超重和肥胖对初中生自尊的影响

目的 了解超重和肥胖对初中生自尊的影响.方法采用横断面调查,通过分层整群随机抽样,用自尊量表配合Zung氏焦虑量表和抑郁量表对郴州市城区3所中学2 042名初中一年级学生进行心理健康状况的评定,同时测量其身高和体质量,并计算体质指数.结果男生与女生、非独生子女与独生子女的自尊量表得分间差异均有统计学意义(P＜0.01),而不同年龄、民族和来源地的学生自尊量表得分间差异均无统计学意义(P＞0.05).正常体质量、超重和肥胖的学生自尊量表得分问差异有统计学意义(P＜0.05),且组间两两比较差异亦有统计学意义(P＜0.05).多元逐步回归分析表明:自尊量表得分与体质指数、焦虑量表得分、抑郁量表得分及性别呈负相关(P＜0.05).路径分析结果显示,体质指数对自尊有直接作用,还可通过焦虑或焦虑-抑郁途径间接影响自尊.体质指数、焦虑和抑郁对自尊影响的总效应由大到小依次为:体质指数、焦虑和抑郁.结论超重和肥胖对青少年自尊可能有直接和间接影响,应采取综合性措施控制青少年超重和肥胖,改善青少年焦虑和抑郁情绪,从而提高青少年自尊水平.     

不同程度抑郁状态大学生反事实思维特点的初步研究

目的 探讨不同程度抑郁状态大学生的自发和诱发反事实思维的特点.方法 采用自我报告法、故事脚本法和反事实思维推理测试(counterfactual inference test,CIT).被试分为4组(正常对照组、轻度抑郁状态组、中度抑郁状态组和重度抑郁状态组),均完成自发反事实思维试验和诱发反事实思维试验及CIT测试,并对反事实思维的数量和合理性及CIT的得分进行比较分析.结果 ①在数量方面,轻度抑郁状态组的自发反事实思维数量明显多于正常对照组、中度和重度抑郁状态组(P＜0.05,P＜0.01),重度抑郁状态组自发反事实思维数量明显少于正常对照组(P＜0.05);而各组产生的诱发反事实思维的数量差异无统计学意义(P＞0.05).②在合理性方面,各组自发反事实思维的合理性差异有统计学意义(P＜0.01),且随着抑郁程度的加重,其合理性明显降低;而诱发反事实思维的合理性仅重度抑郁状态组明显低于正常对照组(P＜0.01),其他组别之间差异无统计学意义(P＞0.05).③在CIT得分方面,重度抑郁状态组明显低于正常对照组(P＜0.05),而其他组别之间差异无统计学意义(P＞0.05).结论 随着抑郁程度的加重,抑郁状态大学生产生自发反事实思维的数量逐渐减少,合理性逐渐降低.不同程度抑郁状态大学生产生的诱发反事实思维数量均无明显差异,而重度抑郁状态大学生诱发反事实思维合理性明显低于正常大学生.     

点穴方法对早期中风偏瘫患者运动功能和抑郁症状的康复效果研究

目的 探讨点穴方法对早期中风偏瘫患者运动功能和抑郁症状的康复效果.方法 60例早期中风偏瘫患者按入院时间先后顺序随机分为点穴组和对照组,每组30例.点穴组在病房常规治疗、护理的基础上,每天进行点穴干预;而对照组只接受病房的常规护理,不进行点穴干预.点穴干预2周后比较2组的运动功能和抑郁情况.结果 干预前2组间运动功能评估量表((MAS)得分和抑郁自评量表(SDS)得分差异无统计学意义(P＞0.05);经过2周的点穴干预,点穴组SDS得分低于相应时间点对照组SDS得分(P＜0.05);点穴组干预后与干预前SDS得分的差值和对照组在2个相应时间点SDS得分的差值比较,差异有统计学意义(P＜0.05);点穴组干预后与干预前MAS得分的差值和对照组在2个相应时间点MAS得分的差值比较,差异亦有统计学意义(P＜0.05).结论 早期应用点穴方法可以促进中风偏瘫患者运动功能恢复,改善患者的抑郁状态,是一种行之有效的中医护理干预措施.     

