抑郁症患者心理治疗的临床研究

目的 通过对照的方法,对抑郁症患者使用单纯抗抑郁药物治疗和药物合并心理治疗的疗效进行比较,探讨心理治疗在抑郁症患者治疗中的作用.方法 选取抑郁症患者120例,随机分成两组.对照组60例,男女各半,年龄18～65岁,平均(38.9±2.53)岁;心理治疗组60例,男女各半,年龄19～67岁,平均(39.7±3.12)岁.两组患者均给予帕罗西汀(商品名赛乐特)20mg/d,对照组单纯用药物治疗,心理治疗组药物加心理治疗,疗程8周.分别于第0周(基线)、干预后第2周、第4周、第8周使用汉密顿抑郁量表(HAMD)和抑郁自评量表(SDS)进行评分.结果 药物合并心理治疗组的治疗效果优于对照组(P＜0.05),且治疗时间越长,两组的疗效差异越明显.结论 心理治疗对抑郁症患者的康复有积极的作用,药物治疗合并心理治疗较单纯药物治疗更有利.     

山东省德州地区已婚育龄妇女弓形虫筛查状况分析

目的:了解已婚育龄妇女弓形虫感染情况以及探讨弓形虫的感染途径、感染与不良生育的关系。方法:于1998年12月～2000年12月采用ELISE方法对1042例育龄妇女进行了TOX-IgM的筛查及有关情况调查。结果:本市已婚育龄妇女TOX-IgM平均感染率为12.18％,正常妊娠组及不良生育组显著高于未孕组(P<0.05);郊区妇女高于市区妇女(P<0.05);有动物接触史及有生食习惯的妇女显著高于无接触史及生食习惯者(P<0.05)。结论:TOX感染是引起不良生育的重要原因之一。建议育龄妇女孕前孕期加强TOX筛查工作,以及早诊治;加强健康教育,改变不良生活习惯;加强水源、粪便等卫生管理。     

心理疏导对孕妇羊水穿刺预约率的影响

为提高出生人口素质,我院自2004年3月开始对孕妇开展产前筛查.通过对孕15周～19周孕妇的血清标志物检查,结合孕妇的年龄、体重和末次月经进行唐氏综合征(DS)、18-三体综合征(爱德华综合征)和神经管畸形(NTD)的风险率估计,筛选出来的DS和18-三体综合征高风险者再进行羊水染色体分析,NTD高风险者用B超进一步确诊,对这3种先天畸形进行产前诊断,以降低先天缺陷儿的出生率.但高风险孕妇普遍存在心理顾虑,在一定程度上影响了进一步产前诊断--羊水穿刺配合率,需要及时进行心理疏导.     

浅谈急性心肌梗死患者的护理和保健指导

急性心肌梗死属冠心病的严重类型，男性多于女性，多发生于40岁以后。该病起病急，病情重，并发症较多，死亡率高。因此，临床护理人员恰当地做好护理和保健指导，对急性心肌梗死患者的治疗康复起着十分重要的作用。     

Association of the Pro12Ala and C1431T polymorphism of the PPAR gamma2 gene and their haplotypes with obesity and type 2 diabetes

OBJECTIVE: To study the association of the Pro12Ala and C1431T polymorphism of the PPAR gamma2 gene and their haplotypes with obesity and type 2 diabetes in Chinese population. METHODS: PCR-restriction fragment length polymorphism was used to determine the Pro12Ala and C1431T polymorphisms in 207 patients with type 2 diabetes and 101 non-diabetic control subjects. RESULTS: (1) In non-diabetic control population, the Ala allele frequency was 0.064, the T1431 allele frequency was 0.252. Haplotype analysis showed that the Pro12Ala and C1431T polymorphisms were in linkage disequilibrium (Do=0.63, r(2)=0.074), which constituted three major haplotypes Pro-C, Pro-T and Ala-T. (2) There were no significant differences of the distribution frequencies of the Pro12Ala and C1431T polymorphism and their haplotypes between the type 2 diabetes mellitus group and non-diabetic control group (P > 0.05). (3) The Pro12Ala polymorphism was associated with blood pressure and lipidemia in diabetic patients. The Ala allele significantly decreased the diastolic blood pressure of non-obese diabetic patients (P < 0.05), but it did not benefit to the obese diabetic patients for the lipidemia (P < 0.05). The C1431T polymorphism was associated with overweight and obesity in diabetic patients. The T1431 allele frequency in the body mass index >/= 25 layer was significantly higher than that in the body mass index < 25 layer (P < 0.05). CONCLUSION: The Pro12Ala and C1431T polymorphisms of the PPAR gamma2 gene might not be a major etiological factor for type 2 diabetes; the C1431T polymorphism was associated with overweight or obesity in diabetic patients.     

