护患沟通中护士行为态度对患者心理的影响调查

目的探讨护士在护患沟通中的行为态度对住院患者心理（焦虑抑郁）的影响。方法以某综合医院最近1个月不同科室的住院患者为干预对象,采用自身前后对照方法,比较干预前后护士行为态度对患者焦虑、抑郁得分的情况。结果干预前调查患者共544人,焦虑、抑郁平均得分分别为（9．32±3．21）分、（9．38±3．49）分;干预后调查患者共483人,焦虑、抑郁平均得分分别为（5．73±3．05）分、（5．39±4．31）分,护士行为态度评分平均得分为91．99±5．89,统计发现,随着护士行为态度评分的升高,患者焦虑、抑郁评分有降低的趋势,具有统计学意义。结论在护患沟通中护士良好的行为态度能减轻住院患者焦虑抑郁状况,满足患者身心健康需求。     

人际交往效能感与低年资护士群体护患沟通能力的关联性分析

目的:对低年资护士群体人际交往效能感水平与其护患沟通能力的相关性进行研究,为提高医疗服务质量提供依据。方法:按方便抽样法选取120名低年资护士(护龄<3年)纳入调查,调查工具采用国内通用的人际交往效能感量表及护患沟通能力评价量表。结果:本组低年资护士人际交往效能感平均得分为(137.27±15.64)分,护患沟通能力平均得分为(151.72±14.02)分,以上两项整体水平均显示中等偏低;多元线性回归分析显示,低年资护士护患沟通能力与人际交往效能感之间存在显著正相关(P<0.01或0.05)。结论:人际交往自我效能感是临床行为中护患沟通能力的良好预测项,护理管理者应注重培养低年资护士群体人际交往效能感水平,以达到促进该群体护患沟通能力的提高。     

临床实践初期护生护患沟通能力现状及影响因素的问卷调查与分析

目的:调查分析临床实践初期护理实习生的护患沟通能力状况及其影响因素,为提高护生的护患沟通能力奠定基础。方法:选取83名护生作为研究对象,采用护患沟通能力问卷进行调查研究,分析护生的护患沟通能力及影响因素。结果:护生的护患沟通能力得分为(61.93±1.68),得分最高的维度是建立和谐关系(14.05±1.31),得分最低的维度是验证感受(6.17±1.15);单因素分析中,影响护生护患沟通能力的因素为性别(t=-20.183,P=0.001)、医院是否进行护患沟通培训(t=7.614,P=0.003),医院进行护患沟通培训的方式(F=28.175,P=0.001);多元线性回归分析中,影响护生护患沟通能力的因素为医院进行护患沟通培训的次数(t=10.017,P=0.003),医院进行护患沟通培训的方式(t=2.613,P=0.001)。结论:临床实践初期护生护患沟通能力水平一般,作为护理管理者应该采取相应的措施制定有效的培训方案。     

新型冠状病毒肺炎疫情背景下高校护生职业认同现状及影响因素分析

目的 了解新型冠状病毒肺炎疫情背景下高校护生职业认同水平现状及影响因素.方法 采用横断面调查方法,于2020年1月至2月招募某高校年龄≥18周岁的在读本科护生.利用自行设计的问卷调查研究对象的一般人口学资料,采用PHQ-9抑郁症状筛查量表调查研究对象的抑郁水平,采用护生职业认同量表(PISNS)调查研究对象的职业认同水平.利用多元线性回归模型分析护生职业认同水平的影响因素,利用限制性立方样图(RCS)进一步分析抑郁和自我刻板印象与职业认同水平之间的非线性关系.结果 最终获得有效问卷512份.研究对象年龄中位数20岁,四分位间距(IQR)19～21岁,31％的研究对象表现为轻度及以上抑郁症状.护生职业认同水平平均得分为3.71分(IQR:3.24～4.12分).其中参加暑期实践、参加医院见习/实习是护生职业认同水平的促进因素,而自我刻板印象得分是护生职业认同水平的阻碍因素,抑郁水平与护生职业认同水平的关系呈U型,当个体抑郁得分<10分时,抑郁得分越高,职业认同水平越低,当个体抑郁得分≥10分时,抑郁得分越高,职业认同水平越高.结论 新型冠状病毒肺炎疫情下高校本科护生职业认同水平较高,护理教育者应重点关注护生的心理健康水平,采取有效提升护生心理健康的干预措施,最终提升其职业认同水平.     

