重复经颅磁刺激对抑郁症患者防御方式的影响

目的 探讨重复经颅磁刺激对抑郁症患者防御方式及应对方式的影响.方法 将入住西安市精神卫生中心医院的166例抑郁症患者按照入院顺序分别编入对照组(n=83)和研究组(n=83).对照组采用抑郁症常规治疗,研究组采用重复经颅磁刺激.采用汉密顿抑郁量表(HAMD)、汉密顿焦虑量表(HAMA)、简易应对方式问卷(SCSQ)、防御方式问卷(DSQ),对抑郁症患者的症状改变和防御方式变化进行评估.结果 对照组和研究组治疗前后HAMD、HAMA评分均有统计学意义(P＜0.05);研究组治疗前后消极应对分、掩饰型因子分有显著性差异(P＜0.05);治疗后2组间比较,消极应对分、掩饰型因子分有统计学意义(P＜0.05).结论 重复经颅磁刺激可以改善抑郁症患者应对方式及防御方式.     

焦点解决技术在提升感染科护士积极情绪中的效果

目的 验证焦点解决技术在提升感染科护士积极情绪中的效果。方法 将150名感染科护士随机分为实验组和对照组,每组75名,两组分别建立微信群,并在群内开展积极赋能基础干预,实验组在对照组基础上给予焦点解决技术干预7d,两组均在干预前和干预7d后完成“积极消极信息注意量表”“积极情绪和消极情绪量表”及“简易应对方式问卷”。结果 干预后实验组护士积极注意增加(t=4.41,P=0.032),消极注意减少(t=5.13,P=0.027);积极情绪增加(t=4.22,P=0.023),消极情绪减少(t=3.80,P=0.044),积极率增加(t=6.78,P=0.019);积极应对方式增加(t=5.14,P=0.031),消极应对方式减少(t=4.66,P=0.038);而对照组变化无统计学差异(均P>0.05)。结论 焦点解决在提升感染科护士积极情绪中的效果显著。     

正念认知法联合抗抑郁药物对抑郁症患者认知功能和心理状态的影响

目的研究正念认知行为的团体治疗与抗抑郁药物治疗对抑郁症患者认知功能和心理状态的影响。方法选取抑郁症患者130例,随机均分为对照组和正念认知组。对照组予以常规抗抑郁药物治疗,正念认知组在对照组基础上进行正念认知行为的团体治疗,比较两组临床治疗疗效及汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、简易应对方式问卷(SCSQ)以及威斯康星卡片分类测试(WCST)。结果正念认知组治疗总有效率明显高于对照组(P＜0.05)。与治疗前比较,治疗后两组HAMD、HAMA评分均降低,且正念认知组下降程度大于对照组(P＜0.05);两组SCSQ评分均有所改善,且正念认知组改善程度大于对照组(P＜0.05);两组WCST均有所改善,且正念认知组应答总数、非持续性错误应答数多于对照组(P＜0.05),持续性错误应答数少于对照组(P＜0.05)。结论正念认知行为的团体治疗联合抗抑郁药物治疗抑郁症患者,能有效促进患者认知功能恢复,改善对应方式,缓解患者焦虑及抑郁情绪,值得临床上进一步推广。     

家庭心理护理对抑郁症患者应对方式和防御方式的影响

目的探讨针对家庭结构的心理护理对抑郁症患者应对方式和防御方式的影响。方法选择124例住院治疗的抑郁症患者,按入院时间顺序入组,分为研究组和对照组各62例。研究组采用针对家庭结构的心理护理,对照组采用抑郁症常规护理。两组分别在第0、12、24周对患者进行汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA),简易应对方式问卷(SCSQ)、防御方式问卷(DSQ)评定。结果在入组第12、24周,研究组的HAMD、HAMA评分、SCSQ积极应对分、消极应对和不成熟型因子分评分与入组时比较差异均有统计学意义(P<0.01),和对照组比较差异均有统计学意义(P<0.05);HAMD减分数与消极应对和不成熟型因子分呈正相关(P<0.05),与积极应对呈负相关(P<0.05);HAMA与消极应对呈正相关关系。结论针对家庭结构的心理护理可以改善抑郁症患者应对方式、防御方式,促进患者抑郁症状的好转。     

内观疗法对精神分裂症伴发抑郁的影响

［摘要］目的　探讨内观疗法对精神分裂症伴发抑郁患者情绪症状及心理状态的影响．方法　对精神分裂症伴发抑郁患者按照入组顺序分组,每组各128例．对照组按照精神分裂症治疗常规,研究组在常规治疗的基础上加用内观疗法,治疗6周．在入组时和出组时分别对患者进行阳性与阴性症状量表（PANSS）、简易应对方式问卷（SCSQ）、防御方式问卷（DSQ）、汉密尔顿抑郁量表（HAMD）、汉密尔顿抑郁量表（HAMA）．结果　第6周研究组HAMD、掩饰型因子分、消极应对因子分值显著低于对照组（t = 2.37、2.33、2.36,P＜0.05）;研究组第6周HAMD、掩饰型因子分、消极应对因子分值显著低于第0周 （t = 2.31、2.42、2.47,P＜0.05） ;研究组及对照组第6周PANSS总分及各因子分显著低于第0周 （P＜0.05）．结论　内观疗法可以改善精神分裂症伴发抑郁患者的心理健康水平,改善抑郁症状．     

