团体人际心理干预与团体认知行为干预对社交焦虑的疗效

目的:比较团体人际心理干预和团体认知行为干预对大学生社交焦虑的疗效。方法:方便选取1314名大学生,采用交往焦虑量表(Interaction Anxiousness Scale,IAS)进行测试,筛取IAS总分≥49分(高焦虑者)275人。参照美国精神障碍诊断与统计手册第四版(Diagnostic and Statistical Manual of Mental Disor-ders,DSM-IV)关于社交焦虑障碍诊断标准的症状学描述,根据自愿的原则,选取社交焦虑程度较重的大学生45名,随机分为3组,每组15人:IPT组,采用团体人际心理干预,每周1次,共8周;CBT组,实施认知行为干预,每周1次,共8周;对照组,实验过程中不予干预。各组在干预前测定社交回避及苦恼量表(Social Avoid-ance and Distress Scale,SADS),干预后再进行IAS和SADS的测定,比较IPT组、CBT组干预前后的疗效及其差别。结果:干预前3组间IAS总分、SADS总分、回避因子分、苦恼因子分差异无统计学意义(P>0.05);干预后IPT组与CBT组的社交焦虑水平均低于对照组,而IPT组与CBT组间各项指标差异无统计学意义。IPT组干预后各项指标得分均低于干预前;CBT组干预后SADS总分、回避因子分、苦恼因子分低于干预前;对照组各项指标前后差异无统计学意义(P>0.05)。结论:团体人际心理干预与团体认知行为干预均能有效缓解社交焦虑水平,人际心理干预可作为治疗社交焦虑的一个重要手段。     

认知行为疗法对大学生焦虑行为的缓解作用

目的:研究认知行为疗法(CBT)对大学生焦虑行为的缓解改善作用。方法:选取40名大学生焦虑症患者,随机分为对照组和CBT治疗组。分别于治疗前、治疗后用焦虑自评量表(SAS)和汉密尔顿焦虑量表(HAMA)进行评分,对结果进行汇总统计分析。结果:两组患者治疗前的SAS评分和HAMA评分对比差异无统计学意义,经CBT治疗9周后,CBT治疗组的SAS和HAMA评分均明显低于治疗前(t=13.796,16.193;P0.01),对照组的SAS和HAMA评分均明显低于治疗前(t=8.800,7.187;P0.01)。治疗后9周CBT组的SAS和HAMA评分均显著低于对照组,具有显著性差异(t=-6.327,-6.957;P0.01),两组两项评分在治疗后1周对比无显著性差异,治疗后第三周CBT组的SAS评分和HAMA评分显著低于对照组(t=-5.061,-2.965;P0.01),治疗6周后,CBT组的SAS评分和HAMA评分显著低于对照组(t=-5.067,-5.147;P0.01)。CBT治疗组SAS和HAMA达标率均显著高于对照组(χ~2=5.013,4.927;P0.01)。结论:认知行为疗法能显著改善大学生的焦虑行为,降低焦虑程度。     

艾司西酞普兰联合认知行为疗法治疗高三学生考前焦虑、抑郁情绪

目的:探讨艾司西酞普兰联合认知行为疗法(CBT)对高三学生考前焦虑、抑郁的疗效。方法:选择在唐山市第五医院就诊的一定数量有过度考前焦虑、抑郁的高中学生,随机分为两组,研究组应用艾司西酞普兰联合CBT进行治疗,对照组单用艾司西酞普兰进行治疗,分别于治疗前、治疗4周、治疗8周和治疗12周后用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)以及药物副反应量表(TESS)进行评定,结果进行统计学分析。结果:治疗前HAMA评分两组间均无显著差异(t=-0.14,P0.05);经治疗4周后,研究组HAMA评分均显著低于对照组(t=-2.23,P0.05),并显著低于治疗前(t=2.23,P0.05);治疗8周后两组HAMA评分无显著差异(t=-0.74,P0.05),研究组显著低于治疗前(t=2.58,P0.05);治疗12周后,研究组HAMA评分再次显著低于对照组(t=-2.26,P0.05),与治疗前相比有极显著差异(t=5.98,P0.01)。治疗前HAMD评分两组间均无显著差异(t=1.73,P0.05);经治疗4周后,研究组HAMD评分均显著低于对照组(t=-2.16,P0.05),并显著低于治疗前(t=2.10,P0.05);治疗8周后两组HAMD评分无显著差异(t=0.22,P0.05),研究组显著低于治疗前(t=2.38,P0.05);治疗12周后,研究组HAMD评分与对照组无显著差异(t=-0.16,P0.05),与治疗前相比有显著差异(t=2.03,P0.05)。两组均未发生严重药物不良反应(χ2=0.32,P0.05)。结论:艾司西酞普兰联合CBT治疗考前焦虑、抑郁起效快,疗效肯定,对于考前焦虑的远期疗效优于单用艾司西酞普兰;耐受性好,安全性高。     

