新型冠状病毒肺炎与心理健康：从生理机制到社会影响

新型冠状病毒肺炎造成了全球大流行, 病死率达到3.4%, 主要是由严重的肺炎引起。但是, 新型冠状病毒对中枢神经系统和心理健康的影响尚不清楚。有证据表明, 受感染的患者可能会出现某些心理病理症状, 包括抑郁、焦虑等情绪障碍以及创伤后压力有关的症状。从全球的角度看, 新型冠状病毒肺炎大流行可能会对人们精神健康产生巨大影响, 其中医务工作者等防疫一线工作人员尤其容易受到影响。本文通过对研究新型冠状病毒肺炎对中枢神经系统和心理健康结局的影响进行了综述, 以期厘清新型冠状病毒肺炎与精神障碍的关联, 并从公共卫生的角度总结新型冠状病毒肺炎的影响。     

新型冠状病毒肺炎流行期间医护人员心理健康与应对方式相关性研究

目的 调查新型冠状病毒肺炎(COVID-19)流行期间六安市区三家三级医院医护人员心理健康的现状,分析医护人员心理健康水平与应对方式的关系。方法 于2020年2月7日～2月15日,使用问卷星形式,采用焦虑自评量表、抑郁自评量表及简易应对方式问卷调查COVID-19流行期间六安市区三家三级医院360名医护人员心理状况,分析医护人员焦虑、抑郁水平及其与应对水平的相关性。结果 COVID-19流行期间六安市区三家三级医院医护人员焦虑粗分(32.82±7.80)分,抑郁粗分(37.90±8.30)分,均高于中国常模,差异有统计学意义(P<0.05)。焦虑阳性者(总粗分≥40分)68例(18.9%),抑郁阳性者(总粗分≥41 分)138例(38.4%);医护人员应对方式总分9～60分,平均为(36.61±8.55)分。积极应对6～36分,平均为(24.49±6.14)分。消极应对1～24分,平均为(12.12±4.19)分;偏相关分析显示,医护人员焦虑得分与积极应对呈负相关(r=-0.315,P<0.05),与消极应对呈正相关(r=0.147,P<0.05)。抑郁得分与积极应对呈负相关(r=-0.374,P<0.05),与消极应对呈正相关(r=0.207,P<0.05)。结论 COVID-19流行期间医护人员存在不同程度的焦虑和抑郁,疫情期间医护人员的心理健康与积极应对方式呈正相关,与消极应对方式呈负相关。     

新型冠状病毒肺炎应激障碍的药物治疗

2019年12月以来,湖北省武汉市不断出现新型冠状病毒感染病例,并逐渐扩散至全国。该病毒传染性高且患者感染病毒后有一定的死亡率。本次疫情中,许多患者在治疗期间出现不同程度的心理应激障碍。本文就新型冠状病毒肺炎疫情期间心理应激障碍相关治疗药物展开综述。其中,在西药方面,介绍了氟哌噻吨、奥氮平等临床疗效与局限性;在中药方面,总结了四逆散、金匮肾气丸等疗效。     

新型冠状病毒肺炎动物模型研究进展

新型冠状病毒肺炎（COVID-19）疫情严重威胁人类健康,已经被列为全球突发公共卫生事件。现已报道的COVID-19动物模型有非人灵长类、腺病毒转导人血管紧张素转化酶2(hACE2)野生型小鼠、叙利亚金黄地鼠、hACE2转基因小鼠、雪貂和中国树鼩等易感动物模型。本文介绍制备各模型的病毒接种途径、病毒接种剂量、模型评价指标及其在疫苗或药物筛选方面的应用,并总结它们的优缺点,以期为治疗COVID-19药物研发选择合适的动物模型提供参考。     

