网络成瘾患者抑郁状况及相关因素调查

目的:了解网络成瘾(Internet Addiction,IAD)患者的抑郁状况及相关影响因素,为IAD患者的治疗提供参考。方法:采用自制的一般资料问卷、抑郁自评量表(Self-Rating Depression Scale,SDS)、家庭功能量表(家庭支持APGAR问卷)对住院治疗的107名IAD患者进行测评,分析IAD患者抑郁的危险因素。结果:IAD患者的抑郁发生率为61.68%,远高于正常群体(χ~2=85.48,P0.001);Logistic回归分析显示,家庭功能严重障碍(P=0.007,OR=5.231,95%CI=1.943~9.887)、非自愿入院治疗(P=0.011,OR=3.112,95%CI=1.764~8.113)、单亲家庭(P=0.032,OR=2.213,95%CI=1.210~6.399)为IAD患者抑郁的显著危险因子;家庭功能良好(P=0.001,OR=0.317,95%CI=0.172~0.857)为IAD患者抑郁的显著保护因子。结论:多数IAD患者存在严重的抑郁情绪;家庭支持状况差、非自愿入院治疗及单亲家庭的患者抑郁状况更差;良好的家庭功能状况有助于抑郁状况的改善。     

江苏盐城地区留守儿童抑郁状况及相关因素

目的:了解江苏盐城地区留守儿童的抑郁状况及相关的影响因素。方法:采用自制的一般资料问卷及儿童抑郁问卷(Children's Depression Inventory,CDI)对盐城地区3所农村中心小学356名留守儿童进行调查。结果:留守儿童的抑郁检出率为25.6%。Logistic回归分析显示,与父母交流频率为每半年(P0.001,OR=7.321,95%CI=2.876~15.128)、双亲缺失型留守儿童(P=0.021,OR=2.134,95%CI=1.654~6.980)、交流中谈论日常琐事(P=0.006,OR=4.321,95%CI=1.908~9.978)、家庭年收入为0~2000元(P=0.012,OR=3.223,95%CI=2.011~8.830)、5~6年级(P=0.003,OR=8.342,95%CI=2.113~19.232)、11~13岁(P=0.015,OR=5.299,95%CI=1.809~15.098)为留守儿童抑郁发生的危险因子,而交流内容为自我感受(P=0.001,OR=0.342,95%CI=0.190~0.799)、1~2年级(P0.001,OR=0.543,95%CI=0.221~0.879)、7~8岁(P0.001,OR=0.655,95%CI=0.207~0.911)为留守儿童抑郁的抗性因素。结论:盐城地区留守儿童的抑郁发生率较高,危险因素和抗性因素应当给予关注。     

孕妇产前抑郁焦虑的危险因素

目的:探讨孕妇产前抑郁、焦虑的相关危险因素,为产前抑郁、焦虑的早期筛查及临床干预提供理论支持。方法:选取昆明市妇幼保健院产前检查的孕妇2112人,采用爱丁堡产后抑郁量表(EPDS)、焦虑自评量表(SAS)于孕28周对其进行问卷调查。采用非条件logistic回归分析探讨产前抑郁、焦虑症状的相关危险因素。结果:孕28周抑郁症状检出率为25.4%,焦虑症状检出率为6.6%。Logistic回归分析显示,抑郁症状的危险因素为低年龄(OR=0.80,95%CI:0.68~0.94)、孕期非坚持工作(OR=1.18,95%CI:1.02~1.36)、对居住环境不满意(OR=1.50,95%CI:1.23~1.83)、期望生男孩(OR=0.86,95%CI:0.77~0.96)、非独子(OR=1.37,95%CI:1.06~1.76)、非计划内怀孕(OR=1.38,95%CI:1.10~1.72);焦虑症状的危险因素为不满意居住环境(OR=1.64,95%CI:1.19~2.26)、与丈夫关系不融洽(OR=2.01,95%CI:1.20~3.37)、非计划内怀孕(OR=1.50,95%CI:1.05~2.14)。结论:本研究提示,年龄越小、孕期未坚持工作、对居住环境不满意、期望生男孩、孕妇非独子、非计划内怀孕的孕妇,越易患产前抑郁症;对居住环境不满意、与丈夫关系不融洽、非计划内怀孕的孕妇,越易患产前焦虑症。     

