肺癌中MTS1/p16和p53基因产物的表达与细胞增殖的关系

目的：研究肺癌中ＭＴＳ１／ｐ１６和ｐ５３基因产物的表达与细胞增殖的关系。方法：应用Ｓ－Ｐ免疫组织化学方法研究６２例肺癌组织中ｐ１６蛋白和ｐ５３蛋白的表达情况，并进行增殖细胞核抗原（ＰＣＮＡ）检测，计算细胞增殖指数（ｐｒｏｌｉｆｅｒａｔｉｏｎｉｎｄｅｘ，ＰＩ）。结果：６２例肺癌组织中ｐ１６蛋白和ｐ５３蛋白阳性率分别为５８．１％和５９．７％。腺癌ｐ１６蛋白的阳性率明显高于小细胞癌（Ｐ＜０．０５）；淋巴结转移阳性组ｐ１６蛋白的表达显著低于阴性组（Ｐ＜０．０５）；ＰＩ分级为Ⅱ级的ｐ１６蛋白表达显著高于Ⅳ级（Ｐ＜０．０５）。不同组织类型肺癌中ｐ５３蛋白的表达未见明显差异，淋巴结转移阳性组ｐ５３蛋白的表达高于阴性组（Ｐ＜０．０１）；不同ＰＩ分级中ｐ５３蛋白的表达，Ⅳ级明显高于Ⅰ级（Ｐ＜０．０５）和Ⅱ级（Ｐ＜０．０５），Ⅲ级明显高于Ⅰ级（Ｐ＜０．０５）和Ⅱ级（Ｐ＜０．０１）。ｐ１６蛋白低表达和ｐ５３蛋白过表达之间未见明显相关。结论：ｐ１６蛋白低表达和ｐ５３蛋白过表达均有促进肺癌细胞增殖的作用，ｐ１６蛋白的表达与肺癌的细胞分化有关，ｐ５３蛋白过表达对肺癌细胞的转移起重要作用。抑癌基因ｐ５３对ＭＴＳ１／ｐ１６基因无明显调控作     

系统脱敏与冲击疗法治疗社交恐怖症的疗效比较

使用系统脱敏疗法和冲击疗法各治疗一组社交恐怖症,随访一年,两组疗效比较,治愈率系统脱敏组为30.7%,冲击组为26.6%。差异不显著(u-0.2397,p>0.05),而系统脱敏疗法循序渐进、病人乐意接受,冲击疗法,虽疗程较短,但患者心理似不易承受.     

易筋经锻炼对心功能和心血管功能影响初探

本工作观察２０例正常人经过易筋经锻炼六个月，比较其前后心功能和心血管功能指标的变化，发现练功后心率明显下降（ｐ＜０．０５），射血分数提高（ｐ＜０．０５），每搏心输出量增多（ｐ＜０．０５），心搏指数增大（ｐ＜０．０５），体动脉顺应性改善（ｐ＜０．０１），表明易筋经练功对心功能和心血管功能的改善有较大作用。本文最后从生物力学角度对此作了初步探讨。     

大肠癌表皮生长因子受体和p53蛋白表达与临床病理特征和预后的关系

为了研究大肠癌表皮生长因子受体（ＥＧＦＲ）和ｐ５３蛋白表达与病理特征和预后的关系，应用免疫组化检测ＥＧＦＲ和ｐ５３在６１例大肠癌中的表达。结果提示：正常大肠粘膜未发现ＥＧＦＲ和ｐ５３阳性表达，而两者在大肠癌均有较高表达（７７．０４％和５５．７５％）。ＥＧＦＲ表达与大肠癌Ｄｕｋｅｓ分期有关（Ｐ＜０．０５）。ｐ５３表达与大肠癌分化程度及Ｄｕｋｅｓ分期有关（Ｐ＜０．０５）。大肠癌生存率随ＥＧＦＲ和ｐ５３表达增高而降低，其中两者４年生存率＞６５％表达组均明显低于＜２５％组（Ｐ＜０．０５），ＥＧＦＲ－ＬＩ和ｐ５３－ＬＩ与生存期均有明显负相关。结果表明：ＥＧＦＲ和ｐ５３表达与大肠癌的进展程度有关，该两项指标对大肠癌临床诊治和预后的评估有重要价值。     

