女性服刑人员精神创伤的特征

目的 调查女性服刑人员精神创伤的特征.方法 在湖南新路职业学校中,采用多级随机整群抽样的原则抽取471个女性服刑人员,分青少年组(年龄≤25岁)和成年组(＞25岁).运用创伤性生活事件问卷(TLEQ)和访谈相结合的技术评估她们的精神创伤经历.结果 (1)90.4%的女性服刑人员至少经历1件创伤性事件,63.7%至少经历3件或以上的多重创伤.青少年组的事件数量多于成年组(平均为4和3件,P＜0.01).暴力和毒品相关犯罪组的事件数量相当(平均4件),都多于经济犯罪组(2件);中学或相当教育程度者的事件数量最多(4件),大专或以上者最少(2件);未婚、离婚/丧偶2组经历的事件数量最多(4件),已婚组最少(2件),均差异有显著性(P＜0.05).(2)最多见的创伤类型是机动车祸(46.9%)、目睹家庭暴力(46.1%)和被抢劫(38.9%).16.7%的女犯在18岁以前遭遇过性虐待.与成年组相比,青少年组经历了更多的创伤类型为被抢劫、目睹被惨打、目睹家庭暴力,以及儿童期性虐待.结论我国文化背景下,女性服刑人员的精神创伤经历相当普遍,是精神创伤的潜在受害者.     

家庭暴力施暴者精神创伤的初步研究

目的 调查家庭暴力施暴者精神创伤的特征,及其与创伤后应激症状的关系.方法 在四川绵阳市某社区确立有严重躯体家庭暴力的男性施暴者50人,选取年龄、受教育程度和家庭结构相匹配的无家庭暴力的男性健康对照组80人.运用创伤性生活事件问卷和访谈相结合的技术评估他们的精神创伤经历;事件影响量表.修订版(IES-R)评估创伤后应激症状.结果 (1)80%的施暴组至少经历3件或以上的多重创伤,高于对照组(46.2%);平均事件数量中位数多于对照组(分别为5.5和3件),均差异有显著性(x2=21.70,P=0.000;Z=3.94,P=0.003).(2)与对照组相比,施暴组经历了更多的创伤类型:亲人的突然死亡(x2=3.74)、目睹家庭暴力(x2=6.24)、被亲密伴侣殴打(x2=10.06)以及儿童期性虐待(x2=4.53～8.45),均差异有显著性(均P<0.05).(3)施暴组IES-R总分和各亚症状分,均高于对照组(均P<0.05),但IES-R总分与创伤数量无关(P>0.05).结论 家庭暴力施暴者有相当普遍的精神创伤经历和突出的创伤后应激症状;对他们进行精神创伤的筛查和相应干预很有必要.     

Morbidity and Trauma Characteristic of Posttraumatic Stress Disorder in the Female Criminals

目的 了解女性罪犯创伤后应激障碍的患病率及创伤事件特征.方法 采用扩展的一般健康问卷(GHQ-12)结合罪犯精神障碍线索调查表为筛查工具,以美国精神障碍诊断与统计手册(DSM-IV)为标准,用 DSM-IV-TR轴Ⅰ障碍定式临床检查患者版为确诊工具,对某监狱在押女性罪犯进行创伤后应激障碍调查.结果 2 186名女性罪犯中,创伤后应激障碍终生患病率和最近1个月患病率(时点患病率)分别为1.41%(31/2 186)和1.01%(22/2 186).终生患病的31例患者中,创伤事件依次为目睹家庭暴力11例(35.48%),被虐待7例(22.58%),爱人或亲密朋友的突然死亡4例(12.90%),被攻击、抢劫4例(12.90%),性侵犯2例(6.45%),其他3例(9.68%).6例(19.35%)经历过2件创伤性事件,3例(9.68%)经历过多重创伤.31例患者中,GAF评分41～50分6例,51～60分15例,61～70分8例,71～80分2例,≤60分占67.74%(21/31).结论 女性罪犯是经历精神创伤和发生创伤后应激障碍的高危人群,加大对女性罪犯创伤后应激障碍防治具有重要意义.     

