护理干预对老年神经衰弱患者失眠的影响

目的研究护理干预对老年神经衰弱患者睡眠状况及生活质量的影响。方法选择2015-01—2016-12收治的136例老年神经衰弱导致失眠的患者,随机分为对照组和观察组,对照组采用常规护理,观察组在常规护理基础上给予护理干预,观察组及对照组均为小组干预指导,每次3~5名患者,每次≥1h,每周干预时间为2次,持续时间为3个月。比较2组患者护理干预后无睡眠障碍率,采取匹兹堡睡眠质量指数PSQI评分,结果 2组患者的年龄、性别、病程、有无睡眠障碍,差异均无统计学意义(P0.05)。观察组无睡眠障碍率,PSQI评分高于对照组,差异具有统计学意义(P0.05)。结论实施护理干预可以有效改善老年神经衰弱患者的睡眠状况,提高其生活质量,值得临床推广应用。     

聚焦解决模式对脑出血患者心理适应及睡眠质量的影响

目的探讨聚焦解决模式对脑出血患者心理适应及睡眠质量的影响。方法选择我院于2014年1月～2016年6月收治的70例脑出血患者。采用随机数字表法将患者分为观察组及对照组,各35例。对照组患者接受延续护理,观察组患者采取聚焦解决模式进行延续护理。观察两组患者的、自我护理能力、心理状况评价、心理社会适应情况评价、睡眠质量以及生活质量。结果护理干预后,两组自我护理能力各项目评分均较护理前明显提高,心理状况评分均较护理前明显降,且观察组改善更显著,差异均有统计学意义(P0.05)。两组患者护理干预后的匹兹堡睡眠质量指数(PSQI)评分均较护理前明显降低,且观察组降低更显著,差异有统计学意义(t=7.366,P0.05)。结论聚焦解决模式可改善脑出血患者的焦虑、抑郁情绪,改善睡眠质量,提高患者的心理适应能力、社会适应能力,值得临床推广应用。     

心理护理对围绝经期综合征患者不良情绪及睡眠的作用

目的探讨心理护理对围绝经期综合征患者不良情绪及睡眠的作用。方法 2013年12月至2015年2月在我院妇科病房选取围绝经期综合征的住院患者76例,并按随机数字表法平均分为两组:对照组和观察组。护理方面,对照组患者给予常规护理干预1月;观察组在此基础上增加心理护理干预1月。护理干预前、后对患者评估SAS、SDS及生存质量量表,并用睡眠监测仪监测患者睡眠情况。结果两组患者在护理干预前SAS、SDS、WHOQOL-100及睡眠情况无明显差异(P0.05)。实施护理干预1月后,与护理干预前相比两组患者SAS、SDS评分均降低,WHOQOL-100评分均升高,睡眠状况得到改善,且差异具有统计学意义(P0.05)。护理干预后观察组SAS、SDS评分均低于对照组,24h内睡眠时间、睡眠维持率均高于对照组,觉醒时间、觉醒次数均低于于对照组,WHOQOL-100评分高于对照组,且上述差异均有统计学意义(P0.05)。结论在常规护理的基础上,增加心理护理可以更有效地改善围绝经期综合征患者的抑郁、焦虑和睡眠情况,更好的提高患者的生存质量,因此值得临床护理工作中推广应用。     

心理护理联合营养支持疗法对胃癌患者围手术期生活质量及人格状况的影响

目的探讨心理护理联合营养支持护理对胃癌患者围手术期人格状况及生活质量的影响。方法病例来源于我院2012年3月~2015年2月收治确诊的114例进行手术的胃癌患者,所纳入病例按照随机数字表法分成观察组与对照组,两组各为57例。对照组给予常规性护理,观察组则在常规护理的前提下进行心理干预护理和营养支持疗法,比较两组患者干预前后的抑郁自评量表(SDS)评分、PSQI睡眠质量评分等。结果观察组干预后SDS评分、焦虑自评量表(SAS)评分、PSQI评分、艾森克人格问卷(EPQ)评分与生活质量量表(SF-36)评分均明显优于对照组,比较差异存在统计学意义(P0.05)。结论心理干预护理联合营养支持疗法能够显著改善患者睡眠质量和人格状况,有效促进患者康复,提高其生活质量,具有重要的临床应用价值。     

