风险评估引导式分层延续干预对急性冠状动脉综合征病人的影响分析

[目的]就风险评估引导式分层延续干预在急性冠状动脉综合征病人中的应用效果进行观察。[方法]选择2018年1月—2018年5月收治于医院的90例急性冠状动脉综合征病人为研究样本,以随机数字表法分为对照组与试验组各45例。对照组接受急性冠状动脉综合征常规延续管理,试验组于对照组基础上加用风险评估引导式分层延续干预,对两组病人干预后的各观察指标进行比较。[结果]试验组病人干预后心功能评价指标明显优于对照组,自我效能感评分明显高于对照组,出院后1年内心血管事件发生率明显低于对照组(P<0.05)。[结论]采用风险评估引导式分层延续干预对急性冠状动脉综合征病人施加干预,可明显改善其心功能状况,提高自我管理效能感,降低心血管事件发生率。     

Inferior Vena Cava Anomalies with Portal Vein System Continuation Presenting as Portal Hypertension with a Long-term Follow-up

Inferior vena cava (IVC) anomalies, such as the absence of an intra-hepatic IVC or IVC hypoplasia, are rare. Usually, these anomalies are asymptomatic and cause few clinical issues. We herien report a 53-year-old woman with IVC anomalies who demonstrated both azygos and portal vein system continuation. Over time, this resulted in gradually progressive portal hypertension due to abnormal hemodynamics. The increased inflow from the IVC to the portal vein system for an extended time may contribute to the development of portal hypertension without liver cirrhosis.     

初治涂阳肺结核缩短化疗期研究

目的 研究适合在结核病控制规划治疗中标准规范有效的化疗方法。方法 使用2HRZS／xHR不固定化疗期方案，采用前瞻性队列研究。结果 468例研究对象中，累计阴转治愈459例，阴转治愈率98.1%，平均化疗期5.1个月；随访满1年时细菌学复发率为0.5%。结论 可以考虑在我国结核病规划治疗中逐步推广使用2HRZS／xHR不固定化疗期短程化疗方案对病人进行治疗管理，保证疗效的前提下能够缩短1个月的疗程。     

Adolescent Smoking Continuation: Reduction and Progression in Smoking after Experimentation and Recent Onset

In the present study, the role of cognitive concepts derived from the Theory of Planned Behavior in adolescent smoking reduction, continuation, and progression was investigated. These concepts include pro-smoking attitudes, perceived social norms regarding smoking, and self-efficacy to resist smoking. Logistic regression analyses were performed on data from 397 Dutch adolescents aged 11-15 years, who had at least once tried smoking. Attitudes, perceived social norms, and self-efficacy, including significant interactions between these three concepts, explained up to 41% of variance in smoking behavior cross-sectionally. Longitudinally, an interaction between pro-smoking attitudes and low self-efficacy increased the chance of reduction in smoking, and all three cognitions inclusive of two interactions between pro-smoking perceived social norms and low self-efficacy or positive attitudes towards smoking predicted progression of smoking. Cognitions may play relatively small roles in adolescent smoking reduction, but do seem to be relevant in progression in smoking after experimentation or recent onset. Interactions between positive attitudes towards smoking and prosmoking perceived social norms provide cumulative risks for adolescents to increase their levels of smoking, whereas interactions between less favorable attitudes and high self-efficacy to resist smoking may provide a protective effect for adolescents to reduce or to quit their smoking.     

The differential impact of risk factors on illicit drug involvement in females

AbstractBackground Initiation of drug use and progression to abuse/dependence involve complex pathways. Potential risk factors may correlate with initiation or progression or both. Are there risk factors that associate with illicit drug use or illicit drug abuse/dependence? Is the magnitude of the association the same for use and abuse/dependence? Does this pattern of association differ across categories of drugs?Methods We used data from female-female adult twins to assess the association of 26 putative risk factors with use and abuse/dependence of six illicit psychoactive drugs. Drug involvement was represented by independent dichotomous outcomes and by a single ordinal variable. Odds ratios were obtained by logistic regression and a continuation ratio was used to test the magnitude of association.Results Factors associate in similar patterns with different drug categories. Some associated factors interact only with initiation while others relate with both stages. There is a stronger association of significant socio-demographic factors with drug use while the psychiatric diagnoses are more strongly associated with progression to abuse/dependence.Conclusions Risk factors may be use-specific, abuse/dependence-specific or common to use and abuse/dependence. The trend of associations is similar across different illicit drugs. This suggests complex, interacting pathways that determine drug habits in individuals. These results are hypothesis-generating and future studies of causal relationships may draw from the outcomes presented in these analyses.     

