Effect of psychological stress on the structure of the temporomandibular joint and the expression of MMP-3 and TIMP-3 in the cartilage in rats

Our aim was to observe the effects of psychological stress on the structure of the temporomandibular joint (TMJ), and to evaluate the expression of matrix metallopeptidase-3 (MMP-3) and tissue inhibitor of metalloproteinase-3 (TIMP-3) in condylar chondrocytes in rats. The rats were divided into 3 groups of 12 according to the duration of psychological stress: 3 weeks or 6 weeks, and 6 weeks of recovery. A fourth group of 12 rats was used as controls. Each rat was evaluated by the open-field test and the weight measured. The results confirmed psychological stress in 24 of the 36 rats (67%). The tissues of the TMJ were stained with haematoxylin and eosin and pathological changes were studied under a light microscope. MMP-3 and TIMP-3 expression was investigated using the SP kit. The experimental groups showed thinning of articular cartilage, shedding of collagen fibres, cracks in the articular discs, and other structural changes that were aggravated with time, from three weeks to six weeks. The 6-week recovery group showed an improvement in these changes, which indicated the initiation of joint repair. The MMP-3 expression rate correlated with the degree of joint lesion, while the TIMP-3 rate showed an opposite trend and was highest in the 6-week recovery group. Our findings clearly indicate that psychological stress may play an important part in the development of TMJ diseases in rats; further studies should be made to extrapolate the results to other models before clinical use.     

青年护理人员面对患者死亡心理应激状况的调查研究

目的 了解青年护理人员面对患者死亡的心理应激状况.方法 应用焦虑自评量表(SAS)、抑郁自评量表(SDS)对8所综合性医院急诊、ICU、临终关怀病房等96名青年护理人员(研究组),94名其他病房的青年护理人员(对照组)进行了调查,并进行对比分析.结果 研究组SAS及SDS评分、抑郁和焦虑的发生率均高于对照组,差异有统计学意义(P＜0.05).结论 经常面对患者死亡的青年护理人员,应激障碍发生率高,心理健康水平较低,值得护理管理者密切关注.     

Psychological response in spinal manipulation (PRISM): a systematic review of psychological outcomes in randomised controlled trials

BACKGROUND: The most important risk factors for back and neck pain are psychosocial. Nevertheless, systematic reviews of spinal manipulation have concentrated on pain and spine related disability, and ignored psychological outcomes. OBJECTIVE: To assess whether spinal manipulation was effective in improving psychological outcome. DESIGN: Systematic review of randomised controlled trials (RCTs). METHODS: RCTs were identified by searching Medline, CINAHL, Embase, CENTRAL, AMED, PsycINFO until November 2005. Trials reporting psychological outcomes including the mental health components of generic outcomes were extracted, and combined where appropriate in meta-analyses. RESULTS: One hundred and twenty nine RCTs of spinal manipulation were identified; 12 had adequately reported psychological outcomes. Six trials with a verbal intervention comparator were combined in a meta-analysis, and found a mean benefit from spinal manipulation equivalent to 0.34 of the population standard deviation (S.D.) [95% confidence interval (CI) 0.23-0.45] at 1-5 months; 0.27 of the S.D. [95% CI 0.14-0.40] at 6-12 months. Eight trials with a physical treatment comparator were combined in a meta-analysis and found a mean benefit of 0.13 of the S.D. [95% CI 0.01-0.24] in favour of manipulation at 1-5 months; 0.11 of the S.D. [95% CI -0.02 to 0.25] at 6-12 months. CONCLUSIONS: There was some evidence that spinal manipulation improved psychological outcomes compared with verbal interventions.     

