卵巢恶性肿瘤患者自我效能感与应对方式的相关性

目的:了解卵巢恶性肿瘤癌患者自我效能感与应对方式的相关性。方法:应用便利抽样法,采用一般自我效能感量表和医学应对方式问卷,对山西省某三级甲等医院158例卵巢恶性肿瘤癌患者进行调查,分析自我效能感与应对方式的相关性。结果:卵巢恶性肿瘤患者自我效能感与面对应对呈正相关(r=0.542,P0.01),与回避应对呈负相关(r=-0.480,P0.01)。结论:卵巢恶性肿瘤癌患者自我效能感水平与面对应对呈正相关,与回避应对呈负相关。鼓励引导患者积极选择面对应对方式分析处理问题,有助于改善患者自我效能感水平。     

2型糖尿病患者自我感受负担自我管理水平及应对方式的调查分析

目的 了解2型糖尿病患者自我感受负担、自我管理水平及应对方式的现状,探讨自我感受负担与自我管理水平、应对方式的相关性.方法 采用横断面调查法,选取2016年5月至2017年5月在安徽医科大学第四附属医院住院的169例确诊为2型糖尿病的患者为研究对象,发放一般资料调查表、患者自我感受负担量表、糖尿病自我管理行为量表、医学应对方式问卷对患者自我感受负担、自我管理水平等进行调查,采用Pearson相关分析法分析2型糖尿病患者自我感受负担与自我管理水平、应对方式的相关性.结果 94.67％的患者存在不同程度的自我感受负担,自我感受负担得分为(30.54±5.84)分;2型糖尿病患者自我管理的6个维度得分最高的为普通饮食(8.83±1.25)分,最低的为药物(4.05±0.95)分;在疾病治疗期间,患者采取的3种应对方式中得分最高的为面对(17.40±2.66)分,得分最低的为屈服(11.51±1.54)分;2型糖尿病患者自我感受负担得分与回避、屈服方式得分呈正相关关系(r=0.313,0.493,P<0.05),与面对方式、自我管理水平得分呈负相关关系(r=-0.231、-0.161,P<0.05).结论 2型糖尿病患者的自我感受负担处于中度水平,面对是患者在疾病治疗期间采取较多的应对方式,2型糖尿病患者的自我感受负担水平与回避、屈服应对方式正相关,与面对方式、自我管理水平负相关.     

应激中介变量与急性白血病化疗患者负性情绪的关系

目的 探讨应对方式、自我效能感和社会支持等应激中介变量与急性白血病化疗患者负性情绪之间的相关性,为发展护理干预模式提供依据.方法 选取122例急性白血病化疗患者,用医学应对方式问卷、一般自我效能感量表、社会支持评定量表及医院焦虑抑郁量表分别测评患者的应对方式、自我效能感、社会支持和焦虑抑郁状况,并分析四者之间的相关性.结果 分别有45.1%(55/122)和42.6%(52/122)的急性白血病化疗患者有不同程度的焦虑和抑郁情绪.急性白血病化疗患者的焦虑情绪与屈服(r=0.456)、自我效能感(r=-0.213)相关(P<0.05),屈服(β=0.456)进入多元线性回归方程,能解释急性白血病化疗患者焦虑状况变异的45.6%(F=31.442,P=0.000).抑郁情绪与屈服(r=0.328)、客观支持(r=-0.179)及社会支持利用度(r=-0.180)相关(P<0.05),屈服(β=0.359)、客观支持(β=-0.227)进入回归方程,能解释急性白血病化疗患者抑郁状况变异的39.8%(F=11.205,P=0.000).结论 急性白血病化疗患者的焦虑、抑郁负性情绪与采取的应对方式、自我效能感及获得的社会支持等应激中介变量有一定的关系,患者更常采用屈服的应对方式来面对现实,自我效能感得分较低,社会支持系统不健全,不利于其心理健康.     

