病友互助模式对宫颈癌根治术后患者希望水平、负性情绪及主观幸福感的影响

目的 探讨病友互助模式对宫颈癌根治术后患者希望水平、负性情绪及主观幸福感的影响.方法 采用随机数字表法将118例宫颈癌根治术患者分为对照组和观察组,每组59例.对照组患者采用术后常规干预,观察组患者在对照组的基础上采用病友互助模式干预.分别采用汉化版Herth希望指数量表(HHI)、焦虑自评量表(SAS)、抑郁自评量表(SDS)、纽芬兰纪念大学幸福度量表(MUNSH)评价干预前后两组患者的希望水平、焦虑及抑郁水平、主观幸福感,统计两组患者干预期间的不良反应总发生率.结果 干预前,两组患者HHI各维度评分及总分、SAS评分、SDS评分、MUNSH中正性和负性评分及总分比较,差异均无统计学意义(P﹥0.05).干预后,两组患者HHI各维度评分及总分、MUNSH中正性评分及总分均高于本组干预前,且观察组患者的上述评分均高于对照组,差异均有统计学意义(P﹤0.05).干预后,两组患者MUNSH中负性评分、SAS及SDS评分均低于本组干预前,且观察组患者的上述评分均低于对照组,差异均有统计学意义(P﹤0.05).干预期间,观察组患者的不良反应总发生率低于对照组,差异有统计学意义(P﹤0.05).结论 病友互助模式可以提高宫颈癌根治术后患者的希望水平和主观幸福感,改善患者的负性情绪,降低不良反应发生率.     

以Peplau人际关系理论为基础的干预模式对肺癌化疗患者心理状态、主观幸福感及生活质量的影响

目的 探讨以Peplau人际关系理论为基础的干预模式对肺癌化疗患者心理状态、主观幸福感及生活质量的影响.方法 将136例肺癌患者根据不同干预方案分为对照组(n=71)和观察组(n=65),对照组患者给予常规干预,观察组患者给予常规干预+以Peplau人际关系理论为基础的干预模式.比较两组患者干预前后的心理状态、主观幸福感及生活质量改善情况.结果 观察组患者下床活动时间、肛门排气时间、肠鸣音恢复时间、住院时间均明显短于对照组(P﹤0.01).干预后,两组患者焦虑自评量表(SAS)、抑郁自评量表(SDS)评分均明显低于本组干预前(P﹤0.01);且观察组患者SAS、SDS评分均明显低于对照组(P﹤0.01).干预后,两组患者主观幸福感各维度评分均明显高于本组干预前(P﹤0.01);且观察组患者主观幸福感各维度评分均明显高于对照组(P﹤0.01).干预后,两组患者生活质量(QOL)量表各维度评分均明显高于本组干预前(P﹤0.01);且观察组患者QOL量表各维度评分均明显高于对照组(P﹤0.01).对照组患者不良反应总发生率为63.38％(45/71),高于观察组的46.15％(30/65)(P﹤0.05).结论 对肺癌化疗患者实施以Peplau人际关系理论为基础的干预模式,可改善患者心理状态,提高主观幸福感及生活质量,临床应用前景广阔.     

陪护家属心理疏导对肝癌合并肾功能衰竭患者焦虑、抑郁情绪及自我管理效能的影响

目的 探讨陪护家属心理疏导对肝癌合并肾功能衰竭患者焦虑、抑郁情绪及自我管理效能的影响.方法 根据术后干预方式的不同将108例肝癌合并肾功能衰竭患者分为观察组(n=55,给予常规干预联合陪护家属心理疏导)和对照组(n=53,给予常规干预).干预前后,采用焦虑自评量表(SAS)和抑郁自评量表(SDS)评估两组患者的焦虑、抑郁状态;采用健康促进策略量表(SUPPH)评估两组患者的自我管理效能;采用中文版36条目简明健康状况调查问卷(SF-36)评估两组患者的生活质量.结果 干预后,观察组患者的SDS、SAS评分均低于对照组患者,差异均有统计学意义(P﹤0.05).干预后,观察组患者SUPPH量表中正性态度、自我减压、自我决策维度的评分及总分均高于对照组患者,差异均有统计学意义(P﹤0.05).干预后,观察组患者SF-36量表中生理功能、生理职能、社会功能、躯体疼痛、情感职能、活力、精神健康、总体健康维度的评分均高于对照组,差异均有统计学意义(P﹤0.05).结论 陪护家属心理疏导干预模式可缓解肝癌合并肾功能衰竭患者的不良情绪,改善患者的自我管理效能和生活质量.     

