心理契约破裂对护士长工作满意度的影响研究

目的探讨心理契约破裂对护士长工作满意度的影响。方法便利抽取福州市3家综合性三级甲等医院131名护士长进行护士长心理契约和工作满意度的问卷调查。结果护士长心理契约存在一定程度的破裂,其中医院现实责任破裂程度最严重;多元逐步回归分析显示心理契约破裂对护士长的工作满意度产生显著影响。结论通过降低护士长心理契约破裂的程度,可以提高护士长的工作满意度。     

长春市成年居民一般心理健康状况及其影响因素分析

目的 了解长春市成年居民一般心理健康状况的分布特征及其影响因素。方法 采用一般健康问卷12项评价量表（12-item general health questionnaire,GHQ-12）对多阶段分层随机整群抽样选取的长春市成年居民进行心理健康状况调查,并利用Logistic回归分析其影响因素。结果 长春市成年居民GHQ-12平均分为2.13分,阳性检出率为21.1% ;其中男性阳性检出率16.6%,女性阳性检出率为25.6%,差异有统计学意义（χ2=72.078,P<0.001）;多因素分析结果显示,女性（OR=1.509,95% CI:1.248～1.824）、婚姻状况为丧偶（OR=1.483,95% CI:1.103～1.995）、睡眠时间为<7 h（OR=1.586,95% CI:1.334～1.885）或≥9 h（OR=1.322,95% CI:1.003～1.743）、职业类型为其他（OR=1.245,95% CI:1.002～1.547）、患有慢性病（OR=2.130,95% CI:1.760～2.578）为影响长春市居民心理健康状况的危险因素;年龄为35岁以上（OR=0.540,95% CI:0.361～0.808;OR=0.497,95% CI:0.328～0.752;OR=0.425,95% CI:0.276～0.656;OR=0.526,95% CI:0.325～0.852）、家庭人均月收入为500元及以上（OR=0.656,95% CI:0.519～0.829;OR=0.571,95% CI:0.445～0.732;OR=0.567,95% CI:0.432～0.761;OR=0.519,95% CI:0.366～0.737）、饮食规律（OR=0.584,95% CI:0.485～0.704）、进行锻炼（OR=0.583,95% CI:0.480～0.709;OR=0.789,95% CI:0.642～0.971）均为心理健康状况的保护因素。结论 长春市成年居民一般心理健康状况较差,相关部门应采取针对性的措施提高居民的基本生活质量,并结合宣讲等方式增加其保健意识。     

IL-17F在口腔鳞状细胞癌患者血清中的表达及意义

目的 探讨IL-17F(interleukin 17F)在口腔鳞状细胞癌(OSCC)患者血清中的表达及意义。方法 收集33例健康对照者、25例经病理证实为白斑的患者和80例OSCC患者的血清,用ELISA方法检测IL-17F的表达水平,分析其与临床病理参数的关系。结果 OSCC患者血清IL-17F水平为65.1±7.2 pg/ml,显著低于健康对照者(202.2±31.5 pg/ml)和白斑患者(168.2±17.4 pg/ml),差异均具有统计学意义(t=6.16,6.22,P<0.05),OSCC患者血清中IL-17F水平与TNM分期明显相关(P<0.05)。受试者工作特征曲线(ROC曲线)显示血清中IL-17F能够很好地区分健康人和OSCC患者(P<0.05),其最佳临界值为37.8 pg/ml。结论 OSCC患者血清中IL-17F的表达降低,提示其可能与肿瘤发生、发展相关。     

颅咽管瘤显微手术的疗效分析

目的 探讨颅咽管瘤手术入路的选择及手术疗效。方法 2004年1月至2015年5月手术治疗颅咽管瘤126例,采用翼点入路54例、前纵裂入路21例、经胼胝体入路19例、经鼻蝶入路32例。结果 肿瘤全切除87例,近全切除28 例,部分切除 11 例。术后颅内压增高症状均得到缓解;41例内分泌异常患者中改善18例;65例视力障碍患者中52例缓解。术后发生钠代谢紊乱117例、尿崩症82例、高热47例、同侧动眼神经瘫痪4例、意识障碍37例、癫痫8例（经药物治疗后均控制良好）。肿瘤复发12例,经伽玛刀治疗,效果良好。结论 术前依据肿瘤的分型选择合适的入路,术中保护好垂体柄、下丘脑及其周围重要神经结构,术后积极处理并发症,对提高患者的生存质量至关重要。     

miR-589-3p靶向DSPP基因对口腔鳞状细胞癌肿瘤干细胞的调控作用

目的:探讨miR-589-3p靶向牙本质涎磷蛋白(DSPP)对口腔鳞状细胞癌(OSCC)肿瘤干细胞增殖、凋亡、侵袭的影响.方法:对OSCC患者和口腔良性肿物患者组织中miR-589-3p和DSPP的表达进行检测,对miR-589-3p和DSPP的相关性进行分析.双荧光素酶报告实验验证miR-589-3p与DSPP的靶向...     

