护理本科生职业生涯规划认知现状

目的 分析护理本科生自我职业生涯管理状况,提出辅导需求及影响因素,对护理本科生实施个体化、全程化及专业化的职业生涯规划辅导模式.方法 对500例护理本科生职业生涯的现状进行问卷调查分析,计数资料采用方差分析;计量资料应用t检验;等级资料采用秩和检验;应用软件SPSS 17.0对数据进行分析,P＜0.05为差别有统计学意义.结果 在校学习护生与在院实习护生的职业规划认知程度不高,导致的原因多有不同,可概括为5个方面.结论 学校与实习医院均应根据本身的环境对职业生涯规划课程模式进行改变.     

1000例儿童屈光状态分析

目的了解学龄前及学龄儿童的屈光状态.方法对昆明医科大学第一附属医院2009年1月到2012年12月眼科门诊接待的3-12岁1 000例儿童（2 000只眼）进行睫状肌麻痹下视网膜检影验光,并对其屈光状态情况进行统计学分析.结果近视最多,占658只眼（65.8%）,远视296只眼（29.6%）混合散光46只眼（4.6%）;其中学龄前近视眼29只（2.9%）,学龄后近视眼629只（62.9%）;学龄前远视眼128只（12.8%）,学龄后远视眼168只（16.8%）;学龄前混合散光眼25只（2.5%）,学龄后混合散光眼21只（2.1%）.结论 3~6岁儿童屈光不正以远视为主,6-12岁儿童屈光不正以近视为主,随年龄增长近视人数增多及程度加深,弱视多发于远视眼.     

小鼠癫痫持续状态时组蛋白H3K9二甲基化水平的变化及其调控作用

目的研究癫痫持续状态对组蛋白H3K9二甲基化修饰的作用。方法用Western blot比较研究小鼠癫痫持续状态后大脑皮层和海马的组蛋白H3K9二甲基化水平及相关蛋白表达水平的变化。利用特异性抑制剂BIX01294处理原代培养的小鼠大脑皮层神经元,观察组蛋白H3K9二甲基化水平对谷氨酸脱羧酶GAD67表达水平的影响。用染色体免疫沉淀技术验证组蛋白H3K9甲基化酶G9a与GAD67的启动子区的相互作用。结果癫痫持续状态能够下调组蛋白H3K9甲基转移酶G9a的表达和组蛋白H3K9的二甲基化水平,同时上调GAD67的表达水平。在培养神经元中,用BIX01294抑制组蛋白H3K9二甲基化水平可以上调GAD67的表达水平。染色体免疫沉淀实验发现G9a能和GAD67启动子区域相互作用。结论癫痫持续状态下调组蛋白H3K9二甲基化水平及组蛋白H3K9甲基转移酶G9a的表达水平,并能引起GAD67表达水平上调。     

昆山市某乡镇托幼儿童营养状况及常见病调查

目的：了解昆山市千灯镇托幼儿童体格发育及营养状况变化趋势,探讨近年来影响托幼儿童体格发育的影响因素以及公、私立幼儿园儿童的差异。方法对2011～2014年昆山市千灯镇托幼儿童定期体检资料进行分析,比较营养不良、肥胖、贫血、视力异常和龋齿的发病趋势,同时比较2014年公立、私立幼儿园以上指标之间的差异,率的比较采用χ2检验。结果2011～2014年托幼儿童营养不良发生率呈先升后降趋势,贫血的患病率呈逐年下降趋势,肥胖、视力异常、龋齿的患病率呈逐年上升趋势,差异均有统计学意义（P<0.05）。公立幼儿园儿童肥胖、视力异常的发生率显著高于私立幼儿园儿童,而营养不良、龋齿的患病率则显著低于私立幼儿园,差异均有统计学意义（P<0.05）。结论昆山市千灯镇儿童健康状况不容乐观。应根据调查结果适时调整防控策略,加强对保健人员及儿童家长营养知识培训。     

Pre-stroke socioeconomic status predicts upper limb motor recovery after inpatient neurorehabilitation