聚焦解决模式对肝癌经导管动脉栓塞化疗术患者负性情绪及生活质量的影响

目的 探讨聚焦解决模式对肝癌经导管动脉栓塞化疗术(TACE)患者负性情绪及生活质量的影响.方法 将100例行TACE术的肝癌患者按不同干预方式分为对照组和观察组,每组50例,对照组患者予以术后常规干预,观察组患者在对照组基础上施以聚焦解决模式.两组患者均干预2个月,比较两组患者焦虑自评量表(SAS)、抑郁自评量表(SDS)评分、并发症发生率、生活质量指数量表(QLI)评分、满意度、术后1及2年复发率、生存率.结果 干预后,观察组患者SAS、SDS评分均明显低于对照组(P﹤0.01).观察组患者术后并发症总发生率为12.00％,明显低于对照组的48.00％(P﹤0.01).干预后,观察组患者QLI量表各维度评分均明显高于对照组(P﹤0.01).观察组患者干预态度、干预水平、沟通能力及教育全面性满意度评分均明显高于对照组(P﹤0.01).两组患者术后1、2年复发率及生存率比较,差异均无统计学意义(P﹥0.05).结论 聚焦解决模式可显著改善肝癌患者TACE术后负性情绪,降低术后并发症发生率,提高患者生活质量和满意度.     

协同管理模式对白血病化疗患者营养状况、生活质量和不良反应的影响

目的 探讨协同管理模式对白血病化疗患者营养状况、生活质量和不良反应的影响.方法 根据干预方法将124例白血病化疗患者分为观察组和对照组,每组62例,对照组患者给予常规干预,观察组患者给予协同管理模式干预.比较两组患者的体重变化、营养指标[白蛋白(ALB)、前白蛋白(PA)、血红蛋白(Hb)]、生活质量[Spitzer生活质量指数(QLI)]和不良反应发生情况.结果 干预后,两组患者的体重均重于本组干预前(P﹤0.05),且观察组患者的体重重于对照组(P﹤0.05).干预后,两组患者ALB、PA、Hb水平均高于本组干预前(P﹤0.05),且观察组患者ALB、PA、Hb水平均高于对照组(P﹤0.05).干预后,两组患者QLI量表各维度评分及总分均高于本组干预前(P﹤0.05),且观察组患者QLI量表各维度评分及总分均高于对照组(P﹤0.05).观察组患者感染、脱发发生率均低于对照组(P﹤0.05).结论 协同管理模式可明显改善白血病化疗患者的营养状况,提高生活质量,减少不良反应.     

正向激励干预联合系统化健康教育在肺癌患者中的应用效果

目的 探讨正向激励干预联合系统化健康教育在肺癌患者中的应用效果.方法 采用随机数字表法将90例肺癌患者分为对照组和观察组,每组45例,对照组患者给予系统化健康教育,观察组患者在此基础上给予正向激励干预.比较两组患者的心理状态、呼吸情况、生活质量、护理满意度和不良反应发生情况.结果 干预后,两组患者焦虑自评量表(SAS)、抑郁自评量表(SDS)评分均明显低于本组干预前(P﹤0.01),且观察组患者SAS、SDS评分均明显低于对照组(P﹤0.01).干预后,两组患者呼吸频率均低于本组干预前(P﹤0.05),最大通气量(MVV)均高于本组干预前(P﹤0.05),观察组患者静脉血氧饱和度高于本组干预前(P﹤0.05);且观察组患者呼吸频率低于对照组,MVV水平高于对照组(P﹤0.05).干预后,两组患者世界卫生组织生存质量测定量表简表(WHOQOL-BREF)量表各维度评分和总分均高于本组干预前(P﹤0.05),且观察组患者WHOQOL-BREF量表各维度评分和总分均高于对照组(P﹤0.05).干预后,观察组患者护理满意度评分高于对照组患者(P﹤0.05).观察组患者的不良反应总发生率低于对照组(P﹤0.05).结论 正向激励干预联合系统化健康教育改善了肺癌患者心理状态和呼吸情况,提高了生活质量和护理满意度,降低了不良反应发生率.     