HPV阳性患者心理焦虑状况调查与分析

目的探讨人乳头瘤病毒(HPV)阳性患者不同心理焦虑状态的程度和特点,为心理评估、治疗及协调医患关系作基础。方法在宫颈病变普查中,通过Zung氏焦虑自评表(SAS)和病人一般资料问卷对其中90例HPV阳性患者进行心理焦虑状态测评。结果不同年龄、职业、文化程度及HPV持续阳性时间不同患者焦虑状况不同;30岁以上妇女、本科及以上学历、公务员患者焦虑状态较重,患病时间越长其焦虑值越大。结论Zung氏焦虑自评表和病人一般资料问卷能够发现不同的HPV阳性患者具有不同心理焦虑状态及其特征,为制定医疗方案和心理干预提供依据。     

老年患者的心理特征及治疗

目的　探讨老年患者的特殊心理状态及治疗措施。方法　观察 1990年 1月 1日至 2 0 0 0年 12月 31日 6 0岁以上住院患者 5 0 0例 ,对有明显心理异常者进行回顾总结。结果　 94%老年患者心理异常 ,心理治疗有效率达 80 % ,并与社会地位、文化水平、经济收入、家庭环境等密切相关。结论　心理因素对老年患者的健康影响较大 ,在药物治疗的同时必须做好切实可行的心理治疗。     

100例肺结核患者心理健康状况调查分析

目的对肺结核患者心理健康状况进行探讨,为完善肺结核综合治疗提供社会心理学依据。方法采用症状自评量表（SCL-90）对100例肺结核患者进行调查。结果肺结核患者SCL-90评定,除强迫和偏执2因子外,其余各因子分和阳性项目数,显著高于国内常模（P〈0.05或0.01）;其中,女性患者评分较男性为高,30-60岁组患者评分高于其他年龄组,评分与病程和文化程度正相关,乡村患者抑郁因子分高于城镇患者,人际敏感因子分却低于后者。结论肺结核患者心理健康水平低下,在进行躯体治疗时应实施针对性心理干预、心理支持和健康教育,以提高患者心理健康水平和生活质量。     

Doctors also suffer when giving bad news to cancer patients

Giving bad news to patients with cancer may generate stress in doctors, who use distancing tactics. The causes of this anxiety come from social conventions and its consequences affect both doctors and their patients. There is no gold standard by which stress may be overcome during the interview but we offer some suggestions that may help.     

住院老年患者心理需求的调查与分析

目的 了解住院老年患者心理需求状况，为医院老年心理护理的完善提供科学依据。方法 应用自制调查表对扬浦区1所老年医院134例住院老年患者进行问卷调查。结果 61．2％的患者对所惠疾病有紧张、怨恨情绪，75．4％的患者不愿长期住院，55．2％的患者住院最大烦恼是病情不了解。认为住院最大安慰是亲人探望的患者占85．8％。认为住院接触最多的是护工的占53．7％；希望居家养老的占52．2％，希望有护士与其聊天的占87．31％，希望有志愿者聊天的占95．5％。结论 住院老年患者在住院期间存在不同程度的身心健康问题和各种心理需求，护理工作者应根据患者的不同文化程度及其病情恰当而适时地做好心理护理。     

肝癌晚期患者转化治疗前后心理痛苦及生活质量的调查

目的 观察并分析晚期肝癌患者在转化治疗前后心理痛苦及生活质量变化情况,以期为临床开展心理干预等提供参考,同时为序贯外科手术治疗做好前期准备。方法 选取2019年7月~2022年3月的60例进行转化治疗的患者,治疗前及治疗2~10个周期后,采用心理痛苦温度计及其问题列表测定心理痛苦程度变化,采用肝胆肿瘤治疗功能评定量表测定患者生活质量。结果 转化治疗后,患者心理痛苦的分值与转化治疗前比较明显降低（P<0.01）;转化治疗后心理痛苦情绪因素紧张、担忧、睡眠问题、记忆力下降和注意力不集中,身体因素疼痛、疲乏、进食问题、消化不良比例明显下降,差异有统计学意义（P<0.05）;转化治疗后,生活质量总分及其中的身体状况、社交/家庭状况、情感状况、功能状况及肝胆特异板块评分较治疗前明显下降（P<0.05）。结论 晚期肝癌患者心理痛苦因素主要集中于情绪因素和身体因素,转化治疗可以明显降低患者心理痛苦程度和提高患者生活质量。     

Allograft Portacaval Shunt in Small-for-Size Liver in Deceased Donor Liver Transplant

Portal hyperperfusion is detrimental to small-for-size livers (SFSLs) in liver transplantation. Surgical techniques modulating portal inflow provide the most effective approach to protect the SFSL. In this report, we describe a technique creating an allograft portacaval shunt that effectively attenuates portal inflow without a requirement of extensive surgical dissection in the recipient during the transplantation.