心理因素对血液透析患者睡眠质量的影响

目的 探讨哈尔滨市终末期肾脏疾病血液透析患者睡眠质量与心理因素的相关性.方法 86例终末期肾脏疾病血液透析患者均使用肾脏疾病生存质量量表中的睡眠质量分量表、艾森克人格问卷(EPQ)、Zung's抑郁自评问卷和Zung's焦虑自评问卷、社会支持问卷、应对方式问卷进行调查.结果 睡眠质量得分与性别、神经质、焦虑、抑郁、年龄、透析年限呈负相关,并存在线性回归关系.与客观支持、对支持的利用度呈正相关.结论 终末期肾脏疾病血液透析患者的睡眠质量与焦虑、抑郁等心理因素相关.因此,必须把心理治疗和躯体治疗有效结合来提高整体治疗的效果.     

增殖性糖尿病性视网膜病变患者心理状态与社会支持的相关性

目的:研究增殖性糖尿病性视网膜病变(PDR)患者心理状态与社会支持的相关性。方法:采用方便抽样方法,对我院收治的200例PDR患者进行问卷调查,包括一般情况调查、焦虑自评量表(SAS)问卷、抑郁自评量表(SDS)问卷和社会支持评定量表(SSRS)问卷,分析患者心理状态与社会支持的相关。结果:SAS评分为(48.76±7.35)分,SDS评分为(53.14±8.92)分;SSRS总评分为(39.75±6.22)分,其中主观支持评分为(21.73±4.06)分,客观支持评分为(9.45±2.39)分,社会利用度评分为(8.68±1.94)分。PDR患者焦虑与SSRS主观支持(r=-0.188,P0.05)、SSRS客观支持(r=-0.180,P0.05)、SSRS社会利用度(r=-0.137,P0.05)及SSRS总社会支持(r=-0.204,P0.05)均呈负相关;PDR患者抑郁与SSRS主观支持(r=-0.191,P0.05)、SSRS客观支持(r=-0.186,P0.05)、SSRS社会利用度(r=-0.152,P0.05)及SSRS总社会支持(r=-0.211,P0.05)均呈负相关。结论:PDR患者心理状态不佳,进行有效的社会支持可以减轻其焦虑、抑郁心理。     

支气管哮喘患者心理健康与应对方式

目的研究支气管哮喘患者的心理健康状况与应对方式。方法以症状自评量表(SCL-90)、抑郁自评量表(SDS)、焦虑自评量表(SAS)、特质应对方式问卷对60例确诊的支气管哮喘患者和50例正常对照者进行调查研究。结果患者组SCL-90总分、躯体化、人际敏感、抑郁、焦虑、敌对、恐惧、偏执、精神病性得分显著高于对照组(t=4.441,5.722,4.124,3.232,5.631,4.300,3.863,1.712,1.982;P<0.05或P<0.01);抑郁和焦虑得分显著高于对照组(t=5.101,7.142;P<0.01)。患者组的积极应对方式显著低于对照组(t=-5.591,P<0.01),消极应对方式显著高于对照组(t=4.482,P<0.01)。相关分析显示,积极应对与SCL-90总分、焦虑、抑郁得分呈负相关(r=-0.238,-0.259,-0.324;P<0.001),消极应对与SCL-90总分、焦虑、抑郁得分呈正相关(r=0.407,0.435,0.442;P<0.001)。结论支气管哮喘患者的心理健康状况较低,存在明显的焦虑和抑郁情绪,且更多采用消极应对方式。     

