治疗性沟通系统护理在急性脑卒中患者中的应用

目的:研究治疗性沟通系统对急性脑卒中患者焦虑抑郁情绪和治疗依从性的干预效果。方法:选取急性脑卒中患者150例,按照随机数字表法分为观察组和对照组各75例,对照组给予常规护理,观察组在此基础上给予治疗性沟通系统护理,应用焦虑自评量表(SAS)评价患者的焦虑情况,应用抑郁自评量表(SDS)评价患者抑郁情况,并比较两组治疗依从性。结果:治疗前两组SAS评分和SDS评分比较无统计学意义(P0.05),治疗后两组SAS评分和SDS评分均显著降低,且观察组低于对照组,比较差异具有统计学意义(P0.05);观察组治疗依从性高于对照组(P0.05)。结论:治疗性沟通系统应用于急性脑卒中护理效果显著,能显著改善患者焦虑和抑郁情况,提高治疗依从性。     

认知干预对老年脑血管疾病患者情绪及治疗依从性的影响

目的：探讨认知干预对老年脑血管疾病患者情绪及治疗依从性的影响。方法将122例老年脑血管疾病患者根据抽签结果随机分为两组,每组61例。两组均予以常规治疗护理及康复训练,观察组在此基础上联合认知干预,观察1个月。于干预前后采用焦虑自评量表和抑郁自评量表评定焦虑抑郁情绪,干预后根据患者的遵医行为评定治疗依从性。结果干预前两组焦虑自评量表和抑郁自评量表评分比较差异无显著性（P＞0．05）;干预后两组均较干预前显著降低（P＜0．01）,观察组显著低于对照组（P＜0．01）。干预后观察组治疗依从率为86．9％,对照组为65．6％,观察组显著高于对照组（ P＜0．01）。结论认知干预能显著改善老年脑血管疾病患者的焦虑抑郁情绪及治疗依从性。     

心理干预对康复期脑卒中伴焦虑抑郁障碍患者情绪及幸福感的影响

目的：探讨心理干预对康复期脑卒中伴焦虑抑郁障碍患者情绪及幸福感的影响。方法将120例康复期脑卒中伴抑郁焦虑障碍患者随机分为两组,每组60例。两组均予以神经内科常规治疗及训练,研究组联合心理干预,观察12个月。于干预前后采用焦虑自评量表、抑郁自评量表评定焦虑抑郁情绪,症状自评量表评定心理健康状况,总体幸福感指数量表评定幸福感, Barthel指数量表评定日常生活活动能力;干预12个月评估两组患者的治疗依从性。结果干预前两组各量表评分比较差异无显著性（ P＞0．05）;干预12个月两组焦虑自评量表、抑郁自评量表及症状自评量表评分较干预前显著降低（P＜0．01）,研究组显著低于对照组（P＜0．01）;干预后各时间点两组Barthel指数量表评分和研究组总体幸福感指数量表评分较干预前显著升高（P＜0．01）,研究组显著高于对照组（P＜0．01）。干预后研究组依从率为96．7％,对照组为81．7％,研究组显著高于对照组（ P＜0．01）。结论心理干预能有效缓解或消除脑卒中患者的焦虑抑郁情绪,提高其心理健康水平、总体幸福感及日常生活活动能力,有利于疾病的预后。     

情志护理干预调节老年脑梗死患者负性情绪和提高治疗依从性的临床分析

目的：探讨情志护理干预对调节老年脑梗死患者负性情绪和提高治疗依从性的效果。方法选取我院收治的149例老年脑梗死患者为研究对象,采用随机分层法分为对照组74例,采取常规护理,观察组75例,在对照组基础上加入情志护理干预,比较两组护理干预前后抑郁自评量表（ SDS）评分、焦虑自评量表（ SAS）评分、治疗依从性以及神经功能缺损（ NIHSS）评分。结果观察组患者经过精心、细致的情志护理干预后,SDS、SAS评分明显低于对照组,差异有统计学意义（ P＜0．05）;治疗依从性明显高于对照组,差异有统计学意义（P＜0．05）;神经功能缺损（NIHSS）评分降低程度明显优于对照组,差异有统计学意义（P＜0．05）。结论情志护理干预可以减弱或者是消除老年脑梗死患者的不良心理反应,有助于情绪调节,提高患者的治疗依从性,促进患者的康复。     

