初产妇配偶抑郁状况与压力、社会支持的相关性研究

目的 研究初产妇配偶抑郁状况及与压力、社会支持的相关性,为相关部门采取措施提高初产妇配偶的心身健康提供依据.方法 采用Beck抑郁问卷、领悟压力量表、社会支持评定量表,对130例初产妇配偶抑郁状况及其与压力、社会支持的相关性进行研究.结果 初产妇配偶抑郁得分均值为(7.12±3.49)分,抑郁发生率为17.7%;初产妇配偶压力与抑郁呈高度正相关(r =0.681,P ＜0.01);社会支持与抑郁呈负相关(r =-0.374～-0.677,P ＜0.01);抑郁组压力高于非抑郁组(P ＜0.01),社会支持总分及其三个维度均低于非抑郁组(P ＜0.01);多元逐步回归分析结果显示:压力、社会支持、初产妇产后恶露异常与否、夫妻感情、初产妇头痛、公婆对婴儿性别期望、产妇与配偶家人关系等7项是影响初产妇配偶抑郁的最主要因素.结论 应加强对初产妇配偶抑郁的科学认识,给予相关方面的指导和有效的支持,才能缓解其压力,防止抑郁发生,从而提高其心身健康水平.     

三峡外迁移民心理健康状况与心理应激社会支持的相关性研究

目的 了解外迁移民的心理健康状况及其相关因素.方法 采用症状自评量表(SCL-90)、团体用心理社会应激调查表(PSSG)、社会支持评定量表(SSRS)对移民和当地居民进行调查.结果 ①移民SCL-90总分及各因子分均高于当地居民组(P<0.05或P<0.01);②相关分析显示移民SCL-90各因子分与生活事件、消极情绪体验、消极应对以及应激总分呈正相关(P<0.01);SCL-90中躯体化因子、抑郁因子以及其他因子与积极应对均呈负相关,其相关系数为躯体化因子(r=-0.175)、抑郁因子(r=-0.134)、其他因子(r=-0.145)(P<0.05);SCL-90中躯体化因子、抑郁因与积极情绪体验均呈负相关,相关系数为躯体化因子(r=-0.125)、抑郁因子(r=-0.162)(P<0.05);移民社会支持中支持利用度与SCL-90各因子分均呈显著负相关(P<0.05).结论 移民心理健康状况较差,经历的心理社会应激较多.     

焦虑抑郁在维持性血液透析患者社会支持与衰弱之间的中介作用

目的 探讨维持性血液透析患者焦虑抑郁、社会支持与衰弱三者之间的关系.方法 采用一般情况调查表、FRAIL量表、社会支持评定量表和医院焦虑抑郁量表对143例维持性血液透析患者进行调查分析.结果 调查对象31.5％存在衰弱;社会支持与衰弱呈显著负相关(r=-0.292,P<0.01),焦虑、抑郁与衰弱均呈显著正相关(r=0.383,P<0.01)(r=0.413,P<0.01),社会支持与焦虑、抑郁均呈显著负相关(r=-0.226,P<0.01)(r=-0.337,P<0.01);中介效应检验显示焦虑在主观支持、支持利用度和衰弱之间起部分中介作用,抑郁在主观支持、支持利用度和衰弱之间起完全中介作用.结论 焦虑抑郁在社会支持与衰弱之间起中介作用,增强患者的社会支持水平和减少焦虑抑郁的产生是延缓衰弱发生的有效途径.     

老年骨折住院患者抑郁与社会支持的相关分析

目的 分析老年骨折住院患者抑郁与社会支持的相关性,为骨科临床心理干预提供依据.方法 对60例老年骨折住院患者,选用老年抑郁量表(GDS)、领悟社会支持量表(PSSS)进行问卷调查和测试,以55例健康老年人为对照组进行对照研究.结果 老年骨折患者抑郁水平明显高于对照组(P<0.01);相关分析表明,老年骨折患者的抑郁与社会支持呈显著负相关(r=-0.354,P<0.01).结论 老年骨折住院患者抑郁水平显著升高,社会支持有利于提高老年骨折患者对应激的应对能力.     

