目的 调查分析老年精神疾病住院患者潜在不适当用药(PIM)现状。方法 回顾分析2021年3月老年住院患者临床诊断、用药情况等资料,依据2017年版《中国老年人潜在不适当用药判断标准》分析处方PIM情况。结果 125例研究对象中,平均年龄(73.31±7.87)岁,平均用药(6.62±2.68)种。101例(80.80%)患者存在140项PIM,81例(64.80%)患者使用了A级警示药物共103项,33例(40.74%)患者使用了B级警示药物共37项;高风险药物39项(27.86%),低风险药物101项(72.14%);PIM发生率排名前3位的药物是奥氮平、利培酮、劳拉西泮;12例患者存在4项与疾病状态相关的PIM。结论 该院PIM发生率偏高,医生和药师应加大力度降低PIM比例,减少不良反应,提高用药安全,促进合理用药。

Objective To investigate the current status of potentially inappropriate medications (PIM) for elderly inpatients with mental illness in a psychiatric hospital. Methods Based on the 2017 edition of “Judgment Standards for Potentially Inappropriate Medications for the Elderly in China”, we retrospectively analyzed the PIM by investigating the clinical diagnosis and medication status of 125 elderly psychiatric inpatients in March 2021. Results Among 125 subjects, the average age was (73.31±7.87) years, and the average medication was (6.62±2.68). There were 101 patients (80.80%) had 140 items of PIM, 81 patients (64.80%) used a total of 103 items of A-level warning drugs, 33 patients (40.74%) used a total of 37 items of B-level warning drugs; there were 39 high-risk drugs(27.86%), 101 low-risk drugs (72.14%); the drugs with top three PIM incidence were olanzapine, risperidone and lorazepam; 12 patients had 4 PIMs related to the disease state. Conclusions The incidence of PIM in this hospital is relatively high. Doctors and pharmacists should be advised to increase their efforts to reduce the proportion of PIM, reduce the incidence of adverse reactions, improve medication safety, and promote rational drug usage.

目的 本项目主要探究关于妊娠期妇女肛肠疾病的患病现状和危险因素分析,为减少妇女在妊娠阶段肛肠疾病的发病几率,有效预防疾病发生提供参考建议。方法 本研究主要采用现况研究,以2020年5月1日—2021年5月在本院就诊的妊娠妇女患者633例作为研究对象。采用现况调查,对研究对象进行临床检查和问卷调查。临床检查为肛肠科检查,包括肛门视诊、肛门直肠指诊检查、肛门镜检查等。问卷调查主要包括五个部分,第一部分为基础资料,包括年龄,居住地(农村/城市),学历、怀孕次数,怀孕时间,流产次数;第二部分为饮食习惯;第三部分为生活习惯和方式;第四部分为肛肠疾病患病信息;第五部分为孕产妇心理焦虑调查量表。使用SPSS、SAS统计学软件对患者数据进行分析,使用t检验和单因素方差分析检测数据之间的差异性,使用多元Logistic回归对危险因素进行分析。结果 通过对妊娠妇女进行肛肠检查,根据临床肛肠疾病诊断标准得知,633名妊娠妇女中,共有437名,患病率为69.03%;根据疾病种类进行分类得知,单纯性疾病:便秘患者156例、痔疮患者105例、肛裂患者35例、肛周脓肿患者29例、直肠脱垂24例、直肠息肉15例、直肠阴道瘘10例;合并疾病:肛裂合并痔疮43例;肛肠类癌症疾病:无;根据数据分析结果得知:633名妊娠妇女中,共有437名,患病率为69.03%;根据差异性分析,肛肠疾病患病率在不同年龄、居住地、生产次数、流产次数、饮食习惯、运动量、饮酒史、焦虑状况等因素之间有统计学差异(P<0.05),在不同学历、吸烟史、睡眠时间之间无统计学差异(P>0.05);经过采用多元Logistic回归分析,结果显示,年龄、生产次数、流产次数、食物喜好、使用水果蔬菜的频率、每日运动量、饮酒史、焦虑状况等是造成妊娠期妇女肛肠疾病发病的独立危险因素。结论 造成妊娠期妇女肛肠疾病的发病的主要影响因素为年龄、居住地、怀孕次数、孕期、流产次数、饮食习惯、运动量、焦虑状况,应该针对以上因素进行防范,有效减少发病率。

