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        find Author "李智" 17 results
        • 胸腔積液及高脂血癥對重癥急性胰腺炎發生的預測作用

          目的探討胸腔積液、高脂血癥與重癥急性胰腺炎(SAP)早期診斷的關系。 方法2010年1月-2014年3月對入院24 h內的120例急性胰腺炎患者按2013年《中國急性胰腺炎診治指南》的診斷標準分為SAP組(68例)和輕癥急性胰腺炎(MAP)組(52例)。兩組均行胸腹部CT及血脂分析檢查,記錄胸腔積液、高脂血癥以及胸腔積液并高脂血癥與SAP發病例數、病死率、腹水、肝功能不全、胰腺假性囊腫的關系。 結果SAP組與MAP組胸腔積液分別為57例(83.8%)和12例(23.1%),高脂血癥分別為52例(76.5%)和17例(32.7%),胸腔積液并高脂血癥分別為47例(69.1%)和7例(13.5%),差異有統計學意義(P<0.001)。SAP組患者中,是否并發胸腔積液者病死率、胰腺假性囊腫發生率差異無統計學意義(P>0.05),并發胸腔積液者腹水、肝功能不全發生率發生率高于無胸腔積液者(P<0.05);是否合并高脂血癥者病死率、胰腺假性囊腫發生率差異無統計學意義(P>0.05),合并高脂血癥者腹水和肝功能不全發生率均高于未合并高脂血癥者(P<0.05);是否同時合并胸腔積液和高脂血癥者胰腺假性囊腫發生率差異無統計學意義(P>0.05),同時合并胸腔積液和高脂血癥者病死率、腹水發生率、肝功能不全發生率均高于未同時合并胸腔積液和高脂血癥者(P<0.05)。 結論胸腔積液、高脂血癥與SAP發生有密切關系,同時還與部分并發癥有關,檢測這兩項指標,對SAP早期診斷及并發癥的早期干預有意義。

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        • Effects of human urine-derived stem cells combined with chondroitinase ABC on the expressions of nerve growth factor and brain-derived neurotrophic factor in the spinal cord injury

          Objective To explore the effects of human urine-derived stem cells (hUSCs) and hUSCs combined with chondroitinase ABC (chABC) on the expressions of nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) in the spinal cord injury (SCI) of rats, and to investigate the underlying mechanism. Methods hUSCs were cultured from human urine, and their phenotypes were detected by flow cytometry. The SCI model of rats were made via Allen method. Sixty Sprague Dawley rats were divided into 5 groups (n=12): the sham operation group (group A), SCI group (group B), SCI+hUSCs group (group C), SCI+chABC group (group D), and SCI+hUSCs+chABC group (group E). Basso, Beattie, Bresnahan (BBB) score was used to measure the lower extremity motor function of rats in each group at 10, 20, and 30 days after operation. Real-time fluorescent quantitative PCR was used to detect the relative mRNA expressions of NGF and BDNF at 30 days. Meanwhile, the protein expression of NGF and BDNF were confirmed by immunohistochemistry staining. The relative protein expressions of Bax and Bcl-2 were detected by Western blot. Results The hUSCs were identified to have multipotential differentiation potential. At 10, 20, and 30 days, BBB score was significantly lower in group B than in groups A, C, D, and E, in groups C, D, and E than in group A, in groups C and D than in group E (P<0.05). Real-time fluorescent quantitative PCR and immunohistochemistry staining demonstrated that the expressions of NGF and BDNF were significantly lower in group B than in groups A, C, D, and E, in groups C, D, and E than in group A, in groups C and D than in group E (P<0.05); but there was no significant difference between groups C and D (P>0.05). Western blot results indicated that the protein expression of Bax was significantly higher in group B than in groups A, C, D, and E, in groups C, D, and E than in group A, in groups C and D than in group E (P<0.05). Meanwhile, the protein expression of Bcl-2 was significantly lower in group B than in groups A, C, D, and E, in groups C, D, and E than in group A, in groups C and D than in group E (P<0.05). Conclusion hUSCs can protect SCI and this positive effect can be enhanced by chABC; this neuro-protective effect may depend on promoting the expressions of NGF and BDNF, and suppressing the neuronal apoptosis.

