强迫症患者瑞典大学人格量表特征及其与防御方式的关系

目的 探讨强迫症患者的人格特质及其与心理防御方式之间的关系.方法 收集34例符合DSM-Ⅳ诊断标准的强迫症患者(强迫症组)及31例健康对照,采用瑞典大学人格量表(SSP)评估2组样本的人格特质,采用防御方式问卷(DSQ)评估2组样本的心理防御特点.结果 强迫症组瑞典大学人格量表的躯体性焦虑、精神性焦虑、应激敏感性、怨恨、兴奋性和不信任6个分量表得分[(57.14±11.54)分,(63.35±10.22)分,(66.95±10.21)分,(61.27±7.09)分,(53.93±9.04)分,(56.72±10.61)分]显著高于健康对照组(t=2.06～5.10,P＜0.05).强迫症组与对照组相比更多地使用投射、被动攻击、潜意识显现、幻想、退缩等不成熟防御机制(t=3.08～6.73,P＜0.01),而较少使用升华、压抑和幽默的成熟防御机制(t=-2.27～4.39,P＜0.05);中间型防御方式反向形成、解除和同一化因子分均显著高于健康对照组(t=2.15～4.66,P＜0.05).强迫症患者SSP除社交愿望和冷漠2个分量表外其余分量表均与不成熟防御机制因子分呈正相关(r=0.375～0.719,P＜0.05);躯体性焦虑分量表与成熟防御机制因子分呈正相关(r=0.378,P＜0.05);精神性焦虑、躯体性焦虑、冲动性、冒险探索、怨恨、不信任、言语攻击和身体攻击8个分量表与中间型防御机制因子分呈正相关(r=0.381～0.548,P＜0.05),除社交愿望分量表外其余分量表均与掩饰因子分呈正相关(r=0.342～0.530,P＜0.05).结论 强迫症患者具有神经质和攻击性人格特质;强迫症患者更多地使用不成熟的防御方式;强迫症患者的人格特质与防御方式之间存在明显的相关性.

Abstract：

Objective To study the relationship between personality and defense mechanism of obsessivecompulsive disorder (OCD) patients.Methods Thirty-four OCD patients were tested with Swedish University Scales of Personality(SSP) and defensive style questionnaire( DSQ), and the result was compared with that of thirty-one normal controls.Results The SSP scores of STA,PsTA,SS,E,TI and M of OCD patients were significantly higher than that of normal controls (t = 2.06 ～ 5.10, P ＜ 0.05 ).Comparing with normal controls, OCD patients tended to use immature and intermediate mechanism such as projection, passive aggression, unconscious emerge, phantasy, withdrawl and reaction formation, but less used mature mechanism such as sublimation, suppression and humor (t = -2.27 ～ 6.73, P＜ 0.05 ).All subscales of SSP in OCD patients, excluding SD and D, had positive correlation with total score of immature mechanism (r = 0.375 ～ 0.719, P ＜ 0.05 ).The OCD patients' SSP scores of STA had positive correlation with mature mechanism (r = 0.378, P ＜ 0.05 ).The OCD patients' STA, PsTA, I, AS, E, M,VTA and PhTA score of SSP had positive correlation with intermediate mechanism (r= 0.381 ～0.548, P＜ 0.05 ).All subscales of SSP in OCD patients, excluding SD, had positive correlation with total score of concealment (r =0.342 ～ 0.530, P ＜ 0.05 ).Conclusion OCD patients have the neurotic and aggressive features of personality;and the personalities of OCD patients have significant correlation with defense mechanism.     

