陆军青年军人心理素质的发展特点研究

目的探讨陆军青年军人心理素质的发展特点。方法采用军人心理素质量表对881名陆军青年军人进行调研。结果①陆军青年军人心理素质各维度得分和总分低于军队常模;②陆军青年军人心理素质随着军龄和年龄增长而逐渐增高,5年军龄和25岁后有明显上升趋势,但在军龄2年后和3年后存在两个转折;③陆军青年军人心理素质的军龄和年龄发展趋势存在性别和职别差异。结论陆军青年军人心理素质较差,但随年龄和军龄的增长呈上升趋势,并且有性别和职别差异。     

婴儿轮状病毒性肠炎57例发病特点分析

目的回顾分析2007年6月至2008年11月我院儿科门诊及住院部轮状病毒性肠炎患儿的发病特点．方法对2007年6月至2008年11月在我院儿科门诊及住院部的57例轮状病毒性肠炎婴儿粪便标本进行常规检查、大便潜血检查、轮状病毒检测,并对12月以下患儿进行喂养情况的调查．结果〉6月≤12月内婴儿,轮状病毒性肠炎发病率最高86％,10～12月份为发病高峰．婴儿腹泻程度与喂养方式的比较：母乳喂养组与人工喂养组、混合喂养组与人工喂养组之间比较差异有统计学意义（P〈0．05）．结论轮状病毒仍是秋冬季婴儿急性腹泻的主要病原,母乳喂养的婴儿尤其6月以下的轮状病毒性肠炎发病率低,并且轮状病毒性肠炎腹泻的程度相对较轻,故应大力提倡母乳喂养．     

老年肺部感染临床特点分析

目的探讨老年肺部感染临床特点．方法回顾性分析老年肺部感染病人170例,分别从临床表现、胸片、CT、痰菌培养、预后方面进行对比分析．结果老年组病人气促、消化道症状、精神状态改变、多肺器功能损害方面均明显高于对照组,差异有统计学意义（P〈0．01）．胸片CT报告老年组间质性肺炎,明显高于对照组,差异有统计学意义（P〈0．01）,老年肺部感染痰培养结果革兰氏阴性杆菌占细菌总数的75．8％,对氨基糖甙类、头孢菌素、喹诺酮类等敏感性较高,老年组合并症和死亡率明显高于对照组．结论老年肺部感染临床表现、胸片、CT结果、痰菌培养、抗生素选择方面有自己的特点,而对其早期诊断和及时治疗比较关键．     

儿童病毒性脑炎临床分析

[目的]探讨儿童病毒性脑炎的临床特点,分析病毒性脑炎的诊治方法。[方法]对303例患儿临床资料进行回顾性分析。[结果]病毒性脑炎临床表现以发热、头痛、呕吐为主,脑脊液和脑电图及CT检查阳性率高。303例中,治愈102例,好转201例,无死亡病例。[结论]儿童病毒性脑炎准确诊断后及时对症治疗,疗效较好。     

名老中医临证能力模型研究

目的 探讨构成名老中医临证能力模型的各种要素,有效挖掘当代名老中医临证经验.方法 研究运用文献学、心理学、统计学的方法,确定名老中医临证经验,建构名老中医临证能力模型,并采用专家经验评定法来检验所建立模型的信度和效度.结果 42份病历中各项典型行为编码的一致性较高,根据典型行为确立了6个能力要素;建构名老中医临证能力模型,检验结果表明所建构的模型具有较高效度.结论 完整的名老中医临证能力模型包含临证沟通能力、临证信息收集能力、临证思维能力、患者取向能力、临证诊疗能力、研究与创新能力6种能力要素和每个能力要素规范的操作性定义,以及能反映能力要素的临证典型行为及其解释.     

大学生网络成瘾者家庭环境特征调查

对大学生网络成瘾家庭环境特征作初步的探索和分析。在网络成瘾的发生率方面,发现是否独生子女、父母工作性质等因素对网络成瘾的检出率无显著影响。男性、高年级和单亲家庭的学生网络成瘾的人数更多;此外,父母文化程度也会影响学生网络成瘾。从网络成瘾的程度看,男性、单亲家庭、家庭经济水平低、父母教育水平低等条件下的学生成瘾程度更深。     

Working with reactant patients: are we prescribing nonadherence?

