述情障碍影响生活质量心理中介作用模型

目的 探讨述情障碍对生活质量的影响及其心理中介作用模型.方法 377名大二、大三学生完成多伦多20个条目述情障碍量表(TAS-20)、世界卫生组织生活质量量表(WHOQOL-100)、自评抑郁量表(SDS)、状态特质焦虑问卷(STAI)、应对方式和社会支持量表问卷调查.运用比较研究分析述情障碍对生活质量的影响;运用Pearson相关分析以及结构方程建模分析方法,确定心理中介作用最佳模型.结果 (1)述情障碍高、中、低分三组之间生活质量各维度及总体生活质量差异具有显著性(躯体功能χ2=35.15,P=0.00;心理功能F=51.44,P=0.00;独立性F=28.75,P=0.00;社会交往F=36.82,P=0.00;生活环境F=26.69,P=0.00;生活信念χ2=38.89,P=0.00;总体生活质量χ2=33.87,P=0.00);(2)各变量之间相关分析具有显著性(P＜0.01);(3)最佳模型为完全心理中介作用模型,能够解释生活质量变异的87.4%,拟合指数均在理想范围内(χ2/df=1.72,GFI=0.927,IFI=0.967,CFI=0.967,RMSEA=0.048),路径系数均具有显著性(述情障碍到负性情绪的路径系数β=0.30,P=0.00;述情障碍到应对方式的路径系数β=0.49,P=0.00;负性情绪到生活质量的路径系数β=-0.94,P=0.00).结论 (1)述情障碍对大学生生活质量具有广泛而显著损害作用;(2)述情障碍对生活质量的作用是一种完全中介效应,通过负性情绪、应对方式、社会支持等中介变量实现;其中负性情绪是关键性中介变量.     

留守儿童心理韧性、情绪对心理健康的影响

目的探讨留守儿童心理韧性、情绪对心理健康的影响,并探讨心理韧性在情绪和心理健康之间的中介效应。方法选取湖南永州796名留守儿童,运用正性情感和负性情感检核表、青少年心理韧性量表和中学生心理健康量表进行调查。结果①正性／负性情绪可以显著预测心理韧性（β=0．875,P〈0．01;β=0．713,P〈0．01）。②心理韧性可以负向预测心理健康状况（β=-0．759,P〈0．01）。③心理韧性在负性情绪与心理健康状况之间部分中介效应显著（P〈0．01）;心理韧性在正性情绪与心理健康状况之间起完全中介效应。结论心理韧性在正性负性情绪与心理健康状况之间起重要的中介作用,正性情绪能够通过心理韧性提升留守儿童心理健康水平。     

癌症患者述情障碍与负性情绪的关系：侵袭性思维的中介作用

目的：探讨癌症患者述情障碍与负性情绪之间的关系,并检验侵袭性思维在述情障碍与负性情绪之间的 作用。方法：采用多伦多述情障碍量表中文版、事件影响量表修订版、流行病调查中心用抑郁问卷、状态-特质焦虑 量表中的状态-焦虑分量表对115名癌症患者进行问卷调查。结果：负性情绪与侵袭性思维及述情障碍各维度存在显 著正相关(r：0.251~0.600,P<0.01),述情障碍总分及其辨别情感困难、描述情感困难因子分值与侵袭性思维呈低至中 度正相关(r：0.261~0.430,P<0.01)。述情障碍对负性情绪不仅具有直接效应,还可通过侵袭性思维间接作用于负性情 绪,侵袭性思维的中介效应占总效应的40.71%。结论：侵袭性思维在述情障碍与负性情绪关系中起部分中介作用。     

领悟社会支持在护理人员述情障碍与消极心理间的调节中介效应

目的 探讨领悟社会支持在护理人员述情障碍与消极心理间的调节与中介效应.方法 采用多伦多述情障碍20个条目量表(TAS-20)、领悟社会支持量表(PSSS)和一般健康问卷(GHQ-20)对河南省某医院的503名护理人员进行问卷调查.结果 护理人员的述情障碍、领悟社会支持和消极心理的得分分别为(54.82±8.43)分、(61.9±9.78)分、(3.70±2.61)分,述情障碍与消极心理呈显著正相关(r=0.49,P＜0.01),领悟社会支持与消极心理呈显著负相关(r=-0.32,P＜0.01),而述情障碍与领悟社会支持呈显著负相关(r=-0.36,P＜0.01);领悟社会支持在述情障碍和消极心理间的调节效应检验中,R12为0.259、R22为0.257,R22没有显著增高,在分层回归的第二层中,t=-0.538,P＞0.05;领悟社会支持在述情障碍和消极心理间作为中介变量的模型拟合指数分别为x2/df=1.645,RMSEA=0.036,CFI=0.995,IFI=0.995,RFI=0.960,TLI=0.984,NFI=0.987,GFI=0.993,AGFI=0.973,模型拟合良好.结论 领悟社会支持在护理人员述情障碍与消极心理间的调节效应不存在,而是发挥部分中介作用.     

