脊髓损伤患者情绪障碍和病耻感的相关性

目的 探讨脊髓损伤患者情绪障碍和病耻感的相关性.方法 采用华西心情指数(HEI)量表和慢性疾病病耻感(SSCI)量表对2020年3-10月于该院就诊的157例脊髓损伤患者进行问卷调查,分析病耻感和焦虑、抑郁等情绪障碍之间的相关性.结果 脊髓损伤患者平均情绪障碍得分为(8.61±5.39)分,情绪障碍的发生率为47.13％;病耻感平均得分为(45.93±14.23)分,脊髓损伤时间会影响患者的病耻感评分(P<0.05).病耻感总分与情绪障碍得分呈正相关(P<0.05).结论 可通过实施干预措施降低病耻感来改善患者的焦虑、抑郁等情绪障碍情况.     

脊髓损伤患者情绪障碍和病耻感的相关性

目的 探讨脊髓损伤患者情绪障碍和病耻感的相关性.方法 采用华西心情指数(HEI)量表和慢性疾病病耻感(SSCI)量表对2020年3-10月于该院就诊的157例脊髓损伤患者进行问卷调查,分析病耻感和焦虑、抑郁等情绪障碍之间的相关性.结果 脊髓损伤患者平均情绪障碍得分为(8.61±5.39)分,情绪障碍的发生率为47.13％;病耻感平均得分为(45.93±14.23)分,脊髓损伤时间会影响患者的病耻感评分(P<0.05).病耻感总分与情绪障碍得分呈正相关(P<0.05).结论 可通过实施干预措施降低病耻感来改善患者的焦虑、抑郁等情绪障碍情况.     

我国公众精神疾病病耻感问题的伦理思考及对策分析

对精神疾病患者的歧视以及由此带来的病耻感，不仅会影响患者的就医行为，还会带来社区隔离和资源缺失，精神卫生问题已成为重大的公共卫生问题和突出的社会问题。从生命伦理学的视角来看，公众精神疾病病耻感的存在违背公正和尊重原则。通过定量描述公众精神疾病病耻感现状，并通过因子分析和二元Logistic回归分析探索公众精神疾病病耻感的影响因素。公众精神疾病病耻感得分为(54.64±11.048)分。因子分析提取4个公因子，分别为隔离、痛苦、接触、共情，累计解释方差68.948%。结果显示年龄、接触史是影响公众精神疾病病耻感的主要因素。建议通过增进了解、提高共情两方面减少歧视，具体来说是通过伦理规制和法治建设落实歧视个人责任以及营造“宽容”社会氛围，强化人类命运共同体理念，以实现公众安全与个人权益之间的恰当平衡。     

236例维持性血液透析患者的病耻感现状及影响因素分析

目的 探究维持性血液透析（MHD）患者的病耻感现状,并对其影响因素进行分析。方法 根据便利抽样法,选取2020年2月—2022月10月在河南省郑州市第三人民医院血液净化中心进行MHD治疗的236例患者作为研究对象,并采用一般资料调查问卷、领悟社会支持量表（PSSS）以及社会影响量表（SIS）进行调查。根据SIS得分情况进行分组,采用Logistic回归分析行MHD患者病耻感的影响因素。结果 MHD患者病耻感得分为（65.03±10.68）分,其中病程较短、社会支持度低、家庭平均收入低、文化水平较低以及未参加肾友会的患者病耻感得分较高,病程较长、家庭平均收入高、社会支持度高、参加肾友会以及文化水平较高者病耻感得分较低（P<0.05）。多因素Logistic回归分析结果显示,患者文化水平、家庭平均收入、是否参加肾友会、病程以及社会支持情况是患者病耻感的影响因素（P<0.05）。结论 MHD患者病耻感得分处于中高等水平。指导患者正确认识疾病,多关注家庭收入较低患者,鼓励患者积极参与肾友会,为患者提供良好的社会支持,均有助于降低其病耻感程度。     

