癌症患者焦虑抑郁情绪与性别、文化程度、医疗费支付方式的研究

目的对癌症患者焦虑、抑郁情绪状况的资料进行比较，探讨癌症患者焦虑、抑郁情绪的特点及其相关因素。方法采用Zung＇s自评焦虑量表（SAS）和Zung＇s自评抑郁量表（SDS），对97例癌症患者进行测定，然后，探讨癌症患者焦虑、抑郁情绪与不同性别、文化程度、经济状况的关系。结果本次调查中不同性别、医疗费支付方式与癌症患者焦虑、抑郁发生率之间无显著差异（P〉0.05），不同文化程度与焦虑发生率有显著差异（P〈0.05）与抑郁发生率无显著差异（P〉0.05）。结论癌症患者中焦虑、抑郁情绪发生率较高，不同性别、文化程度、经济状况与癌症患者焦虑、抑郁情绪的发生率有差别。且发生率明显高于一般人群。     

住院精神病患者焦虑抑郁情绪及影响因素评估

目的探讨住院精神病患者焦虑、抑郁情绪的发生率及其主要影响因素。方法采用焦虑自评量表、抑郁自评量表对153例住院精神病患者的焦虑、抑郁情绪进行评估，并应用自制调查表对其产生的原因进行逐步回归分析。结果住院精神病患者焦虑情绪发生率为30．72％，抑郁情绪发生率为45．09％，同时伴有焦虑抑郁情绪的发生率为28．76％。影响住院精神病焦虑情绪的主要因素为住院次数、病程、家庭经济状况；影响抑郁情绪的主要因素为病程、住院次数、病后家庭及单位和社会关心情况。结论住院精神病患者存在不同程度的焦虑、抑郁情绪，应重视产生这些情绪的影响因素，有针对性的进行干预。     

汶川地震伤员焦虑、抑郁情绪的影响因素及心理干预效果

目的探讨汶川地震伤员焦虑、抑郁情绪的影响因素以及心理干预的效果。方法采用SDS抑郁量表、SAS焦虑量表对46名汶川地震伤员的焦虑抑郁情绪进行评估,使用多元逐步回归分析筛选其影响因素,实施相应的心理干预,观察效果。结果46例地震伤员干预前后焦虑症状发生率分别为89．1％、32．6％,抑郁症状发生率为84．8％、30．4％。影响焦虑、抑郁情绪的因素为：个性特点、地震前家庭经济状况、病后家庭成员的关心程度、治疗期望值、担心出院存在残疾。结论制定针对性强的心理干预措施可明显缓解地震伤员焦虑、抑郁情绪,促进社会功能恢复。     

尊严疗法及人生回顾干预对晚期住院癌症患者尊严及心理状况的影响

目的 比较尊严疗法及人生回顾干预对晚期住院癌症患者尊严、心理状况的影响.方法 选取2家三级甲等医院肿瘤科收治的90例晚期住院癌症患者,按照患者就诊时间先后顺序将患者分为尊严疗法干预组、人生回顾干预组及对照组,每组30例.分别予尊严疗法干预、人生回顾干预及常规干预.干预1个月末,分别评价3组的焦虑、抑郁、尊严得分在组间的差异.结果 与对照组相比,尊严疗法及人生回顾组患者焦虑、抑郁、尊严得分差异有统计学意义(P<0.05);与人生回顾组相比,尊严疗法组尊严得分低于人生回顾组,差异具有统计学意义(P<0.05).结论 尊严疗法及人生回顾干预均可缓解住院晚期癌症患者焦虑、抑郁情绪,提高患者尊严水平,尊严疗法较人生回顾干预更能提高患者尊严水平.     

尊严疗法对住院晚期癌症患者生活满意度及心理状况的影响

目的:观察尊严疗法对住院晚期癌症患者生活满意度及心理状况的影响。方法:将122例肿瘤科住院晚期癌症患者随机分为实验组(n=62)和对照组(n=60),对照组接受常规照护,实验组在此基础上接受尊严疗法。采用重复测量方差分析对干预前、干预15天及30天时两组的生活满意度、焦虑、抑郁及尊严水平进行比较。结果:两组的生活满意度、焦虑、抑郁和尊严得分的组间效应具有统计学意义(P0.05);两组的焦虑、抑郁和尊严得分的时间效应具有统计学意义(P0.05);两组的生活满意度、焦虑、抑郁和尊严得分的干预与时间因素存在交互效应(P0.05)。结论:尊严疗法能有效提高住院晚期癌症患者生活满意度及尊严水平,改善其焦虑抑郁情绪。     

