膳食实物宣教对住院糖尿病患者饮食行为的影响研究

目的探讨膳食实物宣教对住院糖尿病患者饮食行为的影响。方法选取符合标准的2型糖尿病住院患者256例,随机分为对照组和试验组,对照组采用传统糖尿病营养宣教,试验组在传统宣教的基础上结合膳食实物宣教法,观察并分析两组在宣教前后的膳食摄入和营养素摄入情况。结果对照组干预后热量、碳水化合物摄入量较干预前降低(t值分别为9.31,6.72,P<0.05);膳食纤维、钙、维生素C摄入量明显升高(t值分别为12.37,7.37,4.98,P<0.05);蛋类、蔬菜、禽肉类摄入量适宜,豆类、乳类、鱼虾类的摄入量低于建议摄入量,谷类、畜肉类、油脂类的摄入量明显高于建议摄入量;试验组干预后热量、碳水化合物、蛋白质、脂肪、胆固醇、食盐的摄入量均有明显下降(t值分别为19.53,23.95,12.30,20.48,37.55,52.49,P<0.01);维生素C、维生素B1、维生素B2、膳食纤维、钙、铁的摄入量有显著升高(t值分别为31.432,3.087,2.732,21.536,17.733,22.398,P<0.05);干预后试验组与对照组热量、蛋白质、脂肪、膳食纤维、钙、铁、维生素B2、维生素C、胆固醇、食盐摄入量比较,差异均有统计学意义(t值分别为25.31,8.97,11.37,7.71,26.61,4.38,3.69,38.62,29.74,39.41,P<0.05)。试验组谷类、蔬菜、蛋类、禽肉类、豆类、乳类、油脂类的摄入量适宜,鱼虾类的摄入量低于建议摄入量,畜肉类较建议摄入量高。结论在传统宣教方法基础上结合膳食实物宣教,可明显改善2型糖尿病住院患者的饮食行为。     

中医辨识护理结合食物成分识别技术在改善缺血性脑卒中病人膳食结构中的应用

目的分析基于中医辨识护理结合食物成分识别技术的膳食管理在改善缺血性脑卒中病人膳食结构和身体成分方面的效果。方法便利抽样选取2020年4月至2021年11月接受康复治疗的缺血性脑卒中病人72例,按照随机区组结合随机数字表法分为观察组和对照组,各36例。观察组给予中医辨识护理结合食物成分识别技术的膳食干预,对照组给予常规的饮食指导。比较2组病人干预前后的膳食结构和体质量指数(BMI)、腰臀围比变化。结果干预后,观察组BMI、腰臀比均值均下降,且低于对照组和观察组干预前的水平(P < 0.05~P < 0.01),对照组干预前后各指标差异无统计学意义(P>0.05)。干预后,观察组病人膳食中的蛋白质、膳食纤维、维生素A、维生素C、钙、钠的摄入量高于对照组,碳水化合物、脂肪、胆固醇、纳的摄入量低于对照组(P < 0.05);组内比较,观察组干预后的蛋白质、膳食纤维、维生素A、维生素C、钙、钠的摄入量较干预前增加,碳水化合物、脂肪、胆固醇、钠的摄入量降低(P < 0.05~P < 0.01),对照组干预前后各营养素摄入量差异无统计学意义(P>0.05)。干预后观察组病人食物种类摄入过量和不足的占比较干预前降低,其中奶类、蛋类、水果类和蔬菜类摄入量充足占比高于干预前(P < 0.05),干预后观察组蔬菜摄入充足占比高于对照组(P < 0.01)。结论将中医体质辨识护理和食物成分识别技术应用在缺血性脑卒中病人的膳食干预中可以很好地改善病人膳食结构和身体成分,促进疾病康复。     