团体心理护理对脑梗死手术患者负性情绪的影响

目的探讨团体心理护理干预对脑梗死手术患者负性情绪的影响。方法选择2011-01—2013-06在我院神经外科诊断为脑梗死并行手术治疗的患者81例,按照住院号奇偶数分为对照组和观察组,2组患者均给予常规护理,观察组给予团体心理护理干预,比较2组入院初及2周后负性情绪状况及生活质量。结果 2组患者入院初的SAS和SDS评分及生活质量各项评分比较差异无统计学意义(P>0.05),2周后对照组患者的评分高于观察组,差异有统计学意义(P<0.05);2周后观察组生活质量各项评分均优于对照组,差异有统计学意义(P<0.05)。结论团体心理护理干预措施能明显的缓解脑梗死手术患者的焦虑抑郁情绪,并可提高患者的生活质量。     

心理护理对骨科患者焦虑抑郁情绪以及生活质量的疗效

目的研究心理护理对于骨科患者焦虑抑郁情绪以及生活质量的临床效果。方法选取我院从2014年9月至2015年8月收治的100例骨科患者,将100例骨科患者随机分为观察组(50例)和对照组(50例);对照组护理方式为常规护理,观察组在此基础上采取心理护理干预,将两组患者的护理干预前后的汉密尔顿焦虑量表(HAMA)评分与汉密尔顿抑郁量表(HAMD)评分和SF-36健康调查量表评分以及护理干预后的并发症发生率。结果两组患者在护理干预前,HAMA,HAMD和SF-36评分,组间无明显差异(P0.05)。护理干预后两组HAMA评分与HAMD评分均降低,SF-36评分均升高,且观察组HAMA评分与HAMD评分低于对照组(P0.05);观察组的生活质量明显优于对照组,两组比较差异具有统计学意义(P0.05)。在并发症发生率方面,两组比较差异无统计学意义(P0.05)。结论骨科患者予以心理护理可及时疏导患者的焦虑抑郁情绪,提高患者的生活质量,对于改善疾病的预后具有重要的临床意义。     

心理恢复疗法在老年肠梗阻护理干预中的应用效果

目的探究心理恢复疗法对老年肠梗阻患者的临床效果。方法选取2014年2月~2016年4月我院收治的79例老年肠梗阻患者作为研究对象,采取双盲法分两组,对照组39例,采取常规治疗加常规护理;观察组40例,在对照组基础上采用心理恢复疗法,比较两组症状自评量表(SCL-90)、生活质量综合评定(GQOL-74)评分及护理满意度情况。结果与干预前比较,两组护理干预后的患者SCL-90中部分因子评分改善明显,差异显著(P0.05);干预后观察组患者SCL-90部分因子评分、GQOL-74评分均优于对照组,差异具有统计学意义(P0.05);观察组护理满意度为97.5%,对照组护理满意度为82.05%,两组差异显著,存在统计学意义(P0.05)。结论采取心理恢复疗法,可有助于改善老年肠梗阻患者的精神心理状态,并且有助于提升患者的生活质量和护理满意度。     

感恩心理护理干预对气管切开患者的疗效

目的探讨感恩心理护理干预在气管切开患者的应用方法与效果。方法选择2013年2月至2016年1月进行气管切开的呼吸衰竭患者120例,随机分为观察组与对照组,每组各60例。对照组予以常规护理干预,观察组在常规护理的基础上给予感恩心理护理干预,两组护理观察时间为4周。比较两组患者的护理感恩情况、呼吸道感染发生率及认知情况。结果护理干预前两组的护理感恩评分及认知活动各项评分,组间比较差异无统计学意义(P0.05)。观察组与对照组在护理干预后的感恩问卷评分均明显高于干预前的评分,差异有统计学意义(P0.05);且观察组护理干预后的感恩评分明显高于对照组(P0.05)。观察组气管切开呼吸道感染发生率(3.3%)显著低于对照组(16.7%)(P0.05)。护理干预后,两组患者的躯体功能、睡眠、饮食、精神与认知活动评分明显高于护理前,差异有统计学意义(P0.05);且观察组的躯体功能、睡眠、饮食、精神与认知活动评分明显高于对照组(P0.05)。结论感恩心理护理干预能更好地提高气管切开患者的感恩水平,有助于减少呼吸道感染的发生率,提高患者的生活质量。     

综合护理干预对急性脑梗死患者神经功能及生活质量的影响

目的分析综合护理干预对急性脑梗死患者神经功能及生活质量的影响。方法选取我院2014-04—2015-09间收治的60例急性脑梗死患者。将所有患者随机分为2组,均30例,对照组采用常规护理,观察组在常规护理基础上实行综合护理干预,比较2组护理效果。结果观察组生活质量评分显著高于对照组,差异有统计学意义(P0.05);观察组神经功能评分明显高于对照组,差异有统计学意义(P0.05);观察组护理满意度为93.33%,明显高于对照组的76.67%,差异有统计学意义(P0.05)。结论综合护理干预可有效改善急性脑梗死患者神经功能及生活质量,值得应用。     