抑郁类在线健康社区用户参与行为现状及病耻感对其影响研究

目的/意义 探究当前抑郁类在线健康社区(online health communities, OHC)内用户的抑郁倾向及病耻感程度,基于计划行为理论模型,探讨用户病耻感对OHC参与的影响机制,为开展抑郁症防治特色服务工作提供思路和理论支持。方法/过程 线上问卷调查法收集数据,结合计划行为理论、应对方式理论、在线社会支持理论、自我效能理论构建理论模型并提出假设,采用结构方程模型法和Boostrap中介检验法对影响因素及路径进行假设检验。结果/结论 抑郁类OHC中以轻度抑郁倾向用户为主。病耻感正向影响OHC参与行为。用户参与OHC所获得的情感支持并不能替代患者的现实陪伴需求,应当在现实生活中给予其更多的支持和关注,提供更多的资源和途径,帮助其尽早脱离抑郁困境。     

重性精神病患者及家属病耻感调查和相关因素分析

目的：调查重性精神病患者及家属病耻感,并分析其相关因素。方法采用方便取样抽样方式收集收治的重性精神病患者234例,首先对患者一般资料,如性别、年龄、病程等进行统计,分析患者内在病耻感水平,患者病耻感经历,社会支持获得情况及患者生活质量,分析内在病耻感相关因素。结果患者内在病耻感各维度均异常,患者病耻感经历各维度均异常,社会支持获得率降低,生活质量较差,学历越高、有正当职业、社会支持度高、生活质量高以及心理压力小为内在病耻感的负性相关因素,疾病病程越长以及住院次数超过2次为内在病耻感的正性相关因素。结论重性精神病患者内在病耻感强烈,尤其是学历低、无正当职业、疾病病程长、住院次数多者,社会支持获得度低,生活质量差。     

银屑病患者病耻感评估工具及影响因素的研究进展

银屑病患者容易产生病耻感,及时有效评估银屑病患者的病耻感并采取针对性的干预策略,对改善其康复结局、提高生活质量具有重要意义。本文基于文献回顾,系统梳理包括银屑病患者病耻感体验问卷、皮肤病体验问卷、6项病耻感量表、心理疾病内化污名量表、感知病耻感问卷在内的5种银屑病患者病耻感评估工具,并从社会人口学、疾病、心理、社会支持层面总结银屑病患者病耻感的影响因素,以期为开发本土化的银屑病患者病耻感评估工具,科学应用评估工具及开展相关干预提供借鉴。     

头颈癌患者病耻感现状研究进展

病耻感是因患病导致的一种负性情绪应激体验,对患者治疗及社会功能康复不利,影响患者预后和生活质量.本文阐述了头颈癌患者病耻感的现状水平、头颈癌患者病耻感评估工具的现状、病耻感来源及病耻感对患者的影响等方面,为以后开展头颈癌患者病耻感的筛查及诊断提供理论依据,也为医务人员今后采取措施干预病耻感的研究提供重要参考依据,进一步...     

个案管理对社区精神分裂症、双相情感障碍患者病耻感及社会功能的影响

目的 探讨个案管理对社区精神分裂症、双相情感障碍患者病耻感和社会功能的影响。方法 240例精神分裂症或双相情感障碍患者随机分为个案组和常规组,每组120例。常规组给予基础的公共卫生服务,个案组给予社区个案管理服务,为期1 a。观察及对比两组干预前及干预3、6、12个月患者的病耻感评估量表（SSAS）和社会功能缺陷筛选量表（SDSS）得分。结果 个案组干预3、6、12个月后SSAS、SDSS评分均低于同期常规组（P<0.05）。结论 对社区精神分裂症和双相情感障碍患者实施个案管理,可以降低患者病耻感,改善社会功能。     

抑郁症患者的病耻感和社会支持研究

目的探讨抑郁症患者的病耻感和社会支持水平。方法对80例抑郁症患者进行抑郁自评量表、精神病病耻感内在体验量表和社会支持问卷评定,同时分析病耻感的相关因素。结果 1)抑郁症患者具有较高的病耻感;2)抑郁症患者和正常对照组在社会支持总分、客观支持、主观支持和对支持的利用度方面均存在显著性差异;3)抑郁症患者的病耻感与文化程度、抑郁和社会支持相关。结论抑郁症患者的病耻感较高,社会支持水平低,我们在临床工作中应给予足够的重视。     

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.