克罗恩病患者疾病不确定感与焦虑抑郁情绪的相关性

目的:探究克罗恩病患者因疾病不确定感所引发的焦虑抑郁情绪,系统归纳两者之间的关联性。方法:对上海交通大学医学院2017年2月至2019年2月消化内科收治克罗恩病患者以便利抽样法抽取70例并对其临床数据进行回归性分析,所有纳入研究对象对疾病不确定感调查工具为中文翻译Mishel关于疾病不确定感调查问卷(MUIS)、抑郁感...     

克罗恩病患者疾病不确定感与焦虑、抑郁的相关性研究

目的探讨克罗恩病(Crohn’s disease,CD)患者疾病不确定感和焦虑、抑郁的相关性,为制订干预策略提供依据。方法便利抽样法选取2017年4月至2018年5月上海市第十人民医院消化内科收治的70例CD患者为研究对象,采用一般资料调查问卷、中文版Mishel的疾病不确定感问卷(Mishel’s uncertainty in illness scales,MUIS)、患者抑郁症筛查量表(patient health questionnaire-9,PHQ-9)及广泛性焦虑量表(generalized anxiety disorder,GAD-7)对其进行调查。结果 CD患者疾病不确定感总分为(63.81±4.45)分,处于中等水平,焦虑和抑郁得分分别为(7.05±3.89)、(7.31±4.09)分。CD患者疾病不确定感总分及复杂性维度得分与焦虑、抑郁得分呈正相关(均P0.05),疾病不确定感不明确性维度与患者的焦虑、抑郁无相关性(P0.05)。结论 CD患者的疾病不确定感与焦虑、抑郁有关,应采取有效措施减轻患者的疾病不确定感,以改善患者焦虑、抑郁等不良情绪,从而提高其生活质量。     

脑梗死后焦虑抑郁共病患者睡眠障碍特征及影响因素分析

目的研究脑梗死后焦虑抑郁共病患者的睡眠障碍特征及其影响因素。 方法共选取首发脑梗死患者216例,根据患者汉密顿焦虑量表(HAMA)及汉密顿抑郁量表(HAMD)评分,将其划分为焦虑抑郁组、单纯焦虑组、单纯抑郁组及无焦虑抑郁组。对各组患者吸烟、饮酒、文化程度、生活工作压力、日常锻炼频度等一般资料进行比较;运用“匹兹堡睡眠质量指数量表（PSQI）”评价患者睡眠状况,并分析影响焦虑抑郁共病患者睡眠质量的相关因素。 结果各组患者吸烟、饮酒、文化程度、工作生活压力、日常锻炼频度等情况组间差异均无统计学意义（P&rt;0.05）;各组患者HAMA及HAMD评分组间差异均具有统计学意义（P<0.05）,其中焦虑抑郁组患者HAMD总分明显高于其他各组（P<0.01）,HAMA总分则明显高于单纯抑郁组和无焦虑抑郁组（P<0.001）;睡眠质量各维度评分组间差异亦具有统计学意义（P<0.05）,其中焦虑抑郁组PSQI总分及各因子得分均显著高于无焦虑抑郁组（P<0.05）;焦虑抑郁组主观睡眠、睡眠潜伏、睡眠持续性、睡眠效率、白天功能紊乱及PSQI总分显著高于单纯焦虑组（P<0.05）;焦虑抑郁组睡眠潜伏、睡眠持续性、白天功能紊乱及PSQI总分显著高于单纯抑郁组（P<0.05）。通过回归分析发现,年龄、生活工作压力、吸烟、饮酒等是焦虑抑郁共病患者睡眠质量的主要影响因素。 结论焦虑抑郁共病患者睡眠质量较差,主要体现在主观睡眠、睡眠潜伏期、睡眠持续性、睡眠效率、白天功能紊乱等方面;年龄、生活工作压力、吸烟、饮酒是焦虑抑郁共病患者睡眠质量的主要影响因素。     

