50例住院伤残荣誉军人SAS、SDS问卷调查

目的探讨住院伤残荣誉军人的焦虑、抑郁情绪.方法应用焦虑自评量表(SAS)、抑郁自评量表(SDS)进行测查.结果住院伤残荣誉军人SAS均分、SDS均分明显高于常模,二者差异有非常显著性(P<0.01),不同残疾等级间SAS、均分、SDS均分差异无统计学意义(P>0.05);不同年龄间SDS均分差异无统计学意义(P>0.05),SAS均分差异有显著性(P<0.05).结论住院伤残荣誉军人存在较严重的心理卫生问题.     

PBL教学法在医学心理学教学中的应用

①目的探讨PBL教学法在医学心理学教学中的应用价值,以提高医学心理学教学质量.②方法以青岛大学医学院1999级1、2班作为实验班,3、4班作为对照班,实验班采用教师讲授结合以问题为中心的教学法(PBL教学法),对照班采用以教师讲授为主的传统教学方法.③结果实验班与对照班学生基础知识考试成绩比较差异无显著性(t=1.61,P>0.05);而病历分析题考试成绩、总分比较差异有显著性(t=6.86、3.75,P<0.001).④结论 PBL教学方法在促进学生学习积极性,提高学生对知识的应用能力及发挥学生学习主体作用等方面明显优于传统教学方法.     

心理护理干预对行电切术前列腺增生症患者的影响

目的探讨心理护理干预对行电切术前列腺增生症(BPH)患者的影响。方法将80例拟行经尿道前列腺电切术的BPH患者随机分为对照组和观察组各40例,对照组接受常规治疗和护理,观察组在此基础上给予心理护理干预。分别于干预前后1wk采用抑郁自评量表(SDS)和焦虑自评量表(SAS)对两组患者进行评估,观测膀胱冲洗、留置尿管及平均住院的天数及并发症的发生率,并进行对比分析。结果干预后观察组的SAS和SDS评分较干预前明显降低,差异有统计学意义,均P&lt;0.01(t=28.071,22.179),且明显低于同期对照组,差异有统计学意义,均P&lt;0.01(t=7.151,4.829)。观察组术后膀胱冲洗、留置尿管及平均住院天数明显少于对照组,差异有统计学意义,均P&lt;0.01(t=3.096,4.037,15.029)。观察组术后并发症总发生率为17.5%。而对照组为40.0%,两组间差异有统计学意义,P&lt;0.05(X2=4.943)。结论心理护理干预有利于缓解行电切术前列腺增生症患者负性情绪,缩短患者术后康复时间,减少术后并发症的发生。     

应激中唾液免疫功能变化与心理健康状况的关系

目的探讨应激过程中唾液免疫功能变化和心理健康状况的关系.方法选取57名高中学生,测定考试(应激)前后唾液分泌性免疫球蛋白A(SIgA)、唾液皮质醇(Cor)含量,并评定其心理健康状况.结果考试后学生SCL-90评定中强迫、焦虑、敌对、偏执四个因子分高于全国常模(P<0.01),其他因子比较未见明显差异(P>0.05),考试前SCL-90总均分<2.0组学生唾液SIgA分泌量高于≥2.0组(P<0.05);考试后SCL-90总均分<2.0组学生唾液SIgA分泌量高于≥2.0组(P<0.01);考试后两组学生唾液SIgA分泌量明显低于考试前(P<0.01),二组学生考试前后SIgA变化率有明显差异(P<0.05),Cor变化率未见明显差异(P>0.05).结论应激、心理健康状况对免疫功能有重要影响.     

大学新生网络成瘾倾向与心理健康状况的关系

目的 了解目前有网络成瘾倾向大学新生的心理健康状况以及人格特质,探讨影响网络成瘾倾向的相关因素,为预防和早期干预网络成瘾行为提供理论依据.方法 采用台湾陈淑惠编制的中文网络成瘾问卷修订版(CIAS-R)、焦虑自评量表(SAS)、抑郁自评量表(SDS)以及症状自评量表(SCL-90),对南京某大学904名新生进行问卷调查.结果 根据CIAS-R量表判断标准,其中27人(3.7%)被定义为网络成瘾倾向高的学生,称为高危险组,其他则为对照组.男生在CIAS-R量表上的得分[(35.3±9.7)分比女生(31.4±7.0)分]要高,并且差异有显著性(x2=74.649;P<0.01);高危险组在SAS、SDS、SCL-90上的得分[(47.4±9.8)分,(48.4±12.1)分,(184.8±72.5)分]与对照组得分[(40.1±6.7)分,(42.5±9.9)分,(133.0±34.2)分]差异有显著性(x2=-3.881,P<0.01;x2=-2.471,P<0.05;x2=-3.850,P<0.01);CIAS-R量表与其他几个量表的相关系数均差异有显著性;影响CIAS-R量表得分的主要因素是SAS总分(t=3.699,P<0.01)、SDS总分(t=2.356,P<0.05)、强迫因子(t=2.023,P<0.05)、焦虑因子(t=2.046,P<0.05)和敌对因子(t=2.669,P<0.01),回归系数分别为0.181,-0.113,0.196,-0.187,0.161.结论 男生比女生更容易有网络成瘾倾向;高危险组学生存在更多的心理症状,焦虑、抑郁、心理健康状况的所有因子症状均比对照组严重;大学生网络成瘾倾向受到众多心理健康因素的影响.     