早年创伤经历与强迫症的相关性研究

目的 探讨早年创伤经历与强迫症的相关性,并进一步探讨其与强迫症的起病年龄、病程及严重程度的相关性.方法 对符合DSM-Ⅳ诊断标准的185例强迫症患者以及132例健康对照进行早年创伤问卷简表(ETI-SF)评估,并对强迫症患者进行临床资料及Yale-Brown强迫量表的评定.结果 相对于对照组,强迫症组早年创伤量表总分更高[(3.55±3.29)分,(1.51±1.98)分,P＜0.01],而且4个维度得分也均高于对照组,其中普通创伤[(0.89±1.10)分,(0.43±0.77)分,P＜0.01],躯体创伤[(0.98±1.31)分,(0.65±1.04)分,P=0.016],情感虐待[(1.43±1.61)分,(0.38±0.89)分,P＜0.01],性创伤[(0.24±0.59)分,(0.06±0.30)分,P＜0.01],且女性强迫症患者性创伤多于男性患者[(0.33±0.69)分,(0.16±0.45)分,P=0.049].早年创伤总分及各维度分值(除外性创伤)与强迫症患者的起病年龄成负相关(P＜0.01).结论 强迫症患者有较多的早年创伤经历,且经历越多,其起病年龄越早,早年创伤经历可能是强迫症发生发展的重要环境因素之一.

Abstract：

Objective To investigate the association between early trauma experiences and obsessivecompulsive disorder (OCD). Methods One hundred and eighty-five patients who met with OCD diagnosis of DSM-Ⅳ and one hundred and thirty-two healthy controls were recruited. Early trauma experience of all participants was assessed with Early Trauma Inventory-Short Form (ETI-SF) ,and severity of symptoms of OCD patients was evaluated with Yale-Brown Obsessive-Compulsive Severity Scale (Y-BOCS). Results When compared with controls, OCD group showed significantly higher in ETI-SF total score (3.55 ± 3.29 vs 1.51 ± 1.98, P ＜ 0. 01 ) and had greater in general trauma (0.89 ± 1.10 vs 0. 43 ±0.77, P＜0.01 ) ,physical abuse (0.98 ± 1.31 vs 0.65 ±1.04, P=0. 016),emotional abuse(1.43 ±1.61 vs 0.38 ±0.89, P＜0. 01),and sexual abuse(0.24 ±0.59 vs 0.06 ±0.30, P＜0. 01 ). Female OCD patients reported more sexual abuse than male patients(0.33 ±0.69 vs0. 16 ± 0.45, P = 0.049) . There was a negative correlation between onset age of obsessive symptoms and early trauma experiences(P ＜ 0. 01 ), except sexual abuse experiences (P = 0. 10). Conclusion OCD patients have much more childhood traumas, and the more trauma experiences are,the earlier onset of OCD is, which may associated with the development of obsessive-compulsive disorder.     

Fatigue severity of patients with idiopathic chronic fatigue compared to healthy subjects

OBJECTIVE:To analyze the fatigue severity of patients with idiopathic chronic fatigue(ICF) and to compare the severity of this group with that of healthy subjects.METHODS:one hundred and nine ICF patients and 98 healthy subjects were enrolled in this study.Fatigue severity was measured using the Korean-translated Chalder fatigue severity questionnaire.All subjects scored each item on a 10-point scale as a self-rating numeric scale(NRS),and additionally rated their feeling of general fatigue by visual analogue scale(VAS).RESULTS:The total NRS scores of patients with ICF was 53 ± 15 compared with 25 ± 14 of healthy subjects(2.4 folds for physical symptoms vs.1.7 folds for mental symptoms respectively).The VAS scores of patients with ICF were 2.7 times as high as those of healthy subjects.CONCLUSION:This report is the first to compare the severity of fatigue between ICF patients and healthy subjects.This study contains reference data applicable for the management of this disorder in field of complementary and alternative medicine.     

Psychological Factors Are Closely Associated with the Bell’s Palsy: A Case-control Study

