学龄前儿童同伴关系与内化问题的相互预测研究

考察学龄前儿童同伴关系和内化问题之间的相互预测关系,为有效改善儿童青少年心理健康状况提供参考依据.方法 采用整群抽样方法,使用儿童社会性发展量表和儿童行为核对表对山东省菏泽市4所幼儿园220名学龄前儿童进行为期1年的追踪调查,采用交叉滞后分析考察主要变量之间的相互预测关系.结果 随着年级升高,学龄前儿童的同伴关系得分呈上升趋势(F值分别为6.40和4.81,P值均<0.01),而内化问题得分则呈下降趋势(F值分别为7.65和5.46,P值均<0.01);学龄前儿童前测时的同伴关系和内化问题对后测对应行为的预测作用均有统计学意义(β值分别为0.56,0.49,P值均<0.01);前测同伴关系对后测内化问题的预测作用有统计学意义(β=-0.19,P<0.05).结论 同伴关系和内化问题均表现出跨时间的稳定性,早期同伴关系和内化问题均能预测后期的对应行为.早期同伴关系能够预测后期内化问题,而早期内化问题无法预测后期同伴关系.     

电刺激联合生物反馈治疗对改善产后盆底功能的效果观察

目的观察电刺激联合生物反馈治疗对改善产后女性盆底肌肌力及盆底功能的效果,同时探讨其在临床上的应用价值。方法选取2017年11月-2018年10月于山西省某院分娩并复查的女性352例作为研究对象,采用随机数字表法将患者分为训练组(n=235),观察组(n=117)。训练组患者分2个阶段进行电刺激联合生物反馈治疗,每个阶段治疗时间为2周,每周进行2次治疗,治疗次数共8次。观察组患者予以常规康复指导,不予特殊干预,自然恢复。于产后42d、产后6个月时对2组患者进行盆底电生理检测、盆底功能障碍影响简易问卷调查、盆腔器官脱垂/尿失禁性功能问卷调查,观察电刺激联合生物反馈治疗对产后女性早期盆底肌肌力及盆底功能的临床效果。结果产后42d,2组患者I类肌纤维的肌力及疲劳度、Ⅱ类肌纤维的肌力及疲劳度、阴道最大动态压力比较,差异均无统计学意义(P0.05);产后6个月,训练组患者I类肌纤维的肌力及疲劳度、Ⅱ类肌纤维的肌力、阴道最大动态压力明显高于观察组,差异有统计学意义(P0.05);产后6个月,2组患者Ⅱ类肌纤维的疲劳度比较,差异无统计学意义(P0.05)。产后42d,盆底功能障碍影响简易问卷中,2组患者各题选择有影响的人数比例比较,差异无统计学意义(P0.05);产后6个月,盆底功能障碍影响简易问卷中,训练组患者各题选择有影响的人数比例均低于观察组,差异有统计学意义(P0.05)。产后42d,2组患者有性生活人数均较少,盆腔器官脱垂/尿失禁性功能问卷评分比较,差异无统计学意义(P0.05);产后6个月,训练组患者盆腔器官脱垂/尿失禁性功能问卷评分高于观察组,差异有统计学意义(P0.05)。结论产后早期电刺激联合生物反馈训练可改善患者盆底肌肌力及盆底功能障碍,具有良好的临床效果,值得推广应用。     

高通量血液透析和低通量血液透析不同模式对老年维持性血液透析患者血压的影响

目的 观察高通量血液透析(HFHD)与低通量血液透析(LFHD)的不同模式运用到老年患者维持性血液透析(MHD)中对其血压的影响。方法 选择2015年2月—2017年10月本院治疗的MHD老年患者74例,先为其施LFHD 3个月,再为其辅以3个月的HFHD,3次/周,4 h/次,对比不同透析模式对患者血压的影响。结果 实施HFHD后患者的平均动脉压(MAP)有所降低,在第3 h与第4 h透析后,血压把控优于LFHD(P<0.05)。结论 对于MHD老年患者来说,实施HFHD是优良的透析方法。     

