银屑病患者认知功能障碍分析

目的:明确银屑病患者认知功能特点及影响因素。方法:对43例银屑病患者、30名健康对照采用蒙特利尔认知功能评估量表(MoC A)进行认知功能的评估,同时使用贝克抑郁自评量表(BDI)及贝克焦虑自评量表(BAI)进行抑郁及焦虑情绪的评估,并对可能影响银屑病患者认知功能的因素进行分析。结果:银屑病患者的认知功能障碍发生率为30.2%。银屑病认知障碍组视空间功能及执行功能得分分别为1.69±1.25和2.46±0.87,显著低于银屑病认知正常组(3.03±0.80,3.33±0.88)及对照组(3.30±0.75,3.57±0.56),差异均有统计学意义(均P0.05)。经多元回归分析发现,银屑病患者的年龄、病程及BDI评分是影响认知功能的消极因素(P0.05)。结论:银屑病患者的部分认知域功能较正常人群减退,主要累及视空间功能及执行功能。影响银屑病患者认知功能的因素包括年龄、病程与抑郁情绪。     

采用PHQ-9及GAD-7量表评估青少年痤疮患者心理状况的临床研究

目的探讨青少年痤疮患者的精神、心理状况。方法对(13～19)岁男女中学生进行痤疮的筛查,从而获得深圳市青少年痤疮患病率的流行病学数据。根据筛查结果,纳入无痤疮健康对照组600例,痤疮患者601例,使用焦虑自评量表、抑郁自评量表评估两组精神心理状态。结果痤疮患者组焦虑发生率38.4%,抑郁发生率38.9%,高于健康对照组(P 0.001);痤疮患者组GAD-7、PHQ-9评分值也均高于对照组(P 0.01)。痤疮组348例女性患者,其焦虑、抑郁发生率及GAD-7、PHQ-9评分值均高于男性痤疮患者(P 0.05)。中、重度痤疮患者GAD-7、PHQ-9评分值均较轻度痤疮患者高(P 0.05)。结论青少年期痤疮发生率高,痤疮患者容易出现焦虑、抑郁情绪、中重度痤疮、女性患者的焦虑、抑郁心理更明显。     

新型冠状病毒肺炎危重症患者的焦虑抑郁及相关因素分析

目的了解新型冠状病毒肺炎危重症患者的焦虑抑郁状况及相关因素,为采取针对性心理干预提供参考依据。方法在2020年3月对94例新型冠状病毒肺炎危重症患者采用焦虑自评量表及抑郁自评量表进行调查。结果焦虑得分43.30±11.56,发生率为22.34%;抑郁得分45.34±13.35,发生率为25.53%。经Pearson相关分析,新型冠状病毒肺炎危重症患者焦虑与抑郁(P<0.001)、女性(P=0.010)、学历(P<0.001)、住院天数(P=0.003)相关;抑郁与焦虑(P<0.001)、年龄(P=0.009)、职业(P=0.049)、家庭人均月收入(P=0.034)相关。最终回归方程显示性别、年龄、学历、住院天数、家人感染、家人住院是焦虑、抑郁的相关因素c结论新型冠状病毒肺炎危重症患者的焦虑与抑郁情绪明显,需要根据不同的相关因素进行有效的心理干预,以促进患者康复。     

银屑病患者抑郁症状检出情况及影响因素调查分析

目的:了解银屑病患者的抑郁检出情况及影响因素。方法:采用流调中心用抑郁自评量表,对我院皮肤科门诊128名银屑病患者进行调查;使用卡方检验、logistic回归分析进行统计分析。结果:银屑病患者CES-D平均得分为(16.14±4.36),CES-D得分≥16的有56人,抑郁检出率为43.75%;银屑病患者抑郁检出率在不同年龄(χ~2=16.75,P0.01)、文化程度(χ~2=13.01,P0.01)、病情分类(χ~2=43.05,P0.01)和病程(χ~2=9.02,P0.01)患者中均存在明显差异;两两比较发现,30~60岁及60岁以上抑郁症状检出率显著高于30岁以下年龄组(χ~2值分别为16.55、10.37,P0.05),大学及以上组抑郁症状检出率显著低于其他三组(χ~2值分别为12.91、6.12、6.38,P值均0.05);Logistic回归发现重度银屑病患者病情是患者抑郁的明显影响因素,重度银屑病患者抑郁检出风险更高(OR=40.905,95%OR=9.499-176.145)。结论:银屑病患者抑郁的检出率较高,患者抑郁与银屑病病情显著相关。应重视银屑病患者个体化心理健康教育。     