护理人员述情障碍及应对方式与消极心理的关系研究

目的探讨护理人员述情障碍与消极心理的关系以及应对方式在其中所起的中介作用。方法采用多伦多述情障碍20个条目量表(TAS-20)、特质应对问卷(TCSQ)和一般健康问卷(GHQ-20)对河南省某医院的503名护理人员进行问卷调查。结果 (1)述情障碍和消极应对方式与消极心理呈正相关(P<0.01),积极应对方式与消极心理呈负相关(P<0.01)。(2)应对方式在述情障碍和消极心理间作为中介变量的模型拟合指数分别为χ2/df=1.459,RMSEA=0.030,CFI=0.995,IFI=0.995,RFI=0.966,TCI=0.989,NEI=0.985,模型拟合良好。述情障碍和应对方式能够解释护理人员消极心理总变异的99%,其中中介效应占总效应的94.59%。结论述情障碍和应对方式是影响护理人员消极心理非常重要的因素,应对方式在述情障碍对消极心理的影响中发挥重要的中介作用。     

述情能力对延迟就诊冠心病患者负性情绪及睡眠质量的影响

目的分析延迟就诊冠心病患者述情能力的特征并探讨在不同性别中述情能力对延迟就诊冠心病患者心理健康的影响机制。方法选取295例延迟就诊冠心病患者,用多伦多述情障碍量表（TAS）、焦虑自评量表（SAS）、抑郁自评量表（SDS）和阿森斯失眠量表（AIS）进行调查。结果（1）延迟就诊冠心病患者中57.9%存在述情障碍,34.9%可能有述情障碍。（2）延迟就诊冠心病女性患者述情障碍总分（t=2.210,P=0.028）、缺乏描述情感能力得分（t=2.554,P=0.011）及缺乏认识与区别情感和躯体感受能力得分（t=2.788,P=0.006）均明显高于男性。（3）缺乏认识与区别情感和躯体感受能力与延迟就诊冠心病患者的焦虑呈正向关联;缺乏描述情感能力与男性抑郁和失眠呈正向关联;而缺乏认识与区别情感和躯体感受能力与女性抑郁和失眠呈正向关联（P<0.05）。结论延迟就诊冠心病女性患者比男性存在更严重的述情障碍和负性情绪,提高延迟就诊冠心病女性患者的认识和区分情感与躯体感受能力,以及提高男性的描述情感能力对促进其心理健康和改善疾病预后有重要意义。     

上海地区四所高校国际学生心理弹性与负性情绪的关系

目的探讨上海地区高校国际学生心理弹性水平和负性情绪之间的相互关系。 方法以上海市四所大学的181名国际学生为研究对象,采用Connor-Davidson心理弹性量表、霍普金斯症状自评量表和自编问卷进行调研。 结果调研对象的心理弹性平均分为（76.81±12.44）分,霍普金斯症状自评量表平均分为（41.51±9.26）分。偏相关分析显示： 心理弹性与负性情绪各因子间存在负相关（r=-0.387~-0.683,均P＜0.001）。岭回归分析显示： 心理弹性水平、中文掌握程度、学校表现满意程度均对国际学生的负性情绪具有一定负向预测作用（标准化回归系数β=-0.058~-0.37,调整R2=0.438,均P＜0.05）。 结论心理弹性、中文掌握程度和学校表现满意程度对国际学生的负性情绪具有负向预测作用。     

