西宁地区不同妊娠期女性甲状腺功能参考范围的建立及比较

目的 建立西宁地区妊娠女性甲状腺特异性血清检测指标的正常参考值范围.方法 选取西宁地区905名妊娠女性,按孕周分为孕早期(T1期)、孕中期(T2期)、孕晚期(T3期),采用回顾性横断面调查方法,以中位数及95％ 可信区间统计方法建立妊娠各期特异性血清促甲状腺激素(T S H)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)正常参考值范围,并进行相关性分析.结果 西宁地区血清TSH 95％CI为T1期2.08(0.01～4.97)mIU/L、T2期2.30(0.45～4.97)mIU/L、T3期2.35(0.46～4.98)mIU/L.血清FT395％CI为T1期4.57(3.63～5.70)pmol/L,T2期4.43(3.56～5.71)pmol/L,T3期4.31(3.55～5.52)pmol/L.血清FT495％CI为T1期10.65(6.87～12.90)pmol/L,T2期10.31(6.97～12.95)pmol/L,T3期10.22(6.98～12.88)pmol/L.T1期血清TSH与FT3呈负相关.结论 该参考范围与美国甲状腺协会(ATA)推荐参考值范围相比,更适用于青海省妊娠期妇女甲状腺功能监测.     

重庆市抗击新型冠状病毒肺炎一线护士专业生活品质现状调查及影响因素分析

目的 探讨重庆市抗击新型冠状病毒肺炎临床一线护士专业生活品质现状及其影响因素,为突发公共卫生事件时保障护士身心健康提供建议.方法 采用方便抽样法,运用一般情况调查表、护士专业生活品质量表、心理资本量表、组织支持感量表、简易应对方式量表、工作投入量表对重庆市抗击新型冠状病毒肺炎疫情的619名临床一线护士进行横断面调查.结果 619名抗击新型冠状病毒肺炎一线护士专业生活品质量表各维度原始得分为:慈心满意(35.83±7.20)分,工作倦怠(24.54±5.53)分,二次创伤(26.67±6.88)分.年龄、医院等级、定点救治医院、心理资本、组织支持感、应对方式及工作投入是新型冠状病毒肺炎时期一线护士专业生活品质的影响因素(P<0.05).结论 抗击新型冠状病毒肺炎一线护士专业生活品质处于中度水平,应从心理资本、应对技能、医院提供更好的情感及信息支持等方面制订策略来提升突发公共卫生事件一线护理人员的专业生活品质.     

SPECT应用质量评价指标的遴选

目的遴选出一套衡量单光子发射计算机断层扫描(Single-Photon Emission Computed Tomography,SPECT)应用质量的评价指标,为临床评估SPECT应用状态提供参考依据。方法通过德尔菲法咨询45位专家,遴选SPECT应用质量评价指标,采用模糊综合评判法确定各指标权重。结果设备性能、临床管理和组织管理3项为SPECT应用质量评价一级指标,能峰位置、放射性药物管理、规章制度制定等17项为SPECT应用质量评价二级指标。一级指标中设备性能权重最高为0.3522,二级指标权重最高为0.0691,权重最低为0.0487。设备性能二级指标检测频次范围为每周至每半年。结论SPECT固有性能指标是评价其应用质量的核心指标,规范的技术操作和性能检测是SPECT应用质量的保障,健全的管理制度是SPECT应用质量的基础。     

Association between Baseline SBP/DBP and All-Cause Mortality in Residents of Shanxi,China: A Population-based Cohort Study from 2002 to 2015

Objective To investigate the association between blood pressure and all-cause mortality in Shanxi,China.Methods The‘2002 China Nutrition and Health Survey’baseline data in Shanxi province was used.A retrospective investigation was performed in 2015.The effects of SBP and DBP on the all-cause mortality were analyzed using the Cox regression model.The hazard ratio(HR)and 95%confidence interval(CI)were estimated by the sex and age groups.Results The follow-up rate was 76.52%over 13 years,while the cumulative mortality rate for all participants was 917.12/100,000 person-years.The mortality rose with an increasing SBP(χ_trend²=270.537,P<0.001)or DBP level(χ_trend²=57.240,P<0.001).After adjustment for the confounding factors,a significant association between mortality and high SBP(≥160 mm Hg)and high DBP(≥100 mm Hg),with adjusted HR ranging from 1.405-to 2.179-fold for SBP and 1.550-to 2.854-fold for DBP,was noted.Significant HRs for most DBP subgroups were found in>60-year-old participants.Males with DBP≥100 mm Hg had a significantly higher mortality,with an HR(95%CI)of 2.715(1.377–5.351).Conclusion Adults with SBP>160 mm Hg and DBP>100 mm Hg had a higher mortality risk.Sex and age difference was noted in both DBP and mortality risk.     

Effects of Outdoor Temperature on Blood Pressure in a Prospective Cohort of Northwest China

Objective The relationship between outdoor temperature and blood pressure(BP) has been inconclusive. We analyzed data from a prospective cohort study in northwestern China to investigate the effect of outdoor temperature on BP and effect modification by season.Methods A total of 32,710 individuals who participated in both the baseline survey and the first follow-up in 2011–2015 were included in the study. A linear mixed-effect model and generalized additive mixed model(GAMM) were applied to estimate the association between outdoor temperature and BP after adjusting for confounding variables.Results The mean differences in systolic blood pressure(SBP) and diastolic blood pressure(DBP)between summer and winter were 3.5 mm Hg and 2.75 mm Hg, respectively. After adjusting for individual characteristics, meteorological factors and air pollutants, a significant increase in SBP and DBP was observed for lag 06 day and lag 04 day, a 0.28 mm Hg(95% CI: 0.27–0.30) per 1 °C decrease in average temperature for SBP and a 0.16 mm Hg(95% CI: 0.15–0.17) per 1 °C decrease in average temperature for DBP, respectively. The effects of the average temperature on both SBP and DBP were stronger in summer than in other seasons. The effects of the average temperature on BP were also greater if individuals were older, male, overweight or obese, a smoker or drinker, or had cardiovascular diseases(CVDs), hypertension, and diabetes.Conclusions This study demonstrated a significant negative association between outdoor temperature and BP in a high-altitude environment of northwest China. Moreover, BP showed a significant seasonal variation. The association between BP and temperature differed by season and individuals' demographic characteristics(age, gender, BMI), unhealthy behaviors(smoking and alcohol consumption), and chronic disease status(CVDs, hypertension, and diabetes).     