p53、p21、p185蛋白表达与横纹肌肉瘤分化及预后的关系

目的研究ｐ５３、ｒａｓ和ｃ－ｅｒｂＢ－２癌基因蛋白产物ｐ２１、ｐ１８５在横纹肌肉瘤（ＲＭＳ）中的表达及其与ＲＭＳ的分型、分级和预后的关系。方法对确诊的５０例中的４１例有随访的ＲＭＳ用免疫组化ＡＢＣ法标记ｐ５３、ｐ２１、ｐ１８５蛋白，结果发现ｐ５３、ｐ２１、ｐ１８５在ＲＭＳ的阳性率分别为７２％、６８％、６０％，其阳性表达与年龄、性别和ＲＭＳ的组织类型差异无显著性（Ｐ＞０．０５）；但与分化程度有关，其中ｐ５３、ｐ２１在低分化ＲＭＳ的阳性率分别为８５％和８０％，显著高于高分化ＲＭＳ的４２．９％和２８．６％（Ｐ＜０．０５）；ｐ５３蛋白在有转移组ＲＭＳ的阳性率为８６．４％，显著高于无转移组６０．７％（Ｐ＜０．０５）；有随访的４１例病例中。存活１年的ｐ５３蛋白阳性率为８６．７％，显著高于３年的４１．７％（Ｐ＜０．０５）。结论ｐ５３、ｐ２１蛋白表达可作为肿瘤分化及恶性程度的评价指标，而ｐ５３更能反映肿瘤预后，是肿瘤预后差的重要指标之一。     

p53、EGFR和Ki-67抗原在子宫恶性中胚叶混合瘤中的表达

目的：研究子宫恶性中胚叶混合瘤ｐ５３、ＥＧＦＲ和Ｋｉ－６７抗原的表达及与肿瘤临床分期、组织学分级和预后的关系。方法：用免疫组化Ｓ－Ｐ法对２１例子宫恶性中胚叶混合瘤的存档资料作染色观察。结果：ｐ５３、ＥＧＦＲ和Ｋｉ－６７抗原的阳性表达率分别为６１．９％、６１．９％和７１．４％。临床分期Ⅱ～Ⅳ期肿瘤（１０／１２）的ｐ５３阳性表达率明显高于Ⅰ期肿瘤（３／９）（Ｐ＜０．０５）、肿瘤癌性成分Ⅱ级的ｐ５３阳性表达高于Ⅰ期（Ｐ＜０．０５）。６例在１年内死亡的病例，其中５例ｐ５３阳性染色，而５例生存２年以上的肿瘤ｐ５３免疫染色全部阴性，两组比较（Ｐ＜０．０５）。肉瘤成分Ⅲ级的ＥＧＦＲ阳性率高于Ⅱ级（Ｐ＜０．０５），除此而外，ＥＧＦＲ和Ｋｉ－６７的表达和肿瘤分期、预后均无相关性。结论：肿瘤的ｐ５３表达具有预后意义     

心理剧治疗对提高精神分裂症患者自尊水平的对照研究

目的：探讨心理剧治疗对提高精神分裂症患者自尊水平的心理康复作用。方法：采用1：1配对的病例对照研究方法，将康复期精神分裂症患者分为研究组和对照组各12例，在两组均使用抗精神病药物治疗的基础上，仅对研究组辅以心理剧治疗，4周为一个疗程，采用自尊量表（SES）和自卑感量表（FIS）进行治疗前后自身对照和两组相互对照。结果：研究组心理剧治疗后SES评分明显增高而FIS评分明显减低，差异有明显统计学显著性（P均＜0．01）。心理剧治疗后研究组疗效明显，且与对照组比较，SES评分升高而FIS评分减低，差异有统计学显著性（P均＜0．05）。治疗前后两组SES和FIS得分差值相比较差异有明显统计学显著性（P均＜0．01）。结论：心理剧治疗有助于消除康复期精神分裂症患者的自卑心理，提高自尊水平。     

