生活事件、防御方式与紧张型头痛的相关性研究

目的探讨紧张型头痛(TensionTypeHeadache,TTH)住院患者的生活事件、防御方式及其相关关系。方法将35例诊断为TTH的住院军人作为患者组,以35名正常军人作为对照组,分别用生活事件量表及防御方式问卷(DSQ)对他们的生活事件及防御方式进行评定,并对二者进行相关分析。结果TTH患者所经历的正性生活事件分值为5.73±7.16,对照组为14.66±9.98,二者差别有显著性(P<0.01),前者低于后者;TTH组负性生活事件分值为23.29±18.52,对照组为7.09±6.19,两组间差异有显著性(P<0.01),前者高于后者;两组间生活事件总值无统计学差异(P>0.05)。在防御方式上,TTH组的不成熟防御分值为4.73±0.86,对照组为3.67±0.88,前者高于后者(P<0.05);TTH组中间型防御分值为4.74±0.71,对照组为4.46±0.68,前者高于后者(P<0.01);TTH组成熟防御方式分值为4.66±0.89,低于对照组5.56±0.93(P<0.05);两组在掩饰维度上差异不显著。不成熟防御机制及中间型防御机制与负性生活事件之间呈正相关关系,不成熟防御机制与正性生活事件之间、成熟防御机制与负性生活事件之间呈负相关关系。结论TTH住院军人所经历的不良生活事件及对这些生活事件所采取的不适当心理防御机制在TTH的发病过程中起着重要作用。     

生活事件、防御方式与紧张型头痛的相关性研究

目的 探讨紧张型头痛(Tension-Type Headache,TTH)住院患者的生活事件、防御方式及其相关关系.方法将35例诊断为TTH的住院军人作为患者组,以35名正常军人作为对照组,分别用生活事件量表及防御方式问卷(DSQ)对他们的生活事件及防御方式进行评定,并对二者进行相关分析.结果 TTH患者所经历的正性生活事件分值为5.73±7.16,对照组为14.66±9.98,二者差别有显著性(P <0.01),前者低于后者;TTH组负性生活事件分值为23.29±18.52,对照组为7.09±6.19,两组间差异有显著性(P <0.01),前者高于后者;两组间生活事件总值无统计学差异(P >0.05).在防御方式上,TTH组的不成熟防御分值为4.73±0.86,对照组为3.67±0.88,前者高于后者(P <0.05);TTH组中间型防御分值为4.74±0.71,对照组为4.46±0.68,前者高于后者(P <0.01);TTH组成熟防御方式分值为4.66±0.89,低于对照组5.56±0.93(P <0.05);两组在掩饰维度上差异不显著.不成熟防御机制及中间型防御机制与负性生活事件之间呈正相关关系,不成熟防御机制与正性生活事件之间、成熟防御机制与负性生活事件之间呈负相关关系.结论 TTH住院军人所经历的不良生活事件及对这些生活事件所采取的不适当心理防御机制在TTH的发病过程中起着重要作用.     

军人失眠症患者防御机制与心理应激及人格特征的相关研究

目的:研究军人失眠症患者的心理防御机制特点与人格特征和心理应激的关系.方法:采用防御方式问卷(DSQ)、生活事件量表(LES)和艾森克个性问卷(EPQ)对某三级甲等部队医院心理科收治的48例失眠症官兵(研究组)和随机抽取某部50名官兵(对照组)进行调查.结果:①军人失眠症患者更多采用不成熟和中间型防御机制(P<0.05或0.01),最常用采用的6种心理防御因子是:抱怨、回避、退缩、躯体化、幻想、消耗倾向;②军人失眠症患者人格特征多为内向、神经质个性,防御机制与人格特征存在着显著的相关性(P<0.05或0.01).③研究组所遭遇生活事件总数、负性生活事件及正性生活事件均显著高于对照组(P<0.05或0.01),以负性生活事件为主;防御机制同所经历的负性生活事件有显著相关性(P<0.01).结论:军人失眠症患者呈现不同程度的人格缺陷,在应对应激事件时更多采用不成熟和中间型防御机制.     