军校新生自我效能与应对方式、人格特征和急性心理应激反应的关系

目的 探索急性应激中军校新生自我效能对急性心理应激反应的影响作用.方法 用相关问卷调查683名被试的自我效能、应对方式、人格特征;用实验法测量被试急性心理应激反应.结果 ①低自我效能新生人格特征的社会内向(Si)[(54.35±11.95)分,(34.35±10.21)分,P<0.01] 、外显性焦虑(Mas)[(55.10±12.27)分,(37.59±8.58),P<0.01]、依赖性(Dy)[( 54.03±9.53)分,(40.85±9.00)分,P<0.01]和应对方式中的消极应对(Nc)[(10.85±3.83)分,(7.58±3.62),P<0.01]显著高于高自我效能新生,低自我效能新生人格特征的支配性(Do)、社会责任感(Re)和应对方式中的积极应对(Pc)显著低于高自我效能新生(t=5.12,2.11,3.90,P<0.05或P<0.01);军校新生自我效能与人格特征的Si、Mas、Dy和应对方式中的Nc负相关(r=-0.586～-0.359,P<0.01),军校新生自我效能与人格特征的Do、Re和应对方式中的Pc正相关(r=0.172～0.460,P<0.05,P<0.01);在与自我效能相关的人格特征、应对方式诸因素中,Si、Dy、Pc进入回归方程.②低自我效能新生的心理应激总分显著低于高自我效能新生(t=3.92,P<0.01),自我效能与心理应激总分和行为反应、情绪反应、战斗力发挥分量表得分正相关(r=0.187～0.346,P<0.05,P<0.01).结论 人格特征、应对方式影响军校新生的自我效能,自我效能是应激源和急性应激反应间的中介因素.     

高原军人心理弹性状况及影响因素的研究

目的 研究高原军人心理弹性状况及影响因素.方法 采用成人心理弹性量表( RSA)、症状自评量表( SCL-90)、艾森克人格问卷(EPQ)和一般自我效能感量表(GSES),随机选取拉萨和林芝的高原军人756名进行测查.结果 ①高原军人心理弹性状况良好(2.78±0.47)分;不同文化程度的高原军人在未来计划(F=3.261,P=0.039)、家庭凝聚(F=6.428,P=0.002)、计划风格(F=4.135,P=0.016)和RSA总均分(F=4.162,P=0.016)上有显著差异,且大专及以上＞高中＞初中及以下;②RSA低分组在SCL-90( t=10.308,P=0.000)和神经质(t=11.297,p=0.000)的得分显著高于RSA高分组,在自我效能感( t=12.956,P=0.000)和内外向(t=13.004,P=0.000)的得分显著低于RSA高分组;③高原军人的心理弹性与自我效能感和内外向存在显著正相关(r自我效能感=0.48,r内外向=0.46),与神经质和SCL-90存在显著的负相关(r神经质=-0.42,r scL-90=-0.41),进行回归分析结果表明,自我效能感、内外向和神经质对心理弹性具有42％的预测作用.结论 高原军人心理弹性状况良好,自我效能感、内外向和神经质是影响心理弹性的重要因素.     

农村糖尿病患者应对方式和自我效能与其自护行为的相关性研究

目的探讨农村糖尿病患者应对方式和自我效能与其自护行为的相关性。方法应用医学应对方式问卷（MCMQ）、糖尿病自我效能量表(DSES)及糖尿病自护行为量表(DSCS),对159例农村糖尿病患者实施问卷调查,并进行三者相关性分析。结果农村糖尿病患者的自我效能水平和自护行为能力处于中等水平;自我效能和自护行为呈正相关（r=0.86,P＜0.001）;自我效能及自护行为分别与面对因子呈正相关(r=0.44和0.48,P＜0.001);与屈服因子呈负相关(r=0.32和0.29,P＜0.O01)。结论社区护士应注重患者应对方式和自我效能的评估,提供个性化的健康教育,改变应对方式,提高自我效能,改善自护行为。     

多种慢性病管理模式在社区老年高血压患者中的综合应用与评价

目的 分析多种慢性病管理模式在社区老年高血压患者中综合应用的效果,为改进慢性病社区防控效果提供依据。 方法 按照简单随机抽样法从社区卫生服务中心初建慢性病管理档案的老年高血压患者中抽取120例,使用随机数字表法分为干预组和对照组各60例。对照组依照《高血压患者健康管理服务规范》管理,干预组在此基础上融入自我管理、群组管理、家庭干预、同伴教育,6个月后使用《高血压患者自我管理行为测评量表》《高血压自我功效量表》《焦虑自评量表SAS》《高血压病相关知识调查表》对2组患者进行测评。 结果 干预组高血压病相关知识知晓率高于对照组,干预组自我管理行为测评总分(124.50±17.32)分、自我效能得分(63.33±7.02)分均高于对照组(113.77±20.65)分和(58.12±8.68)分,干预组的平均血压(132.63±7.14/74.40±7.46)mm Hg(1 mm Hg=0.133 kPa)低于对照组(140.48±10.69/78.53±7.58)mm Hg、干预组焦虑自评得分(54.15±8.40)分低于对照组(59.41±9.10)分,以上差异具有统计学意义(P<0.05)。干预组自我效能感与焦虑程度呈负相关(r=-0.288,P=0.026),与自我管理行为能力呈正相关(r=0.382,P=0.003)。对自我效能影响最大的因素是自我管理水平(P<0.01),其次是焦虑情绪(P<0.05)。 结论 多种慢性病管理模式综合应用于老年高血压患者的日常管理中有助于患者对疾病知识的掌握,促进其情绪改善,提高自我管理能力,通过自我效能感的提升,促进健康行为的长期改善。      

