早期康复护理对急性心肌梗死患者的疗效

目的：探讨包括健康教育在内的康复护理对早期急性心肌梗死（AMI）患者的疗效。方法：选择入住我科的AMI患者78例,随机分为康复护理组和常规治疗组,每组各39例,两组患者接受内科相同的药物治疗和常规内科护理,康复护理组在此基础上接受健康教育和进行早期活动,比较分析其近、远期疗效。结果：2周时,康复护理组心功能改善情况明显优于常规治疗组[心功能 I级：（64.1％比41.0％）,P＜0.05];随访1年,与常规治疗组比较,康复护理组心绞痛（30.8％比7.7％）、心律失常（25.6％比7.7％）、心力衰竭（17.9％比2.6％）发生率明显降低（P＜0.05或＜0.01）,AMI再发率康复护理组有所减少,但差异无统计学意义（P＞0.05）。结论：早期康复护理能明显提高心肌梗死患者的近、远期疗效,有推广的价值。     

慢加急性肝功能衰竭患者心理合并症的配对病例-对照研究

目的：探讨慢加急性肝功能衰竭（ACLF）患者心理状况及与其他慢性肝脏疾病患者心理症状差异。方法采用病例对照研究,纳入40例 HBV相关ACLF患者,以年龄、性别因素分别匹配40例 HBV相关肝硬化患者、40例慢性乙型肝炎（CHB）患者及40例健康对照,采用描述性分析方法分析不同组间患者心理症状差异。结果汉密顿抑郁量表评分结果提示,HBV 相关 ACLF 组、HBV 相关肝硬化组评分均高于 CHB 组与健康对照组。症状自评量表（SCL-90）评分显示除敌对和偏执2个维度评分无差异,其他8个维度差异均具有统计学意义。结论 HBV相关ACLF患者抑郁程度和精神神经状况较CHB和健康对照组更严重。     

八周简易正念减压训练对老年功能性消化不良患者焦虑抑郁和睡眠质量的改善作用

背景功能性消化不良(functional dyspepsia,FD)容易使患者出现焦虑、抑郁负面心理,影响患者睡眠质量.精神、心理因素在FD疾病中占重要地位,加强了解FD患者的心理状况,以更好的实施针对性的干预措施,降低负面情绪和改善睡眠质量.目的观察八周简易正念减压训练对老年FD患者焦虑抑郁和睡眠质量的改善.方法选取2017-03/2019-06在浙江省金华市第二医院就诊的老年FD患者90例为研究对象,随机分为对照组和观察组各45例.对照组给予常规护理.观察组在对照组基础上给予八周简易正念减压训练干预.观察2组患者干预前后焦虑、抑郁评分变化,匹兹堡睡眠质量指数评分变化、入睡时间、睡眠时间变化情况.结果与干预前比较,2组焦虑自评量表和抑郁自评量表评分均降低(P<0.05),且观察组降低明显于对照组(P<0.05).与干预前比较,2组干预后睡眠质量明显改善(P<0.05),入睡时间明显缩短(P<0.05),睡眠时间明显延长(P<0.05),且观察组明显于对照组(P<0.05).结论八周简易正念减压训练能够有效减轻老年FD患者焦虑、抑郁等负性情绪,改善患者睡眠质量,值得临床推广.     

呼吸与危重症医学科护理人员对雾化吸入治疗应用的调查与分析

目的了解呼吸与危重症医学科的护理人员对雾化吸入态度、技能与知识的应用状况,并分析影响因素。方法采用横断面调查的方法,使用问卷发放(自制问卷),对江苏省内18家医院呼吸与危重症医学科护士的雾化吸入态度、技能和知识掌握情况进行调查。结果共发放795份量表,回收774份,回收率97.3%,涵盖10家三级医院,8家二级医院,调查显示了呼吸与危重症医学科护理人员对雾化吸入态度技能与知识的掌握情况,雾化吸入的知识与态度、技能呈正相关。结论应加强呼吸与危重症医学科护理人员对雾化吸入相关知识的培训,端正其对雾化吸入的态度,从而提高雾化吸入的护理质量,为规范临床护理操作提供依据。     