认知行为干预对晚期前列腺癌去势手术后合并焦虑抑郁情绪患者的效果评价

目的评价认知行为干预对晚期前列腺癌去势手术患者焦虑抑郁情绪及应对方式的影响。方法选取2015年1月至2018年11月广州军区广州总医院诊治的42例晚期前列腺癌去势手术后合并焦虑抑郁情绪患者作为研究对象。按照随机数字表法将其随机分成试验组(n=21)和对照组(n=21)。对照组按照相关诊疗标准进行药物治疗和常规护理;试验组在对照组基础上采用认知行为干预,每周3次。在干预前、术后第7天和术后第14天,用焦虑自评量表(SAS)和抑郁自评量表(SDS)分别评定两组患者的焦虑和抑郁情绪,用医学应对方式得分(MCMQ)评定两组患者应对行为。结果术后7天和术后第14天,试验组患者的SAS和SDS评分均低于对照组,差异具有统计学意义(均P0.05),试验组SAS及SDS评分不同时点间差异均具有统计学意义(均P0.001);干预7天后,两组患者面对得分及回避得分组间差异均具有统计学意义(均P0.05),而屈服得分在干预14天后差异具有统计学意义(P0.001),试验组面对得分比对照组高,回避得分及屈服得分比对照组低,试验组面对得分、回避得分及屈服得分不同时点间差异均具有统计学意义(均P0.001)。随访治疗1年后的患者发现,试验组患者在认知功能、情绪功能、躯体功能、角色功能、社会功能、总体生活质量得分高于对照组,差异均具有统计学意义(均P0.05)。结论认知行为干预能改善晚期前列腺癌去势手术后患者的焦虑抑郁负性情绪,改善应对方式,值得临床进一步推广。     

非淋球菌性尿道炎(宫颈炎)患者抑郁情绪评估分析

目的 探讨非淋球菌性尿道炎(宫颈炎)患者抑郁情绪的发生情况,针对抑郁情绪程度的不同采取相应的心理治疗,提高对非淋球菌性尿道炎(宫颈炎)患者的疗效.方法 以110例非淋球菌性尿道炎(宫颈炎)患者为试验组,以50例正常人为对照组.采用抑郁他评量表中HAMD、抑郁自评量表中SDS和Cattell-16PF三种量表分别对两组进行测评分析.结果 ①用HAMD量表测定试验组的抑郁情绪发生率为51.82%(57/110)重度抑郁的发生率为10.09%(12/110).②用SDS量表测定试验组的抑郁情绪发生率为48.18%(52/110),重度抑郁的发生率为9.09%(10/110).③用HAMD法K=0.82,SDS法K=0.87,说明两种量表评价非淋球菌性尿道炎(宫颈炎)患者抑郁情绪的严重程度一致性较好.④Cattell16PF中稳定性、敏感性、怀疑性和紧张性等人格特质与对照组有明显差异.结论 非淋球菌性尿道炎(宫颈炎)患者存在着明显的心理异常,尤其是抑郁情绪表现突出,在临床诊疗中,对非淋球菌性尿道炎(宫颈炎)患者既要进行行之有效的药物治疗,又应积极了解其心理状况,发现其抑郁情绪等心理症状,针对抑郁情绪加强相应的心理治疗.     

