2型糖尿病与心理障碍关系的分析

目的了解2型糖尿病患者的情绪障碍及其影响因素.方法对160例2型糖尿病患者及105例正常对照者进行了回顾性Znng氏自评抑郁、焦虑量表的调查.结果结果显示糖尿病组抑郁症患病率为36.25%(58/160),焦虑症患病率29.38%(47/160); 对照组分别为3.33%、1.33%(P值均<0.001).抑郁症与体重指数、血糖、TG及CH具有相关性(r分别等于0.62,0.59,0.44,0.46;P值均<0.01).焦虑症与体重指数、血糖及TC也具有相关性(r分别等于0.67,0.62,0.48;P值均<0.01).抑郁量表得分与病程有关(r=0.65, P＜0.01),病程越长抑郁的程度越重、发生率越高.结论 2型糖尿病患者抑郁症及焦虑症的患病率较高,且与糖尿病病程、肥胖、血糖及血脂水平相关.     

抑郁情绪对2型糖尿病患者临床转归的影响

对160例2型糖尿病及105例正常对照者进行了回顾性Znng氏自评抑郁量表的调查。结果显示糖尿病组抑郁情绪患病率为36.25%（58/160）;对照组为3.33%（p〈0.001）。抑郁情绪与体重指数、血糖、TG及CH具有相关性（r分别等于0.62,0.59,0.44,0.46;P均〈0.01）。抑郁量表得分与病程有关（r=0.65,p〈0.01）,病程越长抑郁的程度越重、发生率越高。结论：2型糖尿病患者抑郁情绪患病率较高,且与糖尿病病程、肥胖、血糖及血脂水平相关。     

2型糖尿病合并心肌损害的危险因素分析

目的：探讨2型糖尿病并心肌损害的危险因素。方法：比较2型糖尿病伴或不伴心肌损害的临床特征及心肌 损害的危险因素。结果：2型糖尿病病程长（P＜0．05）、体重指数高（P＜0．01）、空腹血糖高（P＜0．01）、甘油三酯高（P＜0．05）、高血压发生率（P＜0．01）、糖尿病肾病发生率（P＜0．01），是2型糖尿病伴心肌损害的危险因素，继发 性高血压与2型糖尿病的心肌损害直接相关。结论：对2型糖尿病患者应早期加强血糖、体重、高甘油三酯血症和血压控制，以预防糖尿病心肌病。     

糖尿病患者生存质量影响因素分析

目的了解糖尿病患者生存质量、社会支持及伴发焦虑、抑郁的现状，探讨其相关的影响因素。方法应用糖尿病人生存质量特异性量表（DSQL）、社会支持量表（SSRS）、焦虑自评量表（SAS）、抑郁自评量表（SDS），对504例糖尿病患者进行调查。结果糖尿病对健康的损害率为95．64％，对心理、人际关系的影响率为76．19％、30．36％；伴发焦虑、抑郁的比例为11．31％、29．96％；生存质量与病程等因素显著相关（r=0．18～0．55，P〈0．01）；社会支持与年龄等因素显著相关（r〉0．11，P〈0．01）；焦虑、抑郁与并发症等因素显著相关（r〉0．20，P〈0．01）；生存质量、社会支持、焦虑、抑郁在病程、并发症等变量的不同水平之间差异有显著性（P〈0．05）。结论并发症、伴发焦虑、抑郁是影响患者生存质量的主要因素，预防和控制并发症，改善不良情绪是提高生存质量的关键。     

2型糖尿病患者抑郁症发病风险预测及验证

目的：探讨2型糖尿病合并抑郁症的发病比例及相关的危险因素。方法：选择530例2型糖尿病并抑郁症患者填写问卷调查表,对调查表进行分析。结果：530例参与调查的患者中,合并抑郁症者183例（34．5％）,未合并抑郁症者347（65．5％）。单因素分析发现体重指数、糖化血红蛋白、胰岛素敏感指数、病程、并发症数量、家庭人均月收入、职业、情绪类型、社会关系在糖尿病伴抑郁症组和单纯糖尿病组之间差异有统计学意义（P〈0．05）。结论：2型糖尿病患者抑郁症的患病率较高,病程的长短、血糖的控制情况及并发症的多少是抑郁症发病的主要风险。     

