心理护理在胃癌围手术期的应用体会

目的 总结胃癌患者围手术期心理护理方法.方法 对照组选择常规护理,观察组于常规护理的基础上实施心理干预护理,对比分析两组患者的自尊量表、焦虑自评量表及抑郁自评量表评分.结果 护理前,两组患者自尊量表、焦虑自评量表及抑郁自评量表评分差异无统计学意义(P＞0.05);护理后,两组患者自尊量表、焦虑自评量表及抑郁自评量表评分差异存在统计学意义(P＜0.05),其中治疗组自尊量表评分明显高于对照组,其焦虑自评量表与抑郁自评量表评分明显低于对照组.结论 对于胃癌围手术期患者,给予心理护理,可提高患者的自尊心,缓解其精神压力,对患者疾病治疗有着重要的意义,值得在临床护理中推广使用.     

针对性护理干预对老年心绞痛患者临床治疗效果的影响

目的探讨针对性护理干预对老年心绞痛患者的病情改善程度及心理状态的影响。方法将2013年1月-2014年1月呼和浩特市某医院收治的50例心绞痛患者随机分为对照组和观察组,每组25例。对照组患者给予常规护理,观察组患者在常规护理的基础上给予针对性护理干预,比较2组患者护理干预后病情改善程度及护理前后心理状态的变化情况。结果观察组患者治疗总有效率为92.00%,对照组患者治疗总有效率为80.00%,2组比较差异有统计学意义(P0.05)。护理干预后,观察组患者焦虑自评量表(SAS)和抑郁自评量表(SDS)评分均明显低于对照组,差异有统计学意义(P0.05)。结论对老年心绞痛患者给予针对性护理干预,可以提高治疗有效率,改善患者负面情绪,且有利于患者早日康复。     

子宫颈癌患者动脉灌注化疗的护理干预效果

目的观察子宫颈癌患者动脉灌注化疗的护理干预效果。方法选择2014年1月—2016年1月收治的子宫颈癌患者60例,随机分为干预组与对照组,每组30例。两组均给予动脉灌注化疗,观察组在此基础上给予护理干预。观察两组治疗疗效;干预前后采用焦虑自评量表(self-rating anxiety scale,SAS)对焦虑状态进行评分,采用抑郁自评量表(self-rating depression scale,SDS)对抑郁状态进行评分;统计两组治疗过程中的不良反应。计量资料比较采用t检验,计数资料比较采用χ~2检验,P0.05为差异有统计学意义。结果两组治疗后经B超检查显示病灶体积缩小;阴道流血、流液、下腹痛症状于介入后3~5 d缓解。两组均有2例Ⅲb期患者经2次动脉化疗栓塞无效改为放疗,其余均顺利手术切除。两组疗效比较差异无统计学意义(P0.05)。与干预前比较,干预后对照组SAS、SDS评分比较差异无统计学意义(均P0.05),干预组SAS、SDS评分比较差异有统计学意义(均P0.05);干预后干预组SAS、SDS评分[(37.15±6.78)、(41.09±6.43)分]与对照组[(47.08±6.65)、(53.18±5.22)分]比较差异有统计学意义(均P0.05)。对照组不良反应发生率为33.33%,干预组为6.67%,两组不良反应发生率比较差异有统计学意义(P0.05)。结论子宫颈癌患者动脉灌注化疗过程中实施护理干预,可改善患者焦虑抑郁状态,降低不良反应发生率。     

基于互联网技术的综合护理管理对肺癌患者治疗依从性和自我管理效能的影响

目的探讨基于互联网技术的综合护理管理对肺癌患者放射性治疗依从性和自我管理效能的影响,为减少不良反应发生,提高患者生活质量提供参考。方法将2015年2月至2017年4月在浙江省杭州市肿瘤医院住院治疗的160例肺癌患者随机分为干预组和对照组,每组80例,对照组接受常规护理措施,干预组在此基础上接受基于互联网技术的综合护理管理,干预时间为1个月。采用焦虑自评量表(SAS)和抑郁自评量表(SDS)对患者焦虑和抑郁状况进行评分;采用肺癌患者治疗依从性量表对患者的治疗依从性进行评价;采用中文版癌症自我管理效能量表评估患者自我管理效能;采用诺丁汉健康调查表(NHP)评价两组患者的生活质量;并对比两组患者的不良反应发生情况。采用SPSS 20.0统计软件进行独立样本t检验、χ~2检验和重复测量资料的方差分析。结果干预前,两组患者的SAS得分、SDS得分、治疗依从性和自我管理效能差异均无统计学意义(P0.05)。干预2周、1个月后,干预组SAS得分、SDS得分均明显低于对照组,治疗依从性、自我管理效能均明显高于对照组,差异均有统计学意义(P0.05)。干预组不良反应发生率低于对照组,干预组患者的精力、情感、睡眠、社交、活动等各项评分均低于对照组,差异均有统计学意义(P0.05,P0.01)。结论基于互联网技术的综合护理管理能改善患者焦虑、抑郁心理情绪,提高患者治疗依从性及自我管理效能,减少不良反应的发生,提高患者生活质量。     

心理干预对乳腺癌化疗患者心理状态效果观察

目的:探讨心理干预对乳腺癌首次化疗患者心理状态的效果.方法:采用焦虑自评量表(SAS)及抑郁自评量表(SDS),对30例术后首次化疗的乳腺癌女性患者进行心理干预.在干预前后进行心理状况测评,然后比较护理干预前后效果.结果:30例乳腺癌首次化疗的女性患者均有不同水平的焦虑、抑郁情绪,心理干预后焦虑、抑郁评分均下降,两者相比较差异有统计学意义(P<0.01).结论:心理干预能改善乳腺癌首次化疗患者焦虑、抑郁心理,促进患者积极参与治疗,提高疾病的愈后.     