BackgroundLower socioeconomic status (SES) is associated with higher mortality rates and the likelihood of receiving less evidence-based treatment after stroke. In contrast, little is known about the impact of SES on recovery after discharge from inpatient rehabilitation. The aim of this study was to investigate the influence of SES on long-term recovery after stroke.Patients and methodsIn a prospective, observational, multicentre study, inpatients were recruited towards the end of rehabilitation. The 12-month follow-up focussed on upper limb motor recovery, measured by the Fugl-Meyer score. A clinically relevant improvement of ≥5.25 points was considered recovery. Patient-centric measures such as the Patient-reported Outcomes Measurement Information System-Physical Health (PROMIS-10 PH) provided secondary outcomes. Information on schooling, vocational training, income and occupational status pre-stroke entered a multidimensional SES index. Multivariate logistic regression models calculating odds ratios (ORs) and corresponding confidence intervals (CIs) were applied. SES was added to an initial model including age, sex and baseline neurological deficit. Additional exploratory analyses examined the association between SES and outpatient treatment.ResultsOne hundred and seventy-six patients were enrolled of whom 98 had SES and long-term recovery data. Model comparisons showed the SES-model superior to the initial model (Akaike information criterion (AIC): 123 vs. 120, Pseudo R²: 0.09 vs. 0.13). The likelihood of motor recovery (OR = 17.12, 95%CI = 1.31; 224.18) and PROMIS-10 PH improvement (OR = 20.76, 95%CI = 1.28; 337.11) were significantly increased with higher SES, along with more frequent use of outpatient therapy (p = .02).ConclusionsHigher pre-stroke SES is associated with better long-term recovery after discharge from rehabilitation. Understanding these factors can improve outpatient long-term stroke care and lead to better recovery.

KEY MESSAGE

• Higher pre-stroke socioeconomic status (SES) is associated with better long-term recovery after discharge from rehabilitation both in terms of motor function and self-reported health status.
• Higher SES is associated with significantly higher utilization of outpatient therapies.
• Discharge management of rehabilitation clinics should identify and address socioeconomic factors in order to detect individual needs and to improve outpatient recovery.
• Article registration: clinicaltrials.gov {"type":"clinical-trial","attrs":{"text":"NCT04119479","term_id":"NCT04119479"}}NCT04119479.

     

初诊高血压病患者心理、个性和行为特征对控烟效果的影响

目的 观察初诊高血压病患者心理、个性和行为特征对控烟效果的影响.方法 对84例初诊高血压病吸烟患者行控烟治疗,连续3个月后评价控烟效果,并采用A型行为问卷、艾森克个性问卷(EPQ)及症状自评量表(SCL-90)对其进行测评.结果 控烟效果佳者38例,占45.24%;控烟效果差者46例,占54.76%.前者A型行为问卷、EPQ问卷(除外内外向性维度)评分均显著优于后者(P＜0.05,P＜0.01);SCL-90除偏执、阴性项目外,其余项目评分均显著优于后者(P＜0.05,P＜0.01).结论 A型行为类型、神经质和精神病性人格特征及负性情绪是影响控烟效果的重要因素,对此类患者实施控烟的同时予以针对性心理干预可望获得事半功倍的效果.     

高中生排便状况及相关因素调查分析

为了解高中学生排便状况,探讨诱发便秘的相关因素,采取整群分层随机抽样方法,于2009年3～6月对6048名在校高中生进行问卷调查,调查内容包括排便状况及相关因素共86项问题。结果显示,参照罗马Ⅲ便秘的诊断标准,便秘三联症的检出率为46．5％,女性、饮水较少、性格内向、偏食肉类及辛辣食物、生活及排便习惯不规律、常强忍便意、有排便不良习惯者更易出现便秘三联症。结果表明,高中生便秘三联症主要与不良饮食习惯、排便习惯,以及学习紧张等多种因素有关。     

Differences in Long-term Outcome and Prognostic Factors According to Viral Status in Patients with Hepatocellular Carcinoma Treated by Surgery

