目的 初步探讨鼠李糖乳杆菌的产后抗抑郁作用及其潜在机制.方法 在雌性小鼠妊娠期间施用地塞米松磷酸钠建立产后抑郁症(PPD)模型.适应性喂养结束后,将受孕的50只雌性小鼠随机分为鼠李糖乳杆菌干预低剂量组(Ⅰ组)、鼠李糖乳杆菌干预高剂量组(Ⅱ组)、阳性对照组(Ⅲ组)、模型对照组(Ⅳ组)和空白对照组(Ⅴ组).通过灌胃给药进行干预,Ⅰ组和Ⅱ组小鼠分别给予鼠李糖乳杆菌1×107和1×108 CFU(kg·d),Ⅲ组小鼠给予1.8 mg/(kg·d)帕罗西汀,Ⅳ组和Ⅴ组小鼠给予等量的生理盐水,干预时间为4周.通过24 h食物消耗实验、旷场实验、糖水消耗实验检测各组小鼠的行为学表现,反相高效液相色谱法测定5-羟色胺(5-HT)、去甲肾上腺素(NE)及多巴胺(DA)的浓度,RT-qPCR法检测小鼠盲肠中粪肠球菌、双歧杆菌、乳酸杆菌和大肠杆菌的变化.结果 造模前各组小鼠摄食量、体质量变化率、旷场移动距离和速度、糖水消耗百分比差异均无统计学意义(P>0.05).造模后与Ⅴ组相比,Ⅰ组、Ⅱ组、Ⅲ组和Ⅳ组小鼠的摄食量和体质量变化率差异无统计学意义,而旷场移动距离、移动速度和糖水偏爱百分比明显降低,差异有统计学意义(P<0.05).鼠李糖乳杆菌干预后,与Ⅳ组相比,Ⅰ组、Ⅱ组小鼠的抑郁样行为得到改善,体质量变化率、旷场移动距离和速度、糖水偏爱百分比和单胺神经递质浓度较Ⅳ组显著增加(P<0.05),粪肠球菌、大肠杆菌和乳酸杆菌显著下降(P<0.05),双歧杆菌有上升趋势,但未见统计学差异;摄食量没有明显变化.结论 鼠李糖乳杆菌能够改善产后小鼠抑郁样行为,影响小鼠单胺类神经递质,调节肠道菌群,为产后抑郁相关研究提供了新的方向.

目的:探讨鼠李糖乳杆菌对小鼠产后抑郁样行为和运动能力的影响.方法:在小鼠妊娠期间施用地塞米松磷酸钠建立产后抑郁症(PPD)小鼠模型.将受孕的25只小鼠随机分为:鼠李糖乳杆菌干预低剂量组(Ⅰ组)、鼠李糖乳杆菌干预高剂量组(Ⅱ组)、阳性对照组(Ⅲ组)、模型对照组(Ⅳ组)和空白对照组(Ⅴ组).通过灌胃给药的方式进行干预,Ⅰ组和Ⅱ组小鼠分别给予鼠李糖乳杆菌1×107 CFU/(kg·d)和1×108 CFU/(kg·d),Ⅲ组小鼠给予1.8 mg·kg-1·d-1帕罗西汀,Ⅳ组和Ⅴ组小鼠给予等量的0.9％氯化钠溶液,干预时间为4周.通过24 h食物消耗实验、黑白箱实验、强迫游泳实验和悬尾实验检测各组小鼠的行为学表现.结果:造模前各组小鼠摄食量、体质量变化率、白箱停留时间和黑白箱穿梭次数、不动状态持续时间和悬尾不动时间方面,差异均无统计学意义(P>0.05).与造模前相比,造模后和干预后各组小鼠摄食量减少,体质量变化率增加(P<0.05);造模后和干预后Ⅰ组、Ⅱ组、Ⅲ组和Ⅳ组小鼠强迫游泳不动持续时间和悬尾不动时间增加.与造模后相比,干预后各组小鼠体质量变化率增加(P<0.05),干预后Ⅰ组、Ⅱ组和Ⅲ组小鼠强迫游泳不动持续时间和悬尾不动时间减少.造模后与Ⅴ组相比,其余组小鼠黑白箱穿梭次数有所减少,悬尾不动时间升高(P<0.05).干预后黑白箱穿梭次数各组间差异均无统计学意义(P>0.05);干预后与Ⅴ组比较,其余组小鼠的悬尾不动时间增加(P<0.01);与Ⅳ组比较,Ⅰ组、Ⅱ组和Ⅲ组的悬尾不动时间减少(P<0.01).结论:雌性小鼠妊娠期间施用地塞米松磷酸钠表现出产后抑郁样行为,鼠李糖乳杆菌干预后对产后小鼠的焦虑抑郁和运动能力有一定改善.

