置管化疗患者非计划性拔管发生率的影响

目的探究问题导向的管道护理干预对乳腺癌术后经外周静脉置入中心静脉导管(PICC)置管化疗患者非计划性拔管发生率的影响。方法选取我院2015年5月至2018年12月乳腺癌术后PICC置管化疗患者116例,根据入院时间分组,各58例。对照组给予常规管道护理干预,观察组给予问题导向的管道护理干预。对比两组一次置管成功率、静脉炎发生率、非计划性拔管发生率、疼痛评分、导管留置时间、护理满意度评分及干预前后生活质量评分。结果与对照组相比,观察组一次置管成功率明显提高,静脉炎、非计划性拔管发生率明显降低(P<0.05);观察组VAS评分低于对照组,导管留置时间长于对照组,护理满意度评分高于对照组(P<0.05);与对照组相比,干预后观察组生活质量评分明显提高(P<0.05)。结论问题导向的管道护理干预应用于乳腺癌术后PICC置管化疗患者,可提高一次置管成功率,降低静脉炎、非计划性拔管发生率,缓解疼痛,延长导管留置时间,改善生活质量,提高护理满意度。     

集束化护理在早产儿PICC置管与带管过程中的应用

目的探讨集束化护理在早产儿PICC置管与带管过程中的应用效果。方法在2012年5月至2015年5月在我院进行治疗并行PICC置管的208例早产儿患者中,随机选择50例进行回顾性分析,随机分为对照组和观察组,每组25例,对照组给予PICC常规护理干预措施,观察组给予集束化护理干预,比较两组患儿PICC并发症(断管、堵管、穿刺点渗血、静脉炎)发生率。结果观察组患者断管、堵管、穿刺点渗血、静脉炎发生率均明显低于对照组,观察组状况显著优于对照组,对比具有统计学意义(P0.05)。结论集束化护理在早产儿PICC置管与带管过程中的应用价值较大,显著提高了患者护理满意度,改善其生活质量。     

综合护理干预在恶性肿瘤PICC置管中的应用效果

目的探究综合护理干预在恶性肿瘤PICC置管中的应用效果。方法选择2016年1月至2017年12月我院收治的75例恶性肿瘤PICC置管患者,随机分为两组,其中观察组采用综合护理干预,对照组采用常规护理干预。结果观察组PICC并发症发生率显著低于对照组(P0.05);观察组护理满意度显著高于对照组(P0.05)。结论给予恶性肿瘤PICC置管患者综合护理干预,可有效降低PICC并发症发生率,提高护理满意度,效果肯定。     

针对性健康教育对肿瘤PICC置管患者的影响

目的探讨针对性健康教育对肿瘤PICC置管患者的影响。方法纳入2017年1月～2018年8月我院收治的50例肿瘤PICC置管患者进行研究。按照随机对照原则分为对照组和观察组,每组25例。对照组接受常规护理,观察组在此基础上实施针对性健康教育,比较两组患者干预前后自我护理能力测定量表(ESCA)评分、依从性、QLQ-C30生活质量评分变化情况以及并发症发生情况。结果观察组患者干预后自我护理技能评分、自我护理责任感评分、自我概念评分、健康知识水平评分均高于对照组,差异显著(P0.05);观察组患者干预后依从性评分和QLQ-C30评分均高于对照组,差异显著(P0.05);观察组患者并发症总发生率低于对照组,差异显著(P0.05)。结论针对性健康教育可提高肿瘤PICC置管患者自我护理能力、依从性和生活质量,降低并发症风险,值得临床推荐。     

