不同层次护生强化实训状态-特质焦虑的调查分析

目的对不同层次护生实训焦虑状况进行调查,为不同层次护生的心理健康教育提供科学依据。方法状态-特质焦虑量表(STAI-Form Y)对500名实训护生(其中3年专250人,5年专250人)进行问卷调查。结果 3年专护生与5年专护生的状态焦虑和特质焦虑均高于大学生常模,差异有统计学意义(P<0.05)。3年专护生与5年专护生的焦虑程度无显著性差异(P>0.05)。3年专护生、5年专护生的特质焦虑与状态焦虑有显著正相关性,相关系数r3年专=0.73,Pr3年专<0.01,r5年专=0.836,Pr5年专<0.01。结论 5年专护生的特质焦虑高于3年专护生,学历为其主要影响因素;3年专护生的状态焦虑高于5年专护生,就业压力为其主要影响因素。     

海训部队回营后卫生检疫工作的做法和体会

今年夏季,我们组织了大规模的海上练兵,海训期间,环境恶劣,训练条件艰苦,防蚊蝇设施缺乏,给卫生防疫工作带来一定困难。为了防止各种疾病在营区内传播,确保官兵身体健康,我们早计划、早动手,狠抓了部队回营后的卫生检疫工作,具体做法是:     

海洛因戒毒者状态-特质焦虑与人格特征的相关研究

目的：了解海洛因戒毒者的状态一特质焦虑水平及其与人格特征的关系,为海洛因戒断的心理干预提供一定的参考。方法：使用状态一特质焦虑问卷（STAI）以及艾森克人格问卷（EPQ）,对成都某强制隔离戒毒所的60名海洛因戒毒者进行调查。结果：海洛因戒毒者的状态焦虑和特质焦虑都显著高于一般男性人群;海洛因戒毒者的EPQ—E、EPQ—N、EPQ—L与一般男性人群有显著差异。EPQ各维度与状态焦虑和特质焦虑都分别呈正相关和负相关,其中EPQ—N与状态焦虑的相关性显著（r=0．608）,且进入了回归方程,能预测状态焦虑33．0％的变异量;EPQ—N与特质焦虑的相关性显著（r=0．720）,且进入了回归方程,能预测特质焦虑50．1％的变异量。结论：海洛因戒毒者的状态一特质焦虑与人格因素显著相关,其中EPQ—N与特质焦虑的相关性最为显著。     

某部特种兵心理健康与个性、应对、状态-特质焦虑的相关性分析

目的探讨特种兵心理健康与状态-特质焦虑、个性、应对的相关性,为特种兵心理健康教育和心理素质训练提供科学依据。方法随机整群抽取460名某部特种兵,应用一般情况问卷、状态-特质焦虑问卷(STAI)、应对方式问卷、艾森克个性问卷(EPQ)、症状自评量表(SCL-90)实施团体测试。结果特种兵SCL-90总分与中国军人常模无显著性差异,躯体化、强迫、焦虑、敌对、恐怖因子分显著高于中国军人常模(P<0.01或P<0.05);EPQ中EPQ-P、EPQ-N因子分显著低于国内军人常模,EPQ-L因子分显著高于常模(P<0.01);应对方式中解决问题、求助因子分显著高于军人常模(P<0.01),自责、幻想、退避、合理化因子分显著低于军人常模(P<0.01);状态焦虑、特质焦虑分均显著高于国内常模。相关分析显示,SCL-90总均分与EPQ因子分中EPQ-P、EPQ-N及应对方式中不成熟应对方式(自责、幻想、退避)和混合型应对方式(合理化)呈显著正相关(P<0.01);与EPQ因子分中EPQ-E、EPQ-L呈显著负相关(P<0.01)。回归分析显示,对特种兵SCL-90总分有显著性影响的因素由大到小依次为状态焦虑、EPQ-N、合理化、特质焦虑。4个变量的决定系数R2=0.746,对方程检验,F=51.52,P=0.00。结论特种兵总体心理健康状况与国内一般军人相当,心理健康受到个性、应对方式、状态-特质焦虑等中介变量的综合影响,其中保持适度可控的焦虑情绪是维持心理健康的重要因素。     

