带教医护人员疲劳和职业倦怠的相关分析

目的了解我院带教医护人员疲劳和职业倦怠的现状及其相关性。方法采用自制的一般情况调查表、疲劳量表-14和教师职业倦怠量表对我院共250名带教医护人员进行横断面调查,有效问卷237份。结果①疲劳总平均得分为(6.95±3.13)分,各维度平均得分分别为:躯体疲劳(4.51±2.30)分和脑力疲劳(2.57±1.52)分。周平均工作时间为(61.86±17.00)h。脑力疲劳得分性别间差异有统计学意义(t=1.996,P=0.047);躯体疲劳得分在职称间差异有统计学意义(F=3.700,P=0.026)。②TBI表总平均得分为(29.98±9.56)分;情绪衰竭得分和去个性化得分性别间差别有统计学意义(t=2.08,P=0.039;t=2.04,P=0.043);情绪衰竭得分和去个性化得分职称间差异有统计学意义(F=5.74,P=0.004;F=5.70,P=0.004)。③疲劳量表各项得分与教师职业倦怠量表情绪衰竭、少成就感、人格解体呈正相关。结论我院带教医护人员存在不同程度的躯体疲劳、脑力疲劳和职业倦怠(心理疲劳),防治工作应关注男性、高职称的带教医护人员。     

慢性疲劳综合征患者的心理健康状况与疲劳程度的相关性研究

目的探讨慢性疲劳综合征患者的心理健康状况及其与疲劳程度的关系。方法采用症状自评量表(SCL-90)及疲劳量表-14(FS-14)对110例慢性疲劳综合征患者(观察组)及80例健康志愿者(对照组)进行调查。结果两组受试者SCL-90总分及躯体化、强迫、抑郁、焦虑、偏执、精神病性因子评分间差别有统计学意义(P<0.01);FS-14疲劳总分及躯体疲劳评分间差别亦有统计学意义(P<0.01)。慢性疲劳综合征患者SCL-90的躯体化及抑郁2个因子评分与疲劳总分均呈正相关(P<0.05)。结论慢性疲劳综合征患者以躯体疲劳为主,并普遍存在着一定的心理问题。患者疲劳程度越重,躯体化及抑郁症状越明显。     

乳腺癌患者知觉压力与心理健康的关系：应对方式和疲劳的链式中介作用

目的:分析乳腺癌患者知觉压力、疲劳、应对方式与心理健康的关系。方法:选取2021年6～12月安徽省某三甲医院496例乳腺癌患者为研究对象,采用知觉压力量表、中文版疲劳量表、简易应对方式问卷和沃里克-爱丁堡心理健康量表进行问卷调查。结果:乳腺癌患者知觉压力总分(39.13±6.83)分,疲劳量表总分(39.60±7.19)分,积极应对分量表总分(29.87±4.67)分,消极应对分量表总分(10.97±4.42)分,心理健康总分(51.59±8.39)分;积极应对方式与疲劳和压力各维度得分呈负相关(P<0.05),与心理健康呈正相关(P<0.05),消极应对方式与疲劳及压力各维度得分呈正相关(P<0.05),与心理健康呈负相关(P<0.05);脑力疲劳和积极应对在知觉压力和心理健康间的链式中介作用显著(P<0.05),其总效应为-0.747,总间接效应为-0.287,占总效应的38.4%。结论:提高乳腺癌患者积极应对水平可有效降低脑力疲劳带来的负面影响,改善其心理健康水平。     

