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 探究不同类型职业病危害因素对暴露工人生命质量的影响。方法 在某市电子制造业、灯饰制造业、金属冶炼业等能够接触到粉尘、铅、苯以及噪声的6家企业中,采用整群随机抽样法,共计抽取742人为研究对象,对上述企业2015—2017年的职业病危害因素检测报告进行回顾性分析,主要对各企业的职业病危害因素以及暴露水平实施分析,并对企业员工的生命质量情况实施调查。结果 三种不同行业之间的有机溶剂检测合格率比较差异均有统计学意义(P＜0.05),其中有机溶剂检测合格率最低的是金属冶炼业;三种不同行业的粉尘检测合格率差异以及噪声检测合格率比较差异无统计学意义(P＞0.05),其中灯饰制造业的噪声及粉尘检测合格率最低;各行业工作人员的生理、社会功能,心理、情感职能,精神健康,身体疼痛、活力以及总计健康评分差异有统计学意义(P＜0.05),电子制造企业的各项评分均高于金属冶炼业以及灯饰制造业。多重线性回归分析结果发现,电子制造企业的生理与心理健康维度得分均高于灯饰制造业、金属冶炼业,差异有统计学意义(P＜0.05),且主要与运动锻炼以及所从事的行业有较大关联。结论 不同类型的职业病危害因素暴露水平存在一定差异,企业职工的生命质量也会因此受到不同程度的影响,应对存在噪声、粉尘以及大量使用有机溶剂等职业病危害因素企业作为健康监护的重点。

目的 通过评估非直属附属医院临床教学质量的影响因素,探讨保障非直属附属医院同质化教学的方法。方法 将实习同学分为院校组和混合组两组,运用德尔菲法调查法对非直属附属医院临床教学过程中所遇到的困难进行分析,并提出教学改革的意见和评价。结果 得出的调查结论对教师、学生、医院教学管理人员和学校教学管理人员都提出了更高的要求,可以为达到同质化教学提供参考。结论 有针对性的开展临床教学工作,变被动教学为主动的教与学,使临床教学达到同质化,从而达到更佳的教学效果。

Objective To explore the methods of guaranteeing homogeneity teaching in Non-affiliated hospitals by assessing the factors affecting the quality of clinical teaching in Non-affiliated hospitals. Methods Divide the students into two groups:college group and mixed group,to meet the process of clinical teaching in Non-affiliated hospitals in difficulty were analyzed by using the Delphi survey method, and put forward opinions and evaluation. Results the survey findings put forward higher requirements for teachers, students, hospital teaching administrators and school teaching administrators, which can provide references for achieving homogeneity teaching. Conclusion targeted clinical teaching should be carried out to change passive teaching into active teaching and learning, so that clinical teaching can be homogenized, so as to achieve better teaching effect.

目的 应用中国膳食平衡指数(DBI-07)对活动期溃疡性结肠炎(Ulcerative Colitis,UC)患者进行膳食质量评价,并分析其与营养指标、活动度等的关系,为UC患者制订科学的营养干预措施提供依据。方法 选取我院符合纳入标准的82例UC患者进行研究,用食物频率法对患者进行膳食调查,应用膳食平衡指数DBI-07评分系统进行评价,同时进行人体测量及营养指标测定。数据用SPSS 17.0软件进行处理分析。结果 本研究中68.3%的UC患者体质量近半年有不同程度降低,40.2%的患者存低白蛋白血症,34.1%的合并贫血。UC患者TS平均值-20.02±7.97; LBS平均值-22.15±6.78, 其中54.9%存在轻度膳食摄入不足、37.8%存在中度摄入不足;DQD平均值24.27±6.21,其中轻、中度失衡分别占80.5%、17.1%。LBS绝对值与体质量减轻程度呈正相关,P<0.05,与血清白蛋白负相关,P<0.01;DQD与白蛋白呈负相关,P<0.01;4 UC患者LBS绝对值与UC活动度呈正相关,P<0.01;DQD值与UC活动度负相关,P<0.01。结论 以中国膳食平衡指数DBI-07评价UC患者膳食质量,92.7%的患者存在低、中度摄入不足,97.6%的UC患者存在膳食失衡,均明显高于健康人群。摄入不足是UC患者营养不良的重要原因,应对UC患者进行营养补充或营养支持。

Objective To survey the diet quality of UC patients using Chinese diet balance index(DBI-07) and explore their relationship with nutritional index and activity of disease, thereby to provide evidences of nutritional therapy for UC patients. Methods 82 adult UC patients who met the inclusion criteria were included in our study. They were investigated with food frequency questionnaires(FFQ) and diet quality was assessed with DBI-07. Anthropometric measurement and blood examinations were done. Data were analyzed with SPSS 17 software. Results 68.3% of the UC patients loss their weight during the recent 6 months. 40.2% of the patients were found hypoalbuminemia and 34.1% were complicated with anemia. The mean TS,LBS and DQD were -20.02±7.97, -22.15±6.78 and 24.27±6.21 respectively. Percentage of patients in slightly or moderately deficit of food intake were 54.9% and 37.8%. Percentage of the UC patients in slightly or moderately dietary imbalance were 80.5% and 17.1%.The absolute value of LBS and DQD were negatively correlated with serum albumin respectively, and both of them were positively correlated with activity of UC. Conclusion Evaluating the quality of UC with DBI-07,92.7% of UC patients were in slightly or moderately deficit of food intake,97.6% were in slightly or moderately dietary imbalance. These percentages were higher than that of healthy people. It indicated that deficit of food intake is an important reason resulting in malnutrition. Nutrition therapy is essential for UC patients.