思维导图指导下无缝隙全程干预在肝癌手术患者中的效果评价

目的 分析思维导图指导下无缝隙全程干预在肝癌手术患者中的效果.方法 将2017年1月至2018年7月收治的61例肝癌患者作为对照组,将2018年8月至2020年5月收治的61例肝癌患者作为观察组,给予对照组常规干预,于此基础上给予观察组思维导图指导下无缝隙全程干预,比较两组患者术后康复情况、护理满意度,干预前后疾病认知、心理调适情况.结果 观察组患者术后首次下床时间、首次肛门排气时间及术后住院时间均明显短于对照组,首次下床活动持续时间明显长于对照组,差异均有统计学意义(P﹤0.01).干预后,观察组患者疾病认知情况明显优于对照组,心理痛苦各维度评分均明显低于对照组,心理幸福感各维度评分均明显高于对照组,差异均有统计学意义(P﹤0.01).观察组护理总满意度明显高于对照组,差异有统计学意义(P﹤0.01).结论 给予肝癌手术患者思维导图指导下无缝隙全程干预,有助于提高患者疾病认知,调控情绪,促进术后早期康复.     

医院-家庭延续性干预对原发性肝癌患者心理状态、自护能力及生活质量的影响

目的 分析医院-家庭延续性干预对原发性肝癌患者心理状态、自护能力及生活质量的影响.方法 将76例原发性肝癌患者按照随机数表法分为观察组和对照组,每组38例.对照组住院期间行常规护理,出院后不进行任何干预,观察组在对照组基础上于出院后给予1年的医院-家庭延续性干预.比较两组患者的心理状态[焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分]、自护理能力、生活质量、护理满意度及不良反应发生情况.结果 干预后,两组患者的SAS、SDS评分均明显低于本组干预前(P﹤0.01),且观察组患者SAS、SDS评分均明显低于对照组(P﹤0.01).干预后,两组患者自护能力量表各维度评分均明显高于本组干预前(P﹤0.01),且观察组患者自护能力量表各维度评分均明显高于对照组(P﹤0.01).干预后,两组患者健康情况调查简表(SF-36)各维度评分均明显高于本组干预前(P﹤0.01),且观察组患者各维度评分均明显高于对照组(P﹤0.01).观察组患者护理满意度为94.74％(36/38),高于对照组的71.05％(27/38),差异有统计学意义(χ2=7.516,P=0.006).结论 对原发性肝癌患者实施医院-家庭延续性干预可显著提高患者自护能力,改善其负性情绪及生活质量,患者的护理满意度较高.     

改良健康教育方法在肺癌介入手术术后康复、并发症预防中的应用效果分析

目的 研究改良健康教育方法在肺癌介入手术术后康复、并发症预防中的应用效果.方法 将110例接受肺癌介入手术治疗的患者按随机数字表法随机分为对照组和观察组,每组55例.对照组采用常规护理辅以传统健康教育干预,观察组在对照组基础上应用改良健康教育方法干预,两组均干预1个月.比较两组患者术后康复情况;干预前后采用抑郁自评量表(SDS)、焦虑自评量表(SAS)、自我管理效能量表(SUPPH)比较两组患者负性情绪和自我管理效能水平;干预前后比较两组患者肺功能变化;比较两组患者术后并发症发生情况.结果 观察组患者吸氧时间、首次下床时间、拔管时间和住院时间均明显短于对照组,差异均有统计学意义(P﹤0.01).干预后,两组患者SDS、SAS评分均降低(P﹤0.05),且观察组患者SDS、SAS评分均明显低于对照组(P﹤0.01).干预后,两组患者SUPPH各维度评分及总分均升高(P﹤0.05),且观察组患者SUPPH各维度评分及总分均明显高于对照组(P﹤0.01).干预后,两组患者第1秒用力呼气容积(FEV1)、用力肺活量(FVC)均升高(P﹤0.05),且观察组患者FEV1、FVC均明显高于对照组(P﹤0.01).干预后,观察组患者并发症总发生率低于对照组,差异有统计学意义(P﹤0.05).结论 采用改良健康教育方法对行肺癌介入手术患者预后康复效果较好,可调节患者负性情绪,提高自我管理效能,有效改善患者肺功能,减少术后并发症发生.     