脑卒中患者配偶的焦虑抑郁状况及影响因素

目的:卒中事件的发生对卒中患者及其配偶产生沉重的心理压力.文中旨在了解脑卒中患者配偶的焦虑抑郁状况及其影响因素,为制订干预措施提供理论依据. 方法:收集患者及其配偶作为照顾者的基本资料.采用焦虑自评量表、抑郁自评量表和社会支持评定量表的方法,对140例脑卒中患者的配偶进行问卷调查. 结果:脑卒中患者配偶的焦虑自评分均值为(38.3±10.9)分、抑郁自评分均值为(41.1±10.9)分,均高于国内常模(P<0.05);有焦虑症状者占40.7%,抑郁症状者占44.3%,亦均高于正常人群.多元回归分析结果显示,患者配偶抑郁评分与患者Rankin 量表评分值、配偶年龄、自我感觉压力值均有相关性.配偶焦虑评分与患者Rankin 量表评分值、是否工作、自我感觉压力值及客观支持有相关性,其中与是否工作及客观支持呈负相关. 结论:脑卒中患者的配偶存在较严重的焦虑抑郁情绪.患者Rankin 量表评分值高、配偶年龄大、自我感觉压力高是患者配偶抑郁状况的主要影响因素.患者Rankin 量表评分值高、没有工作、自我感觉压力高及客观支持分较低者是患者配偶焦虑状况的主要影响因素.     

D型人格与慢性心力衰竭病人社会心理因素的相关性

目的 探讨D型人格对慢性心力衰竭(CHF)病人社会心理因素影响及两者之间相关性。方法 依据D型人格量表(DS14)将CHF病人分为D型人格组和非D型人格组,两组均在接受治疗前进行一般状况调查表、焦虑自评量表(SAS)、抑郁自评量表(SDS)和社会支持评定量表(SSRS)的测试。结果 CHF病人中D型人格、焦虑、抑郁者分别占34.00%、36.67%、46.67%。D型人格组的焦虑、抑郁评分均明显高于非D型人格组,社会支持总分明显低于非D型人格组(t=5.856~6.335,P<0.01)。D型人格及其消极情感、社交压抑维度均与焦虑、抑郁呈正相关(r=0.230~0.521,P<0.01),均与社会支持呈负相关(r=-0.336~-0.271,P<0.01)。结论 D型人格的CHF病人体验更多的焦虑、抑郁情绪,得到更少的社会支持,心理健康水平较低;D型人格与焦虑、抑郁情绪及社会支持存在相关关系。     

居家老年性痴呆患者配偶的抑郁焦虑状况及影响因素

目的痴呆患者生活自理能力明显下降,因此其配偶常因照顾痴呆患者产生严重的抑郁焦虑症状。文中研究探讨老年性痴呆患者配偶抑郁焦虑状况及其影响因素,为其进行心理干预提供参考依据。方法收集痴呆患者及其配偶作为照料者的基本资料。采用Zung氏抑郁自评量表(self-rating depression scale,SDS)、Zung氏焦虑自评量表(self-rating anxi-ety scale,SAS)及社会支持评定量表(social support rating scale,SSRS)对90例痴呆患者的配偶进行问卷调查。结果痴呆患者配偶的抑郁自评分为(42.5±10.9)、焦虑自评分为(38.6±11.4),且均高于国内正常人群常模(P<0.05)。入组的患者配偶有抑郁症状者占52.2%,有焦虑症状者占42.2%,亦均高于国内正常人群(P<0.05)。多元回归分析结果显示,患者配偶抑郁评分与患者临床痴呆评定量表评分值(clinical dementia rating,CDR)、配偶自我感觉压力值、社会支持利用度有相关性,其中与社会支持利用度呈负相关;配偶焦虑评分与配偶自我感觉压力值和客观支持有相关性,其中与客观支持...     

肿瘤患者TNM分期与焦虑和抑郁及社会支持度的相关性分析

目的 探究肿瘤患者TNM分期及焦虑、抑郁情况和社会支持度,并分析其相关性,为肿瘤患者后续诊疗提供依据.方法 选取2020年1—5月于本院行PET-CT检查的肿瘤患者101例作为研究对象,根据肿瘤TNM分期分为原位癌组(T,n=32)和转移组(n=69),转移组进一步分为淋巴转移组(N,n=29)和远端转移组(M,n=40).采用方便抽样法对肿瘤患者进行问卷调查,包括医院焦虑、抑郁量表(HAD)和社会支持度量表(SSRS).分析肿瘤TNM分期与焦虑、抑郁情况和社会支持度的相关性.结果 原位癌组主观支持分、利用率得分、社会支持总分均高于转移组,原位癌组焦虑、抑郁评分均低于转移组,差异有统计学意义(P<0.05);肿瘤分期与主观支持分、利用率得分、社会支持总分呈负相关,差异有统计学意义(r=-0.36、-0.25、-0.38,P<0.01).肿瘤分期与焦虑、抑郁程度呈正相关,差异有统计学意义(r=0.35、0.38,P<0.01),淋巴转移组主观支持分、利用率得分、社会支持总分得分均高于远端转移组,且焦虑、抑郁评分均低于远端转移组,差异无统计学意义.结论 肿瘤患者存在焦虑、抑郁的风险,患者发生转移的风险大小与患者焦虑、抑郁情况和社会支持度显著相关,而肿瘤患者是否发生远端转移与焦虑、抑郁情况和社会支持度无明显相关性,因此,应加强肿瘤患者的心理护理,尤其是确诊初期,提高患者生存率.     

