目的 探讨乙型肝炎病毒（HBV）表面抗原（HBsAg）阳性肝硬化患者血清中HBV前S1抗原(前S1抗原)、HBV e抗原（HBeAg）及HBV核酸定量检测（HBV DNA）相关性。 方法 2008年7月－2011年5月对97例HBsAg阳性肝硬化住院患者和50份HBsAg阴性的健康体检者血清进行前S1抗原、HBV血清标志物检测及实时荧光定量PCR检测HBV DNA结果进行分析。 结果 97份HBsAg阳性肝硬化患者血清中，前S1抗原、HBeAg及HBV DNA阳性率分别为53.6%（52/97）、22.7%（22/97）及61.8%（60/97）。22例HBeAg阳性血清中，前S1抗原阳性18例（81.8%）， HBV DNA阳性20例（90.9%)。75例HBeAg阴性血清中，前S1抗原阳性34例（45.3%），HBV DNA阳性40例（53.3%），两者的前S1抗原与HBV DNA结果间都具有很好的相关性。HBV DNA含量与前S1抗原及HBeAg阳性结果显示：HBsAg阳性的肝硬化患者血清中HBV DNA阴性率为38.1%（含量＜103 copies/mL），而阳性检出率HBV DNA含量主要集中在103～105 copies/mL，占81.7%（49/60），HBV DNA含量＞105 copies/mL占18.3%（11/60）。 结论 HBsAg阳性的肝硬化患者血清中主要以HBV非HBeAg阳性血清学模式为主，HBV DNA阳性检出率的含量主要集中在103～105 copies/mL。前S1抗原在HBeAg阳性血清中与其含有HBsAg病毒及HBeAg阳性患者具有很好的相关性，而在HBeAg阴性血清中存在着差异。Objective To study the correlation among Pre-S1 antigen, HBeAg and HBV DNA results in patients with HBsAg-positive liver cirrhosis. Methods We retrospectively analyzed the serum pre-S1-antigen, HBV serum markers and real-time quantitative PCR HBV DNA results in 97 patients with HBsAg-positive liver cirrhosis and 50 HBsAg-negative healthy volunteers in our hospital from July 2008 to May 2011. Results Among the 97 samples of HBsAg-positive liver cirrhosis patients’ serum, the positive rates of Pre-S1 antigen, HBeAg and HBV DNA were 53.6% (52/97), 22.7% (22/97) and 61.8% (60/97), respectively. In the 22 samples of HBeAg-positive serum, the number of positive pre-S1 antigen and HBV DNA was 18 (81.8%) and 20, respectively. In the 75 samples of negative HBeAg serum, the number of positive pre-S1 antigen and HBV DNA was 34 (45.3%) and 40 (53.3%) respectively. The pre-S1 antigen was correlated well with HBV DNA results in both the two groups. HBV DNA level, pre-S1 antigen and HBeAg-positive results showed that the serum HBV DNA negative rate of HBsAg-positive patients with cirrhosis was 38.1% (＜103 copies/mL), while the positive rate of HBV DNA level was mainly concentrated at 103~105 copies/mL, accounting for 81.7% (49/60), and HBV DNA level over 105 copies/mLaccounted for only 18.3% (11/60). Conclusions HBsAg-positive patients with cirrhosis mainly have a serum non-HBeAg-positive HBV serology pattern, and HBV DNA positive rate of the content is mainly concentrated at 103~105 copies/mL. There is a good correlation between pre-S1 antigen in HBeAg-positive serum and patients with HBsAg virus or positive HBeAg, while for Pre-S1 antigen in HBeAg-negative serum, it is quite different.
目的 了解高校护理本科生（下称护生）在临床实习阶段对带教教师的具体期望，为临床带教老师的培养提供依据。 方法 以杜威的反思思维理论为基础，使用Van Manen的诠释现象学研究方法暨反思日记分析，于2011年1月对67名护生的临床反思日记进行分析；同时采用自行设计的问卷就护生对临床教学的评价进行调查。 结果 护生对临床带教教师的反思主要集中于5个主题，即期望带教老师制定合理的、有针对性的带教计划并采用灵活多样的教学手段，期望得到带教老师的肯定和鼓励，期望得到独立实践护理角色的机会，期望带教老师注重培养护生的临床思维能力，期望带教老师拥有良好的综合素质；护生对临床教学评价总平均分为（4.51 ± 0.06）分，得分率为87.3%。 结论 临床带教老师在不断提升自身综合素质的同时，应根据护理本科人才能力培养目标制定合理的实习计划，选择恰当的教学方式，提供良好的临床学习环境，以进一步提高临床教学质量。
Objective To investigate the prevalence of depression in patients with chronic obstructive pulmonary disease ( COPD) and risk factors. Methods 215 patients with stable COPD were recruited in the study. The Patient Health Questionnaire-9 ( PHQ-9) standardized scale were performed for the depression survey. Meanwhile CAT, pulmonary function test and the history taking ( sex, age, height, weigh, smoking status, education level) were applied to evaluate all the COPD patients. The COPD patients were classified into A, B, C, and D groups according to 2011 GOLD new COPD classification system. Pearson chi-square test and multivariate logistic modeling were used to estimate the prevalence of depression and the risk factors. Results The prevalence of depression in COPD patients whose PHQ-9 scores ≥7 was 37.7% with 18.5% , 35.8% , 46.5% , and 62.5% respectively in A, B, C, and D groups. There was significant difference in prevalence between each groups ( Plt;0.05) . Compared with the COPD patients without depression, the COPD patients with depression had younger age, more female, higher education level, higher CAT scores and smaller means of body mass index ( BMI) . Logistic analysis revealed that depression in COPD was associated with age, sex, education level, BMI, FEV1% pred and CAT scores. The patients who with younger age, female sex, higher education level, lower FEV1% pred, lower BMI and higher CAT scores were had higher rsik to be complicated with depression. However no significant difference was observed between different FEV1 /FVC or smoking status. Conclusions This study confirms the high prevalence of depression in patients with stable COPD, and the prevalence in A, B, C, and D groups of COPD are different. Sex, age, education level, FEV1% pred, BMI, and CAT scores are the risk factors of depression in COPD.
Objective To explore the effect of antihypertensive therapy for hypertension patients from plateau area. Method A retrospective analysis of medical records for Tibetan patients with hypertension from October to December 2013 in Hospital of Chengdu Office of People’s Government of Tibetan Autonomous Region. Results The study recruited 165 patients. The rate of treatment, control, and compliance of hypertension patients were 86.7% (143/165), 23.8% (34/143), 43.4% (62/143), respectively. The main characteristics of hypertension treatment were higher proportions of single-drug therapy (81.1%, 116/143); among those the Tibetan drug (24.1%), calcium channel blockers (21.6%), diuretics (19.0%), and traditional compound preparation (18.1%) were most commonly used in the antihypertensive therapy. Conclusions The rate of treatment was high, but the rate of control and compliance were low in Tibetan patients with hypertension. It was necessary to carry out hypertension education to patients and strengthen the training of doctors at the plateau.