目的 研究疫情下护理人员的情绪障碍和睡眠障碍情况。方法 应用广泛性焦虑障碍量表(GAD-7),病人健康问卷(抑郁)(PHQ-9),病人健康问卷(躯体症状)(PHQ-15)和匹兹堡睡眠质量指数(PSQI)量表对临床一线护理人员进行心理和睡眠问卷调查,统计情绪和睡眠障碍的发病率,以及其相关性。结果 126名完成量表的临床一线护理人员,焦虑,抑郁,躯体症状,睡眠障碍的发病率分别为:41.9%、31.5%、9.5%和30.8%。相关性分析显示学历,年龄,婚育情况及是否为独生子女与上述情绪、睡眠障碍有相关,差异有统计学意义(P <0.05)。结论 临床一线护理人员焦虑和睡眠障碍发病率高,且二者明显相关,存在相互影响。建议医院随时更新知识指南,加强对护理人员的心理疏导和人文关怀,以减轻护理人员的心理压力。

Objective To study the emotional and sleep disorders of nursing staff under the emerging infections diseases. Methods The generalized anxiety disorder scale anxiety (GAD-7), patient health questionnaire 9(depression)(PHQ-9), patient health questionnaire 15 (somatic symptoms)(PHQ-15), and Pittsburgh sleep quality index (PSQI)were used in our investment. Statistics on the incidence of emotional and sleep disorders, and their correlation were done in our study. Results The incidence of anxiety, depression, physical symptoms, and sleep disorders in 126 nurses were 41.9%, 31.5%, 9.5%, and 30.8%, respectively. Correlation analysis showed that education, age, marital status, and whether or not they were the only children in the family were related to the above-mentioned emotions and sleep disorders (P<0.05). Conclusion The incidence of anxiety and sleep disorders in clinical front-line nurses is high. There are high and significant correlation and interaction between mood and sleep disorders. It is recommended that hospital need to update the knowledge and strengthen the psychological counseling and humanistic care of the nursing staff to reduce the psychological pressure of the nursing staff.

目的 通过波幅整合脑电图(aEEG)长程监测评估胆红素水平(TSB)、脑干听觉诱发电位(BAEP)及脑电图(EEG)异常程度对足月新生儿睡眠结构的影响。方法 对159例高胆红素血症足月新生儿行12小时床边监测长程脑电图,计算aEEG上睡眠-觉醒周期(SWC)安静睡眠(QS)时间长度比例、收集当日的TSB、BAEP及EEG结果。结果 在159例病人中,数据可视化结果显示随着胆红素水平的升高、EEG及BAEP异常程度的增加,QS期的比例逐渐减少。逐步广义线性模型结果证实胆红素水平及EEG异常是导致安静睡眠比例减少的主要因素,而BAEP异常程度则不显著。结论 随着胆红素水平的增高及脑电图异常率的增加,足月新生儿睡眠-觉醒周期安静睡眠比例逐渐减少,SWC结构发生改变。

Objective To investigate the impacts of total serum bilirubin level (TSB), EEG and BAEP abnormalities to full term neonates' sleep-wake cycles' (SWC) structure through the amplitude-integrated electroencephalography (aEEG). Methods Quiet sleep (QS) ratio of SWC within 12 hours of 159 neonates with hyperbilirubinermia were obtained from the aEEG traces, total serum bilirubin (TSB) level, EEG and BAEP results of the recording day were also recorded. Results QS ratio of SWC decreased along with the elevated TSB level, EEG and BAEP abnormality in 159 cases. Furthermore stepwise generalized linear regression model comfirmed the TSB level, EEG abnormalities were the key factors for the reduced QS ratio while the BAEP was no statistically significant. Conclusion Full term neonates' SWC showed a constructive change by means of QS ratio reduction according to the elevating TSB level and EEG abnormality.

