抑郁症患者自动思维及应付方式的性别差异

目的探讨抑郁症患者自动思维、应付方式变化的性别差异.方法对97例抑郁症患者分别在其入、出院时进行测评,测评工具包括自评抑郁量表(SDS)、自动思维问卷和应付方式问卷.此外对100例正常对照亦进行上述测评,其中29例在15～20天后重测.结果病人及对照组的自动思维及应付方式无性别差异,但病人组SDS得分存在性别差异.性别、自动思维、应付方式各指标的logistic回归分析显示,自动思维、幻想、合理化、解决问题有显著性(P<0.05),性别、应付方式其他各指标影响无显著性(P>0.05);治疗后抑郁症组性别、自动思维、应付方式各指标差值的logistic回归分析表明,自动思维的差值有显著性(P<0.05),性别、应付方式其他各指标影响无显著性(P>0.05).结论抑郁症患者的自动思维及应付方式无性别差异,自动思维、幻想、合理化、解决问题对抑郁严重程度有显著影响.     

30例帕金森病(PD)抑郁量表调查

目的 :了解帕金森病 (PD)的抑郁状况及其相关因素。方法 :对 3 0例确诊PD的患者进行临床及Zung抑郁量表 (SDS)检查。结果 :3 0例PD患者 2 5例 (83 % )合并抑郁症 (神经性抑郁 ) ,SDS分高于正常 ,其中轻度抑郁 14例(5 6% ) ,中度抑郁 11例 (4 4 % )。性别、年龄与抑郁无相关 ,PD病情程度重者抑郁明显高于病情轻者 (P <0 0 1) ,混合型较单一型抑郁症多 (P <0 0 5 )。病程 >5年较病程≤ 5年 ,抑郁多见 (P <0 0 5 )。结论 :PD患者多合并抑郁 ,病情重、病程长对抑郁有明显影响。     

抑郁症患者的自动思维及应付方式特征

目的 探讨抑郁症患者的自动思维及应付方式特征.方法 本研究采用随机对照研究,把76例符合<中国精神障碍分类与诊断标准>第三版中抑郁症诊断标准的患者作为研究组,并随机选取正常健康者76名作为对照组.采用自动思维问卷和应付方式问卷对两组进行测评.结果 研究组患者自动思维问卷评分高于对照组;研究组患者应付方式问卷中,退避、自责因子分高于对照组,求助、合理化、解决问题因子分低于对照组.结论 抑郁症患者存在负性自动思维和消极的应付方式.     

自动思维在首发女性抑郁症患者发病中的交互作用

目的：探讨首发女性抑郁症患者自动思维与抑郁症相关的应激因素之间存在交互作用。方法选取住院的60例首发女性抑郁症患者,经过自动思维问卷、功能失调性态度问卷、社会支持量表、应付方式问卷及YG性人格测验测评,用Spearman相关分析及路径分析方法,分析自动思维与抑郁症相关的应激因素在首发女性抑郁症患者发病过程中的相互作用。结果①自动思维总分与抑郁/焦虑总分、功能失调性认知总分、脆弱性、吸引和排斥、完美化和自主性态度等因子分呈正相关（P〈0.05或P〈0.01）。②自动思维总分与十二种性格中的自卑感、神经质、缺乏客观性和非合作性因子分呈正相关,与支配性、社会内外向性因子分呈负相关（P〈0.05或P〈0.01）。③自动思维和自责、合理化呈正相关,自动思维和社会支持总分、主观支持呈负相关（P〈0.05或P〈0.01）。④路径分析表明：自动思维对抑郁有直接预测作用;神经质、完美化、自责、焦虑通过自动思维对抑郁有间接预测作用;主观支持对自动思维有负向预测作用,且通过自动思维对抑郁有间接预测作用（P〈0.05或P〈0.01）。结论自动思维与抑郁症相关的应激因素之间存在交互作用,在开展抑郁症的心理治疗时需要综合考虑这些因素。     

大学生自杀意念者自动思维及应对方式相关性研究

目的:探讨大学生自杀意念者自动思维及应对方式之间的关系。方法:采用自动思维问卷、应付方式问卷对166名研究对象施以问卷调查。调查对象中有自杀意念者80名为自杀意念组(研究组),86名正常大学生为无自杀意念组(对照组)。比较两组的调查情况。结果:有自杀意念组自动思维问卷及退避、幻想、自责得分均高于无自杀意念组(P0.01);求助、解决问题、合理化维度得分低于无自杀意念组(P0.01);相关分析显示:自动思维与退避、幻想、自责呈正相关,与求助、合理化及解决问题呈负相关;Logistic回归分析表明:对于大学生自杀意念者,自动思维与自责是危险因素,求助是保护因素。结论:负性自动思维对于大学生自杀起到诱导作用,积极的求助及有效解决问题能力可预防自杀。     

抑郁症共病因素及其人格特征的相关与回归分析

目的:探讨有无焦虑症状的抑郁症患者的应付方式与人格的关系.方法:对88例抑郁症患者及与之匹配的90例正常对照组进行抑郁自评量表(SDS), 焦虑自评量表(SAS), 艾森克人格问卷(EPQ)和应付方式问卷评定.结果:与正常对照组相比,抑郁症患者SDS, SAS, EPQ的N, P两个维度的得分高于正常对照组,而EPQ的E维度、积极应付方式得分低于对照组. 有焦虑症状抑郁症患者组相对于无焦虑症状抑郁症患者组,SDS, SAS, EPQ的N, P两个维度的得分明显较高,积极应付方式得分明显较低. 相关、回归分析表明SAS, EPQ的E维度及积极应付方式与抑郁症状严重程度的关系更为密切,这三者可解释抑郁症状严重程度变异的52.0%.结论:抑郁症患者发病期的抑郁症状、焦虑症状、神经质、精神质比对照组明显,这些特征在伴有焦虑症状的抑郁症患者中表现更为明显. 有焦虑症状的抑郁症患者比无焦虑症状的患者人格特征更偏内向,更少采用积极的应付方式. 较少采用积极应付方式可能是抑郁症状患者人格特征之一,纳入人格特质的E维度之中.     

