哮喘患儿生活质量与吸入糖皮质激素治疗的相关性分析

目的探讨吸入糖皮质激素(ICS)治疗哮喘对患儿生活质量、肺功能的改善情况与吸入治疗依从性的关系,并分析患儿不服从规范吸入治疗的原因。方法对具有应用ICS治疗指征并能完成填写儿科哮喘生存质量调查问卷(PAQLQ)和平行测量肺功能的83例患儿的资料作回顾分析,评估其生活质量、肺功能改善情况与吸入治疗依从性的关系。结果急性发作期,治疗组的FEV1(1秒钟用力呼气量)和PAQLQ评分均值在治疗前后有显著性差异(p<0.05);坚持治疗时间越长,改善越明显。对照组患儿在急性发作期治疗前后FEV1无改善(p>0.05),PAQLQ评分更低。治疗组与对照组的FEV1、PAQLQ评分均值都有显著性差异(p<0.05);非急性发作期,两组治疗前后的FEV1、PAQLQ评分均值无显著性差异(p>0.05)。结论坚持规范使用ICS治疗的哮喘患儿,其生活质量、肺功能改善比治疗不依从的患儿明显提高,发作时严重程度减轻。     

军队医科大学学员生活事件与心理健康的相关分析

目的了解军队医科大学学员心理健康状况与生活事件的关系。方法采用症状自评量表(SCL-90)和自编生活事件量表对4 786名军队医科大学学员的健康水平和生活事件情况进行评估。结果①军队医科大学学员SCL-90各因子的得分在(1.34±0.42)~(1.894±0.59)分之间,均低于国内普通大学生常模(P<0.01);②军队医科大学学员的生活事件与心理健康有明显相关,r值在0.240~0.511之间,相关程度由高至低依次为:学习、适应、人际关系、挫折事件。结论军队医科大学学员心理健康状况较好,与生活事件的影响程度关系密切。     

Clinical observations on electroacupuncture treatment of unstable bladder

目的:对电针治疗不稳定膀胱进行临床疗效评价.方法:将患者随机分为电针组和对照组,根据治疗前后临床症状积分和生活质量评分的改善情况进行疗效评价.结果:观察指标两组治疗后均较治疗前显著降低(P＜0.05),两组间比较临床症状积分无显著性差异(P＞0.05);生活质量评分电针组较手法组下降明显(P＜0.05).结论:两种治疗方法对不稳定膀胱均有改善,其中电针组生活质量满意度要优于手法组,临床症状积分有低于手法组的趋势.     

健脾消积口服液改善晚期肝癌患者生存质量32例临床研究

目的:探讨健脾消积口服液对改善晚期肝癌患者生存质量的临床疗效.方法:62例患者随机分为两组,治疗组32例与对照组30例均采用相同的西医药疗法,即保肝及对症支持疗法,治疗组32例加用健脾消积口服液治疗.结果:治疗组与对照组近期疗效总缓解率分别为62.5%和40%(P》0.05);临床证候变化比较:治疗组与对照组总改善率分别为75%和53.3%(P》0.05);生活质量变化比较:治疗组与对照组提高及稳定率分别为68.8%和43.3%;两组患者半年、1年生存率分别为65.6%、37.5%和40%、23.3%.两组比较差异有显著性(P《0.05).结论:健脾消积口服液可改善晚期肝癌患者临床症状,提高生活质量,延长生存时间;并有稳定瘤体的作用,有效地控制病情及延缓病情发展;体现了中西医结合治疗晚期肝癌的独特优势.     

