医学生睡眠质量与焦虑抑郁情绪关系的调查分析

目的探讨医学生睡眠质量与焦虑抑郁情绪的相关性,并对影响睡眠质量的有关因素进行分析。方法以匹兹堡睡眠质量指数(PSQI)、焦虑自评量表(SAS)、抑郁自评量表(SDS)为评价工具,采用分层整群抽样方法,调查某医学高等专科学校1~3年级医学生睡眠障碍的发生率及分布特征。结果医学生睡眠障碍的发生率为14.73%,男生(6.85%)女生(7.88%)间无显著性差异。19.52%的学生有抑郁情绪,男女生分别为8.22%和11.30%(P<0.05)。14.73%的学生存在焦虑,并且10.27%的学生焦虑、抑郁情绪并存。PSQI总分与SAS、SDS得分均呈显著正相关。回归分析表明,影响PSQI总分的因素依次为睡眠效率、睡眠障碍、入睡时间、睡眠质量、日间功能、催眠药物、睡眠时间。结论焦虑、抑郁情绪是影响医学生睡眠质量的重要因素,提高医学生的心理素质,增强其适应环境的能力,对于保持良好的健康状态是十分重要的。     

大学生睡眠质量与焦虑抑郁状况及其相关性分析

目的 分析睡眠障碍与焦虑、抑郁的相关性,以期为改善大学生睡眠质量提供一定参考依据。方法 2018年3月应用匹兹堡睡眠量表（PSQI）、焦虑自评量表（SAS）和抑郁自评量表（SDS）对我校4个专业827名大学生进行睡眠质量和心理状态评估。结果 827名大学生PSQI平均总分为（5.73±2.41）分,SAS平均总分为（43.83±9.11）分,SDS平均总分为（41.93±7.71）分。高年级学生、医学类大学生PSQI、SAS、SDS总分高于低年级学生、非医学类大学生PSQI、SAS、SDS总分,差异具有统计学意义（P＜0.05）;PSQI≥8大学生的SDS得分和SAS得分高于5≤PSQI≤7大学生、高于PSQI≤4大学生,SAS≥50分大学生的PSQI总分高于SAS＜50分大学生的PSQI总分,SDS≥53分大学生的PSQI总分高于SDS＜53分大学生的PSQI总分,差异具有统计学意义（P＜0.05）。结论 我校大学生睡眠质量不容乐观,睡眠质量与焦虑、抑郁情绪关系密切,应引起学校管理者及老师的重视。     

大学生负性情绪在反刍思维与睡眠质量间的中介作用

目的:探讨反刍思维各维度对睡眠质量的直接作用,以及负性情绪(抑郁和焦虑)在二者关系中的中介作用。方法:选取391名大学生,采用匹兹堡睡眠质量指数量表(PSQI),反刍思维量表(RRS)、流调中心用抑郁量表(CES-D)以及状态焦虑量表(SAI)分别考察其睡眠质量、反刍思维、抑郁情绪和焦虑情绪。结果:PSQI得分与RRS总分及各维度得分、CES-D得分和SAI得分均呈正相关(r=0.13~0.44,P均0.01)。回归分析显示,RRS的抑郁相关维度正向预测睡眠质量(标准化回归系数=0.49);抑郁和焦虑能够解释反刍思维与睡眠质量间关系40.74%的变异。结论:抑郁相关维度正向作用于睡眠质量;负性情绪在反刍思维与睡眠质量的关系中起到了部分中介作用。     

高原军人的睡眠质量及其与健康状况的相关性研究

目的了解高原军人的睡眠质量及其与自测健康状况的关系。方法采用随机整群抽样法,选择驻西藏某部队官兵490名,应用匹茨堡睡眠质量指数量表(PSQI)和自测健康评定量表(SRHMS)进行问卷调查。结果高原军人PSQI总分为7.14±3.42,14.8%的人睡眠质量较差;睡眠问题主要表现在入睡时间、日间功能障碍和主观睡眠质量成份的得分较高,2分以上所占的百分比分别为56.5%,54.8%和36.94;影响高原军人睡眠质量的主要问题为入睡困难、夜间易醒或早醒;不同睡眠质量高原军人在自测健康状况的3个子量表得分和总分均有非常显著差异(P<0.001)。高原军人睡眠质量各成分得分和总分与自测健康状况3个子量表得分和总分绝大多数呈显著的负相关,尤其与心理子量表的相关更为显著。结论高原军人的睡眠质量不容乐观,他们的睡眠质量对自测健康状况有显著影响,提高高原军人睡眠质量是改善他们自测健康状况的有效途径。     