女性罪犯创伤后应激障碍的患病率及创伤特征

目的了解女性罪犯创伤后应激障碍的患病率及创伤事件特征。方法采用扩展的一般健康问卷(GHQ-12)结合罪犯精神障碍线索调查表为筛查工具,以美国精神障碍诊断与统计手册(DSM-IV)为标准,用DSM-IV-TR轴Ⅰ障碍定式临床检查患者版为确诊工具,对某监狱在押女性罪犯进行创伤后应激障碍调查。结果 2 186名女性罪犯中,创伤后应激障碍终生患病率和最近1个月患病率(时点患病率)分别为1.41%(31/2 186)和1.01%(22/2 186)。终生患病的31例患者中,创伤事件依次为目睹家庭暴力11例(35.48%),被虐待7例(22.58%),爱人或亲密朋友的突然死亡4例(12.90%),被攻击、抢劫4例(12.90%),性侵犯2例(6.45%),其他3例(9.68%)。6例(19.35%)经历过2件创伤性事件,3例(9.68%)经历过多重创伤。31例患者中,GAF评分41～50分6例,51～60分15例,61～70分8例,71～80分2例,≤60分占67.74%(21/31)。结论女性罪犯是经历精神创伤和发生创伤后应激障碍的高危人群,加大对女性罪犯创伤后应激障碍防治具有重要意义。     

暴力高发家系施暴者的精神创伤研究

目的 探讨国内社区家庭暴力高发家系严重躯体施暴者的精神创伤形式及影响,为家庭暴力干预及施暴者的心理治疗提供理论依据.方法 采用线索调查的方法,结合当地派出所、妇联、社区街道办事处、社区卫生服务中心提供的存在严重家庭暴力的备案登记资料,上门走访或电话预约进行面谈及问卷评估,筛选入组暴力家系施暴者(AP) 136例,无暴力家系施暴者(ANP) 93例,暴力家系非施暴者(NAP) 105例,无暴力家系非施暴者(NANP) 198例,评估并比较不同家系来源家庭暴力施暴者的创伤经历及创伤症状.结果 (1)AP组经历的创伤事件数量在6件以上总比例占了66.1％.AP组的创伤事件中位数达到7件,组间比较差异有统计学意义(P＜0.01).(2)AP组的回避[(1.37±0.79)分]、闯入症状分[(1.40±0.80)分]及创伤症状总分[(4.08±2.30)分]均明显高于其他三组,AP组的高警觉性症状分[(1.31±0.88)分]高于NAP组[(0.95±0.75)分]及NANP组[(0.94±0.83)分],ANP组闯入[(1.22±0.80)分]、高警觉性症状分[(1.14±0.85)分]高于NANP组(P＜0.05).(3)目睹家庭暴力、儿童期受虐分、经历创伤事件数量分别与三大创伤主症状分呈显著正相关.结论 暴力高发家系施暴者创伤性事件经历与严重躯体施暴行为呈显著相关.某些创伤事件经历,可能成为家庭暴力施暴行为出现的保护因素.在暴力高发家系中成长的施暴者创伤症状最严重,而闯入、高警觉症状与严重躯体施暴行为显著正相关.     

抑郁症患者的创伤性事件与创伤后应激症状的初步分析

目的初步探讨抑郁症患者的创伤性事件,及其与创伤后应激症状(IES-RC)的关系。方法采用抑郁自评量表(SDS)、焦虑自评量表(SAS)、创伤性事件问卷(TESI)和事件影响量表-修订版(IES-RC),评定了93例抑郁症的住院患者。结果(1)92%的患者经历过至少1件创伤性事件,74%经历的是3件或以上的多重精神创伤;最常见的创伤事件是"亲朋好友的突然死亡"48%、"自然灾害"42%、"目睹家庭暴力"30%。(2)创伤性事件数量与抑郁症患者的IES-RC总分、回避性亚症状分呈正相关,有统计学意义(r,p分别为0.30,0.018;0.34,0.007),但是与抑郁、焦虑症状无关(p>0.05);IES-RC总分与抑郁症状无关(p>0.05),但与焦虑症状关系密切(r=0.46,p=0.000)。(3)某些具体的创伤性事件与IES-RC、SDS分呈正相关,有统计学意义(p<0.05),但SAS分与具体的事件均无关(p>0.05)。结论抑郁症患者普遍经历较多的创伤性事件;创伤事件数量会增加抑郁症患者的焦虑和创伤后应激症状;抑郁症状则与创伤数量无关,但与具体的创伤性质关系密切;减少精神创伤有助于缓解抑郁症患者的抑郁及其他合病症状。     

