慢性阻塞性肺疾病患者肺康复知识和行为的相关性研究

目的:探讨COPD患者肺康复知识和行为的相关性。方法:采用便利抽样法,应用自行设计的肺康复知识、行为问卷对广州市105例COPD患者进行调查。结果:COPD患者肺康复知识总分为(15.32±3.86)分,总体得分指标为63.83%。COPD患者肺康复行为总分为(43.01±7.01)分,总体得分指标为63.25%。肺康复知识和行为总分及各维度之间呈正相关(r=0.274~0.883,P0.05)。结论:COPD患者肺康复知识与肺康复行为具有显著的相关性,患者的肺康复知识水平越高,其肺康复行为也越好,医护人员应寻求有效的干预策略提高COPD患者的肺康复知识,从而提高其肺康复行为,改善其生存质量。     

骨质疏松性椎体压缩性骨折患者疾病知识和健康行为的现状及其相关性研究

目的：了解骨质疏松性椎体压缩性骨折患者骨质疏松知识和健康行为水平的现状，并分析两者之间的相关性。方法：采用便利抽样法选取2021年1-6月衡阳市某4家三级医院收治的300例骨质疏松性椎体压缩性骨折患者作为研究对象。采用骨质疏松知识问卷(OKT)及骨质疏松健康行为量表进行调查，并探讨两者之间的关系。结果：OKT总分平均(8.38±4.57)分；健康行为总分平均(52.93±7.52)分，两者总分均未达标；Pearson相关性分析显示，骨质疏松(OP)知识与健康行为总分呈正相关(r=0.678,P<0.01)。结论：骨质疏松性椎体压缩性骨折患者疾病知识及健康行为水平均较低，医务人员可通过提高患者的疾病知识水平来提高其健康行为，降低骨折再发率。     

成年哮喘患者自理行为及其相关因素的研究

目的了解成年哮喘患者的自理行为及其相关因素。方法采用5分制成人哮喘自理行为问卷对83例成年哮喘患者进行问卷调查。结果被调查的83例哮喘患者整体自理行为得分为(71.7±6.7)分,生理性、心理性及社会性自理行为得分分别为(77.2±7.7)分、(65.8±9.4)分和(70.1±8.9)分。年龄≥60岁、患有其他疾病的患者与年龄<60岁、未患有其他疾病的患者生理性自理行为得分间差异有显著性意义(P<0.05)。参加过哮喘课程学习的患者与未参加学习的患者社会性自理行为得分间差异有显著性意义(P<0.01)。结论哮喘患者总体自理行为较好,生理性自理行为最佳,心理性和社会性自理行为有待加强。医护人员在指导哮喘患者自我照顾的同时,应在心理和社会方面为患者提供更多的指导和帮助,进而提高患者的整体自理行为。     

缺血性脑卒中患者健康行为与健康心理控制源的相关性研究

目的 探讨缺血性脑卒中患者健康心理控制源与健康行为的关系,为提高患者健康行为水平提供新思路.方法 采用便利抽样法,用多维度健康心理控制源量表C表、健康促进生活方式量表Ⅱ对广州市某三甲医院117例缺血性脑卒中患者进行问卷调查.结果 缺血性脑卒中患者健康权威人士(医生)控制均分最高为(4.96±0.87)分,健康机遇控制均分最低为(2.93±1.03)分,健康行为平均得分为(2.25±0.30)分.健康内部控制、健康权威人士(医生)控制与健康行为总分呈正相关(r=0.536、0.235,P＜0.01),健康机遇控制与健康行为总分呈负相关(r=-0.286,P＜0.01),健康权威人士(其他人)控制与健康行为的营养和人际关系维度呈正相关(r=0.186、0.209,P＜0.05).结论 缺血性脑卒中患者健康行为水平较低,倾向于健康权威人士控制,其健康行为与健康心理控制源具有相关性.     

以目标管理法为基础的健康宣教对 2型糖尿病患者自我感受负担与自我管理行为的影响

目的:探究基于目标管理法的健康宣教对2型糖尿病患者自我感受负担以及自我管理行为的影响效果.方法:选取2017年5月—2018年5月于郑州人民医院接受治疗的168例2型糖尿病患者为研究对象,按照随机数表法将所有患者平均分为两组,观察组和对照组各84例患者.对照组采取常规健康宣教,观察组采取以目标管理法为基础的健康宣教,两组患者均干预3个月.使用自我感受负担量表与自我管理行为量表对两组患者自我感受负担以及自我管理行为进行测评;使用焦虑自评量表(SAS)、抑郁自评量表(SDS)测评两组患者焦虑和抑郁情况;使用2型糖尿病患者自我护理量表对两组患者自我护理行为进行测评.结果:观察组患者自我管理行为总分(76.34±4.76)分,对照组患者自我管理行为总分(67.28±4.08)分,且观察组患者伙伴关系、执行自我管理、问题解决以及情绪处理四个分项得分均高于对照组患者(P<0.05).观察组患者自我感受负担总分(10.23±4.48)分,对照组患者自我感受负担总分(19.87±6.61)分,且观察组患者经济负担、情感负担以及身体负担三个分项得分均低于对照组(P<0.05).干预前两组患者SAS与SDS水平比较差异无统计学意义(P>0.05),干预后观察组患者SAS得分(32.54±7.81)分、SDS得分(37.20±6.89)分,对照组患者SAS得分(41.12±6.34)分、SDS得分(43.57±8.29)分(P<0.05).结论:以目标管理法为基础的健康宣教能够提高2型糖尿病患者自我管理行为水平,降低自我感受负担以及焦虑抑郁发生率,对于提高患者生存质量具有积极意义.     

