对急性骨折患者进行认知行为干预效果的研究

目的 探讨认知行为干预对急性骨折患者焦虑抑郁状态的影响.方法 随机将90例男性急性骨折患者分为对照组和实验组,对照组给予常规治疗和护理,实验组在常规治疗和护理的基础上进行认知行为干预,分别于入院后第1天、15天对两组患者用汉密顿焦虑量表(HAMA)和汉密顿抑郁量表(HAMD)测试,并观察两组患者血压、心率的情况.结果 两组患者入院后第1天焦率、抑郁状态比较无显著性差异,住院第15天焦率、抑郁降低程度比较差异有统计学意义(P <0.01);实验组患者血压、心率的改变明显低于对照组.结论 对急性骨折患者进行认知行为干预能缓解患者的焦率、抑郁状态,可促进患者的身心健康.     

认知行为疗法对前庭性偏头痛患者焦虑抑郁情绪的影响

目的:探讨认知行为疗法对前庭性偏头痛(Vestibular Migrain,VM)患者焦虑抑郁情绪的影响。方法:用随机数字表法将65例前庭性偏头痛伴焦虑抑郁的患者分为两组,对照组给予常规治疗及一般心理护理,试验组在此基础上实施为期3周的认知行为疗法,采用汉密顿抑郁量表、汉密顿焦虑量表评价干预效果。结果:试验组干预后抑郁、焦虑评分与干预前比较,差异具有统计学意义(Z=-4.399,-4.584;P0.01),试验组干预后抑郁、焦虑评分与对照组比较,差异具有统计学意义(t=2.006,4.400;P0.01)。结论:认知行为干预疗法可有效缓解前庭性偏头痛患者的焦虑抑郁情绪。     

神经性厌食患者的人格特征及焦虑抑郁症状

目的:探讨神经性厌食患者的人格特征及焦虑抑郁症状,为临床治疗和疾病预防提供参考依据。方法:选取94例同时符合中国精神障碍分类与诊断标准第3版(CCMD-3)和美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)诊断标准的神经性厌食患者,其中限食型41例,暴食/清除型53例;选取72例某精神专科医院实习护士为对照组。两组均采用明尼苏达多项人格(MMPI)、汉密顿抑郁量表(HAMD)、汉密顿焦虑量表(HAMA)进行测查。结果:病例组抑郁症状(85.1%vs.8.3%)和焦虑症状(75.5%vs.2.8%)的检出率高于对照组(均P0.05)。病例组M M PI测试结果除男子-女子气、说谎量表、诈病量表、校正量表的T分与对照组无统计学差异外(均P0.05),精神病态、抑郁、癔病、疑病、偏执、精神衰弱、精神分裂症、轻躁狂及社会内向的T分均高于对照组(均P0.05);T分最高的量表分为精神病态(Pd)(63.8±11.2),其次是抑郁(D)(61.0±12.8),两点编码呈现24/42编码。暴食/清除型患者的疑病(Hs)的T分高于限食型[(53.3±9.9)vs.(58.7±9.3),P0.05]。结论:神经性厌食患者有其特定的人格特征,尤其是精神病态和抑郁更为突出。     

