医学生心理健康水平及相关因素调查

目的　探讨四年级医学生的心理健康状况 ,人格特征。方法　采用 90项症状自评量表 (SCL 90 )和艾森克人格问卷 (EPQ)对 2 4 6名四年级医生进行调查。结果　四年级医学生SCL 90的总分及各因子分 ,除躯体化和人际关系因子分外 ,均高于常模 ,各单项因子分≥ 3的检出率累计为 16 .8% ;医学生的EPQ除男生的N(神经质 )分与常模比较无显著性差异外 ,男、女生的P(精神质 )分和L(掩饰 )分均显著低于常模 (P <0 .0 1) ,E(内外向 )分均显著高于常模 (P <0 .0 1) ,女生的N分显著高于常模 (P <0 .0 1) ;SCL 90的总分及各因子分与EPQ的各因子分除SCL 1(躯体化 ) ,3(人际关系 ) ,4 (抑郁 ) ,7(恐怖 ) ,9(精神病性 ) ,10 (其他 )与EPQ的L分外呈显著相关。结论　四年级医学生的心理健康总体水平偏低 ,其心理问题的发生与其个性特征密切相关     

海训后士兵心理健康状况及相关因素研究

目的　调查某部海训士兵的心理健康状况及其影响因素。方法　采用症状自评量表 (SCL 90 )及艾森克人格问卷 (EPQ) ,对渡海登陆作战演习部队 110 7人进行测查。结果　本次调查对象SCL 90各因子分除人际关系敏感外均高于中国成人常模 ;强迫症状、人际关系、恐怖、偏执、精神病等因子分及总分低于中国军人常模且有显著性差异 ;2 3 0名( 2 0 78%)士兵单项因子分≥ 3分 ;来自城镇的士兵SCL 90各因子分高于来自农村的士兵 ;1年兵组SCL 90各项得分均高于 2年兵组。SCL 90与EPQ得分的相关分析显示 ,情绪越不稳定、受外界因素的刺激产生的情绪反应越激烈 ,性格越内向者SCL 90的各项得分越高。结论　被调查对象心理健康状况良好 ,受军事演习的影响不大 ,但有 2 0 78%的士兵存在不同程度的心理健康问题。较高的文化程度、城市入伍兵、军龄短等因素 ,以及精神质、敌对倾向、内向等人格特点可能是此人群心理障碍发生的促进因素。     

医学生心理健康水平与个性特征及学习成绩相关性的初步分析

目的 :探讨医学生心理健康水平与个性特征及学习成绩的关系。方法 :采用 SCL - 90、EPQ量表施测 ,对所得资料进行比较检验。结果 :5 2 8名医学生中存在心理问题学生占 14.6 %。与 EPQ常模比较 ,除 N分外 ,均存在差异。 SCL - 90量表筛查阳性者 ,N分高、E分低 ,影响个性内外性 (E)特点主要是强迫、人际、抑郁因素 ,影响情绪稳定性 (N)主要是躯体、抑郁、焦虑因素。筛查阳性者与阴性者学习成绩无显著性差异 (P>0 .0 5 )。阳性者学习成绩与 SCL - 90各因子相关性分析 ,人际、焦虑因素可严重影响学生的学习成绩。     

医学生多维生活满意度现状对心理健康的影响及分析

目的：了解专科层次医学生多维生活满意度的现状及其对心理健康的影响,为学校实施心理健康教育提供科学的依据。方法采用自拟调查表和生活满意度量表（MSLSS）、心理健康测评量表（SCL‐90）,对810名医学类专科层次的学生进行生活满意度状况、心理健康的调查。运用SPSS19．0建立数据库进行 t检验、方差分析、相关及回归分析、描述性分析等。结果专科层次医学生在不同性别、籍贯（生源地）、父母文化程度、家庭经济状况,以及是否独生子女、是否学生干部、是否参与社会实践的生活满意度的得分上存在显著差异;生活满意度分值与症状自评表（SCL‐90）中的各因子得分呈负相关（P＜0．01）。结论医学生的生活满意度现况直接影响其心理健康。从干预医学生的生活满意度入手,是学校实施心理健康的重要手段。     

高原汽车兵心理健康状况及相关因素分析

目的：了解汽车兵在高原条件下的心理健康状况及相关因素，为部队心理卫生保健提供依据。方法：采用艾森克个性问卷（EPQ）、症状自评量表（SCL－90）、社会支持评定量表（SSRS）、焦虑自评量表（SAS）、抑郁自评量表（SDS）和生活事件量表（LES）对高原汽车兵进行个性测定和心理卫生状况调查。结果：高原汽车兵EPQ－E分低于全军常模，EPQ－N、EPQ－P分高于全军常模（P＜0．01），EPQ－L无显著性差异（P＞0．05）。大多数SCL－90因子分高于全军常模及普通高原军人（P＜0．01－0．05）。高原汽车兵的心理健康水平与EPQ－N、EPQ－P分及生活事件成正相关，与EPQ－E、EPQ－L及社会支持成负相关。多元回归分析表明，EPQ的N、P因子、负性事件，主观支持、军龄和社会支持总分等因素是影响高原汽车兵心理健康的几个重要因素。结论：高原汽车兵存在较多的心理问题，可能与其居住环境、工作性质及个性特征、社会支持等多种因素有关。     