HIV阳性男男性行为者的抑郁焦虑状况

目的:了解我国HIV阳性男男性行为人群(MSM)的抑郁、焦虑状况,探讨抑郁、焦虑的相关因素。方法:在MSM社区HIV感染者小组的帮助下,在HIV阳性MSM中采用"滚雪球"的方法,共招募HIV阳性MSM 600人,采用电子调查问卷进行调查,获有效问卷541份。使用自编HIV阳性MSM人群健康状况调查表调查研究对象的社会人口学特征及健康行为等,流调中心用抑郁量表(CES-D)和焦虑自评量表(SAS)调查抑郁(CES-D评分≥16分者为有抑郁症状)、焦虑(SAS评分≥50分者为有焦虑症状)状况。结果:研究对象抑郁、焦虑症状检出率分别为44.7%(242/541)和25.1%(136/541)。多因素非条件logistic回归分析表明,抑郁症状的危险因素包括最近1年考虑过自杀(OR=3.31,95%CI:1.73~5.34)、未将HIV感染状况告知男性固定性伴(OR=0.47,95%CI:0.30~0.73)和被歧视经历评分高(OR=1.19,95%CI:1.11~1.29);与月收入≤1500元者相比,月收入为5000元者有抑郁症状的可能性降低(OR=0.34,95%CI:0.17~0.71)。焦虑症状危险因素包括最近1年考虑过自杀(OR=2.43,95%CI:1.40~4.21)、接受抗病毒治疗(OR=1.74,95%CI:1.06~2.84)和被歧视经历评分高(OR=1.12,95%CI:1.05~1.20);与月收入≤1500元者相比,月收入为5000元者检出焦虑症状的可能性降低(OR=0.44,95%CI:0.20~0.94)。结论:本研究提示HIV阳性MSM人群抑郁或焦虑症状检出率高,需要引起重视;降低社会歧视、促进性伴交流与支持、改善经济状况可能有助于提高HIV阳性MSM的心理健康水平。     

高龄产妇产后抑郁状况及影响因素

目的:结合高龄产妇的抑郁状况,探究高龄产妇产后抑郁的影响因素。方法:选择2014年1月至2017年12月的150名高龄产妇作为研究对象,分为抑郁组和对照组。回顾性收集患者基本信息及激素检测指标,进行组间的差异性分析;利用Logistic回归分析高龄产妇抑郁的危险因素。结果:抑郁组高龄产妇平均孕周期高于对照组(t=13.92,P0.001),抑郁组产妇夫妻关系较差、有疼痛恐惧、产时有并发症者比例高于对照组,差异有统计学意义(χ~2=14.12,10.44,11.20;P0.01);抑郁组高龄产妇雌激素降低、孕激素降低、促肾上腺皮质激素释放激素升高、甲状腺激素降低发生比例高于对照组,差异均有统计学意义(χ~2=6.12,5.69,4.65,11.63;P0.05);Logistic回归分析显示,平均孕周期长(OR=1.28,95%CI=1.01～1.63)、夫妻关系差(OR=2.77,95%CI=1.22～6.34)、产时有并发症(OR=1.72,95%CI=1.11～2.65)、雌激素降低(OR=1.36,95%CI=1.01～1.84)、甲状腺激素降低(OR=1.67,95%CI=1.10～2.53)为高龄产妇抑郁的危险因素。结论:高龄产妇雌激素降低、孕激素降低、促肾上腺皮质激素释放激素升高、甲状腺激素降低发生率高,平均孕周期长、夫妻关系差、产时有并发症、雌激素降低、甲状腺激素降低是抑郁的发生危险因素。     