136例腹膜透析患者抑郁状况及影响因素分析

目的 了解腹膜透析患者的抑郁状况,并探讨其影响因素.方法 采用描述性研究设计,应用自编的一般资料调查表、抑郁自评量表、健康状况调查问卷、医学应对方式问卷对136例腹膜透析患者进行调查.结果 136例腹膜透析患者的抑郁发生率为31.6%,腹膜透析抑郁组患者的生活质量低于非抑郁组(P<0.01);非抑郁组的面对、应对方式总分高于抑郁组(P<0.01),非抑郁组在回避、屈服方面得分低于抑郁组(P<0.01);抑郁与生活质量各维度及面对应对方式呈负相关(P<0.01),与回避、屈服应对方式呈正相关(P<0.01).多元逐步回归分析显示,家庭人均月收入、躯体角色功能、情绪角色功能、面对、屈服是腹膜透析患者抑郁的主要影响因素(P<0.01或P<0.05).结论 136例腹膜透析患者抑郁发生率为31.6%,家庭经济收入、患者躯体角色功能及情绪角色功能和面对、屈服应对方式是抑郁的主要影响因素,提示护理人员应有针对性地对腹膜透析患者开展心理干预,以改善患者的心理状况.     

消化系统肿瘤患者术前焦虑及其影响因素分析

目的 了解消化系统肿瘤患者术前焦虑情绪并探讨其影响因素.方法 连续收集拟行消化系统肿瘤外科手术的患者451 例,调查患者一般资料,并施测焦虑自评量表、癌症患者生命质量测定量表中文版核心量表、艾森克人格问卷简式量表中国版及特质应对方式问卷.采用多元线性回归法分析焦虑影响因素.结果 本组的焦虑得分(44.33±8.64)分,阳性检出率32.2%;多元线性回归模型中,患者性别、文化程度、主要陪护者、情绪功能、认知功能、躯体功能、失眠、疲倦、应对方式是焦虑的影响因素(P＜0.05),其中积极应对方式是保护因素.结论 消化系统肿瘤患者术前焦虑较高发,其影响因素为性别、文化程度、主要陪护者、情绪功能、认知功能、躯体功能、失眠、疲倦及积极应对方式.     

老年癌症晚期病人家庭照护者焦虑和抑郁状况的调查与对策

[目的]了解老年癌症晚期病人家庭照护者焦虑和抑郁状况,从而提出相应的对策。[方法]采用Zung焦虑自评量表(SAS)和抑郁自评量表(SDS)对39例老年癌症晚期病人家庭照护者的焦虑和抑郁情绪进行测评。[结果]老年癌症晚期病人家庭照护者焦虑、抑郁发生率分别为56.41%和48.72%。[结论]老年癌症晚期病人的家庭照护者大多存在焦虑和抑郁情绪,需给予心理支持、护理技术及生活护理服务和指导,以缓解家庭照护者的焦虑、抑郁情绪,提高照护水平。     

地市级肿瘤医院癌症相关性抑郁焦虑情绪调查分析

目的通过调查某地市级肿瘤医院癌症患者的抑郁、焦虑情绪发生率,并分析相关影响因素,以期为临床干预提供借鉴。方法各科室由专人对住院患者进行抑郁、焦虑问卷调查,采用SPSS17.0软件包进行数据处理,分析癌症住院患者抑郁、焦虑的发病情况及各因子对癌症相关性抑郁的影响。结果本院癌症住院患者的抑郁、焦虑发病率分别为46.20%和16.60%,暂未发现并发重度抑郁、焦虑患者。癌症相关性抑郁与肿瘤部位、居住地无关(P0.05),经多元线性回归分析得出:性别、年龄、文化程度、经济负担及肿瘤分期为癌症相关性抑郁发生的主要影响因素(P0.05)。结论癌症相关性抑郁发病率较高,对家庭经济负担重、年轻、女性、晚期并转移等癌症患者,应多关注其心理状况,及时发现并早期干预,进一步提高患者生活质量和整体疗效。     