目的 分析超声检查前准备质量评价对超声检查效果的影响。方法 对进行泌尿科B超检查150例患者按数字表法随机分为对照组和实验组各75例,两组患者发放超声检查须知,按检查准备要求按预约时间前来完成超声检查;实验组在检查前对患者准备效果进行评价,及时落实检查须知事项。结果 检查前准备知识知晓、检查前准备质量、按时检查率对照组低于实验组(P＜0.05);检查前准备依从性、服务满意度对照组低于实验组(P＜0.05)。结论 开展检查前准备质量评价能促进患者落实超声检查前准备,提高准备依从性和准备知识知晓率,缩短检查等候时间,提高检查前准备质量和患者服务满意度。

Objective To analyze the influence of pre-preparation quality evaluation on the effect of ultrasound examination. Methods According to the digital table method, 150 patients were randomly divided into the control group and the experimental group, 75 cases in the control group and the experimental group each. The two groups were taken the ultrasound examination, and the ultrasound examination was completed according to the preparation requirements. The patients in the experimental group were evaluated before the examination, and the inspection notes were timely implemented. Results Knowledge of pre preparation, preparation quality before examination, and rate of check on time were lower in the control group than that in the experimental group(P<0.05). The control group was lower than the experimental group(P<0.05). Conclusion The preparation quality evaluation before examination may promote the patient's preparation before the ultrasonic examination, improve the preparation compliance and knowledge awareness, shorten the waiting time, and improve the quality of preparation and the satisfaction of patient service.

目的 研究米氮平和文拉法辛二药连用治疗抑郁症的临床疗效和安全性,以及对患者认知功能及生活质量的影响。方法 选取125例抑郁症患者随机分为三组,A组42例给予文拉法辛,B组41例给予米氮平,C组42例给予米氮平及文拉法辛,疗程均为8周。采用HAMD-17、GQOLI-74集WMS-RC量表作为评价指标。结果 用药8周后总有效率比较,C组>B组>A组,同时,C组与其他两组比较有差异(P<0.05)。治疗前,三组患者WMS-RC各项评分比较无差异(P>0.05),治疗8周后,三组患者各项认知功能均有改善;其中,联合用药的改善效果最为显著。相较于治疗前,三组患者GQOLI-74评分均有不同程度上升,但C组患者上升幅度更大(P<0.05)。结论 联合应用来治疗难治性抑郁症疗效显著,且能帮助恢复患者的认知能力,研究过程中未发现较明显不良反应,故提倡临床推广。

Objective To study on the clinical efficacy and safety of mirtazapine and venlafaxine in the treatment of refractory depression, as well as to improve cognitive function and quality of life in patients. Methods 125 patients were randomly assigned to three groups, including group A: 42 cases with venlafaxine, group B: 41 cases with mirtazapine, group C 42 cases with mirtazapine and venlafaxine, 8 weeks for a course. Results After the treatment, total effective rate: group C>group B>group A. There's no difference between WMS-RC among three groups. After treatment for 8 weeks, cognitive function of three groups was enhanced, and group C was the most significant. GQOLI-74 scores of the three groups were increased, but group C of patients increased even more sharply (P<0.05). Conclusion Mirtazapine and venlafaxine may effectively improve the quality of life and cognitive function of patients with depression. It's high safety and worthy of clinical promotion and application.

目的 探讨手动杠杆式胸外按压心肺复苏(CPR)装置对院内心肺复苏按压质量和复苏疲劳的影响。方法 将12名医学生志愿者分为手动杠杆式胸外按压CPR装置组(LDCPR)(n=6)和徒手标准CPR组(STCPR)(n=6)模拟院内心肺复苏场景进行CPR试验。LDCPR组采用手动杠杆式胸外按压CPR装置对模拟人进行连续6min连续胸外按压,STCPR组徒手对模拟人进行6min连续胸外按压。监测复苏期间按压的深度、频率以及按压者的心率和疲劳程度等变化。结果 随着连续胸外按压的进行,按压者的心率和疲劳程度都在不断增加,有效按压深度超过5 cm次数逐渐减少,但是在连续胸外按压的第4～6min,LDCPR组按压者的心率较STCPR组慢(P<0.05),疲劳程度较轻(P<0.05),有效按压的比例更高(P<0.05)。按压频率两组比较无明显差异。结论 在本模拟人试验中,手动杠杆式胸外按压CPR装置可减轻按压者疲劳,有助于提高院内CPR时长时间胸外按压的质量。

