癌症患者应对方式与心理状况的相关性研究

目的：探讨癌症患者应对方式与心理状况及其相关性,为癌症患者的心理护理提供理论依据。方法：采用特质应对方式问卷(TCSQ)、症状自评量表(SCL 9O)、抑郁自评量表(SDS)和焦虑自评量表(SAS)对60例癌症患者和30例健康对照进行测试,并分析癌症患者应对方式与心理状况的相关性。结果：癌症患者存在严重的心理问题。应对方式中,消极应对得分明显高于对照组(P<0.01),积极应对得分与对照组比较,差异无统计学意义(P>0.05)。癌症患者的SCL 90各因子分均明显高于对照组,突出表现在躯体化、焦虑、抑郁及精神病性四个方面。癌症组不仅SAS评分明显高于对照组（P<0.01）,而且SDS评分也明显高于对照组（P<0.05）,显示癌症患者有较多的抑郁、焦虑情绪反应。积极应对得分与SCL 90总分、总均分、阳性症状均分、强迫症状等因子及SAS、SDS评分呈负相关关系(P<0.05～0.005),消极应对得分与SCL 90（除阳性症状均分、躯体化、偏执因子外）及SAS、SDS评分呈正相关关系(P<0.05～0.005)。结论：癌症患者存在诸多方面的心理问题,应对方式是影响患者心理状况的重要因素。     

重型颅脑损伤患者家属心理状况调查

目的 探讨重型颅脑损伤患者家属的心理健康状况及其影响因素.方法 采用90 种症状自评量表(symptom checklist90,SCL-90) 对40 例重型颅脑损伤患者家属进行心理状态调查,并进行量化分析与评价.结果 重型颅脑损伤患者家属在SCL-90 总分、躯体化、人际关系、抑郁、焦虑、敌对、精神病性等因子评分上明显高于国内常模(P<0.01),而强迫、恐怖、偏执因子评分与常模比较无统计学差异(P>0.05).女性家属SCL-90 总分及除恐怖、偏执、人际关系外各因子分均明显高于男性家属(P<0.05,其中抑郁、焦虑、敌对三项P<0.01).结论 重型颅脑损伤患者家属尤其是女性,是发生心理障碍的高危人群,要高度重视家属的心理健康状况,及时进行心理干预.     

综合心理干预对脑动脉硬化症患者心理状态的影响

目的探讨心理干预对脑动脉硬化症患者心理状态的影响。方法将60例脑动脉硬化症患者随机分为观察组和对照组,每组30例。观察组采用综合心理干预(放松疗法、健康教育、心理护理)和药物治疗;对照组只采用药物治疗,于首次治疗前和治疗8周后由患者分别填写症状自评量表(scl-90)。结果观察组治疗后较治疗前总分及躯体化、抑郁、焦虑、恐怖4个因子得分下降,差异具有显著性(P<0.05),对照组治疗后较治疗前有躯体化1个因子得分下降,差异具有显著性(P<0.05);两组治疗前各因子得分差异无显著性,治疗后两组间比较,观察组有总分及人际关系、抑郁、焦虑、恐怖、偏执5个因子分的改善优于对照组,差异有显著性(P<0.05或P<0.01)。结论脑动脉硬化症患者的心理健康状况较一般人群偏差,可采取放松疗法、健康教育、心理护理等心理干预,改善患者的焦虑、抑郁等心理症状。     

肺结核患者心理状况分析及干预对策

目的:分析肺结核患者心理状况及干预对策。方法:采用症状自评量表对70例初治肺结核患者、复治肺结核患者和难治肺结核患者进行测评比较,并与全国常模进行分析比较。结果:肺结核患者躯体化、人际关系、抑郁、焦虑、敌对、恐怖因子SCL90评分高于全国常模(P<0.05),难治肺结核患者躯体化、人际关系、抑郁、焦虑、敌对、恐怖等因子高于复治肺结核和初治肺结核(P<0.05)。结论:肺结核患者存在心理问题和不良情绪,针对性实施干预对策,改善患者心理状况,提高患者治疗依从性,从而提高复治肺结核患者的生活质量。     

急症死亡患者家属心理健康状况调查及心理危机干预效果分析

目的调查急症死亡患者家属心理健康状况,并分析心理危机干预效果。方法选择急诊科就诊死亡的150例患者的家属作为研究对象,采用症状自评量表(SCL-90)进行调查,评估家属的心理健康状况,分析性别、年龄、学历对心理状况的影响。按随机数字表将150例家属随机分为干预组75例和对照组75例,干预组家属在急诊死亡后3 d内对其家属实施心理危机干预,对照组未实施心理危机干预,比较两组家属干预前后症状自评量表(SCL-90)各因子评分,采用SPSS 19.0进行统计分析。结果男性家属和女性家属躯体化、强迫、抑郁、焦虑评分差异有统计学意义(P<0.05);<60岁家属和≥60岁家属躯体化、强迫、抑郁、敌对、精神病性评分差异有统计学意义(P<0.05);大学本科以下家属和大学本科及以上家属躯体化、强迫、抑郁、焦虑评分、恐怖、精神病性评分差异有统计学意义(P<0.05)。干预组和对照组治疗后躯体化、强迫、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性评分均明显低于治疗前;干预组治疗后躯体化、抑郁、焦虑、恐怖评分均明显低于对照组(P<0.05)。结论急性死亡对其家属产生不良心理影响,应引起临床医护人员的关注,其不良心理状况受性别、年龄、学历因素影响,实施及时、有效、个体化的心理危机干预有利于降低丧亲者的不良心理反应,预防丧亲者发生急性应激障碍。     