艾司西酞普兰联合认知行为疗法治疗隐匿性抑郁障碍的疗效

目的:探讨艾司西酞普兰联合认知行为疗法(CBT)对隐匿性抑郁障碍的疗效。方法:选择在河南省洛阳荣康医院就诊的隐匿性抑郁障碍患者80例,随机分为对照组和观察组各40例。对照组给予艾司西酞普兰治疗,观察组给予艾司西酞普兰联合认知行为疗法治疗。分别于治疗前、治疗4周、治疗12周后用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)进行测评、比较,同时比较两组治疗期间不良反应。结果:治疗前HAMD评分两组间差异无统计学意义(t=0.525,P0.05);治疗4周后及12周后,观察组HAMD评分均显著低于对照组,差异有统计学意义(t=2.129,2.737;P0.05),均显著低于治疗前,差异有统计学意义(t=3.093,9.799;P0.01);对照组治疗4周后HAMD评分低于治疗前,差异无统计学意义(t=1.518,P0.05),治疗12周后评分显著低于治疗前,差异有统计学意义(t=7.560,P0.01)。治疗前HAMA评分两组间差异无统计学意义(t=0.562,P0.05);治疗4周后及12周后,观察组HAMA评分均显著低于对照组,差异有统计学意义(t=2.187,2.471;P0.05),并显著低于治疗前,差异有统计学意义(t=4.704,10.715;P0.01);对照组治疗4周后及12周后,HAMA评分均显著低于治疗前,差异有统计学意义(t=3.020,9.024;P0.01)。两组均未发生严重药物不良反应,不良反应发生率差异无统计学意义(χ~2=0.313,P0.05)。结论:艾司西酞普兰联合CBT治疗隐匿性抑郁障碍临床疗效发挥更快,治疗依从性较好,远期疗效优于单用艾司西酞普兰;副反应较小,有较高安全性。     

音乐干预联合丁螺环酮治疗广泛性焦虑障碍的疗效观察

目的:探讨音乐干预联合丁螺环酮治疗广泛性焦虑障碍的疗效和副反应。方法:将80例广泛性焦虑障碍患者随机分为音乐干预联合丁螺环酮组(干预组)40例和单用丁螺环酮组(对照组)40例,治疗6周,采用汉密尔顿焦虑量表(HAMA)评定疗效,采用副反应量表(TRSS)评定副反应,治疗前、治疗后1周末、3周末、6周末分别评定一次。结果:治疗6周末干预组在HAMA总分、躯体焦虑因子、精神焦虑因子评分上(9.63±3.78,0.52±0.39,0.85±0.28)显著低于对照组(12.65±3.76,0.69±2.89,1.12±0.34),差异具有统计学意义(t=-3.59,-2.20,-3.81;P0.05)。结论:音乐干预联合丁螺环酮治疗能显著改善焦虑症状,治疗广泛性焦虑障碍的效果优于单用丁螺环酮。     

集体认知行为治疗对广泛性焦虑障碍疗效的随机对照研究

目的:探索集体认知行为治疗对广泛性焦虑障碍的临床疗效。方法:采用随机对照研究,最终纳入对照组(n=25)与干预组(n=33),两组均服用度洛西汀30~120 mg治疗。干预组除药物外,接受集体认知行为治疗,每周1次,每次90 min,共8次。采用汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD)、临床评估量表(CGI)在基线、第4周及第8周进行评估。CGI包括病情严重程度(SI)、疗效总评(GI)和疗效指数(EI)3个条目。结果:HAMA评分的重复测量方差分析结果显示,测量时间与分组处理的交互作用有统计学意义(F=4.35,P0.05)。干预组HAMA第4周及第8周的相对于基线的减分值大于对照组,而第4周的痊愈率及有效率高于对照组;在第8周测评点时,干预组HAMD相对于基线的减分值大于对照组,而CGI-SI与CGI-EI评分低于对照组。结论:与单独的药物治疗相比,在药物治疗基础上结合集体认知行为治疗能够早期起效,更为显著地改善广泛性焦虑障碍患者的焦虑症状、抑郁症状和总体病情。     