辽宁省女性护士抑郁症状及其影响因素分析

  目的 探讨辽宁省女性护士抑郁症状及其影响因素,以改善护士的身心健康及生命质量。方法 采用横断面调查方法,以2010年10-11月随机抽取的在辽宁省有代表性的3个大、中、小城市的6所医院工作6个月以上的575名女性护士为对象,进行自填式问卷调查。应用流行病学研究中心抑郁量表评价抑郁症状,应用付出—回报失衡问卷和工作内容问卷评价职业紧张。Logistic回归分析探讨抑郁症状的影响因素。结果 护士的抑郁症状率为67.6%。按OR值的顺序,抑郁症状的影响因素为高付出/回报比（OR=3.037）、睡眠障碍严重（OR=1.990）、有离职倾向（OR=1.756）、护患关系严重紧张（OR=1.632）和高工作要求（OR=1.312）。结论 辽宁省女性护士的抑郁症状率较高,人口学特征、工作状况、生活方式及职业紧张与抑郁症状密切相关。     

实习前护理专科学生自尊和社会支持与心理健康的关系

目的探讨实习前护生自尊和社会支持与心理健康的关系。方法采用自尊量表、症状自评量表(SCL-90)和领悟社会支持量表调查193名实习前护生。SCL-90任一因子分大于3分者共30人为有症状组,余163人为无症状组。结果实习前护生自尊平均得分为(27.347±3.589)分;30名(15.54%)实习前护生存在明显的心理问题;SCL-90的9个因子与社会支持和自尊呈不同程度的负相关;自尊与社会支持呈正相关;有症状组和无症状组的社会支持得分和自尊得分之间差异有统计学意义;逐步回归分析发现,自尊和朋友支持对SCL-90总分影响较大;在有症状组中,抑郁、偏执和强迫对自尊影响较大。结论提高自尊和加强利用社会支持对改善实习前护生心理健康有积极意义。     

合肥市社区卫生服务机构护患风险沟通现况调查

目的了解社区卫生服务机构护士的护患风险沟通能力现状,为提高护士护患风险沟通能力提供参考。方法随机抽取合肥市市区40家社区卫生服务中心(站),采用自行设计问卷,对211名护士的护患风险沟通能力现状进行调查。结果 178人(84.36%)认为护患风险沟通能力很重要;护士整体护患风险沟通能力不高,总得分只有(63.27±5.21)分;高年龄、高学历、高职称组护士护患风险沟通能力得分高于低年龄、低学历和低职称组护士,差异具有统计学意义(P<0.001);211名护士心理健康K10评分(19.10±5.82)分,有45名护士存在心理健康不良,占总人数的21.33%。护士心理健康状况与护患风险沟通能力总分及各因子相关,是护患风险沟通能力的影响因素。结论社区护士护患风险沟通能力较低,需要加强护士在人文社科知识、沟通技能和心理健康方面的培训,提高护理质量。     

护士沟通能力在重症监护病房中的作用研究

目的探讨护士的护患沟通能力在重症监护病房护理工作中的作用。方法选取本院急诊重症监护病房护士20名,进行系统的护患沟通理论培训,设计患者满意度调查问卷对患者进行调查,比较培训前后患者的满意度。结果培训前患者满意度平均分为(78.33±6.41)分,培训后患者满意度平均分为(89.46±4.56)分,两者比较差异有显著性。结论提高护士的护患沟通能力可提高患者满意度。     

护理人员护患沟通能力影响因素的调查研究

目的分析护士的护患沟通能力受到影响的相关因素,并找到相关的原因进行分析解决。方法选取本院护士100名,应用本院自制的护理人员护患沟通能力评价问卷(自评)对全部的护士进行调查。结果经过评价,得到的护理人员护患沟通能力总分为(235.14±27.22)分,进一步分析得到影响护士护患沟通能力的因素为:护患沟通知识的掌握情况、培训平均时间、护士对护患沟通知识提高护患沟通能力的重要性的认识程度等等。结果显示:认为护患沟通知识储备"足够"、"够"的护士的得分显著比"远远不够""不够""一般"的护士要高,经比较,有显著的统计学差异(P0.05);对护士的培训平均时间5 d的护士得分是最高的,认为护患沟通知识能够显著提高护患沟通能力的护士人数要高于其他的,经比较,有显著的统计学差异(P0.05)。结论对护士护患沟通能力产生影响的主要因素包括:护患沟通知识掌握情况、培训平均用时、对护患沟通知识提高护患沟通能力重要性的认识,在临床中要注重对护士护患沟通能力的培训,以提高护患沟通能力,不断地提高护理质量。     

阻塞性睡眠呼吸暂停低通气综合征患者主观睡眠质量与抑郁情绪相关分析

目的 了解阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的主观睡眠质量与抑郁状况以及它们之间的关系.方法 对114例经多导睡眠图(PSG)检查确诊的OSAHS患者采用匹兹堡睡眠质量指数(PSQI)、Beck抑郁问卷(BDI)进行调查.结果 患者在PSQI量表调查中总均分为(7.01±3.07)分,PSQI总分>7分者占38.6%;BDI得分为(8.29±6.46)分.而PSQI得分与BDI存在显著的相关性(r=0.476,P<0.01).结论 OSAHS患者的主观睡眠质量较差,并存在抑郁情绪.睡眠质量与抑郁情绪密切相关.     

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.