自体骨髓干细胞移植治疗肝硬化的护理体会

目的 总结自体骨髓干细胞移植治疗74例肝硬化患者的护理体会,探索自体骨髓干细胞移植治疗74例肝硬化患者的护理方法,以提高护理水平和治疗效果.方法 对74例肝硬化患者进行有效的移植前护理,移植中护理,移植后护理,制订一系列的护理计划,实施有效的护理措施.结果 自体骨髓干细胞移植的74例患者手术顺利进行,肝功能明显改善,病情好转出院.结论 有效的护理措施能使肝硬化患者对自体骨髓干细胞移植这种治疗方法知情充分,保持平和的心态,做好移植前的护理,移植中的护理,移植后的护理是自体骨髓干细胞移植顺利进行的重要保障.     

自体骨髓干细胞肝内移植的护理

目的探讨自体骨髓干细胞肝内移植对肝硬化治疗的护理,为今后相同的病例提供护理经验。方法以自体骨髓干细胞做为供体,在体外分离纯化后移植患者肝内,使受损的肝功能得以恢复和重构。本文对21例患者从术前准备和术中医护患的配合,术后病情的观察和周密的护理,增强患者战胜疾病的信心。结果减少患者活动受限和并发症的发生,使手术顺利进行,成功率100%。结论在自体骨髓干细胞移植治疗肝硬化过程中,护士的充分的准备,医护患的良好的沟通与配合是自体骨髓干细胞移植成功的重要保证。     

自体骨髓干细胞移植对肝硬化患者的自蛋白及肝细胞生长因子的影响

目的探讨自体骨髓干细胞移植治疗肝硬化患者促进肝细胞再生及改善肝功能的机制,并同成人新鲜血浆的疗效进行比较。方法40例肝硬化患者分为两组,一组采用自体骨髓干细胞移植治疗,另一组采用成人新鲜血浆治疗。观察两组患者治疗前后肝功能指标、肝细胞生长因子、白细胞、血小板的变化并进行比较。结果自体骨髓干细胞移植在改善肝脏功能、促进肝细胞再生、提升免疫功能的疗效明显优于成人新鲜血浆。结论自体骨髓干细胞移植治疗肝硬化,可提高白蛋白及肝细胞生长因子的合成、分泌,促进肝细胞损伤的修复,使肝硬化的症状得到改善。     

自体骨髓干细胞移植治疗糖尿病足的护理干预

目的 探讨对糖尿病足患者进行自体骨髓干细胞移植的护理干预.方法 对12例行自体骨髓干细胞移植术治疗糖尿病足的患者给予精心围术期护理.结果 经过骨髓干细胞移植治疗,10例患者创面于3～4周愈合,2例患者未愈,愈合率83%.结论 重视自体骨髓干细胞移植治疗糖尿病足,采取有针对性的护理干预,对顺利开展手术治疗,提高患者的康复有一定的促进作用.     

肝硬化失代偿期患者行自体骨髓干细胞肝内移植术治疗的护理

目的:总结7例肝硬化失代偿期患者行干细胞移植治疗的护理经验,探索自体骨髓干细胞移植治疗的护理措施,为今后相关病例的护理提供经验。方法:以自体骨髓干细胞为供体,进行有效地移植前、移植后护理,制订一系列护理计划,实施有效的护理措施。结果:7例肝硬化患者手术进行顺利,术后患者症状明显改善,肝功能好转,无术肢活动受限及并发症的发生。结论:在自体骨髓干细胞移植治疗终末期肝病过程中,有效的护理措施是自体骨髓干细胞移植得以顺利进行的重要保证。     

