天麻素联合黛力新治疗更年期焦虑状态疗效观察

目的探讨天麻素联合黛力新治疗更年期焦虑状态的治疗效果。方法采用汉密尔顿焦虑量表对前来就诊的更年期妇女（年龄45～55岁）进行测试。量表分值在14分以上的156例患者随机分成治疗组与对照组。治疗组使用天麻素联合黛力新治疗，对照组单用黛力新治疗。结果治疗组总有效率92．30％，对照组总有效率为64．10％，差异具有统计学意义，治疗组治疗后焦虑量表分值平均（7．10±2．02）分，对照组平均（12．94±1．69）分，差异具有统计学意义。结论天麻素对改善更年期焦虑状态有明显疗效。     

Genotypes and Haplotypes of the Estrogen Receptor α Gene (ESR1) Are Associated With Female-to-Male Gender Dysphoria

IntroductionGender dysphoria, a marked incongruence between one's experienced gender and biological sex, is commonly believed to arise from discrepant cerebral and genital sexual differentiation. With the discovery that estrogen receptor β is associated with female-to-male (FtM) but not with male-to-female (MtF) gender dysphoria, and given estrogen receptor α involvement in central nervous system masculinization, it was hypothesized that estrogen receptor α, encoded by the ESR1 gene, also might be implicated.AimTo investigate whether ESR1 polymorphisms (TA)n-rs3138774, PvuII-rs2234693, and XbaI-rs9340799 and their haplotypes are associated with gender dysphoria in adults.MethodsMolecular analysis was performed in peripheral blood samples from 183 FtM subjects, 184 MtF subjects, and 394 sex- and ethnically-matched controls.Main Outcome MeasuresGenotype and haplotype analyses of the (TA)n-rs3138774, PvuII-rs2234693, and XbaI-rs9340799 polymorphisms.ResultsAllele and genotype frequencies for the polymorphism XbaI were statistically significant only in FtM vs control XX subjects (P = .021 and P = .020). In XX individuals, the A/G genotype was associated with a low risk of gender dysphoria (odds ratio [OR] = 0.34; 95% CI = 0.16–0.74; P = .011); in XY individuals, the A/A genotype implied a low risk of gender dysphoria (OR = 0.39; 95% CI = 0.17–0.89; P = .008). Binary logistic regression showed partial effects for all three polymorphisms in FtM but not in MtF subjects. The three polymorphisms were in linkage disequilibrium: a small number of TA repeats was linked to the presence of PvuII and XbaI restriction sites (haplotype S-T-A), and a large number of TA repeats was linked to the absence of these restriction sites (haplotype L-C-G). In XX individuals, the presence of haplotype L-C-G carried a low risk of gender dysphoria (OR = 0.66; 95% CI = 0.44–0.99; P = .046), whereas the presence of haplotype L-C-A carried a high susceptibility to gender dysphoria (OR = 3.96; 95% CI = 1.04–15.02; P = .044). Global haplotype was associated with FtM gender dysphoria (P = .017) but not with MtF gender dysphoria.ConclusionsXbaI-rs9340799 is involved in FtM gender dysphoria in adults. Our findings suggest different genetic programs for gender dysphoria in men and women.Cortés-Cortés J, Fernández R, Teijeiro N, et al. Genotypes and Haplotypes of the Estrogen Receptor α Gene (ESR1) Are Associated With Female-to-Male Gender Dysphoria. J Sex Med 2017;14:464–472.     

Improving attention control in dysphoria through cognitive training: Transfer effects on working memory capacity and filtering efficiency

Impaired filtering of irrelevant information from working memory is thought to underlie reduced working memory capacity for relevant information in dysphoria. The current study investigated whether training‐related gains in working memory performance on the adaptive dual n‐back task could result in improved inhibitory function. Efficacy of training was monitored in a change detection paradigm allowing measurement of a sustained event‐related potential asymmetry sensitive to working memory capacity and the efficient filtering of irrelevant information. Dysphoric participants in the training group showed training‐related gains in working memory that were accompanied by gains in working memory capacity and filtering efficiency compared to an active control group. Results provide important initial evidence that behavioral performance and neural function in dysphoria can be improved by facilitating greater attentional control.     

A meta-analytic review of mood-congruent implicit memory in depressed mood

In studies of explicit memory, researchers have reliably demonstrated that mood-congruent, depressive information is especially likely to be recalled by individuals exhibiting depressed mood. Results from studies of implicit mood-congruent memory in depressed mood, however, have been largely discrepant. The current research reviews 20 studies of implicit mood-congruent memory for emotionally valenced words in the context of dysphoria and clinical depression. Meta-analytic techniques were used to summarize this research. Results indicated that depressive groups exhibited preferential implicit recall of negative information and nondepressed groups exhibited preferential implicit recall of positive information. Also, depressive implicit mood-congruent memory for negative information was associated with recall and encoding tasks that matched with regard to the perceptual versus conceptual processes required. Furthermore, self-relevance emerged as an important moderator for implicit recall in analyses that compared clinically depressed groups to nondepressed groups. These results provide partial support both for the transfer appropriate processing framework of memory and cognitive theories of depression that emphasize self-relevant information. Finally, certain participant characteristics, particularly age and severity of depressive symptoms, emerged as important moderators of the effect of group status on depressive implicit recall biases.     