以工时为核心的护士绩效考核实践

以护理工时为基础,建立以工时核算为核心的老年科护士绩效考核方案,并与医院信息系统相关联。改革后,护士工作效率提高,护理质量提升,护士满意度增加。认为工时绩效考核方案具有一定科学性和合理性,能够充分体现护理人员劳动价值,促进团队协作,提升护理质量。     

Neoadjuvant combination of pazopanib or axitinib and programmed cell death protein-1-activated dendritic cell-cytokine-induced killer cells immunotherapy may facilitate surgery in patients with renal cell carcinoma

BackgroundRadical/cytoreductive nephrectomy or nephron-sparing surgery may be thought to be not safe or unfeasible in some renal cell carcinoma (RCC) patients in which tumor is locally advanced or highly complicated. Neoadjuvant therapy may reduce the volume of the tumor, thus facilitates surgery. The aim the study is to evaluate the efficacy and safety of neoadjuvant combination of pazopanib or axitinib and PD-1-activated dendritic cell-cytokine-induced killer (PD-1/DC-CIK) cell immunotherapy in those patients.MethodsData from 16 RCC patients who received neoadjuvant pazopanib (Group P, n=9) or axitinib (Group A, n=7) plus PD-1/DC-CIK cells immunotherapy were reviewed retrospectively. A total of 9 participants that were potential candidates for radical/cytoreductive nephrectomy (RN/CN) had locally advanced tumor and 5 participants with partial nephrectomy (PN) absolute indications had highly complicated tumors. The efficacy outcomes were based on volume changes of the primary tumor, lymph nodes, and tumor thrombus in 13 participants with complete computed tomography (CT) imaging. The treatment-related toxicities and surgical complications were also reported.ResultsWith a median of 2.1 months treatment, the overall volume of the tumors decreased by a median of 42.30% [interquartile range (IQR): 19.37–66.78%]. Specifically, the median reduction of tumor volume was 88.77 and 15.50 cm³ in group P and group A, respectively (P=0.014). However, participants in Group P were more likely to experience grade 3 or 4 treatment-related adverse events (AEs) than those in Group A (44.4% vs. 0). Finally, all participants were candidates for appropriate surgery after neoadjuvant therapy (as assessed by the surgeon), and 10 participants accepted surgery, including 5 PN, 4 RN/CN, and 1 lymph node dissection. A solitary participant had Clavien grade IV acute renal failure required dialysis and another had grade II lymphatic leakage.ConclusionsNeoadjuvant combination of pazopanib or axitinib and PD-1/DC-CIK cells immunotherapy was well-tolerated and could effectively reduce the volume of tumors in locally advanced or highly complicated RCC patients.     

经皮射频毁损治疗原发性肝癌

目的 评价射频毁损（RFA）治疗原发性肝癌（HCC）的近期疗效、安全性及并发症。方法 采用RF－2000型射频治疗仪,在B超引导下经皮治疗78例HCC患者。结果 78例患者（肝功能Child分级：A级58例,B级14例,C级6例）的110个肿块（平均直经6.1cm,1.9-13.7cm）共进行了105次治疗,平均治疗1．3次和6．3个点,平均随访9．2个月（1－16个月）。患者术后肝功能轻度损害,2周左右恢复正常。最常见的不良反应为低热。6例（7．7％）出现并发症,未发生与RFA治疗直接相关的死亡。43例（55．1％）复发,平均发生在治疗后6．1个月。多因素相关分析显示,原位复发与肿块直径呈显著正相关（P＝0．0001）。无原位复发者其治疗点数与肿块直径存在线性关系（r=0.77216,P=0.0001),回归方程式为y=-1.794 1.733x。结论 RFA是一种治疗HCC安全有效的非手术方法。     

侧柏叶乙酸乙酯提取物对豚鼠离体气管平滑肌的作用

用离体豚鼠气管条,探讨侧柏叶乙酸乙酯提取物对气管平滑肌作用。结果表明,侧柏叶乙酸乙酯提取物能抑制乙酰胆碱,氯化钾所致气管平滑肌收缩,而且能使乙酰胆碱收缩气管平没肌的量效曲线右移,并抑制最大效应,其作用为剂量依赖性心肌肥厚提示侧柏叶乙酸乙酯提取物松驰气管平滑肌作用机制可能与影响Ｃａ＾２＋的跨膜转运有关。     

防滑钢针及Y形酒精滴管在下肢骨牵引病人中的应用

为探讨自制防滑钢针及Y形酒精滴管在下肢骨牵引病人中的应用效果.选择需行下肢骨牵引的病人100例,随机分成实验组和对照组各50例.实验组采用自制防滑钢针及Y形酒精滴管;对照组采用传统钢针及酒精点滴.观察2组病人钢针滑动、压疮、针道感染情况.结果实验组钢针牵引滑动率显著低于对照组(P＜0.01).针道感染率明显低于对照组(P＜0.01).表明应用自制防滑钢针及Y形酒精滴管效果确切,经济实用,使用方便,可有效避免并发症的发生.