          Release date:2017-11-09 10:16 Export PDF Favorites Scan
        • 序貫療法根除初治失敗幽門螺桿菌療效觀察

          【摘要】 目的 分析總結雷貝拉唑、阿莫西林、克拉霉素、替硝唑組成的10日序貫療法根除初治失敗幽門螺桿菌(Helicobacter pylori,Hp)的療效。 方法 將2009年5月-2011年5月在消化科門診及住院經胃鏡確診的胃、十二指腸潰瘍患者65例,經標準三聯療法治療4周后Hp仍陽性的患者隨機分為兩組,治療組33例前5 d用雷貝拉唑10 mg、阿莫西林1.0,每日2次口服,后5 d用雷貝拉唑10 mg、克拉霉素500 mg、替硝唑500 mg,每日2次口服;對照組32例用雷貝拉唑10 mg、枸櫞酸鉍鉀600 mg、呋喃唑酮0.1 g、阿莫西林1.0 g,每日2次,療程10 d。停藥4周后復查Hp。 結果 治療組Hp根除率81.8%,對照組75.0%,兩組比較無統計學意義(Pgt;0.05)。不良反應率分別為12.1%和34.3%,兩組比較有統計學意義(Plt;0.05)。 結論 序貫療法對初治失敗Hp根除率高于四聯療法但無統計學意義,不良反應率低于對照組,可作為根除初治失敗Hp的一種有效方案。

          Release date:2016-09-08 09:27 Export PDF Favorites Scan
        • Arrhythmia heartbeats classification based on neighborhood preserving embedding algorithm

          Arrhythmia is a kind of common cardiac electrical activity abnormalities. Heartbeats classification based on electrocardiogram (ECG) is of great significance for clinical diagnosis of arrhythmia. This paper proposes a feature extraction method based on manifold learning, neighborhood preserving embedding (NPE) algorithm, to achieve the automatic classification of arrhythmia heartbeats. With classification system, we obtained low dimensional manifold structure features of high dimensional ECG signals by NPE algorithm, then we inputted the feature vectors into support vector machine (SVM) classifier for heartbeats diagnosis. Based on MIT-BIH arrhythmia database, we clustered 14 classes of arrhythmia heartbeats in the experiment, which yielded a high overall classification accuracy of 98.51%. Experimental result showed that the proposed method was an effective classification method for arrhythmia heartbeats.

          Release date:2017-04-01 08:56 Export PDF Favorites Scan
        • 應用醫護一體化提高眼科手術部位標識率

          目的了解實施醫護一體化模式對提高眼科手術部位標識率的效果。 方法2013年6月-9月共調查了2 176例眼科手術患者的手術部位標識情況,其中2013年6月-7月為實施醫護一體化前,共1 012例;2013年8月-9月為實施醫護一體化后,共1 164例。對實施醫護一體化前后眼科手術部位標識率的情況進行調查分析。 結果實施醫護一體化后,眼科手術部位的標識率、規范性都有了明顯的提高,標識率由改進前的52.86%提高到94.97%,標識的顏色、位置、形態有了明顯的規范。 結論手術部位標識的應用大大促進了醫生和護士對手術患者安全管理的關注,實施醫護一體化后眼科手術部位的標識率、規范性明顯提高,值得推廣和應用。

          Release date:2016-10-02 04:54 Export PDF Favorites Scan
        • 以團隊為基礎的學習教學模式在外科護理教學中的應用前景探討

          目的 探討以團隊為基礎的學習(TBL)教學模式在本科外科護理教學中的應用前景。 方法 通過分析TBL教學模式特點及收集近年來國內外本科外科護理教學中TBL的應用文獻,對我院本科外科護理教學開展TBL的必要性、可行性及前景進行分析和展望。 結果 本科外科護理教學中TBL有助于學生自主學習的積極性和參與性,提高分析問題和解決問題能力。 結論 TBL作為一種全新的教學方法,其模式的廣泛應用與不斷完善,將為外科護理高素質專業人才的培養發揮積極性的作用。

          Release date:2021-06-23 07:35 Export PDF Favorites Scan
        • 不予體位限制和沙袋壓迫對全麻下行介入術后先心患兒的影響

