目的 探讨急性出血性脑卒中患者血清S100钙结合蛋白B(S100B)、血小板衍生生长因子-D(PDGF-D)、心脏型脂肪酸结合蛋白(h-FABP)及神经元特异性烯醇化酶(NSE)水平与颅内血肿扩大的关系.方法 前瞻性从2019年9月至2020年9月该院接诊的急性出血性脑卒中患者中随机选取125例作为研究对象,根据是否出现颅内血肿扩大,将患者分为血肿未扩大组(82例)和血肿扩大组(43例).检测并比较两组发病后第1天、第7天、第90天的血清S100B、PDGF-D、h-FABP、NSE水平,记录并比较两组入院时的血肿量(V1)和第1次复查CT时的血肿量(V2)以及V2/V1比值,采用Logistic回归模型分析颅内血肿扩大的影响因素.结果 发病后两组内各时间点血清S100B、PDGF-D、h-FABP、NSE水平随时间推移均明显下降(P<0.05);发病后第1天、第7天血肿扩大组S100B、PDGF-D、h-FABP、NSE水平均高于血肿未扩大组(P<0.05),发病后第90天两组S100B、PDGF-D、h-FABP、NSE水平差异无统计学意义(P>0.05).两组V1差异无统计学意义(P>0.05),但血肿扩大组V2及V2/V1比值均大于血肿未扩大组(P<0.05).Logistic回归模型分析结果显示,更高水平S100B、PDGF-D、h-FABP和NSE是急性出血性脑卒中患者血肿扩大的独立影响因素(OR=1.853、1.624、1.842、1.673,P<0.05).结论 发生颅内血肿扩大的急性出血性脑卒中患者血清S100B、PDGF-D、h-FABP和NSE水平升高更为明显,它们均为急性出血性脑卒中患者血肿扩大的独立影响因素.

目的:了解门诊癫痫患儿抗癫痫药超说明书使用情况,探讨其影响因素,为儿科抗癫痫药的合理使用提供参考.方法:总结2019年1月至2020年11月中国人民解放军总医院儿科门诊癫痫患儿病例,参照药品说明书的内容,判断使用抗癫痫药的处方是否存在超说明书用药,统计分析超说明书用药的类型、各品种抗癫痫药超说明书使用情况,并通过单因素分析探讨超说明书用药的影响因素.结果:共收集193例癫痫患儿,其中使用抗癫痫药治疗的有166例,共使用抗癫痫药249例次.3种主要的超说明书用药类型分别为超年龄给药(85例次,占34.1％)、超单药/添加给药(49例次,占19.7％)和超发作类型给药(41例次,占16.5％).抗癫痫药各品种中,超年龄给药占比较高的药品为托吡酯片(78.4％,40/51)和左乙拉西坦片(58.8％,30/51),超剂量给药占比最高的为左乙拉西坦片(9.8％,5/51),超频次给药占比最高的药品为氯硝西泮片(13.6％,3/22),超发作类型给药占比最高的药品为左乙拉西坦片(51.0％,26/51),超单药/添加给药占比最高的药品为左乙拉西坦片(62.7％,32/51).结论:抗癫痫药超说明书使用情况在儿科门诊普遍存在,尤其以超年龄使用最为突出,主要涉及的药品为左乙拉西坦片剂和托吡酯片;年龄、是否为基础用药影响儿科抗癫痫药超说明书使用.

目的 对急性主动脉夹层手术治疗患者应用心理干预护理模式治疗并对其治疗效果进行分析探讨.方法 选择2018年1月～2019年3月我院治疗的48例急性主动脉夹层患者作为研究对象,根据护理方案的不同将48例患者分为心理组和对照组,每组各24例,心理组患者给予心理护理进行干预,对照组患者给予常规护理模式干预.对治疗后心理组和对照组患者的治疗效果进行分析比较.结果 护理后,心理组的SAS和SDS评分明显低于对照组,且在血压和心率方面,心理组也明显低于对照组,组间比较,差异有统计学意义(P<0.05).结论 对急性主动脉夹层手术治疗患者应用心理干预护理模式可以明显降低患者的焦虑抑郁程度,使患者的血压和心率得到明显的下降,护理效果较好,值得推广.

