ABSTRACT
Objective Investigate and intervene the psychological health state of clinical trainees in the hospital of Yuxi City, in order to explore the method to improve the psychological health and clinical quality of teaching. Methods From 2009 to 2013, clinical trainees were investigated by SCL-90. Intervention for interns included holding psychological health lectures and making psychological counseling for the serious interns. At the same time, the teachers were trained to carry out two-way intervention between the teachers and clinic interns and to improve clinical interns' psychological health. Results Before the intervention,among 216 interns,34 (15.74%) showed positive. Except fear factor, other factors were significantly different than national norms ( <0.05). After the intervention, among 149 interns, 20 ( 13.42%) showed positive. Obsessive-compulsive symptom, depression,anxiety,hostility, spirit factors and the mean scores were all lower than before ( <0.05),similar to the national norm.Conclusion Clinical trainees have prominent psychological problems. Teaching hospitals should pay more attention to psychological health of them. Intervention is necessary and effective in improving psychological health and quality of teaching.
ABSTRACT
Objective To investigate the effects of biatrial infusion on pulmonary artery pressure (PAP)after cardiopulmonary bypass (CPB) in patients undergoing mitral valve replacement.Methods Twenty NYHA Ⅱ or Ⅲ patients aged 22-53 yr weighing 34-57 kg undergoing mitral valve replacement complicated by pulmonary hypertension (mean pulmonary artery pressure (MPAP) ＞ 50 mm Hg) were randomly divided into 2 groups ( n = 10 each): infusion via right atrium group (group R) and infusion via both atria group (group B). After induction of anesthesia, a three cavity floating Swan-Ganz catheter was placed via right internal jugular vein to monitor CVP,PAP, pulmonary capillary wedge pressure (PCWP) and CO. The patients received infusion of prostaglandin E1 30-150 ng· kg- 1 · min - 1 and phenylephrine 0.2-0.6 μg· kg- 1 · min- 1 via central veins in group R and infusion of prostaglandin E1 30-150 ng·kg-1 ·min-1 via central veins and phenylephrine 0.2-0.6 μg·kg-1 ·min-1 via left atrium in group B. MAP, HR, MPAP, PCWP, CVP and CO were recorded 5 min before administration (T0), and 5,10, 30 and 60 min after administration (T1-4). Pulmonary vascular resistance index (PVRI), systemic vascular resistance index (SVRI) and CI were also calculated. Results D:\1111111111\MDB\zhmzxzz98201008.mdbCompared with the value at T0, MAP, MPAP, PCWP and PVRI were significantly decreased, while CI was increased at T1-4 in group R, and MAP, CI and SVRI were significantly increased, while HR, MPAP, PCWP, CVP and PVRI decreased at T1-4 in group B ( P ＜ 0.05).MAP, CI and SVRI were significantly higher, while HR, MPAP, PCWP, PVRI and CVP lower in group B than in group R ( P ＜ 0.05). Conclusion Biatrial infusion can effectively reduce PAP and pulmonary vascular resistance after CPB in patients undergoing mitral valve replacement.