慢性乙肝患者抑郁焦虑状况及其影响因素分析

目的：了解慢性乙型肝炎患者的焦虑、抑郁状况及其影响因素,为实施有效的心理干预提供依据。方法应用一般情况调查表及医院焦虑抑郁量表对192例慢性乙型肝炎患者进行调查。结果本组慢性乙型肝炎患者焦虑评分(8.60±4.44)分,抑郁评分(8.24±4.32)分。其中,焦虑阳性92例(47.9%),抑郁阳性87例(45.3%),其中76例患者既有焦虑又有抑郁,占39.5%。焦虑、抑郁受家庭年收入、教育程度、病程及抗病毒治疗4个因素的影响。结论慢性乙型肝炎患者的焦虑、抑郁水平较高,家庭年收入、教育程度、病程及抗病毒治疗为主要影响因素;医务人员应重视其心理状况,实施针对性的心理护理措施。     

酒精依赖患者家属焦虑抑郁状况及其影响因素分析

目的探讨酒精依赖患者家属的焦虑抑郁状况及其影响因素,为制定心理干预措施提供依据。方法对368名酒精依赖患者家属采用焦虑自评量表和抑郁自评量表评定焦虑、抑郁状况,对酒精依赖患者家属不同年龄、文化程度、职业及不同家庭收入的调查结果进行对比分析。结果酒精依赖患者家属焦虑发生率为25．54％,抑郁发生率为19．84％;酒精依赖患者家属≥55岁组焦虑、抑郁发生率均高于其他年龄段（X^2=10．17、8．88,P〈0．01）,文化程度为大专以上的家属焦虑发生率均高于其他文化程度的家属（X^2=11．31,P〈0．01）,个体和无业的家属焦虑、抑郁发生率均高于其他职业,（X^2=13．96、11．57,P〈0．01）,不同家庭人均收入家属焦虑抑郁发生率均无显著性差异（P〉0．05）。结论酒精依赖患者家属存在不同程度的焦虑抑郁情绪问题,不同年龄、文化程度及不同职业对家属的焦虑、抑郁情绪有不同程度的影响,应有针对性的对他们进行心理干预以减轻家属的焦虑、抑郁情绪。     

早孕妇女术前焦虑抑郁及其影响因素分析

人工流产是避孕失败的一种补求措施,大多数早孕妇女对手术存在着焦虑和强烈的恐惧感,他们害怕疼痛、害怕手术意外留下后遗症甚至丧失生育能力.这些不良的应激导致机体的生理、生化、行为等多方面的改变,影响手术进行术后的恢复.因此,了解早孕妇女术前的焦虑、抑郁状况及其影响因素,为针对性对早孕妇女术前开展心理卫生教育和心理咨询提供依据.     

儿童医院医务人员的焦虑和抑郁状况及其影响因素

目的探讨儿童医院医务人员心理焦虑和抑郁现状及年龄、性别、学历、职称、职务、工作年限、每周工作时间、工作压力、家庭收入、婚姻、家庭和睦情况、有无慢性病、有无应激事件等因素对其的影响。 方法利用焦虑自评量表（SAS）和抑郁自评量表(SDS)对儿童医院医务人员进行调查测评。对回收的有效问卷进行标准分的计算,应用SPSS 19.0版统计软件包对标准分进行统计处理,分析年龄、性别、学历、职称、职务、工作年限、每周工作时间、工作压力、家庭收入、婚姻、家庭和睦情况、有无慢性病、有无应激事件等因素对焦虑和抑郁的影响。 结果男性医务人员的SAS总评分［（49.83±12.49）分］和SDS总评分［（54.39±12.14）］均高于女性医务人员［（47.554±12.82）分和（51.92±12.88）分］,男女焦虑及抑郁分值比较,差异有统计学意义（P<0.05);677例医务人员中320例存在焦虑障碍,392例存在抑郁障碍,焦虑伴抑郁障碍的人数为288例。婚姻、家庭和睦情况、有无慢性病及有无应激事件等对焦虑和抑郁分值的影响差异均有统计学意义（P<0.05)。单因素分析显示,学历及家庭收入对焦虑和抑郁分值的影响差异均无统计学意义(P>0.05);年龄、职称、工作年限、工作压力及不同科室工作对焦虑和抑郁分值的影响差异均有统计学意义(P<0.05);职务对焦虑分值的影响差异无统计学意义(P>0.05),职务对抑郁分值的影响差异有统计学意义（P<0.05);每周工作时间对焦虑分值的影响差异有统计学意义(P<0.05),每周工作时间对抑郁分值的影响差异无统计学意义（P>0.05)。多因素Logistic回归分析显示,学历、工作压力、家庭和睦情况、有无慢性病及有无应激事件与焦虑障碍的发生具有相关性(P<0.05);工作压力、家庭和睦情况及有无慢性病与抑郁障碍的发生呈正相关(P<0.05)。 结论儿童医院医务人员焦虑及抑郁情绪明显;工作压力、家庭和睦情况以及有无慢性病对焦虑和抑郁水平的影响作用突出。     