2型糖尿病合并肥胖患者焦虑、抑郁横断面调查与分析

目的：了解2型糖尿病合并肥胖患者焦虑、抑郁状况,分析其影响因素。方法：采用自行设计患者一般资料调查表和疾病相关资料调查表、焦虑自评量表（SAS）、抑郁自评量表（SDS）对128例门诊及住院2型糖尿病合并肥胖患者的焦虑、抑郁状况进行横断面调查及分析。结果：2型糖尿病合并肥胖患者焦虑、抑郁的发生率分别为58.6%和56.2%,焦虑、抑郁评分高于国内常模,差异有统计学意义（P<0.01）。多元逐步回归分析显示BMI、是否接受过糖尿病及肥胖健康教育是其焦虑情绪的主要影响因素;BMI、糖尿病并发症情况是其抑郁情绪的主要影响因素。结论：2型糖尿病合并肥胖患者存在焦虑、抑郁心理障碍,其焦虑情绪主要受BMI、是否接受过糖尿病及肥胖健康教育影响;抑郁情绪主要受BMI、糖尿病并发症情况影响。医务人员应着重关注2型糖尿病合并肥胖患者的心理状态,加强糖尿病及肥胖健康教育,尤其是运动和饮食教育,进行积极的心理疏导,减轻其焦虑、抑郁情绪。     

The effect of x-rays on the rickettsiostatic activity of streptomycin,aureomycin, and penicillin

The effect of x-rays on the rickettsiostatic activity of streptomycin, penicillin and aureomycin in the embryonate egg was investigated. Only a slight reversal of the rickettsiostatic action of 5 mg. of streptomycin occurred in embryonate eggs given 100 r of x-rays at 4 days of incubation, whereas complete reversal occurred in those given 1000 r. Groups of eggs irradiated with intermediate doses of x-rays showed a graded response. The rickettsiostatic activity of 5 mg. (1660 Oxford units/mg.) of penicillin or of 5 mg. of aureomycin was not reversed by doses of x-rays ranging from 100 to 1000 r. 500 r of x-rays reversed the rickettsiostatic activity of 2 mg., 4 mg., 8 mg., or 16 mg. of streptomycin per egg in proportion to the amount of streptomycin injected. The rickettsiostatic activity of 2 mg. of streptomycin was completely reversed and the activity of 16 mg. only partially reversed. Reversal of the rickettsiostatic activity of streptomycin by x-rays was observed when radiation was given up to 6 days after the injection of the antibiotic into 7-day-old embryos. Reversal of the rickettsiostatic activity of 4 mg. of streptomycin could be detected when the antibiotic was injected 3 days after 500 r of x-radiation. Explanations of the observed phenomena are discussed in terms of biochemical and biophysical alterations of the cells of the host.     

心肌组织超声背向散射参数临床应用研究

本文报道了２０例陈旧性心梗（ＯＭＩ）、３３例扩张型心肌病（ＤＣＭ）、５６例高血压病（ＨＴ）、１２例肥厚型心肌病（ＨＣＭ）患者和正常对照组４０例心肌超声背向散射参数检查结果。正常组各节段心肌平均ＩＢ％相近，ＣＶＩＢ略有差异。ＯＭＩ梗塞灶、ＤＣＭ和出现并发症的ＨＴ患者（１９／５６）心肌平均ＩＢ％均增大，ＣＶＩＢ均减低或ＩＢＳ曲线形态异常，无并发症的ＥＴＨ患者ＩＢ％、ＣＶＩＢ无显著改变。ＨＣＭ患者ＩＶＳ的ＩＢ％增大，ＣＶＩＢ减低，ＩＶＳ左室侧１／２心肌ＣＶＩＢ大于右室侧１／２；ＬＶＰＷ的ＩＢ％和ＣＶＩＢ与正常组无显著差异。     