品管圈管理对化疗期胃癌留置外周中心静脉导管患者并发症、生活质量的影响

目的 探讨品管圈管理对化疗期胃癌留置外周中心静脉导管(PICC)患者并发症、生活质量的影响.方法 将2018年6月至2019年4月收治的53例胃癌化疗患者设为对照组,2019年5月至2020年5月收治的53例胃癌化疗患者设为观察组,对照组予以常规干预,观察组在对照组的基础上予以品管圈管理干预,记录并比较两组患者干预前后生活质量、并发症发生情况,同时对干预前后护理人员各项能力评分及护理满意度进行比较.结果 干预后,两组患者生活质量调查问卷(GQOL-74)各维度评分均高于干预前(P﹤0.05),且观察组均明显高于对照组(P﹤0.01).干预后,观察组患者并发症总发生率为9.43％(5/53),低于对照组的28.30％(15/53),差异有统计学意义(P﹤0.05).干预后,护理人员沟通协调能力、品管圈手法、团队凝聚力、责任心、工作积极性、解决问题的能力、幸福感评分均明显高于干预前,差异均有统计学意义(P﹤0.01).观察组患者护理满意度为92.45％(49/53),明显高于对照组的54.72％(29/53),差异有统计学意义(P﹤0.01).结论 品管圈管理干预能提高干预人员各项能力,进而提高胃癌留置PICC化疗患者的生活质量和护理满意度,降低并发症发生率.     

Fat, fiber, fruits, vegetables, and risk of colorectal adenomas

A case-control study was conducted at the National Naval Medical Center (Maryland, USA) from 1994 to 1996 to investigate the possible association between dietary factors and colorectal adenomas. Cases (n = 239) were subjects diagnosed with adenomas (146 new and 93 recurrent) by sigmoidoscopy or colonoscopy. Those with no evidence of adenomas found by sigmoidoscopy were recruited as controls (n = 228). Dietary variables, assessed by a 100-item food frequency questionnaire, were analyzed by the logistic regression model, which was adjusted for age, gender and total energy intake. Variables of fat intake were further adjusted for red meat intake. An increased risk of 7% [odds ratio (OR): 1.07; 95% confidence interval (95% CI): 0.94-1.22] per 5% energy/day from total fat was observed. Every additional 5% unit of oleic acid intake/day significantly increased the adenoma risk by 115% (OR: 2.15; 95% CI: 1.05-4.39). Red meat fat increased the risk by 20% (OR: 1.20; 95% CI: 0.71-2.04), and white meat fat decreased the risk by 67% (OR: 0.33; 95% CI: 0.19-0.95) for every additional 5% unit of respective intake/day. Risk decreased by 41% (OR: 0.59; 95% CI: 0.41-0.86) for every additional 5% unit of fiber intake/day. Vegetable [OR per 100 g of vegetable intake/day: 0.83, 95% CI: 0.67-1.04] and fruit (OR per 100 g of fruit intake/day: 0.92, 95% CI: 0.82-1.03) intake showed an inverse association, and the results are suggestive of an association with the risk for adenomas. In conclusion, a strong positive association between oleic acid intake and colorectal adenoma risk was observed. This is likely to be an indicator of "unhealthy" food (meat, dairy, margarine, mayonnaise, sweet baked food) consumption in this population. Increased intake of dietary fiber was associated with a moderately decreased risk of adenomas.     

