68例慢性乙型肝炎患者对疾病认知及心理和行为问卷调查

目的 了解患者对慢乙肝疾病相关知识认知、对疾病的心理和行为应对情况,以更好评估慢乙肝患者对疾病的认知、防治需求,对待疾病的态度和行为,疾病带给慢乙肝患者的心理压力,为慢乙肝患者的健康管理、心理干预提供依据.方法 对在2011年1月至2013年6月到昆明医科大学第二附属医院肝胆胰内科门诊就诊和住院的68位慢乙肝患者在诊疗前后进行个人访谈和问卷调查,并由受过专业培训的医护人员对问卷调查中发现的问题进行一对一的指导.结果 大部分患者知道疾病的一般知识,对疾病缺乏较深层次的认识.宣教前与宣教后患者在乙肝传播途径、带来的后果认知、加重肝损伤因素的认知及保护家人不受感染的措施等方面问卷得分进行t检验,P＜0.05具有统计学意义.对自我护理和预防保健没有充分认识,患者对乙肝相关疾病知识的认识和了解与文化程度和病程长短有关,69.1％的患者存在一定的心理问题.结论 医护人员加强对慢乙肝相关疾病知识的深度和广度的宣传,针对患者的心理问题给予积极的心理疏导,争取社会支持系统对患者提供有针对性的帮助,提供准确的健康指导和连续的干预,促进患者主动采纳健康行为建议,对监测和防控患者的病情发展,对慢性乙肝患者的未来的健康管理有重要意义.     

Protocol driven palliative care consultation: Outcomes of the ENABLE CHF-PC pilot study

Background

Little has been reported about protocol-driven outpatient palliative care consultation (OPCC) for advanced heart failure (HF).

Evaluation of the anti-candidal activity of methanolic leaf extract of cleistopholis patens (fam. Annonaceae) on candida species isolated from stage II HIV patients

BackgroundCandida species (sp) is implicated in causing opportunistic disseminated mycotic complications in stage II HIV patients. Cleistopholis patens is a West African medicinal tree reported to have significant antifungal activity against C. albicans.ObjectivesThis study aimed to determine the anti-candidal activity of methanolic leaf extract of Cleistopholis patens against Candida species isolated from stage II HIV patients.MethodsThe minimum inhibitory concentration (MIC) of the extract and Nystatin®® was determined by agar dilution method. The killing rate studies of the plant extract and Nystatin® were also determined.ResultsThe extract had activity against all Candida isolates, with the MIC against the five isolates ranging from 6.0 – 9.8 mg/ml. Nystatin® also demonstrated plausible activity against the isolates with MICs ranging from 0.3125 — 25 mg/ml. Candida albicans strain 2 was the most sensitive to both extract and Nystatin® with MIC values of 6 and 0.3125 mg/ml respectively. Candida krusei was the least sensitive with MIC values of 9.8 and 25 mg/ml for the extract and Nystatin® respectively. The killing rate values for the extract ranged from −0.029 to −0.091 min⁻¹ and that of Nystatin® ranged from −0.076 to −0.112¹⁶ min⁻¹.ConclusionsThe results indicate that the methanolic extract of Cleistopholis patens is a promising clinical alternative besides Nystatin® in the treatment of infections caused by Candida species in stage II HIV patients.     

八周简易正念减压训练对老年功能性消化不良患者焦虑抑郁和睡眠质量的改善作用

背景功能性消化不良(functional dyspepsia,FD)容易使患者出现焦虑、抑郁负面心理,影响患者睡眠质量.精神、心理因素在FD疾病中占重要地位,加强了解FD患者的心理状况,以更好的实施针对性的干预措施,降低负面情绪和改善睡眠质量.目的观察八周简易正念减压训练对老年FD患者焦虑抑郁和睡眠质量的改善.方法选取2017-03/2019-06在浙江省金华市第二医院就诊的老年FD患者90例为研究对象,随机分为对照组和观察组各45例.对照组给予常规护理.观察组在对照组基础上给予八周简易正念减压训练干预.观察2组患者干预前后焦虑、抑郁评分变化,匹兹堡睡眠质量指数评分变化、入睡时间、睡眠时间变化情况.结果与干预前比较,2组焦虑自评量表和抑郁自评量表评分均降低(P<0.05),且观察组降低明显于对照组(P<0.05).与干预前比较,2组干预后睡眠质量明显改善(P<0.05),入睡时间明显缩短(P<0.05),睡眠时间明显延长(P<0.05),且观察组明显于对照组(P<0.05).结论八周简易正念减压训练能够有效减轻老年FD患者焦虑、抑郁等负性情绪,改善患者睡眠质量,值得临床推广.     

PE患者应用双源双能CT诊断的临床价值分析

目的研究双源双能CT在周围型肺阻塞(PE)中的诊断价值。方法将我院2015.01~2018.01间收治94的疑似PE患者纳为研究对象,其均行flash双源CT双能量肺动脉成像,扫描图像在后处理工作站中进行LungPBV及LungVessels处理,观察CTPA、CTPA+LungPBV、CTPA+LungVessels对全部栓子的检出效果,并计算LungPBV、LungVessels与CTPA在周围型PE诊断中的一致性。结果分析94例研究对象CTPA、LunPBV、LungVessels图像,并结合其临床症状共确诊32例患者为周围型PE,检出率为34.04%,分析32例周围型PE患者1920支血管,发现172支栓塞肺动脉,其中55支为段动脉、89支为亚段动脉,28支为亚段以下动脉;单纯CTPA共检出152支(88.37%)栓塞肺动脉,CTPA+LungPBV共检出162支(94.19%),CTPA+LungVessels共检出167支(97.09%);LungPBV检查与CTPA在诊断PE中的一致性为84.74%;LungVessels检查与CTPA在诊断PE中的一致性为80.23%。结论LungPBV能有效显示肺组织血流灌注情况,LungVessels可通过碘含量有效显示肺动脉栓子,LungPBV与Lung Vessels软件结合CTPA均能有效提高周围型肺栓塞检出率。