目的 探讨妊娠期高血糖患者母体胰岛β细胞自身抗体对新生儿的影响。方法 选取2014年3月—2016年3月于我院就诊的口服75 g葡萄糖耐量试验(OGTT)异常的孕妇共276例,以60例健康孕妇作为对照组,分别在产前和OGTT试验后空腹抽取静脉血进行检测,检测指标包括谷氨酸脱羧酶抗体(GADA)、胰岛细胞抗体(ICA) )和胰岛素自身抗体(IAA),记录每个出生患儿的体重、Apgar评分、血糖指标进行分析。结果 276例GDM患者中34.41%至少存在一种相关抗体阳性,GDM组GADA阳性、IAA阳性和阴性的搏动指数异常比例均高于健康组(P<0.05),IAA阳性的胎儿生长受限比例比例较GDM组抗体阴性的比例高(P<0.05),妊娠晚期胰岛细胞抗体阳性(OR:6.41,95%CI:1.41~34.13)均为新生儿产后进入ICU进行监护的风险因素,妊娠中、晚期GADA阳性(OR:10.26,95%CI:1.42~75.14) 和妊娠晚期GADA阳性(OR:8.15,95%CI:1.43~46.83)均为新生儿窒息的风险因素 。结论 妊娠晚期胰岛细胞抗体阳性为新生儿产后进入ICU进行监护的风险因素,妊娠中、晚期GADA阳性是新生儿窒息的风险因素。

目的 分析研究不同类型脑梗死患者睡眠结构及其与抑郁的相关性,为脑梗死患者睡眠障碍及抑郁的治疗提供新的思路及理论支持。方法 抽取我院2012年4月—2015年5月接收的124例脑梗死患者进行分组研究,根据脑梗死不同发生部位将患者分为四组,分别为小脑梗死组30例、皮层梗死组33例、脑干梗死组29例及皮层下梗死组32例,对比观察四组患者睡眠结构及睡眠参数和睡眠障碍、HAMD评分的相关性。结果 四组患者睡眠结构相比存在明显差异,脑干梗死组和皮层下梗死组觉醒时间远多于小脑梗死组和皮层梗死组,小脑梗死组NREM 1+2期、NREM期明显短于皮层梗死组、脑干梗死组及皮层下梗死组,小脑梗死组REM期、NREM 3+4期明显大于皮层梗死组、脑干梗死组及皮层下梗死组,各项数据对比差异均有统计学意义(P＜0.05);HAMD评分、PSQI评分和NREM1+2期、觉醒指数呈正相关关系(P＜0.05,r＞0);与REM期和NREM 3+4期呈负相关关系(P＜0.05,r＜0)。结论 皮层下梗死睡眠结构紊乱发生率更高,并且睡眠结构的变化和脑梗死后抑郁评分、睡眠障碍评分具有一定关系。

Objective To study the correlation between sleep structure and depression in patients with different types of cerebral infarction,to provide new ideas and theoretical support for the treatment of sleep disorders and depression in patients with cerebral infarction. Methods 124 patients with cerebral infarction in our hospital from April 2012 to May 2015 were selected. They were divided into four groups according to the different parts of the cerebral infarction, respectively, 30 cases of cerebellar infarction group, 33 cases of cortical infarction group, 29 cases of brainstem infarction group and 32 cases of subcortical infarction group. The correlation of sleep structure and sleep parameters, sleep disorder and HAMD score of the four groups were observed and compared. Results There was a significant difference in sleep structure between the four groups. Brainstem infarction group and subcortical infarction group awakening time was far more than that of cerebellar infarction group and cortex infarction group.Cerebellar infarction group NREM 1+2, NREM period was significantly shorter in cortical infarction, brain stem infarction group and subcortical infarction group. Cerebellar infarction group of REM and NREM stage 3+4 were significantly greater than that of cortical infarction death group, brain stem infarction group and cerebral cortex infarction group. The differences were statistically significant(P<0.05);HAMD score, PSQI score and NREM1+2 period, arousal index was positively correlated (P<0.05, r> 0); And REM phase and 3+4 NREM phase was negatively correlated (P<0.05, r< 0). Conclusion Subcortical infarction sleep structure disorder incidence is higher, and the sleep structure changes and infarction depression score, sleep disorder score has a certain relationship.

