中国男同性爱者儿童期状况对自身性别、性取向的态度及认识,少见经历和心理与艾滋病高危行为的关系(一)

目的 通过对中国男同性爱者（gay）的调查,分析gay儿童期状况,对自身性别、性别角色、性取向的态度及认识,某些少见经历和心理与艾滋病（AIDS）高危因素间的关系,发现影响艾滋病病毒（HIV）传播的深层次因素。方法 从男男性接触者自我填写的问卷中筛选出性引力完全来自同性的240例gay的相关资料,进行一般性描述并进行统计学分析。结果 中国gay的性活跃程度不亚于工业化国家情况,但普遍存在易感染HIV的高危行为。儿童早期认为当女孩更好和不喜欢刀枪类玩具是成年后被动肛交的预示因子。首次性交年龄<16岁者性伴更多,区易遭受伤害。成年后不喜欢自身性别和同性性关系中自认为女性角色者,较多被动肛交,其心理与儿童早期跨性心理-行为有明确的关系,曾被当做女孩抚养者却无此特点。有被迫性交经历和有药物滥用者是高危行为最多的两个gay亚群。曾与女性性交者累计性伴数更多且较多参与群交。恋童、恋老者更多地有偶遇性伴。对gay的伤害与其自杀念头/行为相关。结论 中国gay中存在HIV高水平流行的前景。Gay中的若干小亚群在HIV传播中起到不同的特殊作用。部分gay的高危行为在童年期就有明确的预示因子存在,或者与其对自身的认识、特殊的经历和心理密切相关。     

脑卒中患者疾病体验及其复发风险感知的质性研究

目的 了解首发与复发脑卒中患者的疾病体验,探讨脑卒中患者复发风险感知的特征及变化.方法 采用现象学研究方法,对19例脑卒中患者进行半结构式深入访谈,运用Colaizzi 7步分析法对访谈资料进行分析.结果 首发、首次复发和多次复发脑卒中患者的疾病体验和复发风险感知各有特征.首发脑卒中患者:可识别异常但缺乏专业信息渠道,...     

朱翠玲治疗冠心病经验

介绍朱翠玲教授治疗冠心病的经验。朱师认为冠脉狭窄,与"积证"相似,乃积块形成于脉壁,不通而痛致胸痹心痛;冠脉痉挛,与"风"相关,风盛则冠脉拘急发为胸痹;冠脉闭塞,与"虚"、"积"相连,共同致病,发为冠心病重症及并发症。并予以相应的治则治法:活血化瘀,软坚散积;活血祛风,通络缓急;补气养血,化瘀散积,攻补兼施,辨证施治,临床多年均取得满意疗效。     

许润三教授妇科常见疑难疾病临证思辨特点

许润三教授从医62年,参合各家经验,精于脉理,详于辨证,以善用经方治疗疑难重证著称。临证主张西为中用,中主西随,衷中参西,尤其对妇科疑难疾病,如功能性子宫出血、盆腔炎性疾病、子宫内膜异位症等疾病的治疗有独到之处,充分体现了许老辨病与辨证相结合,方证相应的中医诊疗特色。     

名老中医传承研究模式与研究方法

名老中医是中医学术造诣最深、临床水平最高的群体,传承研究名老中医的临床经验和学术思想,对于推动中医学术发展、加快人才培养、提高临床服务能力都有十分重要的意义。本文提出传承研究的内容应从医术、医理、医道3个层面把握,并较为系统地梳理了师徒型传承、院校型传承、科研型传承等传承研究模式,以及整理研究、临床应用研究、理论创新研究等多种研究方法,以促进名老中医有效传承研究模式与方法的发展,推动中医药学术的传承和创新。     

Women’s experiences of abnormal Pap smear results – A qualitative study

ObjectivesTo describe women’s experiences of abnormal Pap smear result.MethodsTen women were recruited from a women’s health clinic. Qualitative interviews based on six open-ended questions were conducted, transcribed verbatim, and analyzed by content analysis.ResultsThe women believed that their abnormal Pap smear result was indicative of having cancer. This created anxiety in the women, which resulted in the need for emotional support and information. Testing positive with human papillomavirus (HPV) also meant consequences for the relatives as well as concerns about the sexually transmitted nature of the virus. Finally, the women had a need to be treated with respect by the healthcare professionals in order to reduce feelings of being abused.ConclusionsIn general, women have a low level of awareness of HPV and its relation to abnormal Pap smear results. Women who receive abnormal Pap smear results need oral information, based on the individual women’s situation, and delivered at the time the women receive the test result. It is also essential that a good emotional contact be established between the women and the healthcare professionals.     

脑卒中患者远程康复体验质性研究的Meta整合

目的 系统评价脑卒中患者远程康复体验的质性研究,为临床应用及改善远程康复技术提供参考依据。方法 计算机检索PubMed、Web of Science、PsycINFO、CINAHL、Cochrane Library、乔安娜布里格斯研究所（Joanna Briggs Institute,JBI）循证卫生保健中心数据库、Scopus、中国知网、中国生物医学文献数据库、万方等中英文数据库,搜索关于脑卒中患者远程康复的质性研究,检索时限从建库至2020年6月。根据澳大利亚JBI循证卫生保健中心质性研究质量评价标准对文献进行质量评价,运用Meta整合方法对研究结果进行整合。 结果 共纳入13篇研究,提炼出43个明确的研究结果,将相似的研究结果归纳形成13个新类别,综合出4个整合结果：脑卒中患者对信息与通讯技术设备的使用态度;脑卒中患者远程康复感知益处;脑卒中患者远程康复感知障碍;脑卒中患者长期远程康复需求。 结论 远程康复作为传统康复的可替代方式,其效果受到多数脑卒中患者的肯定,但未来研究应注意加强远程康复设备及技术支持工作,构建脑卒中患者远程康复全程同伴支持系统,并丰富脑卒中患者远程康复内容及形式,以进一步提高远程康复的接受度。     

Twin birth: The maternal experience

ObjectiveTwin birth is a special setting for women giving birth, and the experience of childbirth can be different from singleton birth. The objective of this study was to evaluate and compare the childbirth experiences of twin mothers and singleton mothers. We also aimed to identify the risk factors of a negative childbirth experience in the whole study population.MethodsAll live diamniotic twin deliveries in the study hospital of at least 35⁺⁰ weeks of gestation with a plan of vaginal birth were included in this matched groups study from August 2015 to August 2019. For every twin birth, two singleton birth controls were selected and matched with parity, the actual mode of birth, and gestational weeks at birth. Six weeks after birth, a Childbirth Experience Questionnaire (CEQ) was sent to mothers, and 72 twin mothers and 126 singleton mothers returned the questionnaire.ResultsThe twin mothers’ overall childbirth experience was positive. They reported a significantly lower opportunity to choose the birthing position (p < 0.001). Otherwise, there were no differences in the CEQ mean total scores between the study groups. Intrapartum cesarean section raised the risk of a negative childbirth experience and there was a high level of satisfaction with midwifery care among the whole study population.ConclusionThe overall maternal experience in planned vaginal twin birth was positive. Twin mothers felt less often able to choose their birthing position, otherwise the childbirth experience did not differ from that of singleton mothers.     

加强在院病人病历书写质量监控

提高病历的书写质量,必然要加强对病人住院期间病历书写的环节质量进行实时监控,把缺陷消灭在病历形成过程中,保证病历书写及时、客观、真实、全面,进而保障医院安全,防范医疗纠纷。