应用数学模型对癌症患者非器质性的性康复状况进行预测

目的 建立差别函数，对癌症患者非器质性的性康复状况进行了预测。方法 采用书面问卷调查的方法，对19项指标进行单因素分析，寻找可能影响癌症患者性康复的因素。进一步进行判别分析，建立判别函数。结果 患者体力状态，病前经济收入及其占家庭总收入比例，社会地位，担心家人及子女，认为本病能控制或治愈，接受患开门见山事实，病后过性生活，适度的性生活对身体康复的影响，获取有关知识的途径，焦虑及担心将癌症传给配偶等12项指标可能与患者非器质性性康复障碍有关，据此建立的判别函数阳性预测值，阴性预测值及判别准确率分别高达96.2%,100.0%和97.4%。结论 根据可能影响患者性康复的因素所建立的判别函数判别准确性高，可能具有一定的临床应用价值。     

小儿脑性瘫痪的早期诊断与早期治疗

小儿脑性瘫痪是小儿神经系统残疾的主要疾患之一。 1998年我国“九五”攻关课题报道 ,全国 0— 6岁脑瘫患儿有 31万 (患病率为 1.86‰ ) ,并以每年 4 .6万的速度递增。所以 ,小儿脑瘫康复治疗所面临的形势越来越紧迫。早期诊断、早期治疗是使脑瘫患儿获得理想康复疗效的关键。1脑性瘫痪定义脑性瘫痪简称脑瘫 ,是指小儿出生前至出生后 1个月内发育时期的非进行性脑损伤所致的综合征 ,主要表现为中枢性运动障碍和姿势异常 ,同时伴有智力、语言、视、听觉等障碍[1] 。2高危因素[2— 6]小儿脑瘫的主要高危因素有 :①早产、低出生体重 ,尤以胎龄 …     

慢性心力衰竭患者睡眠障碍的临床特点及相关因素分析

目的:研究分析慢性心力衰竭(CHF)患者睡眠障碍的临床特点及其相关因素。方法:回顾性分析2019年7月至2020年7月于菏泽市定陶区人民医院进行治疗的83例CHF患者临床资料,根据其睡眠状态分为正常组和睡眠障碍组,对2组患者临床资料进行单因素比较,选择差异的指标进行非条件Logistic多元逐步回归分析。结果:2组患者年龄、病程、性别、配偶情况、营养不良、睡眠环境、心功能因素比较差异均无统计学意义(P 0. 05);活动耐力下降、抑郁、呼吸障碍、药物不良反应、不良睡眠习惯均为影响CHF患者睡眠障碍的单因素(P 0. 05)。经非条件Logistic多元逐步回归分析可知,活动耐力下降、抑郁、呼吸障碍、药物不良反应、不良睡眠习惯均为影响CHF患者睡眠障碍的独立因素(P 0. 05)。结论:CHF患者睡眠障碍可受到活动耐力下降、抑郁、呼吸障碍、药物不良反应、不良睡眠习惯等因素独立影响,临床应针对以上因素进行合理干预,以期改善患者睡眠情况。     

小儿脑性瘫痪160例诊治分析

目的:通过对160例小儿脑性瘫痪(cerebral palsy,CP)患儿的临床表现、分型、合并障碍及是否早期诊断与康复综合治疗的转归分析,试图为早期诊治CP提供参考依据.方法:通过对2003年9月～2006年12月共诊断CP298例,其中因经济条件、性别、年龄等因素未完成康复治疗138例,余下160例收治我儿科CP康复中心,经临床神经系统检查和发育评定.接收6～9月以上的综合康复治疗,将其高危病史、临床分型、合并障碍的异常表现等情况进行分析.结果:2～6个月的72例有效率100.00%;7～12个月48例有效率95.83%;1～3岁32例有效率90.63%;大于3岁8例有效率75.00%.早产、窒息、颅内出血、重型黄疸是主要高危因素.160例CP患儿中单纯运动障碍56例,占35.00%;合并二重或二重以上障碍的104例,占65.00%.结论:早期发现、诊断、干预,规范的坚持综合康复治疗训练效佳.     