脑室外并腰大池引流治疗高血压脑出血铸形脑室临床研究

目的探讨腰大池持续外引流术治疗高血压脑出血破人脑室的疗效。方法对近5年来收治的42例高血压脑出血破入脑室患者随机分成两组,治疗组20例,对照组22例,治疗组采用脑室外引流加腰大池持续引流术,对照组采用传统的脑室外引流术结合腰穿引流术。结果根据GOS量表评分,治疗组优良率45％,高于对照组的13．6％,差异有统计学意义（P〈0．05）;脑室血肿清除时间治疗组早于对照组（P〈0．05）。结论脑室外引流加腰大池持续引流术对高血压脑出血破入脑室患者的治疗,可降低致残率,提高生活质量。     

马来酸桂哌齐特治疗高血压性脑出血的疗效观察

目的探讨马来酸桂哌齐特治疗高血压性脑出血的临床疗效。方法将64例高血压性脑出血患者随机分为马来酸桂哌齐特组（30例）和对照组（34例）,两组患者均接受脑出血的传统方法治疗,马来酸桂哌齐特组在传统方法治疗的同时静脉滴注马来酸桂哌齐特。对两组患者于治疗前及治疗后第7天、第14天测量脑血肿和脑水肿,同时在入院时和治疗后30d、90d随访时采用ESS评分量表评定神经功能。结果马来酸桂哌齐特组较对照组脑血肿、脑水肿明显减小,ESS评分明显增高。结论高血压性脑出血早期可在应用传统的脑出血治疗方法同时,应用马来酸桂哌齐特,以进一步减轻脑水肿,促进脑血肿吸收,改善神经功能。     

江西近视手术人群角膜前表面非球性参数调查分析

Objective To assess the distribution features of Q-value of corneal anterior surface in Jiangxi myopia population for laser refractive surgery and to investigate the relationship between Q-value and other related parameters, such as spherical equivalent (SE), corneal curvature, cornea astigmatism, wavefront data and age. Methods The K&Q calculator of Orbsean- Ⅱ anterior segment system was used to obtain the Q-value of 6 mm optical zone in 411 cases (822 eyes) .There were 188 male subjects (376 eyes) and 223 female subjects (446 eyes). Accnrding to SE, subjects were divided into three groups including low myopia, moderate myopia and high myopia. According to different age, subjects were divided into three groups including group Ⅰ (age from 17 to 25), group Ⅱ (age from 26 to 34) and group Ⅲ (age from 35 to 44). Statistical analysis was used to comprehend the distribution characters of Q-value and its relations with SE, corneal curvature, cornea astigmatism, wavefront data and age. Results The Q-value of 822 eyes (411 cases) distributed as positive normal distribution, the average of Q- value was -0.148± 0.120 (range from -0.73 to 0.56) and -0.130± 0.128for male subjects and -0.163± 0.110 for female ones with statistically significant difference in Q-value in different genders (t=4.069, P <0.01). A significant difference was observed in Q-value among 17-25 years, 26-34 years and 35-44 years groups (F =4.567, P <0.05) as well as between 26-34 years group and 35-44 years group (P =0.004). However, there was no significant difference found between different myopic groups (F =1.434, P >0.05). The Q-value shown significantly negative relationship with C12, the Q-value show poor relationship with cornea curvature, cornea astigmatism, RMSh and C8. But the Q-value was not related with SE, RMSg, C7, cornea thickness, ocular pressure and age. Conclusions In Jiangxi myopia population for refractive surgery corneal curvature of majority population become flatter from center to periphery (Q<0), minority become steeper from center to periphery (Q>0). The Q-value of corneal anterior surface is independent from myopic SE. The Q-value show poor relationship with cornea curvature, cornea astigmatism, RMSh and C8, C12 is the most important related factor of Q-value. The Q-value is significantly greater in males than in females. A significant difference is observed in Q-value between 26-34 years and 35-44 years group.     

HSP27、增殖细胞核抗原在视网膜母细胞瘤中的表达

目的探讨热休克蛋白(heat shock proteins,HSP)27、增殖细胞核抗原(proliferating cell nuclear antigen,PCNA)在视网膜母细胞瘤(retinoblastoma,Rb)中的表达及其与Rb分化程度和视神经浸润的关系。方法应用鼠抗人HSP27及PCNA的单克隆抗体,采用PV9000二步法免疫组织化学方法,对36例Rb患儿和2例正常对照视网膜组织常规石蜡标本行HSP27及PCNA表达的测定,并分析它们与肿瘤分化程度及视神经浸润的关系。结果HSP27及PCNA在Rb中的表达阳性率分别为69.4%及83.3%;两指标在未分化组阳性表达高于分化组(P<0.05),两指标在视神经浸润组的阳性表达高于未浸润组(P<0.05)。Rb中HSP27的表达与PCNA的表达呈正相关(P<0.01)。结论Rb中HSP27和PCNA的表达与Rb的分化程度、视神经浸润有关。