To observe the differences in psychological status between Bell’s palsy (BP) patients and healthy subjects, and to examine the relationship between psychological factors and the severity of BP, we conducted a case-control, multi-center clinical investigation. A total of 695 subjects were as-signed to the case group (n=355) and the control group (n=340). House-Brackmann grading system and Facial Disability Index (FDI) were adopted to assess the BP patients; Kessler Psychological Dis-tress Scale (K10) and 16 Personality Factor (16PF) scale were employed to evaluate the psychologi-cal distress and personality profiles of all subjects. Two independent samples t test was used to com-pare the differences between cases and controls, and to compare the differences among different BP patients. Pearson correlation analysis was used to examine the relationship between psychological factors and severity of facial paralysis. The results showed that psychological distress (K10) in case group (27.09±5.80) was significantly higher than that in control group (13.43±3.02) (t=-37.219, P=0.000). The scores of personality factor Warmth (A), Openness to Change (Q1), Self-Reliance (Q2) were lower in cases than in the controls (P<0.01, P<0.05, P<0.05, respectively), whereas the scores of Sensitivity (I), Vigilance (L), Apprehension (O), and Tension (Q4) were significantly higher in cases than in the controls (P<0.05, P<0.01, P<0.01, P<0.01, respectively). In addition, the psy-chological distress was significantly higher in female patients, severe (HB score Ⅳ-Ⅵ) patients, and subacute (onset time 72-168 h) patients compared with that in male patients, mild (HB score Ⅰ-Ⅲ)patients, and acute (onset time≤72 h) patients (P<0.05). The scores of personality factor in fe-male patients, severe patients, and subacute patients were also significantly different from male pa-tients, mild patients, and acute patients (P<0.05). The result of Pearson correlation analysis showed that psychological factors (K10, personality A, F, L, N, O, Q4) were closely related to HB scores. We are led to conclude that the psychological status between BP patients and healthy people are different; psychological distress and personality factors are closely associated with severity of facial paralysis.     

A follow-up study on features of sensory gating P50 in treatment-resistant depression patients

Background Depressive disorder is a well-known chronic, recurrent and disabling mental disease with high direct and indirect costs to society in both western and eastern cultures. Approximately 40% of depressed patients show only partial or no response to initial or even multiple antidepressant medications and are usually called treatment-resistant depression （TRD） patients. The present work was to measure the features of sensory gating （SG） P50 in TRD patients with the intent of understanding the characteristics of this disease. Methods In 50 TRD patients, 39 non-treatment-resistant depression （NTRD） patients and 51 healthy controls （HC）, auditory evoked potential P50 was measured using the conditioning/testing paradigm presented with auditory double clicks stimuli, and 36 TRD patients had repeated measurements after an 8-week venlafaxine treatment course. Results All the depressive disorder patients, including the TRD and NTRD groups, showed an increased testing stimulus wave （$2-P50） amplitude compared to controls （P 〈0.01 and P 〈0.05）, but there was no significant difference between the TRD and NTRD groups （P 〉0.05）. There were significant differences in the ratio of testing stimulus （S2） and conditioning stimulus （S1） （S2/S1） and in the value of 100 × （1-S2/S1） among the three groups. Compared to the baseline, TRD patients had no significant changes of features and different expression of P50 after acute treatment （P 〉0.05）. Meanwhile, a statistically significant positive correlation of S2/S1 with the scores of the 17-item Hamilton Rating Scale for Depression （HAMD-17） （P 〈0.01）, and a significantly negative correlation of S1-S2, 100 × （1-S2/S1） with the scores of HAMD-17 （P 〈0.01） were observed in the TRD patients＇ baseline measurement, but there was no correlation after venlafaxine treatment （P 〉0.05）. Conclusions Both the TRD and NTRD patients had obvious SG deficits, with a more severe deficit in TRD patients. Although, with a correlated relationship to the severity of depressive symptoms, SG P50 deficit might be suggested as a trait marker for TRD, and a combination of S2/S1 ratio, S1-S2 and 100 × （1-S2/S1）, was recommended for electrophysiological measurement in TRD patients.     

A randomized double-blinded sham-controlled trial of α electroencephalogram-guided transcranial magnetic stimulation for obsessive-compulsive disorder

Background Obsessive-compulsive disorder （OCD） is a highly prevalent and devastating psychiatric condition.Repetitive transcranial magnetic stimulation （rTMS） is a potential and non-invasive treatment for OCD.Diverse efficacies of rTMS have been reported in different locations or frequencies of the stimulation.The main objective of this study was to assess the treatment effect for OCD with alpha electroencephalogram （αEEG）-guided TMS over dorsal Iateral prefrontal cortex bilaterally.Methods There were 25 OCD patients in the αTMS treatment group and 21 OCD patients in the sham control group.Each subject received 10 daily treatment sessions （5 days a week）.The αTMS group had significant reduction in scores of Yale-Brown Obsessive Compulsive Scale and Hamilton Rating Scale for Anxiety （HAMA） compared with the control group at the end of 2-week treatment and 1-week follow-up.Analysis of variance with repeated measures was used to test the effects between the two groups.Results Significant difference in scores of obsession and HAMA were found between the two groups after treatment.No significant difference in scores of Hamilton Rating Scale for Depression was found between the two groups after the treatment,but statistical significance was shown at the end of 1-week follow-up.Conclusions αEEG-guided TMS may be an effective treatment for OCD and related anxiety.Delayed response to αTMS in depression suggests that it might be secondary to the improvement of primary response in OCD and anxiety.     