近年来,突发公共卫生事件频发,严重威胁着人们身心健康,新冠肺炎疫情的爆发,再次对人类的生命安全提出严重挑战,并将突发公共卫生事件中的健康传播问题推向前台.本文以新冠肺炎为研究背景,阐述疫情防控中健康传播的特殊作用,指出疫情期间健康传播出现的问题,并提出增强议题设置针对性,明确传播对象;完善评价指标,建立以说服为目标的效果评价体系;注重人文关怀,科学掌握健康传播技能等相关健康传播优化策略.

目的 评价模拟飞行特定振动频率对Labnet 6c离心机转速和血型血清学检查结果的影响.方法 测量平地振动条件和平地非振动条件下Labnet 6c离心机在1 500 r/min档及3 000 r/min档时的实际转速.血型血清学专用离心机平地条件检测标准B型RhD阳性(B+)红细胞与倍比稀释抗-RhD IgG和抗-B IgM血清样本反应强度,分别筛选一个凝集强度为4+、3+、2+、1+、阴性时稀释倍数.评价平地和振动条件对于Labnet 6c离心机4+、3+、2+、1+、阴性抗-RhD IgG和抗-B IgM样本的检测结果.结果 平地振动条件下,在1 500 r/min档及3 000 r/min档Labnet 6c离心机转速与平地条件转速均无统计学差异(P＞0.05);Labnet 6c离心机1 500 r/min离心1 min进行检测时红细胞不能形成细胞扣,不适合进行血型血清学检查;3 000 r/min 15s离心可以使检测红细胞形成细胞扣,适合进行血型血清学检查;标定好的4+、3+、2+、1+、阴性抗-B IgM抗体、抗-D IgG抗体分别与标准B+红细胞进行反应,平地非振动条件Labnet 6c离心机检测结果、平地振动条件Labnet 6c离心机检测结果、平地非振动条件血型血清学专用离心机检测结果完全一致,三者两两比较均Kappa值=100％.结论 模拟大型客机飞行特定振动频率对Labnet 6c离心机转速和血型血清学检查结果无明显影响.

目的 观察老年患者监测耳垂血糖和指尖血糖值精确度的影响.方法 选取老年患者150例,同一时间监测手指末梢血糖和耳垂血糖.讨论耳垂血糖值越贴近动脉血糖值,且采血方便、疼痛轻.

分析了大数据时代知识创造、传播与利用环境发生的变化以及图书馆的新使命与航空医学知识服务面临新的挑战,提出了开展航空医学深度知识服务的建议.

目的 输血科带教不同专业实习同学提出可行性的带教建议及方案.方法 通过总结该科的不同专业实习同学的各类及带教经验.结果 不同专业实习同学的带教存在较大差异,应针对不同点进行带教.结论 应从带教师资考核、制定个性化的带教方案、严谨作风等方面规范实习生带教.

目的 测定冠心病患者血浆中人类软骨糖蛋白39(YKL-40)、单核细胞趋化蛋白(MCP-1)、白介素-8(IL-8)的水平,探讨血浆YKL-40,MCP-1,IL-8与冠状动脉病变程度的关系.方法 入选2015年3月—2016年2月于内蒙古医科大学附属人民医院心内病房住院的患者130例,行冠脉CT检查,根据检查结果 并结合病史分为正常对照组43例,单支病变组43例及多支病变组44例.用酶联免疫吸附试验(ELISA)法测定各组血浆YKL-40,MCP-1,IL-8水平,比较YKL-40,MCP-1,IL-8在各组间的表达.结果 ①与正常对照组相比,冠脉病变组血浆中YKL-40水平为(57.03±20.52)ng/mL,IL-8水平为(119.83±14.85)ng/L,MCP-1(47.58±24.34)ng/mL,表达均增高,差异有统计学意义(P<0.05).②单支病变组患者血浆中YKL-40、MCP-1、IL-8水平分别为(44.04±18.07)ng/mL、(45.34±19.05)ng/mL、(68.12±8.36)ng/L,多支病变组患者血浆中YKL-40、MCP-1、IL-8水平分别(68.54±21.14)ng/mL、(47.47±25.74)ng/mL、(119.83±14.85)ng/L,结果显示YKL-40、MCP-1、IL-8与冠脉病变严重程度密切相关,病变越重,YKL-40,MCP-1,IL-8水平越高.各组间比较差异有统计学意义(P<0.05).结论 YKL-40,MCP-1,IL-8与冠状动脉病变程度有关,病变越重,YKL-40,MCP-1,IL-8水平越高.

