强化降压护理对血液透析患者高血压和生活质量的影响分析

目的：探析采取强化降压护理对血液透析患者高血压与生活质量的影响。方法：选取2018年1月—2021年4月连云港市赣榆区中医院收治的68例血液透析患者作为观察对象，随机分为对照组和观察组，每组各34例。将采取常规护理的患者纳入对照组，将实施强化降压护理的患者纳入观察组。观察两组患者血压水平、心理状态变化，从心理、身体、饮食等方面评估患者生活质量改善情况。结果：护理后，观察组收缩压、舒张压分别为（97.64±11.86） mmHg、（78.96±12.34）mmHg,(1 mmHg=0.133Kpa)低于对照组，差异有统计学意义（t=4.899、8.076,P<0.05）。护理后，观察组SDS、SAS评分为（41.89±4.13）分、（41.59±5.51）分，低于对照组，差异有统计学意义（t=6.946、9.078,P<0.05）。观察组心理指数、生活幸福指数、合理饮食、身体表现评分均高于对照组，差异有统计学意义（t=5.908、7.876、3.787、10.345,P<0.05）。结论：对血液透析高血压患者实施强化降压护理，有助于调节患者血压、心理情绪，提高其生活质量...     

神经内科睡眠障碍患者中护理干预后的血压与睡眠质量情况分析

目的：针对神经内科睡眠障碍患者行优质护理干预，总结其对患者血压及睡眠质量的影响。方法：神经内科睡眠障碍病例来源于2021年1月～2021年12月，共计60例，分组依据随机数字表法，观察组（常规护理+优质护理干预）与对照组（常规护理）各30例。对比两组护理前后血压水平、睡眠质量，问卷调查患者护理满意度。结果：两组患者舒张压、收缩压护理前差异无统计学意义（P>0.05），护理后观察组低于对照组，P<0.05，差异显著；两组患者各项睡眠质量评分（PSQI）比较P>0.05，差异无统计学意义，护理后观察组各项评分较对照组降低明显，差异显著，P<0.05；观察组护理满意度为93.33%，高于对照组的70.00%，有统计学意义（P<0.05）。结论：神经内科睡眠障碍患者应用优质护理干预，在改善患者血压指标、提升睡眠质量方面效果突出，患者满意度高，可予以推广。     

基层医院高血压优质护理应用体会

目的:观察基层医院实施优质护理对高血压患者血压、生活质量的影响。方法:将本院2013年5月-2014年9月内科门诊收治的104例高血压患者随机数字表法分为观察组和对照组,每组52例,对照组采用常规护理,观察组采用优质护理,比较两组护理前后血压变化、血压控制、生活质量量表情况。结果:观察组患者护理后的收缩压和舒张压与对照组相比明显改善,比较差异有统计学差异(P0.05);观察组护理后血压控制情况明显优于对照组,比较差异有统计学意义(P0.05);观察组生活质量评分情况优于对照组,比较差异有统计学意义(P0.05)。结论:基层医院对高血压患者开展优质护理,能控制血压,提高患者生活质量。     

5E综合护理模式在腹膜透析患者血压控制、自护能力及社会功能中的应用价值

目的：研究5E综合护理模式在腹膜透析患者血压控制、自护能力及社会功能中的应用价值。方法：选取2018年7月—2020年8月在河南科技大学第一附属医院进行腹膜透析的120例患者作为研究对象,按照实施序号的单双数将其分为对照组和观察组,其中对照组60例患者采用常规护理,观察组60例患者在5E模式的基础上行综合护理,分别对两组患者护理前后的血压变化情况、自护能力（ESCA）、生活质量评分、心血管并发症发生情况及护理满意度进行比较。结果：护理后,观察组患者收缩压和舒张压比对照组患者低,差异有统计学意义（t=8.304、5.306,P<0.05）。护理后,观察组患者ESCA中各维度评分比对照组患者高,差异有统计学意义（t=17.716、6.491、10.851、8.405,P<0.05）。护理后,观察组患者的生活质量各维度评分比对照组患者高,差异有统计学意义（t=10.831、11.812、11.397、11.477,P<0.05）。护理后,观察组患者的心血管各项并发症发生率比对照组患者低,差异有统计学意义（t=5.272、4.430、5.058,P<0.05）。护理后,...     

家庭自测血压在社区高血压患者中的应用效果分析

目的：探讨家庭自测血压在社区高血压患者中的应用效果。方法：选取2021年1月—2022年1月北京市东城区建国门社区卫生服务中心管理的256例社区高血压患者作为研究对象，根据随机数字表法分为观察组与对照组，各128例。对照组实施社区常规管理，观察组在对照组基础上实施家庭自测血压，比较两组血压水平、治疗依从性、满意度。结果：干预前，两组收缩压、舒张压水平比较，差异无统计学意义（P>0.05）；干预1、2个月后，两组收缩压、舒张压水平均低于干预前，且观察组低于对照组，差异有统计学意义（P=0.000 0）。观察组治疗依从率高于对照组，差异有统计学意义（P=0.000 2）。观察组满意度高于对照组，差异有统计学意义（P=0.000 0）。结论：社区高血压患者采用家庭自测血压，血压控制效果好，治疗依从性好，满意度高。     

