门诊老年慢性阻塞性肺疾病患者精神心理因素分析

目的 探讨门诊老年慢性阻塞性肺疾病患者精神心理因素及社会支持情况.方法 采用统一的指导语,运用症状自评量表(SCL-90)及社会支持评定量表(SSRS)对264例老年慢性阻塞性肺疾病患者(观察组)和142例健康志愿者(对照组)进行调查.结果 门诊老年慢性阻塞性肺疾病患者躯体化、强迫症状、焦虑、恐怖、抑郁、精神病性因子及SCL-90阳性项数的均数等指标均明显高于对照组(P<0.05或P<0.01);SSRS评定门诊老年慢性阻塞性肺疾病患者的客观、主观支持及支持总分均明显低于对照组(P<0.05或P<0.01).结论 门诊老年慢性阻塞性肺疾病患者病后心理健康状况较差,社会支持低.因此,在进行躯体治疗的同时应实施心理干预.     

江西省老年人生命意义及其与死亡焦虑的关系

目的调查江西省老年人生命意义状况及其对死亡焦虑的影响。方法采用生命意义感量表(MLQ)中文修订版和死亡焦虑量表对179名老人进行调查。结果江西省老年人生命意义得分较低,并且不同的婚姻类型、养老方式、健康状况老年人生命意义差异有统计学意义;死亡焦虑与拥有意义呈显著负相关(P<0.01),与追寻意义呈正相关。结论江西省老年人生命意义感较低,并且对死亡焦虑有重要的预测作用。     

失能老人居家照顾者抑郁症状及其影响因素

目的了解失能老人居家照顾者的抑郁现况及其影响因素。方法采用整群随机抽样,抽取567名失能老人居家照顾者,应用一般资料问卷、流调用抑郁量表简表(CES-D 10)、领悟社会支持量表(PSSS)、照顾者负担量表(ZBI)进行面对面的问卷调查。结果失能老人居家照顾者抑郁症状的发生率为49.2%。抑郁症状的危险因素为自评健康状态一般和较差(OR=3.238、OR=4.645),照顾负担中度和重度(OR=4.924、OR=18.453),社会支持水平中等和较低(OR=3.261、OR=8.864),且女性照顾者抑郁症状发生率明显高于男性(OR=2.169)。结论失能老人居家照顾者抑郁症状发生风险较高,要重点关注女性、自评健康差、照顾负担重及社会支持水平低的照顾者。     

老年病科住院患者衰弱状况及其影响因素

目的探讨老年住院患者衰弱的分布情况及与失能、共病的相关性。方法选择在四川大学华西医院老年干部科住院的60岁及以上患者进行横断面调查,调查工具包括一般资料调查表、FRAIL量表,Barthel指数评定量表。结果 238例住院患者中衰弱患者111例(46.6%);衰弱前期患者74例(31.1%)。失能者96例(40.3%)。单因素分析结果显示:衰弱与年龄、失能和慢性阻塞性肺疾病(COPD)均有明显相关性(χ~2分别为33.715、104.56、13.721,均P<0.001)。失能与衰弱的Spearman相关系数r为0.661(P<0.001),Kruskal-Wallis检验的H值为104.12,P<0.001。多因素Logistic回归分析结果显示:失能与住院老年患者衰弱独立相关(OR=0.06,95%CI 0.03～0.12)。结论住院老年患者的衰弱发生率随年龄的增加而增加,失能是衰弱的独立危险因素。COPD与衰弱的相关性可能较心血管疾病和其他慢病显著。     

