肝癌与乳癌患者情绪障碍的调查分析

目的 :探讨肝癌与乳癌患者抑郁、焦虑情绪的发生率以及这两种情绪障碍对肿瘤的发生、发展及预后的影响。方法 :采用Zung抑郁自评量表 (SDS)、Zung焦虑自评量表 (SAS)对肝癌组、乳癌组、非癌性疾病对照组各 6 5例进行评定。结果 :抑郁发生率 :肝癌 43 0 8% ,乳癌 2 0 % ,对照组 9 2 3%。焦虑发生率 :三组分别为 2 4 6 2 %、40 %、13 6 %。两组癌症抑郁、焦虑均分都显著高于对照组 (P <0 0 0 1)。结论 :肝癌、乳癌患者与非癌患者相比存在明显的情绪障碍 ,在抑郁、焦虑情绪表达上 ,两组癌症亦有差异。提示合理的针对性心理干预在癌症的控制及生存质量提高上其意义是毫无置疑的     

肠易激综合征患者的个性与心理评估

目的 探讨个性、焦虑、抑郁等精神心理因素与IBS的关系.方法 采用龚耀先修定的艾森克个性问卷(EPQ)、症状自评量表(SCL-90)、Zung氏抑郁自评量表(SDS)、焦虑自评量表(SAS)评测100例肠易激综合征(IBS)患者的个性、精神心理状态,并与健康对照组(100例)的相数据对比.结果 在EPQ量表中,IBS组的E(性格内-外向)分值低于健康组(P＜0.05)、N(神经质)分值高于健康组(P＜0.05);在SCL-90中,IBS患者的躯体化、强迫症状、人际关系、抑郁、焦虑、敌对、恐怖、偏执、精神病性、睡眠饮食障碍各项分值高于健康组(P＜0.05);在SAS、SDS中,IBS患者的分值高于与健康组(P＜0.05).结论 个性、负性情绪(焦虑、抑郁)与IBS密切相关,并且较易产生各种躯体症状.     

健康教育对乳腺癌患者焦虑、抑郁情绪的影响

目的:探讨健康教育对乳腺癌患者焦虑抑郁情绪的影响效果。方法:将40例乳腺癌患者随机分为观察组和对照组各20例。对照组进行常规健康教育,观察组同时实施患者和家属的个性化健康教育。采用Zung焦虑自评量表(SAS)和Zung抑郁自评量表(SDS),分别于入院时和术后1周对两组患者进行评分。结果:健康教育前,观察组与对照组在焦虑、抑郁方面的评分比较差异无统计学意义。健康教育后,焦虑、抑郁各方面的指标评分观察组显著优于对照组。结论:对乳腺癌患者及家属同步实施个性化健康教育,可以改善患者焦虑、抑郁等方面的不良情绪。     

原发性高血压患者的心理状况对睡眠质量的影响

目的探讨原发性高血压患者的心理状况对睡眠质量的影响。方法84例原发性高血压患者均接受心理症状自评量表(SCL-90)和抑郁自评量表(SDS)、焦虑自评量表(SAS)以及睡眠质量调查表调查。SCL-90得分越高,说明患者心理问题越多。根据抑郁及焦虑评分分组,两组进行原发性高血压患者的睡眠质量总分及各项因子评分比较。结果84份问卷均完整合格。原发性高血压患者的躯体化、人际关系、抑郁、焦虑、恐怖和偏执等心理症状因子评分明显高于对照组(P<0·05)。原发性高血压患者中抑郁自评量表标准分≥50分者31例(36·9%)为抑郁组,焦虑自评量表标准分≥50分者35例(41·7%)为焦虑组。抑郁组的睡眠质量总分、入睡、睡眠维持、睡眠自评及睡眠总时间明显高于对照组(P<0·05)。焦虑组的睡眠质量总分、入睡、睡眠维持、睡眠自评及睡眠总时间明显高于对照组(P<0·05)。结论原发性高血压患者存在明显的抑郁、焦虑等心理症状,严重影响其睡眠质量。     

护理干预对冠心病患者焦虑、抑郁情绪的影响

目的:探讨护理干预对冠心病患者焦虑抑郁情绪的影响效果。方法:将40例冠心病患者随机分为干预组和对照组各20例。对照组进行常规护理,干预组对患者实施护理干预。采用Zung焦虑自评量表(Self-Rating Anxiety Scale SAS)和Zung抑郁自评量表(Self-rating depression scale,SDS),分别于入院时和术后3周对两组患者进行评分。结果:护理干预前,干预组与对照组在焦虑、抑郁方面的评分比较,差异无统计学意义(P>0.05)。护理干预后患者在焦虑、抑郁各方面的指标评分干预组显著优于对照组。结论:对冠心病患者及家属同步实施个性化护理干预,可以改善患者焦虑、抑郁等方面的不良情绪。     