认知行为疗法配合中医治疗对脾胃病失眠症患者焦虑、抑郁心理及睡眠质量的影响

目的:分析认知行为疗法配合中医治疗对脾胃病失眠患者焦虑、抑郁心理及睡眠质量的影响。方法:选取2017年1月-2018年1月于我院治疗的脾胃病失眠症患者100例,随机法分组。对照组(n=50)患者采用中医治疗,联合组(n=50)患者应用认知行为疗法(CBT)配合中医治疗。8周后,运用Zung氏焦虑自评量表(SAS)、抑郁自评量表(SDS)评价患者焦虑抑郁心理。匹兹堡睡眠质量指数(PSQI)评价患者睡眠质量,记录所有脾胃病失眠患者临床躯体症状改善情况。结论:联合组治疗后临床躯体症状明显改善,且治疗总有效率较对照组高(χ~2=4.891,P0.05);治疗后联合组患者SAS及SDS各项评分较对照组明显低(t=-7.796,-5.395;P0.01);联合组治疗后PSQI各因子分(睡眠质量、睡眠时间、睡眠效率、入睡时间、睡眠障碍、催眠药物、日间功能)及总分较对照组显著低(t=-6.932,-8.123,-11.515,-7.032,-7.291,-7.147,-9.373,-19.121;P0.01)。结论:CBT疗法配合中医疗法可改善脾胃病失眠患者焦虑抑郁症状,提高睡眠质量,值得临床推广。     

某高校研究生睡民质量与焦虑状况的相关研究

目的 调查当前研究生的睡眠、焦虑抑郁状况并分析它们之间的相关性.方法 随机抽取177名某医科大学研究生,采用匹兹堡睡眠质量量表(PSQI)、焦虑自评量表(SAS)及抑郁自评量表(SDS)进行调查.结果 调查的研究生中,19人(10.7%)睡眠质量状况差;53人(30.5%)呈焦虑状态;51人(29.1%)呈抑郁状态.PSQI指数与焦虑呈正相关(r=0.313,P=0.000).Logistic回归分析结果显示,睡眠障碍E(x2=4.543,OR=4.366,P=0.033)和日间功能G(χ2=9.388,OR=2.363,P=0.002)是导致焦虑的危险因素.结论 研究生的焦虑抑郁与睡眠质量相关,学生工作者可以通过对睡眠质量的干预,改善研究生的焦虑状况.     

护士睡眠质量与焦虑抑郁情绪的相关研究

目的探讨护士的睡眠质量和焦虑、抑郁情绪状况及其相互关系。方法用匹兹堡睡眠质量指数（PSQI）,焦虑自评问卷（SAS）和抑郁自评问卷（SDS）对某医院的护士的睡眠及焦虑抑郁情绪进行了调查。结果 PSQI总均分为7.86±4.03,睡眠障碍发生率为51.3%;46.8%的护士有焦虑情绪,45.3%的护士有抑郁情绪。PSQI总分与SAS总分,SDS总分均有显著性相关（r=0.36,P〈0.01;r=0.29,P〈0.01）。结论睡眠质量与焦虑抑郁情绪有密切的关系,相互影响。     

社区糖尿病患者的综合心理行为干预及情绪影响因素分析

目的:评价社区糖尿病患者的综合心理行为干预效果,筛查患者情绪的影响因素。方法:选取76例糖尿病患者作为研究对象,在药物治疗不变前提下,辅以综合性心理行为干预,分别在干预前、干预后3个月进行生理指标、心理状况的测量随访,并进行比较。采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、简易应对方式问卷(SCMQ)、社会支持量表(SSRS)对患者心理状况进行评估。结果:研究对象干预后焦虑(χ2=4.321,P=0.036)、抑郁阳性率降低(χ2=11.605,P=0.000);主观支持评分较干预前高(t=-2.074,P=0.042);积极应对维度评分较干预前高(t=-2.022,P=0.047)。回归结果显示,糖化血红蛋白对抑郁情绪存在影响。结论:1社区综合心理行为干预可以改善患者心理状况,生理指标改善不明显;2糖化血红蛋白是抑郁的影响因素。     

