中华细胞与干细胞杂志关于“新型冠状病毒疫情”的征稿通知

自新型冠状病毒疫情暴发以来,全国上下团结一心为战胜疫情进行艰苦、顽强的斗争。目前已有2万多名医务工作者奔赴武汉,奋战在抗击疫情的第一线。众所周知,新型冠状病毒给医务人员的预防和治疗工作带来严峻的挑战,人类正在努力寻求更有效更积极的防治方法和途径,而干细胞治疗作为一种新型治疗方法被诸多专家学者提出,则受到极大的关注与重视。为了更好地服务医务人员和科研工作者,杂志为努力搭建疫情防控经验交流,指导临床工作开展,打赢疫情阻击战尽一份绵薄之力。《中华细胞与干细胞杂志》特向全国医务工作者征集关于"新型冠状病毒疫情"相关的研究成果,包括述评·、专家论坛、专家建议、诊治经验、调查研究、病例报告等文章。     

新型冠状病毒肺炎疫情防控期间内镜诊疗相关感染防控建议

针对2019年底出现在我国的新型冠状病毒肺炎疫情,全国上下拼尽全力积极抗疫。目前全国疫情在得到良好控制的同时,各大医疗机构为防控疫情纷纷暂停的各项高风险诊疗项目也陆续开诊。由此根据国家卫生健康委员会最新发布的《新型冠状病毒肺炎诊疗方案(试行第八版)》及《新型冠状病毒肺炎防控方案(第七版)》等文件,结合相关国家规范对新型冠状病毒肺炎疫情防控期间消化内镜、支气管镜及喉镜(软镜)诊疗的感染防控措施进行梳理和总结,提出相关建议以供临床医务工作者参考。     

医院支持性人力资源、组织承诺与医务工作者敬业度关系研究?

??????? 目的 基于人力资源管理学的研究视角，应用结构方程模型，研究医院支持性人力资源实践、组织承诺与医务工作者敬业度的关系，找到改善与提高医务工作者敬业度的方法与途径。方法 利用Amos软件对结构方程模型路径系数及其显著性进行检验分析。结果 医院支持性人力资源实践对医务工作的敬业度不存在直接正向促进关系，而是通过组织承诺这一中介变量正向作用于敬业度。结论 对于医院管理者来说，想要通过支持性人力资源实践提高医务工作者的敬业度，必须首先提高医务工作者的组织承诺，通过组织承诺提高敬业度。     

我国中医医院医务工作者离职意愿及其影响因素分析

目的 调查分析我国中医院医务工作者离职意愿及其离职影响因素,为完善中医院人才管理建言献策。 方法 采用自制的问卷和工作认同量表,运用分层抽样与整群抽样相结合的方法,对我国5省17家中医院共1 096名医务工作者进行了调查。 结果 41.9%的中医院医务工作者有离职意愿;中西部地区、市级医院、年龄≤40岁、已婚、较高职称、认为绩效考核无作用、收入不满意的工作者离职意愿显著更高,人才非正常流失现象较严重;工作认同各维度中工作满意度与组织认同对离职意愿有较关键的负相关影响。 结论 中医院管理层应当有针对性地设计实施人才管理,充分利用收入因素与绩效考核,着力提升职工的工作满意度和组织认同。     

浅谈皮防工作者的思想政治工作

皮肤病防治站作为一种面向大众性、社会性的服务机构,其本身的主要载体是医务工作人员。其思想政治状况的好坏直接关系到皮防工作的医疗水平、社会影响的好坏,甚至还关系到政府的形象。当前,皮防工作者的思想政治工作总体情况是好的。但是在局部,皮防工作者的思想政治工作仍处在一种传统教育模式下。这从根本上阻碍了整个皮防工作水平的发展。为此,加强皮防工作者思想政治工作建设,对皮防工作者思想政治工作进行创新就势在必行了。     

医务社工与志愿者在医院服务管理中作用的评价

目的 通过实证调查采集患者、医务工作者和志愿者对医务社工及志愿者工作的评价,解析医务社工及志愿者在医院服务管理中的作用。方法 采用问卷调查、文献查阅、深度访谈法,调研上海市三家三级甲等公立医院获取第一手资料。结果 调查结果显示,患者、医务人员及医务管理人员高度认可医务社工与志愿者在医院服务管理的作用。结论 医务社工和志愿者在医院服务管理中能发挥独特的作用,可以增进医患沟通,缓解或预防医患矛盾,给患者更多人文关怀和增值服务,一定程度上解决医患之间的诊治经费问题,提升服务品质、降低人力成本,应当得到全社会更多的重视。     

运用新方法培养念珠菌的体会

近年来随着广谱抗生素、免疫抑制剂和抗肿瘤药物的广泛应用,临床上念球菌的感染明显增多,已引起广大医务工作者的重视。为了进一步研究和改进试验方法,提高检测手段,是检验工作者一项重要工作。本文对本院近一年来临床标本所分离出的念珠菌加以分析,结果表明念珠菌的...     