Long-term postoperative survival and prognostic factors were examined retrospectively in patients with hepatocellular carcinoma (HCC) with serum hepatitis B surface antigen (HBsAg) or hepatitis C antibody (HCVAb) and in those without virus infection. Subjects were 265 consecutive HCC patients treated surgically at one institution during the period 1990 to 2006. Postoperative survival was analyzed and compared between HBsAg-positive (B-HCC), HCVAb-positive (C-HCC), and hepatitis B- and C-negative (NBNC-HCC) patients. Prognostic factors for overall and recurrence-free survival were also analyzed. Overall and recurrence-free survival rates were significantly higher in the NBNC-HCC group than in the C-HCC group. Significant prognostic factors for overall survival identified by univariate and multivariate analyses were age, serum alkaline phosphatase (ALP) level, tumor multiplicity, portal vein invasion (Vp), hepatic vein invasion (Vv), and operative blood loss in the B-HCC group; serum albumin level, ALP level, tumor size, and Vv in the C-HCC group; and tumor multiplicity in the NBNC-HCC group. Significant factors for recurrence-free survival were age, ALP level, tumor multiplicity, Vp, and operation time in the B-HCC group; ALP level, prothrombin time, tumor size, Vv, and width of the surgical margin in the C-HCC group; and age, tumor size, tumor multiplicity, and Vp in the NBNC-HCC group. Thus, postoperative survival and prognostic factors in cases of HCC differ according to the presence of serologic viral markers.     

海南省某市COPD合并骨质疏松患者营养状况及其影响因素分析

目的了解海南省某市慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)合并骨质疏松患者营养状况及其影响因素。方法使用问卷法收集2014年3月至2017年5月在本院住院治疗的628例慢性阻塞性肺疾病合并骨质疏松患者的资料,采用Guigoz等人研制的微型营养评估量表对患者进行营养状况评估,收集患者相关临床资料、血红蛋白、血清蛋白浓度等。结果 628例COPD合并骨质疏松患者的微型营养评估量表平均得分为(16.43±4.12)分,其中421例(67.03%)存在营养不良,113例(17.99%)存在营养不良风险,94例(14.97%)营养状况良好。年龄(OR=2.11)、受教育程度(OR=2.53)、病程(OR=2.33)、居住地区(OR=3.15)、医疗费支付方式(OR=4.57)、COPD疾病严重程度(OR=1.78)、骨质疏松症分级(OR=1.94)、膳食摄入状况(OR=2.14)是COPD合并骨质疏松患者营养状况的影响因素(P0.05)。结论 COPD合并骨质疏松患者营养状况较差,并与年龄、受教育程度、病程、居住地区、医疗费支付方式、COPD疾病严重程度、骨质疏松症分级、膳食摄入等有关,医护人员应及时提供针对性的预防措施,改善患者的营养状况。     

中药临床药师培训结业学员返岗工作现状调研

目的了解中药临床药师培训结业学员返岗后的工作现状。方法采用"问卷星"在线调研平台,通过微信方式向已结束中药临床药师培训的学员发放调查问卷,收集结业学员的工作地、所在医院级别、年龄、职称等基本信息,以及返岗后的工作去向、工作内容、临床认可度、培训建议等信息,分析结业学员的工作现状。结果中药临床药师培训学员已覆盖全国30个省、自治区、直辖市,共结业878人,回收调查问卷757份。学员返岗后从事临床药学工作的占77.94%;每周参与临床工作时间占比超过1/2周的仅25.25%,主要原因是科室其他事务繁忙,学员认为能胜任自身工作或能获得临床认可的分别占97.80%和73.73%,92.71%的学员愿意继续从事临床药学工作;96.30%的学员觉得培训非常受益,对培训基地的建议主要集中在培训内容、培训方式、带教等方面。结论绝大部分学员中药临床药师培训结业学员返岗后愿意并能从事临床药师工作,培训基地将不断优化培训模式和内容,努力为中药临床药师行业的发展贡献力量。