南京市全科规范化培训医师心理健康状况调查

目的 了解分析南京市全科规范化培训医师的心理健康状况,探讨改善规培学员心理健康状况方法,为进一步完善全科医师规范化培训提供参考。 方法 2018年10—11月期间,选取南京市11个区共110名全科规范化培训在培学员作为研究对象,采用症状自评量表(SCL-90),以现场发放问卷方式进行心理健康调查,采用SPSS 19.0统计软件对数据进行统计分析。 结果 南京市全科医师规范化培训在培学员SCL-90的阳性检出率为24.5%,总平均分为(121.51±30.69)分,低于全国常模[(129.96±38.76)分],差异有统计学意义(t=-2.888,P<0.05),除强迫因子外,躯体化、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性等8个因子平均分均低于全国常模,其中躯体化、人际关系敏感、抑郁、焦虑、敌对、偏执因子差异有统计学意义(均P<0.05)。规培时间≥1年学员的心理健康状况优于规培时间<1年学员,已完成全科理论学习学员心理健康状况优于未参加全科理论学习学员(均P<0.05)。 结论 南京市全科规范化培训医师整体心理健康状况尚良好,优于全国常模,提高学员专业兴趣,实施全科学员双导师制、进行团体心理健康教育等措施有可能有效改善全科规范化培训医师心理健康状况。      

365名中小学教师的心理健康状况调查分析

目的了解教师这一特殊群体的心理健康状况,为促进教师心理健康、有针对性地开展心理健康教育提供依据。方法采用问卷调查法,使用症状自评量表(SCL-90)对365名教师进行心理健康状况调查分析。结果 SCL-90得分:最低90分,最高450分,总均分142分,标准差57.8分,症状自评因子分在躯体化、强迫、人际关系、抑郁、焦虑等阳性评分上显著高于全国常模(P<0.01),以总均分≥160分作为标准,本次筛查出有心理问题的教师83人,占总数的23%,因子频数分布及比例分布,以SCL-90因子分≥2分的个数,有心理问题的81人,与SCL-90总均分≥160分非标准的83人基本相似。男女之间在因子分上无显著性差异(P>0.05)。结论教育主管部门应关注中小学教师的心理健康状况,促进教师这一特殊群体的心理健康。     

股骨头坏死患者的心理健康状况调查及心理干预

目的了解股骨头坏死患者的心理健康状况并分析其原因。方法采用症状自评量表（SCL-90）对2010年1～12月在北京市小汤山康复医院骨与关节康复科收治的37例股骨头坏死患者进行问卷调查,应用一般性分析、u检验等方法对调查结果进行统计分析。结果 17例（45.95%）股骨头坏死患者SCL-90总分≥160分,心理健康状况较差;股骨头坏死患者SCL-90各项因子中躯体化、强迫、抑郁、焦虑、敌对、恐怖、精神病性7个因子及总分高于常模,差异均有高度统计学意义（均P〈0.01）。股骨头坏死患者主要心理问题表现为抑郁、躯体化、敌意、强迫症状、人际关系敏感等。结论股骨头坏死患者的心理健康水平总体较差,需要进行有针对性的心理治疗与干预。     

483名初中生SCL-90评定结果分析

目的：了解中学学生的心理健康状况，为开展心理咨询和心理卫生保健服务提供依据。方法：采用症状自评量表（SCL-90）、对莱州市文峰中学的在校初中一、二、三、四年级学生进行评定。结果：初中生在SCL-90强迫、敌对、焦虑、抑郁4项因子上的得分高于国内正常青少年常模。不同年级的初中生在SCL-90强迫、焦虑上有差异。男生的强迫因子明显高于女生。SCL-90总分≥160的男生85名（17．60％）女生40名（8．28％）。高年级学生较低年级学生心理问题多。结论：在校初中生的心理健康状况不尽相同，不同年级的初中生心理卫生状况存在差异，在心理咨询和心理卫生保健服务中，应针对其不同特点开展工作。才能收到较好效果。     

某高校临床医学生心理健康状况及影响因素分析

目的探讨临床医学生心理健康状况及其影响因素,为改善临床医学生的心理状况提供理论根据。方法采用青少年生活事件量表（ASLEC）,应对方式问卷（CSQ）,艾森克个性问卷（EPQ）,症状自测表（SCL-90）,对某高校医学院351名临床医学生进行测查。结果心理问题检出率为0.33%-5.82%,依次为偏执,人际敏感,强迫,抑郁,敌意,精神病性等。在偏执因子分中,男生高于女生;在躯体化,抑郁,人际敏感,强迫,因子分女生高于男生,其中躯体化高出显著。三个年级学生在强迫、人际关系敏感、躯体化、抑郁存在显著的差异性。生活事件,应对方式,情绪稳定,神经质,SCL-90各因子之间存在相关。结论在年级,性别间,临床医学生心理问题存在差异,其心理健康度既受生活事件,性格特质,应对方式的直接影响,也存在相互交叉的作用。     