急性肺栓塞常用检查方法及效果评价

肺动脉栓塞的诊断虽在临床工作中较少见到,但却是一种常见的致死性急症,却易被广大临床医务工作者所忽视。本文综述几种简单有效的检查方法,以提高急性PE的诊断率及便于及早治疗并降该病的病死率,并为进一步防治肺动脉栓塞提供参考依据。     

老年糖尿病健康教育的临床伦理学思考

在糖尿病健康教育中,老年糖尿病健康教育的特殊性却常被忽视。从医学伦理学角度出发,分析了老年糖尿病健康教育的特殊性常被忽视的原因有:患者错误的医疗观念和临床医务工作者对老年糖尿病健康教育的认识不足。对这类老年糖尿病健康教育的医德要求有:首先医务工作者要对老年糖尿病健康教育有正确的认识;其次正确处理与协调医患关系和科室间关系;最后正确选择老年糖尿病健康教育的伦理道德观。     

乙肝疫苗HEVAC对乙型肝炎高危传染人群免疫学及流行病学效果观察

<正>作者于莫斯科给予密切接触血液或血液制品的215名医务工作者接种法国巴斯德研究所研制的06AI乙肝疫苗HEVAC(每ml含HBsAg5.34微克,福尔马林0.0048毫克,氢氧化铝0.325毫克),每次接种1毫升。预防乙型肝炎。对其效果进行免疫学和流行病学调查。作者随机选155名非HBsAg携带者和抗—HBs阴性的医务工作者为对照组。结果     

Effects of inhaled nicotine on instrumental learning of blood pressure responses.

The present study investigated the effects of biofeedback of arterial blood pressure on cortical, peripheral, and psychological measures and the dependence of these effects on nicotine. Four groups of subjects, nonsmokers, and habitual smokers who smoked cigarettes during the experimental sessions containing 0.3, 0.8, or 1.5 mg nicotine, respectively, participated in a feedback paradigm in which continuous feedback of mean blood pressure was provided for intervals of 8 s each. While tonic blood pressure did not differ between the groups, the ability to modulate blood pressure (under feedback conditions) was restricted in smokers as compared to nonsmoking subjects; increasing nicotine dosage was accompanied by poorer performance. Independently of habitual smoking and nicotine doses, heart rate increased during feedback and under conditions of blood pressure increase. In smokers, activity in the alpha band was reduced in a dose-dependent manner. Slow cortical potentials (SCPs) during the feedback interval varied with self-induced blood pressure changes in nonsmokers (blood pressure increase was accompanied by reduced surface-negative potential shifts and vice versa), while SCP variations during feedback conditions were small in smokers, more so under the influence of 0.3 and 0.8-mg nicotine, less so under 1.5 mg. Verbal reports suggest that awareness of performance strategies may not be a necessary variable for performance on the blood pressure regulation task.     

Investigation on psychological state of occupational exposure of medical staff in operation room under novel coronavirus

This article mainly explores the psychological state of occupational exposure of medical staff in operation room contaminated with novel coronavirus, and provides targeted suggestions for mental health service of medical staff so as to maintain their physical and mental health. On February 28, 2020, a questionnaire survey was conducted using Internet. Nurses, anesthesiologists and surgeons in the operating room of the First Affiliated Hospital of Harbin Medical University from January 2020 to March 2020 were selected as the research objects. The psychological state of medical staff was investigated by SAS and PSS-14. As on February 29, 2020, 301 valid questionnaires and one invalid questionnaire were received. The survey showed that there was anxiety but no moderate or severe anxiety in the occupational behavior of operating room medical staff, while some medical staff had a certain degree of psychological pressure (P < 0.05). The present survey suggested that medical staff was under anxiety and pressure in different degrees in the operation room because of novel coronavirus contamination during occupational activities, much attention is required to improve mental health of medical professionals and to reduce their negative emotions.     