痴呆患者配偶的心理负担及相关因素

目的:了解居家照顾痴呆患者的配偶的心理和照料负担以及相关因素。方法:在北京城区,按就诊线索收集42例痴呆患者,由经培训的调查员进行入户调查。42例资料齐全,无遗漏。主要调查工具包括对痴呆患者的评定工具:临床分级量表、简明精神状态检查量表(MMSE)、痴呆病人日常生活能力(ADCS-ADL)、阿尔茨海末氏痴呆病理行为问卷(BEHAVE-AD);对照顾者的评定工具:Zung氏焦虑自评量表(SAS)、Zung氏抑郁自评量表(SDS)、照顾者负担问卷(CBI)、痴呆相关知识技能问卷。结果:照顾者的负担重(CBI总分30.7±15.1),他们抑郁情绪(SDS平均分为38.8±8.0,40分以上者42.9%)和焦虑情绪明显(SAS平均分为34.3±8.0,40分以上者23.8%);照顾者对疾病的知识和照顾技能缺乏,有26.2%的照顾者认为痴呆是正常衰老或可治愈的,有57.1%认为患者病情可以好转或能够维持现状。总负担与焦虑(r=0.51,P<0.01)和抑郁(r=0.38,P<0.05)以及患者伴有精神行为异常的严重程度有关(r=0.40,P<0.01);而且照顾者的焦虑情绪与知识技能有关(r=-0.48,P<0.01)。结论:照顾者的心理负担重,焦虑和抑郁情绪明显;照顾者对疾病的知识和照顾技能缺乏;总负担与焦虑和抑郁以及患者伴有精神行为异常的严重程度有关,而且照顾者的焦虑情绪与照顾者的知识技能缺乏有关。     

汶川地震后18个月都江堰地区青少年睡眠问题共患PTSD、抑郁、焦虑状况

目的:考查汶川地震后18个月青少年睡眠问题共患PTSD、抑郁、焦虑状况及其影响因素。方法:采用便利取样,抽取都江堰地区青少年1287人,应用匹兹堡睡眠质量指数、创伤后应激障碍自评量表、儿童抑郁障碍自评量表、儿童焦虑性情绪障碍自评量表、青少年自评生活事件量表、儿童青少年社会支持评定量表等对其进行评估。结果:采用PSQI总分8作为划界分,震后18个月都江堰地区青少年睡眠问题的检出率为28.2%;睡眠问题共患PTSD、抑郁、焦虑的检出率分别为7.5%、15.6%、17.9%。睡眠质量总分与PTSD(r=0.397)、抑郁(r=0.504)、焦虑总分(r=0.463)显著正相关。在检出有睡眠问题的青少年中,有26.4%检出PTSD,有55.4%检出抑郁,有63.4%检出焦虑。多元Lo-gistic回归表明地震中有亲人伤亡、对支持的利用度低、震后较多负性生活事件是睡眠问题共患PTSD的危险性因素;女性、客观支持少、主观支持少、对支持的利用度低和震后较多负性生活事件是睡眠问题共患抑郁的危险性因素;女性、主观支持低、对支持的利用度低和震后较多继发负性生活事件是睡眠问题共患焦虑的危险性因素。结论:震后18个月睡眠问题共患PTSD、抑郁、焦虑较高,评估及干预青少年的睡眠问题对预防精神健康问题有重要意义。     

抑郁障碍患者与家属家庭亲密度适应性和情绪状况的研究

目的探讨抑郁障碍患者与家属的家庭亲密度适应性和情绪状况,为抑郁障碍患者的健康教育及家庭干预提供科学有效的理论依据。方法选择2006年6～9月在北京大学第六医院就诊的抑郁障碍患者95例及共同陪伴的直系家属95例为调查对象。采用家庭亲密度和适应性量表中文版(FACES-CV)、Zung氏焦虑自评量表和Zung氏抑郁自评量表。结果1患者的家庭亲密度得分与国内常模一致(P>0.05),但适应性得分低于国内常模(P<0.01);焦虑、抑郁得分高于国内常模(P<0.01)。家属的家庭亲密度得分高于国内常模(P<0.01),适应性得分低于国内常模(P<0.01)。家属的焦虑得分与国内常模一致(P>0.05),但抑郁得分高于国内常模(P<0.05)。2家庭模式分型构成比:中间型47.9%,平衡性26.3%,极端型25.8%。患者的家庭"拱极模式"以"僵硬—松散型"居多,家属则以"自由—缠结型"居多。3家庭亲密度与患者的家属的文程化度有关,相关系数范围(r=0.21～0.26,P<0.05)、与家庭人数呈负相关(r=-0.21,P<0.01);与患者及家属的焦虑、抑郁情绪呈显著负相关,相关系数范围(r=-0.30～0.37,P<0.01);家庭适应性与患者的年龄(r=0.28,P<0.01)、文化程度(r=0.34,P<0.01)有关。与家属的年龄(r=0.26,P<0.05)文化程度(r=0.22,P<0.05)有关。与患者和家属的焦虑、抑郁情绪呈显著负相关,相关系数范围(r=-0.30～-0.42,P<0.01)。结论家庭亲密度适应性与患者和家属的文化程度、焦虑、抑郁情绪有关,家庭亲密度与患者的家庭人数有关,家庭适应性与患者和家属的年龄有关。     