自血光量子疗法对颅脑损伤者外周血姐妹染色单体互换率的影响

本文对接受自血光量子疗法的颅脑损伤病人外周血姐妹染色单体互换率（ＳＣＥ）进行分析，并与正常人做对照。结果对照组与实验组治疗前比较，无显著性差异（Ｐ＞０．０５），说明此组疾病与ＳＣＥ无关。实验组治疗后３年和治疗前比较，治疗结束时和治疗前比较均有高度显著性差异（Ｐ＜０．０１）；治疗后３年和治疗结束时比较有显著性差异（Ｐ＜０．０５）。前二者说明ＳＣＥ的升高与紫外线照射血液回输有关；后者说明３年后ＤＮＡ有恢复趋势。     

冠心病患者心理干预的对照研究

本文对４６例冠心病患者进行药物和系统心理干预治疗（观察组），并与４２例单纯药物治疗作对照。结果发现治疗前后观察组较对照组Ａ型行为得分改善（Ｐ＜０．０５），心绞痛症状缓解（Ｐ＜０．０５），ＥＣＧＳＴ－Ｔ好转（Ｐ＜０．０５），血ＴＣ下降（Ｐ＜０．０１），血Ｅ及ＮＥ降低（Ｐ＜０．０５）。     

bcl-2、p53表达与乳腺癌预后的关系

目的：探讨ｂｃｌ２ 、ｐ５３ 表达与乳腺癌预后的关系。方法：应用免疫组化ＬＳＡＢ法检测６４ 例乳腺癌及３０ 例乳腺良性病变的表达。分析ｂｃｌ２、ｐ５３ 与乳腺癌组织学分级、腋淋巴结转移、复发和预后的关系。结果：ｂｃｌ２ 与ｐ５３ 表达之间差异有显著性,呈负相关（ Ｐ＜ ０－０５） 。ｂｃｌ２ 和ｐ５３ 表达与组织学分级有关（ Ｐ＜ ０－０５） ,ｂｃｌ２ 表达随分级增加阳性率降低,ｐ５３ 则相反。ｐ５３ 表达与腋淋巴结转移有关（ Ｐ＜ ０－０５） 。ｂｃｌ２ 表达与腋淋巴结转移无关（ Ｐ＞ ０－０５） 。ｐ５３ 表达复发组明显高于无复发组（ Ｐ＜０－０５）;ｂｃｌ２ 表达与有无复发无关（Ｐ＞０－０５）。ｐ５３ 表达阳性率≤５ 年生存组明显高于＞ ５ 年生存组,呈负相关（ Ｐ＜ ０－０５）;ｂｃｌ２ 表达与生存期无关（Ｐ＞ ０－０５） 。结论：ｂｃｌ２ 表达与预后无关,其阳性表达可反映肿瘤属分化较好或属早期阶段。ｐ５３ 可单独作为预后指标;ｐ５３ 表达与预后呈负相关。     

认知行为疗法治疗社交恐怖症对照研究

目的探讨认知行为疗法治疗社交恐怖症的效果。方法51例社交恐怖症患者被分为认知行为组(31例)和氯硝西泮组(20例)治疗8周,进行疗效评定,同时采用社交回避苦恼量表(SAD)进行评定,结果进行比较。结果认知行为组疗效明显优于氯硝西泮组,8周后的SAD评分认知行为组较氯硝西泮组下降明显。结论认知行为疗法是治疗社交恐怖症的有效方法之一。     

Cognitive behavior therapy versus supportive therapy in social phobia: a randomized controlled trial

BACKGROUND: The efficacy of cognitive behaviour therapy (CBT) in social phobia has been demonstrated in several controlled trials and meta-analyses, but no comparison of CBT with supportive therapy (ST) can be found in the literature. METHOD: The aim of the trial was to study the effectiveness of CBT versus ST carried out 'as usual'. Sixty-seven DSM-4 social phobic patients (89% generalized subtype, most with avoidant personality) were randomly allocated into two groups. Group 1 (CBT) received 8 1-hour sessions of individual cognitive therapy (CT) for 6 weeks, followed by 6 2-hour sessions of social skills training (SST) in group weekly. Group 2 received ST for 12 weeks (6 half-hour sessions), then the patients were switched to CBT. All patients agreed not to take any medication during the whole trial. In group 1, 29 patients reached week 6, 27 reached week 12, and 24 weeks 36 and 60 (endpoint). In group 2, 29 patients reached week 6, 28 reached weeks 12 and 18, 26 week 24, and 23 reached weeks 48 and 72 (endpoint). RESULTS: At week 6, after CT, group 1 was better than group 2 on the main social phobia measure. At week 12, after SST, group 1 was better than group 2 on most of the measures and demonstrated a significantly higher rate of responders. This finding was replicated after switching group 2 to CBT. Sustained improvement was observed in both groups at follow-up. Compliance with abstinence from medication increased over time. CONCLUSIONS: CBT was more effective than ST and demonstrated long-lasting effects. This may suggest that social phobia management requires more than a simple and inexpensive psychological intervention.     