新型冠状病毒肺炎疫情期间医护人员的心理状况和影响因素研究

目的 调查新型冠状病毒感染肺炎疫情蔓延期间医护人员的心理状况并探讨影响心理状况的因素。方法 选取2020年1月20日至2月11日合肥市某三甲医院参与抗击新型冠状病毒肺炎疫情的195名医护人员,应用症状自评量表（SCL-90）调查心理状况,并对结果进行分析。结果 195名医护人员中有35人（17.9%）SCL-90总分≥160分,另有22.6%的医护人员有强迫的阳性症状。医护人员SCL-90总分、人际敏感、敌对、偏执4项阳性因子分值均低于中国常模,差异有统计学意义（P<0.05）。多因素logistic回归分析发现护士职业是影响医护人员心理状况的危险因素（P<0.05）。结论 医护人员在新型冠状病毒肺炎疫情期间心理状况总体正常,但存在一定比例的心理异常症状,护理人员明显,应建立个性化有效的心理干预措施,确保疫情期间医护人员能顺利完成任务。     

新型冠状病毒肺炎应以防控为首

2019年12月起,武汉市发生新型冠状病毒肺炎疫情,此新型病毒暂被命名为2019-nCoV。该病毒潜伏期长,传染性强,目前尚无特效针对性药物治疗。抗疫工作重心更应倾向于防控,治疗感染患者的同时切断病毒传播途径,保护健康人群。该文结合国家卫生健康委员会相关防控办法、最新医疗资讯、报道、临床治疗经验等,研究制定疫情防控方案,旨在探讨新形势下,应对新型冠状病毒的防控工作如何制定更全面的防控举措及方法,更大程度上减少交叉感染及疫情蔓延,为疫情防控工作提供新的建议和思路。     

新型冠状病毒肺炎患者55例临床分析

目的分析55例新型冠状病毒肺炎(COVID-19)患者的临床特征及治疗。方法回顾性分析55例COVID-19患者的临床资料,分析患者的流行病学特点、临床表现、实验室检查、影像学表现和治疗及转归。结果 55例患者中,轻型1例,普通型51例,危重型3例。患者首发症状以发热、咳嗽为主,2例患者入院时无明显症状。患者潜伏期(4.56±2.43) d,就诊时病程(4.55±1.56) d,住院时间(15.25±4.68) d。部分患者出现白细胞计数、淋巴细胞计数、中性粒细胞计数和白蛋白降低,CRP、D-D、ALT、AST、SCr升高。85.45%患者胸部CT表现为单肺或双肺多发磨玻璃样病灶。针对COVID-19最常见的治疗方法为阿比多尔+洛匹那韦/利托那韦+干扰素吸入,部分患者使用抗菌药物或糖皮质激素治疗。所有患者病情好转,52例患者治愈出院,3例转至其他医院继续治疗。结论 COVID-19以普通型为主,规范合理使用抗病毒药物可改善患者病情。     

新冠肺炎疫情防控背景下中药学专业线上教学模式研究

本文通过开展调研活动,对新冠肺炎疫情防控期间中药学专业线上教学模式运行的现状进行分析,对比不同教学模式的优缺点,分析影响学生学习效果的因素,针对线上教学过程中存着的问题提出相应的解决方案。注重弘扬战疫精神,激发学生爱国热情和坚定传承发展中医药事业的决心,为今后线上教学模式的改革提供依据,促进信息技术与教育教学深度融合。     

新型冠状病毒肺炎疫情下妇幼保健机构药学服务模式探讨

2019年12月以来,湖北省武汉市陆续发现了多例新型冠状病毒肺炎(COVID-19)患者,随着疫情在全国蔓延,全国各地积极采取疫情防控措施。为保障疫情期间药学工作顺利开展,进一步做好疫情期间“以患者为中心,科学防控”的药学服务,为临床一线医务人员提供有利支持,笔者基于新型冠状病毒的特点和药学日常工作的积累探索建立了药学服务模式策略,旨在为广大一线药学人员防控感染提供参考和帮助。     