Age,Race, Sex,Stage, and Incidence of Cutaneous Lymphoma

BackgroundThe incidence of the T- and B-cell CLs has been well documented, but information pertaining to racial incidence by age, and by burden of disease (stage) have not been extensively documented.Materials and MethodsThe SEER 2004-2008 public use database was investigated. The relative incidence of CL in different races and age groups was examined. Univariate and multivariate stepwise logistic regression was performed for the likelihood of presenting at a higher stage.ResultsOf 4496 patients diagnosed with CL between 2004 and 2008; 1713 patients were diagnosed with MF, 1518 with non-MF cutaneous T-cell lymphoma, and 1265 patients with cutaneous B-cell lymphoma. For MF, there was a trend for females to be less likely to present with a higher T-stage (T3-T4) than males (odds ratio [OR], 0.73) on multivariate analysis (P = .06). For race, AA had a significantly increased risk of presenting with higher T-stage (T3-T4) MF (OR, 1.72) on multivariate analysis (P = .02), compared with white patients. For white, AA, Asian/Pacific Islander, and Native American/other/unknown, the mean age at diagnosis was 59.2, 51.5, 51.3, and 53.8. These groups presented at a significantly different age than white (P = .0001, 0.0001, and 0.0006).ConclusionNonwhite racial groups present with MF at an earlier age compared with white, and AA have increased risk of presenting with higher T-stage compared with white. These findings have significant implications regarding need for earlier diagnosis and understanding the reasons for racial disparity in age and stage of presentation.     

Tobacco, alcohol, diet, occupation, and carcinoma of the esophagus

Information on occupation, smoking, food and beverage consumption, and medical history were compared between 275 incident cases of carcinoma of the esophagus and 275 neighborhood controls who were matched to the cases on age (within 5 years), race, and sex. Tobacco use, mainly cigarette smoking, was a significant risk factor for carcinoma of the esophagus. Ex-smokers of cigarettes showed a reduced risk relative to those who continued to smoke, and current smokers of two or more packs per day displayed a higher risk than those who smoked less. Alcohol consumption was another significant risk factor for carcinoma of the esophagus; there was a highly significant trend with average daily dose of ethanol. Relative to controls, cases also consumed significantly more fried bacon or ham, less fresh fruits and raw vegetables, and were more likely to prefer white than whole grain bread. Finally, there was a significant association between carcinoma of the esophagus and long-term occupational exposure to metal dust; this association was largely confined to the lower one-third section of the esophagus.     

Susceptibility of Ureaplasma urealyticum to tetracycline, doxycycline, erythromycin, roxithromycin, clarithromycin, azithromycin, levofloxacin and moxifloxacin

The in vitro activity of tetracycline, doxycycline, erythromycin, roxithromycin, clarithromycin, azithromycin, levofloxacin and moxifloxacin was tested against 63 clinical isolates of Ureaplasma urealyticum. The minimal inhibitory concentrations (MICs) and the minimal bactericidal concentrations (MBCs) were determined by the broth microdilution method in A7 medium. The MIC(50) and MIC(90) of the tested agents after 24 h of incubation were as follows: tetracycline, 0.5 and 2.0 μg/ml; doxycycline, 0.125 and 0.25 μg/ml; erythromycin, 2.0 and 8.0 μg/ml; roxithromycin, 2.0 and 4.0 μg/ml; clarithromycin, 0.25 and 1.0 μg/ml; azithromycin, 2.0 and 4.0 μg/ml; levofloxacin, 1.0 and 2.0 μg/ml; and moxifloxacin, 0.5 and 0.5 μg/ml, respectively. The MIC values after 24 h and 48 h incubation differed by no more than one dilution for all the agents with the exception of doxycycline (two dilution difference for MIC(90)). Overall, moxifloxacin was the most active agent in vitro against U. urealyticum, with the narrowest difference between MIC and MBC values, followed closely by levofloxacin. Clarithromycin was the most active macrolide.     

Susceptibility of Ureaplasma urealyticum to Tetracycline,Doxycycline, Erythromycin,Roxithromycin, Clarithromycin,Azithromycin, Levofloxacin and Moxifloxacin

Abstract

The in vitro activity of tetracycline, doxycycline, erythromycin, roxithromycin, clarithromycin, azithromycin, levofloxacin and moxifloxacin was tested against 63 clinical isolates of Ureaplasma urealyticum. The minimal inhibitory concentrations (MICs) and the minimal bactericidal concentrations (MBCs) were determined by the broth microdilution method in A7 medium. The miC50 and miC90 of the tested agents after 24 h of incubation were as follows: Tetracycline, 0.5 and 2.0 μg/ml; doxycycline, 0.125 and 0.25 μg/ml; erythromycin, 2.0 and 8.0 μg/ml; roxithromycin, 2.0 and 4.0 μg/ml; clarithromycin, 0.25 and 1.0 μg/ml; azithromycin, 2.0 and 4.0 μg/ml; levofloxacin, 1.0 and 2.0 μg/ml; and moxifloxacin, 0.5 and 0.5 μg/ml, respectively. The MIC values after 24 h and 48 h incubation differed by no more than one dilution for all the agents with the exception of doxycycline (two dilution difference for MIC₉₀). Overall, moxifloxacin was the most active agent in vitro against U. Urealyticum, with the narrowest difference between MIC and MBC values, followed closely by levofloxacin. Clarithromycin was the most active macrolide.     

