生命质量量表应用于海洛因依赖者的效果评价

目的：探讨生命质量量表应用于海洛因依赖者的效果评价。方法：采用药物成瘾者生命质量测定量表（QOL—DA）对120例海洛因依赖者进行测量，分析量表的信度、效度和反应度。结果：QOL—DA量表依从性较好，接受率为97．1％。躯体功能、心理功能、症状／副作用、社会功能4个维度的重测信度分别为0．847、0．728、0．833、0．918，具有较好的重复性。其内部一致性信度系数分别为0．88、0．90、0．91、0．93。治疗前与治疗后1个月除心理功能（P〉0．05）外各维度及总得分均有显著差异（P〈0．05），心理功能在第6个月时发生显著性差异（P〈0．05）。结论：QOL-DA具有较好的信度、效度及反应度，在很大程度上可以反映吸毒者的生命质量状况，能敏感地反映海洛因依赖者戒毒前后生命质量的变化。     

阿片成瘾严重程度量表的初步编制与信息测试

目的：编制阿片成瘾严重程度评定量表，并对量表进行信度检验。方法：参考相关文献自行设计“28项阿片成瘾严重程度量表”(28Items Opioid Addiction Severity Inventory,OASI-28)，对北京市某戒毒治疗机构收治的60例海洛因成瘾者进行结构性访谈。通过小样本预试验，采用同质性信度与重测信度对量表进行信度评价。结果：同质性信度：除家庭后果一项外，其余各因子及量表总的Cronbach‘‘‘‘‘‘‘‘s α。系数在0．5244—0.8140之间。各症状项目分与总分的相关性除第1题(从第一次吸毒时间到成瘾的时间)、第15题(体重变化)和第21题(吸毒后工作情况)外，余者的P值均＜0．05。重测信度：总量表及各因子的重测相关系数介于0.476—0.895之间(P＜0．01)。结论：本量表有较好的同质性信度和重测信度。     

临床试验文献质量评价量表的制作和评价

目的：制备中文临床试验报告质量评价量表，并且对量表的信度和效度进行初步评价。方法：采用专家咨询法（Delphi法）和小组讨论相结合的方法制定量表，咨询专家包括临床药理学家、临床医生、流行病学家、卫生统计学家和医学杂志编辑。专家咨询分三个阶段，形成临床试验文献质量评价量表及量表说明。为评价量表，从2000年治疗高血压的英文临床试验文献中抽取30篇，由两个评价人员应用量表独立进行评价，计算组内相关系数（ICC）评价量表的信度；对文献同时应用CONSORT声明评价作为对照，计算Kendall等级相关系数来判断其效度。结果：经过10名专家第一阶段的咨询，协调系数W为0．505，19个评价项目高度一致；第二阶段咨询，对19个项目赋予权重，共计100分，完成量表制作。信度评价中总分的组内相关系数ICC为0．921，其中引言部分0．987，材料与方法0．875，实施与结果部分0．902，讨论及其他部分0．966，P均〈0．01。与CONSORT声明的评价结果比较，Kendall相关系数r为0.723，P〈0．01，具有较好的一致性。结论：本研究形成的量表制订过程规范，条目清楚，具有较好的信度和效度。     

阿片成瘾严重程度量表的初步编制与信度测试

目的 :编制阿片成瘾严重程度评定量表 ,并对量表进行信度检验。方法 :参考相关文献自行设计“2 8项阿片成瘾严重程度量表”( 2 8ItemsOpioidAddictionSeverityInventory ,OASI - 2 8) ,对北京市某戒毒治疗机构收治的 6 0例海洛因成瘾者进行结构性访谈。通过小样本预试验 ,采用同质性信度与重测信度对量表进行信度评价。结果 :同质性信度 :除家庭后果一项外 ,其余各因子及量表总的Cronbach’sα系数在 0 .5 2 44～ 0 .8140之间。各症状项目分与总分的相关性除第 1题 (从第一次吸毒时间到成瘾的时间 )、第 15题 (体重变化 )和第 2 1题 (吸毒后工作情况 )外 ,余者的P值均 <0 .0 5。重测信度 :总量表及各因子的重测相关系数介于 0 .476～ 0 .895之间 (P <0 .0 1)。结论 :本量表有较好的同质性信度和重测信度。     

早产儿出院后管理依从性量表的研制

目的 编制早产儿出院后管理依从性量表,并进行信效度检验.方法 参照护理结局分类系统,通过质性访谈和德尔菲专家函询初步构建早产儿出院后管理依从性量表,并选取150名早产儿家长进行问卷调查,检测量表信效度.结果 早产儿出院后管理依从性量表共包括2个维度,5个条目.量表水平内容效度指数为0.92,量表各维度与量表总得分相关系数r均呈显著相关水平(P＜0.01).量表Cronbach's α系数为0.86,重测信度为0.88.结论 早产儿出院后管理依从性量表具有较好的效度和信度,简便易行,适用于测评早产儿家长的遵医依从性.     

