脑卒中患者家属生活质量及相关因素

目的 探讨脑卒中患者家属的生活质量及其相关因素.方法 采用世界卫生组织生存质量量表,对108例脑卒中患者家属进行量表评定.结果 ①脑卒中患者家属生活质量各领域评分均低于正常对照组(P＜0.05);②不同关系的家属生活质量在生理、心理、环境和精神等领域评分相似(P＞0.05),而独立性和社会关系领域评分有显著性差异(P＜0.05);③同归分析提示患者的婚姻状况、卒中次数、抑郁自评量表评分和日常生活能力量表评分与患者家属生活质量评分相关.结论 脑卒中患者家属的生活质量下降,与卒中患者的婚姻状况、卒中次数、抑郁自评量表评分和日常生活能力量表评分等因素相关.     

路优泰对卒中后抑郁状况及生活质量的影响

目的 脑卒中后抑郁发病率高，且严重影响患者的神经功能恢复及生活质量，研究路优泰对其情感障碍、神经功能恢复及生活质量的改善作用，为临床提供参考依据。方法 将2004—01／2005-10南阳市中心医院收治90例诊断为脑卒中后抑郁的患者随机分为治疗组45例和对照组45例。治疗组给予口服路优泰，并给予改善脑部血液供应、营养神经细胞及常规康复治疗；对照组给予心理治疗，其余治疗同治疗组。采用汉密顿抑郁量表、日常生活活动能力及生活质量指数量表评分，观察患者治疗前后抑郁状态、日常生活活动能力及生活质量的变化情况。结果 治疗组、对照组总有效率分别为82．2％、60．0％，两组相比差异有显著性意义（x2=5．18，p〈0．05）。治疗组治疗后汉密顿抑郁量表，日常生活活动能力，生活质量指数评分较治疗前明显改善（t=8．2，7．2，2．1，P〈0．05）；治疗后治疗组汉密顿抑郁量表日常生活活动能力，生活质量指数评分较对照组增高（t=8．1，7．4，2．6,p〈0．05）。结论 路优泰对卒中后抑郁状态，日常生活活动能力均有显著改善作用，可促进脑卒中患者的神经功能恢复，提高其生活质量。     

脑卒中患者的生活质量与应对方式以及社会支持的相关性研究

目的：探讨脑卒中患者的生活质量、应对方式及其社会支持状况。方法：采用生活质量综合评定问卷（GQOLI）、医学应对问卷（MCMQ）及社会支持评定量表（SSAS）对60例脑卒中患者（观察组）及60名健康自愿者（对照组）进行测评。结果：①观察组生活质量总分及躯体功能、心理功能、社会功能3个维度评分均显著低于对照组（P〈0．01）；②观察组面对分量表评分显著低于对照组，而屈服分量表评分则显著高于对照组（P〈0．01）；③观察组社会支持总分及客观支持、主观支持、支持利用度评分均显著低于对照组（P〈0．01）；④脑卒中患者的生活质量总分及躯体功能、心理功能、社会功能3个维度评分与面对分量表评分及社会支持总分、客观支持、主观支持、支持利用度3个维度评分均呈显著性正相关，而与屈服分量表评分则呈显著性负相关（P〈0．05或P〈0．01）。结论：脑卒中患者的生活质量偏低，与应对方式及社会支持有关。     

卒中后抑郁对神经功能康复的影响

目的 探讨卒中后抑郁对卒中患者神经功能康复的影响。方法 运用漠密尔顿抑郁量表（HAMD）、神经功能缺损量表（NFDS）、日常生活能力量表（ADL）对198例脑卒中患者进行现状调查．结果 （1）卒中后抑郁的发生率为36．86％；（2）卒中后抑郁患者HAMD、ADL．和NFDS评分高。结论 卒中后抑郁发生率较高，不利于卒中患者的康复。     

社区干预对精神分裂症患者生活质量的影响

目的探讨社区干预对精神分裂症患者生活质量的影响。方法将120例男性精神分裂症患者随机分为实验组与对照组各60例。出院后对实验组家属和患者进行定期康复指导，实施社区干预．对照组不进行特殊指导。对两组患者随访2年，采用日常生活能力量表（ADL）、社会功能缺陷量表（SDSS）和生活质量综合评定问卷（GQOLI-74）对其生活质量进行评估。结果干预后实验组患者GQOLI-74中躯体功能、心理功能、社会功能显著高于干预前，差异有统计学意义（P均〈0．01）；干预后实验组GQOLI-74中各维度得分均高于对照组，差异有统计学意义（P〈0．05或P〈0．01）；ADL的躯体生活自理能力和日常生活能力也高于对照组（P〈0．05），SDSS的社会功能改善程度高于对照组（P〈0．05）。结论社区干预有助于增进患者自我照顾能力，提高服药依从性，减少复发，延缓精神分裂症患者的功能衰退，提高生活质量。     

