以微信为媒介的延续护理在慢性心力衰竭患者中的应用效果

目的探讨以微信为媒介的延续护理在慢性心力衰竭患者中的应用效果。方法选取200例慢性心力衰竭出院患者为研究对象,随机分成对照组和观察组,每组100例。对照组采取常规形式进行延续性护理,观察组则采用以微信为媒介的形式进行延续性护理。比较两组患者出院前、出院后3个月的服药依从性、遵医行为依从性、疾病自我管理能力及满意度。结果出院前,两组患者的服药依从性、遵医行为依从性、疾病自我管理能力、满意度差异均无统计学意义(均P>0.05);出院后3个月,观察组患者的服药依从性、遵医行为依从性、疾病自我管理能力、满意度均较出院前提高,且高于对照组(均P<0.05)。结论以微信平台为媒介的延续护理可提高慢性心力衰竭患者的治疗依从性、疾病自我管理能力及其对护理工作的满意度。     

微信载体+5E健康管理模式在风湿病管理中的应用

目的探讨微信载体+5E健康管理模式在风湿病管理中的应用效果。方法回顾性选取2022年1至2月新疆维吾尔自治区人民医院风湿免疫科收治的176例初治风湿病患者为研究对象,其中采用微信载体+5E健康管理模式进行护理干预76例,为观察组;采用本院现行的慢性病护理健康管理模式进行护理干预100例,为对照组。比较两组患者出院前后服药依从性以及延续护理满意度。结果出院前两组患者服药依从性评分比较,差异无统计学意义（P=0.652）;出院后1、2个月,观察组患者服药依从性得分均明显高于对照组（均P＜0.01）。观察组患者延续护理工具、延续护理模式、延续护理内容、延续护理效果等4个维度评分和延续护理满意度总分均明显高于对照组（均P＜0.01）。结论微信载体+5E健康管理模式有助于提高风湿病患者服药依从性和延续护理满意度,值得在临床推广应用。     

格林模式对PCI术后服药依从性及生活质量的影响

【摘要】 目的 探讨格林模式对经皮冠状动脉介入术（PCI）后患者服药依从性及生活质量的影响。方法 回顾性分析2016年1月～2017年6月收治的PCI术后患者120例临床资料,根据不同干预方法分为对照组64例和观察组56例。对照组采用常规护理干预,观察组在对照组基础上应用格林模式的护理干预,比较两组干预3个月后服药依从性、自我效能与家庭关怀、生活方式、生活质量,继续随访6个月记录患者预后情况。结果 干预3个月后,观察组MMAS 8得分、GSEE、APGAR评分、GQOL1 74、SAQ评分均高于对照组（P＜005）;干预3个月后,两组自我实现、职业安全维度得分对比差异无统计学意义（P＞005）,观察组运动保健、均衡饮食人际支持维度得分均高于对照组（P＜005）;随访6个月,两组不良心血管事件发生率对比,差异无统计学意义（P＞005）。结论 格林模式应用于PCI术后患者护理干预效果良好,有利于改善患者服药依从性和生活质量的提高。     

行为干预联合针对性宣教对心肌梗死PCI术患者服药依从性、认知程度及再狭窄发生率的影响

目的：探讨行为干预联合针对性宣教对心肌梗死PCI术患者服药依从性、认知程度及再狭窄发生率的影响。方法选取我院2014年9月至2015年7月期间收治的经确诊为心肌梗死的患者92例,随机分为观察组和对照组,每组46例,对照组给予术前准备、PCI术后及急性心肌梗死的常规护理,观察组在对照组基础上进行行为干预联合针对性宣教护理,比较两组服药依从性、认知程度及再狭窄发生率。结果两组12个月随访成功率均为100%。出院后3个月服药依从性比较无明显差异（P＞0.05）;观察组出院后6个月、12个月服药依从性明显高于对照组(P＜0.05)。观察组病情认知程度评分显著高于对照组,再狭窄发生率4.35%明显低于对照组17.39%(P＜0.05)。结论行为干预联合针对性宣教护理可明显提高心肌梗死PCI术患者服药依从性、认知程度,降低再狭窄发生率。     

延续护理对老年冠状动脉介入术后患者康复效果的影响

目的 探讨延续护理随访对老年患者冠状动脉介入术（PCI）后康复效果和生活质量的影响。方法 选取2015年6月～2016年2月于我院行PCI治疗的冠心病患者140例,随机分成对照组与观察组各70例。对照组采用常规护理,观察组予以延续护理,比较两组患者术后的康复效果及生活质量。结果 观察组心血管不良事件的发生率为5.71%,明显少于对照组的17.14%（P＜0.05）;两组患者出院12个月后心功能（LVEF）、6MVT距离均明显高于手术前,且观察组LVEF、6MVT距离明显高于对照组（均P＜0.05）;观察组患者在出院后6、12个月的SF-36评分中的生理、心理及社会功能和总体生活质量评分均明显高于对照组（P＜0.05）,且其分数呈上升趋势。结论 延续护理随访可提高老年患者PCI术后的康复效果和生活质量,可在临床推广应用。     