心房颤动患者射频消融术后参与运动康复障碍和促进因素的混合研究

目的探讨心房颤动(房颤)患者射频消融术后参与运动康复的障碍和促进因素。方法采用便利抽样法, 2022年3—8月从南京医科大学第一附属医院心血管内科"云病房"招募房颤射频消融术后3个月内的285例患者为研究对象, 采用心脏康复障碍量表评估患者参与运动康复的障碍、运动自我效能感量表评估患者的运动自我效能。对其中的22例患者进行半结构化访谈, 提炼主题。结果 285例房颤患者中, 参与过运动康复项目者202例(70.88%)。研究显示, 工作/时间冲突、缺乏心脏康复知识、健康/躯体功能受限影响患者运动康复参与情况(P<0.05)。质性研究提炼出3个影响患者运动康复情况的主题:能力、机会和动机。结论房颤患者运动康复参与受到家庭责任、能力、动机、机会多因素影响。医务人员应综合考虑以上因素, 全方位、多角度、针对性地制定相应的干预措施, 切实改善患者的运动康复参与情况。     

脑出血合并脑器质性精神障碍患者认知功能障碍分析

目的:探讨脑出血合并脑器质性精神障碍患者认知功能障碍的影响因素。方法:对我院2014年1月~2016年9月就诊的130例脑出血患者的临床资料进行回顾性分析,根据脑出血发生次数分为首次脑出血组67例和复发脑出血组63例,测评认知功能,分析影响患者认知功能障碍的相关因素。结果:复发脑出血组认知功能障碍发生率显著高于首次脑出血组(P0.05)。高年龄、高血糖、高血脂、高血压、饮酒、吸烟及出血量≥30 ml均与认知功能障碍发生有关(P0.05)。结论:高年龄、高血糖、高血脂、高血压、饮酒、吸烟及出血量≥30 ml均会使脑出血所致脑器质性精神障碍患者认知功能障碍发生率增加,监测脑出血患者认知功能障碍危险因素,加强患者记忆力、注意力等康复训练,有助于脑出血患者认知功能障碍的预防及康复。     

老年脑卒中患者的康复需求及影响因素研究

目的:了解老年脑卒中患者的康复需求,并分析其相关影响因素。方法:对我院门诊收治的100例老年脑卒中患者进行问卷调查,调查患者对健康教育、运动训练、吞咽训练等方面的康复需求。根据调查结果,将其分为需求组和无需求组,采用单因素和多因素Logistic回归分析影响康复需求的相关因素。结果:研究对象对健康教育、运动训练、吞咽训练、针灸按摩、康复支具、心理干预、日常生活能力训练等7个方面的康复需求评分为(3. 07±0. 58)分、(3. 25±0. 67)分、(3. 12±0. 61)分、(2. 98±0. 54)分、(2. 76±0. 51)分、(2. 93±0. 56)分、(3. 02±0. 59)分。以运动训练康复需求得分最高。多因素Logistic回归分析显示,年龄、文化程度、家庭月收入、病程、神经功能缺损评分、日常生活能力评分、残疾程度是影响老年脑卒中患者康复需求的因素(P 0. 05)。结论:老年脑卒中患者的康复需求存在差异,年龄、文化程度、经济状况、病程、神经功能和日常生活能力、残疾程度等为其影响因素。     