正畸治疗牙周病72例临床效果分析

目的：观察正畸治疗用于口腔错畸形所致牙周病的实际疗效,评价其临床应用价值。方法：选择72例口腔错畸形患者,其中成年组33人,青少年组39人,均同时合并牙周病,接受正畸治疗,比较两组治疗时间、患者满意度及托槽脱落情况。结果：本次研究中,成年组平均治疗时间（18±4.5）个月,青少年组平均治疗时间（15±4.2）个月,组间差异有统计学意义（P〈0.05）;成年组托槽脱落率为12.12%（4/33）,满意率为93.94%（31/33）;青少年组托槽脱落率为15.38%（6/39）,满意率为82.05%（32/39）,组间差异无统计学意义（P〈0.05）。结论：成年人接受正畸治疗需要较长的治疗时间,但对于任何年龄阶段的口腔错畸形所致牙周病患者,口腔正畸治疗均能获得较好疗效。     

农村女性应激障碍患者的应激因素

有研究表明，社区普通人群中创伤后应激障碍（PTSD）的终生患病率，男性为5％，女性为10．4％；普通人群中女性的患病率是男性的2倍。在临床工作中亦发现，由精神创伤引起的应激障碍患者女性多于男性，尤其农村女性患者。为了解农村女性患者心理创伤因素，故展开调查，现将调查结果报告如下。     

单中心1536例肾活检病理资料分析[1]

目的：分析与总结2004～2021年内蒙古医科大学附属医院肾内科单中心肾活检病理分布特点与病理谱变迁。方法： 集内蒙古医科大学附属医院肾内科2004年1月～2021年11月行经皮肾活检患者的一般资料及病理资料,按患者年龄分为4组：A组：14～20岁,B组：21～40岁,C组：41～60岁,D组：＞60岁;按肾活检时间分为2004～2009年组、2010～2015年组和2016～2021年组,分析近18年来我院肾活检患者的病理类型特点及变迁。结果：（1）共纳入1536例肾活检病例,其中原发性肾小球疾病（PGD）1369例（89.13%）,继发性肾小球疾病（SGD）123例（8.01%）,病理类型叠加20例（1.30%）,肾小管间质疾病23例（1.50%）,遗传性肾病（Alport综合征）1例。（2）在PGD中,IgA肾病（IgAN） 499例,为数最多,占36.45%,男性多于女性;其次是膜性肾病（MN）,483例,占35.28%,男性多于女性;第三是肾小球微小病变（MCD）,占14.48%,女性略多于男性。继发性肾小球疾病中,狼疮性肾炎（LN）最多,占29.27%,女性发病率高于男性;其次是糖尿病肾病（DN）,占22.76%,男女比例相当;第三是过敏性紫癜肾炎（HSPN）,占20.33%。（3）在PGD中,IgAN以 B组最多,占51.24%;MN以C组最多,占47.86%;MCD以A组最多,占23.38%。在SGD中,LN以 A、B组居多,分别占50%、44.9%;DN以 C组最多,占39.58%;高血压肾损害B组较多;HSPGN 中A组最多、D组最少;ANCA相关肾炎（AAGN）则D组最多,占42.86%。（4）在2004～2009年、2010～2015年和2016～2021年3个时间段中,系膜增生性肾小球肾炎（MSPGN）的比例逐年减少,MN的比例逐年增加,从13.6%（2004～2009年）增加至43.5%（2016～2021年）。结论：PGD仍是我国最常见的肾小球疾病,尽管MN近5年有明显增加趋势,但IgAN仍是最常见的PGD,男、女发病相当,以21～40岁居多;MN以41～60岁男性高发;LN仍是最常见的SGD,中青年女性居多,其次为DN;近年来AAGN行肾活检的比例大幅度升高。     

延迟性创伤后应激障碍的流行病学特征及相关因素

创伤性事件是非常事件,它们威胁到个体生命、身体或精神世界的完整,使个体面临极度的无助和恐惧。1998年Bres lau等 [1]进行了社区流行病学研究,结果表明将近 90%的人在其一生中至少暴露于一件创伤性事件,平均每人经历的显著性创伤事件的数量是 4. 8,男性(5. 3)高于女性 (4. 3)     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.