126例高血压患者焦虑抑郁情绪的调查分析

目的 分析原发性高血压患者焦虑抑郁情绪的伴发情况.方法 采用Zung编制的焦虑自评量表(self-rating anxiety scale,SAS)和抑郁自评量表(self-rating depression scale,SDS),对原发性高血压患者126例和体检健康者120例进行评定分析.结果 高血压组焦虑发生率35.7%,抑郁发生率15.9%;对照组焦虑发生率25.8%,抑郁发生率6.6%.高血压组SAS、SDS得分明显高于对照组,差异有统计学意义(P<0.05).结论 部分原发性高血压患者存在明显焦虑抑郁情绪,应加强临床医生对焦虑抑郁症状的识别.     

成人偏头痛患者并发焦虑/抑郁状况及睡眠特点分析

目的研究成人偏头痛患者并发焦虑/抑郁障碍的状况,了解偏头痛患者的睡眠特点。方法本研究选择成人偏头痛患者94例,正常对照60例。应用一般资料问卷、焦虑自评量表(SAS)、抑郁自评量表(SDS)及匹兹堡睡眠量表(PSQI)问卷对上述研究对象进行问卷调查。通过对偏头痛组和正常对照组的焦虑/抑郁情绪及睡眠状况进行评估和比较,了解偏头痛患者并发焦虑/抑郁的状况,并了解偏头痛患者的睡眠特点。结果 (1)偏头痛患者中并发焦虑/抑郁的比例为46.8%/50.0%,以并发轻度焦虑/抑郁最常见,(轻度25.5%/28.7%,中度16.0%/12.8%,重度6.4%/8.5%);偏头痛患者并发情绪障碍以焦虑、抑郁共存为主(44.7%)。(2)偏头痛患者失眠症发生率58.5%,存在主观睡眠质量差、入睡时间长、睡眠短缺、睡眠效率低、睡眠难维持及日间功能障碍等睡眠特点。结论偏头痛患者并发焦虑抑郁及睡眠障碍比例明显高于正常人群,偏头痛患者中,焦虑/抑郁障碍与睡眠障碍相互影响。     

心理干预对慢性支气管炎伴焦虑和抑郁患者的影响

目的:探讨心理干预对慢性支气管炎伴焦虑、抑郁患者的影响.方法:选择伴有抑郁、焦虑情绪障碍的87例慢性支气管炎患者,并将其随机分成两组.对照组患者仅给予常规治疗,研究组患者在常规治疗基础上给予心理干预3周.观察治疗前后两组患者Zung氏焦虑自评量表(SAS)和抑郁自评量表(SDS)评分.结果:与对照组比较,研究组患者SAS、SDS评分显著降低(P＜0.01).结论:心理干预可明显改善慢性支气管炎伴焦虑、抑郁患者的心理健康状态,提高其心理应激水平.     

连续护理干预对老年脑卒中患者负性情绪及睡眠障碍的影响

目的:探讨连续护理干预对老年脑卒中患者的负性情绪及睡眠障碍的影响。方法:选择老年脑卒中患者112例,随机分为观察组和对照组,各56例。对照组患者进行常规护理干预,观察组患者在常规护理的基础上采用连续护理干预。对2组患者干预前后的抑郁自评量表、焦虑自评量表评分情况及干预后睡眠障碍改善情况进行比较。结果:观察组干预后的抑郁自评量表和焦虑自评量表评分均明显低于干预前和对照组 （P < 0.01）。观察组干预后匹兹堡睡眠质量指数量表评分的降低程度均明显优于对照组（P < 0.01）。结论:对老年脑卒中患者实施连续护理干预,可明显减轻患者的负性情绪,改善患者的睡眠障碍。     

心理干预在重型肝炎护理中的作用

目的分析一般支持性心理治疗和认知疗法在重型肝炎护理中的作用。方法将56例重型肝炎患者随机分为两组。两组均接受相应的内科综合治疗及护理措施,治疗组同时采用支持性心理治疗和认知疗法。用症状自评量表(SCL-90),Zung焦虑自评量表(SAS),Zung抑郁自评量表(SDS)分别评估治疗后两组患者的心理状况,并进行对比。结果治疗组实施心理干预后SCL-90躯体化,焦虑、抑郁精神症状得分与对照组间差别有显著性意义(P<0.05)。结论心理干预能有效改善重型肝炎患者的身心症状。     

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.