2型糖尿病合并肥胖患者焦虑、抑郁横断面调查与分析

目的：了解2型糖尿病合并肥胖患者焦虑、抑郁状况,分析其影响因素。方法：采用自行设计患者一般资料调查表和疾病相关资料调查表、焦虑自评量表（SAS）、抑郁自评量表（SDS）对128例门诊及住院2型糖尿病合并肥胖患者的焦虑、抑郁状况进行横断面调查及分析。结果：2型糖尿病合并肥胖患者焦虑、抑郁的发生率分别为58.6%和56.2%,焦虑、抑郁评分高于国内常模,差异有统计学意义（P<0.01）。多元逐步回归分析显示BMI、是否接受过糖尿病及肥胖健康教育是其焦虑情绪的主要影响因素;BMI、糖尿病并发症情况是其抑郁情绪的主要影响因素。结论：2型糖尿病合并肥胖患者存在焦虑、抑郁心理障碍,其焦虑情绪主要受BMI、是否接受过糖尿病及肥胖健康教育影响;抑郁情绪主要受BMI、糖尿病并发症情况影响。医务人员应着重关注2型糖尿病合并肥胖患者的心理状态,加强糖尿病及肥胖健康教育,尤其是运动和饮食教育,进行积极的心理疏导,减轻其焦虑、抑郁情绪。     

青少年1型糖尿病患者焦虑状况调查与相关因素分析

目的 了解青少年1型糖尿病患者焦虑状况并探讨其影响因素,为制定对策提供依据.方法 选取江苏省青少年糖尿病夏令营的1型糖尿病患者118例,采用焦虑自评量表调查,分析焦虑状况及其影响因素.结果 118例患者焦虑阳性检出率32.2%,其标准分显著高于国内常模(P＜0.01);多元逐步回归分析显示:患者焦虑自评量表标准分与起病年龄、糖化血红蛋白控制正相关(P＜0.05),与病程负相关(P＜0.05).结论 青少年1型糖尿病患者的焦虑情况明显高于国内常模,起病年龄越大、糖化血红蛋白控制越好、病程越短的患者焦虑情绪越明显.宜实施健康教育,并通过网络、电话交流方式以及开展夏令营等活动,增加与患者的沟通,为其树立健康的信念,进一步改善其心理状况.     

Ⅱ型糖尿病负性情绪及其影响因素

目的：探讨Ⅱ型糖尿病负性情绪状态及其影响因素，方法：采用Zung抑郁、焦虑自评量表，测度子68例Ⅱ型糖尿病患抑郁及焦眠评,贫时调查了空腹血糖、糖化血红蛋白（HbAic)、并发症，化水平对其的影响。结果Ⅱ型糖尿病患抑郁、焦虑评分明显高于国内常规模组，血糖控制不良，有并发症以及化水平低，其抑郁、焦虑评分显高于相应对照组。结论：Ⅱ型糖尿病患存在明显的负性情绪，血糖控制状况、并发症、化水平及其有重要影响。     

健康教育对糖尿病合并慢性乙型肝炎患者焦虑抑郁情绪的影响

目的 探讨人文关怀护理对2型糖尿病合并慢性乙型肝炎患者焦虑抑郁情绪的影响.方法 将60例2型糖尿病合并慢性乙型肝炎患者随机分为A组与B组,每组30例,抽取同期健康志愿者30名设为C组.A组与B组患者均予以常规健康教育,A组施以人文关怀护理干预,观察3个月.于干预前及干预3个月末采用焦虑自评量表评定3组焦虑状况,抑郁自评量表评定3组抑郁状况;同时检测A组与B组患者糖化血红蛋白,并进行对比分析.结果 人文关怀护理干预前后两组患者焦虑自评量表及抑郁自评量表评分均显著高于C组(P＜0.01).干预后两组患者焦虑自评量表、抑郁自评量表评分及糖化血红蛋白均较干预前显著下降(P＜0.01),且A组均较B组下降更显著(P＜0.01).结论 2型糖尿病合并慢性乙型肝炎患者均存在不同程度的焦虑抑郁情绪,人文关怀护理干预能显著改善患者的焦虑抑郁情绪,提高治疗依从性,有利于促进患者的全面康复.     