卵巢子宫内膜异位囊肿粘连程度及相关因素分析

Objective To investigate the relationship between degree of endometrioma adhesions and clinical feature, surgical treatment and postoperative recurrence. Methods From Jan 2003 to Mar 2008, 662 patients with endometrioma undergoing laparoscopic ovarian endometrioma excision in Peking Union Medical College Hospital were studied retrospectively. All patients were classified into four groups according to the extent of adhesions: 31 cases in none adhesions group, 123 cases in mild adhesions group (filmy thickness, avascular, easily separated adhesions), 310 cases in moderate adhesions group (less than a half of ovary was adjacent to dense thickness adhesions which was difficult to separate, or above a half of ovary were adjacent to filmy thickness adhesions) and 198 cases in severe adhesions group (above a half of ovary was adjacent to dense thickness, well vascularized adhesions which was difficult to separate, and always involved the other pelvic organs, observed angiogenesis). The comparison of degree, characteristics, period of pain, lab test, surgical management and postoperative recurrence was performed among those above groups. In the mean time, risk factors and multinomial logistic regression were analyzed. Results (1)Clinical characteristics: The incidence of patients with dysmenorrhea, dyspareunia, straining feeling in anus, chronic pelvic pain and the level of CA125 (>35 kU/L) was remarkably higher in moderate-to-severe adhesion groups than in none-to-mild adhesions groups (P=0.000, 0.000, 0.001, 0.006 and 0.000, respectively). Infertility rate were significantly higher in severe adhesions group(15.7%,31/198) than none adhesions group(3.2%,1/31), mild adhesions group(11.4%,14/123) and moderate adhesions group(9.7%,30/310, OR=1.728, P<0.05).(2)Operating time and blood loss: Operating time of each groups was as followed: (37±15) min in none adhesions group, (42±19) min in mild adhesions group, (50±20) min in moderate adhesions group and (63±22) min in severe adhesion group. Blood loss was (23±12) ml in none adhesion group, (31±27) ml in mild adhesion group, (40±32) ml in moderate adhesion group and (70±67) ml in severe adhesions group. Thicker adhesions result in longer operation time and more blood loss. (3)Combined with other disease: The ratio of patients who combined with adenomyosis or deeply infiltrating endometriosis in moderate-to-severer adhesion groups was higher than patients in none-to-mild adhesions groups (OR=3.466, P=0.000). (4) Postoperative recurrence: It was categorized into recurrence of pain and cyst. Moderate-to-severe adhesions was related to higher recurrence rate of pain (OR=1.685,P=0.046), but was irrelevant to recurrence of cyst. Conclusion The more extent of endometrioma adhesions was related to severer pelvic pain symptoms, longer operating time and more blood loss. Postoperative pain recurrence rate was observed in moderate-to-severe adhesion group. Extent of adhesions was irrelevant to cyst recurrence.     

高压氧辅助治疗颅骨缺损15例

本文探讨高压氧 (HBO)辅助治疗 15例颅骨缺损病人的临床效果 ,并与对照组 13例进行比较 ,HBO组治疗后病人的神经精神症状明显改善 ,有效率达 85 %左右 ,颅骨修补率高达 93 % ,治疗有效率明显优于对照组 (P <0 0 5 )。     

失代偿期肝硬化与HBV感染状况的调查

通过对79例失代偿期肝硬化患者血清HBV感染指标调查分析后发现:肝硬化者中有HBV感染者占77.2％(61/79),并且以男性居多占63.3％(50/79)。提示:HBV感染是我国肝硬化的主要发病因素;男女性间乙肝后肝硬化的发病率有显著性差异,P<0.05。对59例进行了HBV二对半血清学检测的失代偿期肝硬化者分析后发现:HB_sAg、HB_eAg、抗HB_e都阳性及HB_sAg、抗HB_e、抗H_C都阳性者出现机率最高,与其余组合阳性者间有显著性差异,P<0.025。其意义有待探讨。     

小鼠胰岛分离纯化方法的比较

胰岛移植已成为治疗Ⅰ型糖尿病的一种新型手段,而增加胰岛收获量,提高胰岛纯度一直是胰岛移植中面临的重要问题。足够数量、活性良好的胰岛细胞植入受体后,可逆转糖尿病的高血糖状态,并可防止严重并发症的出现。为了推进临床应用,在动物身上摸索较好的提取     

清肺理气活血利气法治疗肺心病67例

从1980年至1990年以清肺、理气、活血、利水法治疗肺心病67例,在临床上收到满意的效果,现报道如下。一般资料 67例均系住院患者,心功能全部失代偿,其中男56例,女11例,年龄40岁以下1人,40～49岁14人,50～59岁30人,60～69岁11人,70岁以上6人;病程10年以上20人,15年以上15人,20年以上27人,25年以上5人;合并支气管扩张6例,结核5例,轻度肺脑8例,冠心病4例,主要表现:咳嗽、胸闷、咳痰、气短、喘息胸痛、心悸、呼吸困难、紫绀、浮肿等。诊断与治疗标准:本组67例肺心病,病     

贲门粘膜撕裂综合征21例临床分析

贲门粘膜撕裂综合征２１例临床分析李晓燕，段丽萍，张磊，蒋海燕，贾友兰贲门粘膜撕裂综合征又称Ｍａｌｌｏｒｙ－Ｗｅｉｓｓ综合征，是引起上消化道出血的原因之一。近年来由于急诊内镜的开展，有更多的病例被发现。本文就１９８４年－１９９４年我院经内镜检查证实的２...