地震救援后施救者的心理状况分析

目的研究救援行为对施救者心理状况的影响。方法选择参与救援的20名解放军战士（观察组）与普通人（对照组）,填写症状自评量表（SCL-90）、艾森克人格问卷（EPQ）以及焦虑抑郁自评量表（SDS、SAS）,作为研究指标进行测验和分析。结果观察组与对照组在抑郁（f4）和敌对（f6）两个因子分上有显著差异。观察组EPQ的L分分值于地震一个月后显著高于对照组（P〈0．05）。结论施救行为对于施救者心理状况有影响。主要表现为情绪抑郁和敌对态度,掩饰性增强。     

个案管理模式在处置HIV职业暴露中的作用研究及效果观察

目的探析处置人类免疫缺陷病毒(HIV)职业暴露中应用个案管理模式的作用与效果。方法选取2018年1月至2020年12月期间40例HIV职业暴露医护人员作为研究对象,所选对象在HIV职业暴露处置中均实施个案管理模式。记录与对比干预前后心理症状情况、焦虑与抑郁情绪变化情况。结果 40名医护人员干预后,症状自评量表(SCL-90)评分较干预前低,焦虑自评量表(SAS)评分与抑郁自评量表(SDS)评分较干预前低,差异有统计学意义(P 0.05)。结论在处置HIV职业暴露中实施个案管理模式,可减轻其心理症状,有效减轻焦虑与抑郁情绪。     

认知疗法对梅毒血清固定女性患者焦虑抑郁情绪的影响

目的:探讨认知疗法对梅毒血清固定女性患者焦虑抑郁情绪的影响。方法:将120例梅毒血清固定女性患者随机分成干预组和对照组(各60例),两组治疗前均予以焦虑自评量表(SAS)和抑郁自评量表(SDS)评定其焦虑抑郁情绪,对照组常规青霉素驱梅治疗3周,干预组在常规治疗基础上加认知疗法,3周后对患者重新评分,并进行比较。结果:干预组患者治疗前后SAS、SDS评分比较,差异均有统计学意义(t值分别为12.79、13.86,P值均<0.01);对照组患者治疗前后评分比较,差异无统计学意义(t值分别为0.80、0.65,P值均>0.01)。结论:认知疗法对改善女性梅毒血清固定患者焦虑抑郁情绪有积极意义。     

神经精神功能障碍性皮肤病

20120227 神经性皮炎患者抑郁焦虑情绪测查/孙晓雯(甘肃天水市一院皮肤科),马家驰//中国皮肤性病学杂志.-2011,25 (4).-294 ～ 295选用抑郁自评量表(SDS)和焦虑自评量表(SAS)测查125例门诊神经性皮炎患者抑郁焦虑情绪状况,并与中国常模数值比较.结果显示,SDS( 49.65±11.08)和SAS(53.43±12.39)标准分均值均高于常模组数值(41.88±10.57,33.80±5.90),差异均有统计学意义(P均＜0.001).认为神经性皮炎患者抑郁和焦虑情绪突出.     

Cervical smears and human papillomavirus typing in sex workers

OBJECTIVES: Sex workers are at increased risk for sexually transmitted infections (STI), human papillomavirus (HPV) and hence cervical cancer. In Belgium screening for cervical cancer starts at the age of 25, and is at 3 yearly intervals. The aim of this study is to assess risks for abnormal cervical smears and HPV in sex workers and decide whether the current screening policy is sufficient for them. METHODS: In an outreach programme for sex workers results of 653 smears sampled between 1992 and 2001 were analysed, and compared to a control group matched for age from the general population in 2001. Separately, 99 consecutive samples were typed for HPV and compared to an equal control group, matched for age. Smears and typing were performed according to current techniques. RESULTS: In the sex worker group 2.6% were diagnosed with atypical glandular cells of undetermined significance (AGUS)/atypical squamous cells of undetermined significance (ASCUS), 15.6% with low grade squamous intraepithelial lesion (LSIL), and 2.9% with high grade squamous intraepithelial lesion (HSIL), and in the control group results were 1.4%, 2.9% (p<0.001) and 0.6% (p<0.001) respectively. When considering only those under 25 years, 24.4% should have further follow up. Of the sex workers, 77.4% were positive for one or more types of HPV (55.9% for high risk HPV), in comparison with 27.6% of the control group (14.3% for high risk HPV) (p<0.001). In high risk HPV samples more LSIL and HSIL were found. CONCLUSION: Abnormal smears and high risk HPV were significantly more prevalent in sex workers than in controls. Current screening policy would miss many sex workers with an abnormal smear who should be referred for further follow up. It is proposed to screen sex workers when they enter prostitution regardless of their age.     