不同状态焦虑水平对军人自我和谐和认知功能影响的比较研究

目的探讨不同水平状态焦虑对军人自我和谐和认知功能的影响,为缓解焦虑和利用焦虑提供依据。方法参加军事演习的某部军人228名,以测得的STI均值大于均数1个标准差为高状态焦虑(A组),以小于1个标准差为低状态焦虑(B组),1∶1配对各选34人,两组间比较特质焦虑得分有显著性差异(P<0.05)。测得自我和谐量表(SCCS),评定认知作业成绩,A、B组对照比较。结果状态焦虑平均值A组42.06±6.84,B组30.91±6.25,A组和B组间比较P<0.05。SCCS得分中,低自我和谐A组55.8%(19/34),B组17.6%(6/34);两组比较自我经验不和谐、灵活性及刻板性均有统计学差异(P<0.01)。简单认知作业成绩中视觉注意、听觉注意、注意分配A、B组两组之间无统计学意义,复杂认知实验中短时记忆、双手协调、双脚协调、复杂鉴别反应时间A组为4.61±3.47、1.30±0.36、0.95±0.28、14.07±2.86,B组为1.49±1.21、2.48±0.38、2.40±0.82、9.16±1.65、两组之间差别有统计学意义(P<0.01)。结论军事活动中军人高特质焦虑更可能发生高水平状态焦虑,高水平状态焦虑比低水平状态焦虑对自我和谐和复杂认知功能有更大的影响。     

产前焦虑孕妇状态-特质焦虑与个性特征关系的研究

目的了解产检门诊产前焦虑症孕妇状态-特质焦虑与个性的关系,为产前焦虑的防治提供指导。方法采用焦虑自评量表和状态特质焦虑量表,对200例孕15周以上孕妇进行横断面调查和统计分析;并应用艾森克个性问卷对产前焦虑孕妇进行测评。结果 200例孕妇中产前焦虑的报告率为29.5%,焦虑组比非焦虑组的心理焦虑水平高(P <0.05),状态焦虑得分状态焦虑分与EPQ-N成正相关,与EPQ-E之间为负相关的关系;而特质焦虑分别与EPQ-P、N之间显示出正相关的关系,与EPQ-E、L之间显示出负相关的关系负相关(P<0.01)。结论产前焦虑症孕妇焦虑水平高于非焦虑孕妇,其状态-特质焦虑与个性特征有一定关联。     

强制戒毒所内脱毒后的阿片类依赖者的焦虑状况调查

目的:研究阿片类依赖者脱毒后的焦虑状况,探讨影响焦虑的主要危险因素及保护因素,为实施针对性的心理干预提供依据。方法:应用状态-特质焦虑量表及自拟信息问卷对155例强制戒毒所的阿片类依赖者进行调查。结果:阿片类依赖者的状态焦虑和特质焦虑得分均显著高于正常人群(P<0.05);影响阿片类依赖者状态焦虑的主要因素有:进入戒毒所时间(在戒毒所时间长为保护因素)、滥用毒品时间、性别(女性为保护因素)、戒毒次数和每日毒品用量;影响特质焦虑的主要影响因素有:滥用毒品时间、受教育程度和婚姻状况(已婚为保护因素)。结论:阿片类依赖者脱毒后焦虑水平高;进入戒毒所时间、女性和已婚为焦虑的保护性因素。建议针对阿片类依赖者脱毒后焦虑情况实施心理干预     

颅脑损伤后血清皮质醇变化及MRI改变的临床意义

目的对患者在颅脑损伤后的1个月内血清皮质醇的变化及MRI改变进行分析和总结,探讨其临床意义。方法对本院在2012年1月~2012年12月期间收治的238例颅脑损伤患者（设为观察组）的血清皮质醇进行检测,检测时间为患者受伤后的1d、14d、28d。将其与本院60例健康人员（设为对照组）进行对比和分析。对患者的伤情严重程度使用GCS来进行评分,预后采用患者伤后1个月的GOS评分。对患者的皮质醇变化和GCS、GOS之间的关系进行分析和研究。对患者的头颅进行MRI检测,研究下丘脑-垂体在影像学上的改变与皮质醇之间的关系。结果患者在颅脑受伤后的第一天皮质醇要明显高于对照组（正常人群）,差异具有统计学意义（P〈0.05）;在患者受伤后的一个月中,皮质醇异常情况延续的时间越长,患者的预后越差,根据GOS的评分,患者在第1、14d的血清皮质醇要明显高于对照组患者,差异具有统计学意义（P〈0.05）。结论患者在颅脑受伤以后,皮质醇会得到明显的升高,损伤程度越重,升高的幅度越明显;在预后GOS的GOS评分中,预后越差,皮质醇的升高持续时间就会越长。     