利巴韦林在新型冠状病毒肺炎治疗中的应用及注意事项

目前针对新型冠状病毒肺炎尚无特效药物,一些药物可能在体外研究中有效,但仍处于临床试验阶段,临床应用需谨慎。利巴韦林是核苷类广谱抗病毒药物,临床上多用于治疗呼吸道合胞病毒引起的病毒性肺炎与支气管炎、皮肤疱疹病毒感染等。本文以国内外文献为基础,对利巴韦林的抗病毒作用机制、药代动力学、药效学、体外研究、既往冠状病毒中的应用、临床应用、用法用量、治疗药物监测及不良反应等方面进行综述,为利巴韦林的临床应用提供参考。     

跨海登陆演习对军人心理和生理功能的影响

目的探讨跨海登陆演习对官兵心理和生理功能的影响。方法采用放射免疫方法(RIA)检测参演官兵演习前后血清白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子(TNF)、血清皮质醇和醛固酮水平,应用军人心理应激自评问卷(PSET)进行心理状态的调查,将血清学检测结果与军人心理应激自评结果进行相关性分析。结果参加演习后血清IL-2降低和IL-6、IL-8、TNF升高,与演习前比较有显著性差异(P<0.05),而演习后PSET分值≥70官兵IL-2降低和IL-6、IL-8、TNF升高更明显(P<0.05);126名官兵参加演习后血清皮质醇和醛固酮均升高,与演习前比较有显著性差异(P<0.05),演习后PSET分值≥70官兵血清皮质醇和醛固酮升高更明显(P<0.05)。结论登陆演习作为一种强烈的应激行为对机体免疫系统产生一定的抑制,也可引起人体内分泌激素水平的改变,有必要选择适宜的心理训练和体能训练来提高官兵的免疫能力和心理应激能力。     

Health advice provided to hostelers from Australia: influence of a travelers' information evening

BACKGROUND: Little is known about the health advice provided to hostelers and the role and influence of hosteling organizations' travelers' information evenings in giving travel health advice. This study was designed to investigate these in relation to the Australian context. METHODS: In 1997, hostelers attending travelers' information evenings in two regional centers and one metropolitan location in Queensland were asked to complete self-administered questionnaires. RESULTS: Of 158 questionnaires, 110 (69.6%) were returned. Missing data have been excluded from the analysis. About two-thirds of the hostelers attending the travelers' information evening reported being age 35 years or younger (43/65, 66.2%). Almost two-thirds of attendees were female (42/65, 64.6%). The hostelers responding to this study were fairly evenly divided between regional centers (54/110, 49.1%) and the metropolitan center (56/110, 50.9%). Hostelers indicated that they were traveling to Europe and the United Kingdom (53/62, 85.5%), Canada (17/62, 27.4%), Asia (15/62, 24.2%), United States (10/52, 19.2%), and other destinations (7/51, 13.7%), mostly Africa. Hostelers were significantly more likely to have obtained travel health advice (x = 5.02, df = 1, p <.05) if they were traveling within 6 weeks. Hostelers indicated that they obtained advice from general practitioners (41/67, 61.2%), travel agents (29/67, 43.3%), books (22/67, 32.8%), travel clinics (10/67, 14.9%), and other sources (6/67, 9.0%). Most hostelers indicated that they learnt something new about healthy travel from the travelers' information evening (76/100, 76.0%). Of those hostelers who had not sought travel health advice or who had not planned to seek travel health advice prior to the travelers' information evening, almost all indicated that they now would seek travel health advice (32/33, 97.0%). CONCLUSIONS: This cross-sectional study found that most hostelers attending an international hosteling organization's travelers' health information session in Australia were in the younger age groups and were predominantly female. Most of these hostelers had sought travel health advice from general practitioners, travel agents, and books. The information provided by the healthy travel session of the travelers' information evenings appeared to be of some benefit to hostelers, particularly as it appeared to have prompted most hostelers who had not yet sought travel health advice to do so.     

