强迫症患者及其一级亲属的三维人格特征

目的 探讨强迫症(OCD)患者及其一级亲属的三维人格特征.方法 采用三维人格问卷对329例正常对照,84例OCD患者和48例强迫症一级亲属(OCDF)进行测评.结果 OCD组寻求刺激因子1(novelty-seeking,NS1)、奖赏依赖因子3(reward-dependence,RD3)因子得分低于正常对照组(P<0.05).OCD组NS、躲避伤害(harm-avoidance,HA)维度得分高于OCDF组(P<0.05).结论 OCD组和OCDF组三雏人格特征都表现为HA高分,NS和RD低分,两组三维人格特征具有相似性.     

森田疗法绝对卧床期前、后强迫症患者的脑诱发电位变化

森田疗法被认为可以让患者从自我束缚中解放自己,通过阻断不良应激与症状之间的恶性循环,减轻症状所带来的不良后果及扩大注意力的广度,同时可以让患者更自如地处理所面对的其他事情。森田疗法的适应证主要为内省力和完善欲较强的所谓的森田神经质,包括强迫症(OCD)和焦虑症。本研究检测绝对卧床期前、后OCD患者4种脑诱发电位的变化,现报道如下。     

强迫症患者人格特征与临床症状的关系

目的 探讨强迫症患者的人格特征及其与临床症状的相关性.方法 采用耶鲁-布朗强迫量表(Y-BOCS)和明尼苏达多相人格测定问卷(MMPI)对105例强迫症患者进行测试,并与中国常模对照.结果 强迫症患者的D、Hy、Pd、Pt因子标准分及男性Hs和女性Pa因子标准分均显著高于常模.强迫症患者明尼苏达多相人格测定的D、Pd与强迫思维分呈正相关;Pa、Sc、Si与强迫思维及强迫行为分均成正相关;Pt与强迫思维分、强迫行为分及强迫总分均呈正相关.结论 强迫症患者可能存在病态心理状态;强迫症患者的人格特征与其临床症状可能存在一定的相关性. Abstract： Objective To study the personality of obsessive-compulsive disorder(OCD) patients, and the relationship between the clinical symptoms and the personality of OCD patients. Methods One hundred and five OCD patients were tested with Y-BOCS and MMPI, the result was compared with the chinese normals. Results The MMPI scores of D,Hy,Pd,and Pt of OCD patients,Hs of male OCD patients and Pa of OCD female patients were significantly higher than that of the chinese normals (P<0.01). The scores of Dand Pd of OCD patients had positive correlation with the severity of obsessive thinking. The scores of Pa,Sc and Si of OCD patients had positive correlation with the severity of obsessive thinking and symptoms. Pt scores of OCD patients had positive correlation with the severity of obsessive thinking,compulsive behavior and symptoms.Conclusions OCD patients may have morbid psychology.The personality charaeteristics of the OCD patients may have positive correlation with clinical symptoms.     

青少年强迫症患者及其父母性格特征的研究

目的 探讨青少年强迫症患者的性格及其父母的性格特征.方法 采用自行设计的调查表收集资料,按中国精神障碍分类与诊断标准第3版的诊断标准将100例儿童青少年分为观察组（50例）和对照组（50例）,对每一位青少年进行艾森克人格问卷（EPQ问卷）的调查.结果 ①观察组与对照组秩和检验显示：观察组与对照组中青少年EPQ各维度均有差异,精神质：Z1=-3.38,P＜0.01 内外向：Z2=-2.78,P＜0.01 神经质：Z3=-4.79,P＜0.01.观察组与对照组的父母EPQ评定中：父亲神经质与对照组比较差异有统计学意义,Z4=-3.09,P＜0.05.母亲内外向与对照组比较差异有统计学意义,Z5=-2.41,P＜0.05.②关联性分析显示：患者精神质与母亲神经质呈正相关,r=0.23,P＜0.05.患者内外向与父亲内外向呈正相关,r=0.21,P＜0.05.患者内外向与与母亲精神质呈负相关,r=-0.23,P＜0.05.③Logistics回归分析：对青少年及其父母EPQ各维度值进行分析显示,影响强迫症发生的主要因素有：患者精神质、性格内向、神经质、父亲神经质、母亲精神质、性格内向.结论 青少年性格及其父母性格特征是强迫症发生的可能影响因素.     

