小学生冲动性人格与受虐待经历的关系

目的 研究受虐待小学生冲动性人格的发展特点及其与受虐待经历的关系.方法 采用儿童期虐待史自评量表(PRCA)和Barratt冲动性人格量表(BIS-11),对172名小学五、六年级学生进行测评,分别评估他们的冲动性人格和受虐待情况.结果 受虐待者的无计划冲动性、动机冲动性和冲动性总分均高于未受虐待者[冲动性总分(40.39±10.68)分vs(30.34±10.26)分,t =5.96,P ＜0.01],男生的动机冲动性明显高于女生[(28.98±14.42)分vs(24.46±11.52)分,t =2.28,P ＜0.05].躯体虐待、情感虐待和虐待总分与无计划冲动性、动机冲动性和冲动性总分呈正相关(r =0.337～0.514,P ＜0.01),忽视与冲动性人格所有因子和总分呈正相关(r =0.187～0.419,P ＜0.05或P ＜0.01),性虐待仅与动机冲动性呈正相关(r =0.192,P ＜0.05).情感虐待对无计划冲动性、动机冲动性和冲动性总分具有正向预测作用(Beta值=0.185～0.395,t =1.975～5.589, P ＜0.05或P ＜0.01),忽视对无计划冲动性、注意冲动性和冲动性总分具有正向预测作用(Beta值=0.272～0.294,t =3.037～3.756,P ＜0.01),躯体虐待和性虐待对动机冲动性具有正向预测作用(Beta值=0.213,t =3.025,P ＜0.01;Beta值=0.157,t =2.441,P ＜0.05).结论 小学生的冲动性人格与受虐待经历有关,儿童虐待对冲动性人格的形成具有预测作用.     

面肌痉挛患者决策能力的初步研究

目的 探讨面肌痉挛患者在风险明确情境下的决策功能.方法 采用风险明确的骰子投掷实验(GDT)对面肌痉挛患者进行决策能力评估.收纳了28例门诊诊断明确的面肌痉挛患者,并与性别、年龄、教育程度相匹配的30例健康对照组进行对比.同时完成了神经心理学背景测试,比较两组被试在这些测试的差异性.结果 与健康对照组相比,面肌痉挛组存在风险明确情境下的决策功能受损,表现为面肌痉挛组净得分低于健康对照组,两组差异有统计学意义(t=-3.491,P=0.001);两组被试在GDT 4个选项中也存在差异:单个数目的组合(F=13.059,P=0.001)及3个数目的组合(F=6.599,P=0.013)的差异有统计学意义;两组被试在Stroop色词测试、数字广度(倒序)中差异无统计学意义;而两组被试在数字广度(正序)(t=-2.839,P=0.006)、词汇流畅性(t=-2.193,P=0.032)、负反馈利用率(t=-3.368,P=0.001) 存在显著差异.结论 面肌痉挛患者在风险明确情境下的决策功能受损,可能与执行功能及负反馈利用率受损有关.     

帕金森病患者的决策认知障碍

目的 探讨帕金森病(PD)患者的社会决策认知能力.方法 将20例首发PD患者以及与其人口学资料相匹配的健康对照组(HC)作为研究对象,采用爱荷华博弈任务(Iowa Gambling Task)进行社会决策行为能力的测试.采用Hoehn-Yahr分级量表对PD患者的严重程度进行评定.结果 与HC组相比,PD组不仅存在词汇流畅性以及数字广度障碍,而且存在决策认知障碍.在博弈任务中,PD组的总不利选择次数明显高于HC组(分别为51.6±5.8,46.8±8.2),差异有统计学意义[t_(38)=2.12,P=0.04].采用2(组)×5(阶段)的方差分析比较两组不同阶段的总有利选择,结果 发现,2组间的主效应显著[F_(1,38)=6.16,P=0.01];不同阶段的主效应亦显著[F_(4,152)=2.43,P=0.04].随着博弈任务卡片选择次数的增多,HC组有利选择次数逐渐增加;而帕金森病患者却不具有此种稳定的决策行为模式.同时研究还表明,PD患者的总不利选择次数与患者的疾病严重程度呈正相关(r=0.52;P＜0.05).结论 PD患者存在决策认知功能障碍,而这种社会决策障碍可能与前额叶眶面功能异常有关.     