氯硝西泮治疗儿童社交恐怖症

目的对氯硝西泮与丙咪嗪治疗儿童社交恐怖症的疗效及不良反应比较。方法儿童社交恐怖症36例（男15例，女21例，年龄12.23±2.30岁，病程2.13±0.84年），采用氯硝西泮1-4mg/d.po.治疗8周。另外，采用丙咪嗪治疗同类病人32例（男性14例，女性18例，年龄12.56±2.53岁，病程2.29±0.91年），用量25-75mg/d，po.治疗8周。结果氯硝西泮组显效率为56％，总有效率为81％，丙咪嗪显效率为50％，总有效率75％，两组疗效差异无显著意义（P〉0.05）,氯硝西泮组不良反应较丙咪嗪少。结论氯硝西泮对儿童社交恐怖症有肯定的治疗作用，近、远期疗效较好，且不良反应少。     

Palmtop computer-assisted group therapy for social phobia

This article describes the application of group computer-assisted therapy for social phobia. The computer program includes a diary function for ongoing self-monitoring of anxiety as well as guidance on the practice of relaxation, cognitive restructuring, and self-control desensitization. Although the program was originally designed to treat individuals with generalized anxiety disorder (GAD), it was hypothesized that the program also would be effective for individuals with social phobia; therefore, it was implemented in a group of individuals with a primary diagnosis of GAD or social phobia. We present the case of a client with social phobia who received six sessions of group therapy and who carried the ambulatory computer throughout this treatment. Outcome data suggest that the treatment was highly effective for this client as well as others with a diagnosis of social phobia or GAD.     

Behavioral treatment of childhood social phobia

Sixty-seven children (ages 8 and 12) with social phobia were randomized to either a behavioral treatment program designed to enhance social skills and decrease social anxiety (Social Effectiveness Therapy for Children, SET-C) or an active, but nonspecific intervention (Testbusters). Children treated with SET-C were significantly more improved across multiple dimensions, including enhanced social skill, reduced social fear and anxiety, decreased associated psychopathology, and increased social interaction. Furthermore, 67% of the SET-C group participants did not meet diagnostic criteria for social phobia at posttreatment compared with 5% of those in the Testbusters group. Treatment gains were maintained at 6-month follow-up. The results are discussed in terms of treatment of preadolescent children with social phobia and the durability of treatment effects.     

Long-term outcome of social phobia treated by exposure.

BACKGROUND: There is very little information on long-term follow-up of social phobia. METHODS: A consecutive series of 70 patients satisfying the DSM-IV criteria for social phobia was treated in an out-patient clinic with behavioural methods based on exposure homework. Forty-five patients were judged to be remitted after eight individual sessions of psychotherapy. A 2 to 12 year (median = 6 years) follow-up was performed. Survival analysis was selected to characterize the clinical course of patients. Assessments were performed before treatment, at the end of therapy, after 1 year, and subsequently on a yearly basis, and utilized selected items of Paykel's Clinical Interview for Depression. RESULTS: Six of the 45 patients (13%) had a relapse of social phobia at some time during follow-up. The estimated cumulative percentage of patients remaining in remission was 98 after 2 years, 85 after 5 years and 85 after 10 years. Such probabilities increased in the absence of a personality disorder, of residual social phobic avoidance after exposure, and of concurrent use of benzodiazepines. CONCLUSIONS: The findings suggest that, even though one patient out of three is unable to complete treatment or does not benefit sufficiently from it, exposure treatment can provide lasting effects to the majority of patients with social phobia. Disappearance of residual, subclinical social phobic avoidance appears to be the target of treatment.     