BACKGROUND:Middle-aged females, especially perimenopausal females, are vulnerable to depression, but the potential mechanism remains unclear. Dopaminergic and GABAergic system dysfunction is involved in the pathophysiology of depression. In the current study, we used 2-month-old and 11-month-old C57BL/6 mice as young and middle-aged mice, respectively. Chronic immobilization stress (CIS) was used to induce depressive-like behaviour, and the sucrose preference test (SPT), tail suspension test (TST) and forced swim test (FST) were used to assess these behaviours. We then measured the mRNA levels of dopamine receptor D1 (DRD1) and the GABAA receptors GABRA1, GABRB2 and GABRG2 in the nucleus accumbens (NAc) and prefrontal cortex (PFC).RESULTS:We found that immobility time in the FST was significantly increased in the middle-aged mice compared with the middle-aged control mice and the young mice. In addition, the preference for sucrose water was reduced in the middle-aged mice compared with the middle-aged control mice. However, CIS did not induce obvious changes in the performance of the young mice in our behavioural tests. Moreover, the middle-aged mice exhibited equal immobility times as the young mice in the absence of stress. Decreases in the mRNA levels of DRD1, GABRA1, and GABRB2 but not GABRG2 were found in the NAc and PFC in the middle-aged mice in the absence of stress. Further decreases in the mRNA levels of DRD1 in the NAc and GABRG2 in the NAc and PFC were found in the middle-aged mice subjected to CIS.CONCLUSIONS:Our results suggested that ageing could not directly induce depression in the absence of stress. However, ageing could induce susceptibility to depression in middle-aged mice in the presence of stress. CIS-induced decreases in DRD1 and GABRG2 levels might be involved in the increase in susceptibility to depression in this context.

C-藻蓝蛋白具有抗癌、抗氧化、抗炎活性等多种功能,然而其对乳腺癌细胞的抗癌作用及机制尚不明确.本研究应用不同浓度(0～500 μg/mL)的C-藻蓝蛋白处理人乳腺癌细胞系MDA-MB-468.研究显示,C-藻蓝蛋白以剂量依赖性方式抑制MDA-MB-468细胞的增殖并降低细胞的菌落形成能力.C-藻蓝蛋白通过上调了Fas和cleaved-caspase 3的表达并下调Bcl-2的表达来诱导细胞凋亡.C-藻蓝蛋白处理以剂量依赖性方式显著降低COX-2的表达并抑制细胞迁移能力.C-藻环蛋白以剂量依赖性方式促进p38 MAPK和JNK的磷酸化,p38 MAPK和JNK抑制剂处理可显著抑制C-藻红蛋白诱导的细胞死亡.本研究表明C-藻蓝蛋白能够抑制三阴性乳腺癌MDA-MB-468细胞的增殖,促进细胞凋亡,抑制细胞迁移能力.C-藻蓝蛋白的抗癌机制可能与激活p38 MAPK和JNK信号传导有关.

目的 了解护理学生考前焦虑、学业拖延症的现状及其影响因素,为缓解护理学生考前焦虑、学业拖延症提供可靠的依据.方法 选取西安医学院在校护理学生483名作为研究对象,应用一般资料、焦虑自评量表及一般拖延量表,于考试前一周对研究对象进行问卷调查.结果 焦虑症者461例,发生率为95.4％,拖延症者276例,发生率为57.1％.是否喜欢护理专业、性格类型及接受知识的能力对考前焦虑有显著的影响(P<0.05);是否喜欢护理专业及性格类型对学业拖延症有显著的影响(P<0.05).结论 护理专业学生大部分都存在考前焦虑症,同时大部分都是轻度焦虑,喜欢护理专业、A型性格及接受知识能力强的护理学生考前焦虑较轻;部分护理学生存在拖延症,喜欢护理专业及A型性格的护理学生学业拖延症较轻.

