局部振动对家兔血清单胺类神经递质的影响

目的探讨振动对外周单胺类神经递质的影响,研究振动性神经损伤机制。方法将24只新西兰家兔随机分为低接振强度组[接振强度为ahw(4)3.03 m/s2]、中接振强度组[接振强度为ahw(4)6.13 m/s2]、高接振强度组[接振强度ahw(4)12.25 m/s2]和无接振对照组,用液相色谱-电化学检测法测定血清中单胺类神经递质:去甲肾上腺素(noradrenalin,NE)、5-羟色胺(5-serotonin,5-HT)和多巴胺(dopamine,DA)。结果振动中、高接振强度组血清中NE、5-HT和DA在接振不同时间,与相同时间段的对照组比较,均有明显升高(P<0.01),与同组接振前比较,也有明显升高(P<0.01)。总体上,随实验时间延长和接振强度增大,NE、5-HT和DA有升高趋势。结论振动可引起单胺类神经递质升高,可能参与振动性神经损伤机制。。     

论高校体育教学中的健康教育

本文揭示了新时期高校体育教学中实施健康教育的内涵，并对如何促进大学生身体、心理和社会适应能力等方面的全面发展，贯彻执行“健康第一”的指导思想提出了对策和建议：如在高校体育教学中培养学生良好的生活方式，养成有规律的学习与生活习惯，结合自身和专业特点选择体育项目，参加体育锻炼要经常和持之以恒，学会自我心理调整等。     

Use of the Acute Care Hospital Foodservice Patient Satisfaction Questionnaire to monitor trends in patient satisfaction with foodservice at an acute care private hospital

Aim:  To demonstrate how the Acute Care Hospital Foodservice Patient Satisfaction Questionnaire can be used to monitor trends in foodservice satisfaction.
Methods:  Three one-day surveys of foodservice satisfaction were conducted in 2003–05. All adult hospital inpatients with the exception of intensive care, cardiac post-operative care, labour ward and day surgery patients were eligible. The response rate was 48% (2003), 42% (2004) and 60% (2005). This took place in an acute care 440-bed private hospital. Overall foodservice satisfaction, dimensions of foodservice satisfaction (food quality, meal service quality, staff/service issues and the physical environment) and two independent statements (temperature of the hot foods, ability to choose different sized meals); satisfaction by gender, length of stay, age, diet type and appetite for 2005. Scores were calculated for overall satisfaction, four dimensions of satisfaction and two independent statements. Chi-squared analysis was used to determine the effect of gender, age, diet type and appetite on overall satisfaction. Correlation analysis was used to assess the association between overall foodservice satisfaction and length of stay.
Results:  Ratings of overall foodservice satisfaction, four dimensions of foodservice and two independent foodservice items were high, consistent with previous findings. Of the foodservice dimensions, the staff/service issues were the most positively rated and food quality the least positively rated. Patients' expectations of the foodservice were significantly associated with overall satisfaction. Quality improvement activities focused on the lowest scoring components of the questionnaire.
Conclusion:  The Acute Care Hospital Foodservice Patient Satisfaction Questionnaire can be used to determine trends in foodservice satisfaction and identify areas to target for quality improvement initiatives.     

经皮肾微造瘘大功率钬激光碎石术与气压弹道碎石术治疗复杂性肾结石的比较

目的比较经皮肾微穿刺造瘘大功率钬激光碎石术与气压弹道碎石术治疗复杂性肾结石的有效性和安全性。方法回顾性分析我院自2005年1月～2007年10月使用大功率(45～60W)钬激光碎石术与气压弹道碎石术治疗复杂性肾结石患者82例92侧的临床资料,比较两种碎石方法的手术时间、结石取净率、术中出血量、并发症发生率等指标。结果钬激光组48侧患肾,气压弹道组44侧患肾,钬激光组平均碎石取石时间67min(43～124min),低于气压弹道组99min(66～142min)。钬激光组I期治疗结石排净率为75%,Ⅱ期治疗后结石总排净率为87.5%;气压弹道组I期治疗结石排净率为63.6%,Ⅱ期治疗后结石总排净率为75%。钬激光组术中出血量63ml(20～210ml),低于气压弹道组术中出血量125ml(40～310ml)。手术并发症发生率钬激光组为8.3%,低于气压弹道组18.1%。结论经皮肾微穿刺造瘘大功率钬激光碎石术治疗复杂性肾结石较气压弹道碎石术碎石时间短、效率高、手术并发症低,是治疗复杂性肾结石的有效方法。     