2型糖尿病患者自尊水平与焦虑、抑郁状况的关系研究

目的调查2型糖尿病患者自尊水平、焦虑及抑郁现况,并分析三者之间的相关性,探讨自尊的影响因素。方法采用Rosenberg自尊量表、广泛性焦虑障碍量表和患者健康问卷对221例2型糖尿病患者进行问卷调查。结果 2型糖尿病患者自尊得分为(26.52±4.07)分,低于国内常模(P<0.01);并发症种类与焦虑、抑郁是自尊水平的主要影响因素。结论 2型糖尿病患者的自尊水平较低,医护人员在进行护理干预或健康教育时,应关注糖尿病并发症、焦虑和抑郁水平高者,帮助其做好自我心理调适,从而提高患者自尊水平。     

老年2型糖尿病患者抑郁情况及危险因素分析

目的:调查老年2型糖尿病患者抑郁情绪障碍的患病情况,分析与之相关的危险因素。方法:选取200例老年2型糖尿病患者,对其进行一般情况、代谢指标等的检查,就患者的心理状态、影响病情变化的相关精神因素进行问卷调查。采用抑郁自评量表评价受试者的抑郁状态,用Logistic回归模型进行统计分析其抑郁情绪障碍与相关影响因素的关系。结果:200例老年2型糖尿病患者中有79例伴有抑郁情绪障碍,占39.5%。进入抑郁单因素非条件Logistic回归方程的有性别、吸烟史、糖化血红蛋白、眼底病变、家族史、并发症数目、担心无法根治、担心长期依赖胰岛素;多因素分析结果显示糖化血红蛋白、眼底病变和担心长期依赖胰岛素与老年2型糖尿病患者抑郁情绪障碍存在统计学差异。结论:抑郁是老年2型糖尿病患者常见的情绪障碍,糖化血红蛋白、眼底病变、担心长期依赖胰岛素是老年2型糖尿病患者抑郁情绪障碍的独立危险因素。     

健康教育对首次住院的精神分裂症患者家属情绪的影响

目的 探讨健康教育对首次住院的精神分裂症患者家属焦虑抑郁情绪的影响.方法 对30例首次住院的精神分裂症患者家属进行健康教育,并采用焦虑自评量表(SAS)、抑郁自评量表(SDS)分别在患者入院与出院时对患者家属焦虑抑郁情绪进行测评.结果 健康教育前,30名患者家属的SAS、SDS评分,与国内常模比较,差异有统计学意义(P＜0.05).健康教育前后,患者自身的SAS、SDS评分比较,差异有统计学意义(P＜0.05).结论 通过健康教育可改善首次住院的精神分裂症患者家属的焦虑抑郁情绪.     

健康教育对首次住院的精神分裂症患者家属情绪的影响

目的探讨健康教育对首次住院的精神分裂症患者家属焦虑抑郁情绪的影响.方法对30例首次住院的精神分裂症患者家属进行健康教育,并采用焦虑自评量表(SAS)、抑郁自评量表(SDS)分别在患者入院与出院时对患者家属焦虑抑郁情绪进行测评.结果健康教育前,30名患者家属的SAS、SDS评分,与国内常模比较,差异有统计学意义(P<0.05).健康教育前后,患者自身的SAS、SDS评分比较,差异有统计学意义(P<0.05).结论通过健康教育可改善首次住院的精神分裂症患者家属的焦虑抑郁情绪.     