大学生的睡眠质量与抑郁、焦虑的关系

目的:探讨大学生的睡眠质量与抑郁、焦虑症状严重程度的关系。方法:选取580名大学生,采用匹兹堡睡眠量表(PSQI)、抑郁自评量表(SDS)、焦虑自评量表测试(SAS)分别测查其睡眠质量以及抑郁、焦虑症状严重程度。SDS标准分≥53分为抑郁组,53分为无抑郁组;SAS标准分≥50分为焦虑组,50分为无焦虑组。结果:PSQI总分与SDS得分、SAS得分正相关(r=0.58、0.47,均P0.01)。得到抑郁组39例、无抑郁组488例,焦虑组147例、无焦虑组380例;其中抑郁症状的大学生PSQI总分高于无抑郁症状者[(9.2±2.2)vs.(5.5±2.2),P0.01],有焦虑症状的大学生PSQI总分高于无焦虑症状者[(7.2±2.6)vs.(5.3±2.1),P0.01];且PSQI总分对SDS得分和SAS得分的主效应均有统计学意义(F=22.64、14.00,均P0.01)。PSQI总分与SDS得分正向关联(β=0.58,P0.01),对SDS得分解释率为33.4%;PSQI总分与SAS得分正向关联(β=0.47,P0.01),对SAS得分的解释率为22.1%。结论:大学生睡眠质量是衡量抑郁、焦虑严重程度的重要指标。     

大学生高海拔驻留时间对睡眠质量的影响

目的:考察高海拔缺氧对睡眠质量影响的时间效应,以及焦虑、抑郁情绪对睡眠质量可能存在的影响。方法:采用序列追踪设计,使用匹兹堡睡眠质量量表(PSQI)、焦虑自评量表(SAS)、抑郁自评量表(SDS),追踪测试首次进入高海拔地区(3650米)大学生的睡眠质量和焦虑、抑郁水平,3次测试分别完成于驻留7天、3个月和1年。结果:对于实验组而言,3次测量的PSQI总分存在显著差异(F=3.62,P0.05)。进一步多重比较发现,居住满1年时的PSQI总分显著低于3个月时的PSQI总分(P0.05),其他两两间差异均不显著(P0.05);实验组3次测量的焦虑总分与对应的3个PSQI总分相关均不显著(P0.05);实验组3次测量的抑郁总分与对应的3个PSQI总分相关均不显著(P0.05)。结论:高海拔驻留时间影响睡眠质量,但随着驻留时间的延长,睡眠质量会得到恢复和改善。没有发现焦虑、抑郁情绪对高海拔缺氧环境下的睡眠质量存在影响的证据。     

医学生睡眠质量与心理健康及总体幸福感的关系

目的了解医学生睡眠质量状况,探讨睡眠质量与心理健康和总体幸福感的关系。方法采用匹兹堡睡眠质量指数量表(PSQI),症状自评量表(SCL-90)和总体幸福感量表(GWB)对348名医学生进行问卷调查。结果①医学生PSQI总分为(5.86±2.51),有24.4%的医学生睡眠质量差;男生、女生在入睡时间因子上有显著差异(t=-2.40,P0.05);低年级、高年级在入睡时间因子上有显著差异(t=2.13,P0.05);②医学生SCL-90得分与全国青年常模相比,在SCL-90总分、人际敏感、抑郁和偏执因子上有显著差异(t=-11.79,-4.79;P0.01;t=-2.46,P0.05;t=-5.59,P0.01);不同性别医学生心理健康状况无显著差异;低年级、高年级医学生在SCL-90总分和各因子得分上差异显著(P0.05);③PSQI总分、主观睡眠质量、入睡时间、睡眠时间、睡眠障碍、催眠药物、日间功能障碍因子与SCL-90得分显著正相关(P0.01),而与GWB得分显著负相关(P0.01)。结论医学生睡眠质量总体状况较差;医学生心理健康水平总体上好于全国青年常模,高年级优于低年级;医学生睡眠质量越差其心理健康水平和总体幸福感也越低。     

居家养老老人睡眠质量对抑郁情绪的影响

目的:了解居家养老老人睡眠和抑郁状况,进一步考察老年人睡眠质量对抑郁情绪的影响作用。方法:采用匹兹堡睡眠质量指数量表(PSQI)和老年抑郁量表(GDS)对186名老年人进行问卷调查。结果:122.6%的老人存在睡眠障碍,其中女性比男性需要更长的时间入睡(t=-2.00,P0.05),高龄老人的睡眠总体情况明显比低龄老人差(t=2.85,P0.05),丧偶老人的睡眠效率比在婚的老人低(t=-2.81,P0.05);239.8%的老人有抑郁情绪,丧偶老人比在婚老人更易有抑郁情绪(t=-3.20,P0.005),受教育程度越高其抑郁情绪越低(F=5.246,P0.005);3PSQI总分与GDS总分显著正相关,日间功能障碍对老年抑郁有显著的预测作用,解释量达14.2%。结论:居家养老老人的睡眠质量与抑郁情绪呈显著负相关,睡眠质量对老年抑郁有一定的预测作用。     