高海拔环境下驻训军人情绪特点的动态研究

目的研究高海拔环境下驻训军人的情绪变化特点.方法采用抑郁自评量表(self-rating depression scale,SDS)和焦虑自评量表(self-rating anxiety scale,SAS),对某进高原训练的部队50名军人进行连续测评,对不同海拔高度、进入高原不同时间和不同军事作业阶段军人的情绪反应特点进行动态跟踪研究.结果①不同海拔之间,SDS得分有显著差异(P＜0.01),SAS得分没有显著差异(P＞0.05);SDS和SAS得分在2 620、2 800 m和4 308 m的海拔均显示非常显著的差异,SDS得分明显高于SAS(P＜0.01).②进入高海拔环境不同时间之间,SDS得分有显著差异(P＜0.01),SAS得分无显著差异(P＞0.05);SDS和SAS得分,在进入高海拔环境1～6周均显示非常显著的差异,SDS得分明显高于SAS(P＜0.01).③不同军事作业阶段之间,SDS得分显示显著差异(P＜0.01),SAS得分无显著差异(P＞0.05);SDS和SAS得分除进高原前低海拔地区训练阶段外,其它军事作业阶段均显示非常显著的差异,SDS得分明显高于SAS(P＜0.01).结论高海拔环境对军人情绪反应产生明显影响,抑郁和焦虑反应出现明显的分离现象,抑郁反应程度明显高于焦虑.     

宁夏回族大学生应对方式及影响因素分析

目的 探讨宁夏回族大学生应对方式及影响因素.方法 采用应对方式问卷（CSS）、自尊量表（SES）、抑郁量表（SDS）及艾森克（成人）人格问卷（EPQ）对宁夏两所高校的402名回族大学生进行调查.结果 回族大学生中,女生求助得分显著高于男生（P＜0.05）,贫困学生的解决问题得分显著高于非贫困生（P＜0.05）,不同信仰程度的回族大学生在求助因子得分上差异有统计学意义（P＜0.05）.解决问题应对方式与自尊呈正相关,与抑郁、人格精神质维度呈负相关;自责与抑郁、神经质、精神质呈正相关,与自尊呈负相关;幻想与抑郁、内外向、神经质、精神质呈正相关,与自尊呈负相关;退避与神经质呈正相关;合理化与抑郁、神经质、精神质呈正相关,与自尊呈负相关.结论 宁夏回族大学生的应对方式与性别、家庭状况、信仰程度、抑郁、焦虑、人格特征等因素密切相关.     

护理干预在非小细胞肺癌患者同步放化疗中的应用

①目的 探讨护理干预对局部晚期非小细胞肺癌(NSCLC)同步放化疗患者焦虑及抑郁情绪的影响.②方法 将65例同步放化疗的局部晚期NSCLC患者随机分为护理干预组和对照组.对照组采用常规同步放化疗,干预组在常规同步放化疗的基础上加用护理干预技术,两组患者在治疗前、治疗结束时采用抑郁自评量表(SAS)、焦虑自评量表(SDS)进行问卷调查.③结果 治疗前干预组和对照组SAS及SDS得分差异均无统计学意义(P＞0.05).干预组在治疗后SAS及SDS得分明显降低,与治疗前比较差异有统计学意义(P＜0.05),而对照组在治疗前后SAS及SDS得分无明显变化,差异均无统计学意义(P＞0.05).④结论 NSCLC患者存在明显的心理障碍,护理干预可显著降低患者的焦虑、抑郁水平.     