偏头痛缓解期基于患者报告的结局评价量表的性能考评研究

目的评价偏头痛缓解期基于患者报告的结局(PRO)评价量表的性能。方法本研究纳入2012年6月-2013年2月在上海市徐汇区中心医院等国内4家医院神经内科门诊就诊的偏头痛患者共120例。患者均认真填写PRO调查量表的各项内容。对各单位研究人员进行统一培训,建立Epidata数据库,采用二次录入方式录入数据。以分半信度、克隆巴赫α系数评价量表的信度,以内容效度、标准效度评价量表的效度,以总体反应度、条目反应度及维度反应度评价量表的反应度,以接受率、完成率、完成时间评价量表的可行性。结果前后两次调查的该量表分半信度分别为0.876和0.910,克隆巴赫α系数分别为0.884和0.888;各维度条目与本维度的相关系数均大于与其他维度的相关系数;前后两次调查PRO量表总分与VAS总分、SF-36总分相关系数分别为0.700、0.601和-0.613、-0.658;量表的接受率、完成率均为100%。结论偏头痛PRO量表内容全面、结构合理,适合偏头痛的临床特点,具有良好的性能,其疗效评价方法科学,临床再验证结果可信。     

阿片依赖程度评定量表的编制与信度测试

目的:编制阿片依赖程度评定量表,并对量表进行信度检验.方法:参考相关文献自行设计"12项阿片依赖程度量表"(12 Items Opiate Addiction SeverityInventory,OASI-12),对北京市公安局强制戒毒所收治的360例海洛因依赖者进行结构性访谈.其中88例首次评估后2周重测.依据访谈获得的数据采用同质性信度和重测信度对量表进行信度评价.结果:同质性信度:各因子及量表总的Cronbach's α系数在0.4128～0.8224之间.各症状项目分与总分的相关系数在0.473～0.670之间,P值均为0.000.重测信度:12个条目的重测相关系数在0.581～0.900之间,P值均为0.000.各因子的重测相关系数在0.793～0.858之间,P值均为0.000.量表总分的重测相关系数为0.872,P值均为0.000.结论:该量表具有较好的同质性信度和重测信度.     

SF-36量表在测定慢性病患者生命质量中的应用考评

目的 通过测定6种慢性病患者的生命质量，对SF-36英国发展版量表的信度、效度和反应度进行考评。方法 用 SF-36英国发展版对住院的6种慢性病患者进行生命质量的测定，分析包括内部一致性信度和重测信度；结构效度、效标效度和区分效度；反应度。结果 SF-36具有较好的信度，除SF外，各领域的内部一致性系数和重测信度系数均在0．7以上，SF的信度系数也在0．6以上。反应度分析显示。SF-36的反应度较好，但测量时间对反应度有一定的影响。SF-36的效度一般，特别是在VT、MH方面效度不佳。结论 SF-36用于慢性病患者的生命质量评估还有待进一步研究，应用于治疗效果评价时注意评价时间对结果的影响。     

肺结核患者自我效能量表信度和效度评价

目的 评价肺结核病患者自我效能量表的信度和效度,为评估肺结核患者自我效能提供有效的测评工具.方法 用自行研制的肺结核患者自我效能量表对确诊的肺结核患者进行测量,采用Cronbach'a系数评价量表内部一致性的信度,用pearson相关系数和配对t检验分析重测信度,用因子分析评价量表的效度.结果 肺结核患者自我效能量表的Cronbach'a系数为0.802,两次测量之间pearson系数r在0.567 ～ 0.728之间,因子分析可解释总变量的71.846％,各条目的因素负荷在0.651 ～ 0.862之间,量表具有良好的信度和效度.结论 本量表有具有较好的信度和效度,可作为测评肺结核患者自我效能的工具之一,也可为对肺结核患者的针对性的综合性心理干预提供依据.     

