Caregiving styles and anxiety among couples: coping versus not coping with cardiac illness

Background and Objectives: partners’ caregiving efforts are not always beneficial to both recipient and provider. Bowlby’s conceptualization of caregiving style as a stable predisposition may clarify such caregiving effects. The relationship between caregiving style (compulsive and sensitive) and anxiety among couples coping with cardiac illness and a matching control group not coping with cardiac illness were assessed. We hypothesized that one’s compulsive caregiving would associate positively, and one’s sensitive caregiving would associate negatively, with one’s and one’s partner’s anxiety across contexts (cardiac and non-cardiac) and gender. Design: A comparative design of 131 couples with a diagnosis of husbands’ acute cardiac syndrome and 68 matched couples in the community was applied. Methods: The Adult Caregiving Questionnaire and the Brief Symptoms Inventory were administered. Results: Structural equation modeling revealed that one’s compulsive caregiving was positively associated with one’s anxiety, across most contexts. Multi-group analyses revealed that the associations between one’s compulsive caregiving and one’s partner’s anxiety levels differed depending on gender and context. Conclusions: The distress which emerges in an individual who takes on a caregiving role and in his/her partner seems to result not only from the demands of the concrete caregiving situation but also from one’s and one’s partner’s developmental history.     

两种水化疗法对预防对比剂肾病的效果研究

比较两种水化疗法对对比剂肾病(contrast-induced nephropathy,CIN)的预防效果。将150例患者随机分为氯化钠水化组(50例)、碳酸氢钠水化组(50例)和常规治疗组(50例),检测患者造影前3天内及造影后第3天、7天的血肌酐、尿素氮和尿β2微球蛋白。分析三组患者CIN的发病率。结果两水化组CIN的发病率均显著低于常规治疗组(P0.05),两水化组间CIN的发病率无明显差异(P0.05)。结果提示两种水化疗法对CIN的预防效果相仿。     

左主干或多支冠脉病变的选择:PCI或CABG?

近年来,PCI技术越来越多地实践于左主干和多支冠脉病变,但与CABG相比,其疗效一直受到质疑。本文对近年来PCI和CABG的疗效比较做一总结,发现对于左主干和冠脉多支病变,CABG仍优于PCI。但随着生产力水平的发展和社会需求越来越高的双重作用下,两项技术都必然会有新的发展,两者疗效的比较还会继续,我们将拭目以待。     

辩证地探讨精神应激与冠心病的关系

冠心病是严重威胁人们生命和影响生活质量的一种心身疾病,精神应激不仅是不可忽略的重要危险因素之一,而且是一种致病因素。但是精神应激不一定都会引起冠心病,这其中有个体的基因素质和心理素质的作用。它的中介机制主要有脂肪途径和非脂途径。     

Acute effects of alcohol on cardiovascular reactivity to stress in college-age Type A (coronary prone) individuals

Healthy college-age males and females classified as Type A or Type B were randomly assigned to an alcohol (N=24) or a no-alcohol condition (N=24). Subjects were exposed to a verbal stress quiz while blood pressure, heart rate, peripheral vascular response (PVR), and self-reported anxiety indices were monitored. Results indicated that alcohol effected a reduction in resting levels of systolic blood pressure and a tonic reduction in the peripheral vascular response. Alcohol attenuated the systolic blood pressure, heart rate, and PVR to stress and efffected a decrease in anxiety following the Stressor. When analyzed relative to the participants' drinking experience, data indicated that the strongest stress-modulating effect of alcohol was evidenced by Type A subjects who have been identified as long-term drinkers. During recovery from stress Type A subjects identified as short-term drinkers maintained high levels of PVR. Types A and B subjects who did not ingest alcohol evidenced high PVR levels during stress. The findings are discussed in terms of the protective action of moderate chronic alcohol use on cardiovascular disease risk reduction in persons evidencing the coronary-prone behavior pattern.     

危重冠心病患者介入治疗的法学思考——从法律学的角度探讨介入治疗的临床适应症

冠心病是目前严重威胁我国人民健康的一种常见病,由于种种原因一部分晚期冠心病患者,来诊时已经失去介入手术和外科搭桥的最佳时机,而且对于这部分病人来讲,药物治疗往往无效,他们的治疗应何去何从,是目前医学界极具争议的话题。试从法律学的角度,探讨危重冠心病患者介入治疗的可能性及必要性,为临床工作提供法律指导。     

从现代系统科学角度看冠状动脉支架置入术后再狭窄

随着介入治疗技术在临床的广泛应用,目前已成为治疗冠心病(CAD)的主要方法之一.目前国内外指南一致推荐对于CAD的大多数de novo病变常规置入支架,可有效减少单纯球囊扩张的并发症和再狭窄的发生率,但支架内再狭窄的形成又日益突出,成为严重影响介入治疗远期疗效的主要问题.对再狭窄发生机制的研究近十年来取得诸多新进展,对其发生机制的研究和探索为解决这个世纪难题提供了理论基础和依据.本文应用现代系统科学的自组织理论,从哲学角度深入认识和理解这一病理过程.     

遵循指南,恰当进行冠心病的介入治疗

如何遵循指南,结合冠心病患者实际情况和具体病变.恰如其分地为患者实施经皮冠状动脉介入治疗(PCI).使获益最大化,而风险最低化,是每一位心血管介入医生的追求和面临的问题.应正确和严格选择冠心痛患者PCI适应证,合理运用PCI的各种手段,牢固树立冠心病全面治疗观念.PCI仅仅是冠心病全面治疗的一个组成部分,必要的介入、外科治疗和合理药物治疗的联合应用,是心血管疾病治疗的发展方向.     

干细胞移植治疗冠心病的现状与未来

冠心病仍然是全球的主要死亡原因.其所造成的心肌梗死及慢性心力衰竭对生活质量的影响和由此造成的高额医疗费用促使我们不断寻求新的医疗措施.近几年有关干细胞用于心肌梗死后心肌再生、心肌内新生血管形成,可能还会改善梗死后的心功能的研究成为心脏病学研究的最热门领域.尽管干细胞治疗有可能使心力衰竭的治疗得到彻底的革命,但仍有部分问题需要澄清.已发表的各个研究结果设计不尽相同,致使对该项治疗的效果较难得出一致的结论.但这些研究都强调干细胞治疗在未来心血管疾病的治疗中可能会发挥较大的作用.干细胞治疗与药学、外科及介入治疗的结合会显著改善冠心病患者的预后.     

冠心病预防的健康管理模式初探

本文将健康管理中的连续动态理念与现有的社区慢性病管理相结合,构建冠心病预防的健康管理模式。通过冠心病预防策略和策略实施两方面来阐述这一冠心病预防健康管理模式的连续动态性。同时采用SWOT分析法对此模式的应用进行综合评价。希望通过对冠心病预防工作的思考,完善现有的社区慢性病防治工作。