创伤病人的手术与焦虑状态调查

采用状态——特质焦虑问卷及１０项躯体性焦虑测试题，对４０例外科创伤病人手术前后的焦虑状态调查显示：术前状态焦虑量表评分显著高于术后；术前躯体性焦虑评分显著高于术后；高特质焦虑评分亚组与低特质焦虑评分亚组术前状态焦虑评分无显著差异，但术后则前者显著高于后者；急诊手术者手术前后状态焦虑评分显著高于择期手术者。     

Use of topiramate, a new anti-epileptic as a mood stabilizer

Rationale: Because some anti-epileptic drugs (AEDs) are effective in bipolar affective disorders, the new AED topiramate (TPM) may be effective in psychiatric illnesses. TPM was evaluated in mood disorders refractory to previous therapies including newer AEDs. Methods: Charts of 58 consecutive patients, 39 outpatients (15 males, 24 females) and 19 inpatients (6 males, 13 females) were reviewed. TPM 25 mg. b.i.d. was added to existing therapy and titrated in 50 mg increments every 3–7 days. Improvement was rated on a Likert global assessment scale of marked, moderate, mild, or no improvement or worse, based on quality of sleep, appetite, mood, and concentration. Results: Of the 58 patients with psychiatric disorders, 44 patients had rapid cycling bipolar disorders characterized by manic, hypomanic, or mixed episodes. Eighteen patients had previously failed to respond to lamotrigine and/or gabapentin in addition to conventional mood stabilizers. Fourteen were Bipolar I, six Bipolar II, and seven mixed, ten patients had cyclothymic disorder, seven had bipolar disorder not otherwise specified. Of the remaining 14 patients, nine had schizoaffective disorder, three patients had dementia and two had psychosis. Mean duration of TPM treatment was 16.0 weeks; mean TPM dosage approximately 200 mg/day. Thirty-six of 58 (62%) patients exhibited marked or moderate improvement, usually within days or weeks. Twenty-three of 44 (52%) patients with bipolar affective disorders showed marked or moderate improvement. Minimal/no improvement was observed in 16; six were rated as worse. Adverse events included delirium in one patient with Bipolar Disorder Type I who overmedicated with TPM (800 mg) and tranylcypromine sulfate (170 mg) combined with alcohol. Other adverse effects were minor and included: paresthesias, somnolence, fatigue, impaired concentration and memory, nausea, and diarrhoea. Limitations: This study was performed in a nonrandom open and retrospective fashion. Therefore, any findings are limited by the design of this study. Conclusion: TPM may be useful in patients with mood disorders unresponsive to traditional therapy and warrants further clinical investigation.     

简明心境量表(BPOMS)的初步修订

目的 :修订并检验简明心境量表 (BPOMS)的信度和效度。方法 :对 886名大学生实施该量表 ,并对其中 74人间隔 9天评定重测信度。随机抽取 87名门诊初诊神经症患者进行BPOMS、抑郁自评量表(SDS)和焦虑自评量表 (SAS)的测查 ,评定效标效度。选取 87名年龄、性别和文化与病例组相匹配的正常个体为对照组填写BPOMS ,评定区分效度。结果 :BPOMS的重测信度系数在 0 40 6～ 0 664之间 ,α系数在0 70 5～ 0 890之间 ,具有较满意的信度。原量表共有 6个维度 ,本研究对BPOMS进行因素分析后提取了 5个维度 ,仍能够合理地解释该量表的结构。修订后BPOMS的“抑郁”维度与SDS、“紧张”维度与SAS的相关系数分别为 0 60 5和 0 60 2 (P <0 0 1) ,神经症组与对照组在BPOMS和各维度的得分均有显著性的差异 (P<0 0 1) ,说明BPOMS有良好的区分效度和效标效度。结论 :该量表具有良好的信效度 ,是测量个体心境状态简便易行的工具。     

Coping strategies,hostility, and depressive symptoms: A path model

Previous studies of coping, hostility, and depressive symptoms have highlighted the significant relations between all possible pairs of these 3 variables. To more completely explore the nature of depressive symptoms, we link them all together in this study by testing a coping→hostility→depressive symptoms path model. One hundred forty participants completed psychological questionnaires measuring coping strategies, hostility, and depressive symptoms. While controlling age and social class as covariates, SPSS stepwise regression analyses were used to examine relations among these 3 constructs. Results suggest that coping has a direct relation with depressive symptoms as well as an indirect relation mediated by hostility. Passive coping may lead to increased hostility, resulting in depressive symptoms. Active coping may have the opposite effect. These findings suggest that the inclusion of measures of both coping strategies and hostility yields a more thorough understanding of concomitants of depressive symptoms. From a clinical perspective, knowing what coping strategies a person uses and how much anger they experience and express may be useful in guiding the management of depressive symptoms.     

Do changes in mood and concerns about weight relate to smoking relapse in the postpartum period?

Summary The majority of women who quit smoking during pregnancy will resume smoking during the postpartum period. Little is known, however, about the predictors of postpartum relapses to smoking. Changes in mood and increases in concerns about weight are common during the postpartum period, and these factors may affect womens postpartum smoking behavior. In this paper, we present a model of the relationship among mood, weight concerns and postpartum smoking. Data from previous postpartum relapse prevention trials are reviewed and evidence of a connection between changes in mood and weight concerns to postpartum relapse is presented. Directions for future research on the prevention of smoking relapses during the postpartum period, and the roles of mood and weight concerns in smoking relapse are presented.     

