个案管理模式在慢性心力衰竭患者中的应用效果

目的:观察分析个案管理模式在慢性心力衰竭(chronic heart failure,CHF)患者中的临床应用效果。方法:选取同济大学附属上海市第十人民医院心内科住院患者为研究对象,其中2017年7月至10月的20例患者作为对照组,2017年11月至2018年2月的20例患者作为实验组,其中对照组接受常规护理进行管理,实验组应用个案管理模式管理,比较两组CHF患者管理结果的差异性。结果:干预前两组患者的焦虑自评量表(Self-rating Anxiety Scale,SAS)和抑郁自评量表(Self-rating Depression Scale,SDS)评分比较,差异无统计学意义(P>0.05)。干预后两组患者的SAS,SDS评分均有所降低,与干预前比较,差异有统计学意义(P<0.05);实验组患者干预后SAS,SDS评分低于对照组,差异有统计学意义(P<0.05);实验组患者生活质量评分高于对照组,差异有统计学意义(P<0.05);两组患者干预后住院时间和住院费用的比较,差异无统计学意义(P>0.05)。结论:个案管理模式能够有效改善CHF患者的生活质量和心理状态,建议临床推广使用。     

配偶夫妻沟通对孕妇睡眠质量、心理状态的影响

目的:研究配偶夫妻沟通对孕妇睡眠质量、心理状态的影响.方法:采用随机数表法将2017 年6 月至2018年9 月于中国人民解放军联勤保障部队第901 医院进行产前检查的100例孕妇分为观察组与对照组,每组50例.对照组给予常规心理干预,观察组在其基础上增加配偶夫妻沟通干预.比较干预前后2 组孕妇睡眠质量和心理状态.结果:干预1个月后,观察组孕妇睡眠质量评分明显降低,且低于对照组(P<0.05);干预后2组孕妇汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评分均明显降低,且观察组孕妇评分明显低于对照组(P<0.05).结论:加强配偶夫妻沟通可有效改善孕妇焦虑、抑郁等负面情绪,提高睡眠质量.     

围术期康复护理对髋关节置换术患者睡眠状态及髋关节功能的影响

目的:研究围术期康复护理对髋关节置换术患者髋关节功能及睡眠状态的影响.方法:选取2016年8月至2018年10月福建医科大学附属三明第一医院骨科收治的髋关节置换术患者90例作为研究对象,随机分为观察组和对照组,每组45 例.分别进行系统化和常规康复护理.比较2组术前和术后匹兹堡睡眠质量指数量表(PSQI)和Harris评分.结果:与术前比较,术后2组Harris评分显著提高,观察组患者术后1,3,6个月髋关节功能评分均高于对照组(P<0.05).与术前比较,术后2组PSQI评分降低,观察组PSQI评分低于对照组(P<0.05).结论:系统化康复护理更有利于髋关节置换术后患者髋关节功能的康复以及睡眠质量的提高,具有重要的临床价值.     

中山市护理人员参与新型冠状病毒肺炎疫情防治工作期间心理健康状况调查分析

目的调查中山市护理人员参与新型冠状病毒肺炎疫情防治工作期间的心理健康状况。方法选取新型冠状病毒肺炎流行期间参与疫情防治工作的一线护理人员,采用综合医院焦虑抑郁量表(HAD)进行调查。结果共计342名护理人员接受调查。HAD焦虑部分得分:0~7分246(71.93%)名,8~10分的60(17.54%)名,11~21分的36(10.53%)名;抑郁部分得分:0~7分251(73.39%)例,8~10分的51(14.91%)名,11~21分的40(11.70%)名;不同年龄护士HAD量表抑郁部分评分差异有统计学意义(P<0.05),高年龄段(≥41岁)的护士抑郁得分较高。结论新型冠状病毒肺炎流行期间,多数护士不存在明显的抑郁焦虑现象,应加强对高年龄段护士的心理关注。     

乳腺癌术后患者婚姻质量与负性情绪、社会支持的相关性

目的调查乳腺癌术后患者婚姻质量,并探讨负性情绪、社会支持与乳腺癌术后患者婚姻质量的相关性。方法选取西安交通大学第二附属医院肿瘤外科的乳腺癌术后患者110例,采用一般情况调查问卷、中国人婚姻质量问卷(CMQI)、焦虑自评量表(SAS)、抑郁自评量表(SDS)和社会支持评定量表(SSRS)进行调查。结果患者的婚姻质量总分低于常模,SAS和SDS评分均高于常模(P<0.05)。患者的婚姻质量评分与SAS评分、SDS评分呈负相关,与社会支持评分呈正相关(P<0.05)。结论乳腺癌术后患者婚姻质量会降低且容易产生负性情绪,医护人员应该加强对其心理健康的关注,提高对患者的社会支持。     

Evidence that conditioned stress enhances outflow of dopamine in rat prefrontal cortex: A search for the influence of diazepam and 5-HT1A agonists

We evaluated the impact of conditioned stress on outflow of dopamine in the rat prefrontal cortex. Exposure of rats to an environment associated with aversive stimuli-foot shock enhanced outflow of dopamine in a similar way as seen during the conditioning session when foot shocks were applied. Diazepam (2.5 and 10 mg/kg) dose-dependently decreased outflow of dopamine and, when given in a dose of 10 mg/kg, but not 2.5 mg/kg, decreased enhanced dopamine outflow evoked by conditioned stress. On the other hand, ipsapirone (10 mg/kg, but not 2.5 mg/kg) and buspirone (2.5 mg/kg) enhanced basal outflow of dopamine. When ipsapirone (10 mg/kg) and buspirone (2.5 mg/kg) were given to rats exposed to conditioned stress, the stress-evoked elevation in dopamine outflow was abolished. Ipsapirone in a dose of 2.5 mg/kg was ineffective in the stress paradigm tested. It is concluded that conditioned stress in vivo enhances dopaminergic neurotransmission in the rat prefrontal cortex, this effect being attenuated by diazepam, a classic anxiolytic drug, and by such novel anxiolytics as ipsapirone and buspirone, which operate via serotonergic 5-HT_1A receptors. Although ipsapirone and buspirone blocked stress-induced enhancement of dopamine outflow, this effect seems to result from their influence on the basal outflow of dopamine. Differential effects of diazepam and 5-HT_1A agonists on basal and stress-induced alterations in dopamine outflow are discussed in terms of their possible effectiveness in various types of general anxiety disorders. © 1996 Wiley-Liss, Inc.     

A non-linear optimal greenhouse control problem with heating and ventilation

A simplified non-linear dynamic model of greenhouse crop growth with constraints on the state and the control signal is considered. The weather is assumed to be known. The optimization criterion is to minimize the heating and ventilation cost. In this paper a novel solution is presented for the case when both the heating cost and the ventilation cost are included in the criterion. Important properties of the optimal solutions are clarified. It is found that neighbouring maxima and minima of a particular function of the outside temperature, the solar radiation and the heat transfer coefficient decide whether heating or ventilation has to be applied. A numerical example is given.     

Short communications on the existence of touch points for first-order state inequality constraints

The appearance of touch points in state-constrained optimal control problems with general vector-valued control is studied. Under the assumption that the Hamiltonian is regular, touch points for first-order state inequalities are shown to exist only under very special conditions. In many cases of practical importance these conditions can be used to exclude touch points a priori without solving an optimal control problem. The results are demonstrated on a simple example.