肠道易激综合征患者情绪障碍分析

目的 研究肠道易激综合征患者和正常人之间负性情绪的差异和情绪障碍。方法 采用医院焦虑及抑郁亚量表自评。结果 病例组焦虑或抑郁亚量表评分明显高于对照组（P＜0．0001和P＜0．001），病例组伴有可疑焦虑和抑郁障碍为34％和44％以及确诊焦虑症和抑郁症分别为36％和12％；焦虑抑郁并存为54％，其中确诊占6％。结论 本研究表明肠道易激综合征患者伴有较多的精神障碍，特别是共病状态或焦虑症所占比例较抑郁症更高，临床实践中应给予重视。     

聚焦解决模式在2型糖尿病抑郁症心理护理中的应用价值

【目的】探讨以聚焦解决模式为基础的心理护理干预方法在2型糖尿病（T2DM ）抑郁症中的应用价值。【方法】采用汉密尔顿抑郁量表对240例T2DM患者的抑郁状况进行评估,选择其中合并抑郁的患者100例,分为观察组和对照组,每组50例。对照组采用常规健康教育、心理护理及药物治疗,观察组在对照组治疗方案的基础上加以聚焦解决心理护理模式进行干预,比较两组住院时间、住院费用和生活质量等。【结果】观察组住院时间及住院费用显著低于对照组（P ＜0．01）;观察组干预后抑郁焦虑评分值明显降低,干预前后比较有统计学意义（P＜0．01）;观察组干预后生活质量明显提高（ P＜0．05）。【结论】以聚焦解决模式为基础的心理干预策略能为糖尿病抑郁症的患者提供有效的心理护理,有效的控制血糖,提高生活质量。     

整形美容手术接受者50例心理状态解析

目的：探讨整形美容手术对受术者心理状态的影响。方法：采用焦虑自评量表、抑郁自评量表、自尊量表、体像障碍自评量表及艾森克人格问卷的方法，对50例受术者进行问卷调查，并进行结果分析。结果：在50例整形美容受术者中，术前焦虑、抑郁状态者分别为57％和27％。受术者术后自尊量表分值较术前上升2．631（P＜0．01），体像障碍及精神质量表、神经质量表和掩饰程度分值分别下降6．131（P＜0．01）、1．966（P＜0．05）、3．458（P＜0．01）和2．829（P＜0．01）。术前受术者体像障碍与抑郁状态相关性r＝0．193（P＜0．05），回归方程为y＝0．125x＋30．278。结论：受术者的自尊和体像障碍状态在整形美容手术术后有明显的改善。     

老年2型糖尿病患者抑郁状况调查及相关危险性分析

目的 调查老年2型糖尿病患者抑郁的患病率,分析与抑郁相关的危险因素.方法 报告了本社区2010年8-11月应用Beck抑郁问卷(BDI)进行抑郁评分的154例老年2型糖尿病患者的抑郁情况.同时采集糖尿病患者的年龄、性别、糖尿病病程,体质量数,血糖情况,糖尿病治疗情况及并发症患病情况.结果 52.6%的患者存在不同程度抑郁症,老年糖尿病患者合并抑郁的发生与性别,年龄,空腹血糖、糖尿病治疗情况,合并高血压及周围神经病变密切相关(P＜0.05).相关分析显示,抑郁与女性(r=0.297 P=0.028)、胰岛素使用(r=0.257 P=0.048)、合并高血压(r=0 257 P=0 049)、合并周围神经病变(r=0.345,P=0.020)相关.多元逐步回归分析显示,性别和周围神经病变进入回归方程,标准化回归系数分别为0.373(P=0.009)和0.380(P=0.007).结论 老年2型糖尿病患者抑郁的患病率较高,性别和合并周围神经病变是糖尿病合并抑郁的独立危险因素.     

健康教育对伴有抑郁的2型糖尿病的影响研究

目的 了解2型糖尿病患抑郁症发生率，探讨健康教育与干预治疗对抑郁症状及糖脂代谢的影响。方法 采用Zung抑郁自评量表(SDS)对160例糖尿病患进行测评，选出2型糖尿病合并抑郁症状59例，随机分为试验组30例，对照组29例，在原药物治疗基础上，对试验组采用集体授课、单个指导、看书自学的方式实施糖尿病健康教育培训。结果 2型糖尿病合并抑郁症状发生率为36．9％，经健康教育与干预治疗3个月后，试验组抑郁指数显降低(P＜0．05)，糖脂代谢显改善(P＜0．05)，抑郁转归发生率高，与对照组比较差别显(P＜0．01)。结论 2型糖尿病患常合并抑郁症状，健康教育强化干预治疗可改善抑郁症状及糖脂代谢，是促进患学习DM知识，提高对治疗的依从性和自我管理能力的有效途径。     

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.