Well‐Being and Personal Growth in Mothers of Full‐Term and Pre‐Term Singletons and Twins

The present study examined well‐being and personal growth in mothers (n = 414) 1 year after childbirth. We examined the contribution of the event characteristics (birth of singletons or twins, full‐ or pre‐term babies, first or non‐first child, spontaneous pregnancy or fertility treatments and infant temperament), internal resources (attachment anxiety and avoidance) and external resources (marital quality and maternal grandmother's support). Regressions indicated that having a first child, child's easier temperament, lower attachment anxiety and avoidance, grandmother's emotional support and some aspects of the spousal relationships contributed to well‐being. Personal growth was found to be related to the birth of a pre‐term baby or babies, positively associated with maternal grandmother's support, and the marital quality of parenthood, and negatively with mothers' education. Beyond the findings that well‐being and personal growth are related to the availability of certain resources, the current study demonstrates that the two outcomes are separate phenomena that reveal different patterns of associations with other variables. Several explanations for the findings are proposed, and practical implications are discussed. Copyright © 2014 John Wiley & Sons, Ltd.     

Mental Well‐Being Mediates the Relationship between Perceived Stress and Perceived Health

The association between stress and health has been well researched in the past; however, comparatively few mediators have been tested to understand the underlying mechanism. With increasing awareness on mental well‐being, this study evaluated the relationship between perceived stress and perceived health and examined mental well‐being as a mediator. Two‐hundred undergraduates aged 21 to 26 years completed the English Perceived Stress Scale, Health Status Questionnaire and Asian Mental Well‐Being Scale that assess perceived stress, perceived health and mental well‐being, respectively. Factor analysis and structural equation modelling on the Perceived Stress Scale replicated the reported two‐factor structure after excluding an insignificant item. Linear multiple regression analyses indicated that perceived stress was negatively associated with perceived health. Results showed that mental well‐being partially mediated the relationship between perceived stress and perceived health, although it is acknowledged that this association could be bidirectional. Findings from the present study suggest that future research could focus on reducing stress and improving mental well‐being to alleviate the effect of stress on health. Copyright © 2013 John Wiley & Sons, Ltd.     

《中医体质量表（韩文版）》在韩国人群中应用的横断面研究

目的 通过横断面调查,了解韩国人群中医体质类型分布规律,探索性分析影响韩国人群中医体质的影响因素。方法 2014年5—11月,选取居住于首尔地区的300例韩国人,运用《中医体质量表（韩文版）》调查其中医体质类型,比较不同性别、不同职业、不同体质量指数者的中医体质类型,并与中国常模的中医体质类型进行比较。结果 300例被调查人群中,平和质69例,其余8种偏颇体质225例,兼夹体质6例,居于前3位的偏颇体质类型为阳虚质（占14.3%）、湿热质（占13.3%）和阴虚质（占12.7%）。不同性别者的体质类型比较,差异具有统计学意义（P<0.05）;不同职业者的体质类型比较,以及不同体质类型者的体质量指数比较,差异均无统计学意义（P>0.05）;与中国常模的体质类型分布比较,差异具有统计学意义（P<0.01）,其中韩国人群阳虚质构成比高于中国常模,气虚质构成比低于中国常模。结论 韩国人群的中医体质类型存在性别差异,其分布情况可能与中国人群不同,但尚需要大样本数据的验证。     

7194例次心律失常急诊分析

目的：了解阜外心血管病医院心律失常急诊的患者特点。方法：在急诊病历计算机管理的基础上，分析了５年共７１９４例次因心律失常而来急诊患者的性别、年龄、心律失常构成比及基础疾病情况。结果：心律失常急诊７１９４例次占全部急诊患者的２６％。其中５０岁以下者以室上性心动过速为首位，心律失常（４１．０％），而心房颤动、心房扑动在５０岁以上者中构成比最高（５９．０％）。风湿性心脏病是心房颤动的主要基础疾病，其它心律失常以特发心律失常为主要病因。室性心动过速（室速）、心室颤动构成比虽低，但因病情急重而要引起高度重视。结论：对急诊心律失常的分析可为提高急诊工作水平提供有价值的信息。     

中医舌象特征与体质类型关联系统的设计与实现

针对中医舌象特征与体质类型之间可能存在着某些关联这一重要问题,本文设计并实现了一个中医舌象特征与体质类型关联系统,为揭示其中的内在关联规律提供科学有效的方法和技术手段。本文从系统结构、系统功能和系统特点等方面详细介绍了系统的设计与实现。系统利用计算机对受检者的体质信息和舌象信息进行采集和自动分析识别,并利用特异性和敏感性分析找出舌象特征与体质类型之间的内在关联。该系统的识别和分析结果可作为中医临床诊治的一项科学、可靠的实践依据,同时该系统能够为中医诊断研究者提供一个研究中医舌象与中医体质内在关联的综合软件平台。     

Three-Year Experience of Pouch Dilatation and Slippage Management after Laparoscopic Adjustable Gastric Banding

Purpose

Pouch dilatation and band slippage are the most common long-term complications after laparoscopic adjustable gastric banding (LAGB). The aim of the study is to present our experience of diagnosis and management of these complications.

