军人职业压力量表的编制及信效度分析

目的 编制军人职业压力量表并检验其信效度.方法 参考国内外有关职业压力理论,心理测量学原则,结合军队特点自行编制了军人职业压力量表.对1100名军人进行测试,并对其中51名官兵同时测量中国军人心理健康量表(CMMHS).利用统计软件对军人职业压力量表进行信度、效度检验.结果 根据因子分析的因子负荷结果,最后形成8个因子,分别为人际关系、军旅特殊生活、经济压力、工作压力、婚姻家庭、个人发展、角色不清及领导能力.总量表及各分量表的Cronbach'α系数为0.709～0.953(P＜0.01);各因子间相关系数为0.374～0.873(P＜0.01);重测相关系数为0.593～0.813(P＜0.01);量表各因子与CMMHS有较好的效标关联效度,相关系数为0.303～0.389(P＜0.05).结论 该量表具有较好的信度和效度,达到了心理测量学标准,能够作为测量军人职业压力的有效工具.     

军人心理疾病预测量表的信度及效度检验

目的:检验军人心理疾病预测量表的信度和效度. 方法:对236例军人心理疾病患者及487名健康官兵采用军人心理疾病预测量表进行测评,对其中57名健康官兵同时测试症状自评量表(SCL-90),对另50名健康军人在1周后使用本量表进行重测.研究组患者以中国精神疾病分类方案与诊断标准(第3版)为金标准,进行临床诊断.分析本量表的信、效度及量表评估与临床诊断的符合率.结果:总量表重测信度为0.820,分量表为0.354～0.812,P<0.05或0.01;总量表Cronbach′α系数为0.868,分量表为0.359～0.789,P均＜0.01;量表各因子之间及与总分之间相关系数为0.140～0.842(P<0.01).量表因子与SCL-90大部分因子呈显著正相关(P<0.05或0.01).心理疾病患者的量表总分及各因子分显著高于对照组(P<0.01).量表的精神病性、抑郁、躁狂、神经症、人格偏移因子分评估与临床诊断一致率分别为69.1%,76.3%,81.4%,64.4%,81.8%.结论:军人心理疾病预测量表的信度和效度符合心理测量学要求.     

军人职业倦怠量表的信效度检验

目的 研制军人职业倦怠量表,并对其信度、效度进行检验.方法 采用随机整群抽样方法 ,选取1000名健康官兵,并分为A(500名)、B(500名)两组.用研制的军人职业倦怠量表对两组被试进行测试.对其中的280人同时使用本量表和工作倦怠问卷进行施测;对收集的A组数据进行探索性因素分析和相关分析,B组数据进行验证性因素分析.结果 经相关分析发现:总量表的Cronbach'α系数为0.917,各因子的Cronbach'α系数为0.719～0.847;总量表的分半信度为0.920,各个因子的分半信度为0.723～0.867.总量表与各分量表之间的相关系数为0.731～0.808(P＜0.01),各分量表之间的相关系数为0.386～0.627(P＜0.01).经探索性及验证性因素分析发现:所测数据与理论模型(成就感、躯体化、自我评价、人际关系、消极怠工);相一致,拟合指标的卡方值为771.914,自由度(DF)为395,相对卡方值为1.954,P=0.000,近似误差均方根为0.044,拟合优度指数、比较拟合指数、增值拟合指数分别为0.904,0.919,0.920.军人职业倦怠量表总分及各因子分与工作倦怠问卷的总分及各因子分之间具有显著的相关性.结论 自行研制的军人职业倦怠量表具有较好的信度和效度.     

中国军人心身健康量表的研制

目的 编制中国军人心身健康量表,并对其进行信、效度检验.方法 结合开放式问卷调查及以往研究,编制本量表.随机整群抽取1050名军人进行测试,并随机选择其中60名被试,同时施测中国心身健康最表(CPSHS);2周后对其中61名被试进行本量表的重测.通过探索性因子分析及相关分析,检验量表的信效度.结果 中国军人心身健康量表由11个因子构成:呼吸系、心血管系、消化系、骨骼肌肉、皮肤系、生殖内分泌系、神经系、焦虑、抑郁、精神病和家族史,另加一个掩饰分量表,经因子分析修正获得91个条目组成的正式量表.各因子之间的相关系数为0.103～0.778(P<0.01),各因子与总量表之间的相关系数为:0.600～0.859(P<0.01);总量表及各因子的重测相关系数为:0.427～0.901(P<0.01);Cronbach(α)系数为:0.618～0.935(P<0.01);分半相关系数为:0.349～0.855(P<0.01).本量表与CPSHS的对应因子呈显著性相关,相关系数为0.425～0.979(P<0.05或0.01).结论 中国军人心身健康量表具有较好的信度和效度,符合心理测量学要求.

