前后入路联合内固定治疗颈椎病的手术配合体会

目的：观察应用无缝隙配合模式对颈椎病患者在接受前后入路联合内固定手术治疗的过程中实施手术配合的临床效果。方法将88例接受前后入路联合内固定手术治疗的颈椎病患者随机分为对照组和观察组,每组44例。对照组采用常规配合模式实施手术配合;观察组采用无缝隙配合模式实施手术配合。结果两组治疗效果差异无统计学意义（ P＞0.05）;观察组内固定手术操作时间、术后颈椎功能恢复正常时间、术后接受恢复治疗时间明显短于对照组（P＜0.05）;围手术期出现不良反应的例数明显少于对照组（P＜0.05）;手术护理模式患者满意度明显高于对照组（P＜0.05）;治疗后颈椎病再次复发率明显低于对照组（P＜0.05）。结论应用无缝隙配合模式对颈椎病患者在接受前后入路联合内固定手术治疗的过程中实施手术配合有较好的治疗效果。     

优质护理在腹式子宫肌瘤切除术患者围术期的应用分析

目的:探究优质护理在腹式子宫肌瘤切除术患者围术期的应用。方法:随机选取我院妇科收治的100例腹式子宫肌瘤切除术患者进行分析研究,并将全部患者按照随机数字表法平均分为观察组与对照组两组各50例,对照组给予常规围术期护理,观察组给予围术期优质护理措施。结果:经过优质护理的观察组患者手术情况、住院时间、手术时间、术中出血量和住院时间均明显优于对照组。结论:在对子宫肌瘤手术室中患者进行护理的过程中结合人性化护理措施能够显著提高护理疗效,在临床上具有广泛的推广价值。     

优质护理在颈椎病患者围术期的应用效果观察

目的 探讨优质护理在颈椎病患者围术期中的应用效果.方法 选取2013年9月-2014年9月我院收治的74例颈椎病患者,随机分为观察组和对照组.观察组给予围术期优质护理,对照组给予常规护理,比较2组患者的住院时间、心理状态以及护理满意度.结果 观察组住院时间明显低于对照组(P＜0.05);观察组心理状态明显优于对照组(P＜0.05);观察组护理满意度为94.59％,明显高于对照组的78.38％,差异有统计学意义(P＜0.05).结论 对颈椎病患者采用优质护理能够减少住院时间、减轻心理压力,提高护理满意度.     

高龄高危前列腺增生症患者经尿道双极等离子电切术的围手术期护理

目的探讨高龄高危前列腺增生症(BPH)患者经尿道双极等离子前列腺电切术(PKRP)的围手术期护理对策,以及围手术期全程优质护理服务对患者的影响。方法选取广东省乐昌市人民医院泌尿外科2011年1月-2012年10月住院的高龄高危BPH患者80例,随机均分为观察组与对照组。观察组40例实施围手术期全程优质护理,对照组40例实施常规护理。对临床疗效和护理质量进行观察分析,比较2组患者前列腺切除重量、手术时间、术中出血量、术后膀胱持续冲洗时间、留置导尿管时间、手术并发症发生情况、术后住院时间及患者满意度情况。结果术前2组患者一般情况比较差异无统计学意义(P>0.05);观察组手术时间、术中出血量、术后膀胱冲洗时间、住院时间明显小于对照组,差异有统计学意义(P<0.05);术后并发症发生率低于对照组,患者满意度高于对照组,差异有统计学意义(P<0.05)。结论高龄高危前列腺增生症患者采用全程优质围手术期护理措施能有效提高护理质量,减少术后并发症的发生,保证手术安全并提高患者满意度。     

胆囊结石患者腹腔镜胆囊切除术围手术期的护理体会研究

目的探讨胆囊结石患者腹腔镜胆囊切除术(LC)围手术期的护理方法及效果。方法抽取2015年10月至2017年10月来我院普外二科住院后应用LC治疗的围手术期胆囊结石患者520例,随机平均分为两组,分别给予常规护理(对照组)及干预护理同时采用优质护理服务(观察组),对两组患者的护理效果进行对比分析。结果观察组患者的术中出血量、术后排气时间、术后疼痛情况、术后住院时间及切口感染均优于对照组。结论在胆结石患者LC围手术期给予干预护理同时采用优质护理服务,有利于提高患者的治疗效果,有助于术后恢复和降低并发症的发生率,值得临床推广应用。     