          目的:旨在探討不予體位限制和穿刺處沙袋壓迫對全麻下行介入術后的先心患兒的影響。方法:將2007 年1 月至 2008 年12 月的50 例全麻下行介入術清醒后送入CCU(冠心病監護病房)先心患兒隨機分成2組(即實驗組和對照組),兩組均用彈力繃帶加壓包扎穿刺處的前提下,對照組按常規給患兒取平臥位,頭偏向一側,穿刺側肢體制動,并沙袋壓迫穿刺處8~12h,平臥12h或以上;實驗組患兒穿刺側肢體不予制動,穿刺處也不沙袋壓迫,患兒可取任意體位(包括由父母抱在懷中休息),觀察兩組患兒舒適度、穿刺處出血并發癥、患兒父母、醫護人員等的影響。結果:實驗組患兒的舒適度、對患兒父母、醫護人員的影響明顯優于對照組,而穿刺處出血并發癥方面兩組無顯著差異。 結論:不予體位限制和穿刺處沙袋壓迫對全麻下行介入術后先心患兒的影響是增加患兒的舒適度,減少患兒父母的焦慮,減輕醫護人員的工作負荷,而穿刺處出血并發癥不增加。

          Release date:2016-09-08 10:00 Export PDF Favorites Scan
        • 可大龍不同給藥濃度對輸注血管的影響

          目的:本研究旨在了解可達龍不同給藥濃度對輸注血管的影響。方法:將2006~2008年對房顫行三維射頻消融術后使用可達龍48例患者隨機分為兩組,即實驗組和對照組,實驗組的可達龍藥物濃度為1.2 mg/ mL,以0.5 mg/min勻速輸注;對照組為12 mg/ mL,以0.5 mg/min勻速輸注,觀察不同給藥濃度對輸注血管的影響。結果:對照組組靜脈炎的發生率顯著高于實驗組. 結論:可大龍不同給藥濃度對輸注血管的影響顯著。

          Release date:2016-09-08 09:56 Export PDF Favorites Scan
        • 權變理論在大型災害時手術資源調度中的應用研究

          目的總結大型災害發生后如何有效調度手術資源的方法。 方法對2013年4月20日-22日蘆山地震發生后,就應急手術中的護理人員、醫療物質的調度方式及效果進行回顧分析。 結果在災害發生后的72 h內順利完成各類手術69臺,骨科手術共計30臺,其中脊柱骨折15臺、肢體骨折12臺、骨科復合術3臺;神經外科血腫清除術17臺;兒外科手術12臺;普外科剖腹探查術8臺;胸外行剖胸探查術2臺。平均開放時間180 min。術后3 d隨訪,傷員生命體征平穩,均未發生院內感染,于不同時間段痊愈出院。 結論權變理論的應用,可以靈活機動的調動各種資源,保證組織目標的實現,確保地震手術患者的救治需求。

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        • Clinical Application Value of Steel Wire Located Biopsy of Nonpalpable Breast Lesion by X-Ray

          目的探討鉬靶X線導絲定位切除觸診陰性乳腺病灶手術的臨床應用價值。 方法對291例299個觸診陰性乳腺病灶在鉬靶X線指引下經導絲定位并切除活檢,確定病理類型。 結果299個觸診陰性乳腺病灶中乳腺癌病灶42個(14.05%),癌前病變40個(13.38%),良性病變257個(85.95%),其中乳腺癌灶多表現為簇狀或彌漫細點狀鈣化,乳腺癌病灶中原位癌22個(52.38%,22/42),浸潤癌Ⅰ期13個(30.95%,13/42),Ⅱ期4個(9.52%,4/42),Ⅲ期3個(7.15%,3/42)。40例乳腺癌患者(2例為雙側癌)均長期隨訪,最長隨訪時間為10年,復發轉移2例。應用鉬靶X線診斷乳腺癌的靈敏度為92.86%(39/42);特異度為95.33%(245/257),診斷比值比(DOR)為265.42。 結論鉬靶X線導絲定位病灶切除技術可提高觸診陰性乳腺病灶的早期診斷率,指導手術切除病灶,其組織損傷小,可靠性高,促進了乳腺癌二級預防,適合二級醫院廣泛應用。

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