精神分裂症患者与其一级亲属的社会认知功能比较研究

目的：对比分析精神分裂症患者与其一级亲属在社会认知功能方面存在的差异。方法随机选取100名精神分裂患者和该100名患者一级亲属,调查他们的一般资料,并进行威斯康星卡片分类测验、持续操作测验和韦氏成人记忆量表修订版的测评。通过 t 检验和卡方检验比较患者组和亲属组认知功能的差异。结果无论是亲属组还是患者组,均有超过一半的人存在工作记忆-执行功能缺陷,但两组存在工作记忆-执行功能缺陷的概率差异有统计学意义,患者组存在工作记忆-执行功能缺陷的比例高于亲属组(χ2=4.582,P =0.032);而两组人群的注意障碍(χ2=1.496,P =0.221)和记忆障碍的差异无统计学意义(χ2=3.380,P =0.066)。结论与精神分裂症患者相比,其一级亲属存在工作-执行功能缺陷的比例较低,但存在同样风险的注意障碍和记忆障碍。     

Multisite Near Infrared Spectroscopy During Cardiopulmonary Bypass in Pediatric Patients

Multisite near infrared spectroscopy (NIRS) monitoring during pediatric cardiopulmonary bypass (CPB) has not been extensively validated. Although it might be rational to explore regional tissue saturation at different body sites (namely brain, kidney, upper body, lower body), conflicting results are currently provided by experience in children. The aim of our study was to evaluate absolute values of multisite NIRS saturation during CPB in a cohort of infants undergoing pediatric cardiac surgery to describe average differences between cerebral, renal, upper body (arm), and lower body (thigh) regional saturation. Furthermore, the correlation between cerebral NIRS and cardiac index (CI) at CPB weaning was evaluated. Twenty‐five infants were enrolled: their median weight, age, and body surface area were 3.9 (3.3–6) kg, 111 (47–203) days, and 0.24 (0.22–0.33) m², respectively. Median Aristotle score was 8 (6–10), and vasoactive inotropic score at CPB weaning was 16 (14–25). A total of 17 430 data points were recorded by each sensor: two‐way ANOVA showed that time (P < 0.0001) and site (P = 0.0001) significantly affected variations of NIRS values: however, if cerebral NIRS values are excluded, sensor site is no more significant (P = 0.184 in the no circulatory arrest [noCA] group and P = 0.42 in the circulatory arrest [CA] group). Analysis of NIRS saturation changes over time showed that, at all sites, average NIRS values increased after CPB start, even if the increase of cerebral saturation was less intense than other sites (P < 0.0001). Detailed analysis of interaction between site of NIRS measurement and time point showed that cerebral NIRS (ranging from 65 to 75%) was always significantly lower than that of other channels (P < 0.0001) that tended to be in the range of oversaturation (80–90%), especially during the CPB phase. Average cerebral NIRS values of patients who did not undergo circulatory arrest (CA) during CPB, 10 min after CPB weaning, were associated with average CI values with a significant correlation (r = 0.7, P = 0.003). In conclusion, during CPB, cerebral NIRS values are expected to remain constantly lower than somatic sensors, which instead tend to show similar elevated saturations, regardless of their position. Based on these results, positioning of noncerebral NIRS sensors during CPB without CA may be questioned.     

Real‐Time Observation of Thrombus Growth Process in an Impeller of a Hydrodynamically Levitated Centrifugal Blood Pump by Near‐Infrared Hyperspectral Imaging

Understanding the thrombus formation in cardiovascular devices such as rotary blood pumps is the most important issue in developing more hemocompatible devices. The objective of this study was to develop a hyperspectral imaging (HSI) method to visualize the thrombus growth process within a rotary blood pump and investigate the optical properties of the thrombus. An in vitro thrombogenic test was conducted using fresh porcine blood and a specially designed hydrodynamically levitated centrifugal blood pump with a transparent bottom. The pump rotating at 3000 rpm circulated the blood at 1.0 L/min. The bottom surface of the pump was illuminated with white light pulsed at the same frequency as the pump rotation, and the backward‐scattered light was imaged using the HSI system. Using stroboscopic HSI and an image construction algorithm, dynamic spectral imaging at wavelengths ranging from 608 to 752 nm within the rotating pump was achieved. After completing the experiment, we collected the red thrombus formed in the pump impeller and quantified the thrombus hemoglobin concentration (Hb_thrombus). The spectrum changed around the center of the impeller, and the area of change expanded toward the impeller flow path. The shape corresponded approximately to the shape of the thrombus. The spectrum change indicated that the light scattering derived from red blood cells decreased. The Hb_thrombus was 4.7 ± 1.3 g/dL versus a total hemoglobin of 13 ± 0.87 g/dL. The study revealed that Hb_thrombus was reduced by the surrounding blood flow.     

