维和行动部署后工程兵领悟社会支持、积极消极情感与适应不良的关系研究

目的 探讨领悟社会支持、积极消极情感对维和工程兵适应不良的影响.方法 整群抽样抽取3个战区某部参加过维和行动3年内的280名工程兵为研究对象.采用领悟社会支持、积极消极情感量表、军人适应不良自评量表进行测量.结果 ①部署后维和工程兵适应不良总分显著低于军人常模,适应不良障碍检出率为14.7％.其中行为问题障碍为3.8％,情绪问题障碍为6.4％,人际问题障碍为8.3％,环境适应障碍为3.4％.②适应不良与领悟社会支持、积极情感呈显著负相关(r=-0.26,r=-0.17,P＜0.01),与消极情感呈显著正相关(r=0.32,P＜0.01).③路径分析发现,领悟社会支持对适应不良具有直接负向预测作用(β=-0.13,P＜0.05),积极消极情感在领悟社会支持与适应不良的关系中发挥中介作用.结论 维和工程兵部署后整体适应性较好;领悟社会支持、积极消极情感是影响维和工程兵适应不良的重要因素.     

依恋、社会支持、应对方式在生活事件影响心理健康的中介作用

目的 探讨依恋、应对方式、社会支持在生活事件对心理健康影响的中介效应.方法 采用整群抽样的方法对哈尔滨市某技工学校一年级新生372人进行中学生亲密关系经历量表(ECR),症状自评量表(SCL-90),应对方式量表(CSS),青少年生活事件量表(ASLEC),领悟社会支持量表(PSSS)问卷调查.结果 (1)生活事件与依恋焦虑因子呈显著正相关(r=0.293～0.356,P＜0.01),与情绪集中性应对各因子呈显著正相关(r=0,259～0.509,P＜0.01),与SCL-90总分呈显著正相关(P＜0.01);领悟社会支持与SCL-90总分呈显著负相关(r=-0.238,P＜0.01).(2)结构方程模型(拟合指数:χ2=540.593,RMSEA=0.114,NFI=0.864,CFI=0.884,P＜0.01)分析显示生活事件影响心理健康的中介因素为情绪集中性应对、依恋焦虑因子、领悟社会支持,其中情绪集中性应对的中介效应最大,占总效应的33.2%.结论 生活事件直接影响心理健康,并通过情绪集中性应对、依恋焦虑、社会支持的中介作用间接影响心理健康.     

社会支持、应对方式在依恋影响心理健康中的作用

目的 探讨依恋对心理健康的直接影响以及依恋通过应对方式、社会支持对心理健康的间接影响.方法 采用整群抽样的方法 对哈尔滨市某技工学校一年级新生372人进行亲密关系经历量表(ECR),症状自评量表(SCL-90),应对方式量表(CSS),领悟社会支持(PSSS)问卷调查.结果 (1)SCL-90总分与父、母,同伴依恋焦虑,与父、母依恋回避呈显著正相关(r=0.165～0.370,P＜0.01);与情绪集中性应对显著正相关(r=0.291～0.552,P＜0.01);与领悟社会支持呈显著负相关(r=-0.245,P＜0.01).(2)父、母,同伴依恋焦虑与情绪集中性应对呈显著正相关(r=0.237～0.383,P＜0.01),而父、母,同伴依恋回避与问题集中性应对呈显著负相关(r=-0.267～-0.403,P＜0.01).(3)领悟社会支持与父、母,同伴依恋回避呈显著负相关(r=-0.425～-0.459,P＜0.01),而与父、母,同伴依恋焦虑相关不显著.(4)依恋焦虑通过应对方式影响心理健康,应对方式的中介效应占总效应的65.2%;依恋回避调节领悟社会支持.结论 (1)依恋焦虑和回避对心理健康状况都有直接影响;(2)依恋焦虑也可通过情绪集中性应对的中介作用间接影响心理健康,依恋回避通过对社会支持的调节效应影响心理健康.     