心理干预改善恶性肿瘤患者情绪障碍的临床分析

目的:分析心理干预改善恶性肿瘤患者情绪障碍的临床效果。方法:选取120例恶性肿瘤患者分成对照组和实验组,为对照组患者实施常规化疗,为实验组患者实施常规化疗合并心理干预。在入院四周后和入院时采取焦虑自评量表和抑郁自评量表实施评定。结果:治疗四周后,实验组患者SDS评分及SAS评分均低于对照组患者,P0.05,差异统计学意义显著。结论:心理干预能够有效降低恶性肿瘤患者抑郁情绪和焦虑情绪。     

心理护理干预对恶性肿瘤骨转移患者的效果研究

目的研究心理护理干预对恶性肿瘤骨转移患者的效果。方法选取我院2015年3月至2015年7月收治的52例恶性肿瘤骨转移患者,随机平均分为A组和B组。A组行心理护理干预,B组行传统护理干预。比较护理干预后两组患者的临床治疗效果。结果护理前,两组患者的焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分和生活质量评分比较差异均无统计学意义(P>0.05)。护理干预后,两组患者的生活质量评分、SAS及SDS评分比较差异均有统计学意义(P<0.05)。结论心理护理干预能改善恶性肿瘤骨转移患者的焦虑和抑郁情绪,提高患者生存和治疗的信心以及生活质量。     

骨科手术患者实施护理干预对术后焦虑抑郁状态的效果分析

目的：观察并分析骨折手术患者实施护理干预的临床效果。方法：选取本院2013年收治的64例骨折患者作为研究对象,按照随机数字表法将其分为对照组和干预组各32例。对照组采取常规护理,如协助患者进行术前检查及其他针对性治疗等。干预组在常规护理的基础上采取护理干预,如心理护理等。采用抑郁自评量表（SDS）和焦虑自评量表（SAS）评价两组患者术前、术后抑郁和焦虑改善情况,同时采用生活质量综合评定问卷（GQOLI-74）评价和比较两组患者的生活质量。结果：两组护理前的抑郁和焦虑评分比较差异均无统计学意义（P〉0.05）。护理干预后,干预组的抑郁和焦虑评分分别为（37.23±6.30）分、（36.51±5.24）分,均明显低于对照组的（47.25±6.39）分、（47.67±8.31）分,差异均有统计学意义（P〈0.05）。两组护理前生活质量评分的比较差异无统计学意义（P〉0.05）,两组护理后的生活质量评分均明显升高,且干预组的生活质量评分明显高于对照组,差异均有统计学意义（P〈0.05）。结论：骨折手术患者实施心理护理等护理干预能够有效改善患者抑郁和焦虑状态,同时提高患者生命质量,值得在临床上推广。     

心理干预治疗高血压合并焦虑抑郁的效果分析

目的探讨心理干预治疗高血压合并焦虑抑郁的效果。方法选取2015年3月-2017年2月重庆市某医院收治的180例高血压合并焦虑抑郁的患者为研究对象。采用随机数字表法将患者分为研究组和对照组,每组90例。对照组患者进行常规治疗,研究组患者在对照组治疗基础上进行心理干预。比较2组患者的治疗效果;比较2组患者治疗前后汉密尔顿抑郁量表(HAMD)和焦虑自评量表(SAS)评分。结果研究组患者治疗总有效率为88.9%,高于对照组的62.2%,差异有统计学意义(P0.05)。治疗前,2组患者HAMD及SAS评分比较,差异无统计学意义(P0.05);治疗后,2组患者HAMD及SAS评分均低于治疗前,且研究组低于对照组,差异均有统计学意义(P0.05)。结论心理干预应用于高血压的治疗中,可提高降压效果,改善患者焦虑抑郁症状,临床效果显著,值得推广应用。     

营养干预和护理在晚期胃癌患者中的应用

目的探讨营养干预和护理在晚期胃癌患者中的应用效果。方法收集汕头大学医学院附属肿瘤医院2015年1月-2017年8月收治的80例晚期胃癌患者,按照随机数字表法分为观察组和对照组,每组各40例。两组患者均给予护理支持治疗措施,观察组在以上基础上给予营养干预措施。采用抑郁自评量表(SDS)和焦虑自评量表(SAS)评价患者心理状态并比较两组患者营养不良发生率。结果治疗前两组SDS、SAS差异无统计学意义(P0.05),治疗后两组SDS、SAS均降低,并且观察组SDS、SAS评分降低幅度大于对照组,差异有统计学意义(P0.05);治疗后,观察组营养不良率为20.0%,低于对照组的42.5%,差异有统计学意义(P0.05)。结论营养干预联合护理支持措施可有效改善晚期胃癌患者抑郁、焦虑等负面情绪,提高患者营养状况。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.