圣约翰草提取物治疗卒中后抑郁患者的临床观察

目的探讨圣约翰草提取物对卒中后抑郁患者抑郁状态及其神经功能缺损症状的影响。方法将90例脑卒中后抑郁患者随机分为研究组和对照组各45例。对照组进行神经内科常规治疗及心理治疗，研究组在在此基础上加用圣约翰草提取物，两组患者入院第3天及治疗后第2周、3周、4周均进行汉密尔顿抑郁量表（HAMD）和美国国立卫生研究院卒中量表（NIHSS）评分。结果治疗组HAMD评分和NIHSS评分明显减少，治疗后组间比较差异有统计学意义（P〈0．05）。结论圣约翰草提取物是一种较理想的抗抑郁药物，对改善卒中后抑郁及神经功能缺损症状效果显著。     

帕罗西汀并心理干预治疗卒中后抑郁和焦虑共病者81例临床观察

目的：探讨脑卒中后抑郁和焦虑共病对患者生活能力和神经功能康复的影响，及帕罗西汀合并心理干预临床疗效。方法：将脑卒中伴抑郁和焦虑障碍共病者81名随机分成3组，分别接受单用帕罗西汀治疗（A组）、帕岁西汀并心理治疗（B组）以及单用脑血管药物治疗（C组）。采用斯堪的那维亚脑卒中量表、Barthel指数、汉密尔顿抑郁量表、汉密尔顿焦虑量表评估疗效。结果：脑卒中患者中，抑郁和焦虑的共病率为65．9％，A组、B组各项评分与C组比较，差异均有统计学意义。结论：卒中后抑郁和焦虑病人单用帕罗西汀或合并心理治疗均能促进患者神经功能康复和提高生活质量，且帕罗西汀并心理干预的疗效更好。     

首发支气管哮喘患者心理健康状况及生存质量分析

目的调查首次发病支气管哮喘患者的心理健康状况,并分析心理学因素对患者生活质量的影响。方法采用抑郁自评量表、焦虑自评量表、多伦多述情障碍评定量表、社会支持评定量表、特质应对方式问卷、世界卫生组织生存质量测定量表简表调查112例首次发病支气管哮喘患者及110例正常对照者的心理健康状况。结果①首发支气管哮喘患者SAS评分显著高于对照组（t=4．89,P〈0．01）,SDS评分也显著高于对照组（t=3．69,P〈0．01）;②首发支气管哮喘患者较对照组客观支持少（t=2．05,P〈0．05）,对社会支持的利用较差（t=5．69,P〈0．01）;③首发支气管哮喘患者更多采用消极的应对方式（t=2．17,P〈0．05）;④患者较对照组存在述情困难,表现为难以描述自己的情感（t=6．35,P〈0．01）;⑤患者生活质量差于对照组,主要体现在生理领域（t=2．00,P〈0．05）;⑥相关分析结果表明,患者的生活质量受焦虑、抑郁情绪、述情困难、应对方式、较少的社会支持以及对支持的利用不足等多方面影响（P〈0．05或〈0．01）。结论首发支气管哮喘患者存在较多心理问题,影响患者的生活质量。心理健康状况差是支气管哮喘发病的危险因素。     

脑卒中后抑郁与心理社会因素的关系研究

目的：探讨脑卒中后抑郁发生率及影响其发生的心理社会因素。方法：采用Zung自评抑郁量表和A型行为类型问卷对69例脑卒中患者进行评定．同时收集患者的年龄、性别、行为类型、文化程度、婚姻状况、医疗费用负担状况等资料。结果：脑卒中后抑郁的发生率为59．42％。A型行为组抑郁发生率显著高于非A型行为组（P〈0．01）；有配偶组抑郁发生率明显低于无配偶组（P〈0．05）；自费组抑郁发生率高于医保组（P〈0．05）。结论：脑卒中后抑郁发生率较高，其发生与患者的行为类型、婚姻状况、医疗费用负担状况有关。     

惊恐障碍患者防御方式的对照研究

目的：探讨惊恐障碍患者的防御方式及其与焦虑抑郁、功能状况的关系。方法：采用防御方式问卷对47名伴或不伴广场恐怖的惊恐障碍患者和37名健康对照者评估其防御方式，同时以汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）评估其焦虑抑郁状态，并以功能大体评定量表评估近一周的社交职业功能水平。结果：①惊恐障碍组不成熟防御方式总分、投射、分裂、退缩和躯体化得分高于对照组（P〈0．05）；中间型防御方式总分、理想化、假性利他、伴无能之全能和交往倾向得分高于对照组（P〈0．05）；惊恐障碍组成熟防御方式总分、幽默得分显著低于对照组（P〈0.001）；②惊恐患者的不成熟防御方式总得分与受教育程度呈负相关（r=-0．357，P〈0．05），交往倾向得分与功能大体评分呈负相关（r=-0．384，P〈0．01）.结论：惊恐障碍患者使用不成熟和中间防御方式增多，使用成熟防御减少。     

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.     

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.     

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.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

'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.