乌鲁木齐三甲医院150例维持性血液透析患者膳食营养素摄入状况调查

目的了解维持性血液透析(MHD)患者膳食营养素摄入状况,为针对性营养干预提供依据。方法采用3天24h膳食回顾法了解150例MHD患者各类食物实际平均摄入量和每标准人日能量及主要营养素的摄入量,并进行简单的人体测量。结果 MHD患者每标准人日摄入热量为1 164.39Kcal,占供给量标准DRIs的48.5%;蛋白质摄入量为46.56g,占DRIs的62.1%;无膳食维生素B12摄入;膳食营养素锰摄入过高。脂肪供能明显低于推荐合理比例,碳水化合物能量明显高于推荐合理比例。结论 MHD患者热能摄取过低,多种膳食营养素摄入不足,碳水化合物供能比过高,脂肪供能比相对偏小,需要进行综合性的营养干预。     

101例糖尿病病人膳食状况调查分析与干预对策

目的 通过调查糖尿病患者膳食结构分析评价其合理性并提出干预对策.方法 采用食物频数法和24小时膳食回顾法对101例糖尿病患者的膳食状况进行调查.结果 被调查患者膳食中粮谷类的比重低,禽肉类和水产类比重过高;与2002年全国营养调查的城市居民各类食物平均摄人情况相似.总能量摄入过高,三大营养素中脂肪供能比明显偏高,碳水化合物的供能比和膳食纤维的摄入量未达到要求.胆固醇摄入超过推荐量标准;而B族维生素和钙的摄入量均未达到推荐量标准.结论 被调查糖尿病患者膳食结构不合理,建议适当降低总能量和脂肪的摄入,增加膳食纤维的摄入,平衡膳食,均衡营养素;加强糖尿病营养教育.     

妊娠晚期孕妇膳食情况与巨大胎儿的关系

目的：探讨妊娠晚期孕妇膳食情况与巨大胎儿发生之间的关系。方法：采用24h回忆法对120例孕周〉34周的孕妇在产前检查时询问前一天膳食情况,调查膳食中热量、蛋白质、无机盐等营养素的摄入量。随访孕妇至分娩,其中24例分娩巨大儿,96例分娩正常体重新生儿,比较两组孕妇妊娠晚期膳食情况及体重增加情况。结果：两组孕妇的膳食结构较合理,三大生热营养素的供能比例与RDA基本一致,摄入蛋白质中有1/3以上优质蛋白。但巨大儿组孕妇能量摄入量显著高于对照组及RDA（P〈0.05）,对照组能量摄入量显著低于RDA（P〈0.05）。两组孕妇钙、维生素A、维生素B1、维生素B2及锌的摄入量均显著低于RDA（P〈0.05）,且巨大儿组孕妇孕期增重明显高于对照组（P〈0.05）。结论：妊娠晚期限制主食量,增加副食量,尤其是动物性食品有利于预防巨大儿的发生。     

糖尿病患者膳食调查结果分析

目的了解住院糖尿病患者膳食营养素摄入情况和营养状况。方法对我院68例住院糖尿病患者进行膳食调查、人体测量及部分实验室检查，对热能、营养素摄入情况和食物构成进行分析，并对患者的营养状况进行综合评价。结果每天总热量摄入偏低，钙、锌、硒、视黄醇、硫胺素、核黄素等低于（RNI）供给量标准。营养状况评价约22．1％的患者存在不同程度的热量一蛋白质营养不良。结论对糖尿病患者应采取以下干预措施：①加强营养知识的宣传教育，让患者掌握正确的饮食治疗方法，纠正不良的饮食习惯；②饮食中应增加奶制品及豆制品的摄入量，以补充钙的不足；③每天摄入一定数量粗杂粮和蔬菜，以补充B族维生素及膳食纤维，必要时应用膳食纤维制品（如魔芋精粉、精制麦麸等）；④相应增加乳、蛋、禽及海产品的摄入，提高优质蛋白质的比例。     