老年高血压患者心理状况临床分析

目的:研究老年高血压患者的心理健康状况。方法:运用症状自评量表(SCL-90)自测精神心理症状。结果:老年高血压患者抑郁和敌对2项因子高于常模组(P<0.05),躯体化症状、强迫、焦虑、恐怖及精神病性共5项因子的标准分和阳性项数目显著高于常模组(P<0.01),而人际关系和偏执2项因子两组比较,差异无统计学意义(P>0.05)。结论:社会心理因素与高血压病的发生有一定的相关性,在高血压病的防治工作中应当引起重视。     

唇腭裂患儿父母心理状况调查分析

目的 :了解唇腭裂患儿父母的心理健康状况 ,为其进行心理支持和治疗提供依据。方法 :采用SCL - 90症状自评量表对唇腭裂患儿的 60名父母及正常儿童的 60名父母进行心理调查。结果 :患儿组父母SCL - 90总分、阳性项目数及抑郁、焦虑和恐怖因素分明显高于对照组 (P <0 .0 5 )。患儿母亲在躯体化、强迫、人际关系、抑郁、焦虑、偏执和精神病性诸因子分和阳性项目数上明显高于父亲 (P <0 .0 5 )。结论 :唇腭裂患儿的父母心理健康状况较差 ,尤以患儿母亲较为突出 ,需给予必要的心理支持和治疗。     

心理干预对同期放化疗中晚期宫颈癌患者心理健康状况的影响

目的:探讨心理干预对中晚期宫颈癌患者同期放化疗患者心理健康状况的影响.方法:将96例住院放化疗的中晚期宫癌颈患者随机平均分为两组,干预组在常规护理的基础上实施心理干预,常规组采用常规护理,两组患者在放化疗前和放化疗7d后采用精神症状自评量表(SCL-90)进行问卷调查.结果:心理干预前两组患者SCL-90各因子分比较,差异无显著性(P＞0.05).心理干预7d后对照组患者躯体化、强迫症状、抑郁、焦虑、敌对性、恐怖、精神病性等因子分与对照组比较,差异有显著性(P＜0.01),人际关系、偏执等因子分与对照组比较差异有显著性(P＜0.05).结论:心理干预结同期放化疗治疗中晚期宫颈癌患者的负性心理状况有明显改善作用.     

腹腔镜和开腹手术对子宫肌瘤患者心理状况的影响研究

目的:调查子宫肌瘤患者腹腔镜术后和开腹术后的心理状况及其影响因素。方法:运用症状自评量表(SCL-90)评定两种不同手术方法组患者的心理状况,并对术后出现心理问题患者进行单因素和多因素分析。结果:腹腔镜组患者与开腹组患者相比较,躯体化、焦虑、抑郁、偏执因子差异有显著性(P<0.05)。单因素分析家庭关系、文化程度、月收入、手术方式,两组间差异有统计学意义(P<0.05)。多因素回归分析显示家庭关系(OR=1.856;95%CI:1.247~2.653)、教育程度(OR=2.3631;95%CI:1.465~3.574)和手术方式(OR=1.672;95%CI:1.119~2.362)是术后心理问题发生的独立影响因素。结论:子宫肌瘤术后群体有比较明显的心理问题,但其中腹腔镜组患者较开腹组患者的心理健康状态好。术后患者的心理状况低下与家庭关系、文化程度和手术方式有关。     

护理干预对老年急性冠脉综合征患者心理社会适应状况的效果评价

目的对老年ACS患者的心理社会适应状况和护理干预措施进行总结分析,探讨有效的老年ACS患者临床护理措施.方法采用症状自评量表(SCL-90)对103例患者分别于入院后1天和出院前1天进行心理社会适应状况分析,分析采用综合护理干预措施后的效果.结果老年ACS患者在躯体化、强迫、人际关系、抑郁、焦虑、惊恐、偏执等因子方面与中国老年常模差异显著性,P<0.05,而在敌对、精神病性等方面与中国老年常模差异无显著性,P>0.05;对103例患者进行护理干预后,在躯体化、强迫、人际关系、抑郁、焦虑、惊恐、偏执等方面评分差异有显著性,P<0.05.结论鉴于老年ACS患者的社会适应能力特点,及早对患者进行有针对性的综合护理干预措施.     

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.