The Relative Salience of Daily and Enduring Influences on Off‐Job Reactions to Work Stress

Work stress is an important determinant of employee health and wellness. The occupational health community is recognizing that one contributor to these relationships may be the presence of negative off‐job reactivity to work, which we argue involves continued thoughts directed towards work (cognitive reactivity), continued negative mood stemming from work (affective reactivity), and the alteration of post‐work behaviours in response to work factors (behavioural reactivity). We explored the relative contributions of daily work stressors, affective traits, and subjective job stress perceptions to negative off‐job reactivity. These relationships were evaluated in a study of hospital nurses (n = 75), who completed trait measures and then provided self‐assessments of daily work stress and off‐job reactions for four work days. The results of several multilevel analyses indicated that a main‐effects model best described the data when predicting cognitive, affective, and behavioural reactivity from daily work stressors, affective traits, and subjective job stress perceptions. A series of multilevel dominance analyses revealed that subjective job stress perceptions dominated the prediction of behavioural reactivity, while trait negative affect dominated the prediction of affective reactivity. Theoretical implications and the relative salience of daily and enduring contributors to negative off‐job reactivity are discussed. Copyright © 2015 John Wiley & Sons, Ltd.     

膜截流分子量在新型生物人工肝免疫安全性中的作用研究

目的 探讨膜截流分子量对新型生物人工肝(bioartificial liver,BAL)支持系统免疫安全性的影响.方法 应用D氨基半乳糖静脉滴注比格犬建立肝功能衰竭模型.急性肝功能衰竭犬根据BAL隔离膜截流分子量的大小分为两组:A组:200 kD组；B组:1200 kD组.两组均接受新型2次BAL治疗,每次6h.观察各组体内IgG、IgM、50％补体溶血单位(CH50)变化及反应器内抗体漏过情况.结果 在第一次BAL治疗后两组的IgG和IgM水平均没有发生明显的变化.在第2次治疗后第7天,1200 kD组的IgG和IgM水平明显升高,200 kD组IgG和IgM水平仍未出现明显上升或下降.在第一次BAL治疗后,两组CH50都出现暂时性的下降,在治疗后1h达到最低值,而后缓步上升,在7d后恢复至治疗前水平.反应器内培养液中IgG、IgM及CH50检测结果显示,1200 kD组在治疗结束后IgG、IgM及CH50含量显著高于200 kD组.结论 膜截流分子量可能是影响BAL异种免疫排斥的重要因素之一.     

体外循环与非体外循环冠状动脉旁路移植术围术期治疗结果对比分析

目的：比较体外循环冠状动脉旁路移植术(conven-tional coronary artery bypass grafting,CCABG)与非体外循环冠状动脉旁路移植术(off-pump coronary artery bypass grafting,OPCABG)治疗结果，评价两种方法优越性．方法：将350例冠状动脉旁路移植术患分为0PCABG和CCABG组，0PCABG组在非体外循环心脏跳动下完成冠状动脉旁路移植术，CCABG组建立常规体外循环，心脏停跳或跳动下完成冠状动脉旁路移植术．对两组患的术前及术后各指标进行对比分析．结果：两组患术前治疗及一般情况如性别、年龄、体质量、心梗史、心功能、合并糖尿病、高血压等无差别；手术时间、血管桥数无差别；术后0PCABG组呼吸机辅助时间、住ICU时间、住院时间及住院费用比CCABG组低，术后早期并发症如开胸止血、伤口感染、心律失常、呼吸道并发症等的发生率0PCABG组为6．4％，CCABG组为9．1％，0PCABG组无1例死亡，CCABG组死亡率为1．5％，两组比较无显性差异．结论：0PCABG可减少手术创伤，缩短术后呼吸机辅助时间、ICU治疗时间及住院时间，降低住院费用，但不能替代CCABG．     

改进静脉采血技术 提高采血成功率

目的探讨提高真空静脉采血成功率的方法与效果。方法将200例静脉采血的患者随机分为实验组与对照组,每组100例。实验组采用改良的真空静脉与特殊静脉采血法,对照组则按常规注射器静脉采血法。结果对照组与实验组在疼痛情况、采血成功率方面比较,均有显著性差异(均p<0.05),与对照组相比,实验组个体疼痛感低于对照组,而在采血成功率方面高于对照组。结论改良的真空静脉与特殊静脉采血法可有效减轻患者采血时的疼痛,提高真空采血成功率。     

非体外循环跳动心脏上冠脉旁路术治疗观察

目的　总结非体外循环跳动心脏上冠脉旁路术治疗体会。方法　我院自 2 0 0 1年 3月— 2 0 0 2年 5月对 6例有心绞痛 ,内科药物治疗无明显好转 ,冠脉造影确诊为 3支病变 ,不适合冠脉腔内支架治疗的病人行非体外循环跳动心脏上冠脉旁路术。女 3例 ,男 3例。年龄 5 6 6 8岁 ,平均年龄 6 1 5岁。心功能 (NYHA)ⅢIV级。左室射血分数 (LVEF) 0 4 0 6。病人均伴有陈旧性心梗。前胸正中切口 ,采用左乳内动脉和大隐静脉为移植材料。结果　本组病人术后全部存活 ,平均搭桥2 6 7根。左乳内动脉桥 6根 ,其余为大隐静脉桥。采用“蛇形桥”2例 ,近端“Y”型吻合 2例。所有病人术后心绞痛消失 ,活动量增加 ,生活质量明显提高。对手术表示满意。结论　非体外循环跳动心脏上冠脉旁路术安全 ,经济 ,有效 ,病人容易接受 ,并可应用于多支血管病变     

浅谈“甲襞微循环加权积分法”

作者观测了2763例不同病种不同病期患者的甲襞微循环,对于1984年闻世的“甲襞微循环加权积分法”给予高度的评价。同时指出,这种检查方法需要在临床实践中加以充实和提高。作者认为,“管襻脱落”的发生机理和临床意义不同于“管襻出血”,应该把“管襻脱落”作为一项独立的观测指标。汗腺导管的出现率差别很大,应重视其临床意义,增加其权值。甲襞微循环形态,流态及襻周状态部分指标的分值宜作适当的补充和修订。为了把对病人甲襞微循环连续观测的结果更形象更直观地表示出来,作者提出了b=2a-X的校正公式。     

Consistent non-cartesian off-axis MRI quality: calibrating and removing multiple sources of demodulation phase errors.

The consistency of off-axis MRI with non-Cartesian sequences across a large number of scanners is highly variable. Improper timing alignment of the gradient fields, data acquisition system, and real-time frequency demodulation reference signal, which are necessary for off-axis imaging, is an important source of this variability. In addition, eddy currents and anisotropic gradient delays cause deviations in k-space trajectories that in turn make the demodulation reference signals inaccurate. A method is presented to quickly measure the timing error in the frequency demodulation reference signal and separate it from anisotropic gradient delays. k-Space deviations, as measured with a previous gradient calibration technique, are shown to be a second source of demodulation phase errors that degrade image quality. Using the timing delay and k-space deviations, a retrospective phase correction is applied to each k-space sample before the data are regridded during reconstruction. The timing delays of four MR scanners were measured to be 4.2-7.5 micros below the manufacturer's suggested delay. Significant degradation in 3D radial (3D projection reconstruction (PR)) knee and breast images are retrospectively corrected while a partial prospective correction is applied for spiral imaging. The method allows for more consistent performance of non-Cartesian sequences across multiple scanners without operator intervention.