老年抑郁症患者的发病诱因及临床表现

目的:探讨老年抑郁症患者的发病诱因及临床表现。方法:选取老年抑郁症患者50例作为观察组,中青年抑郁症患者50例作为中青年抑郁组,健康老年50例作为健康对照组。根据《正常中国人生活事件量表》记录观察组与健康对照组被试1年内情况,根据24项版本《汉密顿抑郁量表》记录观察组与中青年抑郁组患者抑郁状态情况,根据《汉密顿焦虑量表》判定观察组与中青年抑郁组抑郁严重程度。对比观察组与健康对照组患者不同诱因的影响,对比观察组与中青年抑郁组患者临床症状、焦虑程度。结果:观察组患者重病外伤、家庭不和、无经济来源(医保)、家属重病或丧偶、无婚姻发生率(64%、84%、52%、78%、52%)均高于健康对照组(34%、56%、26%、50%、24%),差异具有统计学意义(P0.05)。观察组患者抑郁总分(37.28±1.57)高于中青年抑郁组(28.37±1.74),差异具有统计学意义(P0.05)。观察组患者焦虑、认知障碍、躯体症状发生率(84%、74%、86%)均高于中青年抑郁组(56%、56%、60%),差异具有统计学意义(P0.05)。结论:重病外伤、家庭不和、无经济来源(医保)、家属重病或丧偶、无婚姻是老年抑郁症发生的主要诱因。其在临床表现中以焦虑/躯体化、阻滞、绝望感尤为突出。     

伴抑郁情绪内科门诊患者的血管内皮功能

目的:探讨内科门诊患者的抑郁情绪与血管内皮功能的关系。方法:采用横断面调查,选取就诊于三甲综合医院内科门诊,汉密顿抑郁量表17项评分≥17分和临床总体印象评分≥4分的63例患者作为伴抑郁情绪组,选取汉密顿抑郁量表17项评分7分、汉密顿焦虑量表评分≤6分、临床总体印象评分≤2分的63例患者作为无抑郁情绪组,两组年龄与体质量指数均匹配。调查患者是否存在冠心病、糖尿病、脑梗死病史,并对血糖、血脂、血压指标进行测查,采用Endo-PAT2000检测仪评估内皮功能指数(RHI)。结果:多重线性回归分析结果显示,RHI水平与伴抑郁情绪呈负向关联(β'=-0.31,P0.001)。按有/无冠心病病史分层分析伴抑郁情绪与RHI水平的关系,有冠心病病史的患者中,伴抑郁情绪者(n=28)与无抑郁情绪组(n=22)的RHI差异无统计学意义[(1.8±0.5)vs.(1.8±0.7),P0.05];无冠心病病史的患者中,伴抑郁情绪者(n=47)的RHI水平低于无抑郁情绪者(n=53)[(2.1±0.6)vs.(2.4±0.6),P0.05]。结论:内科门诊抑郁情绪患者可能存在内皮功能障碍。     

音乐放松训练对癌症放疗患者的心理干预

目的 探讨音乐放松训练对癌症患者在放射治疗期间抑郁、焦虑情绪的影响.方法 61名接受放射线治疗的癌症住院患者按照接受放射治疗的时间先后分为两组,其中一组30名患者在放疗过程中接受音乐放松训练的心理干预(干预组),另一组31名患者不予干预(对照组).且在放疗的不同时期采用汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD)对患者进行心理问卷调查.结果 HAMA、HAMD评分结果显示:干预组与对照组相比,放疗开始第0周焦虑、抑郁差异不显著,无统计学意义[HAMA分(t=0.026,P=0.979);HAMD分(t=0.906,P=0.369)];放疗开始后第4周的焦虑、抑郁差异有统计学意义[HAMA分(t=2.763,P=0.008);HAMD分(t=2.134,P=0.037)];放疗开始后第8周的焦虑、抑郁差异有统计学意义[HAMA分(t=2.468,P=0.016);HAMD分(t=2.578,P=0.012)].结论 在临床上对于癌症放疗患者给予音乐放松训练进行心理干预,对缓解或减轻患者焦虑、抑郁等情绪有一定的帮助,从而增加其癌症治疗的依从性.     

帕罗西汀联合阿立哌唑治疗抑郁症临床观察

目的 探讨帕罗西汀联合小剂量阿立哌唑治疗抑郁症的疗效及安全性.方法 将60例抑郁症患者随机分为两组,研究组给予帕罗西汀加小剂量阿立哌唑治疗,对照组单用帕罗西汀治疗,疗程6周.采用汉密顿抑郁量表及汉密顿焦虑量表评定临床疗效,副作用量表评定不良反应.结果 治疗6周末两组汉密顿抑郁量表及汉密顿焦虑量表评分均显著性下降(P＜0.01),研究组起效快(P＜0.05),但6周末两组显效率无差异,两组不良反应均轻微.结论 帕罗西汀联合小剂量阿立哌唑治疗抑郁症起效快、疗效肯定、不良反应少.     

