海训士兵心理健康状况与应对方式相关性研究

目的研究海训期间士兵的心理健康水平及其与应对方式的关系，为部队士兵的心理健康教育提供科学依据。方法采用症状自评量表(SCL-90)和简易应对方式问卷(SCSQ)，测评480名海训士兵的心理健康状况和应对方式，并进一步分析两者的相关性。结果海训士兵SCL-90中的躯体化、恐怖和精神病性因子分值显著高于国内常模；SCSQ中积极应对方式和消极应对方式都显著低于常模；士兵的消极应对方式得分与SCL-90各因子得分呈显著正相关。结论应高度重视海训士兵心理健康状况：消极应对方式不利于士兵的心理健康．要优化和锻炼士兵对生活事件的积极应对方式和态度。     

480名士兵海训期间心理健康状况调查

目的　研究海训期间士兵的心理健康状况,为部队官兵的心理卫生工作提供科学依据。方法　采用症状自评量表 (SCL-90)和自制调查问卷测评海训士兵的心理健康状况及相关资料。结果　躯体化、恐怖和精神病性3个因子得分显著高 于常模;不会游泳组士兵在敌对、恐怖、偏执3个因子上得分显著高于会游泳组士兵;对海训有顾虑的士兵总均分和各因子得 分均显著高于无顾虑的士兵;73.8%的士兵认为有必要进行心理健康指导。结论　对海训士兵的心理健康状况应予以重视, 尤其是不会游泳和对海训有心理顾虑的士兵,应进行有针对性的心理辅导。     

护理实习大专生心理健康水平与应对方式相关性研究

目的调查护理实习大专生心理健康水平及其与应对方式的相关性。方法采用症状自评量表和简易应对方式问卷对188名护理实习大专生进行调查。结果护理实习大专生躯体化、强迫、抑郁、焦虑和恐怖因子得分高于国内常模(P<0.01);积极应对得分与消极应对得分均低于常模(P<0.01或P<0.05);消极应对得分与症状自评量表各因子分呈正相关(P<0.01)。结论护理实习大专生消极的应对方式与心理健康水平密切相关,护理教育者应对护理实习大专生进行有针对性的心理干预。     

脑卒中患者亲属照顾者应对方式与心理状况的调查

目的 探讨脑卒中患者亲属应对方式、心理健康状况以及护理干预措施.方法 应用特质应对方式问卷、症状自评量表（SCL-90）以及自制健康知识知晓情况调查表,对100例脑卒中患者亲属进行调查.结果 脑卒中患者亲属消极应对因子得分离于常模,其SCL-90躯体化、人际关系、抑郁、焦虑因子得分均高于常模（P＜0.01）;相关分析表明,脑卒中患者亲属SCL-90躯体化因子得分与积极应对得分呈负相关（P＜0.05）,SCL-90总分、人际关系、抑郁、焦虑、敌对因子得分与消极应对得分呈正相关（P＜0.01或P＜0.05）;患者亲属均知道疾病的诊断,但缺乏护理知识与技能以及与此相关的健康知识.结论 脑卒中患者亲属多采用消极应对方式,其心理健康状况较差,且与应对方式密切相关.     

结核性胸膜炎患者负性心理与应对方式相关性研究

目的:探讨结核性胸膜炎患者负性心理与应对方式的相关性。方法:选取2017年12月1日~2019年12月1日收治的结核性胸膜炎患者80例作为研究对象,采用自制调查问卷、症状自评量表(SCL-90)、简易应对方式问卷(SCSQ)对患者进行问卷调查,记录相关评分,并分析两者之间的关系。结果:结核性胸膜炎患者SCL-90各因子得分均高于全国常模(P<0.05);结核性胸膜炎患者消极应对、积极应对得分低于全国常模(P<0.01);结核性胸膜炎患者精神病性、敌对、抑郁、躯体化、焦虑、人际关系敏感、恐怖、强迫、偏执等因子均与积极应对无相关性(P>0.05),与消极应对方式呈正相关(P<0.05)。结论:结核性胸膜炎患者负性心理较为严重,且在临床中主要表现为消极应对,而消极应对方式对负性心理的影响较大,临床应重视对患者的健康教育、心理干预,缓解患者不良情绪,提高其积极应对能力。     