强化式心理干预联合技巧性语言沟通对康复期精神分裂症患者认知、沟通及生活质量的影响

目的:探讨强化式心理护理联合技巧性语言沟通对康复期精神分裂症(SP)患者认知、沟通及生活质量的影响.方法:根据不同护理方式将90例SP患者分为干预组(n=48)和常规组(n=42);常规组给予常规护理干预,干预组在其基础上给予强化式心理护理配合技巧性语言沟通,两组均干预3个月.干预前、干预3个月后,采用MATRICS共识认知成套测验(MCCB)、SP患者生命质量量表(SQLS)、沟通与互动技巧量表(ACIS)、焦虑/抑郁自评量表(SAS/SDS)分别评估患者认知功能、生活质量、沟通与互动技巧、心理状况.结果:干预后,两组患者的认知功能指标评分高于干预前(P<0.05),且除注意警觉、推理与问题解决能力外,其他认知功能指标组间比较,差异具有统计学意义(P<0.05);与干预前相比,两组干预后ACIS评分均升高,且干预组高于常规组(P<0.05);两组干预后SAS、SDS和SQLS评分均降低,且干预组低于常规组(P<0.05).结论:强化式心理联合技巧性语言沟通可较好地促进康复期SP患者的认知功能、沟通能力,提高其生活质量,并减轻负面心理.     

感觉输入训练在产后压力性尿失禁患者中的作用研究

目的探讨感觉输入训练在产后压力性尿失禁患者中的临床疗效。方法选取2018年1月至2019年5月本院收治的产后压力性尿失禁患者40例作为研究对象,随机分为两组,每组20例。对照组予以经阴道生物电刺激治疗及家庭Kegel训练,观察组在对照组基础上进行15 min的感觉输入训练。比较两组盆底肌肉表面肌电值和治疗前后尿失禁生活质量问卷评分。结果治疗前,两组盆底肌肉表面肌电值比较差异无统计学意义;治疗后,两组快速收缩阶段肌电值比较差异有统计学意义(P<0.05),前静息、紧张性收缩阶段、耐力收缩阶段及后静息比较差异无统计学意义;治疗前后,观察组快速收缩阶段、紧张性收缩阶段、耐力收缩阶段值比较差异有统计学意义(P<0.05);治疗前后,对照组快速收缩阶段、紧张性收缩阶段、耐力收缩阶段值比较差异有统计学意义(P<0.05)。结论感觉输入训练配合经阴道生物电刺激治疗能提高产后压力性尿失禁患者的快速收缩阶段的盆底肌肌电值,即提高Ⅱ类肌纤维的肌力,值得临床推广应用。     

Demirjian法在乌鲁木齐市维吾尔族未成年人年龄推断中的应用

目的:研究Demirjian法推断乌鲁木齐市3~16岁维吾尔族儿童、青少年实际年龄的适用性。方法:收集乌鲁木齐市新疆医科大学第一附属医院口腔中心符合纳入标准的年龄在3~16周岁的维吾尔族儿童、青少年口腔曲面断层片362例(男195例,女167例),按照Demirjian法记录牙齿发育指数及牙龄,并对实际年龄与Demirjian法推断的牙龄进行配对t检验,将牙齿成熟指数和年龄进行曲线拟合,初步建立两者间的数学模型。结果:直接应用用Demirjian法进行年龄评估时,其推断的年龄与实际生活年龄之间的差异有统计学意义(P0.05),牙齿成熟指数(Y)与实际年龄(X)的相关回归方程如下:Y(男)=-61.119+20.965X-0.686X2,Y(女)=-74.475+25.214X-0.901X2。结论:Demirjian法不能用于测定乌鲁木齐市3~16岁年龄段维吾尔族儿童、青少年的年龄,使用时需进行适当的修正。     

推拿按揉法加背俞穴埋线治疗变应性鼻炎临床研究

目的:探讨推拿按揉法加背俞穴埋线治疗变应性鼻炎的临床效果。方法:选取2017年6月~2019年5月收治的变应性鼻炎患者88例,随机分为对照组和观察组各44例,均给予服用枸地氯雷他定,观察组在此基础上给予推拿按揉法加双侧背俞穴埋线治疗,比较两组临床疗效、治疗前后鼻部症状和体征积分,IgE、TNF-α、IL-4、IL-12水平及临床复发率。结果:观察组总有效率为93.18%,高于对照组的79.55%(P<0.05);观察组鼻部症状体征积分改善程度优于对照组(P<0.05);观察组IgE、TNF-α、IL-4、IL-12水平改善程度优于对照组(P<0.05);观察组复发率为4.70%,低于对照组的41.19%(P<0.05)。结论:推拿按揉法加背俞穴埋线治疗变应性鼻炎可显著减轻临床症状和体征,改善患者炎性因子水平,并有助于降低复发率。