Materials and Methods

The pars flaccida technique with anterior fixation of the fundus was routinely used. All band adjustments were performed under fluoroscopy. We analyzed the incidence, clinico-radiologic features, management, and revisional surgeries for treatment of these complications. We further presented the outcome of gastric plication techniques as a measure for prevention of these complications.

Results

From March 2009 to March 2012, we performed LAGB on 126 morbidly obese patients. Among them, 14 patients (11.1%) were diagnosed as having these complications. Four patients (3.2%) had concentric pouch dilatations, which were corrected by band adjustment. Ten (7.9%) had eccentric pouch with band slippage. Among the ten patients, there were three cases of posterior slippage, which were corrected by reoperation, and seven cases of eccentric pouch dilatation with anterior slippage. Three were early anterior slippage, which was managed conservatively. Two were acute anterior slippage, one of whom underwent a revision. There were two cases of chronic anterior slippage, one of whom underwent a revision. The 27 patients who underwent gastric plication did not present with eccentric pouch with band slippage during the follow-up period.

Conclusion

The incidence of pouch dilatation with/without band slippage was 11.1%. Management should be individualized according to clinico-radiologic patterns. Gastric plication below the band might prevent these complications.     

系统中医学指导下重振整体诊疗模式探讨

就中医学整体诊疗模式的临床探索进行理论总结及学术探讨。首先回顾了近年来经典中医学的整体诊疗及其异化,深刻认识到要打破和纠正现代分科诊疗的局限,必须认识和遵循人的生命及其病变的整体性,重振和发展中医学的整体诊疗模式。其次对重振中医整体诊疗的临床探索进行了理论总结,实践证明中医学整体观是中医整体辨证、诊断、调理、养护的理论基础。最后探讨了重振与复兴中医学整体诊疗模式的方法,认为要在系统中医学指导下以天生人观点、元整体观点、系统质观点为核心,发展中医学的现代整体观。并以此为基础,开拓和发展中医的现代化整体诊疗模式。     

不同肥胖表型者中医体质特点分析研究

背景　有研究表明肥胖者和代谢紊乱者的中医体质类型存在一定的相似性,但是不同肥胖者发生代谢紊乱的风险不完全相同,是否中医体质为其内在原因？目前尚不可知。目的　探究不同肥胖表型者中医体质特点。方法　从2012年6月-2014年1月北京同仁医院、安徽中医药大学第一附属医院以及广东省中医院珠海医院治未病中心健康体检人群1 814例数据库中,排除年龄<18岁者、分析变量存在缺失值及体质量过轻和超重者,纳入1 267例体质量正常和肥胖样本进行分析。根据代谢正常/异常及体质量正常/肥胖组合形成4种代谢肥胖表型,即代谢正常体质量正常表型（MHNW）、代谢异常体质量正常表型（MUNW）、代谢正常肥胖表型（MHO）、代谢异常肥胖表型（MUO）。采用中医体质量表评价中医体质,采用最小二乘回归法（控制社会人口学因素及行为习惯因素）计算不同肥胖表型者9种中医体质（平和质、气虚质、阳虚质、阴虚质、痰湿质、湿热质、血瘀质、气郁质、特禀质）得分。结果　1 267例调查对象中,MHNW 584例（46.1%）,MUNW 207例（16.3%）,MHO 174例（13.7%）,MUO 302例（23.9%）。不同肥胖表型者平和质、阳虚质、痰湿质得分比较,差异均有统计学意义（P<0.05）;其中MUO者平和质得分高于MHNW和MUNW者,阳虚质得分低于MHNW和MUNW者;MHO和MUO者痰湿质得分高于MHNW和MUNW者（P<0.05）。男性不同肥胖表型者平和质、阳虚质、痰湿质得分比较,差异均有统计学意义（P<0.05）;其中MUO者平和质得分高于MHNW和MUNW者,阳虚质得分低于MHNW和MUNW者;MUNW、MHO和MUO者痰湿质得分高于MHNW者（P<0.05）。女性不同肥胖表型者阳虚质、痰湿质得分比较,差异均有统计学意义（P<0.05）;其中MUO者阳虚质得分低于MHNW者,MHO者痰湿质得分高于MHNW和MUNW者,MUO者痰湿质得分高于MUNW者（P<0.05）。结论　代谢状况相近的情况下,肥胖者痰湿质、平和质倾向更高,阳虚质倾向更低;体质量相近的情况下,不同代谢状况者未表现出明显的体质差异。但男性和女性情况有所不同,男性肥胖者和代谢异常者均表现为较高的痰湿质倾向;女性仅有肥胖者表现为较高的痰湿质倾向,而代谢异常者未发现较高的痰湿质倾向。