军校医学生应激生活事件与心理健康的相关研究

目的　探讨军校医学生应激生活事件与心理健康水平的关系。方法　对某军校医学生 3 42人进行青少年生活事件量表 (ASLEC)和SCL 90测试 ,分析差异及相关性。根据测试结果 ,实施心理辅导 ,比较辅导前后心理健康水平。结果　被试 6个月内生活事件发生频率最高的是学习负担 (91 9%) ,考试失败 (84 4%)。生活事件各因子得分与SCL 90各因子呈正相关。心理辅导后 ,心理健康状况有所改善。结论　应激生活事件是影响军校医学生心理健康的重要因素。心理辅导能有效地削弱生活事件的影响 ,提高学生的心理健康水平。     

50例慢性乙型肝炎病人心理健康状况的调查分析

目的 调查住院慢性乙型肝炎病人的心理健康状况。方法 采用症状自评量表（SCL一90）,艾克森个性问卷（EPQ）及生活事件量表（LES）对50例慢性乙型肝炎病人进行测定并与50例正常组对照比较。结果 SCL-90除人际敏感、精神病性因子外,其它因子分显著高于对照组（P〈0．05）。EPQ神经质（N）分显著高于正常对照组（P〈0．01）。LES负性刺激量、总刺激量明显高于对照组（P〈0．05）。结论 慢性乙型肝炎病人具有神经质个性,经历的应激性生活事件较多,心理健康状况较差。     

乳腺癌患者心理健康状况的对照研究

目的：了解乳腺癌患者心理健康状况。方法：应用症状自评量表,艾森克个性问卷,生活事件量表对50例乳腺癌患者的心理健康状况进行了检查,并以50名正常人作对照。结果：乳腺癌组SCL－90总分和6个因子分均高于对照组（P＜0．05或P＜0．01）;负性生活事件量表分显著高于对照组（P＜0．05）;EPQ之E因子分低于对照组,N因子分高于对照组（P＜0．01）。结论：乳腺癌患者和的心理健康状况较差。改善乳腺癌患者的心理健康状况,对该病的康复和预后有重要意义。     

军校医学研究生心理健康状况和个性特征的分析

目的 :评价军校研究生入学后的整体心理健康状况、个性特征及心理健康状况与个性的关系 .方法 :采用症状自评量表 (SCL 90 )、艾森克个性量表 (EPQ) ,流调中心用抑郁量表 (CES D)对 1 98名新入学的某军校医学硕士研究生 ,进行整群抽样、现况研究 .问卷由学生自行填写独立完成 .结果 :SCL 90各项指标中男性研究生阳性项目均分高于女性研究生(P <0 .0 5 ) .在EPQ量表评分中男性研究生的P值评分高于女性 (P <0 .0 1 ) ,女性研究生的L值评分高于男性研究生 (P<0 .0 1 ) .在自我评价性格类型 (A组 :内向型 ,B组 :中间型 ,C组 :外向型 )不同的研究生中SCL 90的各项指标的评分均是A组最高 ,其中人际关系敏感和精神病性因子的评分与B组和C组差异显著 (P <0 .0 5 ) .在A组人群中有 2 2 .9%的抑郁评分大于 2 0分 ,而在B组和C组只有 8.5 %和 6 .1 %的研究生抑郁评分大于 2 0分 .有心理阳性症状的研究生在A ,B ,C组中所占的百分比分别是 31 .4 % ,2 2 .2 %和 1 8.2 % .结论 :性别因素不是影响医学研究生心理健康状况的主要因素 ,研究生的个性特征影响着研究生的心理健康状况     

应对方式及相关因素对医学生心理健康的影响

目的 :探讨医学生心理健康和应对方式的相关关系。方法 :对杭州师范学院医学院医学生共 2 36人 ,进行了心理健康评定量表 (SCL 90 )和应对方式问卷 (SCQ)测试。结果 :( 1)医学生中女生在解决问题 (t =- 2 75 ,P <0 0 1)、求助 (t=- 3 0 3,P <0 0 1) 2个因子分上显著高于男生 ,而合理化 (t=4 5 0 ,P <0 0 1)因子分显著低于男生 ;独生子女在求助、自责和幻想 3个因子上显著低于非独生子女 (P <0 0 1)。 ( 2 )不成熟型应对方式 (自责、幻想和退避 )与SCL 90的 9个因子均呈显著正相关 ;成熟型应对方式与SCL 90的 3个因子呈显著负相关 (P <0 0 5 )。 ( 3)SCQ各因子与心理健康水平的回归分析表明 ,自责和幼想 2个因子进入了对心理健康水平的回归方程 ,对心理健康状况的预测作用较大。结论 :应对方式对医学生心理健康状况有影响作用     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.