Objective To discuss the effect of applying internet-based formative evaluation in paediatric nursing teaching. Methods Three nursing classes from grade 2015 were selected as research subjects, and determined randomly as test group, control group 1 and control group 2. Internet-based formative evaluation was used in the test group, while control group 1 used traditional test papers, and control group 2 skipped formative evaluation. Results Analysis of the results and the total scores of the final examination showed no significant difference between the test group and the control group 1 (P>0.05), but the scores of both groups were significantly higher than that of the control group 2 (P<0.05). The scores of the students' evaluation to teachers in test group was better than that in control group 1 and control group 2, and the differences between the three groups were statistically significant (P<0.05). The average time of exams in the test group was shorter than that of control group 1, and the difference between the two groups was statistically significant (P<0.05). The cost of the test group was 0 yuan, while the cost of the control group1 was 638 yuan. Conclusion Although there is no significant difference in the teaching effect between the internet-based formative evaluation and traditional test papers , internet-based tests can significantly improve the students' interest in learning, increase the efficiency of teaching and learning, and improve the teaching quality . The internet-based formative evaluation can be widely used in nursing teaching.

To explore the effects of group singing therapy on depression symptoms and quality of life of patients with stable chronic obstructive pulmonary disease (COPD).

目的:调查妊娠中晚期妇女抑郁状况及其影响因素.方法:采用便利抽样法选取陕西三地6所医院877例孕妇为研究对象,用爱丁堡产后抑郁量表、妊娠压力量表、领悟社会支持量表进行问卷调查.结果:孕妇抑郁得分(9.32±5.24)分,妊娠抑郁检出率26.9％;分层回归分析显示住房满意度(OR=1.429,P<0.01)、与伴侣关系(OR=1.543,P<0.01)、婆媳关系(OR=1.572,P<0.01)、社会支持(OR=0.929,P<0.001)和妊娠压力(OR=1.040,P<0.001)是妊娠抑郁的影响因素.结论:陕西省中晚期妊娠妇女抑郁发生率较高,与社会人口因素、妊娠压力及社会支持状况有关;孕妇抑郁状况有待改善,须提供孕期心理保健,帮助其顺利度过妊娠期,提升母婴健康水平,改善母婴结局.

目的 探讨药物干预(加巴喷丁、糖皮质激素)对腹腔镜下子宫全切(TLH)患者术后快速康复及血清炎性因子的影响.方法 选取2016年7月-2017年7月于西安医学院第一附属医院(全科医学院)妇科住院接受腹腔镜下子宫全切术治疗的患者50例,随机分为2组(n=25),实验组患者在术前2h给予口服加巴喷丁及糖皮质激素;对照组患者术前2h给予口服安慰剂药物;分别记录2组患者术后1、6、12、24 h视觉模拟评分法(visual analogue scale,VAS)数值,以及2组患者术后首次按压静脉自控镇痛(patient-controlled intravenous analgesia,PCIA)泵的给药时间和PCIA药物24h的累积使用量;术后患者首次下床活动及肠道排气时间、住院时间以及恶心呕吐等不良反应发生率;于入手术室时,术后4、8、12 h分别抽取患者肘静脉血,ELISA测定血清中炎性因子白介素-6(interleukin-6,IL-6)、肿瘤坏死因子α(tumor necrosis factor α,TNF-α)的表达水平.结果 实验组患者术后1、6hVAS评分低于对照组(均P＜0.05);实验组患者术后首次按压PCIA泵给药时间以及PCIA药物24 h的累积使用量低于对照组(均P ＜0.05);实验组患者术后首次下床活动及肠道排气时间、住院时间、恶心呕吐不良反应发生率均低于对照组(均P＜0.05);实验组患者血清中IL-6、TNF-α的表达水平在术后不同时间节点(4、8、12 h)均低于对照组,差异具有统计学意义(均P＜0.05).结论 术前加巴喷丁及糖皮质激素的联合应用干预,可降低手术应激及炎性因子产生,进而减少术后不良反应发生率,促进腹腔镜下子宫全切患者术后快速康复.

