军人急性应激反应量表的研制

目的 编制军人急性应激反应量表,并对其信效度进行检验.方法 以急性应激理论和心理测量学原则为依据,结合开放式问卷调查及以往研究,编制本量表.整群随机抽取630名军人进行测验,并随机选择其中50名被试,同时施测中国军人心身健康量表;2周后对其中50人进行本量表的重测.通过探索性因素分析、验证性因素分析和相关分析,检验量表的信效度.结果 军人急性应激反应量表包括9个公共因子及1个掩饰因子.模型拟合指数分别为CMIN=1219.476,DF=593,P=0.000,CMIN/DF=2.056,IFI =0.927,TLI=0.902,CFI =0.924,RMSEA=0.059;各因子之间的相关系数为0.284 ～0.572,各因子与总量表之间的相关系数为0.700 ～0.846(P＜0.05或0.01).本量表与中国军人心身健康量对应因子之间相关系数为0.338～0.962 (P＜0.01).总量表和各因子的重测相关系数为0.379 ～0.909(P＜0.05或0.01).总量表和各因子Cronbaeh;s系数为0.606 ～0.926;总量表和各因子的分半系数为0.466～0.855.结论 军人急性应激反应量表的信效度符合心理测量学的要求.     

大学生偶像崇拜量表的初步编制及信效度检验

目的 编制大学生偶像崇拜量表.方法 通过查阅文献、访谈及小组讨论,建立量表结构,并确定初始量表项目54条.在广州的高校大学生中施测,3次选取110、182和277名大学生为样本.采用项目分析、探索性因素分析、信度分析和验证性因素分析等统计方法对数据进行统计分析.结果 大学生偶像崇拜量表由四个分量表构成:迷恋程度、理性认识程度、关注程度、行为改变程度.共有20个项目,各项目因素负荷为0.552～0.841.四个分量表的α系数分别为0.894,0.715,0.769,0.758,总量表的α系数为0.889.验证性因素分析拟合度较高(RESEA=0.064,GFI=0.89,NFI=0.96,NNFI=0.98,CFI=0.98,IFI=0.98).结论 量表具有良好的心理测量学特性,可以作为大学生偶像崇拜的工具.     

心境焦虑问卷维文版在医学院校大学生中的信效度研究

目的 评估心境焦虑问卷维文版在医学院校维吾尔族大学生中的信度和效度.方法 选择335名维吾尔族医学大学生完成心境焦虑问卷,进行量表的内部一致性和验证性因素分析.结果 心境与焦虑症状问卷(MASQ-SF)全量表的α系数为0.92,4个分量表的α系数在0.81~0.92之间;全量表的分半信度系数为0.76,4个分量表的分半信度系数为0.81~0.91.验证性因子分析结果显示CFI=O.92,IFI=0.92,NNFI=0.92,RMSEA=0.07.结论 MASQ-SF的信度与效度达到了心理测量学要求,能够有效的评估维吾尔族大学生的焦虑抑郁水平.     

军人职业倦怠量表的信效度检验

目的 研制军人职业倦怠量表,并对其信度、效度进行检验.方法 采用随机整群抽样方法 ,选取1000名健康官兵,并分为A(500名)、B(500名)两组.用研制的军人职业倦怠量表对两组被试进行测试.对其中的280人同时使用本量表和工作倦怠问卷进行施测;对收集的A组数据进行探索性因素分析和相关分析,B组数据进行验证性因素分析.结果 经相关分析发现:总量表的Cronbach'α系数为0.917,各因子的Cronbach'α系数为0.719～0.847;总量表的分半信度为0.920,各个因子的分半信度为0.723～0.867.总量表与各分量表之间的相关系数为0.731～0.808(P＜0.01),各分量表之间的相关系数为0.386～0.627(P＜0.01).经探索性及验证性因素分析发现:所测数据与理论模型(成就感、躯体化、自我评价、人际关系、消极怠工);相一致,拟合指标的卡方值为771.914,自由度(DF)为395,相对卡方值为1.954,P=0.000,近似误差均方根为0.044,拟合优度指数、比较拟合指数、增值拟合指数分别为0.904,0.919,0.920.军人职业倦怠量表总分及各因子分与工作倦怠问卷的总分及各因子分之间具有显著的相关性.结论 自行研制的军人职业倦怠量表具有较好的信度和效度.     

认知情绪调节问卷维文版在医学院校大学生中的信效度研究

目的 评估认知情绪调节问卷(CERQ)维文版在医学院校维吾尔族大学生中的信度和效度.方法 2014年331名维吾尔族医学大学生完成认知性情绪调节问卷,进行量表的内部一致性和验证性因素分析.结果 CERQ全量表的α系数为0.88,9个分量表的α系数在0.57~0.89之间;全量表的分半信度系数为0.70,9个分量表的分半信度系数为0.57~0.89.验证性因子分析结果显示CFI=O.93,IFI=0.93,NNFI=0.92,RMSEA=0.06.结论 CERQ的信度与效度都达到了心理测量学要求,能够有效地评估维吾尔族大学生的认知情绪调节策略.     

军人情绪调节方式量表的编制

目的 研制军人情绪调节方式量表,为部队情绪调控训练与心理选拔提供参考.方法 对心理学家、军事专家、军人进行开放式问卷和半开半闭问卷的调查研究,据此编制初始问卷,再整群抽样测查6地区陆海空军人( n =1738),对问卷进行鉴别力分析、因素分析及信效度检验,最后形成22题的正式问卷,即军人情绪调节方式量表.结果 量表的内部一致性系数为0.875,分半信度为0.854;各因素的内部一致性系数为0.680～0.769,分半信度为0.659～0.723;量表各因素与问卷总分的相关系数为0.656～0.791;量表各因素之间相关系数为0.110～0.791;量表中鉴别指数D≥0.4的题目占全部题目数的42.86%.结论 编制的军人情绪调节方式量表具有良好信效度,为部队开展心理健康教育与训练提供了理论和实践的依据.     

