Objective To compare the clinical effects of intravascular ultrasound (IVUS) and blood flow reserve fraction (FFR) in guiding the treatment of critical disease of coronary artery.Methods Forty nine patients with coronary artery disease who underwent coronary angiography were divided into IVUS group (n=43) and FFR group (n=51).In IVUS group,such as MLA ＜4 mm2 or coronary artery stenosis was insufficient,but IVUS showed unstable plaque,and we went the PCI treatment;in the FFR group,FFR＜0.75 was regarded as coronary stenting sign.The patients were followed up for 6 months.The incidence of cardiovascular adverse events was compared between the two groups.Results (1)There was no significant difference in general information and coronary angiography between the two groups (P＞ 0.05).(2)The proportion of interventional therapy in IVUS group was higher than that in FFR group (P＜0.01).(3)The incidence of adverse events between the two groups was not statistically significant (P＞0.05).Conclusion IVUS and FFR examination can be used to guide the interventional treatment of critical disease of coronary artery.However,the accuracy of IVUS can not replace the status of blood flow reserve.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">通过器官捐献伦理问卷调查表,调查社会人群对器官捐献和对器官捐献有关伦理问题的了解程度。发现得分最高的,是高学历者、医务人员和大学生。分析认为,高学历者、医务人员和大学生较一般人群而言,有较高的文化水平和器官捐献相关知识,理解器官捐献的价值,所以捐献意向高。需要建立通俗易懂的器官捐献理论体系进行宣传,提高社会人群对器官捐献的认识,推动器官捐献工作。认为脑死亡重要但要谨防被质疑。应建立新的生命观,新的孝道观等器官捐献的理论体系观念。</span>

Objective:To evaluate the benefit of Bivalirudin on acute myocardial infarction for percutaneous coronary intervention.Method:A total of 122 AMI patients receiving PCI were divided into two groups,Heparin group(n=55) and Bivalirudin group(n=67).We compared the procedural success rate,creatinine,ST segment percentage fall back,platelet and NT-porBNP.The safety evaluation were the incidence of bleeding and major adverse cardiac events(MACE) within 30 days of PCI.Result:ST segment percentage fall back was similar at 1-hour after the PCI procedure between two groups(P>0.05).Bivalirudin group had higher NT-porBNP levels than Heparin group before the procedure(P=0.097>0.05),however,those in two groups were similar,Bivalirudin group had lower NT-porBNP levels than Heparin group at 24-hour after the procedure(P>0.05).The mild bleeding rate during two groups were meaningful(P=0.002<0.05).The levels of platelet and creatinine at 24-hour after the PCI,the procedural success rate and the survival rate within 30 days were similar(P>0.05).Conclusion:Bivalirudin is safe and effective during emergent PCI,bleeding rate is less than Heparin.

目的：探讨维持性血液透析患者营养不良的原因及护理干预对其的影响。方法：64例维持性血液透析患者，随机分为对照组（常规护理）和观察组（护理干预），对两组护理前后血清白蛋白、血清总蛋白，以及营养不良发生率进行比较。结果：护理前，对照组和观察组血清白蛋白、血清总蛋白水平比较，差异无统计学意义（P＞0.05）；护理后，两组血清白蛋白、血清总蛋白水平明显升高（P＜0.05），与对照组相比，观察组血清白蛋白、血清总蛋白水平明显升高，营养不良发生率显著降低（P＜0.05）。结论：个性化的护理干预能够明显改善维持性血液透析患者的营养状况，降低营养不良发生率。

目的:通过分组试验及回顾性分析来探讨低钙透析液对透析相关性高血压患者的疗效。方法:对高血压透析的患者共31例进行低钙透析液透析,采用自身对照的方法进行指标采集,将透析液的钙离子浓度由1.5mmol/L更换为1.25mmol/L,对血压、血钙和iPTH值进行比较。结果:研究患者于首次更换1.25mmol/L钙离子浓度透析液后的收缩压显著下降;于治疗4周以后,收缩压有明显降低;收缩压数据经比较具有显著差异(P<0.05);首次更换1.25mmol/L钙离子浓度透析液治疗后,血钙出现明显下降(P<0.05);在治疗4周以后,血钙与治疗前比较明显下降,数据与治疗前比较具有显著差距(P<0.05)。结论:降低钙透析液浓度进行透析的方法有助于透析相关性高血压的控制,但容易引起血钙降低,因此在降低钙透析液浓度的同时,严密监测患者血钙变化情况。

目的:分析护理干预对首次血液透析直接穿刺患者舒适度的影响。方法:对照组41例采用常规护理方法;研究组45例,在常规护理的基础上,增加对患者认知、情绪和行为三方面的护理干预。对两组患者的舒适度情况、透析过程中并发症的出现情况进行对比分析。结果:研究组患者舒适度情况明显优于对照组,且在透析过程中并发症的发生率明显低于对照组,两组数据经统计学分析,有显著性差异(P<0.05)。结论:对首次血液透析直接穿刺患者采取护理干预的方法,能有效提高患者的舒适度,并减少透析过程中并发症的发生。

目的:总结整休护理在血透中应用和实施效果,通过学习血透知识和总结好的经验,进一步提高血透的护理水平.方法:回顾性总结分析我院 2008.4-2010.6用整体护理的68例的血透患者的护理资料.通过在实践中探索和实施,总结护理临床经验.结果:通过整体护理,我们系统了护理方法、优化了护理质量、提高了护理水平、减少或减轻了血透的并发症.也促使了患者早期康复.结论:整体护理在血透治疗中的应用效果显著,整体的护理质量明显提高,有临床推广的价值.