福州地区围绝经期妇女症状与中医病理因素相关性研究

目的:分析不同年龄段妇女的中医证候分布及影响妇女健康状态的因素,为中医药防治围绝经期综合征的临床研究提供参考。方法:通过流行病学调查研究,采用证素辨证的方法,设计统一科研调查表,采用改良Kupperman Index(KI)及四诊信息采集表为每一例观察对象建立档案。结果:情绪波动、疲乏、失眠为围绝经期女性主要临床表现。影响改良Kupperman Index积分的病位证素是肝、脾,病性证素是湿、阴虚、阳虚、血瘀、血虚。结论:综上所述,围绝经期女性病性多属本虚标实、虚实夹杂,“肝郁”为围绝经期综合征病理变化的重要环节。     

单指数、双指数、拉伸指数模型DWI在胶质瘤术前分级中的应用

目的探讨单指数、双指数、拉伸指数模型扩散加权成像(diffusion weightedimaging,DWI)对胶质瘤术前分级的诊断性能,评价灌注参数与血流量(cerebral bloodflow,CBF)的相关性。材料与方法收集经手术病理证实为脑胶质瘤的病例34例,包括低级别17例,高级别17例。受试者术前均行常规扫描、3D动脉自旋标记成像(threedemensional arterial spin labeling,3D ASL)及多b值DWI序列扫描,利用FUNCTIONTOOL后处理软件中的单指数模型计算得到表观扩散系数(apparent diffusion coefficient,ADC),利用双指数模型得到D、D*、f值,利用拉伸指数模型得到分布扩散系数(distribute diffusion coefficient,DDC)、水分子各向异性(alpha,α),利用3D ASL后处理软件得到CBF值。所得各参数利用SAS9.4统计软件进行分析。结果高级别胶质瘤ADC、D、f、DDC、ɑ值低于低级别胶质瘤,D*值高于低级别胶质瘤,P值均<0.05;全部胶质瘤D*与CBF呈正相关(r=0.51,P<0.05);受试者工作特性(receiver operatingcharactsteristic,ROC)曲线分析得出:ɑ、D、DDC、ADC值的曲线下面积(area undercurve,AUC)分别为0.969、0.965、0.961、0.957,其诊断阈值分别为0.88×10^-3mm^2/s、0.86×10^-3mm^2/s、1.10×10^-3mm^2/s、1.11×10^-3mm^2/s。结论单指数、双指数、拉伸指数模型DWI为胶质瘤术前提供更多诊断信息,ɑ、D、DDC、ADC值在鉴别高、低级别胶质瘤均有较高价值,且灌注参数D*与CBF呈正相关。     

Evaluation of a parenting program for children with behavioural problems: Signposts in Singapore

Abstract

Background The Signposts for Building Better Behaviour program, developed by the Parenting Research Centre, Victoria, Australia, was conducted at a public hospital facility in Singapore.

Method More than 1,000 parents completed the program, and filled in questionnaires about their child's behaviours.

Results Parents rated themselves in the questionnaires as being significantly less hassled, stressed, depressed, and anxious after attending the program. They were more confident and satisfied with managing their child, and rated their children's behaviours as having improved. Effect sizes ranged from 0.12 to 0.59. The findings were maintained 3 months after completion of the program.

Conclusions The study provides evidence of the cross-cultural applicability of the principles underlying the Signposts program. As there are long-term repercussions when children's behaviour problems are not dealt with appropriately, such behaviour management programs should be made more available to parents and caregivers.     

护士长工作疲溃感和婚姻质量相关性的研究进展

简述了工作疲渍感、婚姻质量的概念及其关系，并对护士长工作疲渍感和婚姻质量的研究现状进行综述。     

Middle-aged women's awareness of cholesterol as a risk factor: Results from a national survey of Korean Middle-aged Women's Health Awareness (KomWHA) study

Background

Dyslipidemia, a risk factor for cardiovascular disease (CVD), is more prevalent in middle-aged women than in men of the same age in Korea. This study, the first national survey that focused on cholesterol in Korean women, aimed to: (1) assess their awareness and knowledge of cholesterol, (2) evaluate their risk reduction behavior, and (3) examine differences in these variables among geographical regions in Korea.

