艾滋病防治人员随访管理能力干预效果评价及影响因素分析

目的探讨河南省示范区艾滋病防治人员随访管理能力的干预效果及其影响因素。方法采用匿名问卷的调查方式,在随访干预前后对河南省5个艾滋病防治示范区从事艾滋病随访管理的工作人员进行基线和随访调查,并对相关影响因素进行Logistic回归分析。结果基线和随访调查分别纳入研究对象139人和128人,分别对艾滋病防治人员随访管理能力进行测评,河南省艾滋病防治人员基线与随访调查的随访管理能力平均得分分别为(27.12±3.30)分和(30.51±6.42)分,差异具有统计学意义(P<0.001)。随访干预后调查对象随访管理能力平均得分及其8项基本技能得分均高于基线调查得分,且差异具有统计学意义(P<0.05)。采用非条件Logistic逐步回归分析显示,影响艾滋病防治人员随访管理能力干预效果的主要因素是流行水平(OR=6.191)、培训次数(OR=25.631)、随访工作时间(OR=4.958)3个变量。结论随访干预能够进一步提高艾滋病防治人员的随访管理能力,在今后的工作中要加强对艾滋病防治人员的随访干预和系统培训。     

一般管理人员职业紧张状况及紧张反应的影响因素

目的 探讨一般管理人员职业紧张状况及紧张反应的影响因素.方法 采用职业紧张量表(OSI-R),对事业、企业单位/部门、科室的一般管理人员(研究组)569例,随机抽取工厂、机关、服务和商业等行业的职工(对照组)319例,共计888例进行研究.结果 ①一般管理人员的职业任务、紧张反应总均分及各子项(除工作环境子相外)得分均显著高于对照组[( 31.96±5.98)分,(26.18±5.44)分;(35.76±4.20)分,(24.23±5.70)分.(22.54±3.14)分,(17.25±5.15)分;(24.27±4.88)分,(22.45±6.39)分;(27.30±3.41)分,(22.37±4.42)分;(22.36±4.02)分,(20.18±5.96)分;P ＜0.01],仅自我保健子项得分显著高于对照组[(30.42±5.55)分,(28.39±6.74)分;P ＜0.01].②紧张反应与职业任务呈明显正相关(r =0.319 ,P ＜0.01).③个体紧张反应、业务紧张反应的主要影响因素(按从强到弱顺序排列):责任感、任务冲突、工作环境、任务模糊、工龄;心理紧张反应的主要影响因素:责任感、任务不适、工作环境、任务冲突、任务模糊;人际关系紧张反应的主要影响因素:任务冲突、年龄、娱乐休闲、工作环境.躯体紧张反应的主要影响因素:任务模糊、责任感、自我保健.结论 针对一般管理人员的主要紧张源,紧张反应及其影响因素,采取有针对性的干预措施,以降低一般管理人员的职业紧张程度,保护和促进工作能力是职业卫生领域面临的重要任务之一.     

北海市HIV/AIDS病例随访检测现状及影响因素分析

目的 了解广西壮族自治区北海市现存艾滋病病毒(Human immunodeficiency virus,HIV)感染者和艾滋病(acquired immunodeficiency syndrome, AIDS)病例(简称HIV/AIDS)随访检测现状及相关影响因素。方法 从传染病监测系统中艾滋病防治基本信息系统下载艾滋病疫情数据，采用描述性统计、t检验、χ²检验、多因素logistic回归模型等方法，对北海市HIV/AIDS进行随访检测影响因素分析。结果 截至2020年底，北海市现存HIV/AIDS 1 320例，北海市艾滋病随访检测比例从2016年的88.30%上升至2020年的94.09%。单因素分析显示年龄、报告年限、婚姻状况、传播途径、病程阶段、样本来源、户籍地、抗病毒治疗等对随访检测比例的差异有统计学意义。多因素分析显示接受抗病毒治疗(OR=175.512,95%CI:71.989～427.908)、高年龄(OR=1.025,95%CI:1.002～1.048)、病程阶段为AIDS(OR=2.450,95%CI:1.135～5.285)、外地户籍(OR=...     