癔症患者心理防御机制的研究

目的 探讨癔症(HyS)患者的心理防御机制及其与患者个性特征的关系.方法 HyS组30例,正常对照(NC)组66例,入组时按要求填写防御方式问卷(DSQ)和艾森克人格问卷(EPQ).结果 HyS患者投射、退缩和躯体化防御机制分和不成熟型防御因子分[分别为(3.64±1.45)分,(5.63±2.29)分,(5.33±2.36)分,(4.74±1.27)分]均高于NC组[分别为(2.61±1.09)分,(4.33±2.02)分,(3.86±1.60)分,(3.98±0.91)分],差异具有显著性(均P<0.01).解除、理想化、假性利他、同一化防御机制分和中间型防御机制因子分也显著高于对照组(P<0.01).压抑、幽默防御机制分、成熟防御因子分和掩饰因子分均显著低于正常对照组(P<0.05).EPQ结果:HyS患者精神质标准分、神经质标准分和掩饰标准分显著高于NC组(P<0.01)].内-外倾因子分与正常对照组比较差异不显著.相关分析结果:HyS患者组成熟型防御因子分与EPQ的SP分呈显著负相关.结论 HyS患者使用不成熟和中间型防御机制的倾向明显,较少使用成熟防御机制;后者与患者不良的个性特征尤其是精神质个性特征有关.     

卖淫妇女心理防御机制及心理健康状况研究

目的探讨卖淫妇女的心理防御机制与心理状况以及二者的关系。方法分别用防御方式问卷(DSQ)和症状自评量表(SCL-90)对83名卖淫妇女(研究组)和41名女大学生(对照组)进行调查。结果研究组不成熟防御机制、中间型防御机制评分[(4.78±1.02)分,(4.96±0.86)分]均高于对照组[(3.95±0.68)分,(4.26±0.73)分](P<0.01);研究组SCL-90中9个因子评分均显著高于对照组(P<0.01);相关分析发现,研究组不成熟防御机制与SCL-90中9个因子均存在显著正相关(P<0.01),中间型防御机制与SCL-90中9个因子也存在显著正相关(P<0.01或P<0.05),掩饰因子与SCL-90中的强迫、敌对、偏执、躯体、抑郁呈正相关(P<0.01或P<0.05)。结论卖淫妇女过多地使用不成熟防御机制及中间型防御机制,心理状况差,且二者存在明显的相关性。     

精神分裂症患者健康一级亲属的心理防御机制研究

目的:探讨精神分裂症患者健康一级亲属的心理防御机制。方法:对收集的112例精神分裂症患者健康一级亲属作为研究组和100例健康对照者作为对照组。采用防御方式问卷(DSQ)评估比较两组研究对象的心理防御机制。结果:1研究组研究对象的不成熟型和中间型防御机制分数高于对照组(P<0.01);成熟型防御机制,两组研究对象无显著差异(P>0.05);2在不成熟防御机制中,研究组研究对象的投射、被动攻击、潜意显现、幻想、分裂、躯体化以及中间型防御机制的反向形成、伴无能之全能、隔离等因子分显著高于对照组(P<0.01),其余各因子差异无显著(P>0.05);在成熟防御机制方面,两组研究对象的各因子差异无显著(P>0.05);3精神分裂症患者的一级亲属中父母、兄弟姐妹和子女在心理防御机制的应用总体相似。结论:本研究提示精神分裂症患者的健康一级亲属存在不成熟防御机制和中间型防御机制,有必要对其进行心理干预,以促进其向成熟防御机制转化。     

