高风险科室护士在新型冠状病毒肺炎流行期间的心理状况

目的调查新型冠状病毒肺炎（COVID-19）流行期间，高风险科室护士的心理状况及影响因素，以采取积极有效的干预，确保投疫工作顺利进行。方法选取2020年2月金华市中心医院急诊抢救室、ICU80位高风险科室护士为研究对象，采用手机线上问卷调查的方式进行心理状况调查。分别采用中文版心理弹性量表、事件影响量表、应对方式量表对心理弹性、事件影响、应对方式进行评估，并采用单因素、Pearson相关分别分析影响因素、相关性。结果本研究收回问卷80份，有效回收率100%。高风险科室护士心理弹性、事件影响、成熟型应对和不成熟应对得分分别为（66.60±13.52）、（31.83±9.48）、（415.81±3.82）、（19.16±5.69）分。心理弹性、事件影响、应对方式得分与护士年龄、婚姻状况、职称、工龄、科龄有关（均P＜0.05），与学历无关（P＞0.05）。高风险科室护士心理弹性与成熟型应对呈正相关（P＜0.05），与事件影响、不成熟型应对呈负相关（均P＜0.05）。结论对于高风险科室的护士，在COVID-19流行期间应加强心理弹性训练，特别是要对＜25岁、初级职称、科龄和工龄＜5年、已婚护士分层级培训专业知识及技能，开展心理关怀。     

胸外科护士生活方式及其与工作压力、生活质量的相关性研究

目的探讨胸外科护士生活方式及其与工作压力、生活质量的相关性。方法选取2009年1月～2010年12月在解放军总医院胸外科护士61名,按年龄、夜班情况、职称分类,分别行一般情况调查表、生活方式调查表、工作压力源量表、生活质量评定量表调查,数据资料运用SPSS 16.0软件进行统计学分析,生活方式与工作压力、生活质量的相关性使用Pearson相关性分析。结果依≤30岁、〉30～40岁、〉40岁顺序,生活方式评分、生活质量评分显著升高,工作压力评分显著下降;依无夜班、有夜班顺序,生活方式评分、生活质量评分显著降低,工作压力评分显著升高;依副主任护师、主管护师、护师、护士顺序,生活方式评分、生活质量评分显著降低,工作压力评分显著升高;各组间比较差异均有统计学意义（P〈0.05）。生活方式各指标与工作压力各指标存在负相关性（P〈0.05）;生活方式各指标与生活质量各指标存在正相关性（P〈0.05）。结论胸外科护士的生活方式越好,生活质量越高,工作压力就越低,生活方式与工作压力负相关,生活方式与生活质量正相关。     

心理契约对护士创新行为的影响

目的探讨心理契约对护士创新行为的影响。方法对浙江省某医院266名护士进行问卷调查,了解其创新行为及心理契约状况,并探讨两者间的关系。结果①护士创新行为评分平均为（4．58＋0．73）分,处于中等水平。不同年龄、工作年限及职称护士的创新行为评分比较,差异有统计学意义（P〈0．05）;②Pearson相关分析结果显示,护士创新行为得分与心理契约履行程度各维度得分均显著负相关（r：一0．542一0．441,P〈O．05）;②多元回归分析显示,医院发展责任、医院现实责任、个人发展责任、和个人现实责任均为护士创新行为的影响因素。结论心理契约是影响护士创新行为的重要因素。     

早期帕金森病患者嗅觉与认知功能、冷漠和疲劳症状的相关性分析

目的研究早期帕金森病患者嗅觉与认知功能、冷漠和疲劳症状的相关性。方法选择2015年1月至2017年12月就诊的65例早期帕金森病患者为观察组,另按照1:2比例选择同期性别、年龄相匹配的健康体检者130例为对照组。用Sniffin''Sticks检测法、蒙特利尔认知量表（MOCA）、冷漠评估量表和帕金森疲劳量表对两组人群的嗅觉功能、认知功能、冷漠程度和疲劳程度进行评估,并研究观察组患者嗅觉与认知功能、冷漠和疲劳症状的相关性。结果观察组患者的嗅觉功能与认知功能评分[（17.52±0.75）、（20.61±0.49）分]均显著低于对照组[（30.63±0.87）、（25.34±0.45）分],差异均有统计学意义（均P＜0.05）;冷漠程度和疲劳程度评分[（47.43±2.56）、（44.15±16.17）分]均明显高于对照组[（18.76±1.32）、（23.86±7.76）分],差异均有统计学意义（均P＜0.05）。Pearson相关性分析显示,嗅觉功能评分与认知功能评分呈正相关（r=0.325,P＜0.05）,与冷漠评分呈负相关（r=-0.538,P＜0.05）,嗅觉功能评分和疲劳程度无相关性（P＞0.05）。结论早期帕金森病患者存在嗅觉、认知障碍和冷漠、疲劳症状,并且其嗅觉功能与认知功能和冷漠症状存在相关性。     