目的 研究不同剂量甲基苯丙胺(methamphetamine,METH)对小鼠空间学习记忆的影响及可能机制.方法 以C57BL/6小鼠为研究对象,采用0.5、1.0、2.0mg/kg的METH或生理盐水,在每天的Morris水迷宫行为学习前腹腔注射给药,连续5d,每天4轮的定位航行实验训练,最后一次训练完24 h后进行空间探索实验,观察不同剂量METH对小鼠空间学习记忆的影响.测试后立即采用颈椎脱臼法处死小鼠,并剥离海马组织,采用Western blot方法检测海马中ERK1/2(extracellular signal-regulated kinase)、CREB(cAMP response element-binding protein)磷酸化水平的变化.结果 相比盐水组小鼠,1.0 mg/kg METH组小鼠爬台潜伏期明显缩短(P＜0.05),在目标象限的停留时间(P＜0.05)、穿台次数(P＜0.05)明显增加;0.5、2.0 mg/kg METH对小鼠空间学习记忆无明显影响,但是0.5 mg/kg METH组小鼠呈现记忆促进趋势,而2.0 mg/kg METH组小鼠呈现记忆破坏趋势;1.0 mg/kg METH组小鼠明显伴随海马中p-ERK1/2(P＜0.05)、p-CREB(P＜0.05)水平的增高.结论 1.0 mg/kg METH明显提高小鼠空间学习能力及记忆水平;在0.5、1.0、2.0 mg/kg的METH三个剂量之间,METH的效应呈倒U曲线型;海马中ERK1/2、CREB可能参与METH诱导的小鼠空间学习记忆的提高.

目的 :调查孕妇在妊娠期压力状况及其影响因素,为提出针对性的干预措施提供依据.方法 :收集陕西地区孕妇1044例,采用一般资料调查表 、妊娠压力量表对其进行问卷调查,分析其妊娠期间压力状况及影响因素.结果 :孕妇妊娠压力总分(26.28±14.25)分,按得分指标分类,轻度压力784例(75.1％),中度压力255例(24.4％),重度压力5例(0.5％);压力源各因子中,"为确保母子健康和安全而引发的压力感"得分指标最高,为43.57％.妊娠压力的主要影响因素为:居住地类别 、对住房的满意度 、与伴侣母亲的关系.结论 :经济状况及家庭成员情感支持是影响孕妇妊娠压力水平的重要因素,为经济困难者提供必要的社会援助 、为家庭情感支持不足者实施心理干预,是缓解妊娠压力,帮助其顺利度过妊娠期,提升母婴健康水平的重要措施.

目的 评估不同的康复计划在干预多发性硬化症(MS)女性下尿路功能障碍(LUTD)中的作用.方法 选取2015年6月至2018年6月在西安医学院第二附属医院收治的81例MS女性患者为研究对象,按照随机数字表法分为3组,每组各27例.第Ⅰ组采用骨盆底肌肉训练(PFMT)与肌电图(EMG)生物反馈和虚拟神经肌肉电刺激(VNES),第Ⅱ组采用PFMT与EMG生物反馈和阴道内VNES,第Ⅲ组采用PFMT与EMG生物反馈和经皮胫神经刺激(TTNS).所有患者接受12周干预.评估干预前、后3组患者24 h尿垫试验、3天膀胱日记、尿动力学研究结果,采用膀胱过度活动症症状评分表(OABSS),国际失禁问卷调查表-简表(ICIQ-SF)评估3组患者对排尿异常的自我认知以及对生活质量的影响.结果 与干预前比较,12周后3组患者24 h尿垫重量、尿急、排尿不畅、急迫性尿失禁和残余尿量显著下降,最大尿流量显著增加,差异有统计学意义(P<0.05).与干预前比较,第Ⅱ组和第Ⅲ组的夜尿次数和尿不尽明显减少,差异有统计学意义(P<0.05).3组患者干预前后差值比较,第Ⅱ组患者24 h尿垫重量、残余尿量和急迫性尿失禁的降低水平,及最大尿流量的提高水平明显优于其他两组,差异有统计学意义(P<0.05).与干预前相比,3组患者在OABSS评分和ICIQ-SF评分方面显著改善,差异有统计学意义(P<0.05);3组干预后ICIQ-SF评分比较,Ⅱ组和Ⅲ组评分改变更加明显,组间差异有统计学意义(P<0.05).结论 阴道内VNES或TTNS联合使用PFMT可有效改善MS患者的下尿路功能障碍.PFMT和VNES的组合在减少膀胱过度活动症方面具有一定优势.