Platelet Aggregation in Patients with Severe Viral Hepatitis

Platelet aggregation ratio (PAR) was assessed in 45 patients with severe viralhepatitis (SVH) with Born's method.The PAR of normal individuals,patients with acuteicteric hepatitis,and those with chronic active hepatitis were also studied to serve ascontrols.It was found that PAR decreased markedly in SVH patients,which was marked in theearly stage of SVH,more marked in the intermediate stage,and most marked in the latestage.The changes of PAR were in negative correlation with those of serum total bilirubin,and in positive correlation with those of prothrombin activity.The reduction of PAR inSVH patients might be ascribed to the defect of platelets themselves as revealed bycross-over experiments.The results of this study indicate that PAR may be useful in judging the severity ofSVH patients since the degree of PAR reduction parallels closely with the severity of liverdamage.Finally,the condition of platelets in vivo and in vitro in SVH patients werediscussed.     

矿难后创伤后应激障碍患者明尼苏达多项个性量表的研究

Objective To investigate the diagnostic value of the MMPI and understand the personality characteristics of posttraumatie stress disorders(PTSD) in the survivors after mining accident. Methods Mea-surements were conducted with the MMPI in 48 survivors of the 7.29 mining accident. Results Survivors with PTSD obtained a significantly higher F,Hs,Pa,Pt,Sc in MMPI (67.27±17.81,61.13±13.35,65.27±12.61, 62.47±11.78,62.40±15.08, respectively ) than whom without PTSD (50.67±7.19,50.89±12.77,51.56± 7.38,51.33±10.09,50.89±7.03, respectively) (P<0.05). There was still a significant difference between sur-vivors with and without PTSD after the 7.29 mining accident has past one year. Conclusion The survivors with and without PTSD after mining accident have series mental health problems,but their personality characteristics is different. MMPI can provided important auxiliary diagnosis value for PTSD.     

Evaluation of airway obstruction at soft palate level in male patients with obstructive sleep apnea/hypopnea syndrome: dynamic 3-dimensional CT imaging of upper airway

This study examined the dynamic characteristics of upper airway collapse at soft palate level in patients with obstructive sleep apnea/hypopnea syndrome(OSAHS) by using dynamic 3-Dimensional(3-D) CT imaging.A total of 41 male patients who presented with 2 of the following symptoms,i.e.,daytime sleepiness and fatigue,frequent snoring,and apnea with witness,were diagnosed as having OSAHS.They underwent full-night polysomnography and then dynamic 3-D CT imaging of the upper airway during quiet breathing and in Muller’s maneuver.The soft palate length(SPL),the minimal cross-sectional area of the retropalatal region(mXSA-RP),and the vertical distance from the hard palate to the upper posterior part of the hyoid(hhL) were compared between the two breathing states.These parameters,together with hard palate length(HPL),were also compared between mild/moderate and severe OSAHS groups.Association of these parameters with the severity of OSAHS [as reflected by apnea hypopnea index(AHI) and the lowest saturation of blood oxygen(LSaO2)] was examined.The results showed that 31 patients had severe OSAHS,and 10 mild/moderate OSAHS.All the patients had airway obstruction at soft palate level.mXSA-RP was significantly decreased and SPL remarkably increased during Muller’s maneuver as compared with the quiet breathing state.There were no significant differences in these airway parameters(except the position of the hyoid bone) between severe and mild/moderate OSAHS groups.And no significant correlation between these airway parameters and the severity of OSAHS was found.The position of hyoid was lower in the severe OSAHS group than in the mild/moderate OSAHS group.The patients in group with body mass index(BMI)≥26 had higher collapse ratio of mXSA-RP,greater neck circumference and smaller mXSA-RP in the Muller’s maneuver than those in group with BMI<26(P<0.05 for all).It was concluded that dynamic 3-D CT imaging could dynamically show the upper airway changes at soft palate level in OSAHS patients.All the OSAHS patients had airway obstruction of various degrees at soft palate level.But no correlation was observed between the airway change at soft palate level and the severity of OSAHS.The patients in group with BMI≥26 were more likely to develop airway obstruction at soft palate level than those with BMI<26.     