目的 了解高职医学生职业决策困难现状及其主要影响因素,提出改善对策。方法 采用分层整群抽样方法,选取广州市某职业院校740名全日制医学生进行问卷调查。结果 被调查高职医学生职业决策困难总平均分值为(3.55±0.647),其中职业规划探索维度均分最低为(3.42±0.797),其它维度均分从低到高分别是职业目标探索(3.49±0.766)、职业信息探索(3.58±0.678)和职业自我探索(3.69±0.659);单因素方差分析结果显示,不同专业、所在专业是否为第一志愿、不同家庭所在地的高职医学生职业决策困难分值均存在差异(P<0.05);多元逐步回归分析结果显示,家庭所在地、学校职业规划指导课程、兼职或见习的经历、学校活动(就业指导讲座、职业规划大赛等)、对所学专业的就业前景很乐观、学校提供了充足的就业信息、曾参加过创新创业大赛,是医学生职业决策困难的预测因素(P<0.05)。结论 高职医学生职业决策困难程度处于中等水平,学校可通过开展有针对性的职业指导,建立系统的职业决策困难测评与干预体系,搭建实践、就业服务平台等方法改善高职医学生职业决策困难状况,为学生提供强有力的支持与保障;政府可加大政策导向,引导高职医学生面向基层就业。

Objective To understand the current situation and main influencing factors of career decision-making difficulties of higher vocational medical students, and put forward improvement countermeasures. Methods The method of stratified cluster sampling was adopted, with 740 full-time medical students from a vocational college in Guangzhou being investigated. Results The average score of career decision-making difficulty of medical students surveyed in higher vocational colleges was (3.55±0.647), in which the average score of the career planning exploration was the lowest (3.42±0.797), and the average scores of other dimensions from low to high were career goal exploration (3.49±0.766), career information exploration (3.58±0.678) and career self-exploration (3.69±0.659). The results of one-way analysis of variance (ANOVA) showed that there were significant differences in the scores of career decision-making difficulties of medical students in higher vocational colleges among different majors, the major being the first choice or not, and different living places (P<0.05). The results of multiple stepwise regression analysis showed that family location, school guidance courses for career planning, part-time or trainee experience, school activities (employment guidance lectures, career planning competitions, etc.), being optimistic about the employment prospects of their majors, schools providing sufficient employment information, and having participated in innovation and entrepreneurship competitions were predictors of difficulties in career decision-making for medical students (P<0.05). Conclusions The difficulty of career decision-making of medical students in higher vocational colleges was in the middle level. Schools can establish a systematic evaluation and intervention system aiming at career decision-making difficulties by carrying out targeted career guidance, and build practice and employment service platform to improve the career decision-making difficulties of medical students in higher vocational colleges, and to provide strong support and security for students. The government can enhance policy guidance for medical students in higher vocational colleges to apply for primary hospital.

大便失禁是肛肠外科常见疾病,可导致患者生活质量下降,并引起一系列社会心理问题,其发病率随着年龄增加明显上升。肛门括约肌复合体损伤是大便失禁的最常见原因。目前的治疗方式包括保守治疗和手术治疗,但治疗效果仍不理想,尤其是长期治疗效果较差。最近,许多临床前和临床研究对大便失禁的干细胞疗法进行了探索,作为一种新的治疗方式,干细胞疗法有望彻底治愈大便失禁。本文就干细胞疗法治疗大便失禁的动物模型、损伤和修复机制、疗效等方面进行综述。

Fecal incontinence is a common anorectal surgical condition that can lead to decreased quality of life and a range of psychosocial problems in patients, and its incidence increases significantly with age. Damage to the anal sphincter complex is the most common cause of fecal incontinence. Current treatment modalities include conservative and surgical treatment, but treatment outcomes remain suboptimal, especially in the long term. Recently, many preclinical and clinical studies have explored stem cell therapy for fecal incontinence as a new treatment modality that holds promise for a complete cure of fecal incontinence. This paper presents a review of animal models, mechanisms of injury and repair, and efficacy of stem cell therapy for fecal incontinence.

目的 调查临床护士对新型冠状病毒肺炎的知信行现状,为制定相关培训策略提供依据。方法 采用便利抽样法,2020年3月选取我院的1 007名临床护士作为研究对象,采用一般资料及临床护士对新型冠状病毒肺炎知信行问卷对其进行调查。结果 1 007名临床护士对新型冠状病毒肺炎的知识、态度、行为得分分别为(28.82±9.22)分、(52.04±5.52)分、(55.38±7.93)分,新型冠状病毒肺炎知信行总分为(136.24±14.52)分。不同年龄、职称、职务、工作年限、何时参加过穿脱防护服操作培训及考核新型冠状病毒肺炎知识得分比较,差异均有统计学意义(P<0.05);工作年限、何时参加过穿脱防护服操作培训及考核,其新型冠状病毒肺炎态度得分比较,差异均有统计学意义(P<0.05);是否参加过穿脱防护服操作的培训及考核、何时参加过穿脱防护服操作培训及考核、是否参加过咽拭子采集的培训及考核的新型冠状病毒肺炎行为得分比较,差异均有统计学意义(P<0.05)。结论 临床护士对新型冠状病毒肺炎的知识得分处于较低水平,态度和行为得分较好,建议护理管理者需加强临床护士对新型冠状病毒肺炎的知识学习及相关培训,以提高护士知识及技能水平。

