骨肿瘤患者情感障碍相关因素调查分析

目的 了解骨肿瘤患者抑郁、焦虑情绪的发生率，并对其相关因素进行分析。方法 对210倒骨肿瘤住院患者，应用抑郁自评量表（SDS）、焦虑自评量表（SAS）、汉密顿抑郁量表（HAMD）、汉密顿焦虑量表（HAMA）和自行设计的情感障碍影响因素调查表，进行情感状况及其相关因素的调查和分析。结果骨肿瘤患者抑鄙和焦虑的发生率分别为52．9％和21．4％；患者的SDS、SAS标准分显著高于常模（均P〈0．01）；不同病期骨肿瘤患者的情感障碍阳性率比较，差异有显著性意义（均P〈0．01）。影响骨肿瘤患者的情感因素诸多，但以对医疗费用（73．3％）、治疗效果的担心（62．9%）最为显著。结论 骨肿瘤患者情绪障碍严重，应及早给予心理干预和必要的社会支持，以提高患者的治疗效果及生存质量。     

心理干预对牙科患者焦虑情绪影响的研究

目的：探讨心理干预对治疗牙科患者牙科焦虑症（dental anxiety,DA）的作用以及对口腔临床治疗的影响。方法：采用焦虑自评量表（self-rating anxiety seale,SAS）和抑郁自评量表（self—rating depression scale,SDS）对一般牙科患者予以筛选,筛选出分值高于50分的焦虑抑郁患者60例并随机分为2组,分别给予心理干预治疗和一般治疗,对数据进行统计分析。结果：心理干预治疗组与对照组相比,患者的SAS和SDS分值有非常明显降低（P〈0．01）,心理干预治疗组的同组患者中,其在心理干预前后的SAS和SDS分值有非常显著差异性（P〈0．01）。结论：心理干预对缓解牙科患者的焦虑情绪有显著效果。     

心理干预疗法在治疗慢性前列腺炎中的应用

目的观察心理干预疗法联合药物治疗慢性前列腺炎（CP）的临床效果,探讨慢性前列腺炎的心理治疗问题。方珐将192例CP患者随机分为两组,对照组96例,采用临床常规方法进行治疗;治疗组96例,在接受临床常规治疗的同时应用心理干预疗法。疗程2个月。治疗前后两组分别应用国际慢性前列腺炎症状评分（NIH—CPSI）测评症状严重程度,国际勃起功能指数-5（IIEF-5）测评患者性功能状况,焦虑自评量表（SAS）、抑郁自评量表（SDS）测评患者焦虑、抑郁等情绪障碍的患病状况。各项结果进行统计学分析。结果治疗后两组患者前列腺炎症状和性功能障碍均有改善,但治疗组改善程度明显优于对照组（P〈0．05）。对照组治疗后SAS、SDS评分无显著性差异（P〉0．05）;而治疗组治疗后SAS、SDS评分有显著性差异（P〈0．005）。结论心理干预可有效改善慢性前列腺炎患者的心理状态和性功能状况。对于CP患者在进行常规治疗的同时应积极应用心理干预治疗。     

中等护理专业课堂教学现状分析及对策

目的探讨晚期肿瘤患者家属的焦虑、抑郁情绪及采取的应对方式．以指导心理干预，提高其生活质量。方法选用Zung焦虑自评量表（SAS）和抑郁自评量表（SDS）、简易应对方式量表（SCSQ）对236名晚期肿瘤患者家属（观察组）和236名慢性病患者家属（对照组）进行调查。结果观察组SAS和SDS评分与对照组和国内常模比较，差异有显著性意义（均P〈0．01）；观察组积极应对和消极应对总分与对照组比较，差异无显著性意义（均P〉0．05）。观察组SDS评分与积极应对分呈负相关（P〈0．01）。结论晚期肿瘤患者家属多伴有焦虑和抑郁情绪，并受多种因素影响，帮助他们改善应对方式，可以提高生活质量。     

放松训练辅助治疗焦虑症效果观察

目的探讨放松训练辅助治疗焦虑症的效果。方法将132例焦虑症患者随机均分为观察组和对照组。两组均予常规药物治疗，对照组辅以简单的娱乐活动，观察组增加放松训练，2周（1个疗程）后采用焦虑自评量表（SAS）、抑郁自评量表（SDS）评定治疗效果。结果观察组放松训练前后SAS、SDS评分比较，差异有显著性意义（均P〈0．01）；治疗后SAS、SDS评分与对照组比较，差异有显著性意义（均P〈0．01）。结论放松训练能有效改善患者的焦虑、抑郁情绪，提高临床疗效。     

未婚人工流产手术妇女术前焦虑抑郁与心理压力的关系研究

目的：探讨术前人工流产术妇女术前焦虑抑郁与心理压力的状况及其关系。方法采用焦虑自评量表（SAS）、抑郁自评量表（SDS）和中文版知觉心理压力量表（CPSS）对200例术前未婚人工流产术妇女进行术前调查,分析SAS 、SDS与CPSS之间的关系。结果术前人工流产术妇女CPSS评分总分为（27.52±6.39）分,HRS者检出率为39％;SAS、SDS评分分别为（56.38±13.25）分、（53.38±11.25）分,明显高于国内常模（37.23±12.58）分、（41.38±10.57）分（t=193.47、14.64,P＜0.01）。术前未婚人工流产术妇女焦虑抑郁与心理压力存在显著正相关（P＜0.01）。结论焦虑抑郁情绪会加重术前未婚人工流产术妇女的心理压力,消除焦虑抑郁情绪能够缓解心理压力。     