从“筋骨、痹痿、虚实、动静、刚柔”谈膝骨关节炎功能障碍的特点

膝骨关节炎(KOA)属于进展性骨关节病,其功能障碍主要表现为膝关节疼痛、僵硬、屈伸行走不利或受限,以及关节失稳、运动控制下降和本体感觉低下等。我国KOA患者众多,且还在逐年增加,引起的功能障碍严重影响着患者健康与生活质量,因此对其开展康复的研究与实践至关重要。中医康复着眼于功能,注重辨证康复,是我国康复医学的固有特色及优势。前期的研究基于KOA功能障碍的中医证候表现,本研究经大量文献梳理及多年临床实践,从“筋骨、痹痿、虚实、动静、刚柔”5个角度为切入点,提出KOA功能障碍具有“筋骨同病、痹痿并见、虚实错杂、动静失衡、刚柔失常”5个基本特点。鉴于KOA功能障碍具有早、中、晚三期的阶段性特点,在该病发生发展的不同阶段,其功能障碍在“筋骨、痹痿、虚实、动静、刚柔”之间的表现又各有所侧重。本研究从“筋骨同病、痹痿并见、虚实错杂、动静失衡、刚柔失常”5个方面分别阐释了KOA功能障碍的特点:“筋骨同病”侧重于病位,是KOA所致功能障碍的基本病机特征,贯穿于其发病的始终;“痹痿并见、虚实错杂”偏重病性,是KOA功能障碍的基本特点;“动静失衡”偏重病因,是引起KOA病情反复及加重的重要因素;“刚柔失常”则是兼具病状与病因,是膝关节失去“骨正筋柔”的表现方式,也是KOA功能障碍的重要特征。本研究旨在进一步完善KOA的中医康复理论,为其康复治疗提供参考。     

北京城区2万查体人群大肠息肉发病情况调查

目的 :调查北京城区查体人群大肠息肉发病情况。方法 :对北京城区部分查体人群普查大肠肿瘤发病情况 ,人数为 1 9852 ,30岁以上均接受化学法粪隐血试验 ,阳性者再接受免疫法粪隐血试验。所有普查对象均填表登记 ,符合 7个所列条件为高危人群。免疫法粪隐血试验阳性或高危人群接受全结肠镜检查。结果 :72 3例患者接受全结肠镜检查 ,共有 2 0 5(2 8.35 % )例发现大肠息肉 ,包括男 1 36名 ,女 69名 ,平均年龄 58.61±1 4 .2 5岁 ,显著高于非息肉患者平均年龄 48.53± 1 4 .2 6岁 (P <0 .0 1 ) ,男性所占比例显著高于非息肉患者 (P<0 .0 5)。结肠镜息肉检出率随年龄递增而升高 ,50岁以上检出率达 40 %。 2 0 5例大肠息肉患者中 ,包括腺癌 1 4例 (6 .83 % ) ,良性息肉 1 91例 (93 .2 0 % )。在明确息肉具体分类的 61例良性息肉中 ,包括增生性息肉 3例 (4.92 % ) ,炎性息肉 1 7例 (2 7.87% ) ,腺瘤性息肉 41例 (67.2 1 % )。对大肠息肉患者及结肠镜检查未发现异常者 ,经Logistic回归分析 ,大肠息肉的二个独立危险因素为年龄 >50岁 (OR :2 .886 ,95 %CI :1 .972 -4 .2 2 2 ,P <0 .0 1 )及大肠息肉病史 (OR :2 .92 9,95 %CI:1 .664 - 5 .1 55 ,P 相似文献   

260例非器质性头痛患者头痛相关因素分析

目的:分析260例非器质性头痛患者头痛的相关因素,为临床上非器质性头痛的诊断和治疗提供科学依据。方法 :用表格对2009年6月~2010年2月在郑州大学第一附属医院神经内科门诊就诊的非器质性头痛患者的资料进行收集,总结患者的一般情况和头痛的相关因素。结果 :260例非器质性头痛患者中,女性多于男性(男:女=1:1.17)。随着收入的增高非器质性头痛的发病人数逐渐降低。发病率较高的职业是农民和学生。所有非器质性头痛患者有50.78%合并焦虑抑郁状态。紧张和压力是诱发头痛加重的最主要因素。其中有9例患者在病程中出现了头痛特点的转换。结论:非器质性头痛患者与性别、年龄、职业、收入等均存在相关性,在临床中要特别关注合并焦虑抑郁状态的非器质性头痛以及头痛特点转换。     

Identified risk factors and adolescents’ beliefs about triggers for headaches: results from a cross-sectional study