围术期护理干预对普外科腹腔镜手术患者并发症的影响

目的探讨应用围术期临床护理路筘对普外科腹腔镜手术患者并发症的影响效果。方法选取2010年4月至2013年4月于青岛市城阳区人民医院行腹腔镜手术患者100例,随机分为观察组和对照组各50例．对照组给予围术期常规护理,观察组在围手术期常规护理的基础上给予临床护理路径管理。观察对比两组的术后并发症发生率、住院时间、住院费用及患者的满意度。结果观察组术后并发症的发病率明显低于对照组,住院时间和住院费用明显低于对照组,患者的满意度明显高于对照组,差异具有统计学意义（P〈0．05）。结论应用围手术期临床护理路径管理干预预防普外科术后肺部并发症临床效果显著,有效的提高了临床护理质量。     

护理风险管理对老年冠心病病人介入手术护理质量的影响研究

目的研究护理风险管理在老年冠心病患者介入手术护理质量中的影响。方法选本院心内科收治的老年冠心病患者46例为研究对象,随机分成对照组和观察组。给予对照组常规护理;观察组在常规围手术期护理基础上再给予风险管理护理。观察两组护理效果。结果观察组手术效果、在术中的配合程度都要明显优于对照组(P0.05);术后并发症要明显少于对照组(P0.05);术后住院时间要明显短于对照组患者(P0.05);对护理人员的满意程度要显著优于对照组患者(P0.05)。结论对老年冠心病患者实施围手术期常规护理加以风险管理护理可以明显缩短患者的住院时间,增强患者对手术的配合,减少患者术后并发症的发生,从而可以提高患者的手术效果。     

脑动脉瘤介入栓塞术的围手术期护理研究

目的:探究脑动脉瘤介入栓塞术的围手术期护理。方法:选取脑动脉瘤患者40例,随机分为对照组和观察组,每组各20例。两组患者均给予脑动脉瘤介入栓塞术,对照组给予常规护理,观察组给予围手术期优质全面护理,观察两组患者护理后的情况。结果:对照组患者住院时间长于观察组,剧烈头痛、呕吐、意识障碍、心烦等临床症状对照组消失的时间长于观察组,并发症的人数对照组也多于观察组,半年后复查情况对照组比观察组差,两组指标差异有统计学意义(P<0.05)。结论:给予脑动脉瘤介入栓塞术患者围手术期优质护理较常规护理恢复快,并发症少,因此,临床应推荐围手术期优质护理的措施。     

快速康复外科护理在经鼻蝶入路垂体瘤切除术围术期护理中的效果分析

目的 探讨快速康复外科护理在经鼻蝶入路垂体瘤切除术围术期护理中应用效果。方法 选择我院2016年3月～2019年3月收治的经鼻碟入路垂体切除术患者中50例作为研究对象,按照随机数字表法分为对照组(n=25)与研究组(n=25),对照组患者给予常规围手术期护理,研究组患者在此基础上实施快速康复外科护理,比较两组手术相关指标、护理不良事件及护理满意度。结果 两组术中出血量及手术时间比较,差异无统计学意义(P0.05);研究组患者的入住监护室时间、术后住院时间、不良事件总发生率、护理总满意度均优于对照组(P0.05)。结论 对经鼻碟入路垂体瘤切除术患者予围手术期快速康复外科护理,能够有效降低护理不良事件发生率,缩短患者住院时间,提高患者护理满意度,值得临床推广应用。     

围手术期优质护理在子宫内膜息肉手术患者中的应用价值

目的探讨围手术期优质护理在子宫内膜息肉手术患者中的应用价值。方法选择于2015年6月至2016年8月泌阳县妇幼保健院妇产科收治的60例子宫内膜息肉患者为研究对象,随机分为观察组(优质护理干预,30例)和对照组(常规护理措施,30例),所有患者均行宫腔镜手术治疗。比较两组治疗效果及术后并发症发生情况。结果观察组患者住院时间、手术时间均短于对照组,差异有统计学意义(P<0.05);观察组患者术中出血量、术后并发症发生率均低于对照组,差异有统计学意义(P<0.05)。结论对宫腔镜下治疗子宫内膜息肉患者给予围手术期优质护理干预,临床应用更具优势,可有效缩短患者治疗周期,减少术中出血量,预防并减少术后并发症的发生,具有较高的应用价值。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.