Secretion of salivary immunoglobulin a in relation to age,saliva flow,mood states,secretion of albumin,cortisol, and catecholamines in saliva

Salivary immunoglobulin A (IgA) is one characteristic humoral factor of the local immune system in the upper respiratory tract. Epidemiological studies emphasize the importance of secretory IgA in the protection from infections of the upper respiratory tract. However, due to high interindividual variability of secretion of salivary IgA, it remains difficult to define normal ranges. This series of studies focused on identification of factors influencing basal secretion of salivary IgA. The results indicate a significant relationship between age and salivary IgA concentration. Children below 7 years have lower salivary IgA concentration than children above 7 years or adults. Furthermore, a significant inverse relationship between saliva flow and salivary IgA concentration was found. Gender, mood states, salivary albumin, salivary catecholamines, and salivary cortisol were not associated with salivary IgA. It can be concluded that for defining normal ranges of salivary IgA, age and saliva flow have to be considered.     

The Recuperative Effects of REM Sleep and Stage 4 Sleep on Human Performance After Complete Sleep Loss: Experiment 1

Twelve young (17–21 yrs) male Navy recruits volunteered for a sleep loss study. After 4 baseline days, the Ss were completely deprived of sleep for 2 days and nights. Next followed an experimental phase of 2 days and nights after which all Ss received 2 nights of uninterrupted sleep. During the experimental phase, the 4 Ss in the REM-deprived group were aroused whenever they showed signs of REM sleep. The 4 Ss of the stage 4-deprived group were aroused whenever they showed signs of entering stage 4 sleep, and the 4 Ss of the Control group had uninterrupted sleep. All tests (speed and accuracy of addition, speed and accuracy of self-paced vigilance, errors of omission in experimenter paced vigilance, immediate recall of word lists, and mood) showed significant impairment after the first night of complete sleep loss. But during the experimental (sleep-stage-deprivation) and recovery phases, all three groups showed equal rates of recovery. Depriving the S of stage REM or stage 4 during recovery sleep does not affect the recuperation rate. Frequent arousals (50–100 per night) also do not impair recovery. The amount of sleep is probably more important than the kind of sleep.     

北京女校大学生进食障碍与心境的问卷调查

目的:探讨北京女校大学生的进食障碍状况及其相关心境。方法:通过班级集体施测的方法,采用进食障碍问卷(EDI)和简式简明心境问卷(POMS-SF)对北京市女子大学352名年龄为17-25岁的大学生进行调查,同时搜集被试的体重、身高等人口学资料(身高=161±5厘米,体重=52.3±5.61千克)。结果:当前北京女校大学生进食障碍的相关行为普遍存在;与体形偏瘦和过瘦的学生相比,体形正常的大学生进食障碍相关的不良态度和行为表现较为严重;进食障碍相关的不良态度和行为存在年级差异(X~2=17.94,P<0.01),大一、大四较为严重;进食障碍症状与不良心境相关(r=0.42,P<0.01)。结论:北京女校大学生进食障碍相关态度和行为较严重,并与其心境和其它因素有一定关系。     

超微量肝素在治疗重症肺炎中的应用（附41例报告）

目的：探讨超微量肝素在重症肺炎患儿治疗中的应用。方法：对我科于1998年5月--2001年5月收治的重症肺炎共41例,随机分为常规治疗组和肝素治疗组,对两组资料进行分析并进行统计学处理。结果：肝素治疗组在热退时间、吸氧时间、肺部体征消失时间、住院天数皆明显短于常规治疗组。结论：在重症肺炎的治疗中加用超微量肝素治疗具有安全、有效、副作用少等作用,易于在临床推广。     

人文医疗在阴式全子宫切除术联合阴道后壁修补术治疗子宫脱垂合并肠疝患者中的应用

目的探究人文医疗在阴式全子宫切除术联合阴道后壁修补术治疗老年子宫脱垂合并肠疝(阴道后壁膨出)患者中的应用效果。方法选择2018年1月至2019年12月期间天长市中医院收治子宫脱垂合并肠疝患者120例作为研究对象。全部入选病例均行阴式全子宫切除术联合阴道后壁修补术治疗,采用随机数字表法将病例分为对照组和观察组,各60例。对照组给予常规护理,观察组给予人文医疗护理。对比2组患者中文版知觉压力量表(CPSS)评分、抑郁自评量表(SDS)、焦虑自评量表(SAS)评分、心理弹性量表-简表(RS-14)、护理服务满意度、皮质醇(Cor)、心率及平均动脉压。结果护理前,2组CPSS、SDS、SAS及RS-14评分组间比较的差异无统计学意义(P>0.05);护理7 d后,2组CPSS、SDS、SAS及RS-14评分均较护理前降低,且观察组均低于对照组,差异有统计学意义(P<0.05)。观察组患者的满意度(96.67%)较对照组高(80.00%),差异有统计学意义(P<0.05)。观察组手术结束时2组患者的Cor、心率及平均动脉压较对照组低,差异有统计学意义(P<0.05)。结论人文医疗应用于子宫脱垂合并肠疝患者护理中,能够改善其不良情绪,缓解心理压力,减少手术的应激反应,提高患者对护理满意度。