不同分娩方式产妇的焦虑抑郁情绪调查分析

目的：探讨不同分娩方式产妇焦虑抑郁情绪差异,分析其发生状况以及可能的影响因素。方法根据分娩方式不同将2013年10月至2014年5月在成都市某医院产科及某区妇幼保健院分娩的380例产妇分为剖宫产组和顺产组,采用自编一般信息问卷、抑郁自评量表和焦虑自评量表分别对产妇进行测评。结果剖宫产组与顺产组焦虑情绪在产后前3 d 组间比较差异有统计学意义(t 1=-3.292、t 2=-2.316、t 3=-2.666;P 均<0.05);经多元 logistic 回归分析筛选出剖宫产组的焦虑影响因素为泌乳量,顺产组产妇焦虑的影响因素为产后天数、产后下床活动时间及泌乳量;剖宫产产妇产后前3 d 抑郁情绪逐渐减轻但此后递增,顺产产妇5 d 内抑郁情绪逐渐减轻。运用多元 logistic 回归分析,筛选出剖宫产组抑郁情绪的影响因素为泌乳量、产后自行排尿时间,顺产组抑郁情绪的影响因素为泌乳量、产后天数。结论不同分娩方式的产妇均普遍存在产后焦虑抑郁情绪,关注产妇心理健康,适时进行心理干预,对产妇的产后恢复以及新生儿的健康成长具有重要意义。     

Tissue Engineered Cartilage Integration to Live and Devitalized Cartilage: A Study by Reflectance Mode Confocal Microscopy and Standard Histology

This study investigated the in vivo formation of engineering cartilage within living or devitalized cartilage discs using reflectance mode confocal microscopy and conventional light microscopy. Pig articular chondrocytes were suspended in fibrin glue and placed between two cartilage discs. Four experimental groups were prepared: in groups 1 and 2, the cell-hydrogel composite was placed between two live or between two devitalized cartilage discs, respectively; in groups 3 and 4, acellular fibrin glue was placed between two live or between two devitalized cartilage discs, respectively. Samples were implanted in the back of nude mice and analyzed after 2, 5, and 8 weeks. Results showed that engineered cartilage seems to grow more homogenously when the cell-seeded gel was placed between devitalized cartilages than when it was placed between live cartilage matrices. Confocal microscopy provides valuable information on the integration of tissue-engineered cartilage with native tissue and could be useful for nondestructive imaging in vivo.     

Volatile organic compounds produced by Aureobasidium pullulans induce electrolyte loss and oxidative stress in Botrytis cinerea and Alternaria alternata

Aureobasidium pullulans is a yeast-like fungus that produces volatile organic compounds (VOCs) with antifungal properties. VOCs have the potential to trigger the production of intracellular reactive oxygen species (ROS), lipid peroxidation and electrolyte loss in microorganisms. The relationship among A. pullulans VOCs, induced ROS accumulation and electrolyte leakage was investigated in Botrytis cinerea and Alternaria alternata in vitro. Exposure to a mixture of A. pullulans VOCs: ethanol, 2-methyl-1-propanol, 3-methyl-1-butanol and 2-phenylethanol, resulted in electrolyte leakage in both B. cinerea and A. alternata. Fluorescence microscopy using 2′,7′-dichlorofluorescein diacetate indicated triggered ROS accumulation in exposed fungal mycelia and the presence of the superoxide radical was evident by intense red fluorescence with dihydroethidium. Partial inhibition of enzymes of the mitochondrial respiratory chain complex I of B. cinerea and A. alternata by pre-treatment with rotenone reduced ROS accumulation in hypha exposed to A. pullulans VOCs and reversed the VOCs inhibition of fungal growth. Scanning electron micrographs revealed that B. cinerea and A. alternata hypha exposed to A. pullulans VOCs had altered cell wall structures. Our findings give insights into the potential mechanisms involved in the antifungal properties of A. pullulans in the suppression of B. cinerea and A. alternata growth in vitro.     

人体生命科学馆作为“三生教育”基地模式的探讨

目的探讨以人体生命科学馆作为实践教育基地的“三生教育”模式,为更好的开展大学生“三生教育”探索新的思路和方法。方法在我校公共卫生学院2010-2012级新生入学教育中,把人体生命科学馆作为实践教育基地开展“三生教育”活动,并进行问卷调查。结果85．7％的人觉得“三生教育”的开展应该理论与实践结合;87．6％的人认为把人体生命科学馆作为“三生教育”实践基地,是一种新的“三生教育”模式,具有较好的效果。结论以人体生命科学馆作为实践教育基地的“三生教育”模式加深学生个人对生命价值和意义的理解,为“三生教育”活动的开展提供较好的思路和方法。     