Abstract：

Objective To develop a Chinese military psychosomatic health scale(CMPHS) and examine its reliability and validity. Methods Based upon the previous researches, the Scale was compiled according to open-ended inventory survey. The data was collected from 1050 subjects chosen by random cluster sampling. 60 of them were tested with the CPSHS at the same time, while 61 of them were retested with the CMPHS after two weeks. The reliability and validity were examined by exploratory factor analysis ( EFA) and correlation analysis. Results According to the factor analysis results, 11 factors were extracted, namely espiratory apparatus, alimentary system,skeletal and musculature,integument,regeneration and endocrine,nervous system, anxiety, depression, psy-choticism and family history. There were 91 items in the formal scale when one lie subscale was added. The correlation between subscales were 0. 103 ～ 0. 778 (P < 0. 01) , the correlation between subscales and total scale were 0.600 ～0.859(P<0.01). The test-retest correlation coefficients of total scale and subscales were 0.427 ～0.901 (P < 0.01); the Cronbach (α) coefficients were 0. 643 ～ 0. 935 (P < 0. 01) ; and the split-half correlation coefficients were 0. 349 ～ 0. 855 (P < 0. 01 ). The correlation coefficients were 0. 425 ～ 0. 979 (P < 0. 05 or 0. 01 ). Conclusion The Chinese military psychosomatic health scale has acceptable psychometrics properties on reliability and validity.     

军人职业压力量表的编制及信效度分析

目的 编制军人职业压力量表并检验其信效度。方法 参考国内外有关职业压力理论，心理测量学原则，结合军队特点自行编制了军人职业压力量表。对1100名军人进行测试，并对其中51名官兵同时测量中国军人心理健康量表（CMMHS）。利用统计软件对军人职业压力量表进行信度、效度检验。结果根据因子分析的因子负荷结果，最后形成8个因子，分别为人际关系、军旅特殊生活、经济压力、工作压力、婚姻家庭、个人发展、角色不清及领导能力。总量表及各分量表的Cronbachα系数为0．709～0．953（P〈0．01）；各因子间相关系数为0．374～0．873（P〈0．01）；重测相关系数为0．593～0．813（P〈0．01）；量表各因子与CMMHS有较好的效标关联效度，相关系数为0．303～0．389（P〈0．05）。结论 该量表具有较好的信度和效度，达到了心理测量学标准，能够作为测量军人职业压力的有效工具。     

大学生自杀倾向量表的初步编制

目的 编制一个中国大学牛自杀倾向量表,为高校开展健康教育和自杀预防提供参考工具.方法 以Mann等提出的自杀应激-易感模型为理论依据,在文献复习和个案访谈的基础上构建大学生自杀倾向量表的理论因子及条目,并通过德尔菲法和预调查进行条目筛选.利用条目分析、信效度检验全面考察量表的心理测量学特征.结果 经条目筛选,最终保留23个条目.探索性因子分析将量表划分为5个维度,与预想的因素结构基本一致.在此结构下进行信效度分析,条目与其分鬣表的相关性较高(r=0.586～0.852),各分量表与总量表相关密切(r=0.534,0.830),而各分量表间呈低中度相关(r=0.073～0.619),均表明量表的内容效度较好.总量表及各分量苗表与CES-D和BHS相关均达到0.001显著水平,表明聚合效度较好;总量表及各分量表均能区分大学生和抑郁症患者2组人群(P＜0.01),表明量表的区分效度较好.总量表的Cronbach's 系数、分半信度和重测信度分别为0.872,0.740,0.784.结论 大学生自杀倾向量表信效度指标基本达到了心理测量学要求,可以作为大学生自杀倾向的测评工具.     