Occurrence,Efficacy, Metabolism,and Toxicity of Triclosan

Triclosan has broad-spectrum anti-microbial activity against most gram-negative and gram-positive bacteria. It is widely used in personal care products, household items, medical devices, and clinical settings. Due to its extensive use, there is potential for humans in all age groups to receive life-time exposures to triclosan, and, indeed, triclosan has been detected in human tissues and the environment. Data gaps exist regarding the chronic dermal toxicity and carcinogenicity of triclosan, which is needed for the risk assessment of triclosan. The US Food and Drug Administration (FDA) nominated triclosan to the National Toxicology Program (NTP) for toxicological evaluations. Currently, the NTP is conducting several dermal toxicological studies to determine the carcinogenic potential of triclosan, evaluate its endocrine and developmental-reproductive effects, and investigate the potential UV-induced dermal formation of chlorinated phenols and dioxins of triclosan. This paper reviews data on the human exposure, environmental fate, efficacy of anti-microbial activity, absorption, distribution, metabolism and elimination, endocrine disrupting effects, and toxicity of triclosan.     

Histologic features of bladder cancer in Boston,USA, Manchester,UK, and Nagoya,Japan

Histologic characteristics of bladder cancer in Boston, USA, Manchester, UK, and Nagoya, Japan, were evaluated. In each of these areas broadly-based series of cases were assembled during a collaborative case-control study. The present analysis was based on 589 cases in Boston, 484 cases in Manchester, and 241 cases in Nagoya. A single pathologist reviewed a slide of the primary tumor without reference to identifying information or other data. The primary histologic type of nearly all tumors was transitional-cell, and there was little variation in the proportion of transitional-cell tumors among the study areas. Nor was there much variation in the distribution of histologic grade, the proportion of tumors showing submucosal invasion, or the proportion of tumors with a papillary surface. Age at diagnosis was strongly correlated with histologic grade. The proportion of grade III (most malignant) tumors was about twice as high among patients 80 years of age and over as among those aged less than 50. An apparent association between age and submucosal invasion was explained in large part by the relationships of histologic grade to submucosal invasion and to age. Other histologic features had only weak and inconsistent relations with age. None of the features evaluated showed consistent associations with history of cigarettesmoking or with sex.     

A comparison of general,genitourinary, bowel,and sexual quality of life among long term survivors of prostate,bladder, colorectal,and lung cancer

ObjectivesStudies of local stage prostate cancer survivors suggest that treatments carry risk of persistent impotence, incontinence, and bowel dysfunction. To examine impacts of cancer type and side effects on health-related quality of life (HRQoL) in long-term cancer survivorship, we evaluated 5-year follow-up of patients with prostate cancer and compared results with a matched group of male long-term survivors of other local-stage cancers.Materials and MethodsWe examined genitourinary, bowel and sexual symptoms, and general quality of life. Matched survivors of colorectal, lung, and bladder cancers were recruited via registries in 3 different regions in the United States. Patients were surveyed 3–5 years after diagnosis with the SF-12 and EPIC to evaluate general mental and physical health-related quality of life (HRQoL) and patient function and bother.ResultsWe analyzed responses from long-term prostate (n = 77) and bladder, colorectal, and lung cancer (n = 124) patients. In multivariate analysis, long-term local stage prostate cancer survivors had significantly higher SF-12 physical component scores but did not differ from long-term survivors of other cancers in terms of their SF-12 mental summary scores. Prostate survivors had similar mental, urinary, bowel, and sexual HRQoL compared to long-term survivors of other local stage cancers.ConclusionLong-term general and prostate-specific HRQoL was similar between local stage prostate and bladder, colorectal, and lung patients with cancer. Future research focusing on factors other than initial treatment and the cancer type per se may provide more meaningful information regarding factors that predict disparities on HRQoL among longer-term survivors of early stage male cancers.