肝豆状核变性患者生存质量与社会支持状况及其相关分析

目的探讨肝豆状核变性（hepatolenticulardegeneration,HLD）患者生存质量与社会支持状况及其相关性。方法采用社会支持量表（socialsupport ringscale,SSRS）和生存质量测定量表（WHOqualityoflifescale,WHOQOL一100）对30例HLD患者和30例健康人（对照组）进行问卷调查。了解HLD患者生存质量与社会支持状况及其相关性。结果HLD组患者生存质量总分（273．60±15．24）分明显低于对照组健康人群（345．53±2．70）分,各维度得分均明显低于对照组,两组比较,差异具有统计学意义（均P〈0．01）;社会支持总分（35．73±1．72）明显低于对照组健康人群（45．50±1．68）分,各维度得分均明显低于对照组,两组比较,差异具有统计学意义（均P〈0．01）;HLD患者生存质量总分及各维度与社会支持总分及各维度呈正相关（均P〈0．01或P〈0．05）。结论HLD患者生存质量及社会支持明显低于健康人群,其生存质量与社会支持呈正相关,即得到的社会支持越多生存质量越好。     

冠状动脉搭桥术后患者社会支持、应对方式与生存质量的相关性研究

目的探讨冠状动脉搭桥术（coronary artery bypass graft,GABG）后患者社会支持、应对方式与生存质量的相关性。方法应用社会支持评定量表、简易医学应对问卷、SF-36生存质量量表对42例冠状动脉搭桥术后患者进行调查。结果冠状动脉搭桥术后患者社会支持总分高于国内常模（P〈0．01）。应对方式中采用面对应对方式的得分高于常模（P〈0．05）;回避应对方式的得分与常模相似（P〉0．05）;屈服应对方式得分低于常模（P〈0．05）。面对应对方式与SF-36总分及躯体功能、机体疼痛、总体健康、活力、情感角色和心理健康均呈正相关（均P〈0．05）。回避应对方式与总健康及情感角色呈负相关（P〈0．05）;屈服应对方式与社会功能及心理健康呈负相关（P〈0．01）。社会支持总分与躯体功能、总体健康感觉、活力、情感功能及心理健康维度均呈正相关（均P〈0．05）;主观支持与SF-36总分及其活力、心理健康维度呈正相关（均P〈0．05）;社会支持利用度与活力、社会功能、情感角色、心理健康及SF-36总分均呈正相关（均P〈0．05）。结论CABG患者所获得的社会支持、采取的应对方式在一定程度上影响术后患者的生活质量。护理人员应认识良好的社会支持与积极的应对方式对CABG术后患者康复的重要性。并及时、及早评估CABG患者的社会支持系统及其所采取的应对方式对生活质量的影响．制订综合性护理干预方案,以提高患者的生活质量。     

肝移植患者生存质量与社会支持的相关性研究

目的研究肝移植患者生存质量与社会支持的相关性,探讨提高这一特殊人群生存质量的有效途径。方法采用描述、相关性研究方法,对76例肝移植患者进行生存质量和社会支持的问卷调查,并分析两者相关性。结果肝移植患者生存质量中的生理领域得分（15．10±2．30）,总生存质量得分（13．38±2．91）,均与社会支持总分呈正相关;心理领域与客观支持呈正相关;心理领域、社会关系及总生存质量与主观支持呈正相关;心理领域、独立性领域与对支持的利用度呈正相关（P〈0．05或〈0．01）。结论肝移植患者生存质量与社会支持密切相关,护士应重视社会支持系统对提高肝移植患者生存质量的作用,并有效利用。     

慢性心力衰竭患者生活质量与社会支持的相关性研究

目的探讨慢性心力衰竭患者生活质量和社会支持的相关性。方法采用心功能不全生活质量量表和社会支持评定量表对111例慢性心力衰竭患者进行调查。结果慢性心力衰竭患者的生存质量得分（62．13±16．27）分,社会支持总分（24．17±7．64）分,两者呈显著正相关（P〈0．01）。结论慢性心力衰竭患者的生存质量受社会支持程度的影响,通过实施综合的护理于预措施予以支持,以提高患者的生存质量：     

肝癌患者生命质量及其影响因素的研究

目的了解肝癌患者的生命质量及其影响因素。方法采用基本情况调查表和肝癌患者生命质量测定量表对51例肝癌患者进行调查。结果肝癌患者的生命质量普遍较低，各维度水平从低到高依次为心理功能、社会功能、躯体功能和症状副作用。经济条件差、自费医疗、有黄疸或腹水的患者的生命质量较差（P〈0．01），尤其在心理功能和社会功能方面；年轻患者心理功能得分也较低（P〈0．05）。结论护理人员应重视肝癌患者社会与心理方面的评估，并采取积极措施，提高患者的生命质量。     