Responsiveness and minimal clinically important difference of the Chinese version of the Low Vision Quality of Life Questionnaire after cataract surgery

AIM: To investigate the Chinese version of the Low Vision Quality of Life Questionnaire (CLVQOL) as an instrument for obtaining clinically important changes after cataract surgery. METHODS: Patients underwent cataract surgery in Shanghai General Hospital, Shanghai Jiao Tong University, who fit the inclusion criteria were recruited. Two CLVQOLs were administered, including a preoperative CLVQOL and a CLVQOL at the end of the 3mo follow-up period, and were completed using face-to-face interviews or phone interviews conducted by trained investigators. The minimal clinically important difference (MCID) was calculated using an anchor-based method and a distribution method. In addition, the responsiveness of the questionnaire was measured. RESULTS: A total of 155 residents were enrolled. The average visual acuity (VA) preoperatively was 0.08 (SD=0.05), and it increased to 0.47 (SD=0.28) at the end of follow-up. Statistically significant positive changes in the CLVQOL scores indicated significant improvement of vision related quality of life after cataract surgery. With the larger value between the two results as the final value, the MCID values of the CLVQOL (scores of the four scales as well as the total score) were 8.94, 2.61, 4.34, 3.10 and 17.63, respectively. The CLVQOL has both good internal and external responsiveness. CONCLUSION: CLVQOL scores are appropriate instruments for obtaining clinically important changes after cataract surgery. This study is an effective exploration for establishing cataract surgery efficacy standards, which helps clinical and scientific research workers in ophthalmology to gain a more in-depth understanding when using CLVQOL.     

高龄患者生活行为与冠心病发病的相关性研究

目的研究生活行为与高龄患者冠心病发病的关系。方法对91例年龄≥80岁的高龄老年冠心病人的生活行为及5年来的生活事件进行流行病学调查。采用问卷访问、体格检查、查阅住院病历的方法获得数据。结果对高龄老年冠心病人影响较大的负性生活事件依次为丧偶、子女病重或去世、重大财产损失、搬家等。心绞痛组和心肌梗死组A型行为倾向与正常组比较差异有统计学意义。结论负性生活行为与冠心病有关,起诱导剂的作用。     

Assistance respiratoire veino-veineuse et assistance circulatoire veino-artérielle avec oxygénation extracorporelle. Questions,réponses

A round table, organized by the French Society of Perfusion (Sofraperf) at the French national congress on extracorporeal circulations (Perfusion 2013), was attended by perfusionists, anaesthesiologists, intensivists and surgeons around the theme of respiratory veno-venous support and veno-arterial circulatory support with extracorporeal oxygenation in intensive care units. The debate was conducted in a participatory manner by bi-directional questions–answers session between moderators and assistance. The authors report management of this type of therapy that is not perfectly homogeneous, supported on literature data. Cannulae, cannulation, circuit, oxygenator, anticoagulation, control, surveillance, weaning are subject to paragraphs with defined entry whose contents are mutually enriching.     

The effect of near‐peer tutoring on medical students' performance in anatomical and physiological sciences

Healthcare professional schools across the world are implementing near‐peer tutoring (NPT) programs owing to numerous benefits to both tutors and tutees. This study determined whether higher attendance at NPT sessions led to improvements in course grades for high and low performing students. Fourth‐year medical students used the USMLE Step 1 question format to tutor first‐year medical students during the second half of the Structure and Function (SF) module, i.e., SF2. Attendance was recorded and students were accordingly divided into three groups: high, moderate, and low‐no attendance. Students’ performances in SF1 and SF2 were compared using Student's t‐test. Differences among the three groups were analyzed using ANOVA and Scheffé post hoc test (P< 0.05). Students who earned 70–79% (C) in SF1 were further examined on the basis of their attendance rate and performance in SF2. Those who attended three or more sessions completed a survey evaluating the NPT program. Course grades were significantly higher in SF2 than SF1 for all students, regardless of attendance rate. However, students who received a C grade in SF1 and had high or moderate attendance improved significantly in their SF2 course grade. Most students agreed that the NPT program was valuable and they evaluated the tutors highly. They also agreed that NPT prepared them for course exams and Step 1, but did not reduce anxiety and stress about Step 1. The positive effect of the NPT program resulted in its expansion to include all first‐year modules. Clin. Anat. 30:922–928, 2017. © 2017 Wiley Periodicals, Inc.