Objective The application of autologous blood donation can decrease allogeneic blood transfusion and transmitted disease,and can effectively avoid the homoimmune reaction,should be taken seriously.Methods Statistical analysis of the clinical use of autologous blood in our hospital during 2013-2015,and summarized the unused rate about storage of autologous blood transfusion.Meanwhile,the application of stored autologous blood in 4 surgical departments in 2015 was analyzed.The patients (n=216) received surgical operation from January to December 2015,were collected and divided into two groups.The control group (n=81) consisted of patients who did not donate autologous blood,and transfused allogeneic blood during surgery or surgery.135 cases who donated autologous blood,and transfused autologous blood during operation or after operation were observation group.The incidence of adverse effects of blood transfusion and average hospital stay were compared between the two groups,and statistical analysis was performed.Results Stored autologous blood collected 756 cases (1 385 U),mainly distributed in the general surgery (340/756,45.0％),hematology (176/756,23.3％),urinary surgery (122/756,16.1％),and gynecology obstetric (46/756,6.1％),accounting for 90.5％ (684/756).The storage of autologous blood transfusion in 2013-2015 unused rate is about 6.6％ (91.5 U/1 385 U).Compared with the allogeneic blood transfusion group,the average hospital stay and of autologous transfusion were significantly lower (20.38±8.868 vs 23.23±11.718,P＜0.05).Average hospital stay in urinary surgery was remarkably decreased (17.28±5.575 vs 24.16±14.546,P＜0.05).Conclusion Autologous blood transfusion is a safe and effective blood transfusion regimen for elective surgery patients with less operative bleeding (≤800 mL).It can relieve the influence of blood tension,reduce the amount of intraoperative blood loss,facilitate postoperative recovery,and lessen the patient's medical expenses.Therefore,storage of autologous blood transfusion should vigorously propaganda and promotion,but the discard rates should be attention.

目的:探讨血液透析治疗过程中收缩压的波动变化对患者生存率的影响.方法:选择124例在2013年1月～2016年12月行规律血液透析的尿毒症患者,收集患者的年龄、病史、透析前后患者的动脉血压变化、死亡人数,分析动脉压变化对患者生存状态影响.结果:进行随访48个月,死亡27例,血透后动脉差升高＞20mmHg(1 mm Hg=0.133 3 kPa)及下降≥10mmHg的患者较血透前后收缩压力差在-10 ～20 mm Hg之间的患者发生死亡的人数占比均升高,差异具有统计学意义(P＜0.05).结论:分析显示血透后动脉压差升高＞ 20 mm Hg及透析后动脉压差下降≥10 mm Hg的患者的死亡率明显升高.

麻醉恢复室(post anesthesia care unit,PACU)是麻醉恢复期病人继续进行严密观察和监测,直至病人的生命体征恢复到稳定状态的场所。主要收治当日全身麻醉病人术后未苏醒者和全身麻醉后病人情况尚未稳定者,或神经功能未恢复者[1]。为保证病人在麻醉恢复期间的安全,深化护理专业内涵,提升护理服务水平。我科2015年起将马斯洛需要层次论应用于病人恢复护理中,切实落实了精细化护理服务的内涵,即满足病人基本生活的需要,保证病人的安全,保持病人躯体的舒适,取得了良好的临床护理效果。现介绍如下。