慢性阻塞性肺疾病患者生活质量及其影响因素

目的分析慢性阻塞性肺疾病(COPD)患者生活质量的现状,并探讨影响其生活质量的相关因素。方法选取2013年3月至2014年3月在大连医科大学附属第一医院三部呼吸科住院的COPD稳定期患者88例作为研究对象。将患者一般情况调查表、圣乔治呼吸问卷(SGRQ)、疾病家庭负担量表(FBS)、领悟社会支持量表(PSSS)、焦虑量表(SAS)、抑郁量表(SDS)相结合,采用SPSS17.0统计软件进行分析。结果不同疾病COPD患者SQ无差异。年龄、家庭经济收入对COPD患者生活质量有影响。相关分析显示,患者心理状况与生活质量有很强的关联,抑郁、焦虑的情况越重,SQ越差。多因素分析显示,经济收入越低、经济负担越重、自我活动能力越小、焦虑程度越重,家庭成员躯体健康越差,影响单项得分越高,SQ越差。结论 COPD患者的生活质量普遍较低。影响COPD患者生活质量的主要因素是年龄、经济收入、心理因素、疾病负担等。     

海口市失能老人健康状况与需求影响因素

目的了解海口市失能老人健康状况,分析其需求影响因素。方法按照随机抽样方法,收集琼山、秀英、龙华、美兰等4个样本区391例失能老人的有效问卷,采用杨茗编制的老年失能评估量表(EDAS)进行评估。结果轻度失能老年人244例(62.40%)、中度失能117例(29.92%)、重度失能23例(5.88%)、极重度失能7例(1.79%)。失能严重程度在年龄、离退休前职业、精神抑郁、居住情况等方面的差异有统计学意义(P均<0.05),而在性别、受教育程度、婚姻状况、家庭人均月收入、慢性疾病、吸烟、饮酒、运动锻炼、陪护情况等方面差异无统计学意义(P>0.05)。结论需要建立一套符合失能老人的长期中医药防治体系、医疗护理体系和相应的保险制度,以保障年龄较大、独居、空巢、失能和低收入老年人为重点,支持和鼓励养老服务机构发展,增加养老机构的数量及床位数,增强社会机构和社区养老的保障能力,形成提供生活照料、家政服务、康复护理、医疗保健等服务的居家养老服务模式。     

糖尿病患者自我效能感、应对方式及人格特征的相关性

目的探索影响糖尿病患者的相关心理社会因素。方法采用配比病例对照研究。选取烟台市几大医院住院、门诊的糖尿病患者150例,以年龄、性别、文化程度为配比因素,选择健康志愿者150例为对照组。自编一般情况调查表,选用一般自我效能感量表(GSES)、特质应对方式问卷(TCSQ)、社会支持评定量表(SSRS)、艾森克人格问卷(EPQ)、焦虑自评量表(SAS)、抑郁自评量表(SDS)进行调查并应用单因素及主成分Logistic回归分析。结果积极应对与一般自我效能感、社会支持总分、主观支持、支持利用呈显著正相关;与EPQ的P分呈显著负相关。抑郁与焦虑呈显著正相关;与一般自我效能感、社会支持总分、主观支持、支持利用、EPQ的E分呈显著负相关。焦虑与EPQ的N分呈显著正相关。消极应对、焦虑、抑郁、EPQ的P分、L分,以及教育程度与饮酒是糖尿病的危险因素;而积极应对、EPQ的N分是糖尿病保护因素。结论糖尿病患者在面对日常生活的各种刺激时采取了较多的消极应对方式,而这一点又使糖尿病患者获得较少的主观支持并且对支持的利用也较低。     

养老院失能老人照顾者负担现状及影响因素

目的探讨养老院失能老人护理人员的照顾者负担水平及其影响因素。方法采用目的抽样调查锦州市养老院失能老人护理人员,实际调查对象129名。采用一般资料问卷、Barthel指数评定量表和自行编制的护理人员照顾者负担量表。结果调查对象照顾者负担得分平均为(43.790±9.419)分。失能老人生活能力平均为(50.236±9.623)。年龄、文化程度、从事老年护理时间、月工资收入、累计接受培训时间与护理人员照顾者负担水平有关(P<0.05)。多元线性回归分析显示影响养老院失能老人照顾者负担的因素有失能老人生活能力、照顾失能老人的数量、轮休时间安排及累积培训时间。结论养老院失能老人照顾者普遍存在负担,与生理、心理及社会等因素有关。管理者需要提高床位-照顾者人员配比,加强养老照顾者培训,尤其需要改善工作时间安排。     