A social media microinfluencer intervention to reduce coronavirus disease 2019 vaccine hesitancy in underserved Tennessee communities: A protocol paper

BackgroundCentral to effective public health policy and practice is the trust between the population served and the governmental body leading health efforts, but that trust has eroded in the years preceding the pandemic. Vaccine hesitancy among adults is also a growing concern across the United States. Recent data suggest that the trustworthiness of information about the coronavirus 2019 (COVID-19) vaccine was a larger concern than the vaccine’s adverse effects or risks.ObjectiveThis study aims to describe the methods used to create a public health microinfluencer social media vaccine confidence campaign for the COVID-19 vaccine in underserved Tennessee communities. A secondary objective is to describe how the Social-Ecological Model (SEM) and Social Cognitive Theory may address vaccine hesitancy using community pharmacies.MethodsIn late 2020, 50 independent community pharmacies in underserved communities across Tennessee were involved in a public health project with the State of Tennessee Department of Health and the University of Tennessee Health Science Center College of Pharmacy. The project involved a 3-pronged, pharmacy-based COVID-19 vaccination outreach project, including (1) social media messaging (i.e., microinfluencer approach), (2) community partner collaboration, and (3) in-pharmacy promotion. Quantitative and qualitative data will assess the quality and effectiveness of the program. Social media outcomes will also be assessed to measure the impact of the microinfluencer social media training.ResultsProject implementation is planned for 6 months (January 2021 to June 2021) after an initial month of planning by the research team (December 2020) and preceding several months of assessment (July 2021 and beyond).ConclusionsNovel, theory-based approaches will be necessary to improve vaccine confidence. One approach to promoting public health, derived from the SEM, may be to use trusted microinfluencers on social media platforms, such as local community pharmacists and community leaders.     

Prenatal exposure to methylmercury and child development: influence of social factors

BACKGROUND: In the Seychelles Child Development Main Study (SCDS), at 19 months of age, enhanced MDI scores were associated with increasing methylmercury (MeHg) exposure in higher caregiver IQ groups at several levels of family income. We performed a similar analysis of the 66-month evaluations to determine if the modifying influences of social and environmental factors were consistent with those previously observed. METHODS: Prenatal MeHg exposure was determined by analysis of maternal hair growing during pregnancy. Children in the cohort (N=711) were evaluated for cognitive ability (McCarthy Scales of Children's Abilities), language development (Preschool Language Scale), drawing and copying (Bender Gestalt Test), scholastic achievement (the Woodcock-Johnson Test of Achievement), and behavior (the Child Behavior Checklist). Interactions between prenatal MeHg exposure and caregiver intelligence, socioeconomic status (SES), home environment, and gender were examined by multiple regression analysis. RESULTS: The median prenatal MeHg exposure was 5.9 ppm (range=0.5-26.7 ppm). Gender significantly influenced the association between prenatal exposure and drawing and copying; however, the effects were not consistent. Prenatal exposure interacted with one or more social or environmental covariates for general cognitive ability, overall language ability, and prearithmetic achievement. Again, the effects were not consistent across either endpoints or covariate categories. CONCLUSIONS: Evidence of a small influence by social and environmental variables at 66 months is neither internally consistent nor consistent with earlier results. Overall, a consistent pattern of effect modification (EM) has not been observed, suggesting that the results may be due to chance.     

军事演习对官兵生理指标的影响及心理行为训练

目的研究军事演习应激对官兵生理机能和数字搜索能力的影响及其心理行为训练的效果。方法以某部参加军事演习的186名官兵为研究对象,随机分为研究组和对照组各93名。研究组演习前进行4周的心理行为训练干预。在干预开始前2d内(演习前)和演习结束后2d内(演习后),分别对两组进行血压和心率测量、最大摄氧量(VO2max)测定、数字搜索能力测试(FST)。结果组内比较,研究组演习前、后各项指标变化不显著(P>0.05);对照组演习后收缩压、舒张压和心率波动范围分别高于演习前(P<0.01),VO2max和FST总分分别低于演习前(P<0.05)。组间比较,演习后研究组收缩压、舒张压、最大心率和心率波动范围均低于对照组演习后(P<0.05),VO2max和FST总分均高于对照组演习后(P<0.01)。结论军事演习应激导致官兵明显的生理和心理应激反应,心理行为训练可减轻军演应激反应的程度。