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Objective:To investigate the status and their relationship of new nurses ′ transition shock, spiritual climate and nurses ′ intention to stay on the job, to explore the mediating effect of transition shock between spiritual climate and intention to stay among newly graduated nurses. Methods:A convenient sampling method was used from October to December in 2019 to investigate 231 new graduate nurses from four hospitals in Qingdao City with the general data questionnaire, the New Nurses ′ Transition Shock Scale, the Nurses ′ Intention to Stay on the Job Scale and the Spiritual Climate Scale. Results:The total score of new nurse retention intend was (20.65 ± 4.30) points, spiritual climate score was (63.20 ± 19.28), and transition shock score was (82.92 ± 22.33) points. Transition shock was negatively correlated with spiritual climate and intention to stay ( r values were -0.451, -0.548, P<0.01) ; spiritual climate was positively correlated with intention to stay ( r value was 0.450, P<0.01). Transition shock played a partial mediating role in spiritual climate and intention to stay (37%). Conclusions:Spiritual climate of the work environment can directly or indirectly affect the intention to stay through the transition shock among newly graduate nruses. Managers can take appropriate intervention measures to improve the spirit climate of the department, alleviate the impact of new nurses ′ transformation and stabilize nursing team.
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Objective: To evaluate the effects of different doses of naloxone combined with dezocine on postoperative analgesia in patients with breast cancer. Methods: One hundred and twenty patients with modified radical mastectomy were enrolled in the Tianjin Medical University Cancer Institute and Hospital, between May 2018 and January 2019. The patients were randomly assigned into group L, group M, group H, and group C (n=30). Patients in each group were administered 0.15 mg/kg of dezocine. Patients in group L, group M, and group H were intravenously instilled with naloxone (0.5, 1.0, and 1.5μg/kg, respectively), while patients in group C were administered equal volumes of normal saline. We recorded the time of awakening and removing the laryngeal mask in each group, and the blood pressure and heart rate of each patient around the time of removing the laryngeal mask. We determined the visual analog scale (VAS) scores of pain, Bruggrmann comfort scale (BCS) scores, and Ramsay sedation scores at 1h (T1), 6h(T2), 12h (T3), and 24h (T4) postoperatively, and the number of remedial analgesia and postoperative adverse reactions were recorded in each group after surgery. Results: The time of awakening and removing the laryngeal mask in group L, group M, and group H were shorter than that in group C, and group M had the shortest awakening time (P<0.05). The VAS scores of the patients in group M at T1, T2, and T3 were lower than those in the other three groups (P<0.05). The number of postoperative remedial analgesia and adverse reactions in group C were higher than those in the other three groups (P<0.05). Conclusions:Naloxone (1.0 μg/kg) combined with dezocine (0.15 mg/kg) can enhance the postoperative analgesic effect of dezocine, shorten the awakening time, and reduce the adverse reactions.
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Objective To explore the clinical features of female diagnosed recurrent major depression (MD) comorbidity with general anxiety disorder (GAD).Methods 301 females patients with recurrent major depression were interviewed by specially trained interviewers with using computer evaluation system and divided into comorbidity group and non-comorbidity group according to whether comorbid MD with GAD or without GAD.The comparison between the two groups included items of demographic,clinical data,assessment of psychopathology,Eysenck neuroticism questionnaire (EPQ),stressful life events,parental bonding instrument.Results 25.2％ of patients of MD coexistence GAD.There was no significant difference in sociodemographic data between the two groups.Significant differences among total number of depression symptoms(OR=1.439,95％ CI =1.049-1.975,P =0.024),duration of illness(OR=1.253,95％ CI =1.010-1.475,P=0.048),psychomotor agitation(OR=2.031,95％ CI =1.123-3.676,P=0.019),suicidal thought(OR=2.228,95％ CI =1.010-4.912,P=0.047),anxiety(OR =5.547,95％ CI =1.935-15.896,P=0.001),irritable(OR=1.956,95％ CI =1.081-3.542,P=0.027) were identified between the two group.In the comorbidity group,the score of nenroticism dimention derived from EPQ was also higher(OR=2.287,95％ CI =1.674-3.124,P=2.287× 10-7) than that of non-comorbidity group.There was no significant difference of stressful life events between two groups(OR=1.118,95％ CI =0.913-1.368,P=0.280).Conclusion This study suggests the phenomena that female patients of recurrent depression disorder comorbidity with general anxiety disorders is common in clinical.The patients comorbid MD and GAD have more symptoms,neuroticism and be worse in severity.
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Objective To explore the clinical features of female recurrent major depression(MD) patients with and without suicidal ideation.Methods 301 female recurrent major depression patients were interviewed by specially trained interviewers using computer evaluation system and divided into suicidal ideation group and non-suicidal ideation group according to suicidal ideation.The comparisons between the two groups were investigated on items of demographic, clinical data, assessment of psychopathology, Eysenck neuroticism questionnaire, stressful life events.Results 66.4％ of MD patients have suicidal ideation.Compared with non-suicidal ideation group, there were more total number of MD symptoms (8.58±0.77, OR=2.476, P=1.154× 10-9) and melancholia symptoms (6.74±1.07, OR=1.546, P=0.001) and it was more common in the factors of less appetite (OR=2.201, P=0.011), lose weight (OR=2.030, P=0.004), early morning awakening (OR=1.774, P=0.045), worthless (OR =2.352, P=0.014), impaired decision-making (OR=2.044, P=0.018), hopelessness (OR=7.130, P=6.651 × 10-9) ,helpless (OR=2.046, P=0.049) in suicidal ideation group.Also in suicidal ideation group the scores of neuroticism dimension (OR=1.631, P=0.024) were higher, and they were more suffered from stressful life events (OR=1.302, P=0.008).Binary logistic regression analysis indicated that total number of MD symptoms (OR=4.840, P=1.154×10-8) ,stressful life events (OR=1.392, P=0.014) and hopelessness (OR=3.528, P=0.008)were significantly associated with suicidal ideation.Conclusion Specific clinical features are associated with suicidal ideation among female patients of recurrent depression disorder.Hopelessness, stressful life events are risk factors of suicide ideation in female recurrent major depression patients.Integrated clinical assessment should be taken for recurrent major depression patients with suicidal ideation.