Objective To explore the relationship among professional adaptability ,group attachment and aca-demic help-seeking in college nursing students .Methods Total 840 college nursing students were investigated with the professional adaptability scale ,the group attachment scale and the academic help -seeking scale by strati-fied sampling method .Results The total score and the dimensions of professional adaptability were negatively cor-related with the total score and the two dimensions of group attachment (r= -0 .38 to -0 .08 ,all P＜0 .05) ,as well as the score of avoidance of academic help -seeking (r= -0 .24 to -0 .16 ,P＜0 .001) ,while positively corre-lated with instrumental help -seeking (r= 0 .26 to 0 .30 ,P＜0 .001) .The result of structural equation modeling indicated that instrumental help -seeking and avoidance of academic help -seeking had a partial mediating effect on the relationship between group attachment avoidance and professional adaptability .The value of mediating effect was 22% and 21% respectively .Conclusions The nursing educators should improve the level of students'group at-tachment and professional adaptability according to the characteristics of students'academic help-seeking .

目的 探讨空巢老人疏离感、心理韧性、生活质量这三者之间的作用过程,为制订改善空巢老人生活质量的措施提供理论依据.方法 通过分层随机抽样的方法选取西安市3个社区205例空巢老人,对其进行一般资料、一般疏离感问卷、心理韧性量表及生活质量问卷的调查,用SPSS19.0对数据进行相关分析及中介效应分析.结果 ①空巢老人疏离感与心理韧性(r=-0.395,P<0.001)及生活质量(r=-0.161,P<0.001)之间呈负相关,而心理韧性与生活质量之间呈正相关(r=0.145,P<0.01).②心理韧性在空巢老人疏离感对其生活质量的作用过程中起部分中介效应,中介效应占总效应的比例为44.70％.结论 空巢老人的疏离感可直接影响其生活质量,亦可通过作用于心理韧性进而影响其生活质量.

[目的]探讨护士组织文化、工作满意度与离职意愿的关系,为降低护士的离职意愿提供参考.[方法]本研究为横断面调查,应用组织文化量表、工作满意度量表、离职意愿量表对943名护士进行调查.[结果]护士离职意愿与组织文化及工作满意度呈负相关(r=-0.176,P＜0.01;r=-0.104,P＜0.01);组织文化与工作满意度呈正相关(r=0.268,P＜0.01).工作满意度在组织文化和离职意愿间起部分中介作用.[结论]护士工作满意度、组织文化对其离职意愿都有一定的预测作用,工作满意度在组织文化和离职意愿间起部分中介作用.

Objective To explore the effects of motivational interviewing health education on the self-management behavior and lung function of the community-elderly patients with stable chronic obstructive pulmonary disease(COPD).Methods Totally 215 elderly patients with stable COPD from Xi'an community were enrolled by convenience sampling,and the patients were randomly divided into control (n=108) and experimental group (n=107) using the random number table.The patients in the experimental group received motivational interviewing health education for 6 months in addition to usual health education for both groups.The two groups were examed by self-management behavior (smoking,respiratory function exercises,muscle exercises,home oxygen therapy,medication adherence and inhaled drugs method) and lung function before and after intervention.Results In the experimental group,smoking cessation rate [72.9％ (78 cases) vs.84.1％ (90 cases),x2 =7.40],respiratory-function exercises (often) [16.8％ (18 cases) vs.84.1％ (90 cases),x2 =99.35],muscle exercises (often) [30.8 ％ (33 cases) vs.87.0％ (93 cases),x2 =69.49],frequent home-oxygen therapy [9.3％(10 cases) vs.35.5％(38 cases),x2 =30.50],medication following the doctor's advice [36.5％(39 cases) vs.86.9％ (93 cases),x2 =57.67]and right inhaled-drugs method [44.9％ (48 cases) vs.95.3％(102 cases),x2 =65.00]were much greater than those before intervention (all P＜0.05).Lung function including vital capacity (VC) [(2.53±0.41) L vs.(2.66±0.58)L,t =-2.62],forced vital capacity (FVC) [(2.51 ± 0.45) L vs.(2.64 ± 0.60) L,t =-2.56],forced expiratory volume in one second (FEV1) [(1.59±0.23)L vs.(1.74±0.47)L,t =-2.75],FEV1％ [(63.6±22.8) ％ vs.(73.5±20.9)％,t =-3.38]were significantly improved after 6 months as compared with those before intervention (all P ＜0.05).However,only right inhaled-drugs method was significantly greater than that before intervention in the control group [41.7 ％ (45 cases) vs.61.1％ (66 cases),x2 =8.17,P＜0.05].Conclusions Motivational interviewing health education may improve the self-management behavior and lung function of elderly patients with stable COPD,and it serves as an effective disease-management strategy.

