1型糖尿病儿童青少年生存质量调查分析

目的:通过调查我地区1型糖尿病儿童、青少年的生存质量并作出分析,为1型糖尿病的儿童青少年针对性治疗护理提供依据。方法:2015年12月~2016年12月在我院儿科就诊的1型糖尿病患儿100例,采用一般情况调查量表、儿童生存质量测定量表进行调查分析。结果:1型糖尿病儿童血糖总体控制不良,饮食控制不良,总体生存质量较低,生存质量与血糖水平、居住地、、家庭经济收入显著相关(P0.05)。结论:1型糖尿病儿童、青少年血糖控制总体不良,生存质量下降。医护人员应做好糖尿病相关知识宣教、指导患儿及家属做到血糖控制管理,提高血糖控制水平,提高患儿的生存质量。     

WHOQOL-BREF在社区糖尿病患者生存质量评价中的信度、效度研究

目的探讨世界卫生组织生存质量测定量表简表(WHOQOL-BEFF)在社区2型糖尿病患者生存质量评价应用中的信度与效度。方法应用WHOQOL-BREF、DSQL量表对279例社区2型糖尿病患者进行调查,计算该量表的内部一致性信度、分半信度和结构效度、效标效度。结果WHOQOL-BREF内部一致性评价Cronbachα系数为0.922,分半信度系数为0.902,具有较高的信度。WHOQOL-BREF各条目因子载荷绝大部分在0.5以上;模型拟合优度RMSEA=0.06、NNFI=0.90、CFI=0.91,模型拟合较好,表明该量表具有较好的结构效度;WHOQOL-BREF与DSQL呈显著负相关;相近分量表均有不同程度负相关性,表明该量表有较高效标效度。结论WHOQOL-BREF具有较好的信度和效度,可较好地评价社区2型糖尿病患者的生存质量,与其他相关量表结合使用可使评价结果更加全面。     

对128例1型糖尿病患儿的生存质量调查分析

目的:调查分析1型糖尿病患儿的生存质量,以供临床参考。方法:选取本院2010年8月-2013年7月收治的128例1型糖尿病患儿作为研究对象,分别于入院时和实施健康教育1年后采用儿童生存质量测定量表(PedsQL4.0)对其进行生存质量调查。对比实施健康教育前后一年内患儿生存质量的变化。结果:入院时患儿生活质量评分为(78.23±11.65)分,实施健康教育1年后患儿生活质量评分提高至(90.15±6.75)分,差异有统计学意义(P0.05)。结论:1型糖尿病患儿的生存质量处于相对较差的水平,实施健康教育可有效提高其生存质量,今后应将健康教育贯穿于药物治疗之中进行临床推广。     

青少年1型糖尿病病耻感评估量表的汉化及信效度检验

背景青少年1型糖尿病（T1DM）患者病耻感与其健康结局密切相关。目前国内尚缺乏针对该群体病耻感的测评工具。目的 对T1DM病耻感评估量表（DSAS-1）进行汉化,并检验其在我国青少年T1DM人群中的信效度。方法 采用方便抽样法,选取2022年3月—2023年3月在南京医科大学第一附属医院与南京医科大学附属儿童医院就诊的194例青少年T1DM患者为研究对象。使用Brislin经典回译模型对DSAS-1英文版进行直译、回译与文化调试,最终形成青少年DSAS-1中文版。采用一般资料调查表、青少年DSAS-1中文版、青少年糖尿病优势与韧性量表、亲子关系量表和糖尿病生活质量评估量表进行调查。采用探索性因子分析和验证性因子分析检验量表结构效度,量表内部一致性采用Cronbach’s α系数表示。通过与心理韧性、亲子关系、生活质量量表的相关分析佐证青少年DSAS-1中文版对病耻感的检测作用。结果 共回收有效问卷194份。探索性因子分析和验证性因子分析均表明青少年DSAS-1中文版分为“区别对待”“抱怨和评论”与“身份问题”3个维度,结构效度良好（因子载荷均>0.55,累积方差贡献率=67.98...     

健康测量量表SF-36应用于2型糖尿病患者的信度和效度评价

目的评价健康测量量表SF-36应用于中国2型糖尿病患者生活质量测量的效度和信度。方法应用SF-36量表对216位2型糖尿病患者进行测试,计算该量表的重测信度、内部一致性信度和结构效度、效标效度等。结果SF-36重测信度为0.965～0.986,Cronbach's α系数为0.8621～0.9557。因子分析显示SF-36的结构效度良好,与DMQLS的效标效度为0.328～0.766。结论SF-36具有较好的效度和信度,可用于2型糖尿病患者的生命质量评价。     

