老年青光眼伴视野缺损患者反刍性沉思现状及影响因素分析

目的:调查老年青光眼伴视野缺损患者反刍性沉思现状并分析其影响因素。方法:采用便利抽样法,选取2018年1月—2020年12月在浙江省荣军医院接受治疗的95例老年青光眼伴视野缺损患者为研究对象,采用一般资料调查表、简体中文版事件相关反刍性沉思问卷（C-ERRI）、青光眼患者自我行为管理问卷（GSMQ）对其进行调查。采用单...     

人类适转理论指导下的安宁疗护对临终期肿瘤患者的影响

目的：探讨人类适转理论指导下的安宁疗护对临终期肿瘤患者的影响。方法：选取2020年5月1日～2022年5月31日诊治的64例临终期肿瘤患者作为研究对象，按照随机数字表法分为对照组和观察组各32例，对照组实施常规护理，观察组在常规护理基础上实施人类适转理论指导下的安宁疗护；比较两组干预前后自我感受负担[采用自我感受负担量表(SPBS)]、心理状态[采用焦虑自评量表(SAS)、抑郁自评量表(SDS)]、恐惧疾病进展[采用恐惧疾病进展量表(FoP-Q)]、睡眠状况(包括入睡潜伏期、实际睡眠时长、睡眠质量),睡眠质量采用匹兹堡睡眠质量指数(PSQI)。结果：干预后，观察组SPBS中身体因素、情感因素维度得分及总分均低于对照组(P<0.01),SAS、SDS评分均低于对照组(P<0.01,P<0.05),FoP-Q中括情感反应、自主性丧失、伙伴关系/家庭、应对焦虑维度得分、FoP-Q总分、PSQI评分均低于对照组(P<0.01);干预后，观察组入睡潜伏期短于对照组(P<0.05),实际睡眠时间长于对照组(P<0.05)。结论：人类适转理论指导下的安宁疗护应用于...     

中文版患者积极度量表在慢性心力衰竭患者中的信效度分析

目的修订中文版患者积极度量表(PAM13),并在慢性心力衰竭患者中检验其信度和效度。方法 2016年9月-2017年1月采用方便抽样法对山东省两家三甲医院200例慢性心力衰竭患者进行测评,获取数据,对简体中文版患者积极度量表进行信度、效度检验。结果相关分析法和决断值法对问卷进行项目分析的结果显示,条目与所属模块的相关均达到显著性水平(P<0.01),其中除条目2与所属分量表的相关系数为0.25,其余条目相关系数均在0.4以上,13个条目的决断值(CR值)均>3.0(P<0.01);简体中文版患者积极度量表的Cronbach′sα系数为0.82;内容效度指数(CVI)为0.87;探索性因子分析共提取出4个特征根值>1的因子,解释变量总变异的58.20%,与原问卷模型基本吻合;验证性因子分析显示χ~2/df、AGFI、NNFI、CFI分别为2.24/0.86、0.91、0.92和0.94。结论简体中文版患者积极度量表在慢性心衰患者中的信效度均较理想,测评属性良好。     

EORTC QLQ-C30中文版测定卵巢癌患者生存质量的评价

目的:对用欧洲癌症研究与治疗组织生存质量问卷第3版(EORTC QLQ-C30 V3.0)简体中文版测定我国卵巢癌患者生存质量的心理测量学特性进行考评,为卵巢癌患者的生存质量评价提供依据。方法:采用调查问卷方式,应用EORTC QLQ-C30 V3.0中文版,对2002年1月—2005年12月在北京协和医院就诊的卵巢癌化疗期、恢复期患者各60例进行生存质量测定,并以60例健康妇女作为对照,考评该量表测定卵巢癌患者生存质量的信度和效度。结果:量表的重测信度相关系数r在各个领域均为0.8以上。内部一致性信度的克朗巴赫系数α均在0.8以上。主成分分析显示中文版量表与英文版量表的结构符合。方差分析显示量表能够很好地区分不同组别妇女的生存质量。卵巢癌化疗组在不同领域的生存质量均显著低于恢复组和健康组(P<0.001)。卵巢癌恢复组整体健康状况、躯体功能、角色功能、情绪功能和社会功能评分仍较健康组低(P<0.001),乏力症状和经济领域评分也较健康组有显著差异(P<0.001)。结论:EORTC QLQ-C30 V3.0简体中文版具有良好的信度和效度,可作为我国卵巢癌患者生存质量的测评工具。     

