心理干预对强直性脊柱炎患者生存质量及心理健康状况的影响

目的探讨心理干预对强直性脊柱炎患者的生存质量及心理健康状况的影响.方法采用病例对照研究方法,测查一般资料、生理指标、健康状况调查问卷(SF-36)、社会支持量表(SSRS)、艾森克个性问卷(EPQ)、医学应对问卷(MCMQ)、抑郁自评量表(SDS)和焦虑自评量表(SAS).对82例强直性脊柱炎患者进行为期1个月的追踪研究,42例常规治疗联合心理干预,40例常规治疗.结果 1.SF-36生存质量影响因素逐步回归结果:影响有性别、受教育程度、家庭人均收入、社会支持、应对方式(回避和屈服)和人格特质.2.①SDS分值具有随治疗时间逐渐下降的趋势[心理干预组:(57.24±8.85)分,(54.71±7.51)分,(54.00±8.10)分;对照组:(57.98±8.11)分,(56.71±7.51)分,(55.00±8.11)分,F=4.501,P＜0.05],心理干预组SDS分较无干预组下降明显(P＜0.05).②SAS分值具有随治疗时间逐渐下降的趋势[心理干预组:(50.10±9.41)分,(48.20±6.82)分,(47.29±7.84)分;对照组:(51.23±10.10)分,(50.10±7.24)分,(48.29±7.38)分,F=1.801,P＜0.05],两组SAS分下降程度类似(P＞0.05).3.治疗前后心理干预组在生理机能、躯体疼痛、精力、情感职能四个方面较无心理干预组改善明显.结论 1.影响强直性脊柱炎患者生存质量因素包括性别、受教育程度、家庭人均收入、社会支持、应对方式(回避和屈服)和人格特质.2.心理干预可以明显缓解强直性脊柱炎患者抑郁情绪和生存质量.     

心理干预对强直性脊柱炎住院患者生理和心理的影响

目的 探讨心理干预对强直性脊柱炎住院患者生理和心理状况的作用.方法 采用病例对照研究方法,对82例强直性脊柱炎患者进行随机分组,其中心理干预组42例常规治疗合并心理干预,对照组40例行常规治疗.在治疗前和治疗4周末检测一般资料、生理指标、抑郁自评量表(SDS)和焦虑自评量表(SAS),并作干预前后比较分析.结果 强直性脊柱炎患者治疗前后生理指标变化的差异均无统计学意义.SDS评分随治疗时间而下降,SDS总分心理干预组较无心理干预组下降明显.SAS评分随治疗时间下降,但治疗前后两组SAS评分差值无统计学意义.结论 心理干预可以缓解强直性脊柱炎患者抑郁情绪.     

影响强直性脊柱炎住院患者生存质量社会心理因素调查

目的探讨影响强直性脊柱炎住院患者生存质量的社会心理因素。方法采用问卷调查方法,测查住院82例强直性脊柱炎患者一般资料、健康状况调查问卷(SF-36)、社会支持量表(SSRS)、艾森克个性问卷(EPQ)、医学应对问卷(MCMQ)、抑郁自评量表(SDS)和焦虑自评量表(SAS)。结果①相关分析:SDS,SAS,EPQ各因子和屈服应对因子与SF-36的因子分成负相关(r=-0.522~-0.740);主观支持和支持利用度和回避应对因子与SF-36的因子分成正相关(r=0.451~0.747);②在多因素分析中,性别、受教育程度、家庭人均收入、社会支持、应对方式(回避和屈服)和人格特质的各因子分进入回归方程,有统计学意义(P<0.05)。结论影响强直性脊柱炎患者生存质量社会心理学因素包括性别、受教育程度、家庭人均收入、社会支持、应对方式(回避和屈服)和人格特质。     

心理行为干预对溃疡性结肠炎患者生命质量的影响

目的 探讨心理行为干预对溃疡性结肠炎(UC)患者心理状态和生命质量的影响.方法 符合2000年成都会议诊断标准的39例UC患者随机分为2组,对照组给予常规治疗;试验组在常规对症治疗的基础上给予心理行为干预;12周为1疗程.于入组时、12周末采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、健康状况调查问卷(SF-36)对2组患者进行心理状态和生命质量评定.结果 12周末试验组SAS和SDS评分比入组时均显著降低[分别为(35.25±9.36)分,(46.71±8.52)分;(40.28±7.15)分,(47.83±10.01)分](P ＜0.01).试验组患者治疗前后SF-36各分量表值差异均有显著性(P ＜0.05);治疗后试验组与对照组表值比较除SF一项外均有显著性差异(P ＜0.05).结论 心理行为干预有助于改善溃疡性结肠炎患者的心理状态,提高患者的生命质量.     