国产曲马多对全麻围拔管期反应的影响

目的:观察国产曲马多对全麻围拔管期反应及术后疼痛的影响。方法:选择行静吸复合全麻患者42例,随机均分为两组。观察组在手术结束前约1小时肌肉注射国产曲马多1mg/kg,对照组不用曲马多。观察两组患者围拔管期血液动力学变化及不吸氧时SpO2值,有无躁动及躁动程度、初醒时间和拔管时间,术后疼痛程度评分及有无不良反应。结果:观察组围拔管期MAP、HR、SpO2没有明显变化(P>0.05);对照组MAP在拔管时明显升高(P<0.05);观察组重度躁动的发生率、术后8小时疼痛程度Ⅲ级者明显低于对照组(P<0.05),且不延长初醒和拔管时间。结论:国产曲马多肌肉注射可安全有效地抑制全麻围拔管期反应,且有明显的术后镇痛作用。     

The Rise of the Neophallus: A Systematic Review of Penile Prosthetic Outcomes and Complications in Gender-Affirming Surgery

Background

Penile prostheses are commonly used to achieve erectile rigidity after phalloplasty in trans masculine patients. Implantation poses significant challenges because of the delicate nature of the neophallus and lack of native erectile tissue. Many groups have developed novel phalloplasty and prosthesis insertion techniques, but none have proven superior.

Emotional dysregulation in dysphoria: Support for emotion context insensitivity in response to performance-based feedback

The Emotion Context Insensitivity (ECI) hypothesis predicts that individuals experiencing a sad mood will show diminished reactivity to emotionally evocative stimuli and will not differentiate emotional responses across contexts. Previous work has primarily been limited to studying depressed individuals' emotional responses to film clips, images, and autobiographical memories. The current study builds upon this work by examining emotional reactivity of dysphoric (n = 47) and non-dysphoric (n = 54) individuals to positive and negative feedback about their performance on a task they were led to believe measured social intelligence. Overall, dysphoric individuals reported higher negative emotion and lower positive emotion than non-dysphoric individuals before, during, and after feedback. However, consistent with ECI, dysphoric individuals displayed attenuated emotional reactivity to negative feedback compared to controls. Further, dysphoric individuals' emotional response did not differ to positive and negative feedback, whereas the non-dysphoric group appropriately differentiated their emotional response across these contexts. Findings support the ECI hypothesis and broaden its scope to include emotional reactivity to self-relevant performance feedback.     

An integrative model of excessive reassurance seeking and negative feedback seeking in the development and maintenance of depression

Depression and interpersonal dysfunction are inextricably linked. Interpersonal behaviors in individuals with depression, specifically excessive reassurance seeking (ERS) and negative feedback seeking (NFS), have recently emerged as possible risk factors for interpersonal rejection and future depression. However, existing models integrating ERS and NFS in individuals with depression lack empirical support and fail to provide an adequate explanation for the negative social and psychological consequences that concurrent ERS and NFS create. The proposed model, based on the bias and accuracy literature in close relationships, suggests that individuals with depression desire and elicit global enhancement (through ERS) and specific verification (through NFS) from close others. This model has strong theoretical and empirical foundations and suggests that depression chronicity and interpersonal distress stem from the influence that early core-beliefs about relationships and self-views have on the seemingly adaptive combination of global enhancement and specific verification.     

恶性肿瘤患者的心理护理干预效果分析

目的探讨恶性肿瘤患者的心理护理干预效果。方法将我院80例临床确诊的恶性肿瘤患者随机分为研究组与对照组,每组各40例。对照组患者给予常规护理,研究组患者在常规护理基础上给予心理护理干预,比较两组患者治疗前后焦虑自评量表（SAS）评分、抑郁自评量表（SDS）评分、汉密尔顿焦虑量表（HAMA）评分及汉密尔顿抑郁量表（HAMD）评分情况。结果研究组治疗后SAS评分及SDS评分均较治疗前及对照组显著降低,差异有统计学意义（P〈0.05）;HAMA评分及HAMD评分亦较治疗前及对照组显著降低,差异有统计学意义（P〈0.05）。对照组治疗后SAS评分、SDS评分、HAMA评分及HAMD评分与治疗前比较均无明显改善（P〉0.05）。结论实施合理的心理护理干预能够显著改善恶性肿瘤患者的焦虑、抑郁负性心理,为临床制订恶性肿瘤患者的护理方案提供参考。