长航舰员心理健康状况及影响因素分析

目的 研究长航条件下舰员的心理健康状况及其影响因素.方法 采用随机抽样法调查长航官兵172名.在长航前1周用艾森克人格量表(EPQ)、症状自评量表(SCL-90)对舰员进行心理健康状况评估;在长航4个月后,使用SCL-90、疲劳量表-14(FS-14)、阿森斯失眠量表(AIS)等对舰员进行心理测量与调查.通过前后两次SCL-90量表的总分及各因子得分间的差异检验,并将两次测量结果与军人常模比较,确定长航对舰员心理健康是否有影响.通过SCL-90总分及各因子(第2次测量)与AIS、FS-14、EPQ的相关关系研究舰员心理健康与睡眠、疲劳、人格特质的关系.以SCL-90为因变量,通过多元线性回归分析探究在长航条件下影响舰员心理健康的主要因素.结果 长航4个月后,舰员心理健康水平远低于航行前,两次SCL-90测量间的得分差异具有统计学意义(P＜0.01).人格特质、睡眠、疲劳与舰员心理健康状况具有中等程度相关关系(r＞0.4,P＜0.01).多元线性回归分析显示神经质、晕船程度、睡眠总分、疲劳总分、工作压力、精神质、舰艇适应性是SCL-90总分的影响因素.结论 海上长时间航行对舰员心理健康有不良影响,晕船程度、人格特质、工作压力、睡眠、疲劳、舰艇适应性等是影响舰员心理健康的主要因素.     

外训应急后勤部队军人心理健康与心理素质的相关研究

目的 探讨外训应急后勤部队军人心理健康及其与心理素质的关系.方法 采用症状自评量表(symptom checklist 90,SCL-90)、军人心理素质量表(mental quality questionnaire for armymen,MQQA),对外训部队的230名军人进行测评,分析其心理健康特点及其与心理素质的关系.结果 ①外训军人心理问题检出率为21.3％;其中男性(22.8％)显著高于女性(15.2％)(x2=8.64,P=0.00).外训军人SCL-90得分,躯体化[(1.46±0.63)分]、敌对[(1.49±0.75)分]和精神病性[(1.43±0.68)分]显著高于军人常模(P＜0.05);其中男军人躯体化[(1.49±0.66)分]、精神病性[(1.46±0.72)分]因子分显著高于男军人常模(P＜0.05);女军人差异无统计学意义(P＞0.05).②外训军人SCL-90各因子得分与心理素质各因子得分呈显著负相关(P＜0.05,P＜0.01).③不同心理素质组间比较SCL-90得分,强迫、人际关系敏感、抑郁、敌对性、偏执存在显著差异(P＜0.05).结论 外训应急后勤部队军人心理健康状况较差,心理健康与心理素质密切相关,应加强外训应急后勤部队军人的心理健康教育与训练.     

下岗职工的人格、应对方式与心理健康的关系

目的研究下岗职工应对方式、人格特征与心理健康水平的相互关系.方法对某国有企业中的175名下岗职工采用简易应对量表(SCSQ)、大五人格问卷(NEO-FFI)和症状自评量表(SCL-90)进行调查.结果下岗职工的SCL-90总分及躯体化、强迫、抑郁、焦虑、敌对、恐怖、精神病性得分分别为142.46±49.32,1.75±0.69,1.76±0.70,1.66±0.66,1.54±0.62,1.61±0.64,1.32±0.55,1.38±0.50,显著高于常模,SCL-90总分及躯体化、抑郁、焦虑、敌对的得分高于同一企业的在职职工.多元逐步回归分析表明,神经质、开放性、外倾性、积极应对和消极应对分别被选入了回归模型.结论下岗职工的心理健康水平较低,大五人格中的神经质、开放性以及消极应对方式对其心理健康影响作用较大.     