个体化宣教指导对纠正糖尿病患者饮食营养误区及改善疗效的意义

目的探讨个体化宣教指导对纠正糖尿病患者饮食营养误区及改善效果。方法选取我社区的124例常住糖尿病患者作为研究对象,根据其于社区卫生服务中心建档时间分成A、B两组,各62例。B组予以常规护理措施,A组予以个体化宣教指导护理干预。比对两组患者干预前后血糖指标差异,记录其干预前后热量、脂肪、碳水化合物、膳食纤维、蛋白质、钙、铁、锌、蛋白质、胆固醇等膳食营养摄入变化情况,予以生活质量调查表(SF-36)评估患者健康指数差异。结果 1干预后,两组患者空腹血糖及餐后2 h血糖值均较干预前显著降低,其中A组降幅大于B组(P0.05);2两组患者除碳水化合物水平较治疗前无明显改变(P0.05)外,热量、脂肪、蛋白质、胆固醇等膳食营养摄入指标均较治疗前显著降低,膳食纤维、钙、铁、锌等膳食营养摄入指标则显著提高(P0.05);其中A组患者各指标变化幅度大于B组(P0.05);3 A组患者PF、RP、GH、SF等健康状态评分均显著高B组(P0.05)。结论在社区内对糖尿病患者予以个体化宣教指导措施,可有效纠正其饮食营养误区,改善临床治疗效果,值得临床推广。     

甘泉医院病人集体膳食调查

目的评价病人集体膳食各种营养素供给量的合理性。方法采用“称量法”对住院饮食为普食的２０５例病人进行三日膳食调查。结果病人平均每人每日摄入的总热量、蛋白质、脂肪、碳水化合物、铁、维生素ＰＰ、维生素Ｂ２、维生素Ｃ等基本上达到我国推荐的膳食营养素供给量ＲＤＡ标准。钙、维生素Ｂ１、视黄醇当量的摄入量低于ＲＤＡ标准。结论普食病人每人每日热量摄入充足，三大营养素比例恰当，膳食结构合理。但某些无机盐、维生素供给量应适当增加。     

营养治疗与糖尿病疗效关系的观察

目的观察营养治疗与糖尿病疗效的关系。方法选择住院的糖尿病病人188人,随机分成两组:观察组128人,遵照饮食医嘱,使用营养师专门为之配制的个体化糖尿病饮食;另一组为对照组60人,病人自行控制饮食。分别调查其膳食营养状况、测定其血压、血糖、血脂。结果按照各种营养素的实际摄入量占推荐需要量的百分比比较:观察组能量、蛋白质、脂肪、碳水化合物、Ca、Zn、Fe、维生素B1、维生素C及膳食纤维都是比较理想的;而对照组能量、蛋白质、Ca、Zn、维生素C、膳食纤维是偏低的,而脂肪偏高。观察组与对照组比较差异有统计学意义(p<0.01)。观察组与对照组两组病人血压、空腹血糖及血脂指标治疗前比较差别无统计学意义(P>0.05);营养治疗2周后观察组收缩压、血糖、T G较治疗前均明显降低(p<0.05),而对照组仅血糖比治疗前明显降低(p<0.05);观察组收缩压、血糖、TG较治疗前降低比对照组明显(p<0.05)。结论规范的个体化糖尿病营养治疗可以改善膳食营养的摄入,促进糖尿病患者血糖、血压、血脂的改善,提高临床治疗效果。     

糖尿病患者膳食结构及营养状况调查分析

目的通过调查糖尿病患者膳食结构分析评价其合理性。方法采用半定量食物频数法对60例糖尿病患者的膳食状况进行调查。结果被调查患者膳食中粮谷类的比重小,禽肉类和水产类比重过高,与2002年全国营养调查的城市居民各类食物平均摄入情况相似。总能量摄入过高,三大营养素中脂肪供能比明显偏高,蛋白质、碳水化合物的供能比和膳食纤维的摄入量未达到要求。胆固醇摄入超过推荐量标准;而B族维生素和钙的摄入量均未达到推荐量标准。结论被调查糖尿病患者膳食结构不合理,建议适当降低总能量和脂肪的摄入,增加膳食纤维的摄入,平衡膳食,均衡营养素,加强糖尿病营养教育。     

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.