某军校学员的身心健康状况及其影响因素

目的：调查某军校学员的身心健康状况及其影响因素。方法：以某军校正式大专学员为对象。采用症状自评量表（SCL-90），贝克（BECK）抑郁自评问卷和军校大学生生活事件量表等进行评估。结果：524人中有46人（8.8% )存在不同程度身心健康问题，有年级的差异；该亲迩员SCL-90各因子分大都稍高于青年常模，稍低于军校大学生，强迫和偏执因子分显著高于青年常模，躯体症状，抑郁和精神病性因子分显著低于军校大学生；生活事件，抑郁感和消极应对方式是影响学生身心健康的主要因素。结论：总体上该校学员的身心健康状况良好，但也仍然有不少学员存在各种各样的身心健康问题，以二，三年级学员居多，这与学员的生活事件，抑郁感和消极应对方式有着密切关系。     

医专学生心理健康状况的调查分析

目的：了解医专学生心理健康状况，为医专学生心理健康教育提供理论依据。方法：采用症状自评量表（SCL-90）对463名在校医专学生心理健康状况进行调查和统计分析。结果：医专学生SCL-90总均分、各因子分（躯体化除外）都显著高于全国常模（P〈0．01），医专学生心理问题的的检出率为7．99％；医专学生SCL-90总均分在性别、年级上的差异不显著；高招生SCL-90总均分以及躯体化、强迫、人际敏感、抑郁、焦虑、偏执和精神病性七个因子得分都显著高于单招生（P〈0．01）；临床专业学生SCL-90总均分以及躯体化、强迫、人际敏感、抑郁、焦虑、偏执、精神病性七个因子得分显著高于护理专业学生（P〈0.05或P〈0．01）。结论：医专学生心理健康总体水平较低，高招生、临床专业学生心理健康状况应引起特别关注。     

地方大学生入伍干部学员心理健康状况和个性特征分析

目的:评价地方大学生入伍干部学员的整体心理健康状况、个性特征及心理健康与个性因素的关系. 方法:采用症状自评量表(SCL-90)、艾森克个性问卷(EPQ)及自编的"干部学员基本情况调查表"对414名地方大学生入伍干部学员进行整群抽样、现状研究.问卷由学员自行填写独立完成. 结果:干部学员心理健康问题(SCL-90因子分≥3)检出率为1.0%～7.7%,其主要心理健康问题为偏执、人际敏感、抑郁、敌意和强迫倾向. 其整体心理健康水平高于地方大学生和军校学员,与普通军人相比略有差异. 干部学员SCL-90各因子分与EPQ的E,L维度分呈负相关,与P,N维度分呈正相关. 结论:干部学员的心理健康状况良好. 其人格特质与心理健康状况相关.     

大学新生心理健康状况调查分析

目的：研究大学入学新生的心理健康状况。方法：用艾森克人格问卷（EPQ）、90项症状清单（SCL-90）对长江大学2003年入学的新生作了心理问卷调查，对有效答卷用EPQ，SCL-90及SPSS11．5分析系统作了统计分析。结果：有效问卷EPQ：6491份，SCL-90：7083份，其中EPQ-N〉60占17．35％，SCL-90因子分≥2者占17．37％，其中强迫、人际关系敏感、抑郁、敌对、偏执、焦虑、精神病性等因子大于常模（P〈0．01），男性大于女性（P〈0．01或0．05），位于前三位的是强迫、人际关系敏感和抑郁。结论：大学新生心理问题不容忽视。     

医学研究生心理健康状况调查

目的了解医学研究生的心理健康状况，分析心理问题产生的原因，并提出心理干预的对策。方法利用症状自评量表（SCL-90）、焦虑自评量表（SAS）及抑郁自评量表（SDS）对188名在校医学研究生进行现况调查，采用自评填写问卷方式。统计学分析采用方差分析、t检验和）（2检验。结果医学研究生SCL-90各园子分、总均分和阳性项目数随着年级的发展，研究生群体内部的心理健康情况大体呈现钟型的改变，一年级和三年级的心理健康情况高于二年级（P〈0．05）。焦虑症状阳性总体检出率为9．57％，抑郁症状阳性检出率总体为23．94％。结论医学研究生总体心理健康情况良好，但仍存在较多的问题，心理干预有利于研究生的身心健康发展。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.