心理护理对急性脑血管患者焦虑、抑郁情绪的干预

目的　探讨心理护理对急性脑血管病 ( ACVD)患者焦虑、抑郁情绪的干预作用。方法　将 64例 ACVD病人随机分为对照组和研究组 ,采用焦虑自评量表 ( SAS)和抑郁自评量表 ( SDS) ,评价两组病人入院时和研究结束时的焦虑、抑郁症状。结果　 64例 ACVD病人出现焦虑和抑郁者分别为 43 .75 %和 40 .63 % ;心理护理后 ,研究组 SAS及 SDS评分较入院时明显减少 ,t检验 ,P<0 .0 5。结论　心理护理能有效地改善 ACVD病人的焦虑、抑郁情绪。     

心理护理干预对功能性消化不良患者生活质量及心理状态的影响

目的：观察心理护理干预对功能性消化不良患者生活质量和心理状态的影响。方法将273例功能性消化不良患者随机分为干预组147例与对照组126例。两组均给予相关对症治疗,对照组给予常规护理措施,干预组在此基础上给予心理护理干预。观察护理前后两组生活质量评分和焦虑(SAS)、抑郁(SDS)自评量表评分情况。结果护理后两组生活质量评分和SAS、SDS评分均降低,且干预组低于对照组,差异有统计学意义(P<0.05)。结论心理护理干预用于功能性消化不良患者可明显改善患者心理状态,提高治疗效果和患者的生活质量,值得临床推广应用。     

儿童精神病患者父母心理状况及干预效果

目的 探究儿童精神病患者父母的心理状况及心理干预的效果.方法 采用抑郁自评量表(SDS)及焦虑自评量表(SAS)对50例患儿父母进行量表测评后给予2周的心理干预,设对照组50例,对比患儿父母的心理健康水平及干预效果.结果 患儿父母的SDS评分比较(t=29.85,P＜0.01)、SAS评分比较(t=37.05,P＜0....     

心理干预在胃癌患者围术期的应用研究

目的:探讨心理干预对胃癌患者围手术期的焦虑和抑郁的护理效果。方法:将80例行胃癌的手术患者随机分为观察组40例和对照组40例,观察组采用心理护理,对照组采用常规护理方法,患者均采用抑郁(SDS)和焦虑自评量表(SAS)进行评价,并比较二者的护理效果。结果:观察组抑郁和焦虑指数在治疗后比治疗前显著下降(P<0.01),而对照组治疗后比治疗前抑郁和焦虑指数下降不明显(P>0.05),治疗后对照组的两项指数均明显高于观察组(P<0.01)。结论:对胃癌患者围术期进行心理干预,可以有效降低患者的抑郁和焦虑程度,值得临床推广应用。     

住院乙型肝炎患者情绪障碍及心理干预

目的 了解乙型肝炎患者的情绪障碍和心理干预的效果。方法 对住院的50例乙型肝炎患者进行心理干预,并在心理干预前及心理干预6周后用焦虑自评量表（SAS）、抑郁自评量表（SDS）对患者进行测查。结果 入院时患者的SAS、SDS评分明显高于对照组,心理干预后患者的SAS、SDS评分明显下降。结论 乙型肝炎患者有明显的焦虑抑郁情绪,心理干预是减轻乙型肝炎患者焦虑抑郁情绪障碍的有效方法。     