Methods

A questionnaire survey study was conducted in a randomly selected national sample of 1304 Korean women, aged 40-64 years in 3 geographic regions.

Results

High cholesterol was identified as a cause of CVD by 54.4% of respondents, however, 95.4% did not know their own values. Only 4.1% of respondents were aware of desirable level of total cholesterol. Eight percent of respondents perceived correctly the meaning of high-density lipoprotein cholesterol (HDL-C) as good cholesterol. And 32.9% had cholesterol check at least once a year. No significant regional differences were found in women's awareness and knowledge on cholesterol. No smoking (93.6%), low salt diet (52.5%) and weight management (50.6%) were the most prevalent risk reduction behaviors. Women in the rural area performed less risk reduction behaviors than those in urban area.

Conclusions

Given the low level of awareness and knowledge about cholesterol in these women, nurses need to increase their education about cholesterol and risk reduction behaviors of CVD for middle-aged Korean women, particularly those in rural area. To resolve identified disparities in women's risk reduction behaviors between the rural and urban area, a national-level health policy can result in a successful effort to promote women's awareness of cholesterol and risk reduction behaviors for the cardiovascular health of the public.     

参芪柴芍枳附汤辅治代谢性心脑血管疾病疗效观察

目的:观察参芪柴芍枳附汤辅治心脑血管疾病的疗效。方法:150例分为4个治疗组及1个对照组各30例,4个治疗组分别为糖尿病(消渴)+冠心病(胸痹)、糖尿病(消渴)+椎基底动脉供血不足(眩晕)、糖尿病(消渴)+脑梗死(中风)、糖尿病(消渴)+抑郁症(郁证),对照组为糖尿病(消渴)。对照组根据指南予以常规西医治疗。治疗组在常规西医治疗基础上加用参芪柴芍枳附汤口服,疗程15天。结果:各治疗组空腹血糖控制、中医临床症状及西医疗效均优于对照组(P<0.05)。结论:参芪柴芍枳附汤能改善心脑血管疾病临床症状。     

Electroacupuncture for postpartum urinary retention: A randomized controlled study: 电针治疗产后尿潴留:随机对照研究

Objectiveto observe the clinical effect of electroacupuncture on postpartum urinary retention (PPUR) through a randomized controlled study.Methodsseventy-two PPUR puerperae who met the inclusion criteria were divided into the observation group (electroacupuncture at Cìliáo (次髎BL32) and Zhōngliáo (中髎BL33) group) and the control group (sham acupuncture group) according to the random number table method, with 36 cases in each. Urine catheters were retained. After 3 days of treatment, the therapeutic effect of PPUR was compared between the two groups.Resultsin the observation group, the first urination time was significantly earlier than that in the control group, the first urination volume was significantly more than that in the control group, the bladder residual urine volume was significantly less than that in the control group, and the urinary infection was significantly less than that in the control group, the differences were statistically significant (all P <0.001). Compared with the control group, there were statistically significant differences in catheter removal, independent urination, cured cases, effective cases, ineffective cases, and total effective cases in the observation group (all P < 0.05).Conclusionthe therapeutic value of electroacupuncture at BL32 and BL33 for primiparae with PPUR is significantly obvious. This therapy is worthy of clinical promotion.     

硬化大脑中动脉及豆纹支管壁弹性结构改变及意义

本文用光镜、电镜观察了正常和硬化大脑中动脉及其豆纹支管壁弹性结构的形态。结果显示，硬化大脑中动脉内弹力膜断裂，且以外层断裂明显，波纹状外观消失；而豆纹支内弹力膜结构完整，波纹状外观清晰可见。平滑肌萎缩、变性，胶原纤维增多。提示硬化大脑中动脉破裂出血是内弹力膜破坏，平滑肌萎缩，管壁脆性增加所致；而豆纹动脉是根部存在＂中膜缺损＂，此外受血流冲击引起破裂的可能性大。