维和官兵创伤及压力暴露量表的初步编制及信效度检验

目的 初步编制维和官兵创伤及压力暴露量表,并评价其信度及效度.方法 基于文献回顾和访谈法确定量表的理论模型和结构模型,建立条目池,编制测试条目,经专家修订形成基本条目.于2019年10月对某2批赴南苏丹维和步兵营733名官兵进行测试,通过项目分析等进行条目筛选,应用探索性因素分析等形成基本量表.运用量表于2020年1月对另一批赴南苏丹维和步兵营595名官兵进行验证性测试,以Cronbach'sα系数和分半信度检验量表的信度,通过相关分析、验证性因素分析等验证量表的结构效度,以军事应激症状核查表(PCL-M)为校标表进行校标关联效度检验,通过ROC曲线评估量表的预测效度.结果 量表最终形成5个因子,分别为维和期创伤性事件、个人生活应激源、人际关系应激源、任务评价和过去创伤性事件,共25个条目,累积贡献率达62.909％.验证性因子分析结果显示总量表同质信度Cronbach'sα系数为0.909,分半信度为0.806.结构效度检验中各拟合指数均处于理想标准值范围内,χ2/df=2.438,均方根残差=0.042,近似误差均方根=0.082.各维度得分均与总分呈正相关(r=0.411～0.727,P均<0.01).量表总分与PCL-M校标表总分的校标关联效度为0.623(P<0.01).以5％为划分点计算量表的预测效度,AUC值为0.937(95％CI 0.907～0.967).结论 经过严格的条目筛选后初步编制了维和官兵创伤及压力暴露量表,量表的条目符合代表性好、灵敏度高、区分性好的原则,达到了编制的要求.     

儿童自我控制双系统量表的编制与信效度分析

目的 编制儿童自我控制双系统量表,并检验其信效度.方法 基于自我控制的双系统理论和前人研究成果,编制了儿童自我控制双系统量表.以此量表对选取自五个省的1493个家庭进行调查.通过项目分析筛选项目,对数据进行探索性因素分析和验证性因素分析检验问卷的结构效度,并检验问卷的信度和效标效度.结果 经过探索性因素分析,最后得到的儿童自我控制双系统量表有23个条目,包含5个因子,分别命名为：计划性,冲动性,易分心,坚持性,低延迟满足,累计方差贡献率为50.46％.验证性因素分析所得指标均符合心理测量学的要求（RMSEA=0.044、NFI=0.95、NNFI=0.97、CFI=0.97）.儿童自我控制双系统量表得分以及各分量表得分与自我控制教师评定量表得分的相关均具有统计学意义.儿童自我控制双系统量表的Cronbach oα系数为0.855,各因子的Cronbachα系数分别为0.813,0.803,0.582,0.608,0.620.结论 儿童自我控制双系统量表具有较好的信效度,适合用于评估我国儿童的自我控制能力水平.     

国企职工压力源量表的编制

目的 编制国企职工压力源量表.方法 基于50名国企职工深度访谈的结果,编制此量表.利用它对6400名国企职工施测,获得有效问卷5669份.将被试随机划分为两组,用第1组(n1=2835)数据进行探索性因素分析,用第2组(n2=2834)数据进行验证性因素分析.用症状自评量表(SCL-90)中的焦虑、抑郁和躯体化分量表为效标.结果 探索性因素分析获得15个项目,4个因子:工作压力源、人际压力源、发展压力源和家庭压力源.各因子负荷在0.57～0.84之间,累积方差贡献率为66.329％.验证性因素分析结果表明量表的四因素模型拟合良好(RMSEA=0.066,NFI=0.97,NNFI=0.97,CFI =0.97,IFI=0.97,GFI=0.95).总量表的α系数为0.84,4个因子的α系数在0.75～0.89之间.压力源量表总分及4个因子与焦虑、抑郁、躯体化之间均显著正相关(0.29～0.43,均P＜0.0.1).结论 国企职工压力源量表的信效度均符合心理测量学要求,是可靠的测评工具.     

SMMU军事应激反应性焦虑预测量表的初步编制及其预测率的研究

目的 编制能供我军大批量使用的应激反应性焦虑预测量表.方法 1.以2000名军人为研究对象,参考以往的心理学相关研究,以特质焦虑量表为主,从已有的心理测评量表中选取与本研究目的 相关的208项条目,对军事应激前各项分值与军事应激期状态焦虑总分值的进行相关回归分析,根据其回归系数的大小选取条目组成新的量表并作信度、效度等分析.2.比较在应激前以特质焦虑量表(T-AI)和新量表两种方法区分出的易感人群,在应激时状态焦虑量表(S-AI)高得分的比率.结果 经多元回归分析,208项中有40项条目进入回归方程 (R2 =0.677,F=87.460,P=0.000),初步形成38项的SMMU军事应激反应性焦虑预测量表.量表同质信度Cronbachα系数为0.755,折半信度Guttman系数为0.702,Spearman-Brown系数为0.703.结构效度的检验采用主因子分析法,KMO值为0.926(P＜0.01),量表初步定义特质性焦虑和反应性抑郁两个维度.应激前用特质焦虑量表预测应激期高状态焦虑的预测率为52.20%,而使用SMMU军事应激反应性焦虑预测量表预测率达79.51%(P＜0.01).结论 SMMU军事应激反应性焦虑预测量表量表简便、易行,且有良好的信度和效度.     

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.