简体中文版社会影响量表的修订及信效度检验

目的:对中文版社会影响量表（Social Impact Scale,SIS）进行修订,并检验其信效度。方法:遵循Beaton文化调适指南,应用专家咨询进行文化调适,形成简体中文版SIS。通过便利抽样法,选择417例癌症病人进行问卷调查,评价量表的信效度。结果:简体中文版SIS包括4个维度,共22个条目。量表的条目内容效度指数为0.875～1.000,平均内容效度指数为0.978;探索性因子分析提取4个公因子,累计方差贡献率为64.040%;验证性因子分析显示模型结构拟合良好。总量表的Cronbach’s α系数为0.925,4个维度的Cronbach’s α系数为0.748～0.810,分半信度为0.890,重测信度为0.901。结论:简体中文版SIS信效度良好,可以用于我国癌症病人病耻感的评估。     

基于THRIVE模型对早中期肝癌患者心理成长轨迹的质性研究

目的 探索早中期肝癌患者的创伤后成长心理轨迹,为制订针对性的心理护理干预措施提供参考依据.方法 2020年10月—2021年3月选取重庆市某三级甲等医院感染科住院并接受简体中文版创伤后成长评定量表调查的早中期肝癌患者作为研究对象,以THRIVE模型为框架,采用质性研究中的现象学方法,对14例早中期原发性肝癌患者进行半结...     

脑卒中患者抑郁症状的潜在剖面分析及影响因素研究

目的探讨脑卒中患者抑郁症状的潜在分型并分析不同类别脑卒中患者的特征差异。方法 2019年11月至2020年8月,采用便利抽样法选取郑州市某三级甲等医院神经内科224例脑卒中患者为研究对象,采用一般资料调查表、改良版Rankin量表、病人健康问卷-9、简体中文版创伤后成长评定问卷对其进行调查。采用潜在剖面分析患者抑郁症状的潜在分型,采用多元Logistic回归分析评估各因素对其不同分型的影响。结果脑卒中患者抑郁症状分为4个类别:情绪抑郁型(9.4%);广泛抑郁型(13.8%);抑郁低风险型(58.0%);躯体-情绪混合抑郁型(18.8%)。卒中类型、病程、发病次数、躯体症状数、预后情况和创伤后成长得分是影响脑卒中患者抑郁症状潜在剖面分类的预测因素(均P0.05)。结论脑卒中患者抑郁症状具有4个潜在类别,医护人员应注重不同患者的抑郁特征,实施有针对性的心理干预,缓解其相关抑郁症状。     

中文改良版危重患者家属需求量表的信度与效度评价

目的将简体中文版危重患者家属需求量表加以改良以进一步适应中国人群应用。方法在刘辉教授所翻译的简体中文版危重患者家属需求量表的基础上,通过7名专家评定和对80名患者家属的调查,对改良后量表的效度和信度进行分析评价。结果中文改良版危重患者家属需求量表(M-CCFNI)具有较好的表面效度和结构效度;其克朗巴哈α系数(Cronbach’sα)总量表为0.972,各因子之间介于0.781~0.928之间,内容效度指数(Content validity index,CVI)为0.838。结论中文改良版危重患者家属需求量表具有较好的信度和效度,该量表可用于评估危重患者救治期间的家属需求。     

洛文斯顿认知评定量表评定多发性硬化患者认知障碍的信度和效度初步研究

目的测试洛文斯顿作业疗法认知评定(LOTCA)量表(第2版)简体中文版的信度和内在效度。方法用LOTCA量表简体中文版对41例多发性硬化患者(病例组)和45例健康者(对照组)进行评定,对LOTCA量表的组内信度、内容效度和区分效度进行比较。结果病例组的克朗巴哈α信度系数为0.856,对照组为0.683,病例组每个领域的克朗巴哈α信度系数均0.8。病例组LOTCA量表内容效度较好,各项条目所在领域的相关性好(r=0.504~0.941,P0.05)。LOTCA量表绝大多数项目具有较高的区分效度(P0.05)。结论对于我国多发性硬化患者,LOTCA量表中大部分项目具有较高的信度和效度,适宜在国内临床工作中推广。     

腹膜透析患者创伤后成长状况及其影响因素分析

目的调查腹膜透析患者创伤后成长状况及其影响因素。方法采用一般资料调查表、简体中文版意外创伤后成长量表对上海市某三级甲等医院门诊随访的141例腹膜透析患者进行调查。结果腹膜透析患者创伤后成长总分为(57.65±15.71)分,个人力量维度得分率最高,新的可能性维度最低。婚姻状况、居住状况和家庭人均月收入可解释创伤后成长水平总变异的25.4%。结论腹膜透析患者创伤后成长水平中等偏下,分析腹膜透析患者创伤后成长水平及其影响因素,可为临床护理人员实施个体化干预提供依据。     

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.