Although there are few studies on adolescents’ beliefs about triggers of headache, none of these compared the associations between perceived and observed triggers. This study aimed at comparing the prevalence of self-perceived and observed risk factors for headache among adolescents. Adolescents from the 10th and 11th grades of high schools answered questionnaires on their headaches and on potential risk factors regarding lifestyle, stress and muscle pain. Individuals reporting to have experienced headache in the preceding 6 months were asked to report what they believed to cause their headache (self-perceived triggers). 1,047 (83 %) of 1,260 adolescents reported headaches. Stress, lack of sleep and too much school work were the most frequently reported self-perceived triggers of headache; in contrast the statistical analysis identified alcohol and coffee consumption, smoking, neck pain, stress and physical inactivity as risk factors for headache. Among individuals with headache, 48 % believed that stress might trigger their headaches, while increased stress scores were only observed in 23 %. In contrast, while 7, 4, 0.3 and 0 % of individuals reporting headache considered consumption of too much alcohol, neck pain, physical inactivity and consumption of coffee might trigger their headache, 56, 51, 36 and 14 %, respectively, were exposed to these risk factors. The prevalence of self-perceived triggers of headache does not correspond to the prevalence of identified risk factors for headaches. While the role of stress was overestimated, the high prevalence of the other confirmed risk factors in adolescents with headache suggests potential for prevention by increasing awareness for these risk factors and appropriate interventions.     

峨眉山疗养因子对老年慢性失眠症的疗效观察

目的　观察峨眉山疗养因子对老年慢性失眠症的治疗作用。方法　７５ 例老年慢性失眠症患者用峨眉山疗养因子治疗,观察治疗前后的睡眠情况。结果　治疗后失眠症状明显改善,总有效率达９４ ．７ ％ 。结论　峨眉山疗养因子对慢性失眠症有良好的治疗作用。     

胚胎停止发育相关因素分析

目的探讨胚胎停止发育(胎停育)与相对不良因素的关系。方法采用询问病史和收集病例资料的方法,观察年龄、孕产史、血型分布、夫妇的工作、生活环境、生活习惯、健康状况等方面与胎停育的关联性。结果 518例胎停育孕妇中,25～29岁年龄组所占构成比最高(46.72%);210例O型血孕妇中,25～29岁年龄组占42.56%;345例流产次数≥2次孕妇中,25～29岁年龄组占67.77%。占构成比最高的为25～29岁年龄组、流产次数≥2次及O型血孕妇。518例胎停育孕妇中,有精神刺激者占46.13%;环境因素占26.64%;孕前半年内取环和停服避孕药者占7.1%,明显高于孕前半年以上取环和停服避孕药所占的3.47%;而孕前接受医学检查和咨询的胎停育孕妇占13.13%,又明显低于孕前未接受医学检查和咨询的87.07%。结论为防止多次妊娠行人工流产导致的胎停育,应选择最好的、合理的、有效的避孕措施;在育龄期夫妇中,加强孕前宣传教育,有计划地生育,控制或减少在工作、生活和环境中的不良因素,对降低胎停育的发生尤为重要。而夫妇孕前半年内接受医学检查和医学咨询,是避免胎停育发生的保护性方法之一。     

我院剖官产率上升原因的调查分析

目的 探讨引起剖宫产率上升的相关因素,提出降低剖宫产率的可行性措施.方法 对2000年1月至2009年12月我院剖宫产病例进行回顾性分析.结果 剖宫产率逐年升高,2000年为32.0%,2001年为34.5%,2002年为35.0%,2003年为32.3%,2004年为37.1%,2005年为37.9%,2006年为40.2%,2007年为41.7%,2008年为43.6%,2009年为46.1%.结论 应采取有效措施,降低剖宫产率.

Abstract：

Objective To discuss the related factors about the rising cesarean section rates, and to propose feasible measures to reduce cesarean section rates. Methods Cesarean section cases in our hospital from January, 2000 to December, 2009 were retrospectively analyzed. Results The cesarean section rate increased year by year,32.0% in 2000,34.5% in 2001,35.0% in 2002,32.3% in 2003,37.1% in 2004,37.9% in 2005,40.2% in 2006,41.7% in 2007,43.6% in 2008,46.1% in 2009. Conclusions Effective measures should be taken to reduce the cesarean section rate.     

Relative contribution of intrapersonal and partner factors to contraceptive behavior among taiwanese female adolescents.