目的 探讨婚恋家庭取向心理干预对系统性红斑狼疮患者家庭功能和幸福感指数的效果。方法 将2012年6月1日—2014年5月31日就诊于东莞康华医院内分泌及风湿免疫中心的62名15~58岁的系统性红斑狼疮患者作为研究对象,根据随机化原则将其分成两组,其中30名为干预组,参加本研究设计的婚恋家庭取向的心理干预,余32名为对照组,采用家庭功能评定量表、幸福指数量表及狼疮活动指数量表,对两组进行干预前、干预后、干预后3月和干预后6月作问卷调查。采用重复测量的方差分析进行评估。结果 家庭功能中的问题解决、情感反应、情感介入、总的功能分量表和总分两组干预后重复测量的方差分析两两比较均有统计学差异(P<0.05)。幸福感指数总分两组重复测量的方差分析无统计学意义,但如扩大置信空间至P<0.1,则两组重复测量的方差分析两两比较中干预后3月及6月有一定统计学意义(P=0.08<0.1)。结论 本研究中婚恋家庭取向的心理干预对SLE患者即家庭功能中问题解决、情感反应、情感介入、总的功能及家庭功能总分均有显著的改善作用,对幸福感指数总分则有一定的增进作用,而对已通过心身疾病方式表达了的SLEDAI没有干预作用。

Objective To explore the effect of marital family-based psychological intervention in SLE patients on family assessment device FAD and index of well-being. Methods A total of 62 SLE patients, aged between 15 and 58, who were treated in out-patient of endocrine immune rheumatism center of Dongguan Kanghua hospital from June 1,2012 to May 31,2014. The experimental group was made up of 30 patients who, at random, volunteered to participate in an added marital family-based psychological intervention and the control group was composed of rest 32 cases. At the time of pre-intervention,post-intervention,3 months and 6 months after intervention, both groups were investigated with questionnaires of family assessment device, index of well-being, index of general affect, and systemic lupus erythematosus disease activity index. The results were analyzed with repeated measure variance analysis to explore the effect. Results There were significant multiple-comparison differences by repeated measure variance analysis in the score of FAD's total and sub-scale problem solving, affective responsiveness, affective involvement, general functioning(P<0.05) between experimental and control group after intervention. There were no significant repeated measure variance analysis differences in the score of index of well-being' total, but if enlarging confidence space to P<0.1, there were partial multiple-comparison differences between experimental and control group at the time of 3 months and 6 months after intervention(P=0.08<0.1). Conclusion Marital family-based psychological intervention may significantly improve FAD's problem solving, affective responsiveness, affective involvement, general functioning, and sum of FAD, and partially improve index of well-being, but can not improve SLEDAI which had developed by psychosomatic disease.

       目的   探讨长病程2型糖尿病（T2DM）患者体质指数（BMI）与胰岛β细胞功能间的相关关系。方法    选取2023年12月—2024年3月于承德市中心医院内分泌风湿免疫科住院的260例长病程（病程≥10年）T2DM患者作为研究对象，依据BMI将其分成正常组、超重组和肥胖组，比较三组间一般资料、检验学指标及检查的差异，分析胰岛β细胞功能与各指标间的相关性。结果   三组研究对象在空腹静脉血糖（FPG）、空腹C肽（FCP）、胰岛素抵抗指数（HOMA-IR）、尿酸（UA）、甘油三酯（TG）等上差异有统计学意义（P＜0.05），在胰岛β细胞功能指数（HOMA-β）比较差异无统计学意义（P＞0.05）；肥胖组的FPG、FCP、HOMA-IR、UA、TG均高于正常组（P＜0.05），超重组的UA、TG均高于正常组（P＜0.05），肥胖组的FPG、HOMA-IR、UA高于超重组（P＜0.05），Spearman相关分析结果显示HOMA-β与体质量指数（BMI）无相关性（r=0.046，P=0.461），HOMA-β与UA（r=0.226，P＜0.001）、TG（r=0.148，P=0.017）呈正相关，HOMA-IR与BMI（r=0.279，P＜0.001）与、UA相关（r=0.284，P＜0.001）及TG（r=0.349，P＜0.001）呈正相关，多元线性回归分析显示UA是HOMA-β的影响因素（P＜0.05），BMI、UA、TG是HOMA-IR的影响因素（P＜0.05）。结论    长病程的T2DM患者，其胰岛素抵抗水平随着BMI的增加逐渐升高，而胰岛β细胞功能指数与BMI的相关性不显著。同时，UA和TG也是长病程T2DM患者胰岛β细胞功能的影响因素。