心理学干预对独生子女士兵适应能力的影响

目的：了解心理学干预提高新入伍独生子女士兵适应能力的效果。方法：通过心理学知识讲座等形式，观察比较心理学干预前后独生子女和多生子女士兵心理状况的变化。结果：心理学干预前，独生子女士兵的负性情绪体验显高于多生子女士兵，积极情绪体验显低于多生子女士兵，心理学干预后，独生子女多项负性体验因子得分显降低，而积极应付因子得分显升高。结论：心理学干预可以有效促进入伍新兵尤其是独生子女士兵对新环境的适应能力。     

潜艇部队士兵285名心理健康影响因素的路径分析

目的:探讨潜艇部队士兵心理健康的影响因素及其相互作用方式和途径。方法:于2003-07/08以海军潜艇部队为观察群体,用单纯随机抽样的方法抽取男性军人285名作为调查对象。被试均自愿参加评估,采用艾森克个性问卷评定人格特征、简易应对方式量表评定应对方式、症状自评量表测定心理健康水平。艾森克个性问卷共88个条目,选取量表反映的内外向、神经质、精神质3个维度对人格特征加以分析。症状自评量表由90个问题组成,包含躯体化、强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性9个因子,对每个问题采取5级评分(1～5级,1没有,2很轻,3中等,4偏重,5严重),根据总均分及各因子分的高低来评估心理健康水平,并与中国军人常模进行比较。简易应对方式量表由20个条目组成,采用4级评分,0不采用、1偶尔采用、2有时采用和3经常,量表进一步分为积极应对方式和消极应对方式两个因子。主要观察海军潜艇部队士兵心理健康状况,海军潜艇部队士兵人格特征、应对方式与心理健康关系,并分析人格特征、应对方式对心理健康的影响路径。结果:发放问卷285份,剔除无效问卷10份,回收合格问卷275份,有效率96.5%。①潜艇部队士兵强迫、抑郁、焦虑、敌对、恐怖、偏执、精神病性各因子分及总均分高于中国军人常模,差异具有极显著性意义(P<0.01),人际敏感因子分高于中国军人常模,差异具有显著性意义(P<0.05)。②神经质、精神质与症状自评量表各因子分及总均分呈不同程度的显著性正相关(0.374相似文献   

ICU患者家属应对方式与心理健康状况的相关性研究

目的 了解ICU患者家属应对方式与心理健康状况的关系.方法 采用特质应对方式问卷(TCSQ)和症状自评量表(SCL-90)对47名ICU患者家属进行测量,并与普通病房患者家属组比较.结果 ICU患者家属存在严重的心理健康问题.应对方式中消极应对得分(20.32±7.87),明显高于对照组(30.86±5.42)(P＜0.01),积极应对得分与对照组比较,差异无统计学意义(P＞0.05).积极应对得分与SCL-90总均分、恐怖、抑郁、焦虑等因子呈负相关关系(P＜0.05或P＜0.01),消极应对得分与SCL-90呈正相关关系(P＜0.05或P＜0.01).结论 应对方式是影响ICU患者家属心理健康的重要因素.     

突发性聋患者心理健康状况与应对方式的相关性研究

目的 探讨突发性聋患者心理健康状况与应对方式的相关性.方法 使用症状自评量表(SCL-90)、简易应对方式问卷和一般情况调查表对99例突发性聋患者进行测量.结果 突发性聋患者的SCL-90阳性因子检出率为48.5％,躯体化、恐怖、精神病性因子分高于常模,差异有统计学意义(P＜0.01);积极与消极应对得分均低于常模,差异有统计学意义(P＜0.05);SCL-90总分与消极应对方式得分呈正相关(r=-0.321,P＜0.01).结论 突发性聋患者的心理健康水平和应对方式值得关注.采用消极应对方式的突发性聋患者的心理健康水平较差.     

青少年抑郁症一级亲属心理健康、社会支持与应对方式的相关性分析

目的探讨青少年抑郁症患者的一级亲属的心理健康、社会支持、应对方式的现状及相互关系。方法选取2017年1月~12月在我院就诊的143名青少年抑郁症患者的一级亲属为研究对象(观察组),采用自编一般情况调查表、症状自评量表(SCL-90)、社会支持评定量表(SSRS)、简易应对方式问卷(SCSQ)进行问卷调查及统计分析,与全国常模相关数据进行比较。结果观察组SCL-90总分及焦虑、抑郁、躯体化因子得分显著高于全国常模(P0.05);其他因子与全国常模无显著差异(P0.05)。观察组SCSQ量表的消极应对因子得分显著高于全国常模,积极应对因子得分显著低于全国常模(P0.05)。观察组男性家属SSRS各因子得分与全国常模无显著差异(P0.05),女性家属SSRS量表的主观支持评分显著低于全国常模(P0.05)。SCL-90的总分、躯体化、强迫、焦虑、抑郁、敌对、人际关系敏感与SCSQ的消极应对呈显著正相关,与积极应对和社会支持呈显著负相关;恐怖与消极应对呈显著正相关(P0.05或P0.01)。结论青少年抑郁症一级亲属的心理健康现状不容乐观,社会支持较少,应对方式消极;社会支持、应对方式是影响心理健康的重要因子。     

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.     