克罗恩病患者疾病不确定感及其影响因素

目的 调查分析克罗恩病(CD)患者的疾病不确定感状况及其影响因素,为评估患者疾病不确定感和提出针对性的干预措施提供依据.方法 采用一般资料问卷、Mishel疾病不确定感量表(MUIS-A)对40例CD患者进行问卷调查,分析其影响因素.结果 CD病患者存在较高水平的疾病不确定感,评分为(91.62±15.114)分,家庭经济条件和病程为疾病不确定感水平的主要影响因素(t分别为-2.481,-2.476;P ＜0.05).结论 CD患者疾病不确定感水平普遍较高,主要来源于不明确疾病的症状和不可预测疾病的过程和预后,并与经济条件和病程因素相关;护士应根据患者的疾病不确定感水平,针对性地提供患者信息支持,从而降低患者的疾病不确定感.     

接受羊膜腔穿刺术孕妇的焦虑抑郁状况及其相关因素分析

目的了解接受羊膜腔穿刺术的孕妇及其配偶的认知及焦虑、抑郁状况,探讨自身因素以及配偶因素对孕妇焦虑、抑郁的影响。方法对接受羊膜腔穿刺术的孕妇及其配偶各107例进行问卷调查。调查表内容包括一般资料、羊膜腔穿刺术认知问卷和医院焦虑抑郁量表。结果不同年龄、文化程度、妊娠次数的孕妇焦虑、抑郁水平不同。孕妇的认知水平及配偶的认知、焦虑、抑郁水平是孕妇焦虑、抑郁水平的影响因素。结论在护理工作中,要关注接受羊膜腔穿刺术的孕妇及其配偶,以更好地为接受羊膜腔穿刺的孕妇提供家庭护理。     

女性性病患者焦虑抑郁情绪分析

目的探讨女性性病患者焦虑、抑郁情绪状况。方法采用焦虑自评量表和抑郁自评量表对304例女性性病患者进行评定并与健康女性进行对比分析。结果女性性病患者焦虑发生率为78％．抑郁发生率为82％;焦虑自评量表和抑郁自评量表总分均显著高于对照组（P〈0．01）。结论对女性性病患者应给予积极的心理干预,以解除其抑郁、焦虑和恐惧等心理障碍。     

Adsorptive Monocyte-granulocytapheresis (M-GCAP) for refractory Crohn's disease

Six patients with active Crohn's disease (CD) unresponsive to conventional medications (CM) were treated with Monocyte-granulocytapheresis (M-GCAP). CD patients who scored 200-400 points in Crohn's disease activity index (CDAI) in spite of receiving CM, including enteral nutrition, for at least 2 weeks were enrolled in our double series trial. Each series had 5 weekly M-GCAP and 2 follow-up weeks, and each M-GCAP treated 1,800 ml of patient's peripheral blood. After the 1st series, patients who decreased more than 50 points on the CDAI were deemed responders and enrolled in the second series. Patients with a CDAI score less than 150 points were considered in remission. The patients' quality of life was evaluated using an index (IBDQ) before and after the 1st series. The CDAI was significantly decreased comparing before and after the 1st series (258.2 +/- 36.2 vs. 166.5 +/- 16.6; P < 0.02). 50% of patients (3/6) responded to the therapy, and one case (16.7%) could be induced to remission. Significant removal was revealed only for white blood cells (25.6 +/- 16.9%; P < 0.05), especially granulocytes (29.5 +/- 22.5%; P < 0.05). A statistically significant improvement of IBDQ was revealed in the responders' group (162.3 +/- 17.2 vs. 189.3 +/- 11.5; P < 0.03). M-GCAP could be an effective adjunctive therapy for active CD patients unresponsive to CM allowing them to maintain a high QOL. However, it might be difficult to improve patients who could not be induced to remission after the 1st series by applying another series.     

