医学生心理健康水平及相关因素调查

目的　探讨四年级医学生的心理健康状况 ,人格特征。方法　采用 90项症状自评量表 (SCL 90 )和艾森克人格问卷 (EPQ)对 2 4 6名四年级医生进行调查。结果　四年级医学生SCL 90的总分及各因子分 ,除躯体化和人际关系因子分外 ,均高于常模 ,各单项因子分≥ 3的检出率累计为 16 .8% ;医学生的EPQ除男生的N(神经质 )分与常模比较无显著性差异外 ,男、女生的P(精神质 )分和L(掩饰 )分均显著低于常模 (P <0 .0 1) ,E(内外向 )分均显著高于常模 (P <0 .0 1) ,女生的N分显著高于常模 (P <0 .0 1) ;SCL 90的总分及各因子分与EPQ的各因子分除SCL 1(躯体化 ) ,3(人际关系 ) ,4 (抑郁 ) ,7(恐怖 ) ,9(精神病性 ) ,10 (其他 )与EPQ的L分外呈显著相关。结论　四年级医学生的心理健康总体水平偏低 ,其心理问题的发生与其个性特征密切相关     

乙型肝炎肝硬化病人心理健康状况的调查及分析

目的探讨乙型肝炎后肝硬化病人的心理特点,研究其心理问题与病人个性、应对方式等因素的关系.方法以60例乙型肝炎后肝硬化与中国常模为研究对象,采用艾森克个性问卷(EPQ)、症状自评量表(SCL-90)和慢性肝病医学应对方式问卷(MCMQ)等心理测试法测定病人的个性特征、心身症状和应对方式.结果乙型肝炎后肝硬化组躯体化、强迫、焦虑、抑郁、恐怖、偏执及精神病性显著高于中国常模(P<0.01),人际敏感差异无显著性意义(P>0.05);且乙型肝炎后肝硬化组MCMQ中的面对、回避、放弃应对量分高于对照组.结论乙型肝炎后肝硬化病人在心身症状、个性特征及应对方式上差异均有显著性意义,消极应对方式是影响其心理健康状况的重要因素,不良的心理健康状况是导致疾病恶化甚致死亡的重要原因之一.     

军校医学研究生心理健康状况和个性特征的分析

目的 :评价军校研究生入学后的整体心理健康状况、个性特征及心理健康状况与个性的关系 .方法 :采用症状自评量表 (SCL 90 )、艾森克个性量表 (EPQ) ,流调中心用抑郁量表 (CES D)对 1 98名新入学的某军校医学硕士研究生 ,进行整群抽样、现况研究 .问卷由学生自行填写独立完成 .结果 :SCL 90各项指标中男性研究生阳性项目均分高于女性研究生(P <0 .0 5 ) .在EPQ量表评分中男性研究生的P值评分高于女性 (P <0 .0 1 ) ,女性研究生的L值评分高于男性研究生 (P<0 .0 1 ) .在自我评价性格类型 (A组 :内向型 ,B组 :中间型 ,C组 :外向型 )不同的研究生中SCL 90的各项指标的评分均是A组最高 ,其中人际关系敏感和精神病性因子的评分与B组和C组差异显著 (P <0 .0 5 ) .在A组人群中有 2 2 .9%的抑郁评分大于 2 0分 ,而在B组和C组只有 8.5 %和 6 .1 %的研究生抑郁评分大于 2 0分 .有心理阳性症状的研究生在A ,B ,C组中所占的百分比分别是 31 .4 % ,2 2 .2 %和 1 8.2 % .结论 :性别因素不是影响医学研究生心理健康状况的主要因素 ,研究生的个性特征影响着研究生的心理健康状况     

海训后士兵心理健康状况及相关因素研究

目的　调查某部海训士兵的心理健康状况及其影响因素。方法　采用症状自评量表 (SCL 90 )及艾森克人格问卷 (EPQ) ,对渡海登陆作战演习部队 110 7人进行测查。结果　本次调查对象SCL 90各因子分除人际关系敏感外均高于中国成人常模 ;强迫症状、人际关系、恐怖、偏执、精神病等因子分及总分低于中国军人常模且有显著性差异 ;2 3 0名( 2 0 78%)士兵单项因子分≥ 3分 ;来自城镇的士兵SCL 90各因子分高于来自农村的士兵 ;1年兵组SCL 90各项得分均高于 2年兵组。SCL 90与EPQ得分的相关分析显示 ,情绪越不稳定、受外界因素的刺激产生的情绪反应越激烈 ,性格越内向者SCL 90的各项得分越高。结论　被调查对象心理健康状况良好 ,受军事演习的影响不大 ,但有 2 0 78%的士兵存在不同程度的心理健康问题。较高的文化程度、城市入伍兵、军龄短等因素 ,以及精神质、敌对倾向、内向等人格特点可能是此人群心理障碍发生的促进因素。     