心理干预对2型糖尿病患者抑郁情绪及糖代谢的影响

目的：探讨心理干预对2型糖尿病患者抑郁情绪及糖代谢的影响。方法：将67例2型糖尿病伴抑郁情绪患者随机分为研究组34例和对照组33例，对照组单独采用药物治疗。研究组在药物治疗的基础上联合心理干预。采用焦虑自评量表、抑郁自评量表分别于治疗前及治疗第6周末评定临床疗效，同期实验室检查空腹血糖、餐后2h血糖及糖化血红蛋白。结果：治疗第6周末焦虑自评量表、抑郁自评量表评分研究组明显低于对照组．研究组治疗前后比较差异有显著性意义（P〈0．01）；治疗第6周末空腹血糖、餐后2h血糖及糖化血红蛋白研究组明显低于对照组（P〈0．01）。结论：心理干预能有效改善糖尿病患者的抑郁情绪及血糖水平。     

延续性健康教育对糖尿病患者的影响

目的了解出院后延续性健康教育对糖尿病患者血糖控制、糖尿病知识掌握和情绪变化的影响。方法将308例糖尿病患者随机分为教育组与对照组各154例,教育组接受出院后延续性糖尿病门诊教育,对照组未进行教育,采用血糖及糖化血红蛋白、糖尿病健康知识评分、焦虑自评量表(SAS)和抑郁自评量表(SDS)分别进行患者教育前后测评,同时与对照组比较。结果教育后教育组血糖、糖化血红蛋白比对照组明显改善(均P<0.05),健康教育知识评分教育组较对照组明显提高(P<0.01),SAS、SDS较对照组明显改善(均P<0.01)。结论糖尿病出院后延续性健康教育可改善患者糖代谢、提高患者糖尿病知识水平及改善患者不良情绪状态。     

现代残疾康复理念、政策与社区康复体系研究

本研究分析了当代残疾康复的理念和理论架构,构建了以国际公约、决议和政策、国内法律和政策以及操作性工具3个层次的康复理论体系;运用包容性发展,分析探讨了当代社区康复的体系和特点;就发展康复事业、为残疾人提供全面系统的康复服务提出相关的政策建议。     

Comparison of short-term and long-term protocols for stabilization and preservation of RNA and DNA of Leishmania, Trypanosoma, and Plasmodium

Molecular tools continue to be important in the prevention and control of parasitic diseases. However, using these techniques directly in the field remains a major challenge. Therefore, the preservation of clinical samples collected from endemic field areas for later analysis remains an important preanalytical process. This study aimed at identifying a suitable protocol for stabilization and preservation of RNA and DNA in bioclinical specimens for Trypanosoma, Leishmania, and Plasmodium research. Both spiked and unspiked blood samples were preserved in 7 protocols (different media; storage temperatures). Samples were evaluated for possible degradation of DNA and RNA along the storage duration up to the 10th week. Nucleic acid targets were assessed as follows: (i) Trypanosoma and Plasmodium RNA analysis was done using real-time nucleic acid sequence-based amplification (RT-NASBA) for 18S rRNA and for stage-specific Pfs25 mRNA, respectively; (ii) Trypanosoma DNA assessment analysis was conducted by using a conventional PCR for 18S rDNA; (iii) Leishmania RNA analysis was performed with a quantitative NASBA for 18S rRNA and Leishmania DNA assessment with an RT-PCR for 18S rDNA. Findings suggested that a newly developed L3™ buffer proved to be reliable and suitable for both short- and long-term preservation of parasite nucleic acid material. This buffer is envisaged to be suitable for utilization in field situations where resources are limited.     

Rates and risks of transmission of smallpox and mechanisms of prevention

In 1980, the World Health Organization declared smallpox eradicated from the world; the last known natural case had occurred in Somalia in 1977, and the United States had stopped routinely vaccinating its citizens in 1972. However, with increasing concerns regarding domestic and international terrorism, smallpox has resurfaced as a potential threat to global health. We review the direct and indirect modes of smallpox transmission and how patterns of transmission vary substantially, depending on the severity of circulating disease, vaccination status, environmental and socioeconomic factors, and the setting of an outbreak. We examine mechanisms for controlling outbreaks of disease and preventing further transmission in the event of an outbreak, with an emphasis on smallpox vaccination.     