Objective To investigate the current status of nurses' knowledge, attitude and behavior to new coronavirus pneumonia, to provide the basis for formulating relevant training strategies. Methods In March 2020, 1 007 clinical nurses in our hospital were selected as the research object. The general information and questionnaire about the new coronavirus pneumonia were investigated in these nurses. Results Scores of 1 007 nurses answered the knowledge, attitude and behavior to new coronavirus pneumonia were(28.82±9.22),(52.04±5.52), and(55.38±7.93), respectively. The total score of knowledge, attitude, and behavior to the new coronavirus pneumonia was(136.24±14.52). The differences of scores of knowledge about new coronavirus pneumonia between different ages, job titles, duties, working years, and when they participated in the training and evaluation of wearing and taking off protective clothing were statistically significant (P<0.05). There was a statistically significant difference in the attitude scores of the new coronavirus pneumonia between different working years and when they participated in training and evaluation of wearing protective clothing (P<0.05). There were statistically significant differences in the behavior scores to new coronavirus pneumonia between whether and when they have participated in the training and evaluation of wearing and taking off protective clothing, and whether they had participated in the training and evaluation of pharyngeal swab collection (P<0.05). Conclusion Nurses' knowledge scores for new coronavirus pneumonia are at a low level, but their attitude and behavior scores are higher. It is recommended that new coronavirus pneumonia knowledge and related training should be strengthened for nurses to improve nurses' knowledge and skills.

目的 结合临床现状分析影响护士护患沟通能力的相关因素,并根据影响因素制定相关应对方案。方法 采用《护士临床沟通能力量表》对广州市某三甲医院的941名护士进行调查。结果 护士沟通能力得分为(4.19±0.43)(评分范围为1～5分),其中情感支持能力维度得分最低(4.05±0.37),护士性别、婚姻状况、职称、职务和培训次数不同,其护患沟通能力得分有差异(P<0.05))。结论 护士的情感支持能力有待提高,性别、婚姻状况、职称、职务和接受培训的次数是护患沟通能力的影响因素,管理者应根据护士特征应加强对护士的培训,以提高其护患沟通能力。

Objective Combined with the clinical situation, this paper analyzes the relevant factors that affect the nurse-patient communication ability, and makes relevant countermeasures according to the influencing factors. Methods 941 nurses in a tertiary hospital in Guangzhou were surveyed using the Nurse Clinical Communication Competence Scale. Results The communication competence score of nurses in the hospital was (4.19±0.43) (the score was ranged from 1 to 5), among which nursing staffs' emotional support competence were scored in lowest (4.05±0.37). There was statistically significant in communication competence between nurses with different gender, marital status, job title, position and training times. (P<0.05). Conclusion The emotional support competence of nurses needs to be improved. The gender, marital status, professional title, position and number of trainings are the influencing factors of nurse-patient communication ability. Nursing managers could improve nurses' communication competence by increasing the training of nurses according to their charateristics.

目的 随着治疗水平和疗效的不断提高,急性白血病患者的生存质量越来越受到广泛的关注,本研究旨在探讨急性白血病(AML)患者化疗后生活质量及其相关因素。方法 采用癌症患者生存质量测定量表(European Organization for Research and Treatment of Cancer, EORTC-QLQ-C30)中文版、患者一般状况调查问卷,对268例按照AML患者治疗后1年生活质量进行调查,并将EORTC-QLQ-C30各领域评分与患者的特征进行相关性分析。结果 AML患者年龄、FAB分型、是否恢复工作、ECOG评分、婚姻状态、生存质量评分比较上,差异有统计学意义(P>0.05);不同年龄组AML患者PF、RF、EF、SF、QL、FI评分比较上,差异有统计学意义(P<0.05);不同分型AML患者患者RF、EF、SF、QL、DY、SL、FI评分比较上,差异有统计学意义(P<0.05),恢复工作的AML患者PF、RF、SF、QL评分高于未恢复工作的AML患者,恢复工作的AML患者FA、DY、FI评分则低于未恢复工作的AML患者(P<0.05),结婚AML患者PF、RF、SF、QL评分高于未结婚患者,结婚AML患者FA评分低于未结婚患者(P<0.05);逐步多元回归分析发现,年龄、分型、ECOG评分、婚姻状况与AML生存质量有关。结论 高龄、非M3型、ECOG评分高、未婚是AML生存质量差危险因素,可能作为改善AML患者生活质量预期指标。

