子宫切除术对性生活质量的影响及其干预

目的 :了解子宫切除时宫颈去留对术后性生活质量的影响 ,并观察健康教育干预对提高患者术后性生活质量的作用。方法 :将因子宫良性病变而行子宫切除的病人分为全切组和次切组 ,每组再随机分为干预组和非干预组 ,分别进行术后性生活质量评分比较。结果 :1 在未经心理干预的子宫切除病人中次切组性生活质量评分高于全切组 (P <0 0 5 ) ;2 干预组术后性生活质量评分高于非干预组 (P <0 0 5 )。结论 :子宫切除时保留宫颈及手术前后的健康教育干预有利于患者术后性生活质量的改善     

原发性肺癌患者的血液流变学研究

观察了原发性肺癌患者血液流变学的变化,采用血液比粘度计检测正常组(42例),肺癌组(58例),慢性阻塞性肺病(COPD)组(76例)患者的血沉降率、血球压积、全血比粘度、血浆比粘度及全血还原比粘度。结果:1 COPD组血球压积、低及中切变率时全血比粘度较正常组、肺癌组显著升高(P<0.05).2 肺癌组血沉降率较正常组、COPD组显著升高(P<0.05).3 肺癌组的血球压积、低及中切变率时的全血比粘度较正常组无显著性差异(P>0.05).4 3组高切变率时全血比粘度、全血还原比粘度与血浆比粘度无显著性差异(P>0.05).5正常组与COPD组血沉降率无显著性差异(P>0.05)。结论:肺癌患者血沉降率增高提示其红细胞聚集力增强,而其血粘度无明显改变,可能与红细胞压积无明显改变有关。COPD患者血球压积、血粘度明显增高,可能与长期缺氧有关。     

The 49 K subunit of NADH: ubiquinone reductase (complex I) from Neurospora crassa mitochondria: primary structure of the gene and the protein

Summary The primary structure of the 49 K subunit of the respiratory chain NADH:ubiquinone reductase (complex I) from Neurospora crassa was determined by sequencing cDNA, genomic DNA and the N-terminus of the mature protein. The sequence lengths correlate to a molecular mass of 54002 daltons for the preprotein and 49239 daltons for the mature protein. The presequence consists of 42 amino acids of typical composition for sequences which target nuclear-encoded proteins into mitochondria. The mature protein consists of 436 amino acids and shows 64% similarity to a 49 K subunit of bovine heart NADH:ubiquinone reductase and 33% to a predicted translation product of an open reading frame in the chloroplast DNAs of Marchantia polymorpha and Nicotiana tabacum. Evidence for an iron-sulfur cluster in the subunit is discussed.     

Personal relationships with an intelligent interactive telephone health behavior advisor system: a multimethod study using surveys and ethnographic interviews

The burgeoning of consumer health informatics and virtual health care can help people improve their health. However, little is known about individuals' reactions to such systems. We conducted an evaluation of the telephone-linked care (TLC) system, a computer-based telecommunications system, that functions as an at home monitor, educator, and counselor for patients with chronic health conditions. Our multimethod assessment of individuals' reactions to using TLC included both quantitative and qualitative methods. Ethnographic in-depth open-ended interviews indicated more subtle and surprising reactions to TLC than the overall positive responses from surveys: individuals formed personal relationships with this technology. This relationship formation suggests that TLC designers may have been successful in their attempts to emulate a conversation with a human being. Our study adds to evidence that technology can serve as a projective device for peoples' values and psychological issues. Both designers and users project values and goals onto computer-based technologies and take on different identities through it. Different groups of users, therefore, may see the same technology differently. People also form relationships with technologies, as they did with TLC. These findings, as well as implications for system design and health outcomes, need to be explored in additional studies.     

The New Millennium Palliative Care Project (2000-2003): the impact of specialised GP advisors.

This study describes a novel type of support for GPs caring for patients dying at home: the establishment and evaluation of a telephone advisory service for GPs, run by GPs with a special interest in palliative care (GPwSIs) in the Netherlands 2000-2003. A growing number of GPs called for advice, 10% during out of hours. Prognosis of the patients was generally short (days to weeks in 70% of cases). Most advice sought by GPs concerned symptom management and on evaluation, 85% of the GPs followed the advice.     