编制适用于小儿厌食症的症状积分调查表并对其信度、效度进行分析

目的编制适用于小儿厌食症的症状积分调查表,并对其信度、效度进行分析。方法通过查阅相关文献、核心小组讨论等方法形成量表条目池,小样本反复预调查构建初始量表,对200例厌食症患儿进行调查,运用相关系数法、克朗巴赫系数法、因子分析法等评价量表的信度、效度。结果小儿厌食症症状积分调查表由28个条目组成,各条目重测系数均大于0.7(P0.01),量表的重测信度系数良好、一致性较高;总表的克朗巴赫系数α为0.978,各条目逐条删除后对比,未有任何一条条目会降低总表的内部一致性,说明量表及其各条目内部一致性好;内容效度分析显示28个条目与量表总分相关系数均0.6(0.651~0.869),具有较强的相关性;KMO统计量为0.927,Bartlett球形检验卡方统计量为6 840.433,P=0.000,适合做因子分析。探索性因子分析结果显示前4个主成分的特征值均≥1,累计贡献率为80.091%,故选取前4个公共因子。结论该量表具有良好的信度及效度,能够较好地反应小儿厌食症症状,具有一定的临床科研实用价值。     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

Lung disease and PKCs

The lung offers a rich opportunity for development of therapeutic strategies focused on isozymes of protein kinase C (PKCs). PKCs are important in many cellular responses in the lung, and existing therapies for pulmonary disorders are inadequate. The lung poses unique challenges as it interfaces with air and blood, contains a pulmonary and systemic circulation, and consists of many cell types. Key structures are bronchial and pulmonary vessels, branching airways, and distal air sacs defined by alveolar walls containing capillaries and interstitial space. The cellular composition of each vessel, airway, and alveolar wall is heterogeneous. Injurious environmental stimuli signal through PKCs and cause a variety of disorders. Edema formation and pulmonary hypertension (PHTN) result from derangements in endothelial, smooth muscle (SM), and/or adventitial fibroblast cell phenotype. Asthma, chronic obstructive pulmonary disease (COPD), and lung cancer are characterized by distinctive pathological changes in airway epithelial, SM, and mucous-generating cells. Acute and chronic pneumonitis and fibrosis occur in the alveolar space and interstitium with type 2 pneumocytes and interstitial fibroblasts/myofibroblasts playing a prominent role. At each site, inflammatory, immune, and vascular progenitor cells contribute to the injury and repair process. Many strategies have been used to investigate PKCs in lung injury. Isolated organ preparations and whole animal studies are powerful approaches especially when genetically engineered mice are used. More analysis of PKC isozymes in normal and diseased human lung tissue and cells is needed to complement this work. Since opposing or counter-regulatory effects of selected PKCs in the same cell or tissue have been found, it may be desirable to target more than one PKC isozyme and potentially in different directions. Because multiple signaling pathways contribute to the key cellular responses important in lung biology, therapeutic strategies targeting PKCs may be more effective if combined with inhibitors of other pathways for additive or synergistic effect. Mechanisms that regulate PKC activity, including phosphorylation and interaction with isozyme-specific binding proteins, are also potential therapeutic targets. Key isotypes of PKC involved in lung pathophysiology are summarized and current and evolving therapeutic approaches to target them are identified.     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Gender-related symptoms and correlates of alcohol dependence among men and women with a lifetime diagnosis of alcohol use disorders

This study explored gender-related symptoms and correlates of alcohol dependence in a crosssectional study of 150 men and 150 women with a lifetime diagnosis of alcohol use disorders (AUD). Participants were recruited in equal numbers from treatment settings, correctional centres and the general community. Standardized measures were used to determine participants' use of substances, history of psychiatric disorders and psychosocial stress, their sensation seeking and family history of substance use and mental health disorders. Multivariate analyses were used to detect patterns of variables associated with gender and the lifetime severity of AUD. Men had a longer history of severe AUD than women. Women had similar levels of alcohol dependence and medical and psychological sequelae as men, despite 6 fewer years of AUD. More women than men had a history of severe psychosocial stress, severe dependence on other substances and antecedent mental health problems, especially mood and anxiety disorders. There were differences in family history of alcohol-related problems approximating same-gender aggregation. The severity of a lifetime AUD was predicted by its earlier age at onset and the occurrence of other disorders, especially anxiety, among both men and women. The limitations in the generalizability of these findings due to sample idiosyncrasies are discussed.