急性冠脉综合征患者生活事件与冠状动脉粥样硬化斑块稳定性的相关性研究：抑郁的中介作用

背景　急性冠脉综合征（ACS）主要由不稳定斑块形成及破裂所致。研究表明,生活事件可增加ACS的发生风险,然而生活事件是否可通过影响斑块稳定性导致ACS的发生,目前尚不清楚。同时研究证实,生活事件可引起个体抑郁的负性情绪,且抑郁与斑块稳定性密切相关,然而抑郁是否在生活事件与斑块稳定性间发挥中介作用尚未明确。目的　探究ACS患者发病前1年内生活事件与冠状动脉粥样硬化斑块稳定性的关系,以及抑郁在其中的中介作用。方法　选取2018年9月-2019年4月于哈尔滨市某三级甲等医院心血管内科行冠状动脉造影首次确诊为ACS的患者311例为研究对象。采用生活事件量表（LES）、抑郁自评量表（SDS）调查其发病前1年内生活事件及抑郁的发生情况。同时采用光学相干断层成像技术（OCT）测量患者冠状动脉粥样硬化斑块稳定性,OCT指标包括薄纤维帽粥样硬化斑块（TCFA）（TCFA以纤维帽厚度、脂质核心角度衡量）、斑块破裂、富脂质斑块、血栓、巨噬细胞及胆固醇结晶。结果　165例（53.1%）患者发病前1年内发生生活事件,67例（21.5%）患者存在抑郁。多因素Logistic 回归分析结果显示,生活事件是TCFA〔OR=1.029,95%CI（1.016,1.043）,P<0.001〕、斑块破裂〔OR=1.022,95%CI（1.010,1.034）,P<0.001〕、富脂质斑块〔OR=1.018,95%CI（1.005,1.031）,P=0.005〕、血栓〔OR=1.032,95%CI（1.014,1.050）,P=0.001〕、胆固醇结晶〔OR=1.013,95%CI（1.002,1.024）,P=0.025〕的独立影响因素。Spearman秩相关分析显示,生活事件与SDS评分（rs=0.461,P<0.01）、脂质核心角度（rs=0.385,P<0.01）呈正相关,与纤维帽厚度呈负相关（rs=-0.465,P<0.01）;SDS评分与脂质核心角度呈正相关（rs=0.406,P<0.01）,与纤维帽厚度呈负相关（rs=-0.494,P<0.01）。路径分析及Bootstrap检验中介效应显示,抑郁在生活事件与斑块纤维帽厚度〔β=-0.117,95%CI（-0.157,-0.089）,P<0.01〕及脂质核心角度〔β=0.114,95%CI（0.070,0.173）,P<0.01〕之间起中介作用。结论　发病前1年内生活事件与冠状动脉粥样硬化斑块稳定性密切相关,且抑郁在其中发挥中介作用。因此,早期筛查经历生活事件及发生抑郁的个体,有助于识别斑块不稳定的高危人群,及时实施心理干预有利于减缓不稳定斑块的发生进程,将ACS的防治关口前移。     

INSTRUCTIONS TO AUTHORS

<正>GENERAL INFORMATION World Journal of Hepatology(World J Hepatol,WJH,online ISSN1948-5182,DOI:10.4254)is a peer-reviewed open access(OA)academic journal that aims to guide clinical practice and improve diagnostic and therapeutic skills of clinicians.Aim and scope WJH covers topics concerning arrhythmia,heart failure,vascular disease,stroke,hypertension,prevention and epidemiology,dyslipidemia and metabolic disorders,cardiac imaging,pediatrics,nursing,and health promotion.Priority publication will be given to articles     

The structures of the colonic mucosa-associated and luminal microbial communities are distinct and differentially affected by a prolonged murine stressor

The commensal microbiota of the human gastrointestinal tract live in a largely stable community structure, assisting in host physiological and immunological functions. Changes to this structure can be injurious to the health of the host, a concept termed dysbiosis. Psychological stress is a factor that has been implicated in causing dysbiosis, and studies performed by our lab have shown that restraint stress can indeed shift the cecal microbiota structure as well as increase the severity of a colonic infection caused by Citrobacter rodentium. However, this study, like many others, have focused on fecal contents when examining the effect of dysbiosis-causing stimuli (e.g. psychological stress) upon the microbiota. Since the mucosa-associated microbiota have unique properties and functions that can act upon the host, it is important to understand how stressor exposure might affect this niche of bacteria. To begin to understand whether chronic restraint stress changes the mucosa-associated and/or luminal microbiota mice underwent 7 16-hour cycles of restraint stress, and the microbiota of both colonic tissue and fecal contents were analyzed by sequencing using next-gen bacterial tag-encoded FLX amplicon technology (bTEFAP) pyrosequencing. Both control and stress groups had significantly different mucosa-associated and luminal microbiota communities, highlighting the importance of focusing gastrointestinal community structure analysis by microbial niche. Furthermore, restraint stress was able to disrupt both the mucosa-associated and luminally-associated colonic microbiota by shifting the relative abundances of multiple groups of bacteria. Among these changes, there was a significant reduction in the immunomodulatory commensal genus Lactobacillus associated with colonic mucosa. The relative abundance of Lactobacillus spp. was not affected in the lumen. These results indicate that stressor-exposure can have distinct effects upon the colonic microbiota situated at the mucosal epithelium in comparison to the luminal-associated microbiota.     

INSTRUCTIONS TO AUTHORS

<正>GENERAL INFORMATION World Journal of Cardiology(World J Cardiol,WJC,online ISSN1949-8462,DOI:10.4330)is a peer-reviewed open access(OA)academic journal that aims to guide clinical practice and improve diagnostic and therapeutic skills of clinicians.Aim and scope WJC covers topics concerning arrhythmia,heart failure,vascular disease,stroke,hypertension,prevention and epidemiology,dyslipidemia and metabolic disorders,cardiac imaging,pediatrics,nursing,and health promotion.Priority publication will be given to articles concerning diagnosis and treatment of cardiology diseases.The following aspects are covered:Clinical diagnosis,laboratory diagnosis,