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Objective To compare the effects of different anesthesia on immunologic function during perioperative radical mastectomy in patients having undergone preoperative chemotherapy. Methods Sixty ASA Ⅰ or Ⅱ patients, aged 28-64 yr, weighing 55-70 kg, scheduled for radical mastectomy, were studied. Thirty patients received preoperative chemical therapy for 3-4 weeks were randomly divided into CP group and CS group ( n = 15 each); thirty patients received no chemical therapy were also randomly divided into NCP group and NCS group (n=15 each).Propofol at a rate of 4-6 mg·kg-1·h-1 was infused in group CP and CS and sevoflurane with the end-tidal concentration of 1.5%-2.5% inhaled in group NPC and NCS to maintain anesthesia. Peripheral venous blood samples were taken before chemical therapy, before anesthesia, immediately after operation and at 72 h after operation for determination of the levels of T lymphocyte subsets and NK cells and plasma CK19 mRNA expression (by RT-PCR). CD4+/CD8+ ratio and the micrometastatic rate of the tumor cells were calculated. Results The CD3+ , CD8+ and NK cell level were significantly lower before anesthesia, immediately after operation and at 72 h after operation than before chemical therapy ( P < 0.05). The CD8+ immediately after operation and NK cell level at 72 h after operation in group CP, and CD4+ and NK cell levels immediately and at 72 h after operation in group CS were significantly lower than those before anesthesia ( P < 0.05). CD4+ and NK cell levels immediately and at 72 h after operation were significantly lower in group CS than in group CP, and in group NCS than in group NCP (P < 0.05). The CD4+/CD8+ ratio was significantly lower immediately after operation in group CS than in group CP ( P < 0.05) .There was no significant difference in the micrometastatic rate of the tumor cells among all groups (P > 0.05). Conclusion Sevoflurane combined anesthesia has a stronger inhibitory effect on immunologic function in radical mastectomy patients with preoperative chemotherapy than propofol combined anesthesia.
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BACKGROUND: It has been reported that bioactivity is found to be favored by the co-operative behavior of silanol (Si-OH)or Ti-OH etc. groups on the material surface and the involved calcium ions. To confirm the hypothesis that a new family of organic-inorganic hybrid materials, which incorporate gelatin chains covalently into Si-O-Ti network, is synthesized through sol-gel procedure.OBJECTIVE: To synthesize a hybrid of gelatin and CaO-SiO2-TiO2 system which is used for bone repairing, and observe its structure and bioactivity.DESIGN: Randomized control observation.SETTING; the laboratory, School of Material Science and Engineering, Shaanxi University of Science and Technology. MATERIALS: Gelatin (Sinopharm Chemical Reagent Co., Ltd), titanic acid isopropyl ester (Gu'an Hengye Fine Chemicals Co., Ltd), γ-glycidoxy propyl trimethoxy silane (Jingzhou Jianghan Fine Chemicals Co., Ltd), calcium nitrate (Tianjin Bodi Chemicals Co., Ltd)METHODS: The experiment was carried out in the laboratory, School of Materials Sciences and Engineering, Shaanxi University of Science and Technology between April and August in 2006. A new type of bioactive organic-inorganic hybrid was synthesized through sol-gel processing starting from gelatin, γ-(2,3-glycidoxypropyl)trimethoxysilane (GPSM),Tetraisopropyltitanate (TiPT) and calcium nitrate. ①Structure of the hybrid: The structures of the products were investigated with Fourier transformed infrared (FT-IR) diffusive reflection spectroscope, X-ray diffraction (XRD) instrument and scanning electron microscope (SEM) respectively.②Bioactivity: The products Ti15Ca0 and Ti15Ca20 were soaked in a stimulated body fluid (SBF) to evaluate the morphology of the surfaces by SEM and thin-film XRD. MAIN OUTCOME MEASURES: The structure and bioactivity of the hybrid.RESULTS: ①The hybrid was completely amorphous and its surface was almost homogenous, which implied the covalent bonding between the organic component and inorganic component. FT-IR spectra result verified the occurrence of Si-OH group and Si-O-Ti bond, as well as the addition of TiPT supplied Si-O-Ti bond. ②There were lots of apatite crystallines formed on the surface of hybrid Ti15Ca20 after soaked in SBF for 7 days, which confirmed their in vitro bioactivity. These apatite particles were similar to the bioglass and other bioactive materials in the patterns. CONCLUSION: A new type of organic-inorganic hybrid material, which incorporates gelatin chains covalently into Si-O-Ti network, is synthesized through sol-gel procedure. There are lots of apatite and brushite crystals formed on the surface of the product Ti15Ca2O after soaking in SBF for 7 days, which obviously proves the bioactivity of the hybrid.