       Objective  To explore the correlation between body mass index（BMI）and islet β cell function in patients with long course type 2 diabetes mellitus（T2DM）．Methods  A total of 260 patients with T2DM with a long course of disease（course≥10 years）admitted to the Department of Endocrinology and Rheumatology of Chengde Central Hospital from December 2023 to March 2024 were selected as the study objects，and were divided into normal group，overweight group and obese group according to BMI．Comparison among the three groups in general data，inspection index and and the difference of the islet β cell function were performed，and the correlation among the indexes was analyzed．Results  There were statistically significant differences in fasting plasma glucose（FPG），fasting C peptide（FCP），homeostasis model assessment-insulin resistance（HOMA-IR），uric acid（UA）and triglycerides（TG）among the three groups（P＜0.05），but no statistically significant differences in homeostatic model assessment of β-cell function（HOMA-β）（P＞0.05）．The levels of FPG，FCP，HOMA-IR，UA and TG in the obese group were higher than those in the normal group（P＜0.05）；the levels of UA and TG in the overweight group were higher than those inthe normal group（P＜0.05）；the levels of FPG，HOMA-IR and UA in the obese group were higher than those in the overweight group（P＜0.05）．Spearman correlation analysis showed that HOMA-β was not correlated with BMI（r=0.046，P=0.461），but was positively correlated with UA and TG（r=0.226，P＜0.001；r=0.148，P=0.017），HOMA-IR was positively correlated with BMI，UA and TG（r=0.279，P＜0.001；r=0.284，P＜0.001；r=0.349，P＜0.001）．Multiple linear regression analysis showed that UA was the influencing factor of HOMA-β（P＜0.05），BMI，UA and TG were the influencing factors of HOMA-IR（P＜0.05）．Conclusions  In T2DM patients with long disease course，the level of insulin  resistance increased gradually with the increase of BMI，but the correlation between β-cell function index and BMI was not significant．At the same time，UA and TG are also factors affecting the function of islet β cells in patients with long-course T2DM．

      目的 探讨2型糖尿病（T2DM）睡眠障碍患者使用经颅微电流刺激（CES）联合自我穴位按摩干预的效果。方法 使用随机数表法将南昌大学第二附属医院2022年6月—2023年1月收治的T2DM合并睡眠障碍患者100例分为两组，每组各50例。对照组采用CES干预，基于此，观察组加用自我穴位按摩，比较两组临床疗效、睡眠质量及血糖水平。结果 与对照组干预总有效率80.00%（40/50）比较，观察组干预总有效率96.00%（48/50）更高（χ ² =6.061，P=0.014）；两组干预后匹兹堡睡眠质量指数（PSQI）中入睡时间、睡眠效率、催眠药物、睡眠障碍、睡眠时间、主观睡眠质量、日间功能障碍及总分均降低，且观察组［（0.95±0.28）分、（1.05±0.24）分、（0.55±0.14）分、（0.67±0.20）分、（0.92±0.21）分、（0.82±0.20）分、（0.65±0.18）分、（5.61±1.10）分］均低于对照组［（1.42±0.33）分、（1.30±0.33）分、（1.40±0.26）分、（1.14±0.27）分、（1.31±0.30）分、（1.32±0.37）分、（1.22±0.27）分、（9.11±1.26）分］（t=7.679、4.332、20.354、9.891、7.531、8.406、12.421、14.797，均P＜0.001）；两组干预后餐后2 h血糖（2 hPG）、糖化血红蛋白（HbA_1c）及空腹血糖（FBG）水平均降低，且观察组2 hPG［（6.14±0.68）mmol/L］、HbA_1c［（3.45±0.37）%］、FBG［（5.52±0.48）mmol/L］低于对照组［（7.12±1.25）mmol/L、（4.30±0.34）%、（6.58±0.67）mmol/L］（t=4.870、11.961、9.094，均P＜0.001）。结论 对T2DM合并睡眠障碍患者使用CES联合自我穴位按摩干预效果满意，可有效提高患者的睡眠质量，调节血糖水平。