时间管理倾向对医学生学业拖延的影响:自我同情的中介作用

目的探讨时间管理倾向影响医学生学业拖延的内在机制,为今后的学业拖延干预方案提供理论基础。方法采用分层随机抽样法选取2019年3-6月某市高校499名医学生,采用自编一般资料问卷、时间管理倾向量表、自我同情量表、Aitken拖延量表对其进行调查。结果医学生学业拖延得分为（46.19±8.74）分,处于中等水平。是否为独生子女、不同年级和进入大学以后成绩的学业拖延得分差异均有统计学意义（P < 0.01）;时间管理倾向与学业拖延呈负相关（r=-0.522,P < 0.01）,与自我同情呈正相关（r=0.334,P < 0.01）;自我同情与学业拖延呈显著负相关（r=-0.317,P < 0.01）;时间管理倾向、自我同情与学业拖延的关系显示,时间管理倾向可直接影响医学生学业拖延,也可通过自我同情的部分中介作用影响医学生学业拖延（效应值为10.46%）。结论可以从提高其时间管理能力以及自我同情水平入手改善医学生学业拖延现状。     

不同人格类型对大学生拖延行为的影响

目的 研究大学生不同人格类型对其拖延行为的影响.方法 采用一般拖延问卷（GPS）和大五人格量表简版（NEO-FFI）对126名大学生进行问卷调查.结果 大学生拖延总分为（53.26±9.92）分,84.9％的大学生有不同程度的拖延表现.不同性别、年级的大学生在拖延行为上的差异无统计学意义.在大五人格五因素中,严谨性与拖延行为存在显著负相关（r=-0.563,P＜0.01）,随和性与拖延行为存在显著负相关（r=-0.236,P＜0.01）,开放性与拖延行为存在显著负相关;其中严谨性能有效预测大学生的拖延行为.结论 拖延行为在大学生中普遍存在,低严谨性、低随和性和低开放性的个体更易表现出拖延行为.     

广州市萝岗区基层医院临床护士工作满意度和压力源调查

目的：探讨基层医院护士工作满意度和工作压力现状的影响因素及二者的相关性。方法：本研究整群抽取萝岗区公立医院和非公立医院6家共406名护士,采用一般资料问卷、明尼苏达满意度问卷和护士工作压力源量表进行调查。结果：40岁以上和护龄10年以上的整体工作满意度分值最高,护龄6-10年的护士最低,差异有统计学意义（P〈0.05）。工作压力方面：护龄6-10年的护士最高,护龄5年以下护士压力最低,差异有统计学意义（P〈0.05）。护师工作压力最大（P〈0.05）,护士和主管护师相当。不同职称护士的工作满意度无统计学差异（P〉0.05）。护士对工作环境满意程度：护龄在10年以上的护士评分最高,护龄6-10年的护士对工作环境评分最低,差异有统计学意义（P〈0.05）;年龄在40岁以上的护士对工作环境评分最高,年龄25-29岁护士评分最低,其他3个年龄段满意度居中。合同护士工作满意度低,与正式编制护士比较具统计学差异（P〈0.05）;结论：护理管理者需对满意度较低的项目进行护理制度调整,提高临床护士对工作的满意度,从而留住护理人才,提高护理质量。     