心理干预对首发精神分裂症患者的作用

目的:探讨心理干预对首发精神分裂症患者生活质量和社会功能的影响. 方法:120例首发精神分裂症患者随机分为观察组和对照组各60例.两组均给予阿立哌唑治疗,观察组在此基础上给予心理干预,观察8周,并随访6个月.采用阳性与阴性症状量表(PANSS)、世界卫生组织生活质量量表(WHOQOL-100)及社会功能缺陷筛选量表(SDSS)分别于入组时及随访结束时进行评估. 结果:入组时PANSS、WHOQOL-100及SDSS评分两组间比较差异均无统计学意义(P均>0.05);随访结束时,观察组PANSS总分、阴性症状、阳性症状和SDSS评分均显著低于对照组(P均<0.01);而WHOQOL-100中生活质量总评、独立性领域、社会关系领域评分均高于对照组(P<0.05或P<0.01). 结论:心理干预有助于缓解首发精神分裂症患者的精神症状,提高生活质量及社会功能.     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

腺垂体功能减退症临床特征变化分析

目的探讨腺垂体功能减退症患者的病因结构变化及临床表现。方法回顾性分析我院2013-01—2016-12住院及门诊78例腺垂体功能减退症患者的临床资料。结果男32例(41.03%),女46例(58.97%);诊断时年龄11~89岁,平均62.5岁;鞍区占位(包括术前及术后)52例(66.67%),席汉综合征8例(10.26%),空泡蝶鞍9例(11.65%),病因不明8例(10.26%),垂体-下丘脑发育不良1例(1.28%)。首次就诊科室:纳差厌食、恶心呕吐就诊于消化内科36例(46.15%)最常见。ACTH+TSH+Gn+G激素缺乏为19例最多,占24.36%,ACTH+TSH+Gn缺乏15例,占19.23%。结论腺垂体功能减退症病因结构发生变化,发病人群、首发症状及受累激素也不同,患者女性多于男性,发病年龄偏高,症状不典型,分布于临床多个科室,其中以低钠血症为首发临床表现就诊消化内科最多。     

Standards of instrumentation of EMG

Standardization of Electromyography (EMG) instrumentation is of particular importance to ensure high quality recordings. This consensus report on “Standards of Instrumentation of EMG” is an update and extension of the earlier IFCN Guidelines published in 1999. First, a panel of experts in different fields from different geographical distributions was invited to submit a section on their particular interest and expertise. Then, the merged document was circulated for comments and edits until a consensus emerged.The first sections in this document cover technical aspects such as instrumentation, EMG hardware and software including amplifiers and filters, digital signal analysis and instrumentation settings. Other sections cover the topics such as temporary storage, trigger and delay line, averaging, electrode types, stimulation techniques for optimal and standardised EMG examinations, and the artefacts electromyographers may face and safety rules they should follow. Finally, storage of data and databases, report generators and external communication are summarized.     

Release of endogenous catecholamines from slices of hypothalamus of rats

The release of endogenous catecholamines from superfused slices of rat hypothalamus was studied under basal conditions and during release evoked by 40 mM K⁺. Catecholamines in superfusates, and in extracts of the tissue after stimulation, were isolated by column chromatography and quantitated by liquid chromatography with electrochemical detection. Norepinephrine (NE) was not consistently demonstrable in superfusate collected under basal conditions, but 40 mM K⁺ caused the release of from 2 to 4 ng/g of tissue per min. The addition of cocaine to the superfusate caused increases in basal and evoked release of NE. Epinephrine (E) could be measured in superfusates of slices from male but not female rats and then only when cocaine was added to the superfusate. Accordingly, the concentration of E in hypothalamus was greater in male rats than in female rats. Dopamine (DA) was not consistently measurable in the spontaneous overflow from slices either in the presence or absence of cocaine. K⁺-evoked release of DA could be demonstrated in slices from female rats. The addition of cocaine increased the evoked release of DA from slices from both sexes. Corticosterone, added to cocaine, had no effects on the efflux of any of the catecholamines. The experiments suggest that neuronal reuptake of all catecholamines is very efficient in the hypothalamus both under basal conditions and during evoked release.     