心理干预对精神发育迟滞儿童母亲情绪和生活质量的影响

目的探讨心理干预对改善精神发育迟滞(MR)儿童母亲焦虑抑郁情绪和生活质量的效果。方法将入组50例患儿母亲随机分为对照组和干预组各25例,采用焦虑自评量表(SAS)、抑郁自评量表(SDS)和生活质量综合评定问卷-74(GQOLI-74),心理干预前后对两组母亲进行测评和对照研究,并将干预前两组母亲SDS、SAS评分分别与国内常模比较。结果 1两组母亲干预前SDS、SAS评分均明显高于国内常模,具有显著性差异(t=2.82,2.99,3.31,3.71;P0.01);2干预后干预组SDS、SAS评分均明显高于对照组,具有显著性差异(t=2.81,2.79;P0.01);3干预后干预组GQOLI-74因子评分均明显高于对照组,其中以躯体和社会功能差异显著(t=2.67,2.32;P0.05),心理功能差异非常显著(t=2.89;P0.01)。结论 MR儿童母亲存在严重的焦虑抑郁情绪,心理干预可明显改善MR儿童母亲的焦虑抑郁情绪,并显著提高其生活质量。     

青年血液透析患者的心理压力状况分析及干预对策

目的:分析青年血液透析患者的心理压力状况,探讨其干预对策,提高患者的生活质量。方法:纳入分析我院2012年1月至2017年1月收治的132例青年血液透析患者的临床资料,将患者随机分为两组,实验组67例,男40例,女27例;对照组65例,男34例,女31例。其中对照组予以常规医疗护理,实验组在对照组基础上予以心理干预,分别于治疗前后比较两组患者心理健康(Zung氏焦虑自评量表SAS、抑郁自评量表SDS)和心理压力(中文版知觉压力量表CPSS)的变化。结果:干预前,两组患者SAS、SDS和CPSS评分比较差异无统计学意义(P0.05);干预后,观察组患者知觉压力量表(CPSS)评分明显低于对照组,差异有统计学意义(t=-10.140,P0.05);观察组患者焦虑自评量表(SAS)和抑郁自评量表(SDS)评分明显低于对照组,差异具有统计学意义(t=-10.600,-6.050;P0.05)。结论:青年血液透析患者容易焦虑抑郁,心理压力大,心理干预可缓解患者焦虑抑郁的负面情绪,减轻他们的心理压力。     

“用心聆听”心理护理对住院神经症患者护理效果的观察

目的探讨"用心聆听"心理护理对住院神经症患者的护理效果。方法以60例住院神经症患者为研究对象,分为聆听组和对照组各30例,自制"用心聆听"心理护理记录单,以焦虑自评量表(SAS)、抑郁自评量表(SDS)为监测焦虑、抑郁情绪改善的指标。结果 1个月后两组的SAS、SDS评分均下降,但聆听组下降幅度明显大于对照组。结论 "用心聆听"心理护理可以促进住院神经症患者的焦虑、抑郁情绪的改善。     

肺癌患者化疗前后生活质量、焦虑抑郁情绪的变化及心理干预的作用

目的:探究肺癌患者化疗前后生活质量、焦虑抑郁情绪的变化及心理干预的作用。方法:收集2015年3月-2017年3月在我院接受治疗的83例肺癌患者的临床资料,将患者随机分为观察组和对照组,对照组实行常规护理干预,观察组实行心理干预,采用生命质量测定量表(QLQ-C30)、焦虑自评量表(SAS)和抑郁自评量表(SDS)对患者化疗前后的生活质量、焦虑抑郁情绪进行比较,分析心理干预的作用。结果:观察组化疗后SAS评分和SDS评分,低于对照组(t=-17.373,-14.357;P0.05);化疗后观察组焦虑、抑郁患者比例低于对照组;化疗后观察组生活质量评分总分高于对照组,差异具有统计学意义(t=3.962,P0.01)。结论:心理干预能够有效提高患者化疗后的生活质量,消除焦虑、抑郁等不良情绪,有利于患者的康复。     

心理干预对癌症患者家属负性情绪的影响

目的 探讨综合心理干预对癌症晚期患者家属焦虑抑郁情绪的影响.方法 将86例癌症晚期患者家属随机分为两组.对照组不进行干预,干预组进行团体心理治疗,采用焦虑自评量表(SAS)和抑郁自评量表(SDS)评定其情绪状况,观察比较家属在综合心理干预8周前后SAS和SDS评分结果.结果 干预组患者家属焦虑情绪得到明显改善,前后比较有显著性差异(t=4.225,P＜0.001);干预组患者家属抑郁情绪得到明显改善,前后比较有显著性差异(t=4.345,P＜0.001).结论 综合心理干预可以改善癌症晚期患者家属的焦虑抑郁情绪.     