自体骨髓干细胞移植多支血管介入治疗肝硬化的临床研究

目的研究自体骨髓干细胞移植多级肝动脉分支介入治疗肝硬化的临床疗效。方法实验组40例肝硬化伴有腹水患者,经导管将干细胞悬液移植入肝脏动脉多级分支血管。对照组搜集40例肝硬化患者资料,治疗方法为静脉输入自体骨髓干细胞悬液。在移植后复查肝脏功能,观察实验室指标、临床症状及不良反应情况,与对照组资料进行对比并做统计学分析。结果实验组骨髓干细胞移植后,患者肝脏功能明显改善,实验室指标均明显高于对照组。实验组术中未发生严重并发症,术后近期无不良反应出现。结论自体骨髓干细胞移植治疗肝硬化是目前治疗肝硬化的一种有效手段,采用肝动脉多级分支动脉进行自体骨髓干细胞移植治疗肝硬化比静脉移植干细胞治疗肝硬化具有更加显著的临床疗效。治疗安全有效且副作用小,可作为中晚期肝硬化患者的临床治疗方案。     

自体干细胞移植治疗乙肝后性肝硬化的护理

目的探讨干细胞移植治疗乙肝后性肝硬化患者的护理方法.方法对干细胞移植治疗肝硬化的患者进行术前、术中进行护理干预,术后进行预见性护理.结果20例乙肝后性肝硬化患者进行自体干细胞的移植治疗效果良好,无一例并发症发生.结论加强自体干细胞的移植治疗患者的术前、术后护理,对其并发症进行预见性护理.能保证自体干细胞的移植治疗顺利进行,并取得良好的治疗效果.     

自体骨髓干细胞移植多支血管介入治疗肝硬化的临床研究

目的 研究自体骨髓干细胞移植多级肝动脉分支介入治疗肝硬化的临床疗效.方法 实验组40例肝硬化伴有腹水患者,经导管将干细胞悬液移植入肝脏动脉多级分支血管.对照组搜集40例肝硬化患者资料,治疗方法为静脉输入自体骨髓干细胞悬液.在移植后复查肝脏功能,观察实验室指标、临床症状及不良反应情况,与对照组资料进行对比并做统计学分析.结果 实验组骨髓干细胞移植后,患者肝脏功能明显改善,实验室指标均明显高于对照组.实验组术中未发生严重并发症,术后近期无不良反应出现.结论 自体骨髓干细胞移植治疗肝硬化是目前治疗肝硬化的一种有效手段,采用肝动脉多级分支动脉进行自体骨髓干细胞移植治疗肝硬化比静脉移植干细胞治疗肝硬化具有更加显著的临床疗效.治疗安全有效且副作用小,可作为中晚期肝硬化患者的临床治疗方案.     

自体骨髓干细胞移植介入治疗肝硬化的临床研究

目的 研究自体骨髓干细胞移植介入治疗肝硬化的临床疗效.方法 40例肝硬化伴有腹水患者,经导管将干细胞悬液移植入肝脏动脉,在移植后复查肝脏功能,观察实验室指标、临床症状及不良反应情况.结果 骨髓干细胞移植后,患者肝脏功能明显改善,在全部40例患者中术中未发生严重并发症,术后近期无不良反应出现.结论 自体骨髓干细胞移植治疗肝硬化是目前治疗肝硬化的一种有效手段,自体骨髓干细胞移植治疗可使失代偿期肝硬化患者肝功能明显改善,治疗安全有效且副作用小,可作为中晚期肝硬化患者的临床治疗方案.     

脐血干细胞介入治疗肝硬化患者的护理

目的:总结脐血干细胞介入治疗肝硬化患者的护理方法,提高护理水平,促使患者早日康复,提高生活质量。方法:对6例肝硬化患者进行有效地移植前护理,移植后护理。结果:6例脐血干细胞介入治疗肝硬化患者手术顺利,肝功能明显改善,各种临床症状均缓解,病情好转出院,无并发症出现,成功率100%。结论:有效地护理措施能使肝硬化患者对干细胞移植这种治疗方法知情充分,保持良好的心态,积极配合治疗。做好移植前护理、移植后护理,是干细胞移植顺利进行的重要保证。     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.