团块状灰度变化减轻子宫良性疾病聚焦超声消融术中的远场不良反应

目的：评估团块状灰度变化能否减轻子宫良性疾病聚焦超声消融术中的远场不良反应。方法：开展单中心回顾性临床观察研究,纳入重庆医科大学附属第二医院行聚焦超声消融术的40例子宫良性疾病。比较团块状灰度变化出现前后,在相同能量水平（最小不可耐受能量）下,术中即刻骶尾部或臀部疼痛、放射痛、会阴部痛、肛门胀痛的发生率及不良反应程度。结果：在相同能量水平（最小不可耐受能量）下,团块状灰度变化出现后术中即刻骶尾部或臀部疼痛、放射痛、会阴部痛、肛门胀痛的发生率及不良反应程度明显低于团块状灰度变化出现前（P<0.05）。结论：团块状灰度变化能减轻子宫良性疾病聚焦超声消融术中的远场不良反应。     

食管癌与心理社会因素的关系探讨

目的 :本文采用 1:1配对的病例对照研究方法 ,探讨食管癌与病前心理社会因素的关系。方法 :采用 C型行为问卷和生活事件量表 ,调查病例和对照共 10 0对。结果 :食管癌病人 C型行为的 OR值为 3.0 9,明显高于对照组 ,P<0 .0 0 1;生活事件量表中病例与对照配对得分差的均数为 118.4 2± 52 .36 (LEU) ,食管癌病人得分明显高于对照组 ,P<0 .0 0 1。结论 :食管癌与不良的心理社会因素有关。     

上海市中心城轨道交通网络规划合理规模研究

介绍了估算城市轨道交通网络规划规模的3种方法--几何分析法、运输强度分析法及类比分析法,并结合上海市的实际情况对上海市中心城轨道交通网络规划规模进行了估算。通过对比和分析各种估算结果,提出了上海市中心城轨道交通网络规划的合理规模。     

The contribution of medical burden to 22q11.2 deletion syndrome quality of life and functioning

PurposeTo date, there is no systematic method to quantify the medical burden of individuals with 22q11.2 deletion syndrome (22q11.2DS). This study aimed to design a Medical Burden Scale for 22q11.2DS to evaluate the effect of medical symptoms severity on quality of life (QoL) and functioning in individuals with this syndrome.MethodsIndividuals with 22q11.2DS (n = 76) were included in the study. A multidisciplinary group of physicians determined the severity of symptoms (on a scale of 0 to 4) of 8 major medical systems affected in 22q11.2DS, as well as the level of cognitive deficits and psychiatric morbidity. Regression models were used to evaluate the impact of medical, cognitive, and psychiatric symptoms’ severity on global assessment of functioning (GAF) and QoL.ResultsThe total Medical Burden Scale score was significantly associated with both QoL and GAF scores, beyond the effect of the psychiatric and cognitive deficits. We also found that QoL and GAF scores were associated with the severity scores of specific medical systems, particularly neurological symptoms, but also cardiovascular, ear-nose-throat, endocrinology, and orthopedics.ConclusionQuantifying the medical burden of 22q11.2DS individuals is feasible and indicates the overall and specific contribution of medical symptoms to QoL and functioning of 22q11.2DS individuals.     

Measuring quality of life from the point of view of HIV-positive subjects: the HIV-QL31

Assessment of the quality of life (QoL) of human immunodeficiency virus (HIV)-infected subjects is often based on questionnaires in which the items or questions are not seen to be relevant by patients, nor by the users of the data obtained. It therefore seemed appropriate to return to the issue. The methodological and bibliographical research as well as the consultations we conducted convinced us that the elaboration of a new questionnaire was both necessary and possible. In order to do so, we adopted methodological principles based on the Sickness Impact Profile development methodology. First a bibliographical research was conducted in order to study instruments already used for HIV infection. Then, experts concerned with HIV infection and members of patients' associations were interviewed to assess how opportune the development of a new instrument could be. Following this, a methodology was established for the design and construction of the new instrument. One hundred and eighteen candidate questions were generated from an analysis of the content of 20 patients' interviews, which were subsequently submitted to 102 patients, to obtain finally a set of 31 questions from the interpretation of the results obtained from classic psychometric analysis and also from non-classic methods (item response theory and Rasch model). The concept being measured is the impact of illness being experienced by HIV-infected subjects from their own perspective. The range of health states covered by this questionnaire relates to fairly mild conditions. Rasch analysis of this set of 31 questions (HIV-QL31) shows that it corresponds to one unidimensional construct. A single score can be calculated by simple summation of dichotomous response options. This score is highly reliable (Cronbach's coefficient = 0.93) and is also discriminant regarding the severity of clinical status.     