探讨肥胖大学生社会支持与抑郁的关系

目的 探讨肥胖大学生社会支持与抑郁的关系.方法 对肥胖大学生(肥胖组)171例、正常体质大学生(正常组)186 例进行抑郁量表(CES-D)和社会支持评定量表(SSRS)的测定.对2组大学生的抑郁程度、客观支持、主观支持、对支持的利用度及社会支持总分进行比较.结果 正常组抑郁指数明显低于肥胖组(P<0.01).肥胖组中女性抑郁指数明显高于男性(P<0.01);低抑郁组的客观支持、主观支持、对支持的利用度评分及社会支持总分明显高于高抑郁组和中抑郁组(P<0.01);中抑郁组社会支持总分明显低于低抑郁组(P<0.01);肥胖组抑郁指数与客观支持、主观支持、对支持的利用度和社会支持总分呈负相关(r 分别为-0.304、-0.326、-0.315和-0.376,均 P<0.05).结论 肥胖是大学生抑郁的重要因素,有效降低他们的抑郁程度,应该给予更多的社会支持.     

失独者自我效能感在社会支持和抑郁情绪间的中介作用

目的：探讨失独者社会支持与抑郁情绪间的关系及自我效能感在社会支持和抑郁情绪之间的中介作用。 方法：采用分层整群抽样214名失独者,其中男80人,女134人,年龄49~83岁,用一般自我效能感量表、社会支 持评定量表及抑郁自评量表测量失独者自我效能感、社会支持及抑郁水平。结果：单因素分析结果显示不同年龄 (t=2.85,P<0.05)、有无配偶(t=5.62,P<0.05)、家庭所在地不同(t=3.95,P<0.05)、人均月收入不同(F=3.48,P<0.05) 的失独者社会支持得分不同;人均月收入不同的失独者,自我效能感得分不同,差异具有统计学意义(F=5.46, P<0.05)。相关分析结果显示失独者自我效能感和社会支持得分呈正相关(r=0.26,P<0.01),失独者自我效能感(r=–0.59, P<0.01)和社会支持(r=–0.31,P<0.01)与抑郁得分均呈负相关。中介效应检验结果显示失独者自我效能感在社会支持和 抑郁情绪之间起部分中介作用。结论：年龄<60岁、有配偶、人均月收入高及农村的失独者社会支持水平较高,人均 月收入高的失独者自我效能感较高。社会支持既可以直接预测失独者抑郁情绪,也可以通过自我效能感间接影响失独 者抑郁情绪。社区工作人员在对失独者这一特殊人群进行心理护理时,可以从改变其认知,提升自我效能感方面着手。     

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.     

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.     

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.     

Notes for contributors to Journal of Nanjing Medical University

Journal of Nanjing Medical University (English Edition) JNMU, sponsored by Nanjing Medical University, was established in 1987. It is a bimonthly comprehensive English medical journal published locally and abroad.Since 2007, Journal of Nanjing Medical University (English Edition )was granted Elsevier the full publishing and distribution rights worldwide for the Electronic Edition, excluding the People's Republic of China.     

ANTI-PROLIFERATION EFFECT OF ORIDONIN ON HL-60 CELLS AND ITS MECHANISM

Objcetive To investigate the anti-proliferation effect of oridonin on leukemic HL-60 cells and its mechanism. Methods HL-60 cells in vitro in culture medium were given different concentrations of oridonin. The inhibitory rate of cells were measured by microculture tetrazolium (MTT) assay, cell apoptotic rate was detected by flow cytometry (FCM), morphology of cell apoptosis was observed by hoechst 33258 fluorescence staining, and the activity of telomerase was detected using telomere repeat amplification protocol (TRAP) PCR-ELISA before and after apoptosis occurred. Results Oridonin could decrease telomerase activity, inhibit growth of HL-60 cells, and cause apoptosis significantly. The suppression was both in time- and dose-dependent manner. Marked morphological changes of cell apoptosis including condensation of chromatin and nuclear fragmentation were observed clearly by hoechst 33258 fluorescence staining especially after cells were treated 48-60 hours by oridonin. Conclusions Oridonin has apparent anti-proliferation and apoptotic effects on HL-60 cells in vitro, decreasing telomerase activity of HL-60 cells may be one of its most important mechanisms. These results will provide strong laboratory evidence of oridonin for clinical treatment of acute leukemia.     

