1519例胎儿心电图的临床价值和相关因素分析

目的对1519例胎儿全部实行常规胎儿心电图(FECG)监测工作,探讨胎儿心电图应用情况,并对异常FECG结合临床,进行临床原因分析.方法采用随机湘样方法,应用杭州产FECG-D型胎儿心电图分析仪进行监测.结果发现采用横导联方式进行监测检出率为53.5%:在孕22w进行监测检出率为45.8%;异常FECG检出率为7.64%.结论对1519例FECG的监测发现采用横导联方式并在孕22w～26w期间进行监测检出率最高、波形效果好.并对监测发现的导致FECG异常改变的临床原因与胎儿宫内窘迫的关系进行浅要分析.     

人格测验正反向题目的时间效应

目的通过分析人格测验正反向题目的时间效应,探讨人格测验中题目陈述方式对测验效度及质量的影响,为测验编制及研究提供参考。方法1230名士兵完成计算机呈现的艾森克人格问卷,记录被试完成每个题目所需要的时间,将正反向题目平均用时进行对比分析。结果反向题目整体平均用时显著高于正向题目平均用时(P<0.01);得分的反向题目平均用时显著低于得分的正向题目(P<0.01);未得分的反向题目平均用时显著高于未得分的正向题目(P<0.01)。结论反向题目的引入可以减少人格测验的反应偏差,提高测验的效度,但也会在一定程度上影响被试作答的心理过程。因此在测验编制的过程中应平衡使用正反向题目,但反向题目的语言要尽量简洁明了,减少对被试作答的影响。     

A Novel Mutation in the GATA1 Gene Associated with Acute Megakaryoblastic Leukemia in a Korean Down Syndrome Patient

Although acquired mutations in the GATA1 gene have been reported for Down syndrome-related acute megakaryoblastic leukemia (DS-AMKL) in Caucasians, this is the first report of a Korean Down syndrome patient with AMKL carrying a novel mutation of the GATA1 gene. A 3-yr-old Korean girl with Down syndrome was admitted to our hospital complaining of pallor and fever. The findings of a peripheral blood smear and bone marrow study were compatible with the presence of AMKL. A chromosome study showed 48,XX,-7,+21c,+21,+r[3]/47,XX,+21c[17]. Following GATA1 gene mutation analysis, a novel mutation, c.145dupG (p.Ala49GlyfsX18), was identified in the N-terminal activation domain of the GATA1 gene. This mutation caused a premature termination at codon 67 and expression of an abnormal GATA-1 protein with a defective N-terminal activation domain, and the absence of full-length GATA-1 protein. This case demonstrates that a leukemogenic mechanism for DS-AMKL is contributed by a unique collaboration between overexpressed genes from trisomy 21 and an acquired GATA1 mutation previously seen in Caucasians and now in a Korean patient.     

一般人群中人格维度与心身症状的相关研究

目的：探讨在健康人群中稳定的人格特点与某一时期心身症状的测量之间的关系。方法：对721名被试施测人格量表（QZPS）和SCL-90，通过回归和相关分析探讨两者之间的关系。结果：严谨、沉稳、决断、淡泊和情绪性等人格因素与SCL-90的因子分数正相关，其它人格因素则与SCL-90的因子分数负相关。控制人格因素间的相关之后，进入每个预测心身症状回归方程的人格因素分别为3-5个,其中严谨、自制、沉稳、重感情和热情的回归系数是正值，其它为负值，表明行事严谨、自我克制以及对人热情和重感情等人格特点与心身症状的出现是一致的。结论：人格维度对心身症状有一定的预测能力。     

企业员工应激源的因素结构研究

目的 :该研究旨在确立企业员工应激源的因素结构。方法 :经过对 394 6名被试的探索性因素分析 ,提出企业员工应激源的 9因素结构。结果 :因素分别命名为职业发展、住房问题、工作特征、社会环境、人际关系、经济收入、子女问题、组织气氛和夫妻关系。结论 :企业员工应激源的 9因素结构获得了验证性因素分析的支持。     

Immunohistochemical differentiation between lymphangiographically verified lymphatic vessels and blood vessels

Summary In order to investigate the antigen profile in human lymphatic vessels when compared with blood vessels, postmortem retrograde lymphangiography was done via the thoracic duct on six patients. Formalin fixed, paraffin embedded tissue was stained immunohistochemically for Factor VIII-Related antigen (F VIII R:Ag), with Ulex Europaeus 1 lectin (UEA-1) and for laminin. The results show that the endothelium of blood vessels and lymphatics at all levels of the lymphatic system react positively following staining for Factor VIII-R:Ag and with UEA-1 lectin. The staining for F VIII R:Ag was generally weaker in the endothelial cells lining lymphatic vessels. Staining for the basement membrane component laminin can be used to distinguish lymphatic capillaries and smaller lymphatic collecting vessels from blood vessels.     