The Effect of Intense Pulsed Light Treatment for Chronic Hordeolum

Objective To evaluate the effect of intense pulsed light(IPL) in the treatment of chronic hordeolum.Methods Patients with chronic hordeolum who underwent IPL treatment were enrolled in this study.According to the severity of hordeolum, the patients were treated with IPL 3 to 5 times.Patients’ satisfaction and visual analog scale scores for ocular discomfort symptoms before and after treatment were collected. The number, congestion, long diameter, short diameter and area of nodules were also reco...     

曲美他嗪治疗不稳定型心绞痛

目的 探讨曲美他嗪治疗不稳定型心绞痛(UAP)的临床疗效及对内皮素(ET)、一氧化氮(NO)的表达影响.方法 随机选择UAP患者80例,入选患者被随机单盲分为曲美他嗪组40例和常规治疗组40例.观察统计两组治疗前1周和治疗结束后1周心绞痛发作次数、自拟的疼痛强度及持续时间记分值,检测治疗前后患者血浆ET和NO水平的变化.结果 曲美他嗪组和常规治疗组比较,治疗后患者疼痛发作频率、疼痛强度及持续时间记分均有明显减少,但曲美他嗪组的疗效比常规治疗组明显,差异有统计学意义(P<0.05). 两组治疗都可改善不稳定型心绞痛患者心电图ST段的偏移,但曲美他嗪组的疗效比常规治疗组显著, 差异有统计学意义(P<0.05).两组都可改善心绞痛患者心电图表现,但差异无统计学意义(P>0.05).两组患者治疗后血浆ET水平明显减低,NO水平明显升高,但曲美他嗪组比常规治疗组显著, 差异有统计学意义(P<0.01).结论 曲美他嗪组对不稳定型心绞痛患者疗效明显升高,这种疗效与改善血管内皮细胞功能有关. Abstract： Objective To observe the effects of trimetazidine on plasma concentration of endothelin(ET) and nitric oxide(NO) in patients with unstable angina pectoris(UAP).Methods Randomly selected 80 patients with unstable angina pectoris, patients were randomly divided into trimetazidine group with 40 patients, and conventional treatment group with 40 patients. The clinical effect was observed by the changes of the angina pectoris frequencies and pain period and intensity score per mean day at 1 week pro-treatment and 1 week post-treatment. Plasma concentrations of ET and NO were measured before and after the treatment.Results The frequency, intensity and duration of pain score was significantly reduced in both groups, and the effect of trimetazidine group was obvious than the conventional treatment group, the difference was statistically significant(P<0.05). The two groups can improve the treatment of unstable angina patients ECG ST section of the shift, and the effect of trimetazidine group was obvious than the conventional treatment group, the difference was statistically significant(P<0.05). Two groups of patients can improve angina and ECG, but the difference was not statistically significant(P>0.05). In the two groups, plasma ET was significantly reduced, and plasma NO was significantly elevated,the effect of trimetazidine group was obvious than the conventional treatment group, the difference was statistically significant(P<0.01).Conclusions The effects of trimetazidine on patients with unstable angina pectoris is significantly elevated, and is significantly beneficial to protect the endothelial function.     