HOUSE DUST MITE ALLERGEN （Derp1 AND Blot5） LEVELS IN ASTHMATICS＇ HOME IN HONGKONG

Objective To measure Derpl and Blot5 allergen levels in asthmatics' homes in Hongkong.Methods Seventy houses were enrolled for a mite indoor environment study. Dust samples were obtained from two sites of each patients' house: bed and floor. Derpl and Blot5 levels were quantified by a two-site monoclonal antibody-based ELISA technique.Results The levels of Derpl allergens found in bed (geometric mean (GM) 3.43 μg/g of dust; 95%CI, 1.89-4.96 μg/g)and on the floor (GM 1.12 μg/g of dust; 95%CI, 0.71-1.53 μg/g) indicated significant differences (P=0.005). However, the levels of Blot5 allergens found in bed (GM 19.00 μg/g of dust; 95%CI, 0.89-38.90 μg/g) and on the floor (GM 6.14 μg/g of dust; 95%CI, 0.40-11.90 μg/g) showed no statistically significant difference. In addition, in regards to the exposure index for Derpl and Blot5 allergens found in bed and on the floor, 17.6% in bed and 8.6% on the floor had levels of Blot5 ≥ 10 μg/g of dust, higher than those obtained for Derp1 (7.2% and 0% in bed and on the floor respectively, P＜ 0.05); higher percentages in bed and on the floor (25.0% and 35.7%) were observed for levels of Blot5 =0 μg/g of dust as compared with Derpl in bed and on the floor (4.3% and 14.5% respectively, P＜ 0.05).Conclusions Derpl and Blot5 are the major allergens found in this regional study, Blot5 is a more potent allergen in Hongkong, probably reflecting the high level of exposure to Blomia tropicalis (Bt). Bt and Dermatophagoides pteronyssinus (Dp) allergens should be included for precise diagnosis and effective immuno-therapeutic treatment of mite allergy in Hongkong.     

Acute and mid-term results of pecutaneous transluminal septal myocardial ablation in patients with hypertrophic obstructive cardiomyopathy

Objective: To assess the acute and mid-term results of cardiac function improvements and left ventricular outflow tract gradient (LVOTG)changes in 30 patients displaying hypertrophic obstructive cardiomyopathy (HOCM) treated with percutaneous transluminal septal myocardial ablation (PTSMA). Methods: PTSMA was intended for 32 patients comprising of 13 women and 19men (average years being 54.1 ± 15.5) to be treated in accordance with the following inclusion criteria: The New York Heart As-sociation(NYHA) definition for cardiac functional class Ⅲ or Ⅳ , or class Ⅱ but for whom medical therapies were not tolerated or with syncope; intraventricular septal (IVS) and left ventricular posterior wall (LVPW) hypertrophy asymmetrically associated with ratio of IVS to LVPW≥1.3 and LVOTG≥50 mm Hg at rest or ≥100 mm Hg at provocation (Valsalva maneuver). The target vessels were determined by coronary arteriography that demonstrated more than one septal branch and probatory balloon occlusion produced greater than 50% decrease of LVOTG. Once the target vessel established, the alcohol was administrated into septal ventricular via over-the-wire balloon. LVOTG was assessed by means of echocardiography measurements immediately after procedure and 3 months. Simultaneously, cardiac function class was also evaluated. Results: Two patients were abandoned prior to intervention due to inappropriate septal target vessels and DDD Pacemakers were chosed. Immediately after the procedure, resting LVOTG was reduced from 73.8 ± 35.5 to 16.6 ± 7.8 mmHg, at provocation LVOTG from 149.3 ± 42.5 to 61.9 ± 43.0 mmHg(P ＜0.0001 each) by echocardiography measurements. After 3 months, the mean New York Heart Association class was reduced from 2.8 ± 0.6 to 1.1 ± 1.0(P ＜ 0.0001) and the LVOTG also remained decrease(28.5 ± 6.4 mmHg at rest and 75.3 ± 11.6 mmHg at provocation). Conclusion: PTSMA is a promising nonsurgical technique for relief of symptoms and reduction of LVOTG in hypertrophic obstructive cardiomyopathy.     

IMAGING DIAGNOSIS OF THORACOLUMBAR BURST FRACTURES

Objective To review imaging use in the diagnosis of thoracolumbar burst fractures and to determine the diagnostic value of different imaging methods. Methods One hundred and fourteen patients with 120 thoracolumbar burst fractures were retrospectively reviewed. Plain radiographs were available in all cases; CT scans and MRI were obtained in 96 and 74 cases, respectively. Results A total of 27 burst fractures were misdiagnosed as other types of fractures on radiographs alone, and accounted for 22.5% of all fractures. The results indicated that plain radiographs often fail to delineate the pathological features of thoracolumbar burst fractures, leading to delay in diagnosis. Conclusion In regard to thoracolumbar injury diagnosis, burst fractures should be differentiated from compression fractures. CT should be routinely indicated and MRI examination, when necessary, may be simultaneously considered.