血透专科护士压力负荷现状与职业获益感的相关性

目的 调查血透专科护士压力负荷的现状及影响因素,并分析与职业获益感的相关性,为血透专科护士减轻压力负荷,提高职业获益感提供参考依据,进而为患者提供优质护理。方法 采用便利抽样法抽取2021年3月～4月四川省三所三甲综合性医院的119名血透专科护士及119名肾内科病房护士为研究对象,采用压力负荷量表与职业获益感量表进行问卷调查,并对两组调查结果进行对比分析。结果 独立样本t检验结果显示,血透专科护士与肾内科病房护士压力负荷总分（3.00±1.26、2.70±1.24）分,事件负荷维度（3.49±1.15、3.16±1.23）分、个体脆弱性维度（2.59±060、2.31±1.11）分,差异有统计学意义（均P＜0.05）;线性回归分析结果显示,血透专科护士年龄、职称是压力负荷的影响因素（P＜0.05）;血透专科护士与肾内科病房护士职业获益感得分为（4.19±062、4.23±0.84）分,其中正向职业感知、良好的护患关系、亲友认同、团队归属感、自身成长各维度得分为（4.07±0.62、4.33±0.49、4.04±0.75、4.21±0.75、4.28±0.50;4.10±0.83、4.0±0.83、4.01±0.93、4.28±0.72、4.36±0.74）分;Pearson相关性分析结果显示,血透专科护士压力负荷与护士执业获益感呈显著负相关（r=〖CD*3/5〗0.280,P＜0.05）。〗结论 血透专科护士压力负荷与护士职业获益感均处于中等水平,血透专科护士的压力负荷高于肾内科病房护士,且受年龄、职称的影响,临床实践中应注重血透护士的心理健康,并提升其血透护士的职业获益水平,进而提高护理质量,使患者更大获益。     

某市三级甲等医院护士心理资本对主观幸福感的影响

目的探讨某市三级甲等医院护士心理资本对主观幸福感的影响。方法运用自编一般资料问卷、心理资本量表、主观幸福感量表对242名三级医院护士进行调查,进行相关分析。结果护士的心理资本总评分为（86.62±10.59）分;主观幸福感总体评分为（75.28±10.49）分,不同婚姻状况的护士在主观幸福感总评分及对生活的满足和兴趣维度评分的差异有统计学意义（P < 0.05）,不同年龄段的护士在主观幸福感总评分及精力维度评分差异有统计学意义（P < 0.05~P < 0.01）,不同职称的护士在主观幸福感总评分、对生活的满足和兴趣维度评分、精力维度评分及对健康的担心维度评分差异均有统计学意义（P < 0.05）,不同工作时间的护士在精力维度评分的差异有统计学意义（P < 0.05）,不同科室的护士在对情感和行为的控制维度评分差异有统计学意义（P < 0.05）;通过多元逐步回归分析,乐观、韧性进入回归方程（P < 0.05~P < 0.01）,乐观与韧性这两个变量共能够解释主观幸福感总分16.5%的变异量。结论护士的心理资本及主观幸福感状况比较乐观,心理资本对主观幸福感有显著的预测作用,且越乐观,韧性程度越高,主观幸福感越强。     

慢性焦虑、抑郁对老年轻型急性缺血性卒中患者伴发认知功能障碍的影响研究

目的　探讨慢性焦虑、抑郁对老年轻型急性缺血性卒中患者伴发认知功能障碍的影响。方法　选取2015年6月—2016年6月北京大学国际医院神经内科收治的老年轻型急性缺血性卒中患者98例为研究对象。根据汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）及患者个性特征、抑郁焦虑症状史对患者是否有慢性焦虑、抑郁进行定性判定。采用简易智力状态检查量表（MMSE）对患者进行认知功能评分。比较不同分组患者MMSE评分,采用Pearson相关分析探讨年龄与MMSE评分的相关性,采用多元线性回归分析MMSE评分的影响因素。结果　Pearson相关性分析结果显示,年龄与MMSE评分呈线性负相关（r=-0.221,P=0.029）。女性MMSE评分高于男性,差异有统计学意义（P<0.05）。在均衡年龄和性别后,焦虑组MMSE评分高于无焦虑组,差异有统计学意义（P<0.05）;无抑郁组与抑郁组MMSE评分比较,差异无统计学意义（P>0.05）。多元线性回归分析结果显示,年龄和焦虑为MMSE评分的影响因素（P<0.05）。结论　高龄是老年期认知功能障碍的危险因素,慢性焦虑可能是老年期认知功能障碍的保护因素。     

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.     

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…     

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.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

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.