贵要静脉营养血管远端蒂复合瓣的解剖学特征

背景:前臂皮神经营养血管皮瓣特别适宜手部远端的组织缺损修复,所以了解贵要静脉远端的营养血管及与邻近骨、皮和前臂内侧皮神经的血供关系对临床上前臂皮神经营养血管远端蒂复合瓣的设计有重要意义。目的:研究前臂尺侧缘远端的动脉穿支,为前臂尺侧缘贵要静脉营养血管远端蒂复合瓣的设计提出解剖学理论。设计:单一样本实验。单位:解放军南京军区福州总医院军区骨科研究所临床解剖学研究中心。材料:实验于2004-05/10在解放军南京军区福州总医院军区骨科研究所临床解剖学研究中心实验室完成。研究材料为30侧动脉灌注红色乳胶成人上肢标本(由南京军区福州总医院军区骨科研究所临床解剖学研究中心提供)。方法:将30侧成人上肢标本,以尺骨茎突为观测标志点进行显微解剖。主要观察指标:重点观察:①前臂尺侧缘远端的动脉穿支来源。②动脉穿支与贵要静脉远端的营养血管。③营养血管与邻近骨、皮和前臂内侧皮神经的血供关系。④贵要静脉的浅深交通支。结果:①前臂尺侧缘远端的动脉穿支来自:尺动脉的皮支5～9支,外径(0.7±0.3)mm,尺动脉腕上皮支1～3支,外径(0.6±0.3)mm。在尺骨茎突上方6.0～16.0cm,骨间前动脉发骨皮穿支二三支,骨间后动脉发骨皮穿支1～3支,二者外径在0.4～1.2mm,分布尺骨中下段骨膜及相应区域的皮肤。②上述动脉穿支均发皮支、筋膜支、骨膜支、贵要静脉和皮神经营养血管支,形成贵要静脉旁血管链和皮神经干血管链以及深、浅筋膜和骨膜血管网。结论:前臂尺侧缘远端的动脉穿支是贵要静脉营养血管的来源,营养血管与邻近的骨、皮和前臂内侧皮神经的营养血管同源,是设计贵要静脉营养血管远端蒂复合瓣的解剖学基础。以尺动脉腕上皮支为蒂的远端蒂复合瓣,旋转轴点可达腕关节平面,用于转位修复手部远处的组织缺损。     

Biogenesis of the mycobacterial cell wall and the site of action of ethambutol.

The effect of ethambutol (EMB) is primarily on polymerization steps in the biosynthesis of the arabinan component of cell wall arabinogalactan (AG) of Mycobacterium smegmatis. Inhibition of the synthesis of the arabinan of lipoarabinomannan (LAM) occurred later, and thus in the cases of AG and LAM, the polymerization of D-arabinofuranose apparently involves separate pathways. While the synthesis of these arabinans was normal in an EMB-resistant isogeneic strain, the addition of EMB to the resistant strain resulted in partial inhibition of the synthesis of the arabinan of LAM and the emergence of a novel, truncated form of LAM, indicating partial susceptibility of the resistant gene(s) and providing a new intermediate in the LAM biosynthetic sequence. A consequence of inhibition of AG arabinan biosynthesis is the lack of new sites for mycolate attachment and thus the channeling of mycolate residues into a variety of free lipids which then accumulate. The primary biochemical effects of EMB can be explained by postulating separate AG and LAM pathways catalyzed by a variety of extramembranous arabinosyl transferases with various degrees of sensitivity to EMB.     

Industrial nursing. Functions within the basic health unit

The Law of Prevention of Risks at Work marked an important point of flexion in the tie sanitary professions the field of the labor health. This work will mark the objective to locate to the Industrial Nursing (a company nursing assistant) in a context near the reality. For it, it will be equipped with legal content, and those articles of the Law of Prevention of Risks at Work will be mentioned and of the Regulations for Prevention Services, that establishes the guidelines of performance of the professionals of the Basic Unit of Health (Industrial Medicina and the company nursing assistant) Also will mention the objectives of the First draft of Law of the Reformation of Normative Marco of the Law of Prevention of Risks at Work, consequence of the alarming data of sinisterness and labor accidental.     

Pathogenesis of steatorrhea in chronic diseases of the small intestine

Altogether 150 patients with chronic enteritis and celiac disease with a history of resection of a part of the ileum were examined. It was established that in patients with chronic enteritis, of importance for the pathogenesis of steatorrhea was the deficiency of bile acids during digestion because of hypokinesia of the gallbladder and partial deconjugation of bile acids in the presence of bacterial dissemination of the small intestine. During celiac disease, steatorrhea was caused by the decreased enzymatic function of the pancreas, asynchronism of the food and bile supply to the intestinal lumen, disorders of absorption of lipolysis products. In patients with large resection of the ileum, steatorrhea was associated with abnormality of the enterohepatic circulation of bile acids, bacterial dissemination of the small intestine and reduction of the absorption surface. A schedule of differentiated therapy is offered.     