长期吸烟者血浆皮质醇及β-内啡肽的变化

目的·· :探讨长期吸烟者在戒烟前后血浆皮质醇和 β-内啡肽水平的变化及形成机制。方法·· :于戒烟前后采集长期吸烟者静脉血 ,用放射免疫方法检测血浆皮质醇及血浆 β-内啡肽的含量。结果·· :长期吸烟者的血浆皮质醇(227.82ng·ml-1±s40.03ng·ml-1)及血浆 β-内啡肽(14.68ng·ml-1±s4.48ng·ml-1)明显高于正常组 ;戒断后长期吸烟组的血浆皮质醇(271.92ng·ml-1±s32.19ng·ml-1)明显升高 ,而血浆 β-内啡肽(8.16ng·ml-1±s4.97ng·ml-1)明显降低。结论·· :血浆皮质醇及 β-内啡肽可作为判断戒烟治疗效果的指标之一 ,而改善内源性阿片肽系统及下丘脑 -垂体 -肾上腺轴的功能可能对戒烟有助。     

血清胃促生长素水平在不同甲状腺功能状态的变化研究郭建平

摘要目的探讨血清胃促生长素水平在不同甲状腺功能状态下的变化。方法选择2011年2月至2013年3月我院收治的46例甲状腺功能亢进症（甲亢）患者和48例甲状腺功能减退症（甲减）患者作为观察对象,分甲亢组和甲减组,选取同期40例健康体检者作为对照组,测定患者治疗前和治疗后空腹血清胃促生长素、胰岛素、血糖、游离三碘甲状腺原氨酸（FT。）,游离甲状腺素（FT。）以及促甲状腺激素（TSH）水平,并记录患者身高、体质量等指标,计算出患者胰岛素抵抗指数（HOMA—IR）、胰岛素分泌指数（HOMA—B）等。结果甲亢组治疗前血清胃促生长素水平明显低于对照组,差异显著（P〈0．05）,而甲减组与对照组血清胃促生长素水平无显著性差异（P〉O．05）;研究显示,胰岛素抵抗指数（HOMA—IR）与胃促生长素水平有密切关系。结论不同甲状腺功能状态下,胃促生长素水平也不相同,胰岛素抵抗（IR）可严重影响机体胃促生长素水平。     

老年高血压患者血压变异性比较

目的:探讨老年高血压患者血压变异性的差别.方法:选择原发性高血压84例,进行动态血压监测(ABPM),血压变异性以24 h ABPM监测到的血压标准差(S)作为长时血压变异(LBPV)的指标.结果:84例老年高血压患者白昼、夜间及24小时的收缩压的变异性均大于舒张压的变异性,两者有统计学意义(P＜0.05).结论:老年高血压患者收缩压的血压变异性大于舒张压的血压变异性.     

社区高血压患者收缩压和脉压差增高与C-反应蛋白的相关性分析

目的探讨社区高血压患者收缩压和脉压差增高与C-反应蛋白之间的相关性。方法选择443例原发性高血压C-反应蛋白升高患者,探讨社区高血压患者收缩压和脉压差增高与C-反应蛋白之间的关系。结果收缩压超过160mmHg、脉压差超过60mmHg、合并糖尿病、合并冠心病及合并高脂血症等为高血压发生的相关危险因素,收缩压超过160mmHg及脉压差超过60mmHg为高血压发生的独立危险因素。结论社区高血压患者收缩压升高和脉压差增大与C-反应蛋白升高存在相关性,炎症反应参与老年高血压收缩压升高和脉压差增大。     

季节对血压、血脂的影响

目的探讨不同季节变化对人体血压、血脂的影响。方法分析我院2008年全年健康体检人员体检资料,按月份分为四个季节,比较其血压、血脂的变化。结果人体血压、总胆固醇﹑高密度脂蛋白胆固醇和低密度脂蛋白胆固醇水平在不同季节成周期性变化。收缩压平均水平在冬季明显高于夏季,相差9.31mmHg;总胆固醇和低密度脂蛋白胆固醇平均水平在冬季明显高于夏季,冬季分别为4.80mmol/L和2.65mmol/L,夏季分别为4.62mmol/L和2.39mmol/L,差值分别为0.18mmol/L(4%)和0.26mmol/L(6%)(P<0.05);高密度脂蛋白胆固醇平均水平则相反,冬季为1.44mmol/L,夏季为1.52mmol/L,差值为0.08mmol/L(5%)(P<0.01)。结论在寒冷的冬季,对血压、血脂轻度增高的诊断应充分考虑季节因素,对患者应加强血压及血脂的监测和适当调整药物的剂量。     

Effect of ascorbic acid supplementation on nitric oxide metabolites and systolic blood pressure in rats exposed to lead

Background:

Extended exposure to low levels of lead causes high blood pressure in human and laboratory animals. The mechanism is not completely recognized, but it is relatively implicated with generation of free radicals, oxidant agents such as ROS, and decrease of available nitric oxide (NO). In this study, we have demonstrated the effect of ascorbic acid as an antioxidant on nitric oxide metabolites and systolic blood pressure in rats exposed to low levels of lead.