心理护理干预对冠心病患者负性情绪的影响

目的探讨心理护理干预对冠心病患者负性情绪的影响。方法采用症状自评量表（SCL-90）、焦虑自评量表（SAS）、抑郁自评量表（SDS）对170例冠心病患者进行调查,并将其随机分为干预组及对照组,干预组在进行常规治疗的同时给予心理干预,比较两组疗效。结果1．在SCL-90调查中显示冠心病患者躯体化、抑郁、焦虑等负性情绪均高于常模（P〈0．05）;2．经过心理护理干预后,干预组SCL-90各因子分明显下降,其中躯体化、抑郁、焦虑等具有统计学意义（P〈0．05）,SAS、SDS评分也显著低于对照组（P〈0．05）。结论冠心病患者可伴有多种心理障碍,有效的心理护理干预能显著降低其负性情绪,改善患者症状。     

护理干预对糖尿病患者负性情绪的影响

目的 探讨护理干预对糖尿病患者负性情绪的影响。方法 将78例糖尿病患者随机分为干预组40例和对照组38例。对照组患者给予常规治疗及护理，干预组患者在此治疗的同时给予心理干预、认知重建、社会支持和多元化教育。分别于干预前及干预后4周用焦虑自评量表（SAS）和抑郁自评量表（SDS）对2组患者进行评定。结果干预前2组患者焦虑、抑郁评分差异无显著性（P＞0．05），4周后干预组患者焦虑、抑郁评分显著低于对照组（P＜0．05）。结论 护理干预有助于改善糖尿病患者的负性情绪，提高患者的生活质量。     

脑卒中抑郁及相关因素分析

目的 了解脑卒中抑郁与焦虑情绪、认知功能的关系及预后情况。方法 对144例脑卒中患者进行抑郁自评量表（SDS）、焦虑自评量表（SAS）和老年认知功能量表（SECF）评定。SDS≥50分者为抑郁组,SDS＜50分者为非抑郁组。结果 抑郁发生率是40．27％,有自杀意念者占总数的17．36％。抑郁组认知功能低于非抑郁组,焦虑情绪高于非抑郁组,有非常高度性差异（P＜0．001）。2个月后复查,抑郁组抑郁、焦虑情绪显著降低（P＜0．001）,非抑郁组焦虑情绪亦明显降低（P＜0．01）。两组认知功能改善不明显。结论 脑卒中后抑郁与患者焦虑情绪、认知功能密切相关。住院2个月后抑郁组患者抑郁、焦虑情绪均改善,非抑郁组患者焦虑情绪亦降低,但认知功能改善较慢,2个月内变化不大。     

心理护理改善急性心肌梗死病人焦虑、抑郁情绪的临床研究

[目的]评价心理护理改善急性心肌梗死病人焦虑、抑郁情绪障碍的有效性。[方法]将70例急性心肌梗死病人随机分为治疗组和对照组,对照组给予常规治疗及护理,治疗组在给予常规治疗及护理基础上,给予心理护理和音乐疗法,采用焦虑自评量表（sAS）和抑郁自评量表（SDS）对两组治疗前后的抑郁、焦虑进行评价。[结果]经过心理护理干预1周后两组SDS及SAS评分比较差异有统计学意义（P〈0．05）;出院后1个月治疗组SDS及SAS评分与对照组比较有更显著的改善（P〈0．05）。[结论]心理护理能改善急性心肌梗死病人焦虑及抑郁状态,加速身体康复。     

综合性干预措施对神经症患者康复的影响

目的探索综合性干预措施在神经症患者护理中的作用。方法48例神经症住院患者随机分为对照组（药物治疗）和观察组（药物治疗加综合性干预措施）各24例,分别于治疗前、治疗后（8周后）评定焦虑自评量表（SAS）、抑郁自评量表（SDS）。结果治疗前,两组患者SAS、SDS比较差异均无统计学意义（P〉0．05）。治疗后,观察组SAS、SDS减分率优于对照组,组问比较差异有统计学意义（P〈0．05）,观察组临床疗效优于对照组（P〈0．05）。结论综合性干预措施能有效改善神经症患者抑郁、焦虑情绪,提高治愈率,促进疾病的康复。     

心理干预对慢性乙型肝炎患者家属抑郁及焦虑情绪的影响

目的：探讨心理干预对慢性乙型肝炎患者家属抑郁焦虑情绪的影响。方法选择慢性乙型肝炎患者家属68例,采用随机数字表法随机分为观察组（34例）和对照组（34例）。对照组给予常规护理健康教育,观察组在此基础上给予心理干预,家属均应用抑郁自评量表（ SDS ）及焦虑自评量表（SAS）评估干预前后的心理健康状况。结果干预前,患者家属 SDS 及 SAS评分分别为（39．81±5.34）,（34．67±4．61）分,均高于国内常模,差异有统计学意义（t值分别为9．71,8．92;P＜0．05）;干预前,两组患者家属SDS及SAS评分差异无统计学意义（ P＞0．05）;干预后,观察组患者家属SDS及SAS评分低于对照组,差异均有统计学意义（ t值分别为3．61,2．85;P＜0．05）。结论慢性乙型肝炎患者家属存在一定程度的抑郁焦虑状况,心理干预能改善患者家属的抑郁焦虑状况。     