述情障碍对健康焦虑的影响：认知与元认知的中介作用

目的：采用健康焦虑的认知行为理论及元认知理论,探讨述情障碍、认知因素、元认知因素与健康焦虑 之间的关系。方法：采用简版健康焦虑量表、健康焦虑元认知量表、健康认知量表、多伦多述情障碍量表对1 164 名医学生进行评估。结果：1)相关分析显示：述情障碍、功能失调性信念、元认知和健康焦虑水平之间均存在显著 正相关关系(r=0.227~0.477,均P<0.01)。2)多重中介效应检验结果表明：述情障碍对健康焦虑水平的直接效应不显著 (β=–0.05,95% CI：–0.123~0.021)。述情障碍既能通过功能失调性信念影响健康焦虑(β=0.192,95% CI：0.156~0.235), 还能通过功能失调性信念和元认知的中介链对健康焦虑产生间接效应(β=0.103,95% CI：0.077~0.135),功能失调性信 念在述情障碍和健康焦虑水平之间起完全中介作用(β=0.247,95% CI：0.196~0.290)。结论：功能失调性信念和元认知 在述情障碍对健康焦虑的影响中起到多重中介作用。     

汶川地震两周年后救灾医务人员心理健康和述情障碍的相关性研究

目的 调查汶川地震两周年后灾区医务人员心理健康和述情障碍的相关性.方法 采用症状自评量表（SCL-90）和多伦多述情障碍量表（TAS）,对绵阳市游仙区22个乡镇和3个社区,共计175名医务工作者进行调查,并与安徽省合肥市社区的144名医务工作者作比较.结果 与对照组相比,研究组SCL-90中总分及各因子分均较对照组高,差异有统计学意义（P=0.00）.研究组述情障碍总分,因子1,因子2,因子3得分高于对照组,差异有统计学意义（P=0.00）.研究组述情障碍总分,因子1,因子2与SCL-90中各个因子成正相关,因子3与SCL-90中恐怖成正相关,与其他因子无明显相关性.结论 地震重灾区绵阳市游仙区医务人员相对于一般医务人员的心理健康水平较差,述情障碍作为一种人格特质可能进一步影响心理健康.     

孤独感在社区老年慢性病患者述情障碍和抑郁间的中介效应研究

背景　抑郁和孤独感是老年慢性病患者普遍存在的严重心理问题,述情障碍患者因“情感表达不能”可能会加剧负性心理体验,但其关联机制尚不明确。目的　探讨孤独感在社区老年慢性病患者述情障碍和抑郁间的中介效应。方法　2020年6-8月采用便利抽样法选取合肥市4个社区（望湖城社区、逍遥津社区、三孝口社区、亳州路社区）的509例社区老年慢性病患者为研究对象。采用一般资料调查表、多伦多述情障碍量表（TAS-26,评估述情障碍或情感表达困难）、UCLA孤独感量表（评估对社会交往的渴望与实际水平的差距而产生的孤独感）、中文版患者健康问卷抑郁自评量表（中文版PHQ-9,评估过去２周内抑郁症状的严重程度）进行问卷调查。根据TAS-26得分将患者分为高述情障碍组（TAS-26得分≥平均分）、低述情障碍组（TAS-26得分<平均分）。采用IBM SPSS 19.0和Amos 23.0软件进行数据分析。结果　共回收问卷509份,回收有效问卷492份,有效回收率为96.7%。社区老年慢性病患者中文版PHQ-9得分≥10分的有59例,抑郁症状发生率为12.0%（59/492）。社区老年慢性病患者TAS-26、UCLA孤独感量表、中文版PHQ-9得分分别为（71.8±8.3）、（36.6±8.5）、（6.0±3.2）分,Pearson相关分析结果显示,TAS-26与UCLA孤独感量表得分、中文版PHQ-9得分呈正相关（P<0.01）;UCLA孤独感量表得分与中文版PHQ-9得分呈正相关（P<0.01）。社区老年慢性病患者TAS-26得分的平均值为71.82分,TAS-26得分≥71.82分的患者共243例（高述情障碍组）,TAS-26得分<71.82分的患者共259例（低述情障碍组）。高述情障碍组患者UCLA孤独感量表、中文版PHQ-9得分均高于低述情障碍组（P<0.05）。中介效应检验结果显示,社区老年慢性病患者述情障碍对抑郁有正向影响（β=0.25,P<0.01）,述情障碍对孤独感有正向影响（β=0.68,P<0.01）,孤独感对抑郁有正向影响（β=0.17,P<0.01）。孤独感在述情障碍和抑郁间的标准化间接效应为0.12,述情障碍对抑郁的标准化直接效应为0.25,中介效应占总效应的32.43%。结论　述情障碍能加重社区老年慢性病患者的孤独感和抑郁水平,且孤独感在述情障碍和抑郁间起部分中介作用。因此,社区管理者应早期识别老年慢性病患者的孤独感情绪,积极处理述情障碍对孤独的影响,从而降低其抑郁水平。     

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…     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

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.     

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.     

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.