领悟社会支持在护理人员述情障碍与消极心理间的调节中介效应

目的 探讨领悟社会支持在护理人员述情障碍与消极心理间的调节与中介效应.方法 采用多伦多述情障碍20个条目量表(TAS-20)、领悟社会支持量表(PSSS)和一般健康问卷(GHQ-20)对河南省某医院的503名护理人员进行问卷调查.结果 护理人员的述情障碍、领悟社会支持和消极心理的得分分别为(54.82±8.43)分、(61.9±9.78)分、(3.70±2.61)分,述情障碍与消极心理呈显著正相关(r=0.49,P＜0.01),领悟社会支持与消极心理呈显著负相关(r=-0.32,P＜0.01),而述情障碍与领悟社会支持呈显著负相关(r=-0.36,P＜0.01);领悟社会支持在述情障碍和消极心理间的调节效应检验中,R12为0.259、R22为0.257,R22没有显著增高,在分层回归的第二层中,t=-0.538,P＞0.05;领悟社会支持在述情障碍和消极心理间作为中介变量的模型拟合指数分别为x2/df=1.645,RMSEA=0.036,CFI=0.995,IFI=0.995,RFI=0.960,TLI=0.984,NFI=0.987,GFI=0.993,AGFI=0.973,模型拟合良好.结论 领悟社会支持在护理人员述情障碍与消极心理间的调节效应不存在,而是发挥部分中介作用.     

社会支持在童年虐待与心理健康间的中介作用

目的 探讨研究生的童年虐待经历与心理健康的关系及其社会支持的中介作用.方法 采用整群随机抽样的方法,应用儿童期虐待问卷(CTQ-SF)、主观知觉社会支持量表(PSSS)、自尊量表(SES)和抑郁量表(CESD)对907名研究生进行调查.结果 研究生的童年虐待、社会支持、自尊和抑郁得分分别为(33.88±9.35)分、(68.31±12.01)分、(36.62±4.80)分、(35.85±9.20)分,童年虐待与自尊呈显著负相关(r=-0.32,P＜0.01),与抑郁呈显著正相关(r=0.28,P＜0.01),与社会支持呈显著负相关(r=-0.44,P＜0.01),社会支持与自尊呈显著正相关(r=0.39,P＜0.01),与抑郁呈显著负相关(r=-0.41,P＜0.01);中介效应检验结果表明:①社会支持是童年虐待和自尊之间的中介变量,中介效应占比为42％;②社会支持是童年虐待和抑郁之间的中介变量,中介效应占比为54％.结论 童年虐待不仅直接影响研究生的自尊和抑郁,同时还通过社会支持间接影响研究生的自尊和抑郁.     

应激事件、应对方式和社会支持对实习护生心理健康状况的影响

目的 探讨本专科实习护生心理健康状况的影响因素,及各因素间的交互作用.方法 采用大学毕业生应激性事件量表(CSSS)、特质应对方式问卷(TCSQ)、社会支持评定量表和症状自评量表(SCL-90)对288名本专科实习护生在实习初期进行评定,统计分析采用Pearson相关分析、多因素方差分析、单纯主要效果方差分析.结果 ①应激性事件、消极应对与SCL-90总分呈正相关(r值分别为0.487,0.426,P＜0.01),而积极应对和社会支持与SCL-90总分呈负相关(r值分别为-0.192,-0.135,P＜0.05);②应激性事件、消极应对和社会支持对本专科实习护生心理症状的主效应显著(F值分别为34.062,16.090,20.898,P＜0.01),消极应对与社会支持之间存在交互作用(F值为18.432,P＜0.01);积极应对对心理症状的主效应不显著)(F值为1.853,P＞0.05),但它通过与应激性事件的交互作用对心理症状产生影响(F值为14.579,P＜0.01).结论 对护生的心理健康水平,除了减少应激性事件、避免消极应对以外,还需要增强护生的社会支持系统,鼓励护生建立积极的应对方式,尤其要注意应激性事件与积极应对,消极应对与社会支持之间的交互作用对护生心理健康的意义.     