社会支持对强直性脊柱炎患者生存质量的影响

目的：探讨社会支持对强直性脊柱炎（AS ）患者生存质量的影响。方法选择2012年7月～2013年7月我科确诊AS患者80例作为病例组,选择同期正常健康者80例作为对照组。采用生存质量量表、社会支持量表进行调查并比较。结果病例组生理、心理、社会领域及对社会支持的利用度领域得分低于对照组（P＜0．001）;其生存质量的生理、心理、社会领域及对社会支持的利用度得分与社会支持各因素均呈正相关（P＜0．05,P＜0．01）。结论 AS患者的生存质量较差,对社会支持的利用度低,应帮助患者建立良好的社会支持系统,提高其生存质量。     

肝癌患者社会支持状况调查

目的 调查肝癌患者社会支持得分情况,以提出相应的护理对策,提高其生存质量.方法 采用问卷调查法,对101例在我科住院的肝癌患者进行调查,并对回收问卷进行统计学处理.结果 肝癌患者获得的社会支持得分比正常人高(P＜0.01),不同性别患者的社会支持得分差异无显著性意义(P＞0.05),单身患者获得的社会支持得分较低(P＜0.01).结论 更多的社会支持可以提高肝癌患者的生存质量.     

肠造口患者生活质量与社会支持的关系及护理对策

目的：探讨肠造口患者生活质量与社会支持的关系。寻求康复护理对策。方法：调查86例肠造口患者的社会支持情况，并与正常组进行比较，分析肠造口患者的社会支持与生活质量的相关性。结果；肠造口患者的社会支持明显高于正常组（P〈0．01），社会支持与其生活质量呈正相关（r=0．626、P〈0．001）。结论：肠造口患者获得更多的社会支持，有利于减轻患者应激反应，康复护理过程中重视社会支持可以改善护理效果，提高肠造口患者的生存质量。     

抑郁症患者的述情障碍程度与社会支持状况的相关分析

目的了解抑郁症患者的述情障碍程度与社会支持的关系。方法应用多伦多述情障碍量表（TAS）和社会支持评定量表（SSRS）对86名抑郁症患者进行调查研究。结果抑郁症患者（75．22±13．93）分在多伦多述情量表上的得分明显高于正常组得分（60．19±9．27）分（P〈0．01）,抑郁症患者在因子1描述情感能力和因子2区别情感和躯体感受能力方面的得分最高,明显高于中间值,除了主观支持与述情障碍量表的各个因子都无相关（P〉0．05）之外,描述情感的能力与社会支持总分和其他因子的得分均呈显著的负相关（P〈0．01）,幻想与社会支持总分和其他因子的得分均呈显著的正相关（P〈0．01）。结论抑郁症患者的述情障碍程度与其社会支持状况有关,可以通过解决抑郁症患者的述情问题,来提高其社会支持情况。     

社会支持与食管癌患者生活质量的相关性研究

目的：探讨社会支持与食管癌患者生活质量的相关性及提高患者生活质量的护理对策。方法：调查80例食管癌患者生活质量与社会支持情况，并与正常人群进行比较；分析食管癌患者的社会支持与其生活质量的相关性。结果：食管癌患者的社会支持高于正常人群，两者比较有显著性差异（P〈0．05，P〈0．01）；食管癌患者的社会支持与其生活质量呈正相关（P〈0．05，P〈0．01）。结论：食管癌患者的社会支持较高，社会支持与食管癌患者的生活质量密切相关；护理过程中，不仅要重视患者的生物属性，还要重视其心理属性和社会属性；重视社会支持可以改善护理效果，提高食管癌患者的生活质量。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Modified micro-superior percutaneously-assisted total hip: early experiences & case reports

Because of the extensile nature and familiarity of the standard posterior-lateral approach to the hip, a family of "micro-posterior" approaches has been developed. This family includes the Percutaneously-Assisted Total Hip (PATH) approach, the Supercapsular (SuperCap) approach and a newer hybrid approach, the Supercapsular Percutaneously-Assisted Total Hip (SuperPATH) approach. Such approaches should ideally provide a continuum for the surgeon: from a "micro" (external rotator sparing) posterior approach, to a "mini" (external rotator sacrificing) posterior approach, to a standard posterior approach. This could keep a surgeon within his comfort zone during the learning curve of the procedure, while leaving options for complicated reconstructions for the more practiced micro-posterior surgeons. This paper details one author's experiences utilizing this combined approach, as well as permutations of this entire micro-posterior family of approaches as applied to more complex hip reconstructions.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.