目的 了解合并不同疾病的男性骨量异常患者骨代谢指标、骨密度(bone mineral density,BMD)及骨折的情况.方法对2006年1月至2017年12月在上海市第一人民医院内分泌科骨质疏松亚专科就诊的928例男性骨量异常患者进行回顾性研究.根据研究目的不同,将患者分为有或无糖尿病组、有或无慢性肝病组、有或无慢性肾病组、有或无慢性胃病组、有或无心血管疾病组及骨量减低组和骨质疏松组.分别观察各组各项指标的差异.结果单因素回归分析提示受试者年龄、体重、L1～4 BMD、股骨颈BMD、全髋BMD、β-CTX、慢性胃病、骨质疏松症是骨折史的影响因素,差异具有统计学意义(P<0.05);骨折史与受试者年龄、β-CTX、慢性胃病、骨质疏松症因素成正相关,与体重、L1～4 BMD、股骨颈BMD、全髋BMD成负相关;多因素回归分析提示年龄、BALP、2型糖尿病、骨质疏松是骨折的危险因素,而25OHD水平是骨折的保护性因素.结论对于男性骨量异常患者,需要重点关注年龄较大、β-CTX和BALP水平较高、合并慢性胃病以及2型糖尿病的患者,对这类患者应积极进行抗骨质疏松干预及治疗,以减少此类患者骨折的发生率.

目的 探讨早期院后精细化管理方案对髋关节置换术患者康复效果的影响.方法 选择2019年1—12月骨科行髋关节置换术的出院患者30例作为对照组,采取定期医师门诊复查和电话随访的常规回访管理方式;选择2020年1—10月骨科行髋关节置换术的出院患者30例为观察组,在常规回访管理方式的基础上实施早期院后精细化管理方案.干预至术后6个月,比较两组患者髋关节功能、生活质量评分、并发症发生率.结果 观察组髋关节功能优于对照组,洗澡、如厕、平地行走和上下楼梯维度得分高于对照组,差异有统计学意义(P<0.05);两组并发症发生率比较差异无统计学意义(P>0.05).结论 早期院后精细化管理方案能有效改善髋关节置换术后患者髋关节功能康复,提高生活质量.

目的 调查颌面部骨折患者在手术等待期的口腔健康相关生活质量现状,并分析相关影响因素.方法 采用连续抽样法选取2019年6月至2020年11月入院的颌面部骨折患者作为研究对象,于入院24 h内填写口腔健康影响程度量表(OHIP-14),并采集一般社会学人口学信息、面部损伤严重程度(AIS)得分、痛苦程度得分.结果 共回收有效问卷175份,OHIP-14量表总得分为37.90±11.631,其中功能限制维度评分4.90±2.205、疼痛与不适维度12.17±3.742、能力障碍维度10.15±4.20、身心障碍维度10.73±4.359.分析相关影响因素,结果显示婚姻状况是身心障碍维度的影响因素(P<0.05),面部损伤严重程度(AIS)是OHIP-14总得分、能力障碍维度的影响因素(P<0.05),痛苦程度对OHIP-14总得分及4个维度均有显著影响(P<0.05).结论 颌面部骨折患者在术前等待期的口腔健康相关生活质量较差,主要与家庭支持、面部损伤严重程度及创伤所造成的痛苦程度有关.

目的 探讨“坐-立-行”目标性锻炼改善老年脑梗死患者下肢功能障碍的效果.方法 选取2019年6月-9月上海交通大学附属第九人民医院神经内科收治的急性脑梗死患者66例,随机分为试验组和对照组,每组33例.对照组采用护士讲解和制定康复计划等常规康复教育方法;试验组在与对照组相同处理基础上,加用“坐-立-行”目标性强化锻炼康复训练教育模式.采取简化Fugl-Meyer运动功能评定量表评定患者的下肢运动功能、Berg平衡量表评估患者的平衡功能和Barthel指数评估患者的日常生活能力.比较2组患者干预前、出院时、出院1个月及2个月时下肢运动功能、平衡功能和日常生活能力改善情况.结果 2组出院时、出院1个月、2个月下肢运动功能得分、平衡功能得分、Barthel指数均明显高于同组干预前(P＜0.05);且试验组患者均明显高于对照组(P＜0.05).提示试验组患者的下肢运动功能、平衡功能和日常生活能力都明显提高.结论 老年急性脑梗死患者早期进行“坐-立-行”三要素基本动作锻炼,能有效的促进下肢运动功能的康复,改善生活自理能力,提升患者生活质量.