大学生寻求专业心理帮助态度测量工具的初步研究

目的在综合有关研究文献的观点，以开放问卷调查为基础上，编制适合中国大学生寻求专业心理帮助量表，为研究大学生心理求助提供测评工具。方法从大学生心理求助行为实际出发，对大学生进行开放式问卷调查，随机抽取有代表性的福建省的大学生样本．对问卷作因素分析和效度与信度分析。结果提出信任、需求、容忍度和开放度共4个维度构成大学生寻求专业心理帮助态度的结构和成分；编制的“大学生寻求专业心理帮助态度量表”总量表信度系数为0．8392。结论大学生寻求专业心理帮助态度量表具有良好的信度和效度，可在实际中应用。     

Co‐occurring medical conditions in adults with Down syndrome: A systematic review toward the development of health care guidelines. Part II

Adults with Down syndrome (DS) represent a unique population who are in need of clinical guidelines to address their medical care. Many of these conditions are of public health importance with the potential to develop screening recommendations to improve clinical care for this population. Our workgroup previously identified and prioritized co‐occurring medical conditions in adults with DS. In this study, we again performed detailed literature searches on an additional six medical conditions of clinical importance. A series of key questions (KQ) were formulated a priori to guide the literature search strategy. Our KQs focused on disease prevalence, severity, risk‐factors, methodologies for screening/evaluation, impact on morbidity, and potential costs/benefits. The available evidence was extracted, evaluated and graded on quality. The number of participants and the design of clinical studies varied by condition and were often inadequate for answering most of the KQ. Based upon our review, we provide a summary of the findings on hip dysplasia, menopause, acquired cardiac valve disease, type 2 diabetes mellitus, hematologic disorders, and dysphagia. Minimal evidence demonstrates significant gaps in our clinical knowledge that compromises clinical decision‐making and management of these medically complex individuals. The creation of evidence‐based clinical guidance for this population will not be possible until these gaps are addressed.     

Enhancing a primary care environment: a case study of effects on patients and staff in a single general practice

BACKGROUND: Few studies have examined the effect on patients and staff of the physical environment in primary care facilities. AIM: To explore changes in patient and staff satisfaction, patient anxiety, and patient-doctor communication when a GP surgery moves from old premises to enhanced purpose-built accommodation. DESIGN OF STUDY: Questionnaire surveys, interviews, and focus groups pre- and post move. SETTING: An urban general practice in Bristol. METHOD: Patient questionnaires assessed anxiety (Spielberger State-Trait Anxiety Inventory; STAI), satisfaction with the environment, and communication during the consultation. Staff questionnaires assessed satisfaction with the environment and job satisfaction. Qualitative methods explored patient and staff views in more depth. RESULTS: A total of 1118 pre-move and 954 post-move patient questionnaires showed significant increases in satisfaction scores for reception/waiting areas (mean 6.46, 95% confidence interval [CI]=5.97 to 6.95) and consulting rooms (mean 3.80, 95% CI=3.44 to 4.15) in the new premises. Patients' satisfaction with patient-doctor communication also increased (mean 0.88, 95% CI=0.30 to 1.46) and anxiety scores were significantly reduced before and after the consultation in the new premises compared with the old (STAI mean difference before consultation 0.72, 95% CI=0.37 to 1.08; mean after consultation 0.37, 95% CI=0.03 to 0.72). Patients highlighted the increased space and light, more modern appearance, greater comfort, and novel works of art in the new surgery. Staff workplace satisfaction increased significantly after moving and remained higher than in the old building. CONCLUSION: This large-scale study examining the effects of a UK primary care environment on patients and staff shows that an enhanced environment is associated with improvements in patients' perception of patient-doctor communication, reduction in anxiety, and increases in patient and staff satisfaction.     

精神科青年护士心理健康状况调查

目的探讨精神科青年护士的心理健康状况。方法采用症状自评量袁对67名精神科青年护士进行调查并与中国青年常模对比分析。结果精神科青年护士的焦虑、抑郁、强迫、人际关系敏感因子分均显著高于中国青年常摸，阳性因子分≥2的捡出率最高为焦虑症状，≥3捡出率最高为强迫症状。结论精神科部分青年护士存在不同程度的心理问题，需采取相应的心理干预措施。     

边远驻军官兵身心健康状况及相关因素的调查

目的：调查边远驻军官兵的身心健康状况及其影响因素。方法：以边远驻军官兵为被采用症状自评量素（SCL－90），孤独量表（非大学生版）及自编的一般情况问卷进行测评。结果：250人中有72人（29．2％）存在不同程度的身心健康问题，其中人际敏感，躯体化和强迫症状等是边远驻军官兵主要问题，与部队常模及军校大学生比较，边远驻军官兵的身心健康水平相对较差；其身心健康问题与孤独感，对环境的不适应，睡眠问题及自慰行为存在着显著的线性关系。结论：总体上边远驻军兵的身心健康水平相对较差，存在身心症状的人数较多，其中孤独感，对环境的不适应，睡眠问题及自慰行为等是主要的影响因素。