帕金森病运动症状进展分析

目的分析帕金森病(PD)患者运动症状进展特点。方法采用PD统一评分量表(UPDRS)Ⅲ对912例PD患者进行评估。结果与病程1年的患者比较,除病程1~2年的患者外,其他病程患者的UPDRSⅢ评分、强直分、姿势或步态异常分、轴性症状总分、言语分、步态分显著升高(均P0.05),病程5~6年及14年患者的震颤分,病程5~6年、7~8年、9~13年、14年患者的运动迟缓分、姿势分显著升高(P0.05~0.01)。轴性症状进展速度高于UPDRSⅢ评分。结论 PD患者病程早期UPDRSⅢ评分进展快,震颤症状进展独立于其他症状,轴性症状评分较UPDRSⅢ更敏感地反映疾病加重趋势。     

Effects of prevention of afferentation of the development of the chick optic lobe

BONDY, S. C., M. E. HARRINGTON AND C. L. ANDERSON. Effects of prevention of afferentation on the developmentof the chick optic lobe. BRAIN RES. BULL. 3(5) 411–413, 1978.—The effects of unilateral extirpation of the right optic cup of the three-day incubated chick embryo upon the rate of synthesis and the stability of DNA in the non-innervated optic lobe, have been studied. This surgical procedure prevents innervation of the optic lobe contralateral to the removed eye, while the other optic lobe is normally innervated by retinal ganglion cells of the remaining eye. At the 20th day of incubation, the DNA content of the non-innervated lobe was below that of the paired lobe receiving normal innervation. This deficiency of cell number was caused by two events; death of an excess number of neurons formed early in embryogenesis and a reduced rate of glial proliferation in the later stages of incubation.     

Frequency of accumulation of filaments in adaxonal cytoplasm of Schwann cells of myelinated fibers of rat spinal roots

Summary The frequency of accumulation of 6-nm filaments in the adaxonal cytoplasm of Schwann cells in the 6th lumbar dorsal and ventral roots was evaluated in 4-, 8-, 26- and 45-week-old Sprague-Dawley rats. The frequency was higher in 4- and 8-week-old (growing) rats than in 26- and 45-week old (mature) rats, and also higher in ventral than in dorsal roots in 4-, 8- and 26-week old rats. There were no clusters on certain groups of myelinated fibers according to the size of transverse axonal area, in both the ventral and dorsal roots. Therefore, this accumulation may reflect certain functions of the adaxonal cytoplasm of Schwann cell during natural growth and maturation of the axon and myelin sheath.     

《绵阳市社会心理服务工作管理办法》解读

2018年,国家卫生健康委员会等10部委联合发布《关于印发全国社会心理服务体系建设试点工作方案的通知》,四川省绵阳市被列为全国第一批试点地区。绵阳市人民政府依据《中华人民共和国精神卫生法》等相关法律法规和文件精神,结合前期调查研究和社会心理服务工作的试点实际,编制出台了《绵阳市社会心理服务工作管理办法》,并于2021年12月25日起施行。本文围绕社会心理服务的相关概念、办法总则、重点内容、保障措施等方面进行解读,以期为社会心理服务工作的规范、持续和有效开展提供参考。     

Function of circle of Willis

Nearly 400 years ago, Thomas Willis described the arterial ring at the base of the brain (the circle of Willis, CW) and recognized it as a compensatory system in the case of arterial occlusion. This theory is still accepted. We present several arguments that via negativa should discard the compensatory theory. (1) Current theory is anthropocentric; it ignores other species and their analog structures. (2) Arterial pathologies are diseases of old age, appearing after gene propagation. (3) According to the current theory, evolution has foresight. (4) Its commonness among animals indicates that it is probably a convergent evolutionary structure. (5) It was observed that communicating arteries are too small for effective blood flow, and (6) missing or hypoplastic in the majority of the population. We infer that CW, under physiologic conditions, serves as a passive pressure dissipating system; without considerable blood flow, pressure is transferred from the high to low pressure end, the latter being another arterial component of CW. Pressure gradient exists because pulse wave and blood flow arrive into the skull through different cerebral arteries asynchronously, due to arterial tree asymmetry. Therefore, CW and its communicating arteries protect cerebral artery and blood–brain barrier from hemodynamic stress.     

阿立哌唑对精神分裂症患者生活质量的影响

目的:比较阿立哌唑与利培酮对精神分裂症患者生活质量的影响。方法:60例精神分裂患者随机平分为两组各30例,分别给予阿立哌唑和利培酮治疗。疗程8周。用生活质量综合评定问卷-74(GQOLI-74)、阳性与阴性症状量表(PANSS)及副反应量表(TESS)评定疗效及不良反应。结果:阿立哌唑与利培酮均能显著提高精神分裂症患者生活质量,但阿立哌唑在改善GQOLI-74总分、躯体健康及社会功能维度优于利培酮。结论:阿立哌唑治疗有利于提高精神分裂症患者生活质量。