健康促进模式下护理对老年原发性高血压患者遵医行为、健康行为和血压控制的影响

目的 观察探讨健康促进模式下护理对老年原发性高血压患者遵医行为、健康行为、血压控制的影响。方法 随机选取2020年6月—2023年6月聊城市人民医院收治的120例老年原发性高血压患者,按随机数表法分为对照组(n=60,辅以常规护理)、观察组(n=60,辅以健康促进模式下护理),对比两组遵医行为、自我管理行为、健康行为、自我效能、血压控制效果。结果 观察组遵医行为依从率为95.00%,高于对照组的80.00%,差异有统计学意义(χ²=4.876,P=0.027)。干预后,观察组高血压患者自我管理行为测评量表评分(128.33±7.47)分、健康促进生活方式量表评分(161.65±9.45)分、慢性病自我效能量表评分(48.21±7.35)分,均高于对照组,差异有统计学意义(t=7.927、10.533、3.561,P均<0.001)。观察组血压控制优良率为98.33%,高于对照组,差异有统计学意义(χ²=6.405,P=0.011)。结论 健康促进模式下护理能够进一步提高老年原发性高血压患者遵医行为依从性,可提高患者自我管理能力及自我效能...     

肾移植受者自我管理现状及其相关影响因素研究

  目的  分析肾移植受者目前居家自我管理的现状,并探讨自我效能、焦虑、抑郁及自我管理支持对其的影响。  方法  采用便利抽样法选取2020年10月—2021年2月在北京市两家、长沙市一家三甲医院就诊的270例肾移植受者为研究对象。采用一般资料调查表、慢性病自我效能量表、医院焦虑抑郁量表、肾移植受者自我管理和自我管理支持量表进行问卷调查。  结果  共回收有效问卷265份,肾移植受者自我管理总分为95(84,103)分,各维度中,问题解决为35(30,40)分,伙伴关系为14(12,16)分,自我照顾行为为45(40,49)分。肾移植受者自我管理与其焦虑(r=-0.259,P＜0.01)、抑郁(r=-0.332,P＜0.01)呈负相关关系;与自我效能(r=0.399,P＜0.01)、自我管理支持(r=0.500,P＜0.01)呈正相关关系。多元线性逐步回归分析结果显示,年龄、居住地、移植术后时间、抑郁、自我效能和自我管理支持是肾移植受者自我管理的独立影响因素(均P＜0.05)。  结论  肾移植受者自我管理水平较好,但仍有半数患者处于中等水平。护理人员应重视肾移植受者的自我效能、负性情绪及自我管理支持对其自我管理行为的影响,可通过心理疏导、延续护理干预等方式,增加与患者的有益互动,以提高其自我管理水平。      

焦虑障碍患者生活事件、应对方式及社会支持状况调查

目的 探讨焦虑障碍患者生活事件、应对方式及社会支持的现状.方法 采用生活事件量表、简易应对方式问卷、社会支持评定量表对50例广泛性焦虑症患者(GAD),44例强迫症患者(OCD)、23例社交焦虑障碍患者(SAD)以及99例正常人进行评定.结果 患者组生活事件总分[GAD组(22.46±18.44)分;OCD组(23.68±28.31)分;SAD组(17.22±14.97)分;正常对照组(6.64±9.71)分,F =14.216,P =0.000]和负性生活事件得分[GAD组(18.76±17.99)分;OCD组(20.02±24.98)分;SAD组(12.00±13.16)分;正常对照组(4.56±7.51)分,F =14.391,P =0.000]均显著高于正常对照组;患者组积极应对方式得分( F =16.505,P =0.000)均显著低于正常对照组,广泛性焦虑症组、社交焦虑症组消极应对方式得分显著高于正常对照组;患者组社会支持总分( F =26.506,P =0.000)及客观社会支持( F =7.494,P =0.000)、主观社会支持( F =26.985,P =0.000)和社会支持利用度得分( F =13.931,P =0.000)均低于正常对照组.结论 1.焦虑障碍患者普遍经历了比较多的或者影响比较大的应激性生活事件,更加倾向于采用消极应对方式,社会支持比较匮乏;2. 焦虑障碍的发生发展可能与此类人群的生活事件、应对方式、社会支持情况相关.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.