社区护理在原发性高血压患者中的应用效果

目的：分析社区护理在原发性高血压患者中的应用效果。方法：选取2021年3月—2022年9月北京市丰台区北宫镇社区卫生服务中心收治的80例原发性高血压患者作为研究对象，采用信封法分为两组，各40例。对照组采用常规护理，观察组采用社区护理。比较两组血压水平、健康认知程度、护理依从性、生活质量及护理满意度。结果：干预后，观察组舒张压、收缩压水平均低于对照组，差异有统计学意义(P<0.000 1)。观察组临床症状、疾病危害、并发症及用药方式评分高于对照组，差异有统计学意义(P<0.000 1)。观察组定期复查、用药、运动及饮食依从性评分高于对照组，差异有统计学意义(P<0.000 1)。干预后，观察组躯体功能、角色功能、认知功能、情感功能、社会功能评分均高于对照组，差异有统计学意义(P<0.000 1)。观察组护理总满意度高于对照组，差异有统计学意义(P=0.013 3)。结论：社区护理在原发性高血压患者中的应用效果显著，可改善患者血压水平，提高健康认知程度、护理依从性、生活质量及护理满意度。     

优质护理在妊高症产妇产后出血护理中的应用效果分析

目的探究优质护理在妊高症产妇产后出血护理中的应用效果。方法选取2016年2月至2017年2月淅川县妇幼保健院收治的76例妊高症合并产后出血产妇,按照随机数表法将其分为两组,各38例,给予对照组常规护理,观察组则在对照组的基础上接受优质护理干预。统计对比两组产妇护理前后的生活质量评分及血压变化。结果护理前,两组生活质量评分和血压水平比较,差异无统计学意义(P>0.05);护理后,两组的生活质量评分较护理前均升高,且观察组高于对照组,差异有统计学意义(P均<0.05);护理后,两组的收缩压和舒张压较护理前均降低,且观察组低于对照组,差异有统计学意义(P均<0.05)。结论优质护理应用于妊高症产妇产后出血的护理中,可提高产妇的生活质量,控制其血压水平,值得推广应用。     

疼痛干预及优质护理对老年股骨头置换术患者生活质量的影响分析

目的：分析对老年股骨头置换术患者实施疼痛干预及优质护理的效果。方法：选取2018年1月—2020年1月广州医科大学附属中医医院收治的96例股骨头置换术患者作为研究对象,按随机数表法分为对照组和观察组,每组各48例。对照组实施常规护理,观察组在对照组基础上给予疼痛干预及优质护理,对比两组患者护理前后的焦虑、抑郁情绪评分、疼痛评分、生活质量评分及不良反应发生率。结果：护理前,两组患者SAS、SDS评分比较,差异无统计学意义(t=0.006、0.015,P>0.05);护理后,观察组患者SAS、SDS评分明显低于对照组,差异有统计学意义(t=9.719、8.269,P<0.05)。护理前,两组患者疼痛评分比较,差异无统计学意义(t=0.011,P>0.05);护理后,观察组患者疼痛评分明显优于对照组,差异有统计学意义(t=7.363,P<0.05)。两组患者不良反应发生情况比较,观察组患者明显低于对照组,差异有统计学意义(χ²=7.693,P<0.05)。护理前,两组患者生活质量评分比较,差异无统计学意义(t=0.011,P>0.05...     

全程优质护理对肺癌手术患者疼痛、舒适状况、生活质量及满意度的影响分析

目的探讨全程优质护理对肺癌手术患者疼痛、舒适状况、生活质量及满意度的影响。对照组采用常规护理干预,观察组在常规护理干预的基础上采用全程优质护理干预。方法收集2021年1月至2021年12月在我院就诊的肺癌患者757例作为研究对象,采用随机数字表法进行分组,即对照组(n=378)、干预组(n=379)。结果干预组疼痛评分显著低于对照组,干预组生活质量评分显著高于对照组,差异均具有统计学意义(t=18.090,P=0.000;t=32.813,P=0.000)。干预组患者舒适率97.10%、满意率93.40%均显著高于对照组,差异均具有统计学意义(2=67.935,P=0.000;2=55.236,P=0.000)。结论全程优质护理用于肺癌手术患者,可有效改善患者舒适状况,提高患者生活质量和满意度,减轻患者疼痛程度,值得推广。     

个体化围术期优质护理服务对肛瘘围术期患者心理状态、疼痛的影响

目的 探讨肛瘘患者采用个体化围术期优质护理服务对其围术期心理状态和疼痛程度的影响。方法回顾性选取2020年9月—2021年9月福建中医药大学附属人民医院肛肠科收治的100例肛瘘患者的临床资料,依照护理方法的不同将其分为两组,对照组（n=50）采用常规护理干预,观察组（n=50）采用个体化围术期优质护理,比较两组护理前后的心理状态、疼痛程度、生活质量评分和并发症发生率。结果 护理后,观察组的焦虑自评量表（Self-rating Anxiety Scale, SAS）评分和抑郁自评量表（Self-rating Depression Scale, SDS）评分均低于对照组,差异有统计学意义（P均<0.05）;观察组术后1 d的视觉疼痛模拟评分（Visual Analogue Scale,VAS）为（3.15±0.23）分,低于对照组的（4.02±1.75）分,差异有统计学意义（t=3.485,P<0.05）;观察组生活质量量表（WHO Quality of Life, WHOQOL）评分高于对照组,差异有统计学意义（P<0.05）;观察组并发症发生率低于对照组,差异有统计学...     

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.