Effects of inhaled nicotine on instrumental learning of blood pressure responses

The present study investigated the effects of biofeedback of arterial blood pressure on cortical, peripheral, and psychological measures and the dependence of these effects on nicotine. Four groups of subjects, nonsmokers, and habitual smokers who smoked cigarettes during the experimental sessions containing 0.3, 0.8, or 1.5 mg nicotine, respectively, participated in a feedback paradigm in which continuous feedback of mean blood pressure was provided for intervals of 8 s each. While tonic blood pressure did not differ between the groups, the ability to modulate blood pressure (under feedback conditions) was restricted in smokers as compared to nonsmoking subjects; increasing nicotine dosage was accompanied by poorer performance. Independently of habitual smoking and nicotine doses, heart rate increased during feedback and under conditions of blood pressure increase. In smokers, activity in the alpha band was reduced in a dose-dependent manner. Slow cortical potentials (SCPs) during the feedback interval varied with self-induced blood pressure changes in nonsmokers (blood pressure increase was accompanied by reduced surface-negative potential shifts and vice versa), while SCP variations during feedback conditions were small in smokers, more so under the influence of 0.3 and 0.8-mg nicotine, less so under 1.5 mg. Verbal reports suggest that awareness of performance strategies may not be a necessary variable for performance on the blood pressure regulation task.This experiment was supported by Reemtsma Inc. Hamburg, which also provided the experimental cigarettes.     

Individual reactions and psychophysiologic reactions in patients with mild primary hypertension]

Fourteen male patients with mild hypertension, aged between 20 and 46 years (mean = 32.4 years) measured their arterial blood pressure thrice daily for 6 weeks. Prior to and after this period psychological tests were carried out, including Gough's ACL test and Spielberger's STAI questionnaire. All patients underwent also Kraeplin's test under stress conditions twice during the experiment. It was found that there is significant correlation of personality response syndromes such as: need for acceptance, inferiority complex, need for success, trust to themselves, anger and some values of blood pressure. So-called personality syndrome related to hypertension was established. Psychophysiological picture accompanying emotional stress was discussed and relationship between blood pressure values (prior to and after emotional stress) and personality syndromes were defined.     

心理干预对肿瘤内科患者心理状态和生活质量的影响

摘要目的：调查了解肿瘤内科住院患者的常见心理问题,探讨心理干预对肿瘤内科住院患者心理状态和生存质量的改善作用。方法：对我院2011年3月-2012年4月肿瘤内科86例住院患者随机分为常规治疗组和心理干预组,采取问卷调查及访谈相结合的方式对患者心理问题和生活质量进行调查。结果：对86例目标患者进行数据分析,两组患者在治疗前心理状态没有显著性差别,生存质量测定量表各个项目的评分无显著性差别;经治疗后,心理干预组的心理问题明显改善（p〈0．05）,生存质量评分显著高于常规治疗组（P〈0．05）。结论：多数肿瘤内科住院患者都存在不同程度的心理问题,实施针对性的心理干预措施,可以有效缓解其心理问题并提高生存质量。     

医学研究生失眠现状及其相关因素的调查研究

目的了解医学研究生失眠现状及其相关因素,为提高医学研究生生活质量和促进高层次人才的培养提供建议。方法采用一般资料调查表、阿森斯失眠量表及中文版压力知觉量表于2020年4月17日~5月2日通过网络平台对某医科大学在读硕士研究生进行问卷调查,并进行统计分析。结果本研究共收集416份有效问卷,有45.9%的在读医学研究生发生失眠;阿森斯失眠量表平分为(5.6±3.8)分,压力知觉量表平分为(27.3±7.9)分,其中压力正常者占65.4%,压力较大者占30%,压力太大者占4.6%。压力知觉总体处于正常水平,压力知觉和失眠量表得分呈正相关关系(r=0.51,P<0.01)。结论医学研究生的压力知觉及睡眠状况不容乐观,且压力与睡眠之间存在相关关系。提示有关部门应针对这一群体提供心理和社会支持和相应的医疗支持,以促使医学研究生采取积极的态度和行为应对压力,改善睡眠质量。     

全程心理疏导预防全麻术后导尿管刺激躁动的临床观察

目的:评价全程心理疏导预防全身麻醉术后导尿管刺激躁动的临床效果。方法:全麻下实施胆囊切除手术的80例男性患者为观察对象,随机均分为全程心理疏导组(Ⅰ组)和对照组(Ⅱ组),每组40例。Ⅰ组:术前、麻醉诱导前、苏醒后均对患者施行个体化心理疏导,根据患者具体情况进行沟通,解除其焦虑与恐惧心理。Ⅱ组:常规访视,不进行全程心理疏导。飞利浦多功能监测仪连续监测ECG、HR、SpO2及每3分钟监测一次BP,记录入室后MAP、HR的基础值(T0)、术毕(T1)、拔管后3 min(T2)、10 min(T3)、20min(T4)的血流动力学变化,观察记录拔管后患者因尿管刺激引发躁动评分。结果:Ⅰ组患者苏醒期对尿管刺激反应程度明显低于Ⅱ组,患者在苏醒期血压、心率也较稳定。结论:全程心理疏导可以预防、减轻全麻术后因导尿管刺激而引发的躁动。     

Pressor reactions to psychological stress and prediction of future blood pressure: data from the Whitehall II Study.