慢性阻塞性肺疾病患者DOSE指数与生活质量的相关性

目的探讨慢性阻塞性肺疾病患者DOSE指数与生活质量的相关性。方法采用一般资料调查表、DOSE指数、慢性阻塞性肺疾病临床问卷对103例住院慢性阻塞性肺疾病患者进行调查。结果慢性阻塞性肺疾病患者DOSE指数得分(3. 33±1. 83)分,慢性阻塞性肺疾病临床问卷总得分(2. 73±1. 33)分,DOSE指数与症状维度得分、功能状态维度得分、慢性阻塞性肺疾病临床问卷总得分呈正相关(r=0. 213~0. 471,P0. 05)。结论护理人员应积极运用DOSE指数,预测慢性阻塞性肺疾病患者的生活质量,并将其作为评价生活质量变化的客观依据。     

慢性阻塞性肺疾病合并焦虑抑郁症的临床特征及相关危险因素分析

目的:分析住院慢性阻塞性肺疾病(COPD)患者合并焦虑抑郁症的临床特征及相关危险因素。方法:选取2019年1月至10月武汉大学人民医院呼吸与危重症医学二科153例COPD患者作为研究对象进行横断面研究,根据医院焦虑抑郁量表评分和肺功能结果分为单纯COPD组和COPD合并焦虑抑郁症组,比较2组临床特征,采用单因素和多因素...     

Synthesis and release of gonadotropins and their subunits by long-term organ cultures of human fetal hypophyses

From weeks 13 to 26 of fetal life human hypophyses disclosed a constant content of radioimmunoassayable FSH. Although present already before this period, LH content increased considerably at week 17, along with the appearance of free beta-LH. In long-term organ culture experiments such early differentiating pituitaries proved to be endowed with autonomous synthesis and release of FSH and of free alpha-subunit, while LH, beta-LH and TSH declined to very low levels within a few weeks. Supplementation of the medium with LH-RH (12 ng/ml) significantly increased FSH synthesis and release but was not sufficient to sustain production of beta-LH and LH. It is suggested that other factors than LH-RH are required for differentiation of beta-LH biosynthesis and thus for production of LH.     

Comparative study of enzyme activities degrading sorbitol,ribitol, xylitol and gluconate in guinea pig tissues

Summary In guinea pig tissues the activities of the enzymes D-gluconokinase, sorbitol dehydrogenase, D-ribulo- and D-xylulokinase were measured. D-ribulose and D-xylulose were prepared by isomerisation of D-ribose and D-xylose in pyridine and separated by preparative paper chromatography. The activity patterns of the pentulokinases were identical in all tested organs. The highest activities of these two enzymes were found in adipose tissue, when referred to soluble cell protein, and was higher than the activity in liver and kidney. The high enzyme activities of the pentulokinases in adipose tissue may explain the antilipolytic effect of these pentitols and pentoses in diabetes. The activities of sorbitol dehydrogenase and gluconokinase showed a similar activity pattern in all tested organs of the guinea pig. The highest activities were found in liver and kidney and the lowest in the adipose tissue. The direct metabolism of gluconate in adipose tissue seems impossible. The activity of the pentulokinases are diminished in the tissues of the diabetic rat.     

Effect of actinomycin D and cycloheximide on the release and biosynthesis of gonadotropins by pituitary cell cultures

