需要层次论对子宫肌瘤患者心理状态和性功能的影响

目的 探讨需要层次论对子宫肌瘤患者心理状态和性功能的影响.方法 将我院100例子宫肌瘤手术患者分为观察组和对照组,对照组采用常规护理,观察组在对照组的基础上采用需要层次论进行护理,比较两组患者术后心理状态和性功能的影响.结果 观察组护理后的焦虑、抑郁改善程度显著优于对照组(P＜0.05).且观察组护理后性功能各方面的评分显著优于对照组(P＜0.05).结论 需要层次论可全面提高护理水平,减轻子宫肌瘤患者焦虑、抑郁的情绪,改善患者术后的性功能.     

认知行为干预对心肌梗死患者心绞痛发作及负性情绪的影响

目的 探讨认知行为干预对心肌梗死患者心绞痛发作及负性情绪的影响.方法 将60例心肌梗死患者分为观察组和对照组各30例,对照组采用常规护理,观察组在对照组的基础上加强认知行为干预,比较两组患者心绞痛的发作及负性情绪的变化.结果 观察组护理后心绞痛的发作情况(AF)和心绞痛的稳定状态(AS)显著优于对照组(P＜0.05)；观察组护理后负性心理的改善情况显著优于对照组(P＜0.05).结论 认知行为干预有助于缓解心肌梗死患者的不良心理,提高其应对技巧,改善生活质量.     

心理护理对耳鼻喉科全身麻醉患者的干预效果

目的 探讨心理护理对耳鼻喉科全身麻醉患者的干预效果.方法 将86例耳鼻喉科全身麻醉病人随机分为对照组(40例)与观察组(46例).对照组病人常规护理,观察组病人在常规护理基础上强化心理护理.在病人干预前后采用抑郁自评量表(SDS)评分及焦虑自评量表(SAS)评估负性情绪,并对病人术前血压、心率及苏醒期躁动程度进行评估.结果 观察组病人手术前SDS评分及SAS评分显著低于对照组(P＜0.05),术前血压及心率显著优于对照组(P＜0.05);苏醒期躁动程度显著低于对照组(P＜0.05).结论 对耳鼻喉科全身麻醉患者强化心理护理可显著改善病人焦虑抑郁情绪,血流动力学平稳,有助于手术顺利进行并减少术后病人躁动.     

心理干预对宫颈癌廓清术后患者情绪的影响

目的:探讨心理护理干预对宫颈癌患者廓清术后情绪的影响.方法:选取收治于我院采取廓清术治疗的84例宫颈癌患者,随机将其分为观察组和对照组各42例,其中对照组患者进行常规的临床护理,观察组患者在对照组护理的基础上实施心理护理干预,观察并比较两组患者术后情绪的变化情况.结果:经过心理护理干预,观察组患者的强迫症状、人际敏感性、抑郁、焦虑和偏执等5个方面的负性情绪均显著优于对照组(P＜0.05).结论:实施心理护理干预能显著降低宫颈癌廓清术后患者的负性情绪.     

心理干预对子宫肌瘤手术患者焦虑心理及性功能的影响

目的 探讨心理干预对子宫肌瘤手术患者焦虑心理及性功能的影响.方法 将70例择期行子宫切除的子宫肌瘤患者按随机数字表法分为观察组和对照组各35例,对照组按常规护理,观察组在此基础上实施心理干预.观察2组干预前后焦虑率、SAS评分变化及手术前后性功能变化.结果 观察组干预后焦虑率和SAS评分均较自身干预前显著下降,而对照组则无明显变化；观察组干预后焦虑率和SAS评分均显著低于同期对照组水平.2组术后3个月性功能各项指标均比术前明显改善,观察组术后3个月性功能各项指标均明显优于对照组.结论 心理干预可以有效缓解子宫肌瘤手术患者的焦虑情绪,促进术后性功能的恢复,值得临床推广应用.     

心理护理干预对血液透析患者负性情绪和生活质量的影响

目的:探讨心理护理干预对血液透析患者负性情绪和生活质量的影响.方法:将82例血液透析患者随机分为对照组和观察组各41例,对照组给予常规护理,观察组在此基础上采取心理护理干预.护理干预前后分别采用焦虑自评量表(SAS)、抑郁自评量表(SDS)对两组患者的负性情绪进行评分比较,护理干预后采用简明健康调查量表(SF-36)对两组患者的生活质量水平进行比较.结果:护理干预后观察组患者焦虑、抑郁评分明显低于对照组(P＜0.05),患者生活质量显著优于对照组(P＜0.05).结论:对血液透析患者应用心理护理干预不仅可以有效地改善患者的负性情绪,还能够提高其生活质量.     