PURPOSE: To explore the relative contribution of intrapersonal factors (demographic data, sexual history, and self-efficacy for contraception) and partner factors (perceptions of support from sexual partners for contraception, and relationship power) to contraceptive behaviors among sexually active female adolescents in Taiwan. DESIGN: A cross-sectional design. Female adolescents who have had a steady male sexual partner in the past 3 months (N=375) were recruited as participants. METHODS: Questionnaires including demographic data, sexual history, contraceptive behavior, self-efficacy for contraception, perceptions of support from sexual partner for contraception, and perceptions of relationship power were submitted anonymously for this study. FINDINGS: Participants who had their first sexual experience at less than 14 years of age and were from one-parent families had the least comprehensive contraceptive behavior than did other participants. Number of steady sexual partners was significantly negatively correlated with contraceptive behavior. Self-efficacy, perceptions of support from sexual partner for contraception, and relationship power all were positively correlated with contraceptive behavior. The important explanatory variables of contraceptive behavior were self-efficacy, age of first sexual intercourse, intervals between sexual intercourse, and perceptions of support from sexual partner for contraception. These accounted for 39.1% of variance in contraceptive behavior. CONCLUSIONS: Intrapersonal factors (self-efficacy, age of first sexual intercourse, and intervals between sexual intercourse) were more important than were partner factors (perceptions of support from sexual partners for contraception and relationship power) in influencing contraceptive behavior among sexually active female adolescents in Taiwan. CLINICAL RELEVANCE: Intervention to increase contraceptive behavior among female adolescents should be focused more on intrapersonal factors than on partner factors.     

冠状动脉介入患者围手术期疾病不确定感及影响因素分析

目的调查分析冠状动脉介入患者围手术期的疾病不确定感水平及其影响因素，为提出针对性的干预措施提供依据。方法以一般资料问卷、Mishel疾病不确定感量表（中文版）在术前1d、手术当天及术后3d对97例冠状动脉介入患者进行问卷调查。结果冠状动脉介入患者存在较高水平的疾病不确定感；患者介入史、与冠状动脉介入术手术结果有关的因素（是否放置支架、支架数）、以及性别、病程、文化程度是疾病不确定感的重要影响因素，差异有显著意义。结论冠状动脉介入患者疾病不确定感水平较高，护士应改进常规护理工作，根据患者特点给予个性化信息支持，提高护理质量。     

1～14岁正常小儿血清瘦素水平测定

目的　研究 1～ 14岁正常小儿血清瘦素水平及其与性别、年龄、体质量指数 (BMI)的关系。方法　用免疫放射分析法测定 138例 1～ 14岁正常小儿的血清瘦素水平 ,分析其与性别、年龄的变化趋势 ,以及与BMI的相关性。结果　①不同年龄组小儿血清瘦素水平测定值 ,1～ 5岁、>5～ 10岁、>10～ 14岁 3个年龄组男童分别为 (1.4 9± 0 .4 8) μg/L、(4.87± 3.5 1) μg/L、(3.34± 0 .85 ) μg/L ,女童分别为 (2 .12± 0 .4 7) μg/L、(7.6 9± 5 .84 ) μg/L、(12 .7± 5 .2 2 ) μg/L ,女童的血清瘦素水平随年龄增大而升高 ,男童 1～ 10岁 ,血清瘦素水平随年龄增大呈升高趋势 ,11～ 14岁 ,瘦素水平呈相反变化 ,即随年龄增大而降低 ;②相同年龄组女童的血清瘦素水平明显高于男童 (P <0 .0 1) ;③不论男童、女童 ,血清瘦素水平均与BMI呈显著正相关 (男r =0 .73,P <0 .0 0 1;女r =0 .81,P <0 .0 0 1)。结论　性别、年龄、BMI是影响小儿血清瘦素水平的 3个重要因素。     