MSCT多期薄层扫描在诊断早期胰腺癌中的临床应用

目的 评价研究MSCT多期薄层扫描技术在早期胰腺癌中临床应用诊断价值及其临床意义价值分析.方法 回顾性分析66例行MSCT多期薄层扫描的早期胰腺癌患者并经过手术和病理证实,经MSCT多期薄层扫描比较正常胰腺组织和肿瘤在平扫和多期扫描中的增强变化,依照CT影像学征象诊断胰腺癌并行手术前评估,并与手术结果相比较.结果 早期胰腺癌的直接征象是胰腺内弱强化肿块,间接征象是胰、胆管扩张,胰体尾部萎缩及胰腺轮廓改变. 结论 MSCT多期薄层扫描技术使得胰腺的早期定性诊断和治疗有了明显的改善,是发现早期胰腺癌的最佳扫描方法. Abstract： Objective Appraisement research MSCT expect the scanning technology of thin layer to diagnose value and its clinical meaning in early pancreas cancer. Methods Retrospective analysis 42 patients which was routine MSCT in early stage of many issue scannings of thin layer, pancreas cancer patients confirms via operation and pathology, go through MSCT expect the scanning of thin layer to compare normal pancreas organization and the strengthening change of tumor in being flat to sweep and expect scanning, according to CT the former sign diagnosis pancreas cancer parallel operation assessment of an image, and was compared with operation result appearance. Results In early stage, the direct sign of pancreas cancer was the weak reinforced phyma in pancreas, indirect sign was pancreas, the pipe expansion of gall bladder, pancreas body tail atrophy and pancreas outline change.Conclusions MSCT many issue scannings of thin layer make early stage of pancreas determine the nature to diagnose and treat to have got obvious improvement, it is the best scanning method of discovery early pancreas cancer.     

布地奈德和盐酸氨溴索雾化吸入佐治毛细支气管炎的疗效观察

目的 观察布地奈德和盐酸氨溴索雾化吸入辅助治疗婴儿毛细支气管炎的临床疗效.方法 总结2005年9月至2009年12月我院儿科142例诊断为毛细支气管炎患儿的临床资料,随机分为两组,对照组66例,常规应用糜蛋白酶、地塞米松雾化吸入,同时给予抗感染治疗;治疗组76例,在对照组常规抗感染治疗的基础上应用布地奈德和盐酸氨溴索雾化吸入,观察患儿临床症状、体征消失时间.结果 治疗组显效率明显高于对照组,平均咳嗽消失时间、肺部喘鸣音消失时间、肺部湿啰音消失时间均比对照组明显缩短.结论 布地奈德和盐酸氨溴索雾化吸入辅助治疗婴儿毛细支气管炎疗效显著. Abstract： Objective To observe the effects of budesonide and ambroxol hydrochloric inhalation in treatment of infant bronchiolitis. Methods One hundred and forty-two cases of pediatric bronchiolitis from September 2005 to December 2009 in our hospital were randomly divided into two groups. Control group(66 cases) were treated by chymotrypsin, dexamethasone inhalation as routine, while giving the anti-infective treatment; Treatment group(76 cases) were given budesonide and ambroxol hydrochloric inhalation based on anti-infective thenxpy.To observe the disappearance time of clinical symptoms and signs in the two groups. Results In the treatment group had significantly higher efficiency, the average time of disappearance of cough, chest wheezing disappearance time and lung wet rales disappearance time were significantly shorter than those in the control group. Conclusions Budesonide and ambroxol hydrochloric inhalation has good efficacy for infants with bronchiolitis.     

糖尿病合并急性心肌梗死临床分析

目的 对糖尿病(DM)合并急性心肌梗死(AMI)患者的临床特点及预后进行研究.方法 对40例糖尿病合并急性心肌梗死患者(DM组)和42例非糖尿病急性心肌梗死患者(NDM组)的临床特点及预后进行对比分析.结果 糖尿病患者发生急性心肌梗死组无痛性心梗发生率、冠脉血管病变程度、严重并发症发生率、病死率均明显高于非糖尿病组(P<0.05).结论 糖尿病合并急性心肌梗死临床症状不典型者多,严重并发症发生率高、病情重、病死率高、预后差. Abstract： Objective To investigate the clinical characteristic and prognosis of diabetes mellitus (DM) complicated with acute myocardial infarction (AMI). Methods To compare the clinical characteristic and prognosis of 40 cases of DM complicated with AMI and 42 cases of non-DM with AMI. Results The painless myocardia infarction rate,coronary vascular disease extent,incidence of severe complications and matality were higher in DM patients complicated with AMI than in no-DM patients with AMI. Conclusions The clinical manifestation of DM patients complicated with AMI were atypical and with higher incidence of severe complication and mortality,which leads to poor prognosis.     