The effect of actinomycin D and cycloheximide on the release and biosynthesis of gonadotropins has been studied using pituitary cells in monolayer cultures. Both cycloheximide (1 mM) and actinomycin D (0.15 nM) inhibited partially but significantly, the GnRH-stimulated release of LH and FSH. However, these two antibiotics had no effect on the basal release of gonadotropins. The release of LH and FSH in the presence of high K⁺ (59 mM) concentration was not inhibited by actinomycin D or cycloheximide. It is probable that the release of gonadotropins in a high K⁺ medium, but not that induced by GnRH, results from the alteration of the ion permeability characteristics of the plasma membrane on which the two antibiotics have no effect. Cycloheximide profoundly inhibited incorporation of [¹⁴C]amino acids (AA) into LH and FSH by the cells and GnRH-induced release of AA-LH and AA-FSH. It only partially inhibited the incorporation of [³H]glucosamine (GLN) into LH and FSH at 2 h of incubation but had no effect or a small effect on the GnRH-induced release of GLN-LH and GLN-FSH. These results suggest, on the one hand, that cycloheximide inhibited the synthesis of polypeptide chains of LH and FSH and, on the other hand, that gonadotropic cells contain some non-glycosylated or nascent subunits of LH and FSH that can be glycosylated even in the presence of cycloheximide. Actinomycin D had no effect on the incorporation of either GLN or AA into LH and FSH, but did completely inhibit the GnRH-induced release of labeled gonadotropins and the GnRH-induced incorporation of labeled precursors. These results support the hypothesis that messenger RNA of the gonadotropic cells is stable enough to allow synthesis of the polypeptide chains of LH and FSH during 6 h of incubation. They also support the finding of many authors that the GnRH-induced release of LH and FSH proceeds first through an acute effect that is not affected by antibiotics and then through a priming effect, dependent on protein or RNA synthesis (or both), that is inhibited by antibiotics.     

Challenges and opportunities in advancing models of care for older adults: an assessment of the National Institute on Aging research portfolio

OBJECTIVES: To identify existing projects supported by the National Institute on Aging (NIA) that may relate to the recommendations for models of care (MOCs) presented in the 2008 Institute of Medicine Report, Retooling for an Aging America: Building the Healthcare Workforce. DESIGN: Cross‐sectional analysis of NIA's grant portfolio. SETTING: NIA. PARTICIPANTS: NIA grantees. MEASUREMENTS: NIA's grant portfolio was queried for the period 1999 to 2008 using a variety of search terms related to MOCs. Inclusion criteria were adherence to guiding principles for MOCs (comprehensive care, efficient care, older person as an active partner) or focus on innovative feature(s) of MOCs (interdisciplinary care, care management, chronic disease self‐management, pharmaceutical management, preventive home visits, proactive rehabilitation, transitional care). Exclusion criteria were lack of focus on an intervention and focus on informal caregivers. Expert NIA staff reviewed and validated projects. RESULTS: One hundred thirty‐five grants were identified. These grants represent fewer than 1% of the approximate number of grants NIA has funded over this same period of time (～24,000 grants). Forty‐four percent focused on components of comprehensive care and 34% on active involvement of older adults. Approximately half specifically focused on innovative features of MOCs, ranging from chronic disease self‐management (32%) and proactive rehabilitation (26%) to preventive home visits (1%) and transitional care (1%). The majority of projects were investigator‐initiated grants (46%). CONCLUSION: NIA has supported the development of many interventions that include components of MOCs related to recommendations from the IOM report. The challenge for the future will be determining which of the many components of comprehensive care systems are most effective for which subsets of the elderly population and assessing opportunities for enhanced collaboration between public and private aging research stakeholders.     

《国际医学寄生虫病杂志》2006至2009年论文分析

以中国科学技术信息研究所和万方数据股份有限公司的<中国期刊引证报告(扩刊版)>为依据,对<国际医学寄生虫病杂志>2006-2009年的载文、作者、引文、被引等方面进行统计分析,揭示该刊的出版现状.     

《国际医学寄生虫病杂志》2006至2009年论文分析

以中国科学技术信息研究所和万方数据股份有限公司的<中国期刊引证报告(扩刊版)>为依据,对<国际医学寄生虫病杂志>2006-2009年的载文、作者、引文、被引等方面进行统计分析,揭示该刊的出版现状.     