肺癌化疗患者PICC置管中护理的应用效果评价

目的探讨肺癌化疗患者PICC置管中护理的应用效果。方法选取64例肺癌化疗患者作为研究对象,研究时间为2017年02月至2019年02月,按照护理方法的不同分为两组,对照组给予常规护理干预,观察组给予PICC置管护理,各32例,且对两组患者的并发症发生率(导管脱出、穿刺点渗血、穿刺点感染、静脉炎、血栓形成)、生活质量评分进行观察及评估。结果观察组并发症发生率低于对照组,P0.05;观察组生活质量评分低于对照组,P0.05。结论 PICC置管护理应用于肺癌化疗患者中具有较高的临床价值,有利于降低并发症发生率及提高患者生命质量,值得应用及推广。     

老年肿瘤患者应用改良塞丁格技术超声引导PICC置管的效果观察

目的:探讨超声引导下应用改良塞丁格技术在老年肿瘤患者PICC置管期的护理应用体会.方法:对40例老年肿瘤患者应用PICC化疗,分为对照组与观察组,每组20例,对照组采用盲穿进行PICC置管;观察组采用改良塞丁格技术超声引导进行PICC置管,观察2组的舒适度、1次性置管成功率、血栓形成、静脉炎、出血.结果:观察组患者舒适度、1次性置管成功率、显著高于对照组,而血栓形成、静脉炎、出血、显著低于对照组(P<0.05).结论:改良塞丁格技术超声引导进行PICC置管,成功率及安全性高,有效降低了并发症,提高了患者的满意度,值得临床推广.     

老年患者PICC置管后预防静脉炎、静脉血栓的专项护理

目的探讨置管专项护理干预老年患者PICC置管后预防静脉炎、静脉血栓的效果研究。方法选择2015年1月~2016年10月于我院就诊的120例行PICC置管的老年患者作为研究对象。120例患者随机分为对照组(60例)和试验组(60例)。对照组采取常规护理,试验组采用PICC置管专项护理。探讨置管专项护理干预老年患者PICC置管后预防静脉炎、静脉血栓的效果研究。结果试验组静脉炎发生率(1.67%)低于对照组静脉炎发生率(10.00%);试验组静脉血栓发生率低于对照组(3.33%vs11.67%),差异有统计学意义(P0.05)。护理干预后,试验组炎症因子MCP-1、TNF-α和IL-6水平较对照组均降低(P0.05)。护理干预后,试验组D-D和v WF水平较对照组均降低(P0.05)。护理干预后,试验组无菌操作、基础护理、护理记录、并发症预防、健康教育评分均明显高于对照组(P0.05)。结论置管专项护理干预对老年患者PICC置管后预防静脉炎、静脉血栓形成效果显著。     

食管癌患者PICC置管相关性静脉血栓护理干预的探讨

目的:探讨食管癌患者PICC置管相关性静脉血栓的护理干预。方法:选取我科102例食管癌术后PICC置管患者作为研究对象,随机将其分为对照组与实验组,前者采取日常护理干预措施,后者采取相关血栓性静脉炎干预措施。结果:观察组的静脉血栓发生情况显著低于对照组,P0.05,差异具有统计学意义。结论:采用相关血栓性静脉炎干预的观察组患者静脉血栓的发生率显著低于对照组,P0.05,差异具有统计学意义,均提示对食管癌患者PICC置管过程中行相关血栓性静脉炎护理干预能够有效提高穿刺成功率,降低静脉血栓的发生率,值得临床推广应用。     

胃癌患者PICC置管并发血栓性静脉炎的护理

目的观察胃癌患者PICC置管并发血栓性静脉炎症的护理有效性。方法选择2017年1月至2018年1月我院收治的100例胃癌PICC置管病患为研究对象,将其分为2组,每组50例。对照组接受常规护理,观察组接受针对性护理,分析效果。结果对照组患者血栓性静脉炎发生率为20.00%,导管阻塞率为18.00%。观察组患者血栓性静脉炎发生率为4.00%,导管阻塞率为4.00%。对照组护理满意度为86.00%,观察组为98.00%。(P0.05)。结论经过综合化护理可提升患者治疗依从性。加强患者PICC置管期间安全性。     

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.