Materials and Methods:

The adult male Wistar rats weighing 200-250 g were divided into four groups: control, lead acetate (receiving 100 ppm lead acetate in drinking water), lead acetate plus ascorbic acid (receiving 100 ppm lead acetate and 1 g/l ascorbic acid in drinking water), and ascorbic acid (receiving 1 g/l ascorbic acid in drinking water) groups. The animals were anesthetized with ketamin/xylazine (50 and 7 mg/kg, respectively, ip) and systolic blood pressure was then measured from the tail of the animals by a sphygmomanometer. Nitric oxide levels in serum were measured indirectly by evaluation of its stable metabolites (total nitrite and nitrate (NOχ)).

Results:

After 8 and 12 weeks, systolic blood pressure in the lead acetate group was significantly elevated compared to the control group. Ascorbic acid supplementation could prevent the systolic blood pressure rise in the lead acetate plus ascorbic acid group and there was no significant difference relative to the control group. The serum NOχ levels in lead acetate group significantly decreased in relation to the control group, but this reduction was not significantly different between the lead acetate plus ascorbic acid group and the control group.

Conclusion:

Results of this study suggest that ascorbic acid as an antioxidant prevents the lead induced hypertension. This effect may be mediated by inhibition of NOχ oxidation and thereby increasing availability of NO.     

高尿酸血症与血压、血脂、血糖关系的研究

目的研究健康体检人群高尿酸血症与血压、血脂、血糖的关系。方法采用病例对照方法,以2008年珠海市公务员健康体检中发现高尿酸血症男性患者1129人,女性患者165人为高尿酸组,以性别相同、年龄、职业等因素相近的为对照组,探讨其对血压、血脂、血糖的影响。结果高尿酸血症组收缩压为（132．4±13．1）mmHg、舒张压为（82．1±7．5）mmHg、TG为（2．21±1．43）mmol／L、HDL—C为（1．22±0．31）mmol／L、FPG为（5．92±0．72）mmool／L;对照组收缩压为（128．3±12．8）mmHg、舒张压为（79．5±7．2）mmHg、TG为（1．78±1．38）mmol／L、HDL-C为（1．31±0．33）mmol/L、FPG为（5．80±0．68）mmol／L;两组比较,差异具有极显著性（P〈0.01）。高尿酸组的高血压、血脂异常和空腹血糖升高患病率分别为：28．12％、50．36％、25．04％;对照组的高血压、血脂异常和空腹血糖升高患病率分别为：19．23％、32．86％、16．07％;两组比较,差异具有极显著性（P〈0.01）。结论高尿酸血症与血压、血脂、血糖密切相关,应加强高尿酸血症的健康教育,及早预防。     

A randomized controlled trial of high dose ascorbic acid for reduction of blood pressure, cortisol, and subjective responses to psychological stress

RATIONALE: Physiological responses to stress are considered disruptive to health. High-dose ascorbic acid has reduced indices of stress in laboratory animals. METHODS: We conducted a randomized double-blind, placebo-controlled 14-day trial of sustained-release ascorbic acid (60 healthy young adults; 3 x1000 mg/day Cetebe) and placebo (60 healthy young adults) for reduction of blood pressure, cortisol, and subjective response to acute psychological stress (Trier Social Stress Test, TSST, consisting of public speaking and mental arithmetic). Six subjects from each group were excluded. RESULTS: Compared to the placebo group, the ascorbic acid group had less systolic blood pressure (an increase of 23 versus 31 mmHg), diastolic blood pressure, and subjective stress responses to the TSST; and also had faster salivary cortisol recovery (but not smaller overall cortisol response). Cortisol response to 1 microg ACTH, and reported side-effects during the trial did not differ between groups. Plasma ascorbic acid level at the end of the trial but not pre-trial was associated with reduced stress reactivity of systolic blood pressure, diastolic blood pressure, and subjective stress, and with greater salivary cortisol recovery. CONCLUSIONS: Treatment with high-dose sustained-release ascorbic acid palliates blood pressure, cortisol, and subjective response to acute psychological stress. These effects are not attributable to modification of adrenal responsiveness.     