Abstract]? Objective? To investigate the relevant knowledge, attitude and practice (KAP) of the parents of children with cleft lip and palate, so as to provide reference for the further development of health education. Methods? From August 2016 to February 2017, parents of children with cleft lip and palate admitted in a ClassⅢ Grade A general hospital in Shanghai were selected in the study. General Information Questionnaire, General Self-efficacy Scale (GSES), Parents' Knowledge-Attitude-Practice Questionnaire were used in the survey and the status of their KAP on the disease as well as the influencing factors were analyzed. A total of 142 questionnaires were distributed with 116 valid ones collected, yielding an effective recovery rate of 81.7%. Results? 116 parents of children with cleft lip and palate scored (30.84±7.22),(34.35±5.96) and (29.42±5.74) respectively on disease-related KAP. Among them, "knowledge and attitude" scored a medium level, and 57.8% of the children's parents scored a low level on "practice". Univariate analysis showed that children's gender, mother's educational level, mother's smoking and family monthly income were the influencing factors of parents' knowledge about disease;mother's age and drinking were the influencing factors of parents' attitude;monther's age and smoking were the influencing factors of parents' practice (P＜ 0.05). There was a positive correlation between the scores of disease-related practice of parents and self-efficacy (r=0.211,P＜0.05). Conclusions? Parents of children with cleft lip and palate lack knowledge of cleft lip and palate disease, and have positive attitude but poor action. Through effective and individualized health education of cleft lip and palate, it is hopeful to change their understanding and practice about the disease and further promote the health of children with cleft lip and palate.

目的:观察电针刺激伸肌结合辨证取穴对卒中偏瘫患者腕踝关节康复的临床效果.方法:卒中偏瘫患者168例随机分为对照组84例和观察组84例.两组均接受西医内科药物及康复治疗,在此基础上对照组予辨证取穴进行电针治疗,观察组采用电针刺激伸肌结合辨证取穴治疗,疗程两个月,观察日常生活能力(ADL、Barthel指数评分)、患侧肢体痉挛程度(改良Ashworth分级)的变化.结果:治疗后两组Barthel指数评分有显著差异(P＜0.05),治疗后观察组改良Ashworth分级较治疗前有显著差异(P＜0.05).结论:电针刺激伸肌结合辨证取穴可改善卒中偏瘫患者关节活动度、提高日常生活能力.

Objective: To observe clinical effects of Qi-conducting needling method combined with acusector in treating lumbar disc herniation (LDH). Methods: All 150 patients were randomized into two groups, 75 cases each group. The control group was treated by retaining acusector, the observation group accepted Qi-conducting needling method to promote Qi-circulation and then retaining acusector. The course was two weeks. Clinical effects were observed, VAS and JOA scores were counted and classified before and after treating. Results: Total effective rate of the observation group was 98.5％, higher than 94.5％ of the control group, and the difference had no statistical meaning (P＞0.05); the difference had statistical meaning in the comparisons of VAS and JOA scores and the classification before treating within the same group (P＜0.01), the difference had statistical meaning in the comparisons of VAS after treating between both groups (P＜0.05), the difference had no statistical meaning in the comparisons of JOA scores (P＞0.05). Conclusion: Qi-conducting needling method combined with acusector could relieve LDH patients' clinical symptoms including pain, numbness, sore and swelling and others.

目的:观察柴胡疏肝散联合健耳操治疗耳鸣肝郁气滞证的临床疗效.方法:将100例耳鸣肝都气滞证患者随机分为治疗组51例和对照组49例.治疗组采用柴胡疏肝散联合健耳操治疗,对照组采用甲钴胺联合盐酸氟桂利嗪治疗.治疗后观察患者耳鸣程度的改善情况,对比分析2组治疗效果.结果:治疗组总有效率86.27％,对照组总有效率59.18％,2组比较,差异有统计学意义(P＜0.05).治疗前,2组耳鸣残疾评估量表(THI)评分比较,差异无统计学意义(P＞0.05).治疗后,2组THI评分均较治疗前降低,差异均有统计学意义(P＜0.05);治疗组THI评分低于对照组,差异有统计学意义(P＜0.05).结论:柴胡疏肝散联合健耳操治疗肝郁气滞型耳鸣,效果优于甲钴胺联合盐酸氟桂利嗪治疗.