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.     

手转胎头术失败的原因与分娩结局临床分析

目的 探讨手转胎头术失败的原因与分娩结局.方法 选择2008年1月至2010年12月于我院住院分娩的持续性枕横位、枕后位产妇198例,根据行手转胎头术后结果分为成功组126例、失败组72例.比较两组分娩结局,对比分析失败原因.结果 失败组胎儿体质量≥3500 g的发生率[76.4％(55/72)]明显高于成功组[31.7％(40/126)],差异有统计学意义(x2=30.177,P=0.001)、失败组宫缩乏力发生率[58.3％(42/72)]高于成功组[38.1％ (48/126)],差异有统计学意义(x2=7.569,P=0.006)、失败组骨盆临界或轻度狭窄发生率[38.9％ (28/72)]高于成功组[23.8％(30/126)],差异有统计学意义(x2 =5.030,P=0.002)、失败组手转胎头时机不当(宫口开大＜6 cm、胎头位于坐骨棘上及宫口开大8～10 cm、胎头位于坐骨棘下≥2 cm)发生率[61.1％(44/72)]高于成功组[38.9％(49/126)],差异有统计学意义(x2=9.084,P=0.003).失败组母儿并发症(产后出血、产褥病率、胎儿窘迫、新生儿窒息)发生率高于成功组(x2 =9.586,P=0.002、x2=9.334,P=0.002、x2=5.910,P=0.015、x2=5.240,P=0.022)、失败组剖宫产发生率[72.2％(52/72)]明显高于成功组[34.1 ％(43/126),x2=26.641,P=0.001)].结论 手转胎头术能使难产变顺产,降低剖宫产率,减少母儿并发症,但须积极预防、处理导致手转胎头术失败的原因,对矫正失败后继续矫正及试产应慎重.     

Evidence-Based Pain Management and Palliative Care in Issue Four for 2009 of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly. Issue 4 for 2009 contains 4027 complete reviews, 1906 protocols for reviews in production, and 11447 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 600,000 randomized controlled trials, and 12,200 cited papers in the Cochrane methodology register. The health technology assessment database contains over 7500 citations. This edition of the Library contains 90 new reviews, of which 19 have potential relevance for practitioners in pain and palliative medicine.     

Wie zuverlässig sind Angaben zu nichtentzündlichen ausgedehnten Schmerzen?

ZusammenfassungFragestellung Es wurde geprüft, wie sich der Differenziertheitsgrad zweier Schmerzmessmethoden auf Angaben zur Ausgedehntheit klinischer Schmerzen auswirkt. Zugleich wurde der Referenzzeitraum variiert, über den die Patienten berichten sollten.Methode Erfasst wurde der Einfluss zu Lasten der Befragungsdifferenziertheit durch den Vergleich zweier Körperschema-Bildvorlagen. Drei Referenzzeiträume (Schmerz aktuell, letzte Woche, letztes halbes Jahr) wurden vorgegeben.Ergebnisse Patienten mit ausgedehnten Schmerzen gaben bei differenzierter Befragung um so mehr Schmerzen an, je weiter die Schmerzen zurück lagen und je größer der Berichtszeitraum war. Patienten mit gelenknahen Schmerzen gaben bei hoch differenzierter Befragung weniger ausgedehnte Schmerzen in der Vergangenheit an als bei globaler Einschätzung. Patienten mit Rückenschmerzen berichteten bei differenzierter Befragung zum aktuellen Schmerz über weniger ausgedehnte Schmerzen als bei globaler Befragung.Schlussfolgerung Die Angaben zur Schmerzausdehnung variieren vor allem bei Patienten mit ausgedehnten Schmerzen in Abhängigkeit von der Differenziertheit der Befragung. In diesen Fällen ist die Wahrscheinlichkeit erhöht, dass sich die Beschwerdesymptomatik zumindest teilweise erst in der Reaktion auf die situativen Befragungsbedingungen konstituiert und daher nicht auf andere Befragungsbedingungen generalisiert werden kann.