心理干预对高危儿母亲情绪的影响

目的探讨心理干预对高危儿母亲不良情绪的影响。方法把280例高危儿的母亲随机分为干预组(140例)和对照组(140例),干预组在对高危儿常规保健的同时,按“母亲情绪管理方案”对母亲进行干预;对照组仅对高危儿进行常规保健。采用抑郁自评量表(SDS)和焦虑自评量表(SAS)进行母亲情绪状态评估。结果高危儿的母亲产后3个月内SDS标准分≥50分者59例,占21.07%;母亲产后抑郁自评标准分:1个月(44.75±9.94)分,2个月(42.22±10.55)分,3个月(40.57±10.68)分;产后3个月母亲各月抑郁标准分呈逐月下降趋势(P<0.01);SDS标准分≥50分者,第1个月SDS标准分干预组和对照组分别为(55.50±3.90)分,(52.88±9.05)分;SAS标准分干预组和对照组分别为(46.81±6.82)分,(42.80±8.38)分,2组无显著差别,而干预组SDS标准分第2个月(44.53±7.56)分、第3个月(41.35±7.56)分低于对照组(51.63±10.23)分,(52.46±10.55)分(P<0.01),SAS第3个月标准分(38.45±6.68)分低于对照组(45.53±9.65)分,差异有显著性(P<0.05)。结论高危儿的母亲产后3个月处在情绪障碍的高危状态,在高危儿保健过程中实施母亲情绪干预有效。     

护理干预对肺结核患者心理状态及生活质量的影响

目的 探讨护理干预对肺结核患者心理状态以及生活质量的影响.方法 以在本院治疗的120例肺结核患者为研究对象,患者在本院治疗期间均接受服用相同的抗结核药物治疗.将患者随机分为对照组和观察组,各60例.对照组患接受常规护理,观察组所采用的护理方法为护理干预,两组治疗和护理结束后采用抑郁评估量表(SDS)、焦虑评估量表(SAS)对患者心理状态进行调查,另外采用健康调查问卷对患者的生活质量进行评估.结果 护理前,对照组SDS评分、SAS评分分别为(48.32±6.54)分、(49.65±6.39)分,观察组SDS评分、SAS评分分别为(49.36±6.21)分、(50.39±6.27)分,对照组和观察组护理前,焦虑和抑郁评分差异无统计学意义;护理后,对照组SDS评分、SAS评分分别为(43.24±5.67)分、(46.35±5.97)分,观察组SDS评分、SAS评分分别为(31.20±5.13)分、(33.17±5.21)分,护理后观察组评分下降更为明显,显著低于对照组(P<0.05).对照组、观察组角色功能评分分别为(3.11±1.23)分、(5.24±1.38)分,社会功能评分分别为(3.12±0.57)分、(4.87±1.45)分,躯体功能评分分别为(2.31±0.74)分、(3.78±0.54)分,情绪功能评分分别为(4.22±1.34)分、(6.98±2.37)分,对比有统计学意义(P<0.05).结论 肺结核患者给予护理干预患者情绪能得到一定程度的改善,生活质量有所上升,可在临床中推广应用.     

总责任护士负责制整体护理在妊娠滋养细胞肿瘤化疗患者中的应用

目的 探讨总责任护士负责制整体护理对妊娠滋养细胞肿瘤化疗患者的效果及生存质量的影响.方法 选择2011年1月至2015年6月间我院妇科收治且接受化疗的妊娠滋养细胞肿瘤患者104例,按照随机数字法分为对照组和观察组,每组52例.对照组患者接受常规的护士轮班护理服务,观察组患者接受总责任护士负责的整体护理.于护理干预前后分别采用抑郁自评量表(SDS)、焦虑自评量表(SAS)、多维健康心理控制源量表[MHLC,包括冒险量表(CHLC)、强势他人量表(PHLC)、内控量表(IHLC)三个分量表]和生活质量问卷调查表(QOLQ)调查并比较两组患者心理状态和生活质量.结果 护理干预后,观察组患者的SDS和SAS评分分别为(29.80±6.81)分、(33.71±6.68)分,与护理干预前[SDS=(53.11±5.69)分]、[SAS=(54.28±5.88)分]相比明显降低,也明显低于对照组[SDS=(45.68±5.61)分]、SAS=[(48.27±6.08)分],差异均具有统计学意义(P<0.05);护理干预后,观察组患者的CHLC得分[(17.63±2.84)分]与护理干预前[(25.23±1.91)分]相比显著下降,PHLC得分显著增加[(30.06±3.11)分vs(25.16±2.18)分];同时饮食[(4.35±0.64)分]、心理状态[(4.18±0.51)分]、自理能力[(4.26±0.49)分]、对治疗的态度[(4.31±0.54)分]及对疾病的认识[(4.07±0.52)分]的评分均明显提高,也明显高于对照组饮食:[(2.38±0.62)分,心理状态:(2.19±0.11)分,自理能力:(1.77±0.27)分,对治疗的态度:(2.22±0.33),对疾病的认识:(2.15±0.51)],差异均有统计学意义(P<0.05).结论 总责任护士负责的整体护理干预可以缓解妊娠滋养细胞肿瘤患者的焦虑、抑郁情绪,改善生活质量.     