军人情景特质应对方式量表的研制

目的 编制中国军人情景特质应对方式量表.方法 依据应对理论,研制中国军人情景特质应对方式量表,初量表含18种军人常见应激情景,分别归类为6个情景分量表, 1个掩饰分量表,共有条目110条.随机整群抽取官兵752名进行测试,1周后对其中41名官兵进行重测,并对50名官兵同时测试本量表、艾森克人格问卷(EPQ)及中国军人心理健康量表(CMMHS).通过探索性因子分析及相关分析等,检验量表的信度和效度.结果 正式量表含有90个条目,两个公因子.总量表及2公因子的Cronbach α系数分别为0.893,0.940,0.933,均P＜0.01;重测信度为0.690,0.813,0.636,均P＜0.01.量表与EPQ及CMMHS的大部分因子具有显著的相关性.结论 军人情景特质应对方式量表的信度和效度符合心理测量学原则.     

中文版护生核心能力量表的信效度检验

目的 评价中文版护生核心能力量表（CINS）信、效度.方法 采用经Brislin法翻译并修订的中文版CINS,对266名护理本科生进行调查,运用SPSS17.0进行统计分析.结果 中文版CINS总量表的Cronbachs＇α系数为0.966,各维度Cronbachs＇α系数为0.827～0.951,Guttman分半信度为0.828,各维度Guttman分半系数为0.724～0.942,重测信度为0.737,内容效度为0.956,量表各维度间的相关系数为0.491～0.781（P＜0.01）,各维度与总量表之间的相关系数值为0.738～ 0.884（P＜0.01）.探索性因子分析抽取5个因子,累计解释的总方差为66.404％.结论 中文版CINS具有较高的信、效度,可用于护生核心能力的评估.     

中国军人职业倦怠量表的信效度检验

【】目的 验证中国军人职业倦怠量表的信度和效度。方法 采用随机整群抽样法抽取1292名军人,以中国军人职业倦怠量表进行测评,并对其中130名官兵施测中国军人职业压力量表。利用SPSS17.0、Amos7.0对中国军人职业倦怠量表进行信度、效度检验。 结果 ①中国军人职业倦怠总量表Cronbach′s α系数为0.844,各分量表Cronbach′s α系数为0.683～0.800(P＜0.01);总量表的分半信度是0.834,各因子的分半信度介于0.575～0.758(P<0.01);②量表各因子与总分之间相关系数为0.655～0.809(P<0.01)。中国军人职业倦怠量表总分与中国军人职业压力量表总分相关系数为0.538(P<0.01)。③探索性因素分析结果显示,此研究结果与原量表各条目的因子归类一致;④经验证性因素分析发现,数据与模型拟合程度较高,拟合指标的c₂值为1465.447,近似均方根误差(RMSEA)为0.060,塔克-刘易斯指数(TLI)、比较拟合指数(CFI)、增值拟合指数(IFI)、拟合优度指数(GFI)分别0.949、0.895、0.915、0.893。结论 经本次研究证明,中国军人职业倦怠量表其信度和效度都较好,达到了心理测量学标准,能够作为测量军人职业倦怠的有效工具。     

患者安全胜任力护理人员自评量表的编制及信效度评价

目的 编制患者安全胜任力护理人员自评量表(patient safety competency self-rating scale of nurses,PSCSSN).方法 在全面查阅和研究国内外相关文献的基础上,经2轮专家的函调和预实验对量表的条目进行评价、修改和筛选,形成最终的PSCSSN量表,以3所三级甲等医院791例护理人员为研究对象进行信效度检验.结果 量表由29个条目组成,探索性因子分析共提取4个公因子,与量表理论构建基本一致,各条目在所属因子上的载荷为0.471～0.817,累积方差解释率为64.598％.因子间的相关系数为0.242～0.519,各因子与总分的相关系数为0.619 ～0.822.培训组护理人员PSCSSN总量表得分明显高于未培训组(P＜0.01).量表总的Cronbach's α为0.930,重测信度为0.945,各个因子的Cronbach's α在0.777 ～0.863,重测信度在0.867～0.927.结论 PSCSSN量表具有较好的信度和效度,可以作为评估护理人员的患者安全胜任力的测量工具.     

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.