Chlamydia trachomatis infections in multi-ethnic urban youth: a pilot combining STI health education and outreach testing in Rotterdam, Netherlands

Background/ OBJECTIVES: Testing for Chlamydia trachomatis (Ct) is less accepted in people of non-Dutch ethnicity than Dutch people. We offered additional Ct and gonorrhoea testing through our outreach sexually transmitted infections (STI) prevention programme to determine whether this intervention strategy is feasible and efficient. METHODS: Outreach workers offered test kits to women and men aged 15-29 years, in group and street settings and in a vocational training school. Demographic and behavioural data and characteristics of non-responders were assessed. DNA was isolated (using the MagNA Pure LC system) from urine and tested using the Cobas Amplicor test. RESULTS: Among sexually active people, the test rate differed by venue (groups 80% (74/93), school 73% (49/67), street 17% (49/287); p<0.001). There was no difference in test rate between group and school settings by gender or ethnicity. Ct positivity was 14.5% (25/172); women 20.2% (20/99) versus men 6.8% (5/73); p = 0.01. Ct positivity was highest at school (24.5% (12/49)) and among Surinamese/Antillean people (17.5% (14/80)). Treatment rate of index cases and current partners was 100% and 78%, respectively. CONCLUSIONS: We found a high acceptance of chlamydia testing in group and school settings in both men and women of non-Dutch ethnicity. The prevalence indicates that we have accessed high risk people. Outreach testing and is feasible and most efficient in school and group settings. School screening may have an impact on community prevalence of Ct infections.     

北京地区患者沙眼衣原体、淋球菌及解脲脲原体感染分析

目的分析门急诊患者泌尿生殖道沙眼衣原体(CT)、淋病奈瑟菌(NG)及解脲脲原体(UU)感染情况。方法选取2014年1月至2019年6月北京大学第三医院诊治的23 847例门急诊就诊患者的CT、NG和UU荧光核酸恒温扩增检测结果及相应临床诊断信息进行回顾性分析。结果 23 847例患者中,22 953例男性患者CT、NG、UU的检出率分别为5.0%、2.0%与22.6%;894例女性患者CT、NG、UU的检出率分别为7.9%、1.9%与48.9%。女性患者CT、UU检出率均高于男性,差异具有统计学意义(P=0.000),而NG检出率差异无统计学意义(P=0.858)。按年龄段分层,各性别中CT、NG最高检出年龄段均为≤20岁年龄段。临床诊断明确的男性患者中,CT检出最高为附睾炎(27.4%)人群,NG检出率则以尿道炎患者(16.7%)最高,UU检出率最高为不育症患者(32.6%)。结论女性患者CT检出率高于男性,男性附睾炎患者应注意筛查CT、NG。     

Trends in sexually transmitted diseases and condom use patterns among commercial sex workers in Fukuoka City, Japan 1990-93.

OBJECTIVE: To investigate trends in sexually transmitted diseases (STDs) among female commercial sex workers and in their condom use patterns during the period from 1990 to 1993 in Fukuoka, Japan. METHODS: The study group consisted of a total of 824 commercial sex workers who attended an STD clinic to undergo screening for STDs including chlamydia, gonorrhoea, syphilis, hepatitis B and HIV-1 infection during the period from 1990 to 1993. For detection of Chlamydia trachomatis and Neisseria gonorrhoeae, endocervical smear specimens were taken from the women. Blood samples were obtained for serological diagnosis of syphilis, hepatitis B and HIV-1. Commercial sex workers who visited the clinic during the period from November to December of 1993 were interviewed concerning past (1990 and 1991) and recent (1992 and 1993) condom use patterns. RESULTS: The annual detection rates of C trachomatis and N gonorrhoeae declined significantly from 16.3% in 1990 to 12.2% in 1993 (P < 0.0001) and from 1.5% in 1990 to 0.8% in 1993 (P = 0.0096), respectively. There was a remarkable reduction in the annual syphilis infection rate, from 7.5% in 1990 to 0.5% in 1993 (P = 0.0011). The positive rate for the hepatitis B surface antigen in the women ranged from only 0.6% to 1.9% and none were found to be positive for HIV-1 during the 4-year period. During the same period, there was a significant increase in the proportion of commercial sex workers always using condoms from 6.3% in 1990-91 to 25.3% in 1992-93 (P = 0.0023). CONCLUSION: The prevalences of chlamydia, gonorrhoea, and syphilis infections decreased significantly among commercial sex workers in Fukuoka from 1990 through 1993, and no commercial sex workers were HIV-1 seropositive. The reductions in the prevalence of major STDs may be related to the increased use of condoms.     