Pain and Effusion and Quadriceps Activation and Strength

Context:

Quadriceps dysfunction is a common consequence of knee joint injury and disease, yet its causes remain elusive.

Objective:

To determine the effects of pain on quadriceps strength and activation and to learn if simultaneous pain and knee joint effusion affect the magnitude of quadriceps dysfunction.

Design:

Crossover study.

Setting:

University research laboratory.

Patients or Other Participants:

Fourteen (8 men, 6 women; age = 23.6 ± 4.8 years, height = 170.3 ± 9.16 cm, mass = 72.9 ± 11.84 kg) healthy volunteers.

Intervention(s):

All participants were tested under 4 randomized conditions: normal knee, effused knee, painful knee, and effused and painful knee.

Main Outcome Measure(s):

Quadriceps strength (Nm/kg) and activation (central activation ratio) were assessed after each condition was induced.

Results:

Quadriceps strength and activation were highest under the normal knee condition and differed from the 3 experimental knee conditions (P < .05). No differences were noted among the 3 experimental knee conditions for either variable (P > .05).

Conclusions:

Both pain and effusion led to quadriceps dysfunction, but the interaction of the 2 stimuli did not increase the magnitude of the strength or activation deficits. Therefore, pain and effusion can be considered equally potent in eliciting quadriceps inhibition. Given that pain and effusion accompany numerous knee conditions, the prevalence of quadriceps dysfunction is likely high.Key Words: arthrogenic muscle inhibition, central activation failure, voluntary activation, muscles

Key Points

• Knee pain and effusion resulted in arthrogenic muscle inhibition and weakness of the quadriceps.
• The simultaneous presence of pain and effusion did not increase the magnitude of quadriceps dysfunction.
• To reduce arthrogenic muscle inhibition and improve muscle strength, clinicians should employ interventions that target removing both pain and effusion.

