综合ICU病人烦躁的原因分析及护理

分析综合ICU病人烦躁的原因,对其采取有针对性的护理和改善环境等措施,病人烦躁均得到不同程度的缓解,防止了各类意外事件的发生,促进了病人的康复.     

角音干预对肝火亢盛型自发性高血压大鼠宏观表征及易激惹程度的影响

目的:观察中医五行音乐(角音)对肝火亢盛型自发性高血压大鼠(SHR)宏观表征及易激惹程度的影响,为进一步探讨角音降低高血压肝火亢盛证的血压、改善临床症状及作用机制的研究提供参考。方法:将20只SHR大鼠随机分为角音组(实验组)和对照组,每组10只,实验组给予连续角音干预(4周),对照组不予处理,每周动态采集宏观表征指标,干预前后对宏观表征进行对照观察和比较易激惹程度评分。结果:经过四周的角音干预,与对照组比较,角音组一般状态和尾部的评分显著高于对照组,两者比较有统计学意义(P0.05),但角音组被毛的评分和对照组比较,差异无统计学意义(P0.05);角音组和对照组易激惹程度评分比较,差异有统计学意义(P0.05)。结论:连续角音干预对高血压肝火亢盛证大鼠的宏观表征及易激惹程度评分具有显著的影响。     

Challenging neurological symptoms in paediatric palliative care: An approach to symptom evaluation and management in children with neurological impairment

Neurological symptoms are very common in children with life-limiting conditions and are challenging in terms of burden of illness. Moreover, neurological symptoms can significantly impact the child’s quality of life and contribute to distress among parents, families, caregivers and health care providers. Knowing how to manage and alleviated these symptoms is essential for providing good palliative care. In the present article, the more common neurological symptoms of agitation/irritability, spasticity and dystonia will be reviewed. The aim of the present brief review is to provide a basic approach to both the identification and treatment of these neurological symptoms. A medication table is provided for quick reference. A brief commentary and guidance for the management of pain are also incorporated, with reference to further literature sources.     

新生代农民工易激惹问卷编制

目的:探索新生代农民工易激惹的心理结构并编制问卷。方法:通过访谈、开放式问卷调查、文献检索形成初始项目,合成问卷并施测,通过项目分析、探索性因素分析、验证性因素分析和信效度分析,最终编制出新生代农民工易激惹问卷。结果:新生代农民工易激惹由消极认知、情绪不稳定性、攻击行为和愤怒4个维度构成,共解释变异的62.113%;验证性因素分析表明问卷的模拟程度较好;总问卷和4个因素的Cronbachα系数为0.732~0.909,重新信度为0.706~0.859;同时该问卷的效标效度良好。结论:新生代农民工易激惹由4个维度构成,具有良好的信效度,可用于相关研究和实践。     

The neural substrates of cognitive flexibility are related to individual differences in preschool irritability: A fNIRS investigation

Preschool (age 3–5) is a phase of rapid development in both cognition and emotion, making this a period in which the neurodevelopment of each domain is particularly sensitive to that of the other. During this period, children rapidly learn how to flexibly shift their attention between competing demands and, at the same time, acquire critical emotion regulation skills to respond to negative affective challenges. The integration of cognitive flexibility and individual differences in irritability may be an important developmental process of early childhood maturation. However, at present it is unclear if they share common neural substrates in early childhood. Our main goal was to examine the neural correlates of cognitive flexibility in preschool children and test for associations with irritability. Forty-six preschool aged children completed a novel, child-appropriate, Stroop task while dorsolateral prefrontal cortex (DLPFC) activation was recorded using functional Near Infrared Spectroscopy (fNIRS). Parents rated their child’s irritability. Results indicated that left DLPFC activation was associated with cognitive flexibility and positively correlated with irritability. Right DLPFC activation was also positively correlated with irritability. Results suggest the entwined nature of cognitive and emotional neurodevelopment during a developmental period of rapid and mutual acceleration.     

急性脑梗塞时植物神经应激状态的观察

目的 探讨急性脑梗塞患者植物神经应激状态的临床特点。方法 对108例急性脑梗塞患者植物神经应激状态进行观察。结果 108例中有96例并发植物神经应激状态,主要表现为短暂性心电图改变(79例)、应激性高血压(21例)、应激性高血糖(21例)、应激性溃疡伴出血(5例),有植物神经应激状态者死亡4例。结论 植物神经应激状态可加重急性脑梗塞患者的病情并影响其预后,应加强监护和治疗。     

Irritability and physical symptoms in a three-generation study of Mexican Americans

The association between physical symptom reporting and scores on the irritability subscale on the Buss-Durkee Hostility Inventory was analyzed in a three-generation sample of Mexican americans. Moderate associations were found between symptom-reporting and irritability after controlling for alcohol consumption, smoking, marital status, age, income, education, and depressed affect. The strength of these associations varied by generation and gender. These findings are consistent with the hypothesis that irritability may be associated with illness symptomatology. Implications of these findings for future research are discussed.     

龙利润燥胶囊治疗神经精神障碍阴虚火旺证的疗效观察

目的观察龙利润燥胶囊治疗神经精神障碍阴虚火旺证的疗效及不良反应。方法将120例神经精神障碍阴虚火旺证者随机分为两组,对照组常规西医治疗,治疗组在常规西医治疗的基础上合用龙利润燥胶囊,于治疗前和治疗后1、2．4、6周末分别以简明精神病评定量表（BPRS）和汉密顿焦虑量表（HAMA）的总分减分率及不良反应量表（TESS）评定疗效和安全性。结果两组疗效比较差异有统计学意义（P〈O．05）,治疗组改善烦躁和便秘症状较对照组明显（P〈0．01）,治疗组不良反应出现的频率较对照组低且轻微。结论龙利润燥胶囊治疗神经精神障碍阴虚火旺证疗效满意,它能改善患者烦躁、便秘等主要症状,减少精神科用药量,减轻精神药物副反应,安全性好。     

A new look at quantifying tobacco exposure during pregnancy using fuzzy clustering

Background

Prenatal tobacco exposure is a risk factor for the development of externalizing behaviors and is associated with several adverse health outcomes. Because pregnancy smoking is a complex behavior with both daily fluctuations and changes over the course of pregnancy, quantifying tobacco exposure is a significant challenge. To better measure the degree of tobacco exposure, costly biological specimens and repeated self-report measures of smoking typically are collected throughout pregnancy. With such designs, there are multiple, and substantially correlated, indices that can be integrated via new statistical methods to identify patterns of prenatal exposure.

Method

A multiple-imputation-based fuzzy clustering technique was designed to characterize topography of prenatal exposure. This method leveraged all repeatedly measured maternal smoking variables in our sample data, including (a) cigarette brand; (b) Fagerstrom nicotine dependence item scores; (c) self-reported smoking; and (d) cotinine level in maternal urine and infant meconium samples. Identified exposure groups then were confirmed using a suite of clustering validation indices based on multiple imputed datasets. The classifications were validated against irritable reactivity in the first month of life and birth weight of 361 neonates (Male_{_n} = 185; Female_{_n} = 176; Gestational Age__Mean = 39 weeks).

Results

This proposed approach identified three exposure groups, non-exposed, lighter-tobacco-exposed, and heavier-tobacco-exposed based on high-dimensional attributes. Unlike cut-off score derived groups, these groupings reflect complex smoking behavior and individual variation of nicotine metabolism across pregnancy. The identified groups predicted differences in birth weight and in the pattern of change in neonatal irritable reactivity, as well as resulted in increased predictive power. Multiple-imputation-based fuzzy clustering appears to be a useful method to categorize patterns of exposure and their impact on outcomes.