心理剧治疗对抑郁症患者的作用

目的:探讨心理剧治疗对抑郁症患者的影响.方法:将44例抑郁症患者随机分为研究组和对照组,两组均使用抗焦虑、抑郁药物和常规护理,对研究组辅以心理剧治疗,采用抑郁自评表(SDS)、汉密尔顿抑郁量表(HAMD)和简明应对方式问卷(SCSQ)对两组进行效果评定.结果:SDS、HAMD前后比较有统计学意义(P＜0.01),而组间比较差异无统计学意义(P＞0.05).研究组治疗后积极应对因子高于对照组,消极应对因子低于对照组,差异具有统计学意义(P＜0.01).结论:心理剧治疗能改善抑郁症患者负性情绪,提高心理健康水平.     

正念减压训练对癌症患者焦虑抑郁情绪的影响分析

目的:探讨正念减压训练对癌症患者焦虑抑郁情绪的影响分析。方法:纳入自2012年1月至2016年12月收治的癌症患者100例,并以数字随机方式划分为2组。对照组行一般心理疏导干预,研究组行一般心理疏导干预联合正念减压干预。比较分析两组焦虑抑郁情绪。结果:研究组干预前的焦虑情绪评分与对照组无差异性(t值=0.0289,P值=0.9771),研究组干预后的焦虑情绪评分低于对照组(t值=15.2294,P值=0.0000)。研究组干预前的抑郁情绪评分与对照组无差异性(t值=0.0967,P值=0.9233),研究组干预后的抑郁情绪评分低于对照组(t值=13.7088,P值=0.0000)。结论:正念减压训练对癌症患者焦虑抑郁情绪的影响确切。     

认知行为干预对抑郁症患者防御方式的影响

目的：探讨认知行为干预对抑郁症患者防御方式的影响．方法以住院抑郁症患者为研究对象,共入组146例,按照入组顺序分为研究组和对照组．研究组采用认知行为干预,对照组采用抑郁症常规护理．采用汉密顿抑郁量表（HAMD）、汉密顿焦虑量表（HAMA）、简易应对方式问卷（SCSQ）,防御方式问卷（DSQ）评估抑郁症患者的症状改变和防御方式变化．结果研究组掩饰型因子分、积极应对分干预前后差异有统计学意义（P＜0.05）;第6周研究组和对照组间掩饰型因子分、积极应对分差异有统计学意义（P＜0.05）;干预前后2组HAMD、HAMA评分差异均有统计学意义（＜0.05）;HAMD分与积极应对因子分成负相关（P＜0.05）,与掩饰型防御方式成正相关（P＜0.05）,HAMA分与掩饰型防御方式成正相关（P＜0.05）．结论认知行为干预可以改善抑郁症患者抑郁焦虑症状及其防御方式．     

内观疗法对精神分裂症患者应对方式的影响

目的:探讨内观疗法对精神分裂症患者心理状态及应对方式的影响。方法:将284例精神分裂症患者按照入组顺序分组,对照组按照精神分裂症治疗常规,研究组在常规治疗基础上加用内观疗法,治疗6周。在入组时和出组时分别对患者进行阳性与阴性症状量表(PANSS)、简易应对方式问卷(SCSQ)、防御方式问卷(DSQ)、汉密尔顿抑郁量表(HAMD)、汉密尔顿抑郁量表(HAMA)。结果:第6周研究组掩饰型因子分、消极应对因子分值显著低于对照组(P<0.05);研究组第6周掩饰型因子分、消极应对因子分值显著低于治疗前(P<0.05);研究组及对照组第6周PANSS总分及各因子分显著低于治疗前(P<0.05)。结论:内观疗法可以改善精神分裂症应对方式及防御方式,改善心理状态。     

多元联动护理对抑郁症患者遵医行为及社会功能的影响

目的：分析多元联动护理对抑郁症患者遵医行为及社会功能的影响。方法：选择70例抑郁症患者,根据抽签法分为两组,对照组35例,给予常规护理;观察组35例,给予常规护理+多元联动护理。比较两组遵医行为、社会功能[住院精神病人社会功能评定量表(SSFPI),包括日常生活能力、动性和交往情况、社会活动技能]、抑郁病情、应对方式[简易应对方式问卷(SCSQ),包括积极问题关注、积极情绪关注、消极情绪关注、消极问题关注、心理疏导]。结果：护理3个月后,观察组遵医行为相比对照组较好,日常生活能力、动性和交往情况、社会活动技能评分及积极问题关注、积极情绪关注、心理疏导评分均相比对照组较高,消极情绪关注、消极问题关注评分均相比对照组较低,且轻度抑郁的占比(26例,74.29%)相比对照组(18例,51.43%)较多,差异有统计学意义(P<0.05)。结论：抑郁症患者经多元联动护理干预后,不仅能有效提升患者的遵医行为,提高社会功能,改善抑郁病情,还能促使患者积极面对自身疾病。     

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.