Objective: In spite of high levels of antidepressant nonadherence frequently observed among depressed samples, relatively little research has investigated psychosocial predictors of adherence. Fostering greater collaboration in depression treatment to increase adherence has been advocated, but this strategy has not been adequately studied. The aim of this study was to examine the interaction of provider collaboration and patient reactance in the prediction of antidepressant adherence during the acute treatment phase. Method: Fifty outpatients diagnosed with major depressive disorder beginning antidepressant treatment within psychiatry clinics of the VA San Diego Healthcare System comprised the study sample. Patients were administered questionnaires following their medication evaluations to measure predictor variables. Antidepressant adherence was assessed via brief telephone interviews 3, 6, 9, and 12 weeks after treatment initiation. The roles of provider collaboration, patient reactance, and their interaction in adherence were examined using multiple regression analyses. Results: The interaction between provider collaboration and patient reactance accounted for 18.3% of the variance in 3‐week adherence (P<.01). Among more reactant patients, greater levels of collaboration predicted better adherence, whereas among patients lower in reactance less collaboration predicted better adherence. No relationships were observed beyond the initial 3 weeks of treatment. Conclusions: This study demonstrates that interpersonal process variables are important in influencing antidepressant adherence and challenges the advocacy of more collaboration in antidepressant treatment as a “blanket strategy.” Establishing a more collaborative set with reactant patients may ensure greater early treatment adherence, a critical period during which antidepressants have typically not yet taken effect. Depression and Anxiety, 2009. © 2008 Wiley‐Liss, Inc.     

Differences in characteristics of patients with and without known risk factors for hepatocellular carcinoma in the United States

AIM： To examine the clinical characteristics of a subgroup of patients with hepatocellular carcinoma （HCC） and compare them to those with known risk factors. METHODS： We used the HCC database of 306 patients seen at our institution from January 1, 1995 to December 31, 2001. Of the 306 patients, 63 （20%, group 1） had no known risk factors （hepatitis C virus, hepatitis B virus, alcohol, hemochromatosis or cirrhosis from any cause） and 243 （group 2） had one or more risk factors. RESULTS： The median age was similar in both groups, but there were disproportionate numbers of younger （〈 30 years old）, older （〉 80 years） patients, women （33% vs 18%）, and Caucasians （81% vs 52%） in group 1 as compared to group 2. There were fewer Asians （2% vs 11%） and African Americans （13% vs 27%） in group 1. Abdominal pain （70% vs 37%） was more common while gastrointestinal bleeding （0% vs 11%） and ascites （4% vs17%） were less common in group i compared to group 2. Group 1 had larger tumor burden （median size 9.4 cm vs 5.7 cm） at the time of presentation, but there were no differences in the site （right, left or bilateral lesions）, or number of tumors between the two groups. CONCLUSION： HCC patients without identifiable risk factors have different characteristics and clinical presentation compared to those with known risk factors.Absence of cirrhosis and larger tumor burden may explain the differences in the presenting symptoms.     

Effort-reward imbalance and relational injustice at work predict sickness absence: the Whitehall II study

OBJECTIVES: Sickness absence is a major occupational health problem, but evidence for associations between potentially modifiable psychosocial work factors and sickness absence is still scarce. We studied the impact of relational justice and effort-reward imbalance on subsequent rates of sickness absence. METHODS: The Whitehall II prospective cohort study of British civil servants, 10,308 men and women, was established between 1985 and 1988. Indicators of effort-reward imbalance and the relational component of organizational justice were constructed from questions included at baseline. Participants were classified into three groups (low, intermediate, and high) for both effort-reward imbalance and relational justice. Short (< or =7 days) and long (>7 days) spells of sickness absence during 1985-1989 and 1991-1995 were used to study immediate and longer term effects of work characteristics. RESULTS: After adjustment for age, employment grade, and baseline health, men and women with low relational justice had increased risks of long spells of sickness absence of 14% and 28% in comparison to men and women experiencing high levels of justice. Similar effect sizes (25% and 21%) were found for high vs. low effort-reward imbalance. Both work measures also predicted short spells of sickness absence. Effort-reward imbalance (men and women) and relational justice (women only) each predicted long spells of sickness absence independently of the other. CONCLUSIONS: Both relational justice and effort-reward imbalance are important determinants of sickness absence. Workplace interventions to improve these aspects of working conditions have the potential to reduce levels of sickness absence.     

散发性肌萎缩侧索硬化的临床特征

目的探讨散发性肌萎缩侧索硬化（SALS）的临床特征,为早期准确诊断SALS提供依据。方法回顾分析近年来我院收治的40例SALS患者的临床资料,对其发病特点、症状、体征及实验室检查进行统计分析。结果SALS平均发病年龄52．4岁,30岁以前和75岁以后发病少见。男女发病比例5：3。SALS在临床上隐袭起病居多．但也可呈亚急性起病。上肢远端乏力或肌肉萎缩为最常见的起病症状,其发展一般从起病部位水平或垂直的累及邻近的运动神经元．并发呼吸肌麻痹是SALS最常见的死因。SALS的诊断仍然主要依靠临床表现。EMG检查对确诊SALS的病变范围和诊断无临床表现的隐匿损伤部位有重要意义。MRI检查对鉴别颈椎病及脊髓压迫症、脊髓肿瘤和脊髓空洞症的诊断具有重要的辅助价值。结论SALS以中年发病为主．男性多见．其发展遵循一定的规律。EMG和MRI检查对SALS的诊断和鉴别诊断有重要意义。