自尊在受艾滋病影响儿童领悟社会支持与亲社会行为间的中介作用

目的 探讨受艾滋病影响儿童领悟社会支持、自尊与亲社会行为之间的关系,为受艾滋病影响儿童建立良好的亲社会行为提供理论依据.方法 在河南省受艾滋病影响严重的地区抽取受艾滋病影响儿童300名,采用领悟社会支持量表、自尊量表、亲社会行为量表进行测评,对数据资料进行相关分析、多元线性回归分析、bcbootstrap检验等统计学处理.结果 （1）受艾滋病影响儿童领悟社会支持与自尊显著正相关（r=0.436,P＜0.01）,领悟社会支持与亲社会行为显著正相关（r=0.457,P＜0.01）,自尊与亲社会行为显著正相关（r=0.477,P＜0.01）.（2）回归分析发现,领悟社会支持对受艾滋病影响儿童亲社会行为变异的解释率为20.8％ （F=67.944,P＜0.01）.自尊对受艾滋病影响儿童亲社会行为变异的解释率为22.8％（F=76.146,P＜0.01）.（3）自尊作为中介变量,领悟社会支持对受艾滋病影响儿童的直接效应和间接效应均显著,领悟社会支持对亲社会行为的直接效应估计值为0.272 （P=0.02）,自尊在领悟社会支持与亲社会行为间的中介效应估计值为0.208（P＜0.01）.结论 领悟社会支持、自尊是影响受艾滋病影响儿童亲社会行为的主要因素,自尊在领悟社会支持影响亲社会行为的过程中起中介作用.     

宫颈癌化疗患者领悟社会支持与抑郁的关系:冗思的中介机制

目的 探讨宫颈癌化疗患者领悟社会支持与抑郁关系及冗思在宫颈癌化疗患者领悟社会支持与抑郁间的中介作用.方法 采用抑郁量表、领悟社会支持量表、冗思反应量表对320名宫颈癌化疗患者进行问卷调查.结果 宫颈癌化疗患者中63.8％存在抑郁症状;宫颈癌化疗患者的领悟社会支持与抑郁呈负相关(r=-0.570,P＜0.01),冗思与抑郁呈正相关(r=0.656,P＜0.01),冗思与领悟社会支持呈负相关(r=-0.354,P＜0.01);冗思在宫颈癌化疗患者领悟社会支持和抑郁之间的中介效应显著,Bootstrap输出的95％可信区间为(-0.2235,-0.1255).结论 宫颈癌化疗患者领悟社会支持水平通过影响冗思水平来间接影响抑郁水平,应给予宫颈癌化疗患者更多社会支持,促进患者身心健康.     

本科实习护生社交焦虑与领悟社会支持的关系:自尊的中介作用

目的探讨自尊在本科实习护生社交焦虑与领悟社会支持之间所起的中介作用。方法采用社交回避与苦恼量表、自尊量表、领悟社会支持量表,对168名医学院校本科实习护生进行问卷调查,并运用结构方程模型探讨自尊在社交焦虑与领悟社会支持之间所起的中介作用。结果社交回避与苦恼同自尊呈显著负相关(r=-0.440,P<0.01),自尊同领悟社会支持呈显著正相关(r=0.470,P<0.01),社交回避与苦恼同领悟社会支持呈显著负相关(r=-0.309,P<0.01)。中介效应分析结果显示,自尊在社交焦虑与领悟社会支持之间起完全中介作用(β=-0.24,P=0.55)。结论社交焦虑可以通过自尊的中介作用间接影响本科实习护生领悟社会支持能力。     

濒临破产企业职工心理健康状况与社会支持的相关性研究

目的研究濒临破产企业职工心理健康状况与社会支持之间关系.方法在某濒临破产企业中随机抽取120名职工为调查对象,采用症状自评量表(SCL-90)、社会支持量表(SSRS)进行问卷调查.结果职工的心理健康水平与社会支持总分、主观支持呈显著负相关(P＜0.01),客观支持与躯体化(r=-0.259)、焦虑(r=-0.211)、抑郁(r=-0.265)、恐怖(r=-0.209)显著相关(P＜0.05),焦虑(r=-0.218)、抑郁(r=-0.211)、人际关系(r=-0.213)与支持利用度呈显著负相关(P＜0.01),不同性别、年龄、文化层次职工的社会支持量表评分差异无显著性.结论濒临破产企业职工的心理健康水平与社会支持密切相关,应引起政府、社会、心理工作者的关注.     

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.