护士社会支持与焦虑状况相关因素调查分析

目的了解护士的社会支持与焦虑状况的相关因素,为心理干预提供理论依据.方法采用社会支持评定量表、状态焦虑量表(S-AT)对100名女护士进行调查,并分析其相关因素.结果护士社会支持评分为(37.22±6.94)分,S-AT评分(42.70±7.20)分;护士社会支持与焦虑状态呈负相关,即社会支持越高,焦虑状态越低;年龄<25岁、工龄<5年、未婚、合同护士社会支持明显偏低.结论良好的社会支持有助于减轻护士心理压力,是维护护士身心健康的重要因素.     

Calorie restriction increases serum parathyroid hormone and decreases serum calcitonin levels in patients with maturity onset diabetes mellitus

Calorie restriction is important in managing patients with maturity onset diabetes mellitus (NIDDM). The effect of such restriction on calcium metabolism is not known. The objective of this study was to determine whether patients on calorie restricted diets would show any modification of parathyroid hormone (PTH) and calcitonin (CTN). The serum levels of PTH and CTN were measured by radioimmunoassays in 269 patients with NIDDM. The patients were divided into two groups depending on the intake of calorie, and PTH and CTN were monitored for 2 years. Plasma levels of vitamin D were measured by competitive protein binding assays before and after each program. The level of PTH (520.8±266.0 pg/ml) (mean±S.D.) was significantly (P<0.01) higher in 109 diabetic patients whose calorie intake was restricted for 2 years (diet (D) group) as compared with that (256.6±103.8 pg/ml) of 160 diabetic patients whose calorie intake was not restricted (non-diet (ND) group). The daily oral calcium intake of the two groups did not differ significantly. We found no significant difference in the serum PTH level in the ND groupVS. normal control subjects (248.8±98.4, N=78). The serum calcium concentration and the amount of calcium excreted in urine were slightly but significantly (P<0.01) lower in the D than in the ND group. The rate of tubular reabsorption of phosphate (% TRP) was significantly lower in the D group than that in the ND group (P<0.01). The serum CTN level was significantly (P<0.01) lower in the D group (33.9±11.3 pg/ml) than in the ND group (64.9±21.2 pg/ml) 2 years after each treatment. The plasma 1,25-(OH)₂-vitamin D level was significantly (P<0.01) lower in the D group (22.2±6.6 pg/ml) than in the ND group (50.6±4.2 pg/ml). When the restriction of calorie intake in the D group was canceled, their PTH levels decreased, which was accompanied by increase in the 1,25-(OH)₂-vitamin D levels, whereas their CTN levels were unchanged. These observations suggested that a restricted calorie intake is a risk factor for secondary hyperparathyroidism as well as for a low serum level of CTN in patients with NIDDM.     

A comparison of family functioning when mothers have chronic pain

Multiple aspects of family functioning were assessed when mothers experienced either chronic pain, a chronic illness (diabetes), or no illness. Mothers' and fathers' self-report measures of depression, anxiety, and family environment were collected. Children's self-report measures of depression and anxiety, as well as information about their overall adjustment, were collected. Family communication patterns were also assessed. Families with a mother who had chronic pain had poorer perceived family environments and higher levels of depression and anxiety compared to the other two groups of families. Children from chronic pain families also appeared to be adversely affected. The data suggest that level of disability appeared more salient than the type of chronic illness. Implications of the findings are discussed in light of the fact that mothers with chronic pain in the present sample reported relatively mild disability and were not actively seeking treatment for their condition.     

The frequency of type I heterozygous protein S and protein C deficiency in 141 unrelated young patients with venous thrombosis

The frequency of heterozygous protein C and protein S deficiency, detected by measuring total plasma antigen, in a group (n = 141) of young unrelated patients (less than 45 years old) with venous thrombotic disease was studied and compared to that of antithrombin III, fibrinogen, and plasminogen deficiencies. Among 91 patients not receiving oral anticoagulants, six had low protein S antigen levels and one had a low protein C antigen level. Among 50 patients receiving oral anticoagulant therapy, abnormally low ratios of protein S or C to other vitamin K-dependent factors were presented by one patient for protein S and five for protein C. Thus, heterozygous Type I protein S deficiency appeared in seven of 141 patients (5%) and heterozygous Type I protein C deficiency in six of 141 patients (4%). Eleven of thirteen deficient patients had recurrent venous thrombosis. In this group of 141 patients, 1% had an identifiable fibrinogen abnormality, 2% a plasminogen abnormality, and 3% an antithrombin III deficiency. Thus, among the known plasma protein deficiencies associated with venous thrombosis, protein S and protein C deficiencies (9%) emerge as the leading identifiable associated abnormalities.     

An exploration of the role of the nurses'' uniform through a period of non-uniform wear on an acute medical ward

The nursing staff on an acute medical hospital ward elected to wear their own clothes to work for a period of 2 months. The trial was evaluated using a variety of research methods and it raised a number of issues about the role of uniform, about patients' perceptions of nurses and nurses' perceptions of their role. The study has led to questions being raised about the assumptions that are made if uniform is worn and the appropriateness of a uniform dress.     

Mesenteric and retroperitoneal cysts.

Mesenteric and retroperitoneal cysts are rare intra-abdominal tumors. Ten new patients are presented as well as 152 other cases reported in the English literature. These 162 cases were then analyzed for significant trends. Patients under 10 years of age were significantly different from the older group with respect to a shorter duration of symptoms, a higher number of patients requiring an emergency operation, a lower number of recurrences and the location of the cyst. Patients with retroperitoneal cysts were more likely to have incomplete excision of the cyst and therefore had a higher incidence of recurrence. They also required marsupialization more often. Retroperitoneal cysts should be considered a different entity from mesenteric cysts even though they present clinically in a similar fashion. The outcome of surgical treatment is less satisfactory in patients with retroperitoneal cysts.     

起搏器更换时原起搏电极导线参数及更换指标分析

目的:分析74例更换起搏器时电极导线的各项参数的变化并探讨导线更换指标。方法:本组年龄12~87(62.8±18.4)岁,其中病窦综合征45例,房室传导阻滞29例,均为单腔VVI起搏。结果:至测量时原心室起搏电极导线的埋置时间60~148(97.4±22.8)月,首次埋置时起搏阈值为(0.48±0.24)V,更换时为(1.29±0.64)V(P(0.01),增加0.81V,增幅为168%,首次植入时R波幅为(7.8±3.6)mV,更换时为(5.9±3.4)mV(P(0.05)。植入时电极导线阻抗为(664±122)Ω,更换时阻抗为(726±148)Ω,增幅9.3%(P(0.05)。7例因起搏阈值大于2.0 V或阻抗大于1 250Ω而重新植入电极导线。原电极导线使用率为90.5%。结论:埋置起搏电极导线8~9年后,90.5%原电极导线仍在可使用的范围内,能否支持到再次更换需进一步随访。