军校部队生与地方生人格、应对方式及心理健康研究

目的 了解军校部队生与地方生的心理健康、人格和应对方式等情况,为加强大学生心理健康教育提供依据.方法 采用症状自评量表、艾森克个性问卷、简易应对方式问卷,对临床本科的部队生与地方生进行测评分析.结果 部队生心理健康状况总体上好于地方生,躯体化、人际敏感、抑郁、焦虑等轻于地方生,性格相对外向,且处事相对稳重,应对方式以积极成熟的为主,统计学检验P＜0.05或P＜0.01.结论 军人的责任感与自豪感有助于部队生的心理健康,而对军事化管理出现思想上的错误认识是地方生心理问题产生的主要原因.     

女性毒品犯人格的基本特征及其相关因素的研究

目的 探讨在押女性毒品犯人格的基本特征、类型特征及其影响因素。方法 以252名在押女性毒品犯为被试，对CPI的测验数据进行t检验、Z检验和F检验。结果 ①女性毒品犯不仅与常模团体相比较具有显著特征．而且与男性毒品犯相比较也存在特殊性；②女性毒品犯在4种人格类型上的分布不平衡．较多地在Delta型；③民族、地域、年龄及关押时间对女性毒品犯的人格特征的变异均有一定影响．但减刑次数未见反映出被试人格积极改变的效果。结论 女性毒品犯广泛而明显的消极性人格特征，并与民族、地域、年龄及关押时间有关。     

2型糖尿病患者血清von Willebrand因子变化与微血管并发症的关系

目的 :探讨 2型糖尿病患者的微血管内皮细胞功能损伤与微血管并发症之间的关系。方法 :从 3 3 4名 2型糖尿病患者中选择合并微血管并发症但未合并大血管并发症者 3 2人作为微血管并发症组 ,并选择年龄与之匹配的无大血管及微血管并发症 55人作为无并发症组 ,观察二组患者血清vonWillebrand因子 (vWF)水平 ,并与年龄相接近的正常对照组 ( 4 0例 )比较。结果 :血清vWF水平正常对照组 0 .92U± 0 .44U/ml;无并发症组 1.15U± 0 .42U /ml ;微血管并发症组 1.3 7U± 0 .44U/ml;三组之间均有显著性差异 (P <0 .0 5～ 0 .0 1)。多因素Logistic回归分析表明vWF、空腹血糖分别与糖尿病人是否合并微血管病变显著相关 (ExpB分别为 3 .0 2 3 ,1.3 3 7,P <0 .0 5～ 0 .0 1) ,以vWF为应变量的多元逐步回归分析表明年龄、糖尿病病程、甘油三酯分别与vWF呈显著独立正相关 (B =0 .53 ,0 .3 5,0 .2 9,P <0 .0 5～ 0 .0 1)。结论 :在糖尿病患者中存在不同程度的微血管内皮细胞的损伤 ,此变化随着微血管并发症的进展呈进行性加重。以vWF升高所反映的微血管内皮细胞损伤是一项值得临床推广的研究方法     

Minnesota Multiphasic Personality Inventory (MMPI) cluster groups among chronically ill patients: Relationship to illness adjustment and treatment outcome

Cluster analysis of the MMPI has been utilized widely in the chronic low back pain literature to try to identify reliable patient subtypes predictive of treatment outcome. We extended this methodology to patients with heterogeneous chronic medical conditions by replicating prototypic MMPI cluster group profiles and by relating cluster groups to clinical baseline and outcome data. Subjects were two independent samples (n=254 and n=263) of chronically ill patients admitted to an inpatient medicine/psychiatry unit. Using a four-cluster solution, similar cluster profile groups were replicated in both samples. Consistent differences emerged between cluster groups on functional impairment, psychiatric diagnoses, depression, and psychosomatic symptoms. Cluster group membership also predicted changes in functional impairment and depression six months after treatment. Results are discussed in terms of similarities between chronic low back pain and chronic illness and tailoring treatment to different patient types.This research was supported in part by a grant from the Henry J. Kaiser Family Foundation.