中青年初发2型糖尿病患者希望水平与自我管理的相关性研究

目的:探讨中青年初发2型糖尿病患者希望水平与自我管理行为的相关性。方法:采用便利抽样的方法运用Herth希望量表(Herth hope index,HHI)、2型糖尿病自我管理行为量表(2-CSC)对91例中青年初发2型糖尿病患者进行问卷调查。了解患者希望水平与我管理行为两者的相关性。结果:中青年初发2型糖尿病患者希望水平总分为(30.58±5.77)分,处于中等水平。自我管理行为总分为(82.29±15.003)分,得分指标为61.8%,整体处于中等偏下水平,希望水平总分与自我管理行为总分呈正相关(r=0.919,P<0.000)。结论:医务人员与家人给予患者积极的心理暗示并能指导患者自己采取良好的心理暗示,提高希望水平,促进自我管理行为健康发展。     

北京某高校医学院师生营养知信行水平及其影响因素

目的:了解北京某高校医学院在校师生膳食营养知识、态度及行为情况并探究其影响因素,为改善师生营养观念、开展学校营养教育工作提供依据。方法:以北京某高校医学院在职教师,一、二年级硕士研究生,一、二年级博士研究生和一至三年级本科生为研究对象,采用等比例分层整群抽样的方法抽取师生样本,以电子问卷方式进行调查。组间均数比较采用t检验或方差分析,采用多元线性回归分析营养知识、态度及行为(knowledge, attitude and practice,KAP)评分影响因素。结果:北京某高校医学院师生营养知识平均得分为(5.7±1.5)分;营养知识知晓率为57.3%。营养态度平均得分为(8.3±3.0)分;营养行为平均得分为(5.1±2.0)分。总体营养KAP平均得分为(19.1±4.6)分。其中教师得分(19.9±5.2)高于学生得分(18.9±4.5),女性得分(19.5±4.5)高于男性得分(18.4±4.5),差异均有统计学意义(P<0.05);博士研究生的营养态度、营养行为得分及KAP总分均高于本科生及硕士研究生(P<0.01)。结论:北京某高校医学院在校师生营养态度较为端正,营养知识有待进一步加强,在营养行为上尚有一些不合理之处。性别、身份、学位是影响营养知信行得分的主要影响因素。学校应积极开展营养教育宣传,提高师生营养知识,纠正不良饮食习惯,助力健康中国行动建设。     

北京某高校医学院师生营养知信行水平及其影响因素

目的:了解北京某高校医学院在校师生膳食营养知识、态度及行为情况并探究其影响因素,为改善师生营养观念、开展学校营养教育工作提供依据。方法:以北京某高校医学院在职教师,一、二年级硕士研究生,一、二年级博士研究生和一至三年级本科生为研究对象,采用等比例分层整群抽样的方法抽取师生样本,以电子问卷方式进行调查。组间均数比较采用t检验或方差分析,采用多元线性回归分析营养知识、态度及行为(knowledge, attitude and practice,KAP)评分影响因素。结果:北京某高校医学院师生营养知识平均得分为(5.7±1.5)分;营养知识知晓率为57.3%。营养态度平均得分为(8.3±3.0)分;营养行为平均得分为(5.1±2.0)分。总体营养KAP平均得分为(19.1±4.6)分。其中教师得分(19.9±5.2)高于学生得分(18.9±4.5),女性得分(19.5±4.5)高于男性得分(18.4±4.5),差异均有统计学意义(P<0.05);博士研究生的营养态度、营养行为得分及KAP总分均高于本科生及硕士研究生(P<0.01)。结论:北京某高校医学院在校师生营养态度较为端正,营养知识有待进一步加强,在营养行为上尚有一些不合理之处。性别、身份、学位是影响营养知信行得分的主要影响因素。学校应积极开展营养教育宣传,提高师生营养知识,纠正不良饮食习惯,助力健康中国行动建设。     

心脏起搏器植入患者健康管理知信行现状及影响因素分析

目的 了解心脏起搏器植入患者健康管理相关知识、信念、行为情况及其影响因素.方法 采用自行设计的调查问卷对2018年3月-2019年2月就诊于北京两所三甲医院起搏器门诊的122例患者进行调查.结果 心脏起搏器植入患者健康管理知识总分为(65.7±17.3)分,信念总分为(29.3±4.4)分,行为总分为(18.3±2.9)分.影响知识情况的因素有年龄、是否接受随访;影响信念和行为执行情况的因素为起搏器安装时长.结论 起搏器植入患者的健康管理信念水平较高,知识水平和行为依从性有待提高.护理人员可根据患者特点,采取视频、图片等宣教载体,降低起搏器相关健康知识难度,帮助患者建立正确的信念,从而促使其形成健康行为.     

心脏起搏器植入患者健康管理知信行现状及影响因素分析

目的 了解心脏起搏器植入患者健康管理相关知识、信念、行为情况及其影响因素.方法 采用自行设计的调查问卷对2018年3月-2019年2月就诊于北京两所三甲医院起搏器门诊的122例患者进行调查.结果 心脏起搏器植入患者健康管理知识总分为(65.7±17.3)分,信念总分为(29.3±4.4)分,行为总分为(18.3±2.9)分.影响知识情况的因素有年龄、是否接受随访;影响信念和行为执行情况的因素为起搏器安装时长.结论 起搏器植入患者的健康管理信念水平较高,知识水平和行为依从性有待提高.护理人员可根据患者特点,采取视频、图片等宣教载体,降低起搏器相关健康知识难度,帮助患者建立正确的信念,从而促使其形成健康行为.     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.