认知行为团体治疗对广泛性焦虑障碍患者生活质量改善作用

目的:探讨认知行为团体治疗对广泛性焦虑障碍患者生活质量改善作用。方法:将60例广泛性焦虑障碍患者按照随机数字表法分两组,对照组进行药物治疗,研究组在药物治疗同时进行认知行为团体治疗等康复干预。分别用汉密尔顿焦虑量表(HAMA)、席汉失能量表(SDS)、生活质量问卷(SF-12)对干预后两组患者精神状态、职业、生活质量进行评定和比较。结果:为期8周认知行为团体治疗治疗后,研究组在HAMA评分明显低于对照组(t=-8.837,P0.05),研究组在SDS总分、工作维度、社会生活维度和家庭生活维度评分上显著低于对照组(t=-3.849,-3.925,-3.582,-4.082;P0.05)。研究组SF-12生理维度评分上高于对照组(t=18.553,P0.01),及心理维度评分上高于对照组(t=20.884,P0.01),差异有统计学意义。结论:认知行为团体治疗能够改善患者焦虑情绪,显著降低复发率、提升患者积极情绪和生活质量。     

文拉法辛配合认知行为疗法治疗抑郁症对照研究

目的评价文拉法辛配合认知行为疗法对抑郁症的疗效。方法将64例抑郁症患者随机分为两组,研究组采用文拉法辛合并认知行为治疗,对照组仅用文拉法辛治疗,两组作8周持续治疗观察,于入组前及入组后第4,8周末分别用汉密尔顿抑郁量表(HAMD),汉密尔顿焦虑量表(HAMA)进行评定。结果①治疗前研究组和对照组HAMD、HAMA评分差异无统计学意义。第4周末研究组HAMD评分低于对照组(t=3.081,P<0.05),直至第8周末两组HAMD评分仍有差异(t=4.077,P<0.05);②第4周末研究组HAMA评分低于对照组(t=3.083,P<0.05),直至第8周末两组HAMA评分仍有差异(t=4.079,P<0.05)。结论文拉法辛配合认知行为疗法对抑郁症有效,并且远期疗效好。     

认知行为疗法合并帕罗西汀治疗重度抑郁的对照研究

目的:评价认知行为疗法合并帕罗西汀治疗重度抑郁的疗效和安全性。方法:将符合国际疾病分类(ICD-10)重度抑郁发作诊断标准的66例患者随机分为两组,研究组(n=34)给予认知行为疗法合并帕罗西汀治疗,对照组(n=32)给予帕罗西汀治疗,疗程12周。于治疗前和治疗后2、4、6、8、12周采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、临床总体印象疗效总评量表病情严重程度(CGI-SI)、不良反应量表(TESS)评定疗效和不良反应。结果:治疗前研究组和对照组的HAMD、HAMA评分差异无统计学意义(t=-0.88,0.93;P0.05)。治疗12周后,两组HAMD、HAMA评分均低于治疗前(研究组t=40.26,-27.29;P均0.01;对照组t=19.11,70.85;P均0.01);研究组6、8、12周HAMD、HAMA评分均低于对照组(t=-2.82,-2.84,-3.41;P均0.05;t=-2.14,-3.01,-3.34;P均0.05);研究组有效率高于对照组(χ2=4.799,P0.05);研究组不良反应发生率低于对照组(χ2=4.855,P0.05)。结论:认知行为疗法合并帕罗西汀治疗重度抑郁疗效较好,安全性高。     

认知行为疗法治疗高三学生考前焦虑

目的探讨认知行为疗法(CBT)对高三学生过度考前焦虑的疗效。方法在唐山市某重点高中和某普通高中心理咨询室筛查一定数量有过度考前焦虑的高三学生,应用CBT进行治疗,分别于治疗前、治疗4周和治疗8周后用焦虑自评量表(SAS)和汉密尔顿焦虑量表(HAMA)进行评定,结果进行统计分析。结果经CBT治疗4周后,焦虑自评量表和汉密尔顿焦虑量表评分均显著低于治疗前(t=1.79,6.21;P<0.05);治疗8周后,焦虑自评量表和汉密尔顿焦虑量表评分继续下降,与治疗前相比具有显著差异(t=1.11,7.63;P<0.01)。结论 CBT治疗过度考前焦虑起效快,疗效肯定且随着治疗的深入而递增。     

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.