Asymmetry of the internal connections of the striate cortex of the cat in the projection zone of the center of the field of vision

Studies were carried out on the organization of the internal connections of the striate cortex in cats in the projection zone of the center (0–5°) of the field of vision by microintophoretic application of horseradish peroxidase to electrophysiologically identified orientational columns. The area containing neurons showing retrograde labeling in most cases extended in the mediolateral direction. Labeled cells were located in the upper (II, III) and lower (V, VI) layers of the cortex, and the shapes and orientations of the areas containing labeled neurons in these layers coincided. Spatial asymmetry was detected in the distribution of labeled neurons relative to the orientational column studied. Labeled cells were located predominantly medial to the columns, regardless of the distance from the projection of the area centralis. Considering the visuotopical map of field 17, the asymmetry detected here provides evidence that neurons in orientational columns have more extensive connections with neurons of the peripheral part of the cortex. An asymmetrical distribution of “silent” zones around the receptive fields of neurons in orientational columns is suggested, and that these appear to receive influences from the periphery of the visual field. Laboratory of Visual Physiology and Laboratory of Central Nervous System Morphology, I. P. Pavlov Institute of Physiology, Russian Academy of Sciences, 6 Makarov Bank, 199034 St. Petersburg, Russia. Translated from Fiziologicheskii Zhurnal imeni I. M. Sechenova, Vol. 82, No. 12, pp. 23–29, December, 1996.     

Effects of the lesion of the postcommissural part of the septum on the behavior of the rat.

The effects of the lesion of the postcommissural part of the septum on behavior of the rat has been studied. Results may be summarized as follows. An increase in the exploratory behavior in the open field which decreases rapidly; a decrease in the number of defecations in this test and a decrease in time leaving a dark environment for exploration. In the shuttle box test, no facilitation of the acquisition, but a permanent and quite significant increase in the intertrial activity has been found. We conclude that the lesions tend to decrease the emotivity of the subjects. An interpretation on the basis of the species -- specific defensive reactions explains the transitory and permanent effects of the lesions on the spontaneous activity.     

Counterpointing the functional role of the forebrain and of the brainstem in the control of the sleep-waking system