Hepatitis B and hepatitis C viruses: a review of viral genomes,viral induced host immune responses,genotypic distributions and worldwide epidemiology

Hepatitis B and hepatitis C viruses (HCV) are frequently propagating blood borne pathogens in global community. Viral hepatitis is primarily associated with severe health complications, such as liver cirrhosis, hepatocellular carcinoma, hepatic fibrosis and steatosis. A literature review was conducted on hepatitis B virus (HBV), HBV genome, genotypic distribution and global epidemiology of HBV, HCV, HCV genome, HCV and host immune responses, HCV genotypic distribution and global epidemiology. The valued information was subjected for review. HBV has strict tissue tropism to liver. The virus infecting hepatocytes produces large amount of hepatitis B surface antigen particles which lack the DNA. It has capability to integrate into host genome. It has been found that genotype C is most emerging genotype associated with more severe liver diseases (cirrhosis). The approximate prevalence rate of genotype C is 27.7% which represents a major threat to future generations. Approximately 8% of population is chronic carrier of HBV in developing countries. The chronic carrier rate of HBV is 2%-7% in Middle East, Eastern and Southern Europe, South America and Japan. Among HCV infected individuals, 15% usually have natural tendency to overcome acute viral infection, where as 85% of individuals were unable to control HCV infection. The internal ribosomal entry site contains highly conserved structures important for binding and appropriate positioning of viral genome inside the host cell. HCV infects only in 1%-10% of hepatocytes, but production of tumor necrosis factor alpha (from CD8+ cells) and interferon-gamma cause destruction of both infected cells and non-infected surrounding cells. Almost 11 genotypes and above 100 subtypes of HCV exists worldwide with different geographical distribution. Many efforts are still needed to minimize global burden of these infections. For the complete eradication of HBV (just like small pox and polio) via vaccination strategies, sincere efforts would be required from government and nongovernmental organizations.     

2014 Hypertension Recommendations From the Eighth Joint National Committee Panel Members Raise Concerns for Elderly Black and Female Populations

A report from panel members appointed to the Eighth Joint National Committee titled “2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults” has garnered much attention due to its major change in recommendations for hypertension treatment for patients ≥60 years of age and for their treatment goal. In response, certain groups have opposed the decision to initiate pharmacologic treatment to lower blood pressure (BP) at systolic BP ≥150 mm Hg and treat to a goal systolic BP of <150 mm Hg in the general population age ≥60 years. This paper contains 3 sections—an introduction followed by the opinions of 2 writing groups—outlining objections to or support of maintaining this proposed strategy in certain at-risk populations, namely African Americans, women, and the elderly. Several authors argue for maintaining current targets, as opposed to adopting the new recommendations, to allow for optimal treatment for older women and African Americans, helping to close sex and race/ethnicity gaps in cardiovascular disease morbidity and mortality.     

我国传染病的研究与防治进展

传染病防治事关国家安全、人民健康,虽然我国在传染病防控领域的研究水平不断增强,但传染病防控形势仍然严峻。为全面了解当前我国传染病的防控情况,本文介绍了我国重要传染病的流行现状,系统梳理了我国传染病领域的研究与防治进展,总结我国传染病防控成果。同时分析了我国传染病防控存在的问题,并对未来我国传染病防控提出了建议。     

Pancreaticojejunal anastomosis, using a stent tube, in pancreaticoduodenectomy

We report our technique for pancreaticojejunostomy, using a stent tube, and examine the literature with regard to the use of a stent tube in pancreaticojejunostomy. The total number of stitches in the anastomosis of the pancreatic parenchyma and seromuscle layer of the jejunum should be more than 20, and there should be more than 8 stitches in the anastomosis of the pancreatic duct and parenchyma and all layers of the jejunal wall, even in a normal-sized main pancreatic duct. There is no dead space between the cut end of the pancreatic parenchyma and the jejunal wall. None of the 114 consecutive patients who underwent pancreaticoduodenectomy in our series died. We use a stent because this makes it easier to perform anterior wall anastomosis of the pancreaticojejunostomy. It is easy to find the pancreaticojejunal anastomosis at the anterior wall anastomosis. We never stitch the posterior wall of the anastomosis with a stent tube in place at the anterior wall anastomosis. If the anastomosis leaks, the massive flow of pancreatic juice around the anastomosis is prevented because of the pancreatic juice flowing out of the pancreatic tube.