Objective We aimed to investigate simulated in-hospital cardiopulmonary resuscitation (CPR) quality and rescuer fatigue of external chest compression-only CPR by a manual leverage device(LDCPR). Methods All 12 volunteers (medical staffs: male 6 and female 6) were randomized to standard CPR by hand(STCPR)group (n=6)or LDCPR group(n=6). At STCPR group, continuous external chest compression-only was performed for 6 minutes to simulate in hospital cardiopulmonary resuscitation on a manikin; at LDCPR group, compression-only was performed for 6 minutes by a leverage device on a manikin. We measured blood pressure of the volunteers before and after performing each CPR technique, volunteers self-report fatigue scale and continuously monitored heart rate (HR) of the volunteers during each CPR technique by smart ring. CPR quality measures included chest compression rate and depth. Results During continuous external chest compression-only CPR, compressor's heart rate and fatigue scale were rising continuously, and percent of compress depth >5 cm were declining, too.Compressor's heart rate and fatigue scale were higher in the STCPR group than in the LDCPR group (P<0.05) during the fourth to sixth minutes CPR (P<0.05). Percent of compress depth > 5 cm was higher in the LDCPR group than in the STCPR group (P<0.05) during the fourth to sixth minutes of CPR (P<0.05).Compress rate had not differed between the 2 groups during CPR. Conclusion In the manikin study, manual leverage external chest compress device may reduce fatigue scale and improve long term compression quality during in-hospital cardiopulmonary resuscitation.

目的 研究益精汤对改善男性不育症患者精子质量和提高生育率的临床疗效。方法 将符合纳入标准的100例男性不育症患者随机分为益精汤组和五子衍宗片组进行治疗,治疗后采用ZKPACS-E彩色精子质量分析系统检测精子各项参数标指和调查孕育人数,进行分析对比。结果 通过治疗前后对比,益精汤组的治愈率及临床治愈率较五子衍宗片组高,益精汤组、五子衍宗片组总有效率依次是82%、64%,差异有统计学意义(P<0.05)。益精汤组对患者的精液液化时间、精子活力等指标方面的恢复和改善优于对照组。结论 益精汤能显著提高精子的质量,在治疗男性不育症方面效果显著,值得进一步临床研究和推广。

目的 评价综合营养干预措施与传统的单纯药物治疗对花都区老年原发性骨质疏松 (OP)患者生命质量的影响。方法 采用随机法将符合标准的OP患者随机分配到干预组(A组)和对照组(B组)接受相应的干预处理。干预组给予综合营养干预措施,而对照组只给予单纯的抗骨质疏松药物。结果 干预组人群干预前后生命质量的8个维度中的6个维度得分与干预前比较,差别有统计学意义(P<0.05)。 对照组人群生命质量的8个维度中只有2个维度与干预前比较,得分间差别有统计学意义(P<0.05)。结论 综合营养干预措施可以提高老年OP患者的生命质量。

目的 探讨难治性肠易激综合征(RIBS)患者的生活质量及影响因素。方法 采用症状严重程度量表(IBS-SSS)、汉密尔顿焦虑/抑郁量表(HAMA/HAMD)和生活质量量表(IBS-QOL)对601例消化专科门诊连续IBS患者和同期匹配的100例健康体检者进行测评,并通过多重线性回归分析探讨RIBS患者生活质量的影响因素。结果 RIBS组IBS-QOL总评分及IBS-QOL8个维度评分低于非RIBS组和健康对照组(P<0.05)。RIBS不同亚型间的IBS-QOL总评分无统计学意义(P>0.05),但在冲突行为、健康忧虑、社会反映3个维度方面有统计学意义(P<0.05)。IBS-SSS症状评分和焦虑症状评分为RIBS患者生活质量的影响因素。结论 难治性IBS患者的生活质量差,临床症状和焦虑情绪为其重要影响因素。

Objective To explore quality of life and its risk factors in patients with refractory irritable bowel syndrome(RIBS). Methods 601 IBS patients in gastroenterology clinic and 100 healthy volunteers were invited to complete irritable bowel syndrome- symptom severity scale (IBS-SSS), the Hamilton Rating Scale of Anxiety/ Depression (HAMA/HAMD), Irritable bowel syndrome-quality of life(IBS-QOL). And multiple linear regression analysis was used to explore the determinants of quality of life in patients with RIBS. Results The overall score and subscale scores of IBS-QOL in RIBS group were lower than those in the non-RIBS and healthy group (P<0.05). There were no significant differences in the overall scores of IBS-QOL among different subtypes of RIBS. However, the interference with activities, health anxious, social reaction scores were different among the subtypes (P<0.05). Multiple linear regression analysis demonstrated that quality of life in RIBS was independently associated with the scores in IBS-SSS and HAMA. Conclusion Quality of life in RIBS is obviously decreased. Quality of life in RIBS is closely related to clinical symptoms and anxiety condition.