The secretory phospholipase A2 and transport of lipids by lipoproteins in patients with the risk of cardio-vascular pathology (the system "score") of lower and average degree. The diagnostic significance of the test

The clinical and pathomorphologic data demonstrate that the most frequent cause of cardiac infarction is the formation of "soft" atheromatosis plaques in the intima of arteries. Their rupture results in thrombosis of coronary arteries. The plaques are characterized by higher content of triglycerides. On the basis of the research data, it is possible to validly consider that the detection of secretary phospholipase content A2 conjugated with lipoproteins is the test of systemic inflammatory response. This response is formed under atherosclerosis in vivo as a feedback to the accumulation in the intercellular medium of the endogenic flogogens (initiators of biological reaction of inflammation)--lipoproteins of lower density subclass A. Their utilization in the intima, as a pool of local interstitial tissue, by the resident macrophagocytes transformed from monocytes result in the formation of doth soft and disposed to laceration atheromatosis plaques and the atherothrombosis of coronary arteries and rarer of carotids. Concurrently, the increase of lipoproteins content in blood plasma is supposed to be the test of proliferation of cells in vivo, the smooth muscle cells of medium in particular. The simultaneous detection of content of secretory associated with lipoproteins phospholipase A2 and lipoprotein (a) can be considered as a valid risk factor of atherosclerosis and atherothrombosis--atheromatosis of intima of arteries with the formation of "soft" plaques in the intima, their laceration and thrombosis of coronary arteries and clinical presentation of cardiac infarction. The diagnostic triad of formation of soft plaques in the intima can be composed of the higher level of triglycerides, the content of protein of phospholipase A2 and lipoprotein (a).     

Current data on curarization

The knowledge of the mechanism of action of neuromuscular blocking agents has improved together with the better understanding of the physiology of the neuromuscular junction at the molecular and cellular levels. The main action of competitive neuromuscular relaxants is the blockade of the acetylcholine binding site of the acetylcholine receptor when the latter is its inactive-closed conformation. Owing to the high margin of safety of the neuromuscular transmission, the blockade of an important fraction (75-90%) of acetylcholine receptors is necessary to cause a decrease in muscle strength. An other mechanism of action of competitive agents is the blockade of presynaptic secretion of acetylcholine during repetitive stimulations which may explain the phenomenon of train of four fade or of tetanic fade.     

彩色多普勒超声对开角型青光眼的血流动力学研究及临床意义

目的了解开角型青光眼视神经的血液供应情况。方法用彩色多普勒超声检测开角型青光眼和正常眼眼动脉、视网膜中央动脉和睫状后动脉的收缩期峰值血流速度、舒张末期血流速度、时间平均血流速度、阻力指数和搏动指数。结果在两者之中眼动脉和睫状后动脉的收缩期峰值血流速度差异无显著性（Ｐ＞０．０５）,舒张末期血流速度、时间平均血流速度、阻力指数、搏动指数差异有显著性意义（Ｐ＜０．００１）。视网膜中央动脉的多项血流动力学指标差异有显著性意义（Ｐ＜０．００１）。结论开角型青光眼的视神经存在缺血因素。     

溃疡性结肠炎患者周围血中性粒细胞凋亡和Bcl-2基因的表达

目的　观察溃疡性结肠炎 (UC)患者周围血中性粒细胞 (PMN)凋亡及Bcl 2基因表达的变化。方法　采用流式细胞术检测 18例UC患者周围血PMN凋亡及Bcl 2基因的表达。结果　活动期UC患者PMN凋亡率明显低于健康人对照组和缓解期UC患者 (P <0 .0 1) ,Bcl 2基因的表达明显高于对照组和缓解期患者 (P <0 .0 1)。缓解期UC患者PMN凋亡率与对照组无差别 ,但Bcl 2基因的表达与正常人对照组比较差别有显著性意义 (P <0 .0 1)。不同病情活动期UC患者PMN凋亡及Bcl 2的表达有显著性差异 (P <0 .0 1或P <0 .0 5 )。结论　活动期UC患者周围血PMN凋亡延迟 ,且与病情及疗效密切相关。PMNBcl 2基因表达上调可能是其凋亡延迟的重要分子机制之一。