Prevalence of mood and sleep problems in chronic skin diseases: a pilot study

The relationship between chronic skin problems and mood and sleep disorders merits more attention. Mood and sleep problems add to comorbidity of chronic skin diseases and affect patient compliance with dermatologic treatment. A pilot study was conducted to determine the prevalence of mood and sleep problems in participants with chronic skin diseases in outpatient dermatology clinics at the University of Wisconsin, Madison, using 4 self-assessment questionnaires. Study participants included willing adults with any skin problem of at least 6 months' duration. The participants were asked to complete the questionnaires, which included Current Life Functioning, Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI-II), and Beck Anxiety Inventory. In summary, 15 of 16 participants had poor sleep quality. Six participants had poor sleep quality without any mood problems (depression or anxiety). Mood problems worsened the quality of sleep and functioning. Nine of 16 participants (56.25%) reported mood problems (depression or anxiety). The results show a high prevalence of depression and anxiety and a very high prevalence of poor sleep quality. Considering the negative effect of comorbid psychiatric and sleep problems on treatment and prognosis of chronic skin diseases, this study demonstrates the need for further evaluation and eventual screening of all patients with chronic skin diseases for mood and sleep problems.     

不同剂量和不同剂型甘草酸苷制剂对甲醛和硫酸镍皮肤斑贴试验的影响

目的研究复方甘草酸制剂对甲醛和硫酸镍皮肤斑贴试验的影响。方法选择甲醛和硫酸镍皮肤斑贴试验阳性的患者96例,首次斑贴试验结束后先后给予不同剂量及不同剂型甘草酸苷制剂进行干预。中剂量复方甘草酸苷片50 mg,每日3次口服,连续治疗2周;2个月后给予高剂量复方甘草酸苷片75 mg,每日3次口服,连续治疗2周,均在治疗干预后2周进行斑贴重复试验;2个月后给予静脉干预(复方甘草酸苷注射液60 ml/d),于治疗干预后1周进行斑贴重复试验,并分析不同剂量及剂型复方甘草酸苷制剂对甲醛和硫酸镍皮肤斑贴试验的影响。结果中剂量干预后92例斑贴试验阳性,其中15例为弱阳性(+),75例为强阳性(++),2例为极强阳性(+++),无阴性检查结果,反应程度Z=-3.367,P=0.001。高剂量干预后79例阳性,其中40例为弱阳性(+),39例为强阳性(++),10例为阴性(-),反应性质Z=-5.792,P=0.000;反应程度Z=-8.774,P=0.000。静脉干预后23例阳性,其中11例为弱阳性(+),12例为强阳性(++),36例为阴性(-),反应性质Z=-8.024,P=0.000;反应程度Z=-9.683,P=0.000。结论复方甘草酸苷高剂量和采用静脉注射可对甲醛和硫酸镍皮肤斑贴试验产生明显抑制作用,并对诱发的变应性接触性皮炎有一定的临床疗效。     

四逆加黄连方联合无创正压通气对急诊心力衰竭血清NT-proBNP、Galectin-3、CK-MB及氧动力学指标的影响

目的 观察四逆加黄连方联合无创正压通气用于急性心力衰竭患者疗效的影响,及其对患者Galectin-3、NT-proBNP、CK-MB及氧动力学指标的影响.方法 选取2017年1月—2020年5月于邯郸明仁医院治疗的急性心力衰竭患者162例,按照随机数字表法分为对照组和观察组,每组81例.对照组患者给予无创呼吸机辅助通气...     