抑郁症自杀未遂患者的2年随访研究

目的 了解抑郁症自杀未遂患者的预后及其影响因素.方法 收集56例首发抑郁症自杀未遂患者的2年随访资料,分析其疗效、服药依从性和社会功能等.结果 失访率35.71%,随访患者中63.89%恢复原来的工作或学业,77.78%服药完全依从.疗效指数为3.0±1.2,疗效指数与服药依从性呈负相关.结论 提高抑郁症自杀未遂患者的服药依从性有助于改善其预后. Abstract： Objective To explore the prognosis of first-episode depressive disorder with attempted suicide and the related factors. Methods Fifty-six patients with first-episode depressive disorder with attempted suicide were evaluated by curative effect, medication compliance and social function after 2 years follow-up. Results The missing ratio was 35.71%,63.89% of patients with follow-up recovered the job or got back to school, 77.78% were in completely compliance with the doctor's advice. EI was 3.0±1.2, the score of EI was negatively related with medication compliance. Conclusions High medication compliance of patients with first-episode depressive disorder with attempted suicide may help to improve the prognosis.     

小儿手足口病216例诊治分析

目的 加强对小儿手足口病流行病学及临床诊治特点的认识.方法 对216例小儿手足口病的流行病学及临床诊治特点进行分析.结果 广东南方地区手足口病全年均有发病,四季发病率无明显区别;皮肤黏膜疱疹有多样性临床表现;静脉输注丙种球蛋白或同型血浆治疗早期重症病例疗效显著.结论 正确认识手足口病的流行病学和临床特点对其防治至关重要,静脉输注丙种球蛋白或同型血浆可有效减少早期重症病例恶化. Abstract： Objective To recognize the epidemiology and clinical features of HFMD in children. Methods Epidemiology and clinical characteristics of 216 children with HFMD were analyzed. Results HFMD occurs all the year around in the southern part of Guangdong province, and the incidence of HFMD has no obvious difference during a year. There were varies clinic types of herpeson skin or mucous membrane.Immunoglobulin or plasma can be used to cure severe cases which on early stage. Conclusions Correct knowledge about HFMD is important to it's prevention. Critical cases deterioration can be effectively reduced by the use of immunoglobulin or plasma.     

骶管阻滞复合全麻喉罩通气对小儿血液动力学的影响

目的 探讨骶管阻滞复合全麻喉罩通气对小儿血液动力学的影响.方法 择期下腹部、会阴部或下肢手术小儿60例,ASA I或II级.随机分为单纯气管插管组(T组),骶管阻滞复合气管插管组(CT组),骶管阻滞复合喉罩通气组(CL组),每组20例.分别于诱导前(T0)、插管即刻(T1)、手术开始(T2)、手术开始后30 min(T3)、手术开始后60 min(T4)监测心率(HR)、血压、脉搏氧饱和度、呼气末CO2分压,记录平均动脉压(MAP),中心静脉压,丙泊酚、瑞芬太尼的用量及术后不良反应的发生情况.结果 T组、CT组在T1时点MAP、HR明显高于CL组(P<0.05);CL组、CT组丙泊酚及瑞芬太尼的用量明显少于T组;CL组术后不良反应最少.结论 骶管阻滞复合全麻喉罩通气对小儿的血液动力学影响最小,不良反应少. Abstract： Objective To investigate the effects of caudal block with laryngeal mask airway(LMA) ventilation on the hemodynamics of children undergoing elective surgery under general anesthesia. Methods Sixty ASA Ⅰ or Ⅱ children undergoing selective lower abdominal surgery were randomly divided into 3 groups (n=20):Group T:endotracheal intubation. Group CT:caudal block and endotracheal intubatio. Group CL:caudal block and laryngeal mask airway(LMA) ventilation. HR,BP,MAP,CVP,SpO2,PetCO2 were monitored during anesthesia.HR,MAP,CVP were recorded at proinduction (T0),intubation(T1),operation(T2),30 min after operation(T3) and 60 min after operation (T4).Recording the dosage of propofol,remifentanil and adverse reactions of postoperation. Results MAP,HR at T1 were significantly higher in group T and group CT than that in group CL.The dosage of propofol and remifentanil were significantly less in group CT and group CL than that in group T. Conclusions Caudal block with LMA ventilation have little side effects on hemodynamics of the children undergoing slective surgery with general anesthesia.     