目的 了解正颌手术患者术后不同时间口腔相关生活质量及创伤后成长情况,为正颌患者术后延伸护理提供参考.方法 采用自制的术后不良反应问卷、口腔健康影响程度量表、创伤后成长评定量表于术后1周、术后1个月、术后3个月对53例正颌手术患者进行调查.结果 正颌手术患者术后3个时间段疼痛、麻木、肿胀、咀嚼功能障碍严重程度评分比较,差异有统计学意义(P＜0.05,P＜0.01);口腔健康生活质量总分和功能限制、疼痛与不适、能力受限3个维度评分比较,差异有统计学意义(均P＜0.01);创伤后成长总分和与他人关系、精神变化、对他人的欣赏3个维度评分比较,差异有统计学意义(P＜0.05,P＜0.01).结论 正颌手术患者术后3个月内不良反应程度逐渐减轻,口腔相关功能性生活质量逐渐提高,创伤后成长呈现下降后回升趋势.医护人员应针对患者身心变化特点,给予针对性干预,以促进患者身心康复.

PURPOSE:To determine if 3D-visualization aided preoperative education in patients undergoing orthognathic surgery improves patients' psychological status.METHODS:A total of 240 patients were enrolled in this study,and equally divided into experimental group,and control group.A professionally built 3D-visualization program was used beside regular preoperative education for patients in the experimental group.After preoperative education,basic information,anxiety (SAS) and depression (SDS) were assessed using questionnaire survey.SPSS 17.0 software package was used for statistical analysis.RESULTS:Student's t test showed no difference in patients' age,gender,education background and occupation (P＞0.5) in the two groups.Nine and 11 patients suffered from preoperative anxiety and depression respectively in the control group.Patients in the experimental group showed significant decrease in preoperative anxiety with a ratio of 6.7％ (P＜0.05),and also lower incidence of preoperative depression (8.3％ decrease,P＜0.05) by Chi-square test.CONCLUSIONS:The results suggest that 3D-visualization aided preoperative education can efficiently correct patients' anxiety and depression before surgery,and prepare patients for orthognathic surgery with better performance.

Objective To observe the degree of headache, clinical efficacy and adverse reactions of migraine patients without aura treated with Lixu Qufeng Tongluo prescription. Methods 60 migraine without aura patients were randomly divided into 2 groups. Chinese medicine group of 32 cases were treated with Lixu Qufeng Tongluo prescription, the western medicine group of 28 cases treated with sibelium. Results After treatment, the improvement of headache frequency in TCM group was better than that in western medicine group (P <0.05). The improvement of headache intensity in traditional Chinese medicine group was similar to that of western medicine group (P >0.05).Conclusion Lixu Qufeng Tongluo prescription in the treatment of migraine without aura is better than the routine treatment of western medicine sibelium.

更年期综合征是绝经前后妇女常见疾病,身体、心理、环境和日常饮食等因素均可诱发或加重该病.近年来,中医对更年期综合征的治疗取得了一定进展,且对该病的治疗已慢慢转移到防治老年痴呆、骨质疏松、心血管疾病等伴发疾病方面.

Objective To understand the situation of complicated pulmonary infection after tracheostomy in surgery for head and neck oncology ,provide the reference for preventing and reduce the occurrence of postoperative pulmonary infection.Methods Clinical data of 532 cases were analyzed retrospectively,and the patients were divided into pulmonary infection group (n=80),and non-pulmonary infection group(n=452).The gender,age and time of catheter indwelling were analyzed.Results The age of pulmonary infec-tion group was 22~87 years,(56.11±13.87)years averagely;the indwelling time was 3~58 d,(15.71± 8.87)d averagely.The age of non-pulmonary infection group was 3~88 years,(57.4±14.02)years average-ly,the indwelling time was 2~43 d,(11.35±5.28)d averagely.Compared with female,the male were easy to be complicated with pulmonary infection(χ2=5.340,P=0.013).There was statistical significance of whether to discharge with catheter indwelling between two groups(z=-5.041,P=0.0001).Patients who have tongue,j aw or cheek cancer suffered from pulmonary infection with highest percentage,which were 36.2%,18.8% and 16.2% respectively.Conclusion Patients with the head and neck cancer who received se-lective tracheotomy in surgery have higher incidence of complicated pulmonary infection.More attention should be given to the male and tongue,j aw or cheek cancer patients after surgery,to strengthen the respir-atory tract nursing,and to reduce the incidence of pulmonary infection.