现代残疾康复理念、政策与社区康复体系研究

本研究分析了当代残疾康复的理念和理论架构,构建了以国际公约、决议和政策、国内法律和政策以及操作性工具3个层次的康复理论体系;运用包容性发展,分析探讨了当代社区康复的体系和特点;就发展康复事业、为残疾人提供全面系统的康复服务提出相关的政策建议。     

我院文职护士管理和培训的实践与体会

目的构建文职护士培训、使用及管理的科学方法。方法通过规范管理、科学施训、作为骨干大胆任用等多种管理方式,使文职护士得到充分的发展。结果文职护士群体成长为医院优秀骨干,首批满3年的文职护士顺利通过续聘考核。结论科学的管理培训是文职护士成长的重要基石,对医院护理管理有着重要作用。     

Comparison of short-term and long-term protocols for stabilization and preservation of RNA and DNA of Leishmania, Trypanosoma, and Plasmodium

Molecular tools continue to be important in the prevention and control of parasitic diseases. However, using these techniques directly in the field remains a major challenge. Therefore, the preservation of clinical samples collected from endemic field areas for later analysis remains an important preanalytical process. This study aimed at identifying a suitable protocol for stabilization and preservation of RNA and DNA in bioclinical specimens for Trypanosoma, Leishmania, and Plasmodium research. Both spiked and unspiked blood samples were preserved in 7 protocols (different media; storage temperatures). Samples were evaluated for possible degradation of DNA and RNA along the storage duration up to the 10th week. Nucleic acid targets were assessed as follows: (i) Trypanosoma and Plasmodium RNA analysis was done using real-time nucleic acid sequence-based amplification (RT-NASBA) for 18S rRNA and for stage-specific Pfs25 mRNA, respectively; (ii) Trypanosoma DNA assessment analysis was conducted by using a conventional PCR for 18S rDNA; (iii) Leishmania RNA analysis was performed with a quantitative NASBA for 18S rRNA and Leishmania DNA assessment with an RT-PCR for 18S rDNA. Findings suggested that a newly developed L3™ buffer proved to be reliable and suitable for both short- and long-term preservation of parasite nucleic acid material. This buffer is envisaged to be suitable for utilization in field situations where resources are limited.     

国内外唇腭裂专科护理发展现状的文献研究及分析

目的了解和分析国内唇腭裂专科护理工作发展的现状。方法检索并分析万方医学网、中国知网、Springer Link及PubMed英文数据库近6年有关唇腭裂手术的围术期护理、患儿的喂养、手术安全管理、围术期疼痛研究以及心理护理的相关文献。结果共检索出国内文献89篇(核心期刊20篇)、国外文献22篇,其中围术期护理38篇、患儿的喂养16篇、手术安全管理10篇、围术期疼痛研究10篇、心理护理15篇。结论与国外文献相比,国内论文总结和回顾性居多,应增加研究探讨性论文,从而促进唇腭裂临床护理工作专科化的发展。     

History of violence and subjective health of mother and child

Objective: To study the self-reported prevalence of experienced violence among a cohort of women about two years after giving birth, their health during pregnancy, pregnancy outcomes and their experience of their child’s health.

Setting and subjects: In 2011, a total of 657 women participated in phase III of the Childbirth and Health Cohort Study in Icelandic Primary Health Care, 18 to 24 months after delivery. The women had previously participated in phase I around pregnancy week 16 and phase II 5–6 months after delivery. Data were collected by postal questionnaires.

Main outcome measures: Women’s reported history of experienced violence, sociodemographic and obstetric background, self-perceived health, the use of medications and their child’s perceived health.

Results: In phase III, 16% of women reported experiencing violence. These women felt less support from their current partner (p?p?p?p?p?p?=?0.008).

Conclusions: Our study confirms that a history of violence is common among women. A history of violence is associated with various maternal health problems during and after pregnancy, a higher rate of caesarean sections and maternal reports of health problems in their child 18–24 months after birth.

• KEY POINTS

• Violence is a major concern worldwide. Understanding the impact of violence on human health and developing effective preventive measures are important elements of any public health agenda.

• ??The reported prevalence of experiencing violence was 16% among women attending antenatal care in the primary health care setting in Iceland.