The watercolor effect: a new principle of grouping and figure-ground organization

The watercolor effect is perceived when a dark (e.g., purple) contour is flanked by a lighter chromatic contour (e.g., orange). Under these conditions, the lighter color will assimilate over the entire enclosed area. This filling-in determines figure-ground organization when it is pitted against the classical Gestalt factors of proximity, good continuation, closure, symmetry, convexity, as well as amodal completion, and past experience. When it is combined with a given Gestalt factor, the resulting effect on figure-ground organization is stronger than for each factor alone. When the watercolor effect is induced by a dark red edge instead of an orange edge, its figural strength is reduced, but still stronger than without it. Finally, when a uniform surface is filled physically using the color of the orange fringe, figure-ground organization is not different from that for the purple contour only. These findings show that the watercolor effect induced by the edge could be an independent factor, different from the classical Gestalt factors of figure-ground organization.     

One-year follow-up of continuation convulsive therapy prescribed for depressed elderly patients

Nine elderly patients with major depression were followed for outcome of continuation ECT. All nine patients had poor response to pharmacotherapy of the index episode, favorable response to acute treatment with ECT and, to varying degrees, previous failure of prophylactic pharmacotherapy. Four of the nine patients complied with continuation ECT as recommended for periods of 9 months to 1 year; these patients remained essentially well during the follow-up period, while the five who stopped the treatment prematurely fared poorly (one died, one required chronic hospitalization and three where rehospitalized acutely). These findings suggest the need for controlled studies of continuation ECT in geriatric depression.     

3种宫内节育器避孕效果比较性研究

目的 :比较曼月乐、吉妮与 MCu宫内节育器 IUD的避孕效果。方法 :将 2 50例妇女分成 3组 ,分别放置曼月乐、吉妮与 MCu,随访 12个月 ,对其避孕效果、副反应和续用率进行观察对比。结果 :3种宫内节育器的妊娠率均在低水平 ,相比无显著差异 (P>0 .0 5)。脱落率每百例妇女分别为 1.59、 0 .91和 4.73 ,曼月乐与吉妮组比较差异不显著 (P>0 .0 5) ,与 MCu组相比差异显著 (分别为 P<0 .0 1,P<0 .0 1) ;出血率每百妇女分别为 0 .81、 1.61和 7.80 ,曼月乐组最低 ,与其它两组相比差异显著(P<0 .0 5) ;续用率每百妇女分别为 94.95、 93 .3 6和 85.71,曼月乐组最高 ,与吉妮组比较无显著差异 (P>0 .0 5) ,与 MCu组相比差异显著 (P<0 .0 1)。结论 :曼月乐是 3种 ICU中副反应较小 ,脱落率低且避孕效果较理想的一种。     

日间手术患者智能随访服务系统的设计与应用

目的提高日间手术患者延续护理服务质量.方法设计并应用智能随访服务系统,制定和应用日间手术患者延续智能服务方案,包括连续性随访表格设计、随访问卷自动发送、随访结果实时上传、随访结果智能判断、服务计划智能制定等.以实施后为观察组,以实施前同时段常规随访患者为对照组,比较两组患者人均随访次数、非计划性再就诊率、患者对医院服务的满意度.结果观察组患者380人次,人均随访1.54±0.72人次,对照组329人次,人均随访1.08±0.78次,差异有统计学意义(P<0.001);观察组患者非计划性再就诊率1.32%,低于对照组的4.26%(P<0.05);观察组患者住院服务满意度97.17%,高于对照组的91.43%(P<0.01).结论智能随访服务系统利用信息化远程服务,可提高患者人均随访频次,降低非计划性再就诊率,提高患者满意度.