认知行为治疗改善精神分裂症患者生活质量的随机单盲对照试验

目的:探讨认知行为治疗对精神分裂症患者生活质量的效果及相关因素,为寻找有效改善精神分裂症患者生活质量的方法提供依据。方法:本研究为单盲随机对照临床试验。选取符合美国精神障碍诊断与统计手册第4版(DSM-IV)中精神分裂症诊断标准的医院门诊和住院患者共120例,随机分配到认知行为治疗组(CBT组,n=60)和支持性心理治疗组(ST组,n=60),在药物治疗基础上分别接受15次认知行为治疗和支持性心理治疗。在基线采用世界卫生组织生存质量量表简表(WHOQOL-BREF)、阳性和阴性症状量表(PANSS)、应付方式问卷(CSQ)、非理性信念量表(IBS)及自编药物副反应问卷对两组患者进行盲法评定。第12周、24周采用WHOQOL-BREF和自编药物副反应问卷对患者进行随访评估。结果:第12周,CBT组患者WHOQOL-BREF总分各因子分均高于基线[(77.0±13.9)vs.(73.1±13.8),(22.4±4.5)vs.(21.5±4.7),(18.9±4.1)vs.(17.8±4.3),(9.3±2.2)vs.(8.9±2.3),(26.4±5.0)vs.(24.7±5.3),均P0.05],而ST组患者仅环境因子有显著改善[(23.9±4.7)vs.(25.0±5.2),P0.05],其余因子差异无统计学意义(P0.05)。第24周,两组在WHOQOL-BREF的社会关系和环境因子分上组间效应显著(F=6.77,7.21,均P0.05),CBT组得分均高于ST组。Logis-tic回归分析发现,基线应对方式分数较低、接受CBT及男性对患者的生活质量有正性预测作用(B=-0.25,2.31,-1.64,均P0.05)。结论:认知行为治疗能够有效改善精神分裂症患者的生活质量,且基线应对方式得分相对更低、能接受认知行为治疗及男性患者更容易从治疗中获得生活质量的改善。     

对首发精神分裂症康复期患者实施认知行为干预的效果观察

目的 探讨对首发精神分裂症康复期患者实施认知行为干预(CBT)的效果.方法 将60例首发精神分裂症康复期患者随机分为研究组(n=30)和对照组(n=30),研究组在精神科护理常规的基础上行CBT8周.干预前后分别对两 组患者用症状自评量表(SCL-90)评定心理健康状况.结果 干预后研究组SCL-90评分较干预前明显降低,差异有显著性意义(P＜0.01);治疗后研究组除偏执、精神病性外SCL-90评分低于对照组,差异有显著性意义(P＜0.01).结论 CBT可提高首发精神分裂症康复期患者的心理健康水平,提高治疗依从性.     

认知行为治疗对社区精神分裂症患者的疗效

目的:探讨认知行为治疗对社区精神分裂症患者的短期和长期疗效。方法:本研究为一项随机对照临床试验,纳入符合ICD-10精神分裂症诊断标准的患者32例,随机分成两组,分别接受常规治疗(TAU组,n=16)和常规治疗联合认知行为治疗(CBT组,n=16)。采用阳性与阴性症状量表(PANSS)和临床大体印象量表(CGI)于基线和治疗结束时分别对两组患者进行评定,并随访评估其半年和一年疗效。结果:112周、38周和64周时,CBT组PANSS总分显著低于TAU组(t=-2.174,-2.187,-3.256;P0.05);2在38周和64周时,CBT组阳性症状量表得分显著低于TAU组(t=-2.564,-2.146;P0.05);3在38周和64周时,CBT组一般精神病理症状量表分显著低于TAU组(P0.05);4CBT组的1年随访复发率显著低于TAU组(P0.025),而有效率显著高于TAU组(60.0%VS.20.0%,P=0.039)。结论:认知行为治疗可改善社区精神分裂症患者的症状及病情严重程度,尤其是阳性症状与焦虑抑郁等一般精神病理症状,降低复发率。     

大学生乐观人格与应对方式的关系

目的:探讨大学生乐观人格与应对方式的关系。方法:采用生活定向测验(LOT-R)与应对方式问卷(CSQ)对某高校314名大学生进行问卷调查。结果:1大学生乐观人格在生源地、是否独生子女、是否贫困生等方面不存在显著性差异(P0.05);在性别(t=4.315,P0.01)和年级(F=4.013,P0.01)上存在显著性差异;2乐观者在乐观因子、解决问题、求助上显著高于悲观者,悲观者在悲观因子、自责、退避和合理化上显著高于乐观者;3乐观人格与成熟积极的应对方式(解决问题、求助)呈显著正相关,与不成熟消极的应对方式(自责、退避、合理化)呈显著负相关;4幻想是大学生普遍的应对方式。结论:大学生的乐观人格特质对应对方式具有显著影响。     