血液透析患者生存质量调查及危险因素研究

目的 探讨血液透析患者生存质量状况及相关危险因素.方法 采用终末期肾脏疾病透析患者调查表(Kindeny disease quality of life short form,KDQOL-SFTM)评价血液透析患者的生存质量状况并采用多因素logistic回归模型分析相关危险因素.结果①血液透析患者肾脏病和透析相关生活质量、一般健康生活质量各维度得分均低于一般人群[生理机能( 39.69±19.56)分,(86.02±18.75)分;躯体疼痛(66.33±21.65)分,(81.55±20.83)分;精神健康(58.92±15.87)分,(73.23±16.54)分等].②影响透析患者生存质量的主要因素包括:性别[男:女(46.58±21.67)分:(50.37±22.56)分,P＜0.05]、年龄[≥55岁组:＜55岁组(38.78±16.78)分:(57.78±20.45)分,P＜0.05]、文化程度[高中以上:高中及以下(55.64±21.85)分:(42.59±21.65)分,P＜0.05]、糖尿病患病[非糖尿病:糖尿病(59.47±18.69)分:(47.67±11.33)分,P＜0.05]、医疗保障[自费:医保(43.54±16.85)分:(56.56±19.67)分,P＜0.05]、就业情况[就业:非就业(72.90±12.56)分:(60.87±11.45)分,P＜0.05].③糖尿病患病(OR =26.751)和医疗保障( OR=31.030)、年龄(OR =42.453)是影响血液透析患者生存质量的独立危险因素.结论糖尿病患病、社会保障、年龄是影响血液透析患者生存质量的主要危险因素.     

新疆地区高级职称护理人员工作倦怠现状及影响因素研究

目的 了解新疆地区不同单位级别高级职称护理人员工作倦怠和工作满意度的现况,探讨工作满意度对工作倦怠的影响,以期提高高级职称护理人员工作满意度,降低其工作倦怠水平.方法 采用整群抽样的方法对506名不同单位级别的高级职称护理人员运用工作倦怠量表、工作满意度问卷进行调查.结果 所有研究对象工作倦怠各维度得分中,情绪衰竭为(25.29±11.35)分、去人格化为(5.57±5.51)分、个人成就感为(30.99±9.78)分,其中情绪衰竭和个人成就感均处于高水平倦怠,去人格化处于低水平倦怠.工作满意度总分中,地州级高级职称护理人员为(30.79±5.41)分,明显高于自治区级[(29.66±6.55)分]和县级及以下[(28.23±6.50)分].单因素分析结果显示:年龄、民族、文化程度、个人平均月收入、是否具有行政职务之间在不同单位级别的高级职称护理人员之间比较,差异有统计学意义(P<0.05).多重线性回归结果表明,情绪衰竭维度的影响因素有单位级别、工作满意度、是否具有行政职务,去人格化维度的影响因素有文化程度和工作满意度,个人成就感维度的影响因素是工作满意度(P<0.05).结论 该地区高级职称护理人员工作倦怠处于高水平,工作满意度是其主要影响因素.     

重庆市1059名初中生艾滋病知识、态度、行为及相互关系研究

目的了解初中生艾滋病知识、态度、行为及相互关系,为制定防艾健康教育策略提供依据。方法整群随机抽取重庆市主城、区县初中生共1059例,进行单因素和多因素Logistic回归分析。结果学生对艾滋病传播途径平均知晓率(56.5%)高于基础知识(36.3%)和非传播途径(31.5%)知晓率;年级(OR=2.453)、学校学过否(OR=1.937)、报刊书籍(OR=2.041)及街头广告栏(OR=1.602)是艾滋病知识得分的影响因素;知识得分与态度得分呈正相关(0.283,P<0.01)。结论学校防艾教育是薄弱环节甚至缺失,而防艾知识与态度呈正相关,学校艾滋病健康教育迫在眉睫。     

宁夏农村基层护理管理人员核心能力现状分析

目的调查宁夏农村基层护理管理人员核心能力现状。方法采用注册护士核心能力量表,对来自75所宁夏农村基层卫生服务机构的79名护理管理人员进行问卷调查,并将宁夏农村基层护理管理人员的核心能力与国内常模比较。结果宁夏农村基层护理管理人员核心能力的总分为(149.77±32.20)分,评判性思维科研能力、临床护理、领导能力、人际关系、法律/伦理实践、专业发展及教育/咨询各维度的得分依次为(22.80±6.65)、(22.08±5.50)、(26.90±5.35)、(21.58±4.68)、(22.63±4.48)、(15.32±3.70)和(18.47±4.55)分。与长春6所三级甲等综合性医院护士的核心能力得分相比,总得分差异无统计学意义(P>0.05),但是评判性思维科研能力维度、临床护理维度和人际关系维度的得分低于长春6所三级甲等综合性医院护士的得分,而专业发展维度和教育咨询维度的得分高于长春6所三级甲等综合性医院护士的得分(P<0.05)。结论宁夏农村基层护理管理人员核心能力整体呈中等能力水平,且评判性思维科研能力、临床护理和人际关系三方面的能力相对较低。     