老年人述情障碍与读心能力的相关研究

目的 研究老年人述情障碍和读心能力的关系.方法 108名70岁以上的老年被试接受读心能力、认知能力测试和多伦多述情障碍量表(TAS-20)调查.结果 述情障碍高分组与低分组在读心能力[(16.00±4.84)分,(19.36±2.91)分,t =3.38,P ＜0.01]、一般认知能力上差异有显著性[记忆广度上(5.80±1.42)分,(7.18±1.13)分,t =4.28,P ＜0.01;工作记忆上,t =4.05,P ＜0.01;加工速度上,t =4.80,P ＜0.01].述情障碍与读心能力( r =-0.227,P ＜0.05)、记忆广度( r =-0.377,P ＜0.01)、工作记忆( r =-0.334,P ＜0.01)、加工速度( r =-0.470,P ＜0.01)成绩呈显著负相关.在回归分析中,读心能力、认知加工、受教育程度等自变量对述情障碍量表总分( F =8.594,P ＜0.01)和因子1( F =8.796,P ＜0.01)的回归方程显著,但对因子2( F =1.735,P ＞0.05)和因子3( F =1.181,P ＞0.05)的回归方程不显著.结论 老年人述情障碍与读心能力、几种认知加工能力存在负相关;读心能力与加工速度可能影响述情能力的情绪识别,而不影响情绪描述和外向型思维.     

儿童虐待对小学生行为问题的影响

目的 研究受虐待小学生的行为问题及其与各种儿童虐待形式的关系.方法 对179例小学生进行了儿童期虐待史自评量表(PRCA)和Achenbach儿童行为量表(CBCL)测试.结果 受虐待组小学生CBCL各因子分和总分高于无虐待:CBCL总分[男生(45.02±43.46)分vs(14.41±14.37)分,t=4.79,P＜0.01;女生(37.16±28.34)分vs(17.73±14.58)分,t=4.39,P＜0.01],女生中11～12岁年龄组的社交退缩因子分高于9～10岁组[(3.80±2.91)分vs(2.47±2.94)分,t=2.19,P＜0.05].除性虐待外,PRCA各因子分和总分与CBCL各因子分和总分呈正相关(r=0.213～0.513,P＜0.05或P＜0.01).情感虐待、躯体虐待、性虐待和忽视对男生行为问题具有正向预测作用(Beta值=0.213～0.510,t=2.060～5.032,P＜0.05或P＜0.01);忽视和情感虐待对女生行为问题具有正向预测作用(Beta值=0.199～0.332,t=2.012～3.441,P＜0.05或P＜0.01).结论 儿童虐待可对小学生行为自我调节能力的发展造成不良影响,躯体虐待、情感虐待、忽视和性虐待可显著预测个体的行为问题.     

冲动性-预谋性暴力犯的自恋人格特征与攻击行为

目的 探讨冲动性-预谋性暴力犯的自恋人格特征及其与攻击行为的关系.方法 采用中文版冲动性-预谋性攻击量表（IPAS）和自恋人格问卷对120名服刑男性暴力犯进行整群随机抽样调查,有效被试88名,其中冲动性暴力犯45名,预谋性暴力犯43名.结果 （1）预谋性暴力犯比冲动性暴力犯更具显性自恋人格特征,差异有统计学意义[（59.77±10.89）分,（54.67±10.15）分,P＜0.05].（2）显性自恋和预谋性攻击行为呈显著正相关（r=0.560; P＜0.01）;隐性自恋和冲动性攻击行为呈显著正相关（r=0.440;P＜0.01）.（3）显性自恋的自我钦羡和权欲因子对预谋性攻击行为具有显著的正向预测作用（β=0.442,P＜0.01;β=0.297,P＜0.05）;隐性自恋的易感质因子对冲动性攻击行为具有显著的正向预测作用（β=0.526,P＜0.01）.结论 显性自恋是导致预谋性攻击行为的人格因素,隐性自恋是导致冲动性攻击行为的人格因素.     

抑郁症患者的痛阈及其相关因素研究

目的 探讨抑郁症患者的疼痛敏感性及其相关因素.方法 对20例抑郁症无疼痛患者(抑郁症组)和30例正常人(正常对照组)用贝克抑郁量表(BDI)、贝克焦虑量表(BAI)、阿森斯失眠量表(AIS)进行测查,痛阈测试仪和视觉模拟评分法(VAS)检测被试的痛阈. 结果抑郁症组BDI、BAI、AIS得分和耐痛阈强度刺激下疼痛、难受程度[分别为(30.2±8.79)分,(38.5±12.07)分,(11.7±6.11)分,(69.03±20.17)分,(64.98±25.55)分]高于正常对照组[分别为(10.83±5.4)分,(24.87±4.81)分,(4.9±3.24)分,(50.92±21.16)分,(44.33±23.28)分],差异有显著性( t =9.668、t =5.580、t =5.123、t =3.02、t =2.95,均P ＜0.01),抑郁症组痛阈和耐痛阈[分别为(0.87±0.58)mA,3.82±1.3)mA]低于对照组[分别为(2.09±1.05)mA,(4.43±0.81)mA],差异有显著性( t = 4.697,P ＜0.01; t =2.053,P ＜0.05);痛阈与BDI 、BAI、AIS得分均呈显著负相关( r =-0.581,r =-0.245,r =-0.253; P ＜0.01或P ＜0.05).采用回归分析显示BDI、BAI得分可以预测痛阈.结论 抑郁症无疼痛症状患者痛阈降低,抑郁、焦虑水平与疼痛敏感性有关.     