儿童及青少年1型糖尿病患儿生存质量分析

目的 了解儿童及青少年1型糖尿病患者生存质量,探讨其影响因素。方法 收集住院的儿童及青少年1型糖尿病患儿38例,分为血糖控制良好组（21例）和血糖控制不佳组（17例）,采用儿童生存质量测定量表（PedsQL4.0）进行问卷调查,对数据进行分析,评价患儿的生命质量,并采用Pearson相关对影响患儿生命质量的因素进行多元线性逐步回归分析。结果血糖控制不佳组患儿的生理功能、心理社会功能、生存质量总分较血糖控制良好组低,两组比较差异均有统计学意义（均P＜0.05）。患儿的生存质量与空腹血糖（FPG）、糖化血红蛋白（HbA1c）、餐后2h血糖（2hPG）、糖类抗原19-9（CA19-9）、血清β羟丁酸呈负相关（P＜0.05或0.01）,FPG、血清β羟丁酸为最相关影响因素（P＜0.05或0.01）。结论加强血糖控制,积极预防糖尿病酮症发生,监测CA19-9变化,有利于改善儿童及青少年1型糖尿病患儿生存质量。     

1型糖尿病儿童血糖控制及生活质量状况调查

目的 调查1型糖尿病(T1DM)儿童血糖控制与生活质量的状况。方法 随机抽取98例1型糖尿病患儿展开调查,采集患儿血液标本,并使用生存质量测定量表对患儿血糖控制情况与生活质量状况进行评价分析。结果 98例患儿糖化血红蛋白水平为(7.63±1.97)%;T1DM儿童血糖控制情况与年龄、病程、糖尿病饮食、血糖自我监测、糖尿病教育、居住地、经济水平有关;低龄、病程较短、饮食管理、频繁监测血糖水平、接受糖尿病教育均为T1DM儿童良好控制血糖水平的保护因素;血糖控制良好组生活质量量表生理功能、心理社会功能评分与总分显著高于血糖控制不佳组。结论 T1DM儿童血糖控制水平与生活质量有待提高,可通过加强饮食管理、血糖监测与疾病教育等途径提高血糖控制水平进而提高生活质量。     

糖尿病患者自我管理水平和生存质量相关性研究

目的探讨糖尿病患者自我管理水平和生存质量的相关性.方法采用描述性相关性研究,用密西根糖尿病管理评定量表(DCP)、密西根糖尿病知识测试问卷(DKT)和中国糖尿病患者生存质量特异性量表(DSQL)对214例1型和2型糖尿病患者进行问卷调查.结果(1)糖尿病患者的自我管理处于较高水平的因子有:自我管理能力、药物治疗问题、运动锻炼问题、对疾病的态度、自我管理坚持性及自我管理重要性认识;而较低水平的因子有:饮食依从性、血糖或尿糖检测问题、病情控制问题、糖尿病知识的理解自评及得分.(2)糖尿病患者生存质量的DSQL均值为(54.75±13.05)分,处于中等水平.(3)除血糖或尿糖检测问题因子外,自我管理水平的各个因子与生存质量的DSQL评分存在相关性(r=0.174～0.641,P＜0.05),表现为患者在上述因子的自我管理水平越高,其生存质量水平越高.结论糖尿病患者自我管理水平普遍与生存质量存在中等程度的正相关.     

城乡结合地区糖尿病规范化管理模式的探讨

目的:探讨城乡结合地区糖尿病患者规范化管理模式,为制定适宜的糖尿病社区卫生服务政策提供科学依据。方法:选取本院自2006年1月-2010年1月在门诊确诊的2型糖尿病患者作为研究对象,随机分为研究组和对照组,研究组给予包括健康教育、饮食、运动、药物治疗及心理疏导在内的综合干预,对照组则给予常规药物治疗。分别在干预前和干预后1年,采用一般调查问卷和SF-36生存质量量表对其糖尿病健康知识知晓率、血糖控制水平及生存质量评分进行测定。结果:在干预1年后,研究组糖尿病健康知识知晓率、血糖控制水平及生存质量评分明显好于干预前(P0.05),而对照组糖尿病健康知识知晓率和血糖控制水平与干预前比较,差异无统计学意义(P0.05),但生存质量评分较干预前有明显下降(P0.05)。研究组各项指标明显优于对照组,差异有统计学意义(P0.05)。结论:对城乡结合地区糖尿病患者进行系统、规范化管理,其长期效果明显高于常规模式,值得进一步推广。     

儿童青少年1型糖尿病患者父母生活质量及影响因素

目的：研究儿童青少年1型糖尿病患者父母生活质量及其影响因素,探讨其与1型糖尿病患者疾病控制的相关性。方法进行横断面调查,对广东省1型糖尿病转化医学研究项目中53例儿童青少年1型糖尿病患者父母使用欧洲五维健康量表（ EQ－5D－5L）进行生活质量调查。结果儿童青少年1型糖尿病患者父母的EQ－VAS平均得分为（67．40±9．94）分,低于中国普通城乡居民水平（城市居民83．73分、农村居民79．74分）。患者糖化血红蛋白水平、家庭经济收入、血糖监测频率与患者父母生活质量相关（ P＜0．05）。糖化血红蛋白水平达标患者的父母生活质量评分高于未达标患者（EQ－5D－5L得分0．92 vs 0．85,P＝0．043）。结论儿童青少年1型糖尿病患者父母生活质量与患者血糖控制情况相关,医务人员应重视并加强对患者父母进行相应干预,提高他们的生活质量,从而优化患者的治疗与管理。     

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…     

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.     

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.     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.