This paper reviews the lifetime contributions of the author to the field of sleep-wakefulness (S-W), reinterprets results of the early studies, and suggests new conclusions and perspectives. Long-term cats with mesencephalic transection show behavioral/polygraphic rapid eye movement sleep (REMS), including the typical oculo-pupillary behavior, even when the section is performed in kittens prior to S-W maturation. REMS can be induced as a reflex. Typical non-rapid eye movement S (NREMS) is absent and full W/arousal is present only after a precollicular section. The isolated forebrain (IF) rostral to the transection exhibits all features of W/arousal and NREMS [with electroencephalographic (EEG) spindles and delta waves], arousal to olfactory stimuli, and including the appropriate oculo-pupillary behaviors. These features also mature normally after neonatal transection. REMS is absent from the IF. After deprivation there is NREMS pressure and rebound in the IF, but the decerebrate cat only shows pressure for REMS. Most IF reactions to pharmacologic agents are within expectations, except for the tolerance/withdrawal effects of long-term morphine use which are absent. In contrast, these effects are supported by the brainstem (i.e. seen in the decerebrate cat). In cats with ablation of the telencephalon, or diencephalic cats, delta waves are absent in the thalamus. EEG thalamic spindle waves are seen triggering S for only 4-5 days after ablation. Therefore, true NREMS is absent in chronic diencephalic cats although pre- and postsomniac behaviors persist. These animals are hyperactive and show a pronounced, permanent insomnia; however, a low dose of barbiturate triggers a dramatic REMS/atypical NREMS rebound. Cats without the thalamus (athalamic cats), initially show a dissociation between behavioral hyperactivity/insomnia and the neocortical EEG, which for 15-20 days exhibits only delta and slower oscillations. Fast, low-voltage W rhythms appear later on, first during REMS, but spindle waves and S postures are absent from the start, such that these cats also display only atypical NREMS. Athalamic cats also show barbiturate-sensitive insomnia. Cats with ablation of the frontal cortices or the caudate nuclei remain permanently hyperactive. They also show a mild, but significant hyposomnia, which is permanent in afrontal cats, but lasts for about a month in acaudates. The polygraphic/behavioral features of their S-W states remain normal. We conclude and propose that: (a) the control of the S-W system is highly complex and distributed, but is organized hierarchically in a well-defined rostro-caudal manner; the rostral-most or highest level (telencephalon), is the most functionally complex/adaptative and regulates the lower levels; the diencephalic/basal forebrain, or middle level, has a pivotal role in inducing switching between S and W and in coordinating the lowest (brainstem) and highest levels; (b) W can occur independently in both the forebrain and brainstem, but true NREMS- and REMS-generating mechanisms exist exclusively in the forebrain and brainstem, respectively; (c) forebrain and brainstem S-W processes can operate independently from each other and are preprogrammed at birth; this helps understanding normal and abnormal polygraphic/behavioral dissociations in humans and normal dissociations/splitting in aquatic mammals; (d) NREMS homeostasis is present in the IF, but only REMS pressure after deprivation persists in the decerebrate cat; (e) the thalamus engages in both NREMS and W; (f) insomnia in diencephalic cats is the result of an imbalance between antagonistic W- and S-promoting cellular groups in the ventral brain (normally modulated by the telencephalon); (g) the EEG waves, which are signature for each S-W state, appear to truly drive the concomitant behaviors, e.g. a hypothetical human IF could alternate between behavioral NREMS and W/arousal/awareness; (h) a role for REMS is to keep the individual sleeping at the end of the self-limiting NREMS periods. The need for accelerating research on telencephaling NREMS periods. The need for accelerating research on telencephalic S-W processes and downstream control of the lower S-W system levels is emphasized.     

The development of the ligament of the head of the femur

The hip joints of 30 human male and female fetuses and stillborns between 20 mm and 350 mm crown-rump length were studied by light microscopy. The ligament of the head of the femur developed in situ as a condensation of mesenchyme at the end of the second month of intra-uterine life (IUL), and was vascularized by branches of acetabular vessels early in the fourth month. In the majority of fetuses older than 5.5 months IUL, vessels in the ligament passed a short way into the femoral head within cartilage canals, to supply a small region around the fovea capitis. The remainder of the head was supplied by vessels in canals from around the upper part of the neck. The ligament changed from predominantly cellular to fibrous during the last 4 months of IUL. This increase in strength suggested significant mechanical functions in utero: limitation of adduction-flexion and opposition to postero-superior dislocation were the most likely.     

Topical organization of the projections of neurons of the substantia nigra and the ventral field of the tegmentum of the midbrain to the head of the caudate nucleus of the cat

Neuroscience and Behavioral Physiology -     

Involvement of the striatum in the central regulation of the hormonal functions of the gonads

Studies reported here show that intrastriatal administration of corticoliberin to rats decreases the blood testosterone level. However, in conditions of chemical deficiency of dopaminergic transmission in the dorsal striatum induced by injection of 6-hydroxydopamine, the effect of this neurohormone did not appear. It is concluded that extrahypothalamic corticoliberin is involved in regulating the hormonal reproductive system acting via dopaminergic mechanisms. Translated from Rossiiskii Fiziologicheskii Zhurnal imeni I. M. Sechenova, Vol. 85, No. 4, pp. 594–597, April, 1999.     

Ultrastructure of the endothelium of the drainage system of the eye

The endothelium of the ocular drainage system (Schlemm’s canal, collector tubules, and aqueous veins) in primary juvenile glaucoma undergoes degenerative dystrophic changes with compensatory hypertrophy and proliferation at the initial stages of the glaucomatous process and atrophy and desquamation at advanced and terminal stages. Progressive decrease in the pinocytous function of endotheliocytes, reduction of the protein-synthesizing and mitochondrial compartments of the cytoplasm, and formation of autophagosomes reflect the process of endotheliocyte degeneration in general. __________ Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 145, No. 5, pp. 574–577, May, 2008