抑郁症患者焦虑、人格与应付方式变化及其反应时的研究

目的 探讨焦虑症状、人格、应付方式对抑郁症严重程度的影响，并考察抑郁症患者对负性情绪词的偏好。方法 对27例抑郁症患者及与之匹配的29名对照组进行SDS、SAS、EK2和应付方式问卷评定。测验完成后用E-Prime系统分别进行正、负性情绪词识别的实验。结果与对照组相比，抑郁症患者SDS、SAS、EPQ的N、P两个维度的得分与对照组间差异有显著性意义，EPQ的E维度、积极应什方式得分与对照组间差异有显著性意义。logistic回归分析表明抑郁症状的严重程度与SAS、EPQ的E维度有相关性。抑郁症患者对正、负情绪词的反应时与对照组间差异有显著性意义，在负性情绪词上的反应时与对正性情绪词的反应时间差异有显著性意义。结论抑郁症患者发病期有较高的N、P两个维度的得分，较低的E维度得分，较少采用积极的应付方式。抑郁症患者在情绪词上存在负性偏好。     

抑郁症患者治疗前后应付方式变化特征的研究

目的 了解抑郁痖患者治疗前、后应付方式的变化及其与临床特征的关系。方法 采用应付方式问卷，评定78例抑郁症患者治疗前、后应付方式的改变，并与86例正常对照比较，用HAMD评定疾病的严重程度和疗效。结果 抑郁症患者退避、自责的因子分显著高于正常对照组，求助、解决问题的因子分显著低于对照组。治疗后，退避、自责的因子分降低，与正常对照差异无显著性；求助、解决问题的因子分升高，但仍低于对照组，幻想、合理化的因子分治疗前后差异无显著性，均低于对照组。治疗有效者的退避、自责的因子分低于治疗无效者，而求助、解决问题的因子分高于后者。HAMD的减分率与治疗后退避、自责的因子分呈负相关，与求助、解决问题的因子分呈正相关。结论 抑郁症治疗前后应付方式发生改变，退避、自责、求助、解决问题的应付方式与疾病的变化有关，幻想、合理化的应付方式在抑郁症患者中具有相对稳定性，不同疗效的忠者采用的应付方式不同。     

抑郁症患者治疗前后应付方式变化特征的研究

目的了解抑郁症患者治疗前、后应付方式的变化及其与临床特征的关系.方法采用应付方式问卷,评定78例抑郁症患者治疗前、后应付方式的改变,并与86例正常对照比较,用HAMD评定疾病的严重程度和疗效.结果抑郁症患者退避、自责的因子分显著高于正常对照组,求助、解决问题的因子分显著低于对照组.治疗后,退避、自责的因子分降低,与正常对照差异无显著性;求助、解决问题的因子分升高,但仍低于对照组,幻想、合理化的因子分治疗前后差异无显著性,均低于对照组.治疗有效者的退避、自责的因子分低于治疗无效者,而求助、解决问题的因子分高于后者.HAMD的减分率与治疗后退避、自责的因子分呈负相关,与求助、解决问题的因子分呈正相关.结论抑郁症治疗前后应付方式发生改变,退避、自责、求助、解决问题的应付方式与疾病的变化有关,幻想、合理化的应付方式在抑郁症患者中具有相对稳定性,不同疗效的患者采用的应付方式不同.     

人乳头瘤病毒感染女性患者心理状况与应对方式的相关性分析

目的 调查女性患者人乳头瘤病毒感染心理状况与应对方式的相关因素分析,为临床治疗及心理干预提供有利支持.方法 对2020年9月至2021年12月在中南大学湘雅医院妇科门诊就诊的402例高危型人乳头瘤病毒感染已婚妇女进行问卷调查,其中已婚未育组154例,已婚已育组248例.调查问卷包括应付方式问卷(CSQ)、焦虑自评量表(SAS)和抑郁自评量表(SDS).结果 已婚未育组的SAS和SDS得分均高于已婚已育组(P＜0.05);已婚未育组CSQ量表的求助、合理化和解决问题应付因子得分低于已婚已育组,自责、幻想和退避应付因子得分高于已婚已育组(P＜0.05).已婚未育组SAS得分与解决问题、求助因子得分呈负相关,与自责、幻想、退避、合理化因子得分呈正相关(P＜0.05);已婚已育组SAS得分与解决问题、求助、合理化因子得分呈负相关,与自责、幻想、退避因子得分呈正相关(P＜0.05).已婚未育组的SDS得分与解决问题、求助因子得分呈负相关,与自责、幻想、退避、合理化因子得分呈正相关(P＜0.05);已婚已育组SDS得分与解决问题、求助、合理化因子得分呈负相关,与自责、幻想、退避因子得分呈正相关(P＜0.05).结论 已婚未育组人乳头瘤病毒感染女性患者的焦虑和抑郁程度都明显高于已婚已育组,且两组女性应对方式明显不同,对已婚未育组人乳头瘤病毒感染女性患者采取个性化方案制定和干预,可有效稳定她们情绪并提升她们的生活质量.     

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.