OBJECTIVE--To examine whether reactions of blood pressure to psychological stress predict future blood pressure. DESIGN--Blood pressure was recorded at a medical screening examination after which pressor reactions to a psychological stress task were determined. Follow up measurement of blood pressure was undertaken, on average, 4.9 years later. SETTING--20 civil service departments in London. SUBJECTS--1003 male civil servants aged between 35 and 55 years at entry to the study. MAIN OUTCOME MEASURE--Blood pressure at follow up screening. RESULTS--Reactions of systolic blood pressure to stress correlated positively with systolic blood pressure at follow up screening (r = 0.22, P < 0.01). The dominant correlate of follow up blood pressure was blood pressure at initial screening (r = 0.60; P < 0.01 between initial and follow up systolic blood pressure; r = 0.59, P < 0.01 between initial and follow up diastolic blood pressure). Stepwise multiple regression analysis indicated that reactions to the stressor provided minimal prediction of follow up blood pressure over and above that afforded by blood pressure at initial screening. In the case of follow up systolic blood pressure, systolic reactions to stress accounted for only 1% of follow up variance; systolic blood pressure at initial screening accounted for 34%. With regard to diastolic blood pressure at follow up, the independent contribution from diastolic reactions to stress was less than 1%. CONCLUSION--Pressor reactions to psychological stress provide minimal independent prediction of blood pressure at follow up. Measurement of reactivity is not a useful clinical index of the course of future blood pressure.     

心理干预对肿瘤患者围术期焦虑及抑郁的影响

目的:探讨心理干预对围术期肿瘤患者焦虑及抑郁的影响。方法:选取2013年6月到2014年6月在我院接受手术治疗的肿瘤患者300例,随机分为研究组和对照组,对照组150例患者给予常规基础护理,研究组患者在常规护理的基础上给予心理干预。观察并比较两组患者干预前后的心率和血压变化情况。采用抑郁自评量表(Self-rating depression scale,SDS)和焦虑自评量表(Self-Rating Anxiety Scale,SAS)对患者的心理状况进行评价。结果:干预前,两组患者的心率、血压、SDS及SAS评分无显著差异(P>0.05);干预后,研究组患者的心率、血压、SDS及SAS评分显著优于对照组,差异具有统计学意义(P<0.05)。结论:心理干预能显著减轻肿瘤患者围术期焦虑及抑郁状况,有利于维持患者血压和心率稳定。     

Impact of Mental and Physical Stress on Blood Pressure and Pulse Pressure under Normobaric versus Hypoxic Conditions

Objective

Hypobaric hypoxia, physical and psychosocial stress may influence key cardiovascular parameters including blood pressure (BP) and pulse pressure (PP). We investigated the effects of mild hypobaric hypoxia exposure on BP and PP reactivity to mental and physical stress and to passive elevation by cable car.

Methods

36 healthy volunteers participated in a defined test procedure consisting of a period of rest 1, mental stress task (KLT-R), period of rest 2, combined mental (KLT-R) and physical task (bicycle ergometry) and a last period of rest both at Graz, Austria (353 m asl) and at the top station Dachstein (2700 m asl). Beat-to-beat heart rate and BP were analysed both during the test procedures at Graz and at Dachstein and during passive 1000 m elevation by cable car (from 1702 m to 2700 m).

Results

A significant interaction of kind of stress (mental vs. combined mental and physical) and study location (Graz vs. Dachstein) was found in the systolic BP (p = .007) and PP (p = .002) changes indicating that during the combined mental and physical stress task sBP was significantly higher under hypoxic conditions whereas sBP and PP were similar during mental stress both under normobaric normoxia (Graz) and under hypobaric hypoxia (Dachstein). During the passive ascent in cable car less trivialization (psychological coping strategy) was associated with an increase in PP (p = .004).

Conclusion

Our data show that combined mental and physical stress causes a significant higher raise in sBP and PP under hypoxic conditions whereas isolated mental stress did not affect sBP and PP under hypoxic conditions. PP-reaction to ascent in healthy subjects is not uniform. BP reactions to ascent that represents an accumulation of physical (mild hypobaric hypoxia) and psychological stressors depend on predetermined psychological traits (stress coping strategies). Thus divergent cardiovascular reactions can be explained by applying the multidimensional aspects of the biopsychosocial concept.