神经症的研究进展

目的探讨神经症的病因,防御机制,应对方式,心理治疗及药物治疗的研究进展,以便为其研究、预防和治疗工作提供科学依据。方法以最近20年国内外有关神经症研究的成果为基础,采用文献研究法分析总结了近50余篇有关的研究论文的研究成果。结果神经症患者多内向,情绪明显不稳定,神经质影响心理症状最大;他们的父母较正常人的父母对子女缺乏情感温暖,并有过度的拒绝和过度保护,家庭不和睦,其在发病前一年内负性生活事件数目与严重程度均高于对照组(P<0.01);情绪表达受限,生活单调乏味,父母采取不良教养方式,人际关系紧张等。患者存在防御上的不适当,多使用不成熟或中间型防御机制,缺乏良好的应对方式。心理疗法主要有支持心理治疗,森田疗法,认知领悟疗法和精神分析疗法;而药物以三环类药物,苯二氮卓类为主。药物与心理疗法相结合的疗效比单纯应用心理治疗或药物治疗要好。结论神经症的病因主要有人格特征,家庭环境,生活事件,教养方式,人际关系等。采用心理干预与药物治疗相结合的方法是目前比较公认的。     

Influence of antibody and complement components on phagocytosis and chemiluminescence of macrophages

Macrophages are known to release reactive oxygen species (O₂^?, ¹O₂, H₂O₂, OH·) in response to various membrane stimuliHowever, our studies show that phagocytic stimulation of macrophages is not necessarily accompanied by a stimulation of the oxidative burstWhereas IgG-opsonized erythrocytes were capable to induce phagocytosis and a chemiluminescence response, both being dependent on the number of IgG bound per erythrocyte, C3b-bearing erythrocytes were well ingested but failed to induce any chemiluminescence reactionFurthermore, stimulation of macrophages, via the Fc-receptors, seems to alter their functional state in regard to the activation of a receptor, which enables them to recognize membrane lesions on the target erythrocyteThe presence of IgG and membrane lesions, e.gthe C5b-9-complex of complement, induced a marked increase in chemiluminescence compared with stimulation by IgG-bearing particles aloneThe augmented response of macrophages was at least in part due to an additional release of H₂O₂, which was not liberated in response to IgG-bearing erythrocytesThis «Alesion recognizing receptor» in the macrophage membrane could not be activated by stimulation of C3b-receptors, indicating its functional linkage to the Fc-receptors.     

IL-4–BATF signaling directly modulates IL-9 producing mucosal mast cell (MMC9) function in experimental food allergy

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Quality validation of platelets obtained from the Haemonetics and Trima Accel automated blood-collection systems

BackgroundPlatelet transfusion is required to treat haemo-oncology or trauma patients. Platelet apheresis (PA) performed with apheresis equipment has increased rapidly in recent years. Leucocyte-reduced platelet apheresis (LRPA) can reduce the risk of platelet refractoriness and febrile nonhemolytic transfusion reactions (FNHTRs) for transfusion. Accordingly, this study aimed to investigate and compare the platelet metabolic and functional responses between PA performed with Haemonetics and LRPA performed with Trima Accel cell separator.MethodsThe qualities of platelets collected through PA and LRPA were evaluated in terms of visual appearance, morphology, platelet-aggregation changes, metabolic activities, and bacterium-screening test during 5-day storage. Statistical analyses included two-sample t-test and generalised estimating equation(GEE) method.ResultsDuring 5-day storage in LRPA, residual leucocytes were all <1.0×10⁶, and the parameters of platelet function were as follows: platelet aggregated to agonists such as adenosine 5′-diphosphate (ADP) and collagen, and the extent of shape change and pO₂ showed no statistically significant difference between PA and LRPA. The hypotonic shock reaction (HSR) on days 0, 1, and 3 were significantly higher in LRPA than in PA (71.78±6.92 vs. 64.10±7.42; P=0.002; 71.53±8.98 vs. 62.96±9.84; P=0.007; 68.05±7.28 vs. 57.76±6.80; P<0.0001, respectively). Values of mean platelet volume (MPV) were statistically larger in PA than in LRPA on days 0, 1, and 3. On day 5, the swirling score was higher in LRPA than in PA. The mean lactate levels had no statistically significant difference between PA and LRPA. Moreover, no growth was observed through bacterium-screening test conducted on 40 samples.ConclusionComparison of LRPA and PA products collected from the Trima Accel and Haemonetics automated blood-collection systems, respectively, revealed that both products possessed good platelet qualities even though additional processes are needed to reduce leucocytes. Furthermore, investigating the outcomes of other apheresis instruments with focus on the safety of donors, products, and recipients is necessary.     