脑梗死患者急性期血压变化规律及护理

目的探讨脑梗死患者急性期的血压变化规律和护理方法。方法收集未经血压干预的急性期脑梗死患者157例,按其致病因素进行TOAST分型,同时按其病变部位和病灶大小进行OCSP分型;分别观察各分型1周内的血压变化规律,并探讨合理的护理方法。结果首测血压：急性脑梗死入院后,首次测量血压增高者有141例（89.8%）,其中108例（69%）有高血压史,101例（64.3%）有药物治疗史;且有药物治疗史患者的平均收缩压显著高于其他患者（P〈0.05）。总体规律：脑梗死急性期患者入院当天首测血压值为其最高值,之后7d呈逐渐下降趋势,以前24h最为明显,1周内可基本降至正常水平。分型差异：不同的TOAST及OCSP分型患者血压的分布区间不同,以收缩压表现最为明显;其中大动脉粥样硬化型及腔隙性梗死患者收缩压始终处于较高水平,且其均值显著高于其他TOAST分型（P〈0.05）;后循环型梗死患者收缩压始终处于较低水平,且其均值显著低于其他OCSP分型（P〈0.05）。结论脑梗死患者急性期血压呈显著上升趋势,多数患者经密切护理可在发病1周内降至正常水平;其急性期血压值因患者药物史、发病原因、发病部位及病灶范围等差异有所变动;在护理过程中应加强巡视,进行个体化处理。     

Exercise is good for your blood pressure: effects of endurance training and resistance training

1. Although several epidemiological studies have not observed significant independent relationships between physical activity or fitness and blood pressure, others have concluded that blood pressure is lower in individuals who are more fit or active. However, longitudinal intervention studies are more appropriate for assessing the effects of physical activity on blood pressure. 2. Previously, we have performed meta-analyses of randomized controlled trials involving dynamic aerobic endurance training or resistance training. Inclusion criteria were: random allocation to intervention and control; physical training as the sole intervention; inclusion of healthy sedentary normotensive and/or hypertensive adults; intervention duration of at least 4 weeks; availability of systolic and/or diastolic blood pressure; and publication in a peer-reviewed journal up to December 2003. 3. The meta-analysis on endurance training involved 72 trials and 105 study groups. After weighting for the number of trained participants, training induced significant net reductions of resting and day time ambulatory blood pressure of 3.0/2.4 mmHg (P < 0.001) and 3.3/3.5 mmHg (P < 0.01), respectively. The reduction of resting blood pressure was more pronounced in the 30 hypertensive study groups (-6.9/-4.9) than in the others (-1.9/-1.6; P < 0.001 for all). Systemic vascular resistance decreased by 7.1% (P < 0.05), plasma noradrenaline by 29% (P < 0.001) and plasma renin activity by 20% (P < 0.05). Bodyweight decreased by 1.2 kg (P < 0.001), waist circumference by 2.8 cm (P < 0.001), percentage body fat by 1.4% (P < 0.001) and the Homeostatic Model Assessment (HOMA) index of insulin resistance by 0.31 units (P < 0.01). High-density lipoprotein-cholesterol increased by 0.032 mmol/L (P < 0.05). 4. Resistance training has been less well studied. A meta-analysis of nine randomized controlled trials (12 study groups) on mostly dynamic resistance training revealed a weighted net reduction of diastolic blood pressure of 3.5 mmHg (P < 0.01) associated with exercise and a non-significant reduction of systolic blood pressure of 3.2 mmHg (P = 0.10). 5. In conclusion, dynamic aerobic endurance training decreases blood pressure through a reduction of systemic vascular resistance, in which the sympathetic nervous system and the renin-angiotensin system appear to be involved, and favourably affects concomitant cardiovascular risk factors. In addition, the few available data suggest that resistance training is able to reduce blood pressure.     

The effects of topical prazosin on normal and elevated intraocular pressure and blood pressure in rabbits

A 0.1 mg (base) dose of prazosin, a prostaglandin α- (α₁) adrenoreceptor antagonist, in rabbits effected an early decrease in arterial blood pressure, normal intraocular pressure (IOP) and IOP artificially elevated by water loading. The late drugs effects suppressed elevated IOP, but not normal IOP. The IOP effects of prazosin seem largely independent of the effect on blood pressure.