压缩雾化吸入可必特治疗慢性阻塞性肺疾病急性加重期35例疗效观察

目的 探讨压缩雾化吸入可必特对慢性阻塞性肺疾病急性加重期的疗效和不良反应.方法 将75例患者随机分为两组,对照组30例采用常规治疗,治疗组35例在常规治疗基础上加用雾化治疗,观察两组治疗效果和解除主要症状、体征的时间和住院时间.结果 治疗组住院时间和喘憋、肺部喘鸣音的持续时间均明显短于对照组(P＜0.05).结论 压缩雾化吸入可必特治疗慢性阻塞性肺疾病急性加重期疗效确切,方法简便,不良反应小,值得推广. Abstract： Objective To explore the effect of compressed nebulized inhalation combivent on chronic obstructive pulmonary disease with acute exacerbation. Mehods Seventy-five patients were randomly divided into two groups,the control group(30 cases) with conventional treatment, the treatment group (35 cases) on the basis of conventional therapy plus treatment with the spray were observed lifting of the main symptoms and signs of the time and hospital stay.Results The treatment group hospitalization time and asthmatic lungs duration of wheezing were significantly shorter than the control group (P<0.01). Conclusions Compression combivent aerosol inhalation treatment of chronic obstructive pulmonary disease with acute exacerbation is simple, side effects are little and are worth promoting.     

超声引导下酒精硬化治疗肝、肾囊肿的并发症及处理方法

目的 探讨超声引导下酒精硬化治疗肝、肾囊肿所发生的并发症及处理方法.方法 回顾性分析近年所施行的肝、肾囊肿介入性酒精硬化治疗患者202例(均以无水酒精为治疗药物),其中出现并发症23例,包括出血、酒精不耐受、注入无水乙醇后无法顺利抽出、术中出现明显疼痛、操作过程中针尖脱出等.结果 22例均经对症处理,成功治疗,1例因针尖脱出,未行酒精硬化治疗,仅抽出囊液.结论 超声引导下酒精硬化治疗肝、肾囊肿是普遍采用的有效方法,但可发生少数并发症,如经早期发现并正确处理均能予以治愈. Abstract： Objective To explore the causes and treatment of the complications of alcohol sclerotherapy for hepatic and renal cysts with ultrasound-guided. Methods In recent 4 years, 202 cases of hepatic and renal cysts were treated by alcohol sclerotherapy with ultrasound-guided,among which complications were found in 23 cases by retrospective analysis. Results 22 cases were treated successfully. In 1 case, the needle was falling off from the cyst cavity, the liquid of cyst was drained out. Conclusions Alcohol sclerotherapy is a generally applied and efficient method for hepatic and renal cysts. But a few complications might occur due to different factors, which could be treated successfully if you found them early.     

低分子量肝素在胸部肿瘤合并高凝血状态病人围术期的临床应用

目的 使用低分子量肝素(LMWH)预防胸部肿瘤合并高凝血状态病人的围术期血栓性疾病的发生.方法 对2006年1月至2007年10月我科收治的合并高凝血状态的食管癌、贲门癌、肺癌病人,在围术期皮下注射低分子量肝素,每日1次,从术前3～5 d开始直至病人下床,观察术中出血量及术后胸液量,并统计血栓性疾病发生率.结果 该组病人围术期血栓性疾病发生率得到了明显控制.结论 低分子量肝素对预防胸部肿瘤合并高凝血状态病人的围术期血栓性疾病的发生有明显效果,安全可靠. Abstract： Objective To evaluate the efficacy of low molecular weight heparin for preventing thromboembolism disease in perioperative of thoracic tumor with blood hypercoagulabale state. Methods From January 2006 to October 2007, we diagnosed and treated 72 patients with lung cancer and carcinoma of esophagus and cardia. All the patients were treated with LMWH qd from the 3 -5 days before operation until ambulation after operation. To observe the postoperative total amount effusion and to statistic of incidence of thromboembolism disease. Results Incidence of thromboembolism disease decreased more significantly of this group than usual. Conclusions Application of LMWH for preventing thromboembolism disease in periopetive of thoracic tumor with blood hypercoagulabale state is an effective, safe and reliable treatment.