慢性疲劳综合征气虚证患者疲劳与心理健康状况的关系

目的 探讨慢性疲劳综合征(CFS)气虚证患者疲劳与心理健康状况的关系.方法 收集75例慢性疲劳综合征患者,其中气虚证25例,非气虚证50例.应用疲劳评定量表(FAI)和症状自评量表(SCL-90),对患者疲劳和心理状态进行分析.结果 CFS气虚证患者FAI因子1、因子3的得分分别为(4.29±0.94)分、(5.41±1.03)分,显著高于非气虚证患者(P ＜0.05);CFS气虚证患者在强迫症状、人际关系、抑郁、敌对、偏执和精神病性方面的得分分别为(1.68±0.75)分、(1.76±0.66)分、(1.68±0.75)分、(1.64±0.70)分、(1.60±0.71)分、(1.52±0.51)分,显著高于非气虚证患者(P ＜0.05或0.01);CFS气虚证患者的FAI因子3与心理状态中的躯体化、强迫症状、抑郁和焦虑显著相关(r =0.412～0.511).结论 疲劳对CFS气虚证患者的躯体感受和心理状态同时发生消极影响,而且两者之间密切相关.     

夫妻心理健康、婚姻质量及其关系研究

目的 探讨夫妻心理健康与婚姻质量的关系.方法 采用婚姻主观感受量表(MPS)和症状自评量表(SCL-90)对来自全国28个省、自治区和直辖市的384对夫妻进行测评.结果 (1)丈夫MPS夫妻冲突再子得分[(10.85±5.02)分],低于妻子得分[(11.66±5.63)分],差异有显著性(P＜0.05);(2)丈夫SCL-90的躯体化、人际关系敏感、抑郁、焦虑、恐怖5因子分[分别为(1.44±0.50)分,(1.57 ±0.54)分,(1.50±0.52)分,(1.46±0.54)分,(1.38±0.55)分]低于妻子得分[分别为(1.52±0.54)分,(1.66±0.58)分,(1.59±0.59)分,(1.55±0.58)分,(1.47±0.59)分],差异有显著性(P＜0.05);(3)个体的MPS各指标与自己的以及配偶的SCL-90各因子及总分之间都有显著相关(r=-0.372～0.239,P＜0.01).结论 夫妻对婚姻生活质量的感受相似;丈夫的心理健康好于妻子;个体的婚姻生活感受不仅与自身的心理健康关系密切,且与配偶的心理健康关系密切.     

慢性腰椎间盘突出症患者应对方式特点及心理健康状况调查

目的 了解慢性腰椎间盘突出症患者的应对方式及其与心理健康的关系,为提高患者心理健康及临床综合治疗提供科学依据.方法 对106例慢性腰椎间盘突出症患者采用简易方式应对量表(SCSQ)和症状自评量表(SCL-90)进行调查,并与全国常模作比较.结果 患者积极应对方式得分为1.51±0.58,消极应对方式得分为1.13±0.58.患者SCL-90各因子分与全国常模进行比较.躯体化、强迫、抑郁、焦虑和恐怖症状的因子分显著高于全国常模.将患者消极应对与SCL-90强迫、人际敏感、抑郁、焦虑、敌对性、恐怖、偏执及精神病性因子呈显著相关(P<0.01).结论 加强慢性腰椎间盘突出症患者的应对方式教育,可提高慢性腰椎间盘突出症患者的心理健康水平.     

医务人员心理资本、社会支持与心理健康的关系

目的 探讨医务人员心理资本、社会支持与心理健康的关系.方法 依据方便取样的原则,采用心理资本量表(PCQ-24)、社会支持评定量表(SSRS)及症状自评量表(SCL-90),对河北省某三甲医院101名医务人员进行调查.结果 ①心理资本的自我效能、希望、韧性及乐观得分分别为[(3.73±0.58)分,(3.59±0.60)分,(3.81±0.49)分,(3.70±0.32)分],均在中点以上,各维度之间差异具有显著性(＜0.05).医生自我效能得分高于护士[分别为(3.92±0.66)分,(3.59±0.48)分],差异具有显著性(P＜0.05).不同受教育程度医务人员自我效能有统计学差异(F=2.53,P＜0.05).②心理资本与SCL-90各因子呈负相关(P＜0.01或P＜0.05),社会支持与SCL-90部分因子呈负相关(P＜0.05).③心理资本能显著负向预测SCL-90因子.结论 心理资本与医务人员心理健康密切相关,而社会支持对心理健康无明显影响.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.