离异家庭青少年心理、社会支持度的干预研究

目的探讨综合干预对改善离异家庭青少年不良心理和社会支持状况的作用.方法对124例离异家庭青少年进行精神卫生(SCL-90)、领悟社会支持量表(PSSS)、亲子关系、父母养育方式、经济状况等调查,作多相关分析;把60例SCL-90因子分显著高出常模的个案,分为相匹配的干预组和对照组,对干预组进行12～18个月的综合干预后,复测上述指标.结果离异家庭青少年的社会支持度与SCL-90各因子分呈显著负相关(P<0.05,P<0.01,P<0.001),干预后,干预组的SCL-90总分和因子分显著低于对照组(P<0.001);其社会支持分显著高于对照组(P<0.01).结论综合干预能有效改善离异家庭青少年的不良心理,提高他们的社会支持度.     

离异家庭青少年心理障碍干预效果的相关研究

目的 探讨综合干预，对改善离异家庭青少年心理障碍的作用及其影响干预效果的相关因素。方法 给30例有情绪障碍和行为问题的研究对象，作12－18个月的心理治疗，家庭辅导和学校支持系统的设置，在干预前后，进行精神卫生自评量表（SCL－90）、艾森克人格问卷、社交回避苦恼量表、少儿行为量表（CBCL父母问卷）、亲子关系、父母养育方式、基础肌电值等调查测试；在显著和非显著进步组间，作相关因素比较。结果 SCL－90总分及各因子分、CBCL中多数因子分、人格特征中情绪不稳定分、社交焦虑和回避分、基础肌电值均显著低于干预前（P＜0．01）；显著进步组的医患关系、班主任和父母的配合情况，父母温暖理解分，明显优于非显著进步组（P＜0．05，P＜0．01），后者的学习、家庭经济、与非监护父／母关系差于显著进步组（P＜0．01），父亲拒绝否认、母亲严厉惩罚分高于显著进步组（P＜0．05，P＜0．01）。结论 综合干预能有效改善离异子女不良心理，有多种因素影响干预效果。     

青少年心理障碍患者家庭干预的随访研究

目的 :探索家庭干预对青少年心理障碍患者的康复作用。 方法 :将 112例青少年心理障碍患者及家属随机分为干预组 (62例 )和对照组 (5 0例 ) ,由专业的心理治疗师对干预组进行为期一年、定期综合的心理治疗及心理教育式家庭干预 ,对照组仅为门诊 (或电话 )随访。于入组前及 1年末分别对两组患者的心理症状及教养方式进行SCL -90和EMBU的评估和比较。 结果 :入组前干预组和对照组SCL -90各因子分无明显差异 ,EMBU各因子分差异不显著 (P >0 .0 5 ) ,干预后SCL -90各因子分均明显下降 ,均低于或等于国内常模 ,差异非常显著 (P <0 .0 1) ,EMBU各因子分也有明显的变化 ,差异有显著性 (P <0 .0 5 )。 结论 :家庭干预能有效提高青少年心理障碍患者的心理健康水平 ,提高康复率 ,降低青少年心理障碍的发病率 ,减少药物的使用 ,减少病人的痛苦 ,减轻病人及家属的经济负担     

高校新老学生心理健康状况的对照研究

目的 探讨高校新老学生心理健康状况的差异以及干预的效果。方法 随机抽取新生120人，二年级老学生干预组与未干预组各随机抽取120人，统一进行SCL—90症状自评量表测定，比较新老学生的SCL—90各症状因子得分的差异。结果 未干预组老生的强迫、人际关系、抑郁、敌对、偏执及精神病性因子的得分明显高于新生(P＜0．01)，其中恐怖、焦虑因子分则明显低于新生。老生干预组较未干预组强迫、人际关系、抑郁、敌对及其偏执因子分显性下降(P＜0．01)，焦虑、恐怖以及精神病性因子分无显性变化；但是在校生干预组的强迫、人际关系、抑郁、敌对、偏执以及精神病性因子分仍然显高于新生组(P＜0．01)。结论 对医学院校学生的心理健康教育应该加强，针对其不同的情况有的放失的进行。     

110例离异家庭初中生心理卫生及适应状况的对照研究

目的：了解离异家庭初中生心理,人格,社交,学习等状况,探讨影响他们再适应的主要因素。方法：对110例研究对象作SCL－90,EPQ,社交回避苦恼量表,学习成绩以及相关因素调查,对适应良好和不良组作特质应对,父母养育方式以及精神卫生,离异时间,抚养对象,亲子关系等对照研究,结果：SCL－90大多数因子分显著高于常模（P＜0．01,P＜0．05）,有自杀观念占23％,人格问卷中P,N,E,一个或多个因子高于常模占56％,社交困难占40％,成绩显著低于平均分（P＜0．05）。适应不良组的消极应对分,父母严厉惩罚,拒绝否认,干涉过度,母亲偏爱分显著高于适应良好组（P＜0．01,P＜0．05）,成绩以及与非监护人关系差（P＜0．05）,监护人心理卫生问题多（P＜0．05）。而离异时间,抚养对象,人口学指标等无显著差异（P＞0．05）,男生个性问题发生率高,成绩差,较女生适应困难。结论：研究对象不良心理,社会交往及学习困难发生率高,影响他们再适应的主要因素有：应对方式,父母养育方式和监护人心理状况以及能否获得非监护人的关爱。     