Familial aggregation of anxiety-related quantitative traits in generalized social phobia: clues to understanding "disorder" heritability?

Social phobia, particularly the generalized form, is strongly familial. Given the probable continuity from extremes of normative personality (e.g., shyness) to social phobia to personality disorder (e.g., avoidant personality disorder), it is unlikely that social phobia itself, at the level of an Axis I disorder, is transmitted. Rather, it seems more parsimonious, and in keeping with current notions about the structure and heritability of mental disorders, that one or more temperamental risk factors for social phobia is transmitted. The goal of this study was to explore this possibility by examining relevant quantitative traits in a family study of generalized social phobia (GSP). First-degree (n = 103) relatives of patients with DSM-IV GSP and 65 first-degree relatives of not socially phobic comparison subjects (NC) completed a panel of self-report questionnaires that included measures of trait anxiety, social anxiety, and personality. Regression analysis was used to examine associations between group membership (i.e., whether that family member was a first-degree relative of a GSP proband) and these measures. First-degree relatives of GSP probands scored significantly higher than first-degree relatives of not socially phobic probands on measures of trait anxiety and social anxiety and on the Harm Avoidance subscale of the TPQ. One large factor, accounting for 84% of the variance, was strongly associated with being a first-degree relative of a GSP proband. Quantitative traits elevated in probands with generalized social phobia are also elevated in their first-degree relatives. Future family and genetic studies of social phobia should consider the possibility that one or more traits (or some aggregation thereof) may better approximate the phenotype of interest. More extensive efforts at phenotype refinement should be undertaken before such studies proceed.     

Perception of threat in children with social phobia: comparison to nonsocially anxious children before and after treatment

The present study investigated interpretation bias and reduced evidence for danger (RED) bias in 49 children with social phobia and 49 nonsocially anxious children between the ages of 8 and 14 years, using an ambiguous stories task. A posttreatment and follow-up measure was included for 26 of the socially phobic children to examine whether there would be a change in interpretation and RED bias after a 12-week behavior therapy program. Ambiguous scenarios were presented sentence by sentence. Participants gave interpretations and fear ratings after each sentence, and they rated negative emotions after each complete scenario. Compared to the nonsocially anxious children, children with social phobia displayed both a RED bias and an interpretation bias. After the treatment program, the children with social phobia displayed a reduced tendency to make biased interpretations, but there were no significant posttreatment changes in the RED bias. At 1 year follow-up there was a significant reduction in both interpretation and RED bias and clinical children no longer differed from nonsocially anxious controls.     

Specific ultrarush desensitization in Hymenoptera venom-allergic patients.

BACKGROUND: Hymenoptera venom hypersensitivity is an epidemiologically important problem. The only effective treatment in the management of venom-allergic patients with a history of generalized reactions to insect sting is specific immunotherapy. OBJECTIVE: To demonstrate safety and effectiveness of a modified ultrarush desensitization protocol in venom-allergic patients. METHODS: Fifty-seven patients with Hymenoptera venom allergy underwent a specific 1-day ultrarush desensitization by the subcutaneous route, reaching the cumulative dose of 101.1 microg in 2.5 hours. The maintenance dose (100 microg) was administered after 15 days and thereafter once a month. Patients were followed up for a year. Antihistamines were withheld for 15 days before and during desensitization to not underestimate the incidence of adverse effects. RESULTS: All patients but I completed the ultrarush desensitization. (This patient discontinued the treatment because of a hypertensive crisis not related to the desensitization.) The treatment caused a rapid variation of immunological parameters (IgE, IgG4) since the 15th day. After the desensitization, skin prick test results became negative in 15 patients (27%, decrease of 3.5 log), whereas they decreased in 14 patients (25%, decrease of 1 log). Sixty-four percent showed no adverse effects. Only 7% had a mild systemic reaction. CONCLUSIONS: Ultrarush desensitization is an effective and safe therapy in the management of patients with Hymenoptera venom allergy. In fact, it provides a faster tolerance, without significant differences regarding incidence of severe adverse effects, compared with traditional and rush protocols. It can be adopted for all patients, even children and teenagers.