自我效能感与高中生应对方式及抑郁情绪

目的 探讨高中生自我效能感、应对方式和抑郁情绪之间的关系.方法 采用自我效能感量表(GSES)、应付方式问卷和抑郁自评量表(SDS)对386名高中生进行问卷调查.结果 ①高中男生的GSES得分显著高于高中女生(t=2.550,P＜0.05);高三学生应对因子解决问题的得分显著高于高一和高二学生(F=3.173,P＜0.05);②高中生GSES得分与应对因子解决问题、求助有显著正相关(r1=0.393,P1＜0.01;r2=0.149,P2＜0.01),与自责有显著负相关(r=-0.149,P＜0.01),与SDS得分有显著负相关(r=-0.338,P＜0.001);③GSES得分高与GSES得分低的高中生在应对因子解决问题、自责、退避和SDS的得分上有差异显著(t1 =-7.695,t2=3.472,t3=-3.258,t4=6.800).结论 高中男生的自我效能感显著高于高中女生;高中女生更多使用求助应对方式;自我效能感高、更多使用积极应对方式的高中生,抑郁水平较低.     

The Relationship between Family Function and Coping Style,Social Support of Nurses

目的 探讨护士家庭功能与社会支持、应对方式的相互关系.方法 用家庭功能(FAD)、社会支持量表(SSRS)和应对方式问卷(CSQ)对某医院的护士进行调查.结果 家庭功能各维度均处于一个较好的水平,分值在2.08～2.38之间；家庭功能中的问题解决、沟通、总的功能与应对方式中的解决问题存在显著的负相关(r=-0.15,-0.19,-0.16；P＜0.05)；角色、情感反应、情感介入、总的功能与自责存在显著的正相关(r=0.26,0.19,0.18,0.15；P＜0.05)；沟通、角色、情感反应、总的功能与求助因子存在显著的负相关(r =-0.34,-0.28,-0.22,-0.35；P＜0.01)；问题解决、沟通、总的功能3因子与积极应对存在显著的负相关(r=-0.20,-0.28,-0.25；P＜0.01)；角色、情感反应、情感介入3因子与消极应对因子存在显著的正相关(r=0.23,0.15,0.26；P＜0.05)；沟通、角色、情感反应、情感介入、总的功能与对支持的利用度存在显著的负相关(r=-0.28,-0.27,-0.23,-0.24,-0.37；P＜0.01)；回归分析表明,对支持的利用度和求助可以显著地预测整个家庭功能(F=12.58,P=0.00).结论 护士家庭功能与社会支持及应对方式有显著的相关,对支持的利用度和求助2个因子对整个家庭功能状况有一定程度的预测作用.     

大学生人际信任与应对方式对社交回避的影响

目的:探讨人际信任和应对方式对大学生社交回避的影响。方法:采用人际信任量表(ITS)、应对方式问卷(CSQ)和社交回避及苦恼量表(SAD)对302名大学生进行问卷调查。结果:(1)人际信任与社交回避显著负相关(r=-0.204,P0.001),与应对方式中自责、幻想、退避和合理化因子显著负相关(r=-0.209,-0.156,-0.212,-0.120;P0.05),与问题解决、求助因子显著正相关(r=0.319,0.248;P0.001);问题解决和求助因子与社交回避呈显著负相关(r=-0.322,-0.302;P0.001),自责(r=0.309,P0.001)、幻想(r=0.132,P0.05)、退避(r=0.215,P0.001)和合理化(r=0.132,P0.05)因子与社交回避呈显著正相关;(2)问题解决(t=-4.975,P0.001)、求助(t=-4.761,P0.001)、自责(t=5.003,P0.001)和退避(t=3.159,P0.01)因子在人际信任与社交回避的关系中起部分中介作用。结论:人际信任一方面会对社交回避产生直接的影响,另一方面也通过问题解决、求助、自责和退避应对方式的中介作用间接地影响社交回避。     

认知行为训练改善大学生自我概念和应对方式实验研究

目的 探讨认知行为训练对大学生自我概念和应对方式改善的积极影响.方法 采用随机法选取某高校106名大学生进行调查和实验研究.结果 ①实验组实验前后在个人自我(t=-2.675,P＜0.01)、社会自我(t=-2.444,P＜0.05)、理想自我(t=-2.221,P＜0.05)、自我概念总均分(t=-3.706,P＜0.001)、解决问题(t=-7.760,P＜0.001)、求助(t=-6.475,P＜0.001)和应对方式总均分(t=-6.187,P＜0.001)上存在显著性差异;在自责、幻想、退避和合理化因子上差异不显著,对照组前后测无显著性差异;②用差值方式进一步检验研究结论发现,实验前后实验组和对照组差值在个人自我(t=2.368,P＜0.05)、理想自我(t=2.079,P＜0.05)、自我概念总均分(t=2.566,P＜0.05)、解决问题(t=4.977,P＜0.001)、求助(t=4.957,P＜0.001)和应对方式总均分差值(t=5.421,P＜0.001)上存在显著性差异;在社会自我、自责、幻想、退避和合理化差值上差异不显著;③在家庭结构差异上,在个人自我(t=2.701,P＜0.01)、自我概念均分差值(t=-2.8684,P＜0.01)上存在显著的家庭结构差异;在其他因子及总均分差值上无显著家庭结构差异.结论 认知行为训练能提高大学生的自我概念及应对方式.     