国内外唇腭裂专科护理发展现状的文献研究及分析

目的了解和分析国内唇腭裂专科护理工作发展的现状。方法检索并分析万方医学网、中国知网、Springer Link及PubMed英文数据库近6年有关唇腭裂手术的围术期护理、患儿的喂养、手术安全管理、围术期疼痛研究以及心理护理的相关文献。结果共检索出国内文献89篇(核心期刊20篇)、国外文献22篇,其中围术期护理38篇、患儿的喂养16篇、手术安全管理10篇、围术期疼痛研究10篇、心理护理15篇。结论与国外文献相比,国内论文总结和回顾性居多,应增加研究探讨性论文,从而促进唇腭裂临床护理工作专科化的发展。     

城乡学童个性行为特征调查

目的探讨农村与城市儿童的个性行为特征。方法将97名农村学龄儿童设为农村组,97名城市学龄儿童设为城市组,采用艾森克个性问卷一儿童版和Achenbach’s 行为量表一儿童版进行评定分析。结果两组学龄儿童艾森克个性问卷各维度评分均无显著性差异（P均〉0．05）,且与全国常模相一致（P均〉0．05）;农村组男学童Achenbach’s行为量表违纪行为、攻击行为及外向型因子分均显著高于城市组,女学童退缩、社交问题因子分均显著高于城市组（P〈0．05或0．01）,其他因子分均无显著性差异（P均〉0．05）。结论农村与城市儿童个性无显著差异,而农村儿童存在较多的行为问题,可能与其所受教养和生活方式有关。     

糖尿病视网膜病变筛查与防治中存在的问题及对策

目的探讨糖尿病视网膜病变(diabetic retinopathy,DR)患者筛查和防治中存在的问题及对策。方法以76例糖尿病DR患者为对象,调查未能早期接受眼科诊治的原因。结果存在问题主要是患者对DR防治知识不了解、血糖控制不理想、内科医生未建议进行专科检查等。结论眼科医护人员应密切与糖尿病专科的联系,尽早对DM患者进行DR健康教育,并开展社区DR防治工作。     

罕见和未知基因型珠蛋白生成障碍性贫血的分析与鉴定

目的对珠蛋白生成障碍性贫血(简称地贫)血液学表型阳性但未检出常见地贫基因型的疑似个体做进一步分子水平检测,以明确诊断。方法收集2015年5月至2018年8月在清远市妇幼保健院就诊的地贫血液学表型阳性但常见地贫基因型检测为阴性的标本96例(包括疑似α-地贫88例和β-地贫8例),分别采用单管多重PCR、DNA测序法、荧光定量PCR和芯片捕获测序法检测罕见和未知缺失型地贫基因。结果从上述疑似α-地贫标本中共检出罕见α-地贫基因型17例,其中泰国缺失型(--^THAI/αα)5例,菲律宾缺失型(--^FIL/αα)2例,α^ΔCD303例,α珠蛋白基因拷贝数增加(ααα^anti3.7或ααα^anti4.2)5例,并且发现2例新的α-地贫突变,即α^ΔCD272-279delAGCTTCGG和CD167-169insT。在8例β-地贫特征个体中检出罕见β-地贫基因型Poly A(A>G)2例,-90(C>T)3例,CD37(TGG>TAG)1例,IVS-I-2(T>A)1例,另外还鉴定出1例新的缺失型β-地贫基因(缺失位置为ch11:5,246,000-5,250,500,缺失长度为4kb左右)。结论对未检出常见地贫突变但血液学表型阳性个体进行深度分析,既可提高地贫基因的检出率,有利于遗传咨询和产前诊断,又可能发现新的地贫突变,丰富了中国人群的地贫基因突变谱。     

Prevalence and severity of nausea and vomiting of pregnancy and effect of vitamin supplementation.