交互式阅读陪伴模式对住院患儿及家属焦虑情绪与服务感知的影响

目的：探讨交互式陪伴模式对缓解住院患儿及家属焦虑情绪与护理服务感知度的影响。方法：选取2019月06月～2020年06月我院内科病房的120例患儿为研究对象,按照随机数字表分为干预组和对照组,每组各60例。对照组患儿给予常规的治疗和心理护理,干预组患儿在对照组的基础上由经过专门培训的护士采用线下+线上结合的方式进行交互式阅读。比较干预前后两组患儿焦虑障碍自评量表、患儿家属焦虑自评量表评分及护士对家属支持量表得分。结果：干预组和对照组在干预后患儿焦虑评分为33.57±7.35、35.33±6.99,患儿家属焦虑在干预前后的焦虑评分35.59±5.92、36.85±7.10,差别均无具有统计学意义（P＞0.05）,但两组干预前后患儿焦虑评分差值差别有统计学意义（Z=3.034,P＜0.05）;在护士对家属支持总分方面,干预组显著高于对照组,差别有统计学意义（P＜0.05）。结论：交互式阅读陪伴模式能降低住院患儿的焦虑程度,同时提高家属的护士服务感知度。这种陪伴式阅读不但增加了患儿及家属互动,还帮助患儿更好地了解医疗程序,降低对医院的恐惧。     

瘢痕子宫孕妇阴道试产对母儿结局的影响

目的 探讨瘢痕子宫孕妇不同分娩方式的选择以及对母儿结局的影响。方法 选择2017年1月至2018年12月在合肥市第一人民医院产科住院且符合剖宫产后阴道试产纳入标准的产妇160例,依据医生评估结果及产妇意愿选择分娩方式,按实际分娩结果分为剖宫产后阴道分娩（简称阴道分娩）组68例,再次剖宫产（简称剖宫产）组80例,12例因阴道试产失败急诊行子宫下段剖宫产术（简称阴道试产失败组）。同时选择同期住院分娩的40例单胎顺产初产妇作为对照组。比较各组产妇的临床特征以及分娩信息,分析影响瘢痕子宫产妇阴道试产成功的相关因素。结果 在瘢痕子宫患者中,阴道分娩成功率为85%。阴道分娩组与阴道试产失败组相比,孕妇体质量、体质量指数、距上次剖宫产时间、新生儿体质量、产时出血量、产后24 h出血量差异均有统计学意义（P<0.05）,而孕妇年龄、孕次、产次、瘢痕厚度、新生儿Apgar评分差异无统计学意义（P>0.05）。阴道分娩组孕妇体质量、体质量指数、孕周、距上次剖宫产时间、新生儿体质量、产后24 h出血量、住院时间均小于剖宫产组,差异有统计学意义（P<0.05）,孕妇年龄、孕次、产次、瘢痕厚度、新生儿Apgar评分差异均无统计学意义（P>0.05）。阴道分娩组与对照组相比,分娩时出血量、产后24 h出血量、新生儿Apgar评分、产后住院时间差异均无统计学意义（P>0.05）。结论 瘢痕子宫孕妇在严格的操作规程以及孕期控制体质量指数、胎儿体质量可鼓励阴道试产。     

The clinical profile of musculoskeletal injuries in children attending a major hospital in Delhi,India

Background

Children are vulnerable to musculoskeletal injuries both at home and on the street for various reasons. Morbidity and disabilities resulting from these, mostly preventable, injuries, make them a burden to their families and society. The role of various factors associated with injuries is often not documented.

Methods

This prospective study, done on 100 children aged up to 12 years with musculoskeletal trauma, analysed in details, the various modes of injuries.

Results

One in every five patient was a child below 12 years of age. Boys were injured more than girls. Injuries, especially fractures, were most common in the extremities, the upper limb more commonly injured than the lower limb. Most of the injuries occurred at home. The most common mode of injuries was falls that happened while playing both within and outside the home, followed by road traffic accidents. Most injuries occurred during daytime.

Conclusions

Injuries in children were found to be preventable. Small interventions while constructing homes can contribute tremendously to injury prevention and control in children. Parental awareness about the various modes of injury, role of supervised playing and their responsibility towards injury prevention can play a key role in reducing the morbidity associated with childhood fractures.     

书院制模式下高校医学生医德教育新路径探析——以西安交通大学书院制为例

从我国古代书院制及国外书院制教育环境及特点分析入手,结合西安交通大学书院制学生管理模式,从书院推行通识教育,实施学生综合能力提升计划,打造本科生教育"第二课堂",营造和谐学生生活社区及书院特色文化等方面,为医学生医德教育探索出一条新的路径。