Quadriceps weakness is a common consequence of traumatic knee joint injury^1,2 and chronic degenerative knee joint conditions.^3,4 Arthrogenic muscle inhibition (AMI), a neurologic decline in muscle activation, results in quadriceps weakness and hinders rehabilitation by preventing gains in strength.⁵ The inability to reverse AMI and restore muscle function can lead to decreased physical abilities,⁶ biomechanical deficits,⁷ and possibly reinjury.⁵ Furthermore, researchers^8,9 have suggested that quadriceps weakness resulting from AMI may place patients at risk for developing osteoarthritis in the knee. In light of the substantial influence of quadriceps AMI on these clinically relevant outcomes, we need to improve our understanding of the factors that contribute to this neurologic decline in muscle activity so efforts to target and reverse it can be implemented and gains in strength can be achieved more easily.Joint injury and disease are accompanied by numerous sequelae (ie, pain, swelling, tissue damage, inflammation), so ascertaining which one ultimately leads to neurologic muscle dysfunction is difficult. Whereas a joint effusion can result in AMI,^10–12 the effects of pain are less understood despite many clinicians attributing AMI to pain. Using techniques that introduce knee pain without accompanying injury may provide insights into the role of pain in eliciting AMI.The degree of knee joint damage may play a role in the quantity of AMI that manifests. Hurley et al^13,14 demonstrated that quadriceps AMI, measured using an interpolated-twitch technique, was greater in patients with extensive traumatic knee injury (eg, fractured tibial plateau, ruptured medial collateral ligament, and medial meniscectomy) than patients with isolated joint trauma (ie, isolated anterior cruciate ligament [ACL] rupture). Similarly, patients with more knee joint symptoms (ie, greater number of symptoms and increased severity of symptoms) may present with greater magnitudes of quadriceps inhibition. Recently, investigators¹⁵ have suggested that patients with more pain display less quadriceps strength, supporting this tenet. Given that effusion and pain often present simultaneously with joint injuries and diseases, such as ACL injury and osteoarthritis, examining both the isolated and cumulative effects of these sequelae appears warranted to determine if they influence the magnitude of muscle inhibition.Experimental joint-effusion and pain models are safe and effective experimental methods that allow for the isolated examination of their effects on muscle function. The effusion model, whereby sterile saline is injected directly into the knee joint capsule,⁷ produces a clinically relevant magnitude of the joint effusion that may be present with traumatic injury. Effusion is thought to activate group II afferents responding to stretch or pressure,^16–18 which in turn may facilitate group Ib interneurons and result in quadriceps AMI.⁵ The pain model involves injecting hypertonic saline into the infrapatellar fat pad to produce anteromedial knee pain similar to that described in patients with patellofemoral pain syndrome.¹⁹ Pain is considered to initiate AMI through activation of group III and IV afferents that act as nocioceptors to signal damage or potential damage to joint structures.^16–18 The firing of these afferents then may lead to facilitation of group Ib interneurons, the flexion reflex, or the gamma loop, ultimately resulting in quadriceps inhibition.²⁰ Thus, these models allow us to create symptoms that are associated with knee injury and have the added benefit of providing a way to examine their effects in isolation.Therefore, the purpose of our study was to determine the effects of pain on quadriceps strength and activation and to learn if simultaneous pain and knee joint effusion would affect the magnitude of quadriceps dysfunction. We hypothesized that pain alone would result in quadriceps inhibition and that the magnitude of inhibition would be greater when effusion and pain were present simultaneously.     

即早基因c-fos与脑血管病及学习记忆

即早基因c-fos是广泛存在于原核细胞和真核细胞的高度保守基因.在正常情况下,c-fos基因参与细胞生长、分化、信息传递、学习和记忆等生理过程,而在病理情况下c-fos基因表达及调控变化与多种疾病的发生和发展有关.C-fos在中枢神经系统的某些部位可有基础水平的表达,但表达很低,当受到如脑缺血、脑出血、痫性发作、应激等刺激后,其在数十分钟内做出反应,在对外界刺激-转录耦联的信忠传递过程中起着核内第三信使的重要作用.     

Opportunities and challenges in the prevention and control of cancer and other chronic diseases: children's diet and nutrition and weight and physical activity

OBJECTIVE: The purpose of this article is to review the role of behavioral research in disease prevention and control, with a particular emphasis on lifestyle- and behavior-related cancer and chronic disease risk factors--specifically, relationships among diet and nutrition and weight and physical activity with adult cancer, and tracking developmental origins of these health-promoting and health-compromising behaviors from childhood into adulthood. METHOD: After reviewing the background of the field of cancer prevention and control and establishing plausibility for the role of child health behavior in adult cancer risk, studies selected from the pediatric published literature are reviewed. Articles were retrieved, selected, and summarized to illustrate that results from separate but related fields of study are combinable to yield insights into the prevention and control of cancer and other chronic diseases in adulthood through the conduct of nonintervention and intervention research with children in clinical, public health, and other contexts. RESULTS: As illustrated by the evidence presented in this review, there are numerous reasons (biological, psychological, and social), opportunities (school and community, health care, and family settings), and approaches (nonintervention and intervention) to understand and impact behavior change in children's diet and nutrition and weight and physical activity. CONCLUSIONS: Further development and evaluation of behavioral science intervention protocols conducted with children are necessary to understand the efficacy of these approaches and their public health impact on proximal and distal cancer, cancer-related, and chronic disease outcomes before diffusion. It is clear that more attention should be paid to early life and early developmental phases in cancer prevention.