• ??Women with a history of violence reported worse health in general during pregnancy and delivered more often by caesarean section, compared to women with no such history.

• ??Mothers with a history of violence also evaluated the general health of their child as worse than women with no such history.

• ??The findings of this study support the importance of recognizing and addressing experienced violence among women in primary care.

     

城乡学童个性行为特征调查

目的探讨农村与城市儿童的个性行为特征。方法将97名农村学龄儿童设为农村组,97名城市学龄儿童设为城市组,采用艾森克个性问卷一儿童版和Achenbach’s 行为量表一儿童版进行评定分析。结果两组学龄儿童艾森克个性问卷各维度评分均无显著性差异（P均〉0．05）,且与全国常模相一致（P均〉0．05）;农村组男学童Achenbach’s行为量表违纪行为、攻击行为及外向型因子分均显著高于城市组,女学童退缩、社交问题因子分均显著高于城市组（P〈0．05或0．01）,其他因子分均无显著性差异（P均〉0．05）。结论农村与城市儿童个性无显著差异,而农村儿童存在较多的行为问题,可能与其所受教养和生活方式有关。     

Rates and risks of transmission of smallpox and mechanisms of prevention

In 1980, the World Health Organization declared smallpox eradicated from the world; the last known natural case had occurred in Somalia in 1977, and the United States had stopped routinely vaccinating its citizens in 1972. However, with increasing concerns regarding domestic and international terrorism, smallpox has resurfaced as a potential threat to global health. We review the direct and indirect modes of smallpox transmission and how patterns of transmission vary substantially, depending on the severity of circulating disease, vaccination status, environmental and socioeconomic factors, and the setting of an outbreak. We examine mechanisms for controlling outbreaks of disease and preventing further transmission in the event of an outbreak, with an emphasis on smallpox vaccination.     

通用设计原则与产品研发策略

本文介绍了通用设计的概念和设计原则,并阐述了根据此原则实施通用设计的产品研发策略。通用设计惠及的不仅是残疾人,也惠及了包括普通公众在内的广泛人群,以及企业。应将通用设计的原理应融入政府相关政策和未来发展的规划中,为残疾人以及更多人群提供合理便利的通用设计产品。     

胃癌DNA含量与E-cad、EGFR表达的关系及其意义

目的　探讨胃癌组织DNA含量与E cad、EGFR表达的关系 ,评价其在浸润、转移潜能及预后判断中的作用。方法　应用图像分析仪及SP免疫组化法检测 30例正常胃黏膜上皮、30例不典型增生和 5 0例胃癌组织DNA含量与E cad、EGFR蛋白表达情况。结果　①正常胃黏膜上皮、Ⅰ、Ⅱ、Ⅲ级不典型增生及胃癌组的DI、PI、S %、>5c %逐渐增高 ,与胃癌分期、淋巴结转移显著相关 (P <0 0 1)。②E cad在正常胃黏膜上皮阳性表达率 10 0 % ,EGFR呈阴性表达 ;Ⅰ、Ⅱ、Ⅲ级不典型增生及胃癌E cad阳性表达率逐渐降低 ,EGFR的阳性表达率逐渐升高 ,且差异显著 (P <0 0 5 ) ;E cad表达减弱、EGFR表达升高与胃癌分化差、淋巴结转移显著相关 (P <0 0 1)。③E cad表达阴性的胃癌DNA指数及EGFR表达水平显著高于E cad阳性 (P <0 0 1)。结论　检测DNA含量及E cad、EGFR蛋白表达有助于胃癌的早期诊断及转移潜能和预后的判断。     

Quality and suitability of antimicrobial discs: theoretical and practical sources of error and variability

ABSTRACT

Introduction: The use of antimicrobial discs remains one of the main methods for assessing antibiotic activity. Most discs are made to one of three main standards (FDA, WHO, DIN); these all describe an assay method for assessing the quality of discs using a linear method. Theory predicts a curved relationship, and this is backed up in many cases in practice. In such cases, the assays are potentially invalid. Other sources of uncertainty arising from the manufacturing processes employed are also discussed.

Areas covered: This includes error arising from applying FDA, WHO, and DIN standards, the manufacturing techniques employed, and variation in the materials used in production. The need for a specification that relates directly to the use of the discs is also discussed.

Expert opinion: Manufactured discs, some of which may be out of specification due to curvature and other sources of error, have been used to establish quality zone sizes. Quality zone sizes have then been used to measure the quality of discs. This circular quality system where there is no quantitative check is potentially unsafe. In the many decades of their use, there has been no comprehensive check on the quality of manufactured discs using quantitative, validated assays.