大学生自信与人格特征的关系

目的 了解大学生的自信特点,探讨自信与人格特征的关系.方法 采用个人评价问卷(PEI)和艾森克人格问卷(EPQ)对526名大学生进行测评.结果 ①男生自信得分[(144.71±16.04)分]高于女生[(141.13±15.76)分,t=2.558,P＜0.05];城市学生自信得分[(145.14±15.66)分]高于农村学生[(141.54±15.99)分,t=2.394,P＜0.05];独生子女自信得分[(146.50 ±16.76)分]高于非独生子女[(141.57±15.61)分,t=2.910,P＜0.01];不同年级大学生自信差异有显著性(F=2.708,P＜0.05).②自信与内外向呈显著正相关(r=0.548,P＜0.01),与神经质(r=-0.207,P＜0.01)及精神质(r=-0.476,P＜0.01)呈显著负相关.结论 大学生自信存在性别、家庭所在地、是否为独生子女及年级差异,并且与人格特征密切相关.     

色氨酸羟化酶2基因多态性与反社会人格障碍及其冲动行为的关联研究

目的 探讨色氨酸羟化酶2(Tryptophan Hydroxylase-2,TPH2)基因多态性与反社会人格障碍(Antisocial Personality Disorder,ASPD)及其冲动行为的关系.方法 选取TPH2基因启动子上游多态-703G/T(rs4570625),采用PCR-RFLP基因分型技术测定117例反社会人格障碍患者和142名健康人的TPH2基因启动子上游多态-703G/T分布,运用Barratt冲动量表(BIS-11)评估其冲动行为.结果 ASPD组TPH2-703G/T基因型和等位基因频率分布和对照组间相比差异均有显著性(分别为x2=7.73,P＜0.05;x2=5.12,P＜0.05).基因型GG和等位基因G与ASPD间存在显著正关联[分别为比数比(OR)=1.458,95%可信区间(95%CI)=1.080～1.968;OR=1.479,95% CI=1.045～2.094].ASPD患者GG、GT、TT三组基因型间BIS总分、注意因子、运动因子差异有显著性(P＜0.05),而无计划因子差异无显著性.两两分析显示GG基因型组BIS-11总分及各因子分[分别为(71.28±7.50)分,(19.60±3.41)分,(25.73±4.92)分,(25.95±4.77)分]均高于GT基因型组[分别为(66.23±8.06)分,(17.79±3.02)分,(23.06±3.84)分,(25.38±4.97)分]和TT基因型组[分别为(66.55±8.49)分,(18.50±3.35)分,(23.45±4.08)分,(24.97±4.90)分],其中BIS-11总分、注意因子、运动因子差异有显著性(P＜0.05).G等位基因组BIS-11总分及各因子分[分别为(69.38±8.04)分,(18.92±3.36)分,(24.73±4.69)分,(25.73±4.82)分]均高于T等位基因组[分别为(66.41±8.22)分,(17.98±3.26)分,(23.27±3.94)分,(25.15±4.89)分],其中BIS-11总分、注意因子、运动因子差异有显著性(P＜0.05).结论 在中国汉族人群中TPH2-703G/T多态性可能与ASPD存在遗传关联,GG基因型和等位基因G可能与ASPD正关联,并且和冲动行为相关.     

小学生攻击性人格与受虐待经历的关系

目的 研究受虐待小学生攻击性人格的发展特点及其与受虐待经历的关系.方法 采用儿童期虐待史自评量表(PRCA)、Buss和Perry攻击性人格量表,对172名小学五、六年级学生进行测评,分别评估他们的攻击性人格维度和受虐待情况.结果 与无虐待组相比,受虐待组小学生的攻击性人格各维度分和攻击性总分明显增高:攻击性总分[(32.60±8.01)分vs(19.28±4.97)分,t=11.51,P＜0.01],并且男生的攻击性高于女生:攻击性总分[(26.51±9.74)分vs(21.30±7.09)分,t=3.95,P＜0.01].躯体虐待、情感虐待、忽视和虐待总分与攻击性人格量表各因子分和总分呈正相关(r=0.287～0.797,P＜0.01),性虐待仅与躯体攻击、指向自我的攻击和攻击性总分呈正相关(r=0.159～0.181,P＜0.05).情感虐待能够正向预测躯体攻击、语言攻击、敌意、指向自我的攻击和总攻击性(Beta值=0.274～0.439,t=3.502～7.007,P＜0.01),躯体虐待能够正向预测攻击性人格的所有维度和总攻击性(Beta值=0.172～0.358,t=2.196～5.718,P＜0.05或P＜0.01),忽视能够正向预测愤怒和指向自我的攻击性(Beta值=0.203～0.235,t=2.770～3.207,P＜0.01),而性虐待对攻击性人格没有预测作用.结论 儿童虐待可对小学生的人格发展造成不良影响,使其形成高攻击性人格,躯体虐待、情感虐待和忽视对攻击性人格具有预测作用.     

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…     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

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.