复方甘草酸苷对皮肤斑贴试验的影响

目的 探讨复方甘草酸苷制剂对皮肤斑贴试验的影响.方法 选取皮肤斑贴试验镍阳性(++)或甲醛阳性(++)患者84例,分别给予复方甘草酸苷制剂中剂量干预(复方甘草酸苷片50 mg每天3次)和高剂量干预(复方甘草酸苷片75 mg每天3次)均2周后重复皮肤斑贴试验以及静脉途径干预(复方甘草酸苷注射液,60 ml/d)1周后重复皮肤斑贴试验.应用SPSS 19.0版软件进行秩和检验,从斑贴试验定性和反应程度两个角度分别进行统计学分析.结果 中剂量干预完成研究81例患者,第2次斑贴试验时,66例++,13例+,2例+++,无阴性结果者.两次斑贴试验结果定性无变化;反应程度Z=-2.84,P=0.005,差异有统计学意义.高剂量干预完成研究82例患者,第2次斑贴试验时,37例++,36例+,9例阴性.两次斑贴试验结果:定性Z=-3.000,P=0.003;反应程度Z=-6.247,P=0.000,差异均有统计学意义.静脉途径干预完成研究58例患者,第2次斑贴试验时,12例++,10例+,36例阴性.两次斑贴试验结果:定性Z=-6.000,P=0.000;反应程度Z=-6.289,P=0.000,差异均有统计学意义.结论 复方甘草酸苷制剂口服高剂量和静脉途径应用时,对皮肤斑贴试验反应有明显抑制作用.建议做斑贴试验前应停此药2周.     

Performance of routine syphilis serology in the Ethiopian cohort on HIV/AIDS

OBJECTIVES: To assess the performance of routine syphilis screening during 5 year follow up of Ethiopian factory workers, participating in a cohort study on HIV/AIDS. METHODS: Syphilis serology test results of factory workers, who each donated at least six blood samples were evaluated. Screening in 1997-8 had been performed by the Treponema pallidum particle agglutination (TPPA) assay and in 1999-2001 by the rapid plasma reagin (RPR) test. TPPA had been followed by RPR or RPR by TPPA, in case of a positive screening result. Samples of study subjects showing inconsistent sequential TPPA and/or RPR results were retested independently by three laboratory technicians. RESULTS: A total of 540 cohort participants (8.3% HIV positive at enrollment) donated 4,376 blood samples (mean 8.3 per subject). From 93 of the 176 participants with at least one positive TPPA result during follow up, 152 samples were retested by RPR and/or TPPA. Based on the revised syphilis test results, the 540 cohort participants were classified as having no (70.5%), past (20.6%), prevalent (6.9%), or incident (2.0%) syphilis. The RPR screening test was difficult to interpret and yielded 8.2% biological false positive (BFP) RPR results, or 3.2% if weak positive results were excluded. There was no correlation between HIV infection and BFP RPR reactions. Sample mix-ups were detected in 1.2%. CONCLUSION: Evaluation of routine syphilis screening as performed in a long term cohort study on HIV/AIDS in Ethiopia showed difficulties encountered in syphilis screening programmes such as a high percentage of BFP RPR, inconsistencies in interpretation of the RPR test, and sample mix ups. The findings stress the need to develop a syphilis screening assay that is easy to perform and interpret and to implement quality assurance programmes.     

Anxiety and depression in patients with chronic urticaria and generalized pruritus

Thirty-four dermatology out-patients with chronic idiopathic urticaria and 34 with idiopathic generalized pruritus were investigated using standardized self-assessment psychological questionnaires to determine the incidence of significant symptoms of depression and anxiety. These patients were compared with age- and sex-matched but otherwise unselected general dermatology out-patients. Using the Beck depression inventory, significantly more patients with generalized pruritus (32.4%) had depressive symptomatology (score greater than 14) than controls (13.2%, P less than 0.05). Although more patients with chronic urticaria had depressive symptomatology (14.7%) than controls (4.4%), the difference was not statistically significant. Using the Speilberger state-trait anxiety inventory there were no significant differences between the patients with pruritus or urticaria and their controls with respect to state or trait anxiety scores above the upper 90% probability limit for the general population. Thus, significant depression may be expected in a substantial proportion of patients with idiopathic generalized pruritus but in a relatively small proportion of those with chronic urticaria.