心理干预对预备役参训官兵心理健康的作用

目的探讨心理干预对预备役参训官兵心理健康的作用。方法将300名官兵分为干预组(n=150)与对照组(n=150),干预组接受心理干预,对照组未接受心理干预。采用症状自评量表(Symptom Checklist 90,SCL-90),对两组训练前后的心理健康状况进行测评;测评干预组干预前后的焦虑自评量表(Self-Rating Anxiety Scale,SAS)和抑郁自评量表(Self-Rating Depression Scale,SDS)得分情况。结果两组训练前SCL-90得分无统计学差异(P>0.05);训练后干预组的SCL-90得分明显低于对照组(P<0.01或0.05);干预组心理干预后SAS、SDS得分明显低于干预前(P<0.01)。结论心理干预对参训官兵心理健康有较好的促进作用。     

综合心理行为训练对军事应激条件下新兵心理健康和血糖的影响

目的: 探讨采用心理教育、心理咨询、呼吸放松训练和心理行为训练相结合的综合心理行为训练,对军事应激条件下新兵心理健康和血糖的影响. 方法: 从某部抽取2个新兵集训连的126名新兵随机分为实验组(n=62)和对照组(n=64),综合心理行为训练前后采用症状自评量表(SCL-90),焦虑自评量表(SAS),抑郁自评量表(SDS)进行心理健康的评估,并分别测定5 km武装越野前后血糖的变化. 结果: 实验后实验组SCL-90总分、躯体化、抑郁、偏执、SAS总分和SDS总分,以及应激后血糖均显著低于对照组(P<0.05);实验组实验前后的各评定指标均无显著性差异(P＞0.05);对照组实验后的躯体化、抑郁、偏执、SAS与SDS总分显著高于实验前(P<0.05),应激后血糖显著高于应激前(P<0.01). 结论: 综合心理行为训练有助于提高新兵的心理健康水平,降低新兵对军事应激的心理和生理反应.     

阿片类药物对肺癌疼痛患者心理状态影响的研究

目的探讨阿片类药物对肺癌疼痛患者心理状态的影响。方法选取2010年8月~2015年1月间收治的200例初治肺癌疼痛患者作为研究对象,所有患者均给予阿片类药物治疗,2个月后对治疗前后患者的疼痛程度(VAS)、心理健康程度(SCL90)、焦虑程度(SAS)、抑郁程度(SDS)评分进行比较,同时分析心理状态变化的影响因素。结果镇痛治疗前,200例肺癌疼痛患者的SCL-90、SAS、SDS评分均高于国内常模(t=13.55、8.37、5.46,P0.01)。Logistic多因素回归分析,其心理状态的主要影响因素为癌痛程度、患者的文化程度、病程、患者家属支持及对癌性疼痛的了解程度。经2个月的镇痛治疗后,患者的VAS、SCL-90、SAS及SDS等评分均较治疗前有所改善(t=11.28、22.31、9.66、7.52,P0.05或P0.01),但SCL-90、SAS、SDS评分仍高于国内常模(t=10.92、3.18、6.25,P0.01)。Logistic多因素回归分析,其心理状态的主要影响因素是其他不适症状、对药物副反应的担心、经济因素及文化程度。结论肺癌疼痛患者普遍存在抑郁、焦虑等不良心理状态,阿片类药物可以有效缓解疼痛程度,并在一定程度上改善患者的心理状态。     

伽玛刀术前心理干预对颅内肿瘤患者负性情绪的影响

目的 探讨心理干预对颅内肿瘤患者在接受伽玛刀治疗前情绪障碍的影响.方法 采用认知行为疗法、刺激暴露疗法等心理干预措施,对260例存有心理负性情绪的颅内肿瘤患者进行伽玛刀治疗前的心理干预.采用症状自评量表(SCL-90)、焦虑自评量表(SAS)、抑郁自评量表(SDS),对干预前后进行测评和对照比较.结果 干预前SCL-90、SAS、SDS总分分别为69.12±34.26、40.24±10.28和42.48±12.72,与正常人群比较(41.13±22.36,30.16±8.02,32.98±9.13)差异有显著性(P ＜0.01);干预后患者SCL-90、SAS、SDS总得分分别为49.36±31.22、32.16±7.08和36.166±7.98,与干预前比较差异显著(P ＜0.01).结论 对接受伽玛刀治疗的颅内肿瘤患者进行有针对性的术前心理干预,可以改善患者的焦虑、抑郁等负性情绪,对顺利进行伽玛刀治疗和康复预后具有积极的意义.     

团体心理干预对洪灾灾后居民情绪调节的应用研究

目的 探讨团体心理干预对洪灾灾后居民焦虑、抑郁情绪的效果.方法 按随机数字表法将364例江西抚州地区洪灾灾后居民随机分为干预组和对照组,每组182例.干预组进行为期1个月的一般性社会支持和团体心理治疗,对照组则仅给予一般性社会支持.以焦虑自评量表(SAS)和抑郁自评量(SDS)表评估疗效.结果 干预前,干预组和对照组洪灾灾后居民SAS、SDS评分差异均无统计学意义(t=-0.225,P>0.05;t=-1.795,P＞0.05);干预后,干预组灾后居民的SAS、SDS评分低于入组时,差异有统计学意义(t=-14.795,P＜0.01;t=-19.600,P＜0.01);对照组灾后居民的SAS、SDS评分低于入组时,差异有统计学意义(t=-13.347,P＜0.01;t=-11.784,P＜0.01);干预组和对照组SAS、SDS评分差异有统计学意义(t=5.063,P＜0.01;t=2.764,P＜0.01).结论 团体心理干预对洪灾灾后居民焦虑及抑郁情绪的改善有重要作用.     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.