社区老年人心理弹性特点及其与抑郁的关系

目的 探讨社区老年人的心理弹性特点及与抑郁的关系.方法 采用心理弹性量表(CD-RISC)、老年抑郁量表(GDS)和自编一般情况调查表对620例老年人进行调查.结果 1)社区老年人心理弹性得分为(60.17±14.28)分,与中国社区人群(65.4士13.9)分相比,差异有统计学意义(P＜0.001);2)不同社区性质、婚姻状况、居住方式的社区老年人心理弹性总分及三因素比较,差异无统计学意义(P＞0.05);但不同年龄、文化程度、经济状况、健康状况、慢性病、应激事件、身体锻炼、家人关系的社区老年人心理弹性总分及三因素比较,差异有统计学意义(P＜0.05);不同性别的社区老年人心理弹性总分和力量维度比较,差异有统计学意义(P＜0.05);乐观性维度除在经济状况和家庭关系上差异有统计学意义(P＜0.05),有其余变量上差异无统计学意义(P＞0.05);3)心理弹性及三因素与抑郁呈负相关(r=-0.28～-0.14,P＜0.001);不同抑郁程度其心理弹性得分差异有统计学意义(P＜0.001).结论 社区老年人心理弹性偏低,其心理弹性与抑郁呈负相关.     

原发性高血压患者合并抑郁与血浆同型半胱氨酸水平的相关性研究

目的 探究原发性高血压患者合并抑郁与血浆同型半胱氨酸水平(Hcy)的相关性.方法 选取2011年8月-2012年6月在我院干部病房内科住院治疗的原发性高血压患者163例,通过Zung抑郁自评量表(SDS)和综合医院焦虑抑郁量表抑郁分表筛查患者是否合并抑郁,用循环酶法测定血浆Hcy水平.结果 共有69例(42.3%)患者合并抑郁,有31例(19.0%)患者发生高同型半胱氨酸血症(HHcy).按是否合并抑郁将163例患者分为抑郁组和非抑郁组,两组患者的年龄、体质指数、高血压病程、高血压分级、冠心病合并率间差异均无统计学意义(P＞0.05);两组患者的性别构成、Hcy水平及HHcy发生率间差异有统计学意义(P＜0.05).将163例患者按血压水平分为3组,不同血压分级患者血浆Hcy水平间差异无统计学意义(P＞0.05),不同血压分级患者SDS评分间差异有统计学意义(P＜0.05).结论 原发性高血压患者有较高的抑郁发生率,且存在性别差异,女性高于男性;合并抑郁的原发性高血压患者HHcy发生率及血浆中Hcy水平增加.     

医学研究生心理健康状况调查

目的 了解目前医科专业研究生的心理健康状况,为针对性地开展心理咨询和心理健康教育奠定良好的基础.方法 采用症状自评量表,对585名医学研究生进行心理健康状况自测,并与中国正常人的心理健康评定结果进行比较.结果 ①研究生组的总分、总均分低于正常人组,差别有统计学意义(P＜0.05);阴性项目数高于正常人组,差别有统计学意义(P＜0.05);阳性项目数、阳性症状均分低于正常人组,差别有统计学意义(P＜0.05).②研究生因子得分与正常人因子得分比较, 研究生因子得分:躯体化、强迫、人际关系、抑郁、敌对、偏执和精神病性低于正常人,差别有统计学意义(P＜0.05);焦虑、恐惧低于正常人,差别无统计学意义(P＞0.05).③各年级组研究生比较二年级最高,但没有明显差异(P＞0.05).④有子女组高于无子女组, 没有明显差异(P＞0.05).⑤临床医学研究生班高于基础医学研究生班, 但没有明显差异(P＞0.05).⑥其他民族高于汉族, 差别有统计学意义(P＜0.05).结论 多数研究生的心理健康状况与中国正常成人的心理健康状况相近,且有优于中国正常成人的心理健康状况的趋势.     

50例住院伤残荣誉军人SAS、SDS问卷调查

目的：探讨住院伤残荣誉军人的焦虑、抑郁情绪。方法：应用焦虑自评量表（SAS）、抑郁自评量表（SDS）进行测查。结果：住院伤残荣誉军人SAS均分、SDS均分明显高于常模,二差异有非常显性（P＜0.01),不同残疾等级间SAS、均分、SDS均分差异无统计学意义（P＞0.05);不同年龄间SDS均分差异无统计学意义（P＞0.05),SAS均分差导有显性（P＜0.05)。结论：住院伤残荣誉军人存在较严重的心理卫生问题。     

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.