First successful use of leukocyte apheresis as maintenance therapy for Crohn's disease in the United Kingdom

We describe the case of a 24 year old male with severe fistulating Crohn's disease who failed mutliple modalities of medical and surgical therapy. We present objective and subjective evidence of disease remission after induction and maintenance treatment with leukocyte apheresis. This is the first described case of successful maintenance treatment of severe Crohn's disease with leukocyte apheresis in the United Kingdom. J. Clin. Apheresis 29:181–182, 2014. © 2013 Wiley Periodicals, Inc.     

小檗碱改善5XFAD小鼠抑郁和焦虑

目的:明确小檗碱对5XFAD阿尔茨海默病(AD)转基因小鼠的抑郁和焦虑有无改善作用.方法:将48只3月龄的5XFAD AD转基因小鼠随机分为对照组、小檗碱低剂量组(50 mg/kg)、小檗碱中剂量组(100 mg/kg)和小檗碱高剂量组(150 mg/kg),每组12只,连续灌胃90 d,利用旷场实验、高架十字迷宫实验...     

克罗恩病患者术前体力活动体验的质性研究

【摘要】 目的 了解克罗恩病患者术前体力活动的真实体验,以期为制订针对性的运动方案提供参考。方法 2021年3月－8月,采用目的抽样法选择就诊于南京市某医院择期手术的10例克罗恩患者作为研究对象,对其进行面对面的深入访谈,并采用Colaizzi 分析法进行资料分析。结果 对访谈资料进行分析提炼出5个主题：患者缺乏术前体力活动知识;社会支持系统薄弱;体力活动使排便次数增多或腹痛加重等不适体验;体力活动意愿受疾病病耻感和既往活动体验的影响;体力活动受疾病治疗与医院环境的影响。结论 医护人员须了解克罗恩病患者术前体力活动的体验,关注其术前体力活动的经历,给予针对性的健康宣教、心理指导以及运动指导,改善其术前体力活动水平,提高术前生理储备。     

肠道超声检查在克罗恩病及其黏膜愈合的随访监测中的应用

克罗恩病（Crohn''s disease,CD）是炎症性肠病的一种,肠道超声检查（intestinal ultrasound,IUS）在CD患者初诊及随访中具有重要作用。相比于胃肠镜、磁共振肠道成像（magnetic resonance enterography,MRE）以及计算机断层扫描肠道成像（Computed tomography enterography,CTE）等检查方式,IUS具有无辐射、价格低廉、患者耐受好、重复性高等优点。实现和维持CD患者的黏膜愈合（Mucosal healing,MH）对维持临床缓解和无手术生存率有重要的临床意义。本文综述了IUS在CD及其MH中的应用现状     

Identification of patients with headache at risk of psychological distress

OBJECTIVE: To test the hypothesis that anxiety and depression are associated with headache frequency, severity, and disability. BACKGROUND: There is significant comorbidity between chronic headache and psychological distress. Headache associated with anxiety or depression tends to be more severe and often requires supplementary psychological treatment in addition to headache therapy. Therefore, the identification of patients with headache who are at risk of psychological distress is important. METHODS: One hundred twenty-seven consecutive patients with headache attending a university headache clinic were evaluated. Questionnaires about headache symptoms and psychological distress were completed. Comparisons were made between psychological distress and headache frequency, severity, and disability. RESULTS: Depression and anxiety were significantly greater in the subjects of this study who had frequent headache (>4 days per week) and frequent headache-associated disability (activities reduced or prohibited because of headache >3 days per week). Subjects who reported their headache severity as typically severe were no more likely to report depression or anxiety than those with mild or moderate headache severity. Quality-of-life measures of physical and social functioning, emotional distress, and general health and vitality were reduced in subjects with frequent episodes of headache-associated disability. All areas, with the exception of general health perception, were reduced in subjects with frequent headache. Severe headache was associated with reductions in role and social functioning. CONCLUSIONS: Frequent headache and frequent disability are associated with depression, anxiety, and impaired quality of life. Reports of typical headache severity are less likely to correlate with psychological distress. Therefore, patients with headache who report frequent headache or frequent periods of headache-related disability should be further evaluated for the presence of psychological disturbance.     