《弟子规》教育改善精神科医务人员的职业倦怠

目的:探讨《弟子规》教育对精神科医务人员的职业倦怠的影响。方法:应用职业倦怠测试量表(MBIGS),随机招募60名精神科医务人员作为试验组,将与试验组性别、年龄匹配的机关、医技等非一线60名职工作为对照组。对试验组进行《弟子规》教育。应用汉密顿抑郁量表(HAMD)、汉密顿焦虑量表(HAMA)以及职业倦怠测试量表(MBI-GS)评价教育前后精神科医务人员以及职业倦怠状况的差异。结果:试验组教育前在焦虑及抑郁得分与对照组相比均有显著性差异(t=2.61,3.09;P0.01)。试验组教育前MBI-GS评分的情绪衰竭维度与教育后及对照组比较有显著差异(t=9.172,8.36;P0.01),在去人性化维度与教育后及对照组比较有显著差异(t=3.34,2.65;P0.01),而在个人成就感维度差异不明显(t=0.94,1.98;P0.05)。结论:《弟子规》教育能够改善精神科医务人员的职业倦怠状况。     

骨折后负性情绪调查及心理干预对患者的影响

目的:调查骨折后患者负性情绪状态及原因,分析心理干预对骨折患者负性情绪、心理韧性、并发症发生率的影响.方法:选取2017年1月-2018年12月某院收治的118例骨折住院患者为研究对象,采用汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD)调查患者焦虑、抑郁情况;按照住院顺序奇偶数法将患者分为观察组59例和对照组5...     

急性心肌梗死后焦虑抑郁对血小板活性及疗效的影响

目的:探讨急性心肌梗死(AMI)后焦虑抑郁对血小板活性及抗血小板治疗效果的影响。方法:回顾性分析心肌梗死稳定期患者148例病例资料,均规律服用氯吡格雷75mg/d、阿司匹林100mg/d联合抗血小板治疗,发放汉密顿焦虑量表(HAMA)和汉密顿抑郁量表(HAMD)评估焦虑抑郁情况,并分析其对血小板活化、5-羟色胺(5-HT)及氯吡格雷疗效的影响。结果:焦虑和抑郁组初中及以下学历的几率分别为69.23%、76.47%高于非焦虑组的43.44%和非抑郁组的44.27%,差异均有统计学意义(χ~2=5.711,6.249;P0.05);非焦虑组CD62p、PAC-1、血小板聚集率、血小板5-HT、ADP-P2Y12反应蛋白(PRU值)低于焦虑组,差异有统计学意义(t=-5.261,-3.064,-3.738,-3.062,-2.845;P0.01),抑郁症和非抑郁组上述指标比较,差异有统计学意义(t=-6.312,-4.868,-4.603,-3.675,-3.386;P0.01)。结论 :AMI合并焦虑或抑郁能促使血小板活化,增加血小板聚集率,可能弱化氯吡格雷疗效。     

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.     

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.     

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.     

The case for allele‐specific recognition by the TCR

There is a sharp difference in how one views TCR structure–function–behaviour dependent on whether its recognition of major histocompatibility complex‐encoded restriction elements (R) is germline selected or somatically generated. The generally accepted or Standard model is built on the assumption that recognition of R is by the V regions of the αβ TCR, which is not driven by allele specificity, whereas the competing model posits that recognition of R is allele‐specific. The establishing of allele‐specific recognition of R by the TCR would rule out the Standard model and clear the road to a consideration of a competing construct, the Tritope model. Here, the case for allele‐specific recognition (germline selected) is detailed making it obvious that the Standard model is untenable.     

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.