Objective With the continuous improvement of treatment level and efficacy, the quality of life of patients with acute myeloid leukemia (AML) has attracted more and more extensive attention. This study aimed to explore the quality of life and related factors of patients with acute leukemia (AML) after chemotherapy. Methods The Chinese version of the quality of life scale for cancer patients(European Organization for Research and Treatment of Cancer, EORTC-QLQ-C30, and the general situation questionnaire were was used to investigate quality of life for 268 AML patients one year after treatment.And then the correlation between the EORTC-QLQ-C30 scores in various fields and the characteristics of patients were analyzed. Results There were statistical differences in the scores of age, AML types, work(yes or no),ECOG scores, and marital status in patients (P<0.05).The differences of PF, RF, EF, SF, QL, FI score of AL in different age groups were statistically significant (P<0.05), The PF, RF, EF, SF, QL and FI scores of AML patients in different age groups were statistical different (P<0.05).The scores of PF, RF, SF and QL in AML patients who returned to work were higher than those in AML patients who did not returned to work,while FA, DY and FI scores were the opposite(P<0.05).The PF, RF, SF and QL scores of married AML patients were higher than those of unmarried AML patients,while FA scores were the opposite(P<0.05).Age, classification, ECOG score, marital status were found to be associated with quality of life of AML patients by stepwise multiple regression analysis (P<0.05). Conclusion Old age, non-M3 type, high ECOG score, and unmarried are risk factors for poor quality of life for AML, which may serve as expected indicators for improving the quality of life of patients with acute leukemia.

目的 调查临床医学生医患沟通能力的现状,分析其影响因素。方法 采用《医患沟通技能评价表（SEGUE量表）》对广州市某三甲医院的155名临床医学生进行调查。结果 临床医学生沟通技能总成绩得分率只有58.9%,在5个维度中,沟通结束方面得分率最高,为82.9%,而理解病人方面得分率最低,只有45.5%。性别、接受医患沟通相关培训次数不同的临床医学生,其沟通能力差异有统计学意义（P﹤0.05）。结论 临床医学生的医患沟通能力总体水平有待提高,特别是在理解病人方面。性别和参加医患沟通培训次数是临床医学生沟通能力的影响因素,应加强对医学生在共情能力、情感支持、移情等方面能力的培训,以提高医患沟通能力。

Objective To investigate the status of medical students' doctor-patient communication skill and analyze the influencing factors. Methods An investigation on 155 clinical medical students in a level 3 hospital in Guangzhou was conducted using the Doctor-patient Communication Skills Evaluation Scale （also called SEGUE Scale）. Results The clinical medical students’ scoring rate of communication skill was only 58.9%. Among the five dimensions, the scoring rate of communication skill end was the highest, which was 82.9%, while the scoring rate of understanding patients was the lowest, which was only 45.5%. The difference in communication skill between clinical medical students with different gender and the training times related to doctor-patient communication was statistically significant （P<0.005）. Conclusion The overall level of doctor-patient communication skill among clinical medical students was needed to be improved, especially on understanding patients. Gender and training times on doctor-patient communication training were the influencing factors of communication skills of medical students. Medical students’skills include empathy and doctor-patient communication skills, etc.

代谢综合征(MS)是临床上多个症候群构成的代谢紊乱聚合体。近几十年来,MS的发病率和患病率一直呈上升趋势。笔者整理近5年关于老年代谢综合征研究的相关文献,分析老年人群代谢综合征患病情况、特点及影响因素等,并对老年代谢综合征的防治提出一些建议。

目的 探讨中医妇科门诊患者的焦虑及抑郁的发生情况,优化诊治工作,更好地服务患者。方法 采用焦虑自评量表(SAS)和 抑郁自评量表(SDS)评定190名中医妇科门诊患者的心理状态。结果 中医妇科患者焦虑均分高于正常常模组(P＜0.05),抑郁评分与全国常模相比则无统计学差异(P＞0.05),有焦虑及抑郁症状的患者分别为6.3%及10%。结论 中医妇科门诊患者的焦虑症状较正常人群高,医生在临床诊治过程应重视对患者心理状态的评价,并进行相应的心理干预及人文关怀, 以提高患者对治疗的依从性和满意度,为其身体及心理健康打下良好基础。

Objective To explore the occurrences of anxiety and depression in female TCM gynecology outpatients, and thus to make improvements in diagnosis, treatment, and service for the patients. Methods We adopted Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) to evaluate the mental status of 190 TCM gynecology outpatients. Results Anxiety scores in TCM gynecology group were higher than those in the normal group (P＜0.05), while there was no statistical difference in depression scores between these two groups (P＞0.05). Among the outpatients, 6.3% had symptoms of anxiety, and 10% had symptoms of depression. Conclusion TCM gynecology outpatients show more anxiety symptoms than normal people. We should pay attention to the assessment of those patients' mental status in the process of diagnosis and treatment, and offer psychological intervention and humane care to those patients accordingly. In this way, we could enhance patients' compliance and satisfaction, and help them build a solid foundation in physical health as well as in mental health.