objective After conventional rehabilitation training combined with foot point massage therapy in the early postnatal primipara for rehabilitation,to explore the clinical curative effect of TCM in maternal postpartum pelvic floor muscle rehabilitation. Methods Select 400 cases of postpartum fiber strength abnormal maternal randomly divided into experimental group and control group with 200 cases each. Control group recieves routine rehabilitation therapy ( Kegel training method),and the experimental group using Kegel training combined with point massage to pelvic floor muscle rehabilitation plan,compare two groups patients with muscle voltage and their satisfaction of therapy,and summarize the clinical curative effect. Results The muscle voltage of maternal Ⅰ and Ⅱ class muscle fibers both are improved after rehabilitation therapy,and has significant statistical significance compared with before treatment (P < 0. 01). The muscle voltage of maternal Ⅰ class in treatment group is higher than the one in control group with statistical difference(P < 0. 05). The satisfaction rate of two groups of patients is overall above 80. 5% ,and espe-cially the rate is 90% in treatment group with statistical significance(P < 0. 05). Conclusion Acupuncture point massage combined with rehabilitation training on the postpartum fiber strength abnormal maternal rehabilitation thera-py,can help to improve maternal Ⅰ and Ⅱclass muscle fiber voltage and the study point out the therapy has good curative effect for maternal pelvic floor muscle function rehabilitation.

Objective To analyze influence factors of nursing dependence on patients with oral and maxillo-facial surgery in hospital,to provide reference for personalized care for the patient.Methods 101 cases of inpatients were selected and investigated by using general information scale,the exercise of self-care agency scale and care dependency scale.Results Oral surgical inpatients were in the middle low level about nurs-ing degree of dependence,and nursing dependency score was 54.52 ± 12.871;The degree of dependence of male patients was higher than that of female (t=-2.547,P<0.05).There was significantly difference be-tween the scores of nursing care of patients with different diseases (F=28.858,P<0.01).The score was higher about dependence nursing care of patients with oral and facial tumor j aw inj ury.Patients’self-nurs-ing ability had weak positive correlation with nursing dependence (r=0,163).Conclusion Gender and dis-ease affect degree of nursing dependence oral and maxillofacial surgery,although the same level of patients with routine nursing care,nursing dependence has a certain difference.

无抽搐电休克(MECT)治疗是治疗精神科相关疾病中使用较广、疗效较好的一种方法 [1] 。但是由于MECT治疗过程中,仍会出现一些不良反应 [2] ,再加上患者和家属对MECT不了解,认为MECT治疗就是用电击,恐惧发生意外,认为会留下后遗症 [3] ,使患者产生诸多不良心理反应。为了减轻应激源对患者造成的心理压力,减少不适感 [4] ,减轻不良心理

Objective To build standardized and timeliness perioperative rehabilitation training program of limb function for traumatic spinal cord injury patients based on evidence-based medicine through literature review and the Delphi experts consultation methods.Methods Using Delphi experts consultation methods to structure perioperative rehabilitation training program of limb function for patients with traumatic spinal cord injury.Totally 113 patients from bone spine and bone trauma departments of 3 comprehensive hospitals were selected and divided into control group and limb function rehabilitation training group.Master degree and complication incidence were compared between the two groups.Results Body active passive exercise method,pain reporting and alleviate pain methods,prevention methods and knowledge significance of various complications after discharge in the training group is significantly better than those in the control group(P<0.05).Complications incidence of ROM reduce,abdominal distension and constipation in the training group were significantly less than those in the control group(P<0.05).Conclusion Implementation of traumatic spinal cord injury patients perioperative limb function rehabilitation training scheme can improve the mastery degree of limb function rehabilitation related knowledge,obviously reduce the postoperative complications,and promote the patients' limb function recovery and quality of life.