山东省综合医院感染病房护士专业自我概念及影响因素调查研究

目的 调查山东省综合医院感染病房护士专业自我概念的现状及其影响因素,为提高其专业自我概念水平提供理论依据。方法 利用便利整群抽样的方法, 使用一般资料问卷、护士专业自我概念量表对山东省二级以上20所综合医院422名感染病房护士进行调查,采用方差分析一般资料对综合医院感染病房护士专业自我概念的影响。结果 综合医院感染病房护士专业自我概念总分为(88.06±9.85)分,条目均分为(2.94±0.33)分,趋于积极。其中技能维度得分最高为(3.28±0.48)分,沟通能力维度得分最低为(2.72±0.38)分。一般资料中的年龄、护龄、职称、对感染病房工作满意度以及离开现在岗位的念头(F=4.063、5.743、3.762、4.276、3.285,P均＜0.05)对护士专业自我概念均有影响。结论 综合医院感染病房护士专业自我概念较积极,但尚有一定的提升空间。卫生行政部门和医院管理者应该注意优化护理工作环境,落实福利待遇,完善职业生涯规划管理,提升护士专业自我概念水平。     

男性流动人口生殖健康知识得分及影响因素分析

目的 了解成都建筑工地男性流动人口有关生殖健康方面的知识得分情况并探讨其影响因素.方法 本次调查为流行病学横断面调查,对1 924名成都建筑工地男性流动人口进行调查.本次调查生殖健康知识问题共14个,其中6个问题是关于怀孕避孕和人工流产方面的问题,8个问题是关于艾滋病和生殖道感染方面的问题.将每个知识问题进行得分量化,回答正确得1分,回答错误或不知道得0分,满分为14分.结果 生殖健康知识得分:P_(75)为9分,中位数为6分,P_(25)为3分.不及格人数为1 396人,占72.6%.单因素分析显示差异有统计学意义的因素有:年龄分组(以29岁为界,χ2=11.297,P=0.001)、教育程度(以高中为界,χ~2=10.575,P=0.002)、到本厂的工作时间(以10个月为界,χ~2=9.598,P=0.003)、到本市打工的年龄(以24岁为界,χ~2=9.209,P=0.003)、是否有女朋友(χ~2=13.699,P=0.001)、是否与性伴住在一起(χ~2=18.056,P=0.000)和近6个月以来是否获得生殖健康知识(χ~2=34.945,P=0.000).多因素Logistic分析结果显示:到本厂工作时间(OR=2.113)是生殖健康知识得分的危险性因素;年龄分组(OR=0.724)、到本市打工的年龄(OR=0.699)、是否与性伴住在一起(OR=0.616)、近6个月内是否接受生殖健康知识(OR=0.556)是知识得分的保护性因素.结论 成都建筑工地上的男性流动人口的生殖健康知识得分偏低,对于生殖健康知识不了解.因此,对于建筑工地男性流动人口需加强生殖健康知识的宣传和普及.     

5岁以下儿童家长手足口病知信行现状调查及影响因素分析

目的了解河北省5岁以下儿童家长手足口病相关知识、态度和行为(knowledge,attitude and practice,KAP)现状,探讨其可能的影响因素,为手足口病防治提供科学依据。方法采用分层整群抽样方法抽取石家庄和邯郸6个自然村6~59月龄儿童的家长或看护人9 984名,采用自行设计的问卷进行面对面调查。结果 9 984名家长手足口病KAP平均得分(33.76±7.29)分,及格率为70.60%,其中知识平均得分(10.68±3.47)分,相关知识知晓率66.77%;态度部分平均得分(11.52±3.96)分,家长获得知识途径大部分(67.19%)是通过医生讲解,75.13%认为医生讲解最可靠;行为部分平均得分(11.56±2.26)分,行为形成率82.56%,大部分(92.53%)有饭前便后洗手的良好习惯,但有将近一半(45.96%)洗手时间短于半分钟;知识、态度和行为均及格仅占到总人数的30.97%。多因素非条件logistic回归分析表明,男性(OR=1.107,95%CI:1.007~1.216)、30岁组(OR=1.920,95%CI:1.595~2.310)和30~50岁组(OR=1.638,95%CI:1.354~1.982)、职业为农民(OR=4.322,95%CI:3.236~5.772)和临时工作者(OR=2.122,95%CI:1.561~2.886)、0~月龄(OR=1.168,95%CI:1.000~1.364)和24~月龄(OR=1.294,95%CI:1.112~1.506)、孩子上幼儿园(OR=1.267,95%CI:1.125~1.428)为幼儿家长手足口病KAP得分高的促进因素。结论河北省5岁以下儿童家长手足口病相关认知水平低,获取知识途径单一,因此需加强该类人群健康教育,对不同特征人群采取有针对性的干预措施。     

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.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

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.     

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.