银屑病患者的个性特征、心理状态及生活质量的调查研究

目的 :探讨银屑病患者的个性特征、心理状态及其生活质量。方法 :采用艾森克个性问卷 (EPQ)、症状自评量表 (SCL - 90 )及生活质量综合评定问卷 (GQOLI)对 119例银屑病患者进行了测试 ,并同正常人加以比较。结果 :(1)银屑病组的N分及P分明显高于正常对照组 (P <0 0 1) ;(2 )银屑病组的SCL - 90各因子分均明显高于中国常模 (P均 <0 0 1) ,突出表现在焦虑、抑郁、躯体化及恐怖四个方面 ;(3)银屑病组的总体生活质量较正常对照组差 (P <0 0 1) ,涉及到躯体功能、心理功能、社会功能及物质生活四个维度 ,其中以心理健康和躯体健康影响最大。结论 :银屑病患者存在诸多方面的心理问题及个性改变 ,其生活质量较差。     

248例亚健康者心理健康状态的测定和评价

目的　调查亚健康者的心理状态。方法　采用症状自评量表 (SCL - 90 )对 2 4 8例亚健康者的心理状态进行自评 ,并对评定的分值按性别、职业和亚健康症状严重程度进行比较 ,对测定的 10个因子均值与常模值进行比较。结果　SCL - 90分均值在男女间 (u =5 0 2 ,P <0 0 1)、不同症状严重程度组间 (F =2 4 70 ,P <0 0 5 )、工人亚健康者与以脑力劳动为主要工作的亚健康者间 (F =5 92 ,P <0 0 5 )差异均有显著性意义 ;SCL - 90各因子均值亚健康组与常模间差别均有显著性意义 (P <0 0 1)。结论　亚健康者的心理状态有明显异常 ,应用SCL - 90对亚健康者心理健康状态的测定 ,是进行亚健康诊断和评价亚健康严重程度的有效方法     

海军某部官兵的心理健康状况及其相关因素

目的探讨海军官兵的心理健康状况及其相关因素。方法采用SCL-90和EPQ(成人)问卷,随机抽取了海军某舰队官兵165名为样本进行测试。结果海军某部官兵的SCL-90各项因子分均显著高于中国正常人的常模(P<0·01),强迫与敌对因子分显著高于中国军人常模(P<0·01),躯体化因子分显著低于中国军人常模(P<0·01);其中,心理障碍的检出率为11.80%,主要表现为敌对、强迫、焦虑、偏执等症状;SCL-90因子分与军龄呈负相关,与EPQ中P以及N分量表分呈正相关,与L和E分量表分呈负相关。结论部分海军官兵存在一定程度的心身症状,可能与军龄以及某些人格因素有关。     

颌面创伤住院患者心理状况及影响因素

目的　分析颌面创伤住院患者的心理状态及其影响因素 ,为医护人员进行医疗预防和康复工作提供参考 .方法　采用 SCL - 90 (Symptom check list- 90 )症状自评量表和自制的心理卫生相关因素调查表 ,对我院 1998- 10 /1999- 0 9,12 6例颌面创伤住院患者进行心理测试 .结果　颌面创伤患者SCL- 90总分平均 (15 4± 6 2 )分 .阳性项数目平均为 (32± 2 5 )分 ,显著高于国内常模 (P<0 .0 1) .颌面创伤住院患者 SCL -90各因子分均显著高于国内常模 (P<0 .0 1) .按显著性高低排列 ,前 4位的分别为抑郁、焦虑、恐怖和精神病性 .颌面创伤患者 SCL- 90总均分级别构成符合正态分布 .结论　颌面创伤住院患者的心理健康水平显著低于正常人群 .创伤事件和医源性应激是影响患者心身健康的两个主要原因 .     

冠心病心血瘀阻证与个性特征、心理状态的相关性探讨

目的　探讨冠心病心血瘀阻证患者与其个性特征、心理状态的相关性。方法　运用现代医学心理学测试量表(EPQ和SCL - 90 )对 10 6名冠心病患者进行调查。结果　冠心病心血瘀阻证患者的E分及N分均明显高于常模和对照组 (P <0 .0 5～ 0 .0 1) ,气质类型则以胆汁质为多见 (占 4 9.15 % ) ;在心理状态方面 ,冠心病心血瘀阻证患者焦虑、抑郁及睡眠障碍等因子分明显高于常模和对照组 (P <0 .0 1) ,且不同文化程度间又表现出不同的特点。结论　冠心病心血瘀阻证患者在个性特征及心理状态上具有一定的特点 ,临床应加强患者的心理治疗     

97例强迫症患者SCL-90和EPQ评定结果分析

目的　探讨强迫症患者的精神心理状况 ,并对采用SCL - 90评定强迫症症状的作用与EPQ的相关结果进行评估。方法　采用SCL - 90和EPQ对符合CCMD - 2强迫症诊断标准的患者进行评定。结果　强迫症患者的SCL - 90总分、阳性项目均数以及各因子分均明显高于国内常模 (P <0 0 0 1) ,前 5位因子分依次是强迫、焦虑、抑郁、人际关系、睡眠障碍。男性患者的精神病性、偏执、躯体化 3项因子分高于女性患者有显著性意义。结论　强迫症患者的SCL - 90评定结果与其临床症状基本相符 ,并可反映病情的轻重程度。强迫症患者EPQ中的N量表和P量表与SCL - 90总分及多项因子分明显相关。在临床上可联合应用SCL - 90和EPQ作为筛查强迫症的手段     

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.     

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…     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.