新冠肺炎疫情期间医务人员与非医务人员焦虑抑郁水平及相关因素

目的:探索新冠肺炎疫情暴发期间医务人员与非医务人员焦虑抑郁水平及相关因素。方法:通过微信公众号方式发放在线问卷,共调查医务人员170名,非医务人员217名。内容包括一般情况调查表、广泛性焦虑量表(GAD-7)、患者健康问卷(PHQ-9)和心理弹性量表(CD-RISC-10),采用logistic回归分析焦虑、抑郁情绪的相关因素。结果:医务人员中抑郁情绪检出率42.9%,焦虑情绪检出率46.5%。非医务人员抑郁情绪检出率62.7%,焦虑情绪检出率52.5%。在所有被调查者中,非医务人员(OR=0.58,95%CI:0.36～0.93,P<0.05)是抑郁情绪的危险因素,接触(疑似)感染者(OR=2.63,95%CI:1.43～4.85,P<0.01)是焦虑情绪的危险因素。心理弹性差是抑郁情绪(医务人员：OR=10.36,95%CI:3.46～31.05,P<0.001,非医务人员：OR=17.14,95%CI:6.39～45.97,P<0.001)和焦虑情绪(医务人员：OR=14.30,95%CI:4.68～43.69,P<0.001,非医务人员：OR=11...     

车祸颅脑损伤患者康复治疗期抑郁心理发生的危险因素

目的:探讨车祸颅脑损伤患者康复治疗期抑郁心理发生的危险因素。方法:以2015年11月-2016年10月我院收治的130例车祸颅脑损伤康复治疗期患者为对象,采用汉密尔顿抑郁量表17项(HAMD-17)对纳入患者康复治疗期抑郁心理状况进行评估诊断,观察纳入患者治疗前、康复治疗期HAMD评分变化,依据评估结果将患者分为抑郁组(HAMD-177分)及无抑郁组(HAMD-17≤7分),分析比较两组一般资料及社会支持评定量表(SSRS)评分,采用单因素和多因素Logistic回归分析法分析车祸颅脑损伤患者康复治疗期抑郁心理发生的危险因素。结果:纳入患者康复治疗期HAMD评分较治疗前及国内常模明显高,差异显著(t=11.697,27.837;P0.001);纳入研究130例患者共有80例存在抑郁症,抑郁症发生率为61.54%(80/150);经单因素和多因素Logistic回归分析显示年龄小(OR=-0.321,P=0.012,95%CI=1.017～1.282)、文化程度高(OR=-0.519,P=0.007,95%CI=1.011～2.208)、经济状况差(OR=-0.605,P=0.016,95%CI=1.154～3.430)、无经济赔偿(OR=-0.552,P=0.013,95%CI=1.213～3.983)、颅脑损伤程度高(OR=-0.712,P=0.016,95%CI=1.301～3.992)、有昏迷(OR=-0.313,P=0.014,95%CI=1.001～2.128)和SSRS评分低(OR=-0.449,P=0.005,95%CI=1.009～2.198)是车祸颅脑损伤患者康复治疗期抑郁心理发生的独立危险因素。结论:车祸颅脑损伤患者康复治疗期存在抑郁心理发生风险较高,其危险因素主要包含年龄小、文化程度高、社会支持性差、颅脑损伤程度高等,临床工作中应高度重视其高危因素,对指导合理干预措施有重要参考价值。     