OBJECTIVE: Although nausea and vomiting of pregnancy is the most common medical condition during pregnancy, there are many unanswered questions regarding its cause, epidemiologic features and optimal management. The objectives of this study were to ascertain the prevalence of nausea and vomiting in a sample of Canadian women, to characterize the distribution of their severity and to investigate the role of vitamin B6 deficiency in their etiology. DESIGN: Prospective study. SETTING: Antenatal counselling service for pregnant women. PATIENTS: Three cohorts of women: a prospective, population-based cohort of 193 women, to estimate the rate and severity of nausea and vomiting (cohort A); a cohort of 555 women who sought advice for nausea with or without vomiting, to study the correlation between the maximal daily number of episodes of vomiting and maximal weight loss (cohort B); and a prospective cohort of 301 women who reported vomiting, to correlate vitamin supplementation with vomiting (cohort C). INTERVENTIONS: All 3 cohorts were interviewed during the counselling session, and cohort B was followed up prospectively. OUTCOME MEASURES: Frequency of nausea and vomiting, weight loss, maximal number of daily episodes of vomiting, rate of multivitamin supplementation. RESULTS: Overall, 67% of the women in cohort A reported experiencing nausea or vomiting, or both; 22% reported vomiting, and 9% experienced weight loss. In cohort B there was a significant correlation between the maximal number of daily episodes of vomiting and maximal weight loss, although there was wide variation (r2 = 0.25, p < 0.001). There was a highly significant correlation between the number of daily vomiting episodes and mean weight loss (r2 = 0.99). In cohort C, vomiting was significantly associated with lack of supplementation with multivitamins before 6 weeks' gestation (p = 0.002). CONCLUSIONS: The relation between number of daily vomiting episodes and mean weight loss may serve as a clinical tool to assess the severity of nausea and vomiting in pregnancy and the success of anti-emetics and rehydration regimens. Further study is needed to elucidate the biologic basis of the observed association between vomiting and lack of multivitamin supplementation in early pregnancy.     

头面部血管肉瘤3例报告并文献复习

目的:总结我们对头面部血管肉瘤手术联合放射治疗方法的经验认识。方法:报道3例头面部血管肉瘤病例,并复习相关文献。结果和结论:头面部血管肉瘤是一种少见的、多中心的血管肿瘤,预后差。头面部血管肉瘤的手术治疗常常需要切除较广的范围。放射治疗对头面部血管肉瘤是一种合理治疗,既能使受侵犯的真皮组织和周围皮肤得到进一步治疗,又能保护其下的正常组织。     

History of violence and subjective health of mother and child

Objective: To study the self-reported prevalence of experienced violence among a cohort of women about two years after giving birth, their health during pregnancy, pregnancy outcomes and their experience of their child’s health.

Setting and subjects: In 2011, a total of 657 women participated in phase III of the Childbirth and Health Cohort Study in Icelandic Primary Health Care, 18 to 24 months after delivery. The women had previously participated in phase I around pregnancy week 16 and phase II 5–6 months after delivery. Data were collected by postal questionnaires.

Main outcome measures: Women’s reported history of experienced violence, sociodemographic and obstetric background, self-perceived health, the use of medications and their child’s perceived health.

Results: In phase III, 16% of women reported experiencing violence. These women felt less support from their current partner (p?p?p?p?p?p?=?0.008).

Conclusions: Our study confirms that a history of violence is common among women. A history of violence is associated with various maternal health problems during and after pregnancy, a higher rate of caesarean sections and maternal reports of health problems in their child 18–24 months after birth.

• KEY POINTS

• Violence is a major concern worldwide. Understanding the impact of violence on human health and developing effective preventive measures are important elements of any public health agenda.

• ??The reported prevalence of experiencing violence was 16% among women attending antenatal care in the primary health care setting in Iceland.

• ??Women with a history of violence reported worse health in general during pregnancy and delivered more often by caesarean section, compared to women with no such history.

• ??Mothers with a history of violence also evaluated the general health of their child as worse than women with no such history.

• ??The findings of this study support the importance of recognizing and addressing experienced violence among women in primary care.