急性淋巴细胞白血病(上)

急性淋巴细胞白血病是淋巴前体细胞异常引起的恶性疾病,儿童与成人均可能发生。儿童发病高峰2～5岁。有效治疗的稳步进展使本病在儿童中的治愈率80％以上,同时为新的治疗方案提供了良机,新方案将保留我们在白血病无病生存病例中获得的治疗经验,同时减轻当前强化治疗方案中的毒副作用。     

急性淋巴细胞白血病(下)

5 风险评估对病人的复发风险进行评估以确保只有高危病例才被施予极强治疗.研究表明采用成人方案治疗的青少年病人,其效果要显著差于使用儿童方案治疗的同年龄组.     

冠心病患者实施健康信念模式干预效果评价研究

目的探讨冠心病（CHD）患者实施健康信念模式干预的效果。方法将140例CHD患者随机分对照组和干预组,各70例,对照组给予常规治疗和护理,干预组在对照组的基础上给予健康信念模式干预措施;比较两组的遵医行为、干预效果及生活质量评分。结果实施干预后,干预组的遵医行为备维度得分均明显好于对照组（P〈0．0.01）;干预组的各干预效果指标均明显好于对照组（P〈0．05）：干预组的生活质量各维度指标也明显好于对照组（P〈0．01）。结论CHD患者实施健康信念模式干预后,明显提高CHD患者的遵医行为和生活质量评分,干预效果明显。     

广州市2010年登革4型病毒的分离及其E基因进化分析

登革病毒(DEN)E蛋白在病毒与宿主细胞融合和诱导机体产生抗体等过程中发挥重要作用[1].本研究通过对分离株E基因全序列测定,从分子水平确定其型别,并与广州市历年同型DEN流行株及相关国际流行株进行同源性比较,构建系统进化树,追踪其可能输入来源.     

Associations of sense of coherence with psychological distress and quality of life in inflammatory bowel disease

AIM: To investigate the relationship between sense of coherence, psychological distress and health related quality of life in inflammatory bowel disease (IBD).METHODS: This cross-sectional study enrolled a consecutive sample of 147 IBD (aged 45.1 ± 14.1 years; 57.1% female) patients recruited from a tertiary gastroenterology service. Sixty-four participants met diagnostic criteria for Crohn’s disease, while eighty-three patients had ulcerative colitis. Socio-demographic data (education, age, race, gender, gross monthly income and marital status), disease-related variables (illness activity, relapse rate in past 2 years, history of surgery and time since diagnosis), sense of coherence (Antonovsky’s SOC scale), psychological distress symptoms (Hospital Anxiety and Depression Scale) and health-related quality of life (HRQoL; WHOQOL-Bref) were assessed. Hierarchical multiple regression analyses were performed to identify factors that are independently associated with psychological distress and HRQoL in patients with IBD and to provide indications for possible moderating or mediating effects. In addition, formal moderation and mediation analyses (Sobel tests) were performed to confirm potential moderators/mediators of the relationship between SOC, psychological distress symptoms and HRQoL.RESULTS: Lower SOC scores (std beta= -0.504; P < 0.001), female gender (std beta = 0.176; P = 0.021) and White race (std beta = 0.164; P = 0.033) were independently associated with higher levels of depressive symptoms, while lower levels of SOC (std beta = -0.438; P < 0.001) and higher relapse rate (std beta = 0.161; P = 0.033) were independently associated with more severe anxiety symptoms. A significant interaction between time since diagnosis and SOC was found with regard to the severity of depressive or anxiety symptoms, as the interaction term (time since diagnosis X SOC) had beta coefficients of -0.191 (P = 0.009) and -0.172 (P = 0.026), respectively. Lower levels of anxiety symptoms (std beta = -0.369; P < 0.001), higher levels of SOC (std beta = 0.231; P = 0.016) and non-White race (std beta = -0.229; P = 0.006), i.e., mixed-race, which represented the reference category, were independently associated with higher levels of overall HRQoL. Anxiety symptoms were the most potent independent correlate of most aspects of HRQoL. In addition, anxiety mediated the association between SOC and satisfaction with health, as well as its relationship with physical, mental, and social relations HRQoL. Depressive symptoms also mediated the association between SOC and mental HRQoL.CONCLUSION: Our data indicated that SOC is an important construct, as it influences psychological distress and has significant albeit indirect effects on several HRQoL domains in IBD.