大学生抑郁症与社会资本的关系

目的 了解安徽省不同特征大学生抑郁症状的现况与影响因素,探讨抑郁症状和社会资本之间的相关性。方法 应用便利抽样法选取在校大学生作为研究对象,选择一般资料调查表、社会资本量表和流调中心抑郁量表进行问卷调查,应用问卷星发放问卷,共回收有效问卷439份。结果 本研究中大学生抑郁症状的发生率为19.4%(85/439),与常模18.4%(187/1 015)之间差异无统计学意义(χ²=0.178,P=0.674);二元Logistic回归分析显示,非独生子女(OR=2.153,95%CI:1.065,4.349)、农村户籍(OR=2.137,95%CI:1.070,4.267)、理工科(OR=0.271,95%CI:0.124,0.596)、未参加过社会实践(OR=2.261,95%CI:1.136,4.502)、社会资本量表得分较低(OR=0.759,95%CI:0.670,0.859)是大学生抑郁症状的影响因素。结论 非独生子女、农村户籍、文科类专业学生、未参加过社会实践、社会资本量表得分较低的大学生易出现抑郁症状,高校应对此类大学生的心理健康积极关注。     

成人中重度烧伤早期焦虑抑郁及相关因素分析

目的探讨成人中重度烧伤患者早期焦虑抑郁状况及其相关因素,为进一步实施护理干预积累临床资料。方法对80例中重度烧伤成人患者,在入院1周内脱离危险后,用一般情况调查表和焦虑自评量表(SAS)与抑郁自评量表(SDS)进行调查,分析性别、年龄、文化程度、婚姻、职业、户籍、经济状况、付费类别和社会支持以及烧伤原因、程度和部位,对患者早期焦虑抑郁状况的影响。结果本组患者SAS和SDS评分均显著高于国内常模(t=21.050,21.118;P均<0.001);SAS与SDS显著正相关(r=0.548,P<0.001);多元回归分析,性别、户籍和烧伤程度3因子进入SAS逐步回归方程:y=68.28+9.09x1+5.036x2+3.497x3(F=48.916,P<0.001);烧伤部位、性别和烧伤程度3因子进入SDS逐步回归方程:y=85.651-8.995x1+2.905x2+2.037x3(F=153.055,P<0.001)。结论中重度烧伤成人患者在烧伤早期普遍严重的焦虑抑郁情绪,女性、重度、农村、头面部烧伤患者焦虑抑郁程度更重。     

北京市海淀区老年人焦虑抑郁状况及其影响因素

目的:探讨北京市海淀区65岁以上老年人焦虑抑郁现况及其影响因素。方法:分层随机抽取北京市海淀区29个社区的2464名老年人采用焦虑自评量表(SAS)、抑郁自评量表(SDS)及一般情况调查表进行调查。结果:1老年人情绪问题的检出率为18.5%;2不同年龄的老年人焦虑情绪(χ2=16.157,P0.01)抑郁情绪(χ2=16.157,P0.01)发生率差异显著;3不同年龄阶段老年人焦虑情绪(F=9.132,P0.001)抑郁情绪(F=13.679,P0.001)得分差异显著,不同养老形势老年人抑郁情绪(F=11.90,P0.001)得分差异显著;4脑卒中、冠心病是老年人焦虑情绪(OR=1.9,OR=1.6)和抑郁情绪(OR=1.8,OR=1.4)的危险因素。结论:北京社区的老年人焦虑抑郁情绪问题比较突出,受年龄、养老形势、慢病等多种因素影响,应重视心理健康指导。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

The case for allele‐specific recognition by the TCR

There is a sharp difference in how one views TCR structure–function–behaviour dependent on whether its recognition of major histocompatibility complex‐encoded restriction elements (R) is germline selected or somatically generated. The generally accepted or Standard model is built on the assumption that recognition of R is by the V regions of the αβ TCR, which is not driven by allele specificity, whereas the competing model posits that recognition of R is allele‐specific. The establishing of allele‐specific recognition of R by the TCR would rule out the Standard model and clear the road to a consideration of a competing construct, the Tritope model. Here, the case for allele‐specific recognition (germline selected) is detailed making it obvious that the Standard model is untenable.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.