14例乌司奴单抗治疗克罗恩病的疗效观察与护理体会

目的 总结乌司奴单抗在克罗恩病患者治疗中的护理体会。方法 回顾2020年5月至今我科接收乌司奴单抗治疗的14例克罗恩病患者资料,分析患者的一般资料、用药前后的疾病进展及不良事件的发生情况。结果 14例患者中,8例为首次注射乌司奴单抗,另6例为再次注射;其中,12例患者注射乌司奴单抗后症状明显好转出院。2例患者出现不良事件,均为腹痛、便血等胃肠道症状,最终因效果不理想、不良事件较重,改用其他药物治疗。结论 乌司奴单抗在治疗传统药物或生物制剂效果不佳的活动性克罗恩病患者中有着诸多优势,但在临床使用过程中,护理人员需密切关注可能出现的不良事件,并予以及时的对症处理。     

太极拳运动对帕金森病患者认知功能及健康相关生活质量的影响

目的:探讨太极拳运动对轻度认知障碍帕金森病患者认知功能和健康相关生活质量的影响。方法:将52例轻度认知障碍帕金森病患者随机分为干预组28例和对照组24例。对照组仅接受常规药物治疗和运动建议,干预组在此基础上进行24式杨氏太极拳训练。干预前后采用蒙特利尔认知评估量表(Mo CA)和39项帕金森病生活质量问卷(PDQ-39)进行评定。结果:干预16周后,干预组Mo CA评分较干预前明显提高(P0.05),PDQ-39评分明显降低(P0.05),对照组无显著改变。干预后,干预组Mo CA评分明显高于对照组(P0.05),PDQ-39评分明显低于对照组(P0.05)。结论:太极拳运动对轻度认知障碍帕金森病患者改善认知功能和提高生活质量具有积极意义。     

Expression profiles of circular RNAs in colon biopsies from Crohn's disease patients by microarray analysis

BackgroundCircular RNAs (circRNAs) are involved in various diseases and serve as biomarkers. The present study aimed to investigate unique expression profiles of circRNAs in colon tissues of Crohn''s disease (CD) and search novel biomarkers for the diagnosis.MethodsDifferentially expressed (DE) circRNAs in biopsies from four CD patients, four ulcerative colitis (UC) patients, and four healthy controls (HC) were screened by microarray. Hsa_circ_0062142 and hsa_circ_0001666 were verified in another expanded validation cohort. Bioinformatics analysis was applied to predict the function of two DE circRNAs. Receiver operating characteristic (ROC) curves were constructed to evaluate the diagnostic value of CD.ResultsThe top 10 upregulated circRNAs in CD compared with HC were hsa_circ_0000691, hsa_circ_0001666, hsa_circ_0004183, hsa_circ_0009024, hsa_circ RNA_405324, hsa_circ_0002003, hsa_circ_0085323, hsa_circ_0040994, hsa_circ_0062142, and hsa_circ_0048148; the top 10 downregulated circRNAs were hsa_circ_0049356, hsa_circ RNA_405443, hsa_circ RNA_403556, hsa_circ_0092328, hsa_circ_0003979, hsa_circ_0074491, hsa_circ_0023461, hsa_circ RNA_406237, hsa_circ_0034044, and hsa_circ RNA_400564 (fold change in descending order). The expression levels of hsa_circ_0001666 and hsa_circ_0062142 in CD were significantly higher than those in UC and HC (p < 0.01). ROC curves suggested the favorable diagnostic value of hsa_circ_0062142 and hsa_circ_0001666 (AUC = 0.803 and 0.858, respectively, p < 0.01). In silico analysis indicated that these circRNAs may be involved in the progress of CD.ConclusionHsa_circ_0062142 and hsa_circ_0001666 may play critical roles in the pathogenesis and serve as potential biomarkers of CD.