高血压老人睡眠质量现状及与孤独感的关系

目的:调查了解高血压老人睡眠质量现状及与孤独感的关系。方法:选取乌鲁木齐市某三级甲等医院老年病科就诊的60岁以上高血压老人201例作为调查对象,采用匹兹堡睡眠质量指数量表(PSQI)、UCLA孤独量表进行测评研究。结果:本样本的睡眠障碍发生率为64.18%。单因素分析发现,女性高血压老人PSQI总分及睡眠效率得分显著高于男性高血压老人(t=2.226,P=0.027;t=2.928,P=0.004)。已婚高血压老人主观睡眠质量得分显著低于单身高血压老人(t=-2.340,P=0.020)。空巢高血压老人PSQI总分及主观睡眠质量得分显著高于非空巢高血压老人(t=3.221,P=0.002;t=2.619,P=0.009)。有并发症高血压老人PSQI总分及睡眠效率、日间功能障碍得分显著高于无并发症高血压老人(t=3.209,P=0.002;t=2.754,P=0.007;t=2.394,P=0.018)。家庭关系较为融洽高血压老人PSQI总分及睡眠时间、睡眠障碍、日间功能障碍得分显著低于隔阂多高血压老人(P0.05,P0.01)。年龄60～64岁高血压老人PSQI总分及入睡时间、睡眠时间、日间功能障碍得分显著高于75～79岁老人(P0.05),80岁及以上高血压老人PSQI总分及主观睡眠质量、入睡时间得分显著高于75～79岁老人(P0.05)。孤独感高分高血压老人PSQI总分显著高于孤独感中间、低分老人(P0.05,P0.01)。孤独感进入PSQI总分的回归方程(β=0.536,P0.01)。结论:高血压老人睡眠质量因不同人口学特征而异,孤独感对高血压老人睡眠质量具有一定的预测关系。     

西安市成年人的情绪状态和睡眠质量及其关系

目的:了解西安市成年人情绪状态和睡眠质量的特点及其关系。方法:采用简明心境量表(POMS)、抑郁自评量表(SDS)、匹兹堡睡眠质量指数量表(PSQI)对西安市603名成年人进行问卷调查。结果:1女性的愤怒情绪(t=2.641,P0.01)和抑郁情绪(t=3.910,P0.001)比男性严重,男性的自尊感比女性强(t=-2.649,P0.01);青年人精力比中年人旺盛(t=2.899,P0.01),青年人比中年人容易产生紧张情绪(t=3.298,P0.01)和疲劳情绪(t=3.850,P0.001),但是中年人的抑郁情绪比青年人严重(t=-2.040,P0.05);2本研究中近一半的成年人出现睡眠障碍。女性的睡眠质量比男性差,具体表现为女性在主观睡眠时间(t=2.580,P0.01)、睡眠潜伏期(t=3.900,P0.001)、睡眠效率(t=3.460,P0.01)和总分(t=1.490,P0.001)上得分显著高于男性。白天功能紊乱因子上青年人得分显著高于中年人(t=3.530,P0.01);3紧张、愤怒、疲劳、压抑、抑郁与主观睡眠质量、睡眠潜伏期、睡眠紊乱、白天功能紊乱和PSQI总分呈正相关关系;精力与主观睡眠质量、睡眠潜伏期、睡眠紊乱、白天功能紊乱和PSQI总分呈负相关,自尊感与主观睡眠质量、睡眠持续性、睡眠紊乱、白天功能紊乱和PSQI正相关。结论:西安市成年人情绪状态均低于我国常模,近半数人群的睡眠质量较差。睡眠质量差可能与负性情绪较多、正性情绪较少有关。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.     

Der Einfluß von Nahrungsmitteln und Rauchen auf die klinisch-chemische Diagnostik von Phäochromozytom,Neuroblastom und Karzinoid-Syndrom

Zusammenfassung Der Einfluß von verschiedenen Nahrungsmitteln auf Methoden zur Bestimmung von Adrenalin (AD), Noradrenalin (NA), Vanillinmandelsäure (VMS), Metanephrinen (MN), Homovanillinsäure (HVS) und 5-Hydroxyindolessigsäure (5-HIE) im 24 h-Harn zur Diagnose des Phäochromozytoms bzw. Karzinoid-Syndroms wurde untersucht. Die in die Untersuchung einbezogenen Nahrungsmittel waren: Tee, Kaffee, Mandeln, Ananas, Käse, Walnüsse, Vanillepudding, Bananen, Tomaten und Milchschokolade. Außerdem wurde der Einfluß des Zigarettenrauchens auf die Bestimmung von AD, NA, VMS und MN untersucht.Walnüsse führten zu einer starken Erhöhung der 5-HIE-Ausscheidung. Bananen erhöhten die Ausscheidung von AD, NA, VMS, MN und 5-HIE. Kaffee und Ananas bewirkten eine geringe Zunahme der MN-Werte. Rauchen von 20–30 Zigaretten/Tag beeinflußte keine der vier Variablen.Wenn die beschriebenen Methoden benutzt werden, sollte lediglich auf den Verzehr von Bananen und Walnüssen vor und während der Harnsammelperioden verzichtet werden, da die oberen Normgrenzen im Harn überschritten werden könnten. Ein Verzicht auf Kaffee und Ananas in normalen Mengen ist nicht erforderlich. Es besteht kein Anlaß, weiterhin die bisherigen umfangreichen Restriktionen der übrigen Nahrungsmittel beizubehalten.