目的 探讨城市空巢老人心理坚韧性水平及其影响城市空巢老人心理坚韧性的预测因素.方法 利用分层整群随机抽样方法,在西安市3个区抽取205名社区空巢老人作为研究对象,采用一般资料问卷、心理坚韧性量表、抑郁自评量表进行问卷调查.统计学处理采用t检验、方差分析、秩和检验和多元线性回归分析.结果 ①城市空巢老人心理坚韧性总体均分为134.32±24.68,处于中等水平.②城市空巢老人心理坚韧性的预测因素按影响强弱依次为社会支持感、抑郁得分、子女探视、性别、文化程度,其回归方程为Y=74.262+1.753×社会支持感-0.761×抑郁-27.491×子女探视-6.125×性别+6.498×文化程度(F=495.423,P=0.000),总说服力为52.20％.结论 城市空巢老人心理坚韧性尚处于中等水平,而且影响城市空巢老人心理坚韧性的预测因素按其影响力强弱依次为社会支持感、抑郁、子女探视、性别以及文化程度.提示可以通过城市空巢老人心理坚韧性的预测因素水平推断其心理坚韧性的整体状况,有利于城市空巢老人积极心态的获得,心理健康的提高.

Objective To investigate the effect of internet-based progressive quiz in the teaching of Paediatric Nursing. Methods Two nursing classes in grade 2014 instructed by the same teacher and their mean score of the tests showing no statistical difference were selected. The 2 classes were randomly divided into test class (n=53)with internet-based progressive quiz in the teaching procedure and control class(n=47)with conventional teaching method. Data were analyzed by SPSS 19.0 and measurement data were compared between groups using independent t-test. Results The scores of 3 periodical tests, final examination in the test class and the evaluation of teacher's feedback were higher than those of control class and differences were statistically significant (P＜0.001). Conclusion Internet-based progressive quiz is effective for promoting students' timely review, helping students to strengthen the professional knowledge and improving the quality of teaching.

目的:应用Delphi法构建助产方向本科护生核心技能评价指标体系,为加强助产人员能力建设提供依据.方法:使用改良Delphi法进行调查,对来自不同类型的医院、大学和行政管理部门的21名妇幼助产领域专家进行咨询,根据指标重要性得分的均值大小筛选指标.结果:两轮咨询专家的应答率分别为95.23%和100.00%.权威系数为0.88和0.89,评价反馈时间为5.6 d、4.5 d;专家意见协调系数为0.214和0.237(P<0.001),各评价指标的变异系数为0.00~0.34(第一轮)、0.00~0.28(第二轮),专家意见较一致.助产方向本科护生核心技能评价指标体系由6个一级指标及73个二级指标构成.结论:助产方向本科护生需要广泛的知识和技能.

Objective To explore the influence of singing therapy on anxiety and depression of patients with stable COPD.Methods Toally 56 COPD patients were divided into intervention group and control group according to random digit table.The control group was provided health education and mental nursing.On the base of treatment for the control group,the intervention group received singing therapy for 24 weeks.The anxiety and depression scale was to measure the anxiety and depression before and 24 weeks after intervention.Results There were no differences in HAD score and HAD-A score and HAD-D score between the groups before intervention (P＞0.05),but after intervention,the differences were significant in terms of the HAD score and HAD-A score and HAD-D score (P＜0.01).The scores of intervention group were significantly lower than those of the control group.For the scores,there was no difference in the control group between pre-and post-intervention (P＞0.05),but the scores after intervention were significantly lower than those before intervention in the intervention group (P＜0.001).Conclusion Singing therapy can effectively alleviate anxiety and depression of COPD patients at the stable state.