不同性别人群的冠心病主要危险因素分析

目的分析冠心病(CHD)主要危险因素年龄、高血压、高脂血症、糖尿病在男性和女性人群中的差别。方法经冠状动脉造影检查确诊的冠心病患者608例,其中合并高血压350例,高血脂158例,糖尿病222例。分析男女冠心病发病的年龄及危险因素在不同年龄段的分布。结果冠心病发病平均年龄男性组(55.2±9.9)岁与女性组(64.5±10.1)岁比较有差异(P=0.04),在<50岁亚组中,男性较女性发病率高(P<0.05)。女性组危险因素中高血压病、糖尿病、高脂血症的发生率均明显高于男性组(均P<0.05)。女性高血压在70~79岁亚组较60~69岁亚组下降;糖尿病在男性和女性70~79岁亚组较60~69岁亚组都下降;高脂血症在男性70~79岁亚组构成比下降。冠心病人高血压和糖尿病在男性和女性各年龄亚组构成比差异有统计学意义(P<0.01);高血脂年龄构成比差异无统计学意义(P=0.134)。结论年龄、高血压、高脂血症、糖尿病在男性和女性冠心病患者中有差别。     

Inter-relation of coagulation factors and d-dimer levels in healthy individuals

Summary.  Recently, high levels of coagulation factor (F)VIII, FIX and FXI have been associated with an increased risk of venous thrombosis. For several coagulation factors a substantial hereditary component was found. If regulatory genes are located outside the clotting factor genes, they may regulate the levels of several proteins in the coagulation system. Thus levels would then cluster in individuals. The aim of the present study was to assess the inter-relation among levels of the pro- and anticoagulant proteins in the coagulation cascade. We also investigated the relation between the coagulation factors and d -dimer levels (marker of coagulation activity). All analyses were performed in healthy subjects, the control population of the Leiden Thrombophilia Study (LETS), to eliminate the influence of a prior thrombosis on the interpretation of the results ( n  = 466). Using principal-components analysis, a method intended to explain relationships among several correlated variables, we found a clustering between the vitamin K-dependent factors (prothrombin, VII, IX, X) and FXI and FXII. FV and FVIII clustered with fibrinogen and d -dimer. FXIII remained relatively independent of the other factors. Adding the anticoagulant factors to the analysis resulted in minor changes in the clustering pattern. The anticoagulant factors clustered together. We found relatively independent clusters within the group of pro- and anticoagulant factors, which may suggest that the genetic basis for high or low levels of factors in the coagulation system may, at least partly, lie outside the genes coding for these factors.     

Comparison of Rehabilitation Training at Different Timepoints to Restore Shoulder Function in Patients With Breast Cancer After Lymph Node Dissection: A Randomized Controlled Trial

ObjectiveTo investigate whether advancing the initiation of rehabilitation training compared with the time recommended by the guidelines after breast cancer (BC) surgery is beneficial to the recovery of shoulder function and quality of life.DesignProspective, observational, single center, randomized controlled trial.SettingThe study was conducted between September 2018 and December 2019, with a 12-week supervised intervention and 6-week home-exercise period concluding in May 2020.ParticipantsTwo hundred BC patients received axillary lymph node dissection (N=200).InterventionsParticipants were recruited and randomly allocated into 4 groups (A, B, C, and D). Group A started range of motion (ROM) training at 7 days postoperative and progressive resistance training (PRT) at 4 weeks postoperative; group B started ROM training at 7 days postoperative and PRT at 3 weeks postoperative; group C started ROM training at 3 days postoperative and PRT at 4 weeks postoperative; and group D started ROM training at 3 days postoperative and PRT at 3 weeks postoperative.Main Outcome MeasuresThe primary outcome measure was Constant-Murley Score. Secondary outcome measures included ROM, shoulder strength, grip, European Organization Research and Treatment of Cancer breast cancer-specific quality-of-life questionnaire module (EORTC QLQ-BR23), and SF-36. Incidence of adverse reactions (drainage and pain) and complications (ecchymosis, subcutaneous hematoma, lymphedema) were also assessed.ResultsParticipants who started ROM training at 3 days postoperative obtained more benefits in mobility, shoulder function, and EORTC QLQ-BR23 score, while patients who started PRT at 3 weeks postoperative saw improvements in shoulder strength and SF-36. Incidence of adverse reactions and complications were low in all 4 groups, with no significant differences among the 4 groups.ConclusionsAdvancing ROM training initiation to 3 days postoperative or PRT to 3 weeks postoperative can better restore shoulder function after BC surgery and lead to faster quality of life improvement.