Objective To investigate the effect of aspirin and clopidogrel on platelet function in patients with obstructive sleep apnea syndrome (OSAS) complicated with unstable angina pectoris (UAP). Methods A total of 118 patients with UAP in our hospital were selected from January 2013 to December 2015. According to whether the patients had OSAS or not, they were divided into UAP combined with OSAS group (UAP& OSAS group, n=46) and simple UAP group (n=72). The platelet count, mean platelet volume (MPV), platelet distribution width (PDW), and the platelet aggregation rate before and after anti-platelet therapy with aspirin and clopidogrel were detected. Results (1) There were no significant difference in terms of the platelet count between the two groups [(164.1 ± 63.4) vs (191.2 ± 63.0), P>0.05], but MPV and PDW had statistically significant difference between the two groups [(12.78 ± 1.58) vs (8.97 ± 1.11), (13.51±1.68) vs (9.08±1.35), P<0.05]. (2) Before dual anti-platelet therapy, the platelet aggregation rate in the UAP&OSAS group was significantly higher than that in the simple UAP group [(77.5 ± 5.9)%vs (60.1 ± 5.4)%, P<0.05]. Com-pared with before anti-platelet therapy, the platelet aggregation rate of the two groups significantly reduced [(77.5±5.9)%vs (50.6±5.9)%, (60.1±5.4)%vs (33.3±5.6)%, P<0.05]. However, the rate in UAP&OSAS group was still higher than that in the simple UAP group [(50.6 ± 5.9)%vs (33.3 ± 5.6)%], and the difference was statistically significant (P<0.05). Conclusion Platelet aggregation in patients with OSAS and UAP was increased. Dual anti-platelet therapy decreased platelet aggregation, but it could not completely offset the effect of OSAS on platelet aggregation.

Objective To simulate the temperature changes in the process of body temperature by adjusting thrombelastography (TEG) test in order to understand the changes in coagulation function of the general population under different temperature conditions using TEG detection index.Methods 2 mL sodium citrate was extracted from the whole blood of 47 patients (26 males,21 females;from 19-75 years old).TEG temperature was adjusted to 37℃,38℃,39℃ and 40℃.Sixteen platelet tests were conducted on 47 blood samples.The changes in R,MA,ANGLE and CI values in TEG were observed.The changes in coagulation status were explored.Results The TEG testing index detected at 37℃ and those at 38℃,39℃ and 40℃ were respectively compared.The paired T test statistical method was employed.The P values for R were almost close to 0;the P values for ANGLE were 0,0.001 and 0;the P values for MA were 0.023,0.003 and 0.001;the P values for CI were 0,0.04 and 0.Above all,the P values were less than 0.05,which showed that the testing parameters of R values,MA value,ANGLE value and CI value had significant differences under different temperature conditions.Conclusion At increasing temperature,human body will display deviation in coagulation status in the TEG test and more likely to be in a hypercoagulable state.

选取2015年1月～2015年10月期间我科收治老年住院患者98例作为研究对象,综述了住院老年患者由于各种原因在院期间易发生服药的安全问题以及针对这些安全问题所采取的护理措施,其中包括服药依从性、躺在床上服药、干吞强咽药物、捏鼻子喂药、用果汁、茶水或牛奶服药等错误的服药方法,采取的护理干预包括服药的姿势要求、服药的饮水要求、服药的时间要求等.认为将老年患者正确、安全的服药护理应放在首要位置,能够显著提高治疗效果,减少副作用的发生.

ObjectiveTo study the contribution of unconscious stimuli to visual search performance of pilot candidates.MethodsA total of 15 senior pilot candidates in an Air Force university were recruited as the subjects. A visual search experiment was designed by E-prime 2.0 psychology software so as to control the presentation time of experiment materials and measure the response time and accuracy of the visual search task. The data were statistically analyzed with Two-Way ANOVA.ResultsVariance analysis of task accuracy showed that the main effect of the cue range was remarkable(P<0.05), but the main effect of the duration for each stimuli presentation and the interaction was insignificant (P>0.05). In case of a small cue range, analysis of simple effect on task accuracy showed that the difference was marginally significant statistically(P=0.058). The highest accuracy was achieved when the stimulus presentation time was 35 ms. Variance analysis of response time showed that the main effect of the cue range was remarkable(P<0.05), while, the main effect of the duration for each stimulus presentation and interaction was insignificant(P>0.05).Conclusion The results of behavioral experiments show that those small scale cues of the threshold level (35 ms) can improve pilot candidates' accuracy of visual search, so subliminal perception is processed at a high cognition level. The unseen visual cues can be used to improve visual search performance of pilot candidates.