护理干预对情感障碍患者认知行为的影响

目的 探讨护理干预对情感障碍患者认知行为的影响。方法 将62例情感障碍患者随机分为观察组（30例）和对照组（32例）。两组均给予常规药物治疗及情感支持；观察组在此基础上予以认知行为护理干预。6周后运用症状自评量表（SCL-90）、抑郁自评量表（SDS）评定疗效。结果 观察组干预后SCL-90评分中。强迫、人际关系、抑郁、焦虑、恐怖、躯体化、精神病性各因子分显著低于对照组（P〈0．05。P〈0．01）；SDS评分显著低于对照组（P〈0．01）。结论 护理干预可降低情感障碍患者抑郁、焦虑情绪及躯体症状。促进疾病康复。     

终末期肾病患者睡眠质量与焦虑抑郁情绪的相关性研究

目的探讨终末期肾病患者的睡眠质量与焦虑、抑郁情绪及其相关性。方法对83例终末期肾病患者采用匹兹堡睡眠质量指数（PSQI）、焦虑自评量表（SAS）和抑郁自评量表（SDS）进行调查。结果终末期肾病患者PSQI总分为（11．45土5．37）分,SAS评分为（46．25±8．58）分,SDS评分为（43．67±7．92）分;PSQI与SAS、SDS呈显著正相关（均P〈O．01）。结论终末期肾病患者睡眠质量较差,焦虑、抑郁情绪严重．且睡眠质量与焦虑、抑郁情绪有相关性。需运用心理干预治疗提高终末期肾病患者的睡眠质量。     

太极拳运动对青少年糖尿病患者负性情绪的影响

目的探讨太极拳运动对青少年糖尿病患者负性情绪的影响。方法成立糖尿病太极拳俱乐部．在糖尿病疾病相关知识健康教育基础上。对31例青少年糖尿病患者以太极拳运动方式进行干预。结果干预前糖尿病患者抑郁自评量表（SDS）、焦虑自评量表（SAS）评分显著高于国内常模（均P〈0．01）；干预后患者SDS、SAS评分及血糖水平显著低于干预前（均P〈0．01）。结论太板拳运动可有效改善青少年糖尿病患者的负性情绪，使血糖控制达理想水平。     

多次化疗患者配偶的心理特征及其需求调查

目的 了解多次化疗患者配偶的焦虑和抑郁情况，探讨其相关因素。方法 采用焦虑自评量表（SAS）和抑郁自评量表（SDS）对60名化疗3次及以上患者的配偶进行问卷调查。结果 18．3％配偶存在焦虑情绪．16．7％存在抑郁情绪，其均值均高于常模（均P〈0．01）；其中配偶焦虑与患者化疗不良反应严重程度、配偶年龄呈正相关（P〈0．01、P〈0．05）；抑郁与患者年龄呈负相关；女性焦虑、抑郁得分均高于男性（均P〈0．01）；配偶希望通过多种方式了解关于化疗方案、不良反应表现、预防及处理等相关信息。结论 多次化疗患者的配偶存在一定程度的焦虑抑郁情绪．应结合其需求，对其身心健康给予重视。及时关注化疗期间配偶的心理波动。     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

A Teaspoon Pump for Pumping Blood with High Hydraulic Efficiency and Low Hemolysis Potential

Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.     

A comparison of the inhibitory effects of four volatile anaesthetics on the metabolism of chlorzoxazone, a substrate for CYP2E1, in rabbits

Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Tissue perfusion in relation to cardiac output during continuous positive-pressure ventilation and administration of propranolol or verapamil

Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H₂O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg⁻¹ followed by 0.15 mg · kg⁻¹ · h⁻¹, n=8) or verapamil (0.1 mg · kg⁻¹ followed by 0.3 mg · kg⁻¹ · h⁻¹, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.     

Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts

Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Synergistic interaction between the effects of propofol and midazolam with fentanyl on phrenic nerve activity in rabbits

Background: It has been shown that the depressive effects of both propofol and midazolam on consciousness are synergistic with opioids, but the nature of their interactions on other physiological systems, e. g. respiration, has not been fully investigated. The present study examined the effect of propofol and midazolam alone and in combination with fentanyl on phrenic nerve activity (PNA) and whether such interactions are additive or synergistic. Methods: PNA was recorded in 27 anaesthetised and artificially ventilated rabbits. In three groups, propofol, fentanyl and midazolam were administered intravenously in incremental doses to construct dose-response curves for the depressant effects of each one on PNA. In another two groups, the effect of pretreatment with either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. on the effects of propofol and fentanyl respectively on PNA were studied. Results: Propofol and fentanyl caused a dose-dependent depression of PNA with complete abolition at the highest total doses of 16 mg · kg^?1 i. v. and 32 μg · kg^?1 i. v., respectively. In contrast, midazolam in incremental doses to a total of 0.8 mg · kg^?1 reduced mean PNA by 63%, but approximately 12% of PNA remained at a total dose as high as 6.4 mg · kg^?1. The mean ED₅₀s, calculated from dose-response curves, were 5.4 mg · kg^?1, 3.9 μg · kg^?1 and 0.4 mg · kg^?1 for propofol, fentanyl and midazolam, respectively. Initial doses of either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. acted synergistically with subsequent doses of either propofol or fentanyl to abolish PNA at total doses of 8 mg · kg^?1 and 8 μg · kg^?1, respectively. Conclusion: Fentanyl has a synergistic interaction with both propofol and midazolam on PNA and hence potentially on respiration.     

Influence of dopexamine hydrochloride on haemodynamics and regulators of circulation in patients undergoing major abdominal surgery

Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg^?1 · min^?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min^?1 · m^?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO₂I) and oxygen consumption index (VO₂I) were also significantly increased in the dopexamine group (DO₂I: from 416±91 to 717±110 ml/m² · m²; VO₂I: from 98±25 to 157±22 ml/m² · m²), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow.