蕲蛇的鉴别研究进展＊

蕲蛇是《中国药典》收载的三种蛇类药材（含蕲蛇、乌梢蛇、金钱白花蛇）之一，具有祛风、通络、定惊止痉等功效，其药用价值和经济价值较高，市场需求量较大，为贵细药材。近年来，由于野生资源逐渐匮乏，在经济利益驱使下，蕲蛇商品普遍存在着伪品、混淆品、掺假品，这种质量不一、以次充好、以假代真的情况容易导致用药安全问题。本文通过总结蕲蛇的性状鉴别、显微鉴别、理化鉴别和分子鉴别，以期为蕲蛇等蛇类药材的真伪鉴别和质量的优劣检测提供思路，为进一步鉴别研究、制剂开发提供参考依据，确保用药质量。     

Temperament,character and personality disorders

ObjectiveTo study, whether temperament and character remain stable over time and whether they differ between patients with and without personality disorder (PD) and between patients with specific PDs.MethodsPatients with (n = 225) or without (n = 285) PD from Jorvi Bipolar Study, Vantaa Depression Study (VDS) and Vantaa Primary Care Depression Study were interviewed at baseline and at 18 months, and in the VDS also at 5 years. A general population comparison group (n = 264) was surveyed by mail.ResultsCompared with non-PD patients, PD patients scored lower on self-directedness and cooperativeness. Cluster B and C PDs associated with high Novelty Seeking and Harm Avoidance, respectively. In logistic regression models, sensitivity and specificity of Temperament and Character Inventory (TCI) dimensions for presence of any PD were 53% and 75%, and for specific PDs from 11% to 41% and from 92% to 100%, respectively. The 18-month test-retest correlations of TCI-R dimensions ranged from 0.58 to 0.82.ConclusionsMedium-term temporal stability of TCI in a clinical population appears good. Character scores differ markedly between PD and non-PD patients, whereas temperament scores differ only somewhat between the specific PDs. However, the TCI dimensions capture only a portion of the differences between PD and non-PD patients.     

Distinct temperament and character profiles in first onset vitiligo but not in alopecia areata

Alopecia areata (AA) and vitiligo (V) are diseases that are correlated with psychiatric disorders before, during and after diagnosis. The Temperament and Character Inventory (TCI) is a well‐established approach for investigating personality traits in various psychosomatic diseases. The aim of this study is to compare and investigate the differences in the TCI between patients with first onset AA, patients with V and healthy controls (HC). Participants in the study included 42 patients with first onset AA, 50 adult patients with V and 60 HC who had no history or diagnoses of psychiatric or dermatological disorders. All participants were assessed with the TCI and the Dermatology Life Quality Index (DLQI). Among the temperament traits, the extravagance, disorderliness and total novelty‐seeking scores were lower, and the worry and pessimism scores were higher in patients with V compared with patients with AA and the HC. The mean score of the enlightened second nature and the total self‐directedness score of the character traits were higher in patients with V compared with patients with AA and the HC group. In the AA group, there was a negative correlation only between the reward dependence total score and the DLQI score. This study suggests that patients with first onset V have a distinct temperament, such as being unenthusiastic and unemotional, and character profiles, such as worry and pessimism, independent of their psychiatric comorbidities, and patients with AA do not have a different personality from the non‐affected population.     

血栓性状与急性肺栓塞相关性的动物实验研究

目的：将兔静脉血在体外自然凝固制成栓子，观察不同时间组血栓性状与肺栓塞的相关性。方法：将24只家兔随机分成两组，分别注入体外凝固20分钟栓子与60分钟栓子。将栓子导管导入右心房，建立肺栓塞的动物模型。造影观察PE；大体观察PE后栓子形态；光镜观察肺小动脉内血栓；电镜观察不同时间组血栓的性状。结果：（1）20分钟组未发生PE；60分钟组除2例死亡均发生PE并模拟出PE的临床肺心病型和猝死型。（2）电镜显示20分钟组血栓的纤维蛋白体积大、呈束状，纤维蛋白丝密集排列、结构清晰；60分钟组血栓的纤维蛋白体积小、呈短杆状，纤维蛋白丝疏松排列、部分区域结构不清。结论：（1）导管在右心房注入自身血液凝块可制出有效的PE模型。（2）注入血块的数量及速度的不同，可分别模拟出PE临床急性肺心病型和猝死型。（3）不同时间的血液凝块作为栓子对肺血管血流量影响不同，表明血栓的性状与PE的发生有关。     

86例消化性溃疡患者心理调查研究

目的探讨消化性溃疡患者的心理状况及个性特征。方法 86例内窥镜下确诊为消化性溃疡患者(研究组),采用艾森克人格问卷(EPQ)、症状自评量表(SCL-90)进行测评,并与常模对照。结果研究组SCL-90躯体化、抑郁、焦虑、恐怖等因子分高于常模(P<0.05),EPQ男女N分均高于常模(P<0.05),女性患者E分低于常模(t=4.64,P<0.05)。结论消化性溃疡患者存在明显的心理问题,具有共同的性格特征,心理因素与消化性溃疡的发病有密切关系。     

上海市高中生性格特点及其与血型的相关性研究

目的揭示上海市高中生的性格特点,并分析其与血型的相关性。方法通过采用国际上广泛使用的五因素性格测试问卷,对1696名上海市高中生进行性格测试并辅以相关的问卷调查,采用SPSS生物统计学分析软件对所得数据进行分析。结果目前上海市高中生性格相对稳定;女生比男生更加外向且宜人性特征更加显著;高一和高二学生相比,高一学生更加宜人和具有责任心;重点高中学生更加情绪稳定,偏离神经质;更倾向外向性、经验的开放性、宜人性和责任心。大五模型性格特征与血型间不存在相关性。结论目前上海市高中生性格相对稳定,并且与血型之间不存在相关性。后天的培养对高中生性格的形成和发展有不可忽视的重要作用,家庭和学校应在教育过程中对学生良好性格的培养给予足够的重视。     

No association between polymorphism in tyrosine hydroxylase and personality traits in healthy Japanese subjects

The aim of the present study was to investigate whether there is an association between the (TCAT)_n repeat polymorphism in the tyrosine hydroxylase (TH) gene and personality. The (TCAT)_n repeat polymorphism in the TH gene was genotyped in 898 healthy Japanese subjects. Personality traits were evaluated using the Temperament and Character Inventory (TCI). There was no significant difference in the TCI scores of subjects with and without the T9 allele. Furthermore, no significant association was found between each genotype and the TCI scores, even when the TCI scores were compared with the homozygous genotype. These findings suggest that the (TCAT)_n repeat polymorphism in the TH gene does not contribute to the personality traits evaluated on the TCI in healthy Japanese subjects.     

健康人性格类型与血清脂蛋白组分胆固醇相关性的研究

本文报告对1548名健康人性格类型与血清脂蛋白组分胆固醇的关系进行观察,结果表明A型性格者HDL-C、HDL_2-C、HDL_3-C、HDL_2-C/HDL_3-C均明显低于非A型性格者,而LDL-C/HDL-C则相反。性格类型对LDL-C和VLDL-C无明显影响。不同性别、年龄、职业人群观察结果相似。研究结果说明,A型性格易患冠心病的结论是可信的,性格类型影响血清脂蛋白组分胆固醇水平而发生致病作用可能是原因之一。     

公立医院改革与发展的伦理选择

我国公立医院的牌子是公立，资产属于国家，而经营行为。明显地走上了营利性道路。在公立医院改革与发展路径的选择上，既要反对由政府包办的纯公益路径，也要反对完全市场化的路径，要在坚持公益性的前提下进行有限的市场化。将公共机制与市场机制有机结合。