婴幼儿喘息与母亲心理健康相关性分析

目的：探讨婴幼儿喘息与母亲心理健康的相关性。方法：以婴幼儿喘息患儿60例为观察组,体检正常的儿童60例为对照组,应用焦虑自评量表（SAS）、抑郁自评量表（SDS）对两组母亲进行心理健康调查。对观察组母亲心理干预1年,比较干预前后患儿母亲SAS、SDS评分。结果：观察组母亲SAS及SDS评分分别为42.72±4.54分和40.17±5.65分,高于对照组母亲的36.68±3.67分和35.05±4.75,差异均有统计学意义（P<0.01）。观察组母亲心理干预后SAS及SDS评分分别为36.42±3.73分和38.13±4.96分,较干预前明显下降,差异均具有统计学意义（P<0.05）。结论：婴幼儿喘息患儿母亲更易发生焦虑、抑郁等心理障碍,心理疏导对改善患儿母亲心理状态有正面作用。     

重性精神病患者一级亲属的心理状况分析

目的了解重性精神病患者亲属的心理状况及影响因素,并建议相应改善措施。方法对253例重性精神病患者一级亲属照料者和253例相匹配的对照采用焦虑自评量表(SAS)及抑郁自评量表(SDS)、亲属应激量表(RSS)进行测评,比较SAS、SDS粗分,RSS总分及因子分。结果重性精神病患者亲属SAS、SDS、RSS评分及RSS各因子分[SAS(37.9±6.21)分,SDS(39.3±7.09)分,RSS(13.4±3.79)分,个人压力因子分(4.1±1.81)分,生活被干扰(6.0±2.2)分,负性情绪(3.3±1.29)分]明显高于对照组[相对应的分值分别是(32.5±5.62)分,(33.3±5.89)分,(3.7±2.43)分,(1.3±0.95)分,(1.7±1.21)分,(0.7±0.74)分],男女之间、文化程度不同的亲属组之间差别不明显,与患者的关系不同,不同年龄,不同病人来源及病程不同或发病次数不同的组别之间比较均差异存在显著性。结论重性精神患者亲属存在不同程度的心理问题,并受多种因素的影响。     

心理干预对烧伤患者生存质量的影响

目的探讨心理干预对烧伤患者生存质量的影响。方法采用病例对照研究方法,采用简明烧伤健康量表(BSHS-A)进行问卷调查,对80例烧伤患者进行为期6～12个月的追踪研究,40例常规治疗联合心理干预(简称心理组),40例常规治疗(简称对照组)。结果患者出院时,心理组在BSHS-A问卷总均分和心理功能、社会关系和一般健康状况维度的分值[分别为(286．11±29．06)分,(72．96±7．22)分,(72．48±7,73)分,(68．97±7．07)分]高于对照组[分别为(270．62±35．32)分,(67．63±8．97)分,(68．60±9．21)分,(65．41±8．43)分],差异有显著性(P＜0．05),其中心理功能维度差异有极显著性(P＜0．01)；2组躯体功能分值差异无显著性(P＞0．05)。出院6个月后,2组BSHS-A评分均有下降的趋势,但是心理组在BSHS-A问卷总均分和心理功能、社会关系和一般健康状况维度的分值仍高于对照组,差异有显著性(P＜0．05),其中心理功能维度和社会关系维度差异有极显著性(P＜0．01)；2组躯体功能维度差异无显著性(P＞0．05)。心理组下降显著的有BSHS-A总均分、社会关系和一般健康状况维度,下降非常显著的有心理功能维度；对照组下降非常显著的有BSHS-A总均分、心理功能和社会关系及一般健康状况维度,2组躯体功能维度均下降不显著。结论心理干预可以提高烧伤患者生存质量,显著改善患者心理功能和社会关系及一般健康状况,帮助患者重返社会,但是对于躯体功能影响不明显。烧伤患者出院后生存质量有下降趋势。     

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.