抑郁症患者心理防御方式及其与人格特征相关性研究

目的探讨抑郁症患者特定的防御方式及其与人格特征的相关性。方法采用防御方式问卷(DSQ)、A型行为问卷(TABQ)、汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA),对72名抑郁症患者进行测试,并与72名正常人作对照研究。结果与正常对照组相比,抑郁症患者较多使用不成熟的心理防御机制:退缩、躯体化和中间型心理防御机制:理想化、假性利他,较少使用幻想和期望。HAMD量表分与退缩、躯体化、解除和交往倾向呈显著正相关;HAMA量表分与解除、交往倾向和期望呈显著正相关(P<0.05或P<0.01)。A型行为者在使用不成熟和中间型心理防御机制上显著多于非A型行为者(P<0.05或P<0.01);A型行为者TABQ总分与不成熟型心理防御方式、中间型心理防御方式和掩饰因子均呈显著正相关(P<0.001),与成熟型心理防御机制呈负相关。结论具有A型行为特征的抑郁症患者更多使用不成熟和中间型心理防御方式。     

癌症伴抑郁患者心理防御特点

目的探讨癌症伴抑郁患者心理防御特点。方法采用抑郁自评量表(SDS)及防御方式问卷(DSQ)对70例癌症患者进行测试,根据SDS抑郁指数将患者分成研究组(癌症伴抑郁组)和对照组(癌症不伴抑郁组),比较两组患者的防御方式。结果两组患者SDS粗分及标准分间差别有统计学意义(P<0.001);DSQ因子中不成熟型防御机制得分间差别有统计学意义(P<0.001);不成熟防御机制之投射、被动攻击、潜意显现、抱怨、退缩、躯体化得分,成熟型防御机制之升华,中间型防御机制之否认、交往倾向、消耗倾向、期望得分间差别均有统计学意义(P<0.05)。结论癌症伴抑郁患者更多使用不成熟型防御方式,与癌症不伴抑郁者的防御机制不同。     

强迫症患者的防御机制、父母教养方式及个性特征的调查分析

目的 探讨强迫症患者的防御机制、父母教养方式及其个性特征.方法 采用防御方式问卷(DSQ)、父母养育方式评价量表(EMBU)及艾森克个性问卷(EPQ)对50例强迫症患者进行了问卷调查,并与50例正常受试者加以比较.结果 ①强迫症组中间型和不成熟防御机制因子分均明显高于正常对照组(P<0.01),而成熟防御机制因子分则明显低于正常对照组(P<0.05);②强迫症组父母的情感温暖因子分低.而父母的惩罚、拒绝因子分和母亲的偏爱被试因子分高,同正常对照组比较,差别均具有显著性或非常显著性意义(P<0.01或P<0.05);③强迫症组EPQ的N因子分明显高于正常对照组,而E因子分则明显低于正常对照组(P<0.01).结论 强迫症患者的防御机制、父母教养方式及个性特征与正常人有着明显的不同,它为今后开展分析性心理治疗,实施心理干预措施提供了依据.     

强迫症患者防御方式的对照研究

目的探讨强迫症防御方式的特征及防御机制因子与焦虑、抑郁和强迫症状的相关性.方法对36名强迫症患者和36名健康对照进行防御方式问卷(DSQ)、Zung抑郁自评量表(SDS)、Zung焦虑自评量表(SAS)及耶鲁-布朗强迫量表(Y-BOCS)测查.结果强迫症患者不成熟防御机制因子分及中间型防御机制因子分(F14.69±1.03,F24.93±0.95,F34.92±0.86,F45.30±1.23)高于对照组(F13.67±1.08,F25.68±1.03,F33.63±0.71,F45.63±1.39)(P＜0.05或P＜0.01),而成熟防御机制因子分则低于对照组(P＜0.05或P＜0.01).不成熟防御机制与焦虑、抑郁、强迫思维、强迫总分存在正相关,中间型防御机制与抑郁、焦虑有正相关.结论强迫症患者更多使用不成熟和中间型防御机制,并与焦虑、抑郁、强迫症状密切相关.     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.