护理干预对PCI术后患者服药依从性的影响

目的探讨护理干预对PCI术后患者服药依从性的影响。方法选取2010年3月-2010年9月的PCI术后患者52例为对照组;2010年10月-2011年3月的术后患者56例为护理干预组。干预组在常规护理的基础上实行针对性护理干预。观察两组患者出院后第1、3、6个月服药依从性的差别。结果护理干预组患者在出院后第1、3、6个月的服药依从性均好于对照组。结论针对性护理干预可以显著提高PCI术后患者的服药依从性,从而改善疾病预后,提高生存质量。     

基于合理行动理论的心脏康复教育模式对经皮冠状动脉介入治疗患者运动康复及心血管病危险因素的影响

背景　《中国心血管病报告2017》显示,我国心血管病现患病人数2.9亿。心脏康复的益处已在国际上达成共识。我国心脏康复工作目前处于起步阶段,如何在现有条件下提高我国心血管病患者心脏康复参与度和依从性,是目前亟须解决的首要问题。目的　探讨基于合理行动理论的心脏康复教育模式对经皮冠状动脉介入治疗（PCI）术后患者运动康复和心血管病危险因素的影响。方法　采用便利抽样法,选取2017年3-12月在河南科技大学第一附属医院行PCI术后出院冠心病患者85例为研究对象。采用简单随机分组法,将患者分为干预组43例,对照组42例。干预组实施了心脏康复门诊护士主导的为期12周的心脏康复教育模式,对照组实施传统教育。比较两组干预前后6 min步行距离（6MWD）、日常运动锻炼依从性及心血管病危险因素。结果　干预12周后,67例（78.8%）患者完成随访,干预组34例,对照组33例。干预后干预组患者6MWD较对照组增长（P<0.05）;干预组患者干预后6MWD较干预前增长（P<0.05）。干预组患者干预后体质指数（BMI）、舒张压、低密度脂蛋白胆固醇（LDL-C）水平较干预前降低（P<0.05）。干预后干预组患者戒烟、限酒达标率高于对照组（P<0.05）。对照组患者干预后服药依从性达标率较干预前降低（P<0.05）;干预组患者干预前与干预后服药依从性达标率比较,差异无统计学意义（P>0.05）;干预组患者干预后合理膳食、戒烟、限酒达标率较干预前升高（P<0.05）。结论　基于合理行动理论的心脏康复教育模式促进了PCI术后患者的运动康复,改善了患者心血管病危险因素。     

老年房颤患者抗凝治疗依从性行为助推策略研究

目的：分析老年房颤（AF）患者抗凝治疗依从性行为助推策略的应用价值。方法：选取南昌大学第二附属医院2021年1月-2022年5月心内科住院的100例老年AF患者为研究对象,采用随机数字表法分为对照组和观察组,分别50例。对照组接受常规抗凝护理,观察组在对照组的基础上进行基于助推理论下的老年AF患者抗凝治疗依从性行为提升策略;于干预前、出院前、出院后1个月评估并比较两组抗凝依从性[Morisliy服药依从性量表（MMAS-8）]、自我管理能力及生活质量[房颤患者生命质量量表（AF-QoL-18）]。结果：出院前、出院后1个月,两组MMAS-8评分、自我管理能力及AF-QoL-18评分均较干预前提高,且观察组均高于对照组,差异均有统计学意义（P<0.05）。结论：基于助推理论下抗凝治疗依从性行为提升策略能够提高老年AF患者抗凝治疗依从性及自我管理能力,可改善患者生活质量。     

集束化护理模式对冠心病PCI术患者生活质量与自我管理能力的影响

目的:探讨集束化护理模式对冠心病患者PCI术后生活质量、自我管理能力与心血管事件发生率的影响。方法:纳入临床明确诊断为冠心病且行PCI术的患者160例,随机分成对照组与观察组,每组80例。对照组给予常规护理干预,观察组在常规护理模式的基础上予集束化护理干预,观察6个月,对比两组护理干预后心血管事件发生率、生活质量、自我管理能力及依从性的异同。结果:(1)护理干预后,观察组患者心血管事件发生率较对照组明显降低,依从性较对照组明显提高,差异有统计学意义(均P<0.05);(2)护理干预后,观察组患者生活质量评分与自我管理能力评分均较对照组明显提高,差异有统计学意义(均P<0.05)。结论:集束化护理可明显降低冠心病患者PCI术后心血管事件的发生率,提高其依从性,改善其生活质量与自我管理能力,值得临床推广应用。     

延续性健康教育对PCI术后患者 自我管理水平及预后的影响

目的 探讨延续性健康教育对经皮冠状动脉介入治疗（PCI）术后患者自我管理水平及预后的影响。 方法 选择 2021年3月至2022年3月在温州市中心医院行PCI术并顺利出院的100例患者为研究对象，根据出院后健康教育方案不同分为对 照组及观察组，各50例。对照组行常规健康教育，观察组在常规教育基础上行双轨延续性健康教育，评价指标包括：患者自我效能感 评分、自我管理能力评分、治疗依从性、不良心血管事件、再入院率以及满意度评分。 结果 两组患者干预后自我效能感、自我管理 能力评分均优于干预前（均P＜0.05），观察组在行延续健康教育后，自我效能感评分、自我管理能力评分、治疗依从性均优于对照组 （均P＜0.05）。观察组不良心血管事件、再入院率均低于对照组，健康教育总满意率高于对照组（均P＜0.05）。 结论 延续性健康教 育可有效增强PCI术后患者的自我效能感和自我管理能力，提高患者治疗依从性、预后康复水平及健康教育满意度。     

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.