Objective To investigate the effects of floating feedback training capsule in defending psychological stress on military flight personnel for providing basis to further applications and studies. Methods Forty six military flight personnel were divided into 2 groups randomly: the experiment group(n=26) and the control group(n=20). All persons underwent psychological stress(additive mental calculation & flight simulation operation) and then their indexes of HRV and brain wave were measured. Floating feedback training was performed to defend psychological stress in the experiment group for 30 min, while deep breathing and relaxation training was performed in the control group for 30 min. All persons' indexes of HRV and brain wave were measured again and training assessment questionnaire was filled in. Results ①HRV time domain indexes: compared with control group and before training, experiment group gained significant increase in PNN50(P<0.05,P<0.01).②HRV frequency domain indexes:compared with control group and before training's, experiment group gained significant increase in HFnorm and significant reduction in LF/HF&LFnorm(P<0.05,P<0.01).③The necessity and effectiveness of psychological stress defense training is 96% according to the result of assessment questionnaire. Conclusion Floating feedback training capsule is an effective and popular tool for military flight personnel to defend psychological stress reaction.

Objective To investigate the effects of psychological stress defense training on military flight personnel for providing basis on further applications and studies.Methods 46 military flight personnel were divided into 2 groups randomly:the experiment group (n=26) and the control group(n=20).All person underwent psychological stress(additive mental calculation and flight simulation operation) and then their indexes of heart rate variability(HRV) and brain wave(α&β) were measured.Floating feedback training was performed to defend psychological stress in the experiment group for 30 minutes,while deep breathing and relaxation training was performed in the control group for 30 minutes.All person's indexes of HRV and brain wave(α&β) were measured again and training assessment questionnaire was filled in.Results (1) HRV time domain indexes:compared with control group((15.06±15.03)％) and before training's,experiment group gained significant increase(P＜0.05,P＜0.01) in PNN50((24.29± 17.02) ％).(2) HRV frequency domain indexes:compared with control group and before training' s,experiment group gained significant increase(P＜0.05,P＜0.01) in HFnorm ((22.35± 13.32) ms2) and significant reduction(P＜0.05,P＜0.01) in LF/HF(5.11 ±3.45) and LFnorm((77.65± 13.32) ms2).(3) Brain wave indexes:compared with control group and before training's,experiment group gained significant increase(P＜0.05,P＜0.01) in α waves index(11.08±2.47) and significant reduction(P＜0.05,P＜0.01) in β waves(5.66±4.46).(4)The necessity and effectiveness of psychological stress defense training was 96％ according to the result of assessment questionnaire.Conclusion Psychological stress defense training is an effective and popular way to regulate the psychological stress reaction of military flight personnel.

Objective:To explore and compare the effect of two difficult psychological training prac-tices and the result assessment on acute stress relieving for military pilots ,and offer reference for Chinese troops'psychology health promoting in peacetime and wartime .Methods:This research selected 116 mili-tary pilots for two methods of psychological training ,58 pilots for floating capsule training and the other 58 pilots for abdominal breathing exercises .Study used physical index of galvanic skin response ( GSR) as the evaluation index .Results:Using repeated measures and multivariate analysis of variance process of the general linear model in SPSS and giving comparison among different groups and different measure time pairwise .The results showed that floating capsule training caused obvious change on pilots 'GSR ( F =184.479,P<0.05),but there was no obvious difference in abdominal breathing group .Conclusion:After 10-minute psychological training ,the floating capsule training group shows significant lowering of stress while there is no significant effect in abdominal breathing exercises group .

Objective To investigate the dyslipidemia in patients with psoriasis,and the characteristics of the serum lipids in pa-tients with different types of psoriasis.Methods 332 psoriatic patients were devided into pustular psoriatic,psoriasis vulgaris and erythrodermic psoriasis based on clinical manifestations.Serum lipids of the three groups were analyzed including TC,TG,HDL-C, LDL-C,ApoA1,ApoB and Lp(a).Results The serum concentrations of TC,HDL-C,ApoA1 in patients with psoriasis were signifi-cantly lower than those in control group(P <0.05),while the concentration of Lp(a)was significantly higher in psoriasis patients compared with those in control group(P <0.05).The serum level of TC,HDL-C,LDL-C and ApoA1 in pustular psoriasis group were significantly lower than those in the other two groups(P <0.05).Conclusion The patients with psoriasis have dyslipidemia, and the serious disorder situation could be associated with psoriasis types.