治疗性沟通系统对肿瘤术后化疗抑郁情绪的干预价值

目的 探讨肿瘤术后化疗的抑郁情绪、负性自动思维及生命质量方面应用治疗性沟通系统的干预效果.方法 选取肿瘤术后化疗的患者56例,随机分为观察组和对照组各28例.观察组在一般护理的基础上实施治疗性沟通系统,对照组给予一般护理.采用评抑郁量表(SDS)、自动思维问卷(ATQ)和生命质量测评问卷(QLQ-C303.0)分别对两组干预前后进行评价.结果 两组患者抑郁情绪、负性自动思维及生命质量方面观察组优于对照组(P＜0.05).结论 肿瘤术后化疗的抑郁情绪应用治疗性沟通系统进行干预对患者的抑郁情绪、负性自动思维和生命质量有显著改善,显示肿瘤术后化疗心理干预的有效性和可行性,值得临床推广应用.     

心理护理对食管癌手术病人负面情绪的影响分析

目的 探讨对食管癌患者采取心理护理干预后的影响.方法 选择2020年6月至2022年7月期间我院接诊的食管癌手术患者60例作为观察对象.经随机抽签法将患者分为对照组和观察组,每组各30例.对照组采取常规护理干预,观察组采取心理护理干预.分析对比两组的负面情绪、护理满意度、并发症以及生活质量.结果 护理前,两组SAS及SDS评分均无显著差异(P＞0.05).护理后,观察组的SAS及SDS分值均比对照组显著降低(P＜0.05).观察组并发症发生率比对照组显著降低(P＜0.05).观察组的护理满意度比对照组显著提高(P＜0.05).结论 对食管癌手术患者采取心理护理,能改善患者的负面情绪,降低并发症发生率,提高生活质量以及护理满意度.     

心理护理干预对子宫肌瘤患者手术应激及生活质量的影响

目的:探讨心理护理干预对子宫肌瘤患者手术应激及生活质量的影响.方法:将106例子宫肌瘤手术患者随机分为观察组和对照组各53例,对照组采用常规护理,观察组此基础上给予心理护理干预,比较两组手术应激状态及术后生活质量.结果:观察组术前1h焦虑评分、抑郁评分、心率、收缩压与对照组比较差异有统计学意义(P＜0.05);观察组在出院时、出院1周、出院2周生活质量评分高于对照组(P＜0.05).结论:心理护理干预可改善子宫肌瘤患者的手术应激反应,提高其生活质量.     

系统护理干预对子宫肌瘤术后患者治疗效果的影响

目的:探讨系统护理干预对子宫肌瘤术后患者治疗效果的影响.方法:将84例子宫肌瘤患者随机分为干预组和对照组各42例,对照组进行常规护理,干预组在常规护理的基础上给予系统护理干预,分析比较两组在疼痛、负性情绪、睡眠、胃肠道功能恢复情况以及术后并发症及住院天数等方面的差异.结果:两组干预后疼痛评分、焦虑和抑郁评分、睡眠时间与干预前比较差异有统计学意义(P＜0.05),干预组疼痛评分、焦虑和抑郁评分、睡眠时间高于对照组(P＜0.05);干预组术后恢复指标及护理满意度与对照组比较差异有统计学意义(P＜0.05).结论:系统护理干预可有效缓解子宫肌瘤患者术后的疼痛及负性情绪,增加睡眠时间,提高护理满意度.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

Clinical Pharmacokinetics of Morphine

Morphine, the most widely used mu-opioid analgesic for acute and chronic pain, is the standard against which new analgesics are measured. A thorough understanding of the pharmacokinetics of morphine is required in order to safely and effectively use this analgesic in a wide variety of patients with different levels of organ function. A MEDLINE search was conducted to identify literature published between 1966 and January 2002 relevant to the pharmacokinetics of morphine. These publications were reviewed and the literature summarized regarding unique and clinically important elements of morphine disposition relative to its parenteral administration (including intravenous, intramuscular, subcutaneous, epidural and intrathecal administration), absorption profile (immediate release, controlled release, and sublingual/buccal, and rectal administration), distribution, and its metabolism/ excretion. Special populations, including infants, elderly, and those with renal/liver failure, have a unique morphine pharmacokinetic profile that must be taken into account in order to maximize analgesic efficacy and reduce the risk of adverse events.