癫痫大发作儿童生活质量的研究

应用癫痫患者生活质量量表，以问卷方式，对９１例患儿进行生活质量的研究，并与正常儿童比较及探讨影响因素。结果，患儿生活质量明显低于正常儿童，主要因对发作恐慎、担心长期用药、存在认知障碍及社会交往困难；此外，生活质量与学习成绩也有关。即使发作已被控制，患儿生活质量并无明显改善。因而对患儿除药物治疗外，应加强非药物的心理治疗及提高学习能力，才能提高癫痫患儿的生活质量。     

The Binding of Different Lectins on Peripheral Blood Mononuclear Cells from Patients with Chronic Inflammatory and Malignant Diseases

Peripheral blood mononuclear cells from patients with multiple myeloma, gastrointestinal tumors, and inflammatory bowel disease were analyzed for binding of various lectins. The results demonstrated that in most of the patients with multiple myeloma a significantly increased percentage of cells positive for Lotus tetragonolobus agglutinin (LTA), peanut agglutinin (PNA), soybean agglutinin (SBA), and wheat germ agglutinin (WGA), and a decreased number of Agaricus bisporus agglutinin (ABA) positive cells were present as compared to a normal control group. This could not be shown in malignant or inflammatory disorders of the gastrointestinal tract where only some patients exhibited an increased PNA and LTA binding, respectively. Patients with the systemic malignant disease differed from patients with solid localized tumors by a significantly altered number of ABA, LTA and SBA-positive peripheral blood mononuclear cells. Double fluorescence studies using monoclonal antibodies and lectins revealed that most of the cells expressing receptors for ABA had also receptors for OKT3, whereas most of the cells with receptors for LTA, PNA SBA, and WGA were found to be positive for OKM.     

Clinical use of biofeedback in rehabilitation

Clinical electromyographic (EMG) biofeedback was an outgrowth of diagnostic electromyography and research on the fine control of motor units. In rehabilitation, EMG biofeedback has gained a firm place in the treatment of upper motor neuron lesions, particularly in retraining muscles and inducing relaxation of spastic muscles of stroke patients. In cerebral palsy and musculoskeletal disturbances, additional feedback transducers (e.g., electrogoniometers, pressure-sensitive and position-sensing devices) are gaining wider use. Spasmodic torticollis has proved to be particularly suitable for behavioral methods of treatment, including EMG feedback.     

以工时为核心的护士绩效考核实践

以护理工时为基础,建立以工时核算为核心的老年科护士绩效考核方案,并与医院信息系统相关联。改革后,护士工作效率提高,护理质量提升,护士满意度增加。认为工时绩效考核方案具有一定科学性和合理性,能够充分体现护理人员劳动价值,促进团队协作,提升护理质量。     

构建急性肾损伤患者连续性肾脏替代治疗剂量达成模型

按照课题研究型品管圈活动步骤,针对急性肾损伤患者连续性肾脏替代治疗处方治疗剂量与实际治疗剂量存在较大差异的现状,对剂量管理现状、攻坚点进行分析与发掘,针对性拟定对策并实施,包括建立集束化血管通路管理策略,制定最优滤器管路使用技术方案,构建全流程CRRT智能管理平台。活动开展后,CRRT治疗剂量达成率由78.5%上升至93.5%,治疗时间达成率、平均CRRT治疗日、28 d存活率、出院时透析依赖率等均有不同程度改善,活动效果显著。