颅脑损伤患者家属早期信息需求及影响因素研究

目的：研究颅脑损伤患者家属早期信息需求及影响因素。方法通过分层随机抽样,选择来自温州市三家综合医院的180名颅脑损伤患者家属,应用自制颅脑外伤患者家属信息需求量表调查家属信息需求,并分析相关影响因素。结果患者家属信息需求量表总分为(21.28±2.27)分,各维度中损伤状况得分最高为(3.56±0.31)分,医院规定得分最低为(2.61±0.48)分。患者住院时间≤3 d的家属对损伤状况、治疗措施、检查方法、家属配合及医院规定等维度的信息需求度均较住院时间>3d的家属高,差异有统计学意义(P<0.05)。重型颅脑损伤患者的家属对损伤状况、治疗措施、检查方法、医护资质、治疗费用及家属配合等维度的信息需求度均较轻中型颅脑损伤患者的家属高,差异有统计学意义(P<0.05)。初中以上文化程度的家属对治疗措施、医护资质及家属配合等维度的信息需求度均较初中及以下文化程度的家属高,差异有统计学意义(P<0.05)。颅脑损伤患者家属的信息需求满足度和其对医护工作的总体满意度呈正相关(r=0.495,P<0.01)。结论颅脑损伤患者家属早期具有很强的信息需求度。患者住院时间、患者损伤等级及家属文化程度可能会影响家属的信息需求度。满足家属的信息需求可提高其对医护工作的满意程度。     

缓解期双相情感障碍I型II型患者及近亲属认知功能对照研究

目的：探讨缓解期双相情感障碍I型、II型患者及其近亲属认知功能的临床特征。方法对50例缓解期双相障碍I型患者（BP‐1组）、50例缓解期双相障碍II型患者（BP‐2组）、50名健康近亲属（亲属组）及50名正常人群（对照组）采用持续操作测验和威斯康星卡片分类测验进行测评分析。结果 BP‐1组、BP‐2组及亲属组持续操作测验的正确数评分显著低于对照组（P＜0．05）,且BP‐1组显著低于BP‐2组和亲属组（P＜0．05）。BP‐1组、BP‐2组和亲属组威斯康星卡片分类测验的错误应答数、非持续性错误数显著高于对照组（P＜0．05或0．01）;BP‐1组、亲属组显著高于BP‐2组（P＜0．01）;BP‐1组和亲属组总应答数、完成分类数、正确率、完成第一个分类数所需要应答数、不能维持完整分类数与对照组及BP‐2组比较差异有显著性（P＜0．05或0．01）。结论缓解期双相情感障碍I型、II型患者及其近亲属存在多维度认知功能损害,I型患者任务管理能力损害较明显,II型患者注意力损害明显。     

逍遥散治疗肝郁气滞症候乙型肝炎的近远期疗效研究

目的 探究逍遥散治疗肝郁气滞症候乙型肝炎的近远期临床疗效,为临床研究提供参考依据.方法 选择2011年4月-2014年3月期间我院收治的82例乙型肝炎患者,按照随机数字法分为实验组和对照组,分别为40例与42例.对照组患者给予西利宾胺治疗实验组患者则服用逍遥散治疗.比较两组患者治疗前后肝功能指标的变化,分析两组患者治疗以后近远期临床疗效的差别.结果 治疗前,两组患者的ALT、AST以及TBIL的水平无差异性(P＞0.05).治疗后,两组患者的ALT、AST以及TBIL的水平较治疗前均显著性降低,具有显著性差异(P＜0.05),但实验组患者的三项生化指标的水平较对照组患者治疗后的水平降低更为明显,具有统计学意义(P＜0.05);治疗后,实验组患者显效21例,有效16例,无效3例,总有效率92.5％,显著高于对照组患者的57.1％的总有效率,具有明显差异性(P＜0.05);治疗前,两组患者的症候积分无显著差异(P＞0.05).治疗0.5年、2年、3年后,两组患者的症候积分均降低,但实验组患者的症候积分与治疗前以及对照组患者治疗后,降低更为明显,均具有显著性差异(P＜0.05).结论 使用逍遥散治疗肝郁气滞证侯乙型肝炎患者,能够显著降低ALT、AST以及TBIL的水平,提高乙型肝炎患者近期临床疗效,改善患者的远期中医证候积分,值得在临床上广泛推广.