SARS期间医学生心理健康状况与社会支持相关性研究

①目的 研究在SARS这一特殊时期，医学生的社会支持与心理健康水平的关系。②方法 在SARS期间对唐山市156例医学生用SCL—90量表进行心理健康状况的调查，用社会支持评定量表进行社会支持程度的调查。③结果 社会支持的利用度分与SCL—90症状总分及各因子分均呈负相关，与症状总分、躯体化分、人际关系敏感分、抑郁分、焦虑分、敌对分、恐怖分有显著相关。表明社会支持利用度越高，心理健康程度越高。而客观支持分、主观支持分与SCL—90症状总分及各因子分呈正相关或负相关．无显著性。④结论 在SARS这一特殊时期，医学生的社会支持利用度对心理健康水平有显著的影响．而客观支持和主观支持对心理健康水平无显著影响。     

伴攻击行为精神分裂症患者的人格特征及社会支持研究

目的探讨伴攻击行为精神分裂症患者的人格特征及社会支持的特点。方法对30例伴攻击行为的精神分裂症患者（研究组）和30例不伴攻击行为者（平行对照组）分别进行艾森克个性问卷（EPQ）和社会支持评定量表（SSRS）评定,分析其人格特征及社会支持的特点,并与30名健康者（正常对照组）作对照,两对照组的一般资料与研究组相匹配。结果研究组的EPQ—N、E、P因子分均显著高于平行对照组（P〈0．01）,主观支持和对支持利用度两个因子分均显著低于平行对照组（P〈0．05或P〈0．01）。两组的EPQ—P、N因子分比正常对照组高而SSRS总分及因子分比正常对照组低,差异有统计学意义（P〈0．05或P〈0．01）。结论伴攻击行为精神分裂症患者具有神经质、外向不稳定性、精神病性的人格特点,对支持的利用不足,需要更多的社会支持。     

吸毒人群生理戒断后的心理健康研究

目的：探讨吸毒者生理戒断后的心理健康状况及其治疗。方法：选择123例生理戒断的吸毒者为吸毒组和142名正常人为对照组进行心理测评,测评内容包括SCL－90、社会支持评定、EPQ、SAS和SDS自评量表,然后进行比较,结果：恐怖因子分吸毒组明显高于对照组（P＜0．01）,而且SCL－90总分、EPQ神经质量表（N）、SAS和SDS及社会支持总分低于对照组（P＜0．01）,结论：表明吸毒组有严重心理障碍和个性状况异常,在生理戒断后需长期心理治疗和个性矫正。     

精神分裂症病人的社会支持与康复护理

目的：探讨恢复期精神分裂症病人的社会支持度。方法：用社会支持量表对200例恢复期精神分裂症病人进行调查分析。结果：精神分裂症病人的社会支持低于常模（P〈0．01）；男性与女性相比，在社会支持总分、客观支持分、对支持的利用度均有差异，女性明显高于男性（P〈0．05）；有配偶组的病人社会支持总分、主观支持分、客观支持分及对支持的利用度均高于无配偶组，有显著差异（P〈0．01）；有职业的精神分裂症病人在社会支持总分、主观支持分、客观支持分均高于无职业组（P〈0．05；P〈0．01）；家庭关系好的病人社会支持总分、主观支持分、客观支持分及对支持的利用度均高于家庭关系差的病人，有显著差异（P〈0．05；P〈0．01）；首次住院病人在社会支持总分、主观支持分均高于再次住院的病人，有显著差异（P〈O．05）。结论：提出康复护理对策，提高病人的社会支持：全面评估病人的社会支持的状况，做好健康指导；鼓励病人主动利用社会支持网络；呼吁社会关爱精神分裂症病人，从物质和精神上给予最实惠的帮助；加强职业康复，提高社会支持；优化最大限度发挥家庭的作用和支持；预防复发，增加病人的主观支持。     

复发肺结核患者心理健康及社会支持状况调查

目的分析复发肺结核患者心理健康及社会支持状况特点，为进一步改善复发肺结核患者的治疗，针对性地进行心理干预提供依据。方法采用症状自评量表（SCL-90）、社会支持评定量表（SSRS）对98例复治涂阳患者进行问卷调查研究，记录不同性别、年龄、文化程度及婚姻状态患者的SCL-90、SSRS评分情况。并选择同期初治涂阳患者140例和健康志愿者120例作为对照。采用t检验和方差分析对各项指标均数进行统计分析。结果女性复治涂阳肺结核患者SCL-90阳性项目数高于男性患者（P〈0．01）。不同年龄复发涂阳患者．在强迫症状、人际关系、恐怖3个因子上（P〈0．05）以及客观支持上（P〈0．01）存在差异。不同文化程度复发涂阳患者，在强迫症状、人际关系、抑郁、恐怖、偏执5个因子上以及客观支持上（P〈0．05）存在差异。未婚、离异患者社会支持低于已婚患者（P〈0．01）。复治涂阳肺结核患者SCL-90阳性项目数高于健康对照组（P〈0．01），而客观、主观支持及支持总分低于健康对照组（P〈0．01）。结论复治涂阳患者心理健康水平较差，社会支持低。在严格执行全程督导管理过程中，要注重配合心理干预和治疗。     

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.     

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.     

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.