老年人情绪障碍200例分析

目的探讨老年人情绪障碍的特点及对策。方法对200例老年人的焦虑、抑郁资料进行分析,探讨与躯体疾病、性别、年龄、学历、职业、睡眠等方面的关系。结果老年人焦虑、抑郁在不同教育程度的人群均可发生,学历低者症状较轻,学历高者症状较重。多见于脑卒中、高血压、冠状动脉粥样硬化性心脏病、慢性阻塞性肺病(COPD)、肿瘤、消化性溃疡及睡眠障碍患者。男性多于女性,高龄患者多于低龄患者。以行政管理、科技工作等职业较多见。结论老年人焦虑、抑郁与躯体疾病、年龄、性别、学历、职业、睡眠情况有关,综合医院的医生要注意识别老年人的情绪障碍,及时进行处理。     

体检中心质量管理初探

为加强体检中心的质量管理，通过实行严格准入制度，建立、健全各种岗位责任制，严格执行质量评价和质量反馈制度，加强体检管理信息系统的开发与应用等做法，以确保体检活动的服务对象获得良好的体检服务。     

Attendance at cultural events and physical exercise and health: a randomized controlled study

The aim of this study was to assess the specific biomedico-social effects of participating in cultural events and gentle physical exercise effects apart from the general effect of participating in group activities. This was a randomized controlled investigation using a factorial design, where attending cultural events and taking easy physical exercise were tested simultaneously. The 21 participants, aged between 18 and 74 y were from a simple random sample of people registered as residents in Ume?, a town in northern Sweden. Among the 1000 in the sample, 21 individuals (11 men, 10 women) were recruited into the experiment. Two out of the 21 subjects dropped out and were discounted from our analysis. Nine people were encouraged to engage in cultural activity for a two-month period. Diastolic blood pressure in eight of these nine was significantly reduced following the experiment. There were no marked changes observed in either systolic or diastolic blood pressure in those not required to engage in any form of extra-cultural activity. A decrease in the levels of both adrenocorticotropical hormone (ACTH) and s-prolactin was observed in culturally stimulated subjects, whereas the average baseline s-prolactin level of 7 ng/l for the non-culturally stimulated group was unchanged after the experiment. Physical exercise produced an increase in the high density lipoprotein (HDL) cholesterol level and in the ratio of HDL to LDL (low density lipoprotein). It was concluded that cultural stimulation may have specific effects on health related determinants.     

Vibration-induced multifocal neuropathy in forestry workers: electrophysiological findings in relation to vibration exposure and finger circulation

Objectives: To investigate neural conduction in the upper limbs of symptomatic forestry workers with and without exposure to hand-transmitted vibration. A further aim was to assess the possible relationships between vibration exposure, nerve conduction and finger circulation in the forestry workers who used chain saws. Methods: A detailed neurophysiological investigation was performed on the upper extremities of 20 chain saw workers, 20 forestry operators with heavy manual work but without vibration exposure, and 20 healthy male controls. All subjects were screened to exclude polyneuropathy. Measurements of sensory and motor nerve conduction (velocity and amplitude) were obtained bilaterally from the median, ulnar and radial nerves. To assess peripheral vascular function, the forestry workers underwent a cold test with plethysmographic measurement of finger systolic blood pressure (FSBP). In the chain saw operators, vibration exposure was evaluated according to the International Standard ISO 5349. Indices of daily vibration exposure and lifetime cumulative vibration dose were estimated for each chain saw operator. Results: Sensory nerve conduction in several segments of the median and radial nerves was significantly reduced in the chain saw operators compared with that in the workers doing heavy manual work and the controls. The neurophysiological pattern more frequently observed in the chain saw operators was a multifocal nerve conduction impairment to several neural segments with predominant involvement of sensory rather than motor fibres. Sensory nerve conduction velocities in the hands of the chain saw operators were inversely related to both daily and lifetime cumulative vibration exposures. In the vibration-exposed forestry workers, neither were sensori-motor complaints associated with vascular symptoms (finger whiteness) nor were electrophysiological data related to cold-induced changes in FSBP. Conclusions: Exposure to hand-transmitted vibration, in addition to ergonomic stress factors, can contribute to peripheral nerve disorders occurring in forestry workers who operate chain saws. The findings of this study suggest the existence of an exposure-effect relationship for vibration-induced neuropathy. Different underlying mechanisms are likely to be involved in the pathogenesis of the neurological and vascular components of the hand-arm vibration syndrome. Received: 18 November 1999 / Accepted: 25 April 2000     

Mental health and psychosocial functioning in adolescents with congenital heart disease. A comparison between adolescents born with severe heart defect and atrial septal defect

Twenty-six adolescents, aged 13–18 years, with severe congenital heart disease were matched for sex, age and living area with 26 adolescents with repaired atrial septal defect and regarded as physically fit. These two groups were compared according to somatic condition, psychopathology, psychosocial functioning and chronic family difficulties. A higher rate of psychiatric problems in the complex group, an association between psychosocial functioning and physical capacity, as well as an association between psychosocial functioning and chronic family difficulties were observed. These findings suggest that physical capacity is of crucial importance for mental health and functioning of adolescents with congenital heart disease. The association with chronic family difficulties also suggests that a comprehensive biopsychosocial approach is necessary in the treatment and rehabilitation of these patients.