强迫症患者人格特征及其与父母人格特征的相关性研究

目的探讨强迫症患者及其父母的人格特征,并分析两者之间的相关性。方法选择60例符合中国精神障碍分类与诊断标准(第3版)(CCMD-3)中强迫症诊断标准及国际疾病分类第10次修订本(ICD-10)中强迫性障碍诊断标准的强迫症患者为强迫症组,同时选择性别、年龄相匹配的60例健康者为对照组。对强迫症患者及其父母采用艾森克人格问卷(EPQ)进行评定,并与对照组及其父母进行比较,进行直线相关分析。结果强迫症组神经质(15.0±6)、精神质(7.1±3)得分高于对照组,内-外向(11.2±5)得分低于对照组,差异均有统计学意义(P<0.05)。强迫症组父母、父亲神经质〔(12.3±4)、(12.8±5)〕得分与对照组父母、父亲比较差异均有统计学意义(P<0.05),强迫症组父母、母亲、父亲内-外向〔(10.7±4)、(10.5±5)、(10.8±4)〕得分与对照组父母、母亲、父亲比较差异均有统计学意义(P<0.05),强迫症组母亲精神质(5.2±2.2)与对照组母亲相比差异有统计学意义(P<0.05)。强迫症患者内-外向得分与强迫症患者母亲内-外向得分呈正相关(r=0.368,P<0.05),而与强迫症患者母亲精神质得分呈负相关(r=-0.368,P<0.05);强迫症患者神经质得分与强迫症患者母亲精神质得分(r=0.387,P<0.05)以及强迫症患者父亲神经质(r=0.533,P<0.01)得分呈正相关;强迫症患者掩饰性得分与强迫症患者母亲掩饰性得分(r=0.412,P<0.05)呈正相关。结论强迫症患者的人格特征与其父母相关,强迫症父母具有的某些特质性人格特征,可能通过遗传或者后天教养影响其子女。     

福州地区大学生牙科焦虑症与艾森克人格的相关性

目的 了解福州地区大学生牙科焦虑症的现状,探讨其与艾森克人格的关系。方法 采用改良牙科焦虑测量量表和艾森克人格问卷 (成人)对福州市1 200名大学生进行问卷调查并做数据统计分析。结果 福州地区大学生的牙科焦虑症患病率为55.67%,它与艾森克人格的三个维度均相关(P<0.05),其中与神经质呈正相关(r=0.476),与内外向(r =-0.458) 和精神质(r=-0.380)呈负相关。牙科焦虑症的神经质量表得分高于非牙科焦虑症组,而精神质、内外倾量表的得分则低于非牙科焦虑症(P<0.05)。结论 牙科焦虑症与艾森克人格具有相关性,神经质高分、精神质和内外倾低分者患牙科焦虑症可能性大,牙科焦虑症患者的艾森克人格三个维度的倾向为:精神质偏低,内外倾内向及神经质不稳定。     

国内强迫症的心理治疗

强迫症是临床常见的精神障碍,国内调查其患病率为0.3% ,约占神经症门诊的2% ,强迫症的治疗通常包括药物治疗和心理治疗两种。下面介绍国内常用的几种强迫症的心理疗法。1森田疗法森田疗法是由日本森田正马博士于上世纪20年代创立,主要用于治疗各种有神经质特点的精神障碍。森田将具有疑病、易焦虑、完美理想主义特征的人格特质称作神经质,提出了“疾病=神经质×偶发事件×机会”的学说,森田认为神经质的治疗要点是陶冶神经质素质和破坏精神交互作用。要达到此目的就要对症状“接纳客观,为所当为”。森田疗法于上世纪80年代初期被介绍到中国,…     

强迫症的神经生化研究进展

强迫症(OCD)是一种难治性疾病,最初人们认为本病源于精神因素和人格缺陷,是内心强烈冲突的外在表现.近年来,大量有关OCD的神经生化研究表明,5-羟色胺(5-HT)与强迫症关系密切,提示本病的发生有生物学基础,现将其综述如下:     

社交恐怖症的人格及症状特征与强迫症、抑郁症的比较

目的:通过与强迫症、抑郁症患者进行比较,探讨社交恐怖症患者的人格特征.方法:社交恐怖症(28)、强迫症(29)和抑郁症(30)3组患者共计87例进行艾森克人格问卷(EPQ)以及症状自评量表(SCL-90)的榆测评定.3组患者间的人格进行比较,并对人格和症状进行相关性分析.结果:社交恐怖症组与强迫症组EPQ的内外向因子分差异尤统计学意义,而与抑郁症组差异有统计学意义(P<0.05).人格和部分症状间存在相天性.结论:与抑郁症患者相比,社交恐怖症患者与强迫症患者有更加相似的人格特征,这些结果为今后社交恐怖症的诊疗提供了依据.     

强迫症与抑郁障碍、焦虑障碍地塞米松抑制试验对照研究

目的研究地塞米松抑制试验(DST)在强迫症发病机制中的作用及其对强迫症诊断的价值.方法采用放射免疫测定法测定了29例强迫症(OCD)、27例正常对照(NC)、20例抑郁障碍对照(DD)和17例焦虑障碍对照者(AD)DST皮质醇含量.结果 OCD患者DST阳性率为24.1%,与各对照组比较无显著性差异(P＞0.05);OCD患者8:00血浆基础皮质醇浓度显著高于正常对照组(P＜0.01);DST阳性的7例OCD患者中6例(85.7%)为男性.结论 OCD中存在一组患者DST脱抑制、下丘脑-垂体-肾上腺轴活动过度,该结果独立于抑郁;DST对OCD的诊断作用较小.     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.