团体认知行为治疗对首发精神分裂症缓解期康复的影响

目的:探究团体认知行为治疗对首发精神分裂症缓解期患者康复的影响。方法:将126例首发精神分裂症缓解期患者分为研究组61例和对照组52例,研究组给予团体认知行为治疗。在干预前后分别进行自动思维问卷(ATQ)、症状自评量表(SCL-90)、领悟社会支持量表(PSSS)和应付方式问卷(CSQ)的评估。结果:①干预后研究组的ATQ评分明显低于对照组(t=-2.5914,P=0.0107);②干预后研究组的躯体化(t=-1.9983,P=0.0479)、人际关系敏感(t=-3.1662,P=0.0020)、抑郁(t=-3.0518,P=0.0028)、焦虑(t=-3.5234,P=0.0006)4个因子评分和SCL-90总分(t=-3.5429,P=0.0006)明显低于对照组;③干预后研究组的家庭支持(t=4.1017,P=0.0001)、朋友支持(t=2.6169,P=0.0100)、其他支持(t=2.0738,P=0.0402)和总分(t=3.0232,P=0.0031)均明显高于对照组;④干预后研究组在解决问题(t=2.3990,P=0.0180)、求助(t=2.2410,P=0.0268)因子的评分及成熟应对评分(t=2.3214,P=0.0219)明显高于对照组,自责评分明显低于对照组(t=-2.0490,P=0.0426);⑤干预前后的ATQ评分差值对SCL-90总分差值(P=0.005)、PSSS总分差值(P=0.012)和成熟应对评分差值(P=0.032)、不成熟应对评分差值(P=0.044)起中介效应。结论:团体认知行为治疗可以改善患者负性自动思维,进而改善患者的心身症状、社会支持和应对方式。     

精神分裂症患者生活质量与应对方式的关系

目的探讨精神分裂症患者生活质量与应对方式的关系。方法选取符合美国精神疾病诊断与统计手册第4版(DSM-IV)中精神分裂症诊断标准的医院门诊和住院患者共175例。采用世界卫生组织生存质量测定量表简表(WHOQOL-BREF)和应对方式问卷(CSQ)对患者进行评估。结果生活质量的生理、心理、社会关系、环境4个因子及总分与应对方式中的问题解决呈显著正相关(r=0.41,0.51,0.37,0.34,0.49;P<0.001),与自责呈显著负相关(r=-0.36,-0.44,-0.32,-0.21,-0.38;P<0.01),与回避呈显著负相关(r=-0.16,-0.19,-0.18,-0.16,-0.20;P<0.05);问题解决和自责两种应对方式能够很好地预测精神分裂症患者的生活质量(F=39.68,P=0.00)。结论精神分裂症患者的生活质量与应对方式关系密切,且问题解决和自责两种应对方式可作为生活质量的预测指标。     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

Class II HLA in Georgia Caucasus Tbilisi Georgians and their Mediterranean ancestry: The Usko Mediterranean languages

Georgia (or Sakartvelo in its own language) is a South Caucasus Mts. country with its easternmost part is enigmatically named Iberia, like the Iberian Peninsula, which may refer to rivers “Kura” and “Ebro” or their valleys respectively. Most of their inhabitants speak Georgian which is included within Dene-Caucasian group and Usko-Mediterranean subgroup of languages. The latter includes Basque, Berber, ancient Iberian-Tartessian, Etruscan, Hittite, Minoan Lineal A and others. In the present paper, HLA class II -DRB1 and -DQB1 alleles has been studied and extended haplotypes calculated. Most frequent haplotypes are also of Mediterranean origin (i. e.: (A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*51)-DRB1*13:01-DQB1*06:03, or (A*24-B*35)-DRB1*01:01-DQB1*05:01) and DA genetic distances show that closest world populations to Georgians are Mediterraneans. Georgians also show common extended haplotypes ((A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*13)-DRB1*07:01-DQB1*02:01 and (A*03-B*35)-DRB1*11:01-DQB1*03:01) with Svan people, a secluded population in North Georgia mountains. We can conclude that Georgians belong to a very old Mediterranean substratum according to both linguistics (Usko Mediterranean languages) and HLA genetics.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.