Stress, attachment and skin diseases: a case-control study

Objectives In this case-control study we tested the hypothesis of an association between some psychosomatic skin diseases, attachment style and stress. Patients and methods A total of 177 cases and 194 controls seen between November 1992 and November 1993 at the Istituto Dermopatico dell'lmmacolata (IDD) in Rome, were enrolled into the study. Cases were outpatients with first diagnosis of hyperidrosis, chronic urticaria, generalized pruritus or alopecia areata. Controls were outpatients seen in the same period of time with first diagnosis of pigmenled nevi, keratosis or mycosis. The presence and weight of life stress events were assessed by u standard precoded questionnaire based on the Schedule of Recent Experiences (SRE) and on the Life Experiences Survey (LES). The attachment style was assessed by a modified version of the Shaver and Hazan questionnaire about feelings in a love relationship. We calculated 3 scores for each individual and classified study subjects in 2 groups: 1) "free" (= secure attachment); 2) "not free" (not secure attachment: anxious-ambivalent or avoidant). Questionnaires were self-administered in the presence of a trained psychologist. Adjusted odds ratios (OR) were calculated using a multiple logistic function. Results No association was found between the different stress scores and the skin diseases considered. The crude odds ratio for life stress events in the previous year was 1.4 (95% CI 0.8–2.7). After multiple adjustment for age, sex, marital status and education, the estimated OR was 1.6 (95% CI 0.8–3.0). One significant association emerged between the adult attachment style defined as “not free” and psychosomatic skin diseases: the adjusted OR was 4.0 (95% CI 1.4–12).     

Correlation of quantitative measures with the modified Ashworth scale in the assessment of plantar flexor spasticity in patients with traumatic brain injury

This study of plantar flexor spasticity describes relationships among a traditional qualitative spasticity scale, three potential quantitative spasticity measures and a measure of voluntary ankle muscle function. Thirty-four volunteer adult patients with traumatic brain injuries participated. There were 28 males and 6 females; the mean age was 30.3 years. A battery of five randomly sequenced tests was performed for each subject on one ankle. Tests were: modified Ashworth scale (MAS) scoring; H-reflex testing with and without Achilles tendon vibration; H-reflex testing with and without dorsiflexor contraction; reflex threshold angle and timed toe tapping (TTT). Twenty-six subjects returned to have the second ankle tested, resulting in 60 ankles for the analyses. Spearman's coefficients for correlation of quantitative spasticity measures with MAS scores ranged from 0.39 to 0.49 with associated probabilities 0.002. Pearson coefficients for correlation of quantitative spasticity measures with TTT scores were lower but also significant (P 0.07). Multiple correlation for the set of quantitative measures yieldedR = 0.614 (P < 0.001) with MAS scores andR = 0.365 (P = 0.045) with TTT scores. These findings reveal statistically significant relationships of low to moderate strength among potential quantitative spasticity measures, a traditional qualitative spasticity scale and a simple measure of voluntary ankle muscle function. Understanding these relationships is an essential part of the ongoing search for quantitative spasticity measures.The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.     

Health status of male preparatory school students lodging at a dormitory in Japan

An investigation on the health status of 79 male preparatory school students lodging at a dormitory in Japan was carried out by questionnaire on lifestyles, subjective symptoms and mental status, as compared with two control groups: 73 medical students and 36 new employees. About 83 % of them slept less than 6 hours and 70 % of them did not exercise. Many students are troubled with back pain or lumbago(47%), sensation of incomplete bladder emptying(l6%), loss of visual acuity(55%) and eye fatigue(65%). Self-rating depression scale score of preparatory school students was not significantly higher than those of the control groups. The lifestyles of preparatory school students found to be very restricted and strained. However, no significant differences on mental adverse health effects was found among three groups.     

围产期心理量表的信度、效度评定及围产期心理行为特征的研究

对围产期心理量表的信度和效度进行评定,采用重测信度和同质信度进行信度分析,采用结构效度对量表进行效度分析,经评定本量表有较好的信度和效度。孕期妇女的主要心理特点为依赖心理或幸福感及常见的妊娠反应与饮食习惯改变而带来的忧虑心理;分娩期不良心理特征,主要为紧张不安和烦躁焦虑心理,疼痛难忍等主观感受,及不吃少喝体力消耗严重行为特点;产褥期不良心理主要为产后忧郁心理,感到难以承担母亲责任的消极悲观状态。     

中国地鼠情绪唤醒水平评定量表的制定

为建立一套适合于中国地鼠情绪唤醒水平观测的评定方法,并验证其可靠性,在Ａｄｅｒ 情绪唤醒评定方法基础上进行修订,对中国地鼠进行试测,建立情绪唤醒水平划界分。结果显示总分以５ 分为界,能区分高／ 低情绪唤醒水平的中国地鼠;条目与量表总分呈中高度相关（ ｒ ＝ ０ ．３２６８ ～０ ．７３４７） ,量表总分重测信度良好（ ｒ ＝ ０ ．５８７４ ～０ ．６１０５） ,评定者评分一致性高,符合率达９５－２ ％