血液肿瘤儿童行为问题及心理干预

目的探讨血液肿瘤儿童与正常儿童在行为方面的差异,心理干预在血液肿瘤治疗中的作用. 方法采用Achenbach儿童行为评定量表(CBCL),对57例病程1～5年,年龄6～11岁的血液肿瘤患儿及62例正常儿童进行行为的心理测试.并对15名血液肿瘤儿童在化疗的同时进行3～4个月的心理干预.结果血液肿瘤儿童行为问题明显高于正常儿童,其行为问题发生率为21.1%,男孩多有交往不良、躯体诉述、违纪,女孩表现为抑郁、社交退缩.对血液肿瘤儿童在化疗的同时配合心理干预,可以改善行为问题.结论血液肿瘤儿童易出现行为问题,对其进行必要的心理干预,对血液肿瘤儿童提高生命质量有积极作用.     

心理干预对哮喘儿童行为及家长心理状况的影响

目的:探讨哮喘儿童行为及其家长的心理卫生状况,以及心理干预治疗在哮喘治疗中的作用.方法:根据病例对照研究的原则,应用美国Achenbach儿童行为调查表(CBCL)分别对76名哮喘儿童及正常儿童行为问题进行了调查,应用Symptom Checklist 90症状自评量表(SCL-90)对其父母进行心理状况调查,并对38名哮喘儿童在药物治疗基础上进行了5个～6个月的心理行为干预治疗.结果:哮喘儿童行为问题检出率为45.2%(35例),明显高于正常对照组16.6%(13例),两组差异有显著性.其父母的心理精神压力亦高于正常儿童的父母,主要表现在躯体化、抑郁、焦虑、敌对、恐怖、偏执等方面.对哮喘儿童在药物治疗的基础上配合心理行为的干预治疗,可明显改变哮喘的症状,减少复发.结论:哮喘儿童及其家长容易出现心理行为问题,对哮喘儿童进行必要的心理行为干预治疗,对控制哮喘症状、干预和矫治不良行为、改变家庭环境均有积极作用.     

心理护理干预在血液肿瘤综合治疗中的应用

目的：探讨心理护理干预在血液肿瘤综合治疗中的作用。方法：采用自编心理卫生状况评定量表及90项症状自评量表（SCL-90）对46例血液肿瘤患者及其家属进行心理测试，并随机抽取28例血液肿瘤患者及其家属在化疗的同时予以为期3个月的心理护理干预，随后进行心理测试。结果：血液肿瘤患者及其家属心理卫生问题明显多于健康人及其家属，表现为社会行为问题（3.9±2.7）、个性情绪问题（7.1±4.2）、习惯问题（1.2±1.0）、学习问题（1.3±1.1）较健康人（1.5±1.5，1.6±1.7，0.5±0.5，0.5±0.4）显著增多（P〈0.01）；其家属的强迫（1.9±0.9）、抑郁（1.9±0.8）、焦虑（1.8±0.9）情绪显著增多（1.6±0.6，1.4±0.7，1.5±0.7，P〈0.05）。心理护理干预后，干预组患者的社会行为问题（2.4±1.9）、个性情绪问题（4.1±2.9）较非干预组明显减少（3.9±2.4，7.1±3.9，P〈0.05）；其家属的强迫（1.5±0.7）、抑郁（1.5±0.9）、焦虑（1.4±1.1）情绪亦较干预前显著减少（1.9±1.0，1.9±0.9，1.8±0.6，P〈0.05）。结论：血液肿瘤患者及其家属存在较多的心理卫生问题，心理护理干预可显著提高血液肿瘤患者的生存质量，促进患者及其家属的心身健康。     

哮喘儿童行为问题及干预治疗

目的探讨哮喘患儿与正常儿童在行为方面的差异,及心理行为干预治疗在哮喘治疗中的作用。方法根据病例对照研究原则,应用Achenbach儿童行为调查表分别对84名哮喘儿童及正常儿童的行为问题进行了调查,并对18名哮喘儿童在药物治疗的基础上进行了3～4个月的心理行为的干预治疗。结果哮喘儿童行为问题明显高于正常儿童,哮喘的不同程度、不同性别,其行为问题不完全相同。对哮喘儿童在药物治疗的基础上配合心理行为的干预治疗,可明显改变哮喘的症状。结论哮喘儿童易出现行为问题,对哮喘儿童进行必要的心理行为干预治疗,对控制哮喘症状,干预和矫治不良行为均有积极作用。     

哮喘儿童行为问题及干预治疗

目的：探讨哮喘患儿与正常儿童在行为方面的差异,及心理行为干预治疗在哮喘治疗中的作用。方法：根据病例对照研究原则,应用Achenbach儿童行为调查表分别为84名哮喘儿童及正常儿童的行为问题进行了调查,并对18名哮喘儿童在药物治疗的基础上进行了3－4个月的心理行为的干预治疗,结果：哮喘儿童行为问题明显高于正常儿童,哮喘的不同程度,不同性别,其行为问题不完全相同,对哮喘儿童在药物治疗的基础上配合心理行为的干预治疗,可明显改变哮喘的症状。结论：哮喘儿童易出现行为问题,对哮喘儿童进行必要的心理行为干预治疗,对控制哮喘症状,干预和矫治不良行为均有积极作用。     

放松训练在支气管哮喘患儿心理护理中的作用

目的探讨哮喘患儿的心理特征在家庭应对指导、认知和脱敏治疗中用放松训练进行心理干预，对治疗儿童哮喘的临床疗效。方法对112例6～14岁的哮喘儿童进行问卷调查。同时采用随机对照方法，分为干预组（n=58）和对照组（n=54），2组给予同样药物治疗，干预纽同时进行心理干预，干预前后观察2组临床疗效，复发情况及行为问题检出率等。结果大多数哮喘儿童存在比较明显的心理障碍。通过用放松训练对心理干预治疗，干预组在临床疗效、复发情况及行为问题检出率等方面均优于对照组（P〈0.01）。结论哮喘儿童存在比较明显的心理障碍，利用放松训练对哮喘志儿的心理进行心理干预，其疗效优于单纯药物治疗。     

哮喘儿童心理行为障碍及其早期干预

目的:探讨哮喘儿童心理、行为状况及综合性干预治疗的临床疗效。方法:对学龄期60例哮喘儿童和50例正常儿童进行社会心理状况问卷调查及行为、情绪评定,针对存在的问题进行综合性干预治疗(采用按摩放松疗法、情绪疏导疗法以及实践脱敏疗法),比较治疗前后患儿心理、行为变化情况。结果:71.8%哮喘儿童存在心理障碍,主要表现为对发作的恐惧,长期用药副作用的担忧及社会交往困难;35%的患儿存在行为异常,与正常儿童相比各项指标差异显著,干预治疗后患儿心理、行为状况明显改善,各项指标前后比较差异显著(P<0.01)。结论:哮喘儿童存在心理、行为障碍,在哮喘药物治疗的基础上对其存在的心理、行为障碍进行干预治疗是必不可少的,是提高哮喘儿童生活质量的唯一途径。     

心理干预对恶性血液病儿童生存质量的影响

随着儿童恶性血液病治疗方法的进步,持续缓解率不断提高,恶性血液病儿童的生存质量问题正被广泛的关注.以往对恶性血液病的临床治疗主要采取化疗、放疗、骨髓移植等力法,而临床心理干预被认为是在上述常规治疗之外的一种非必须的方法.随着社会生物心理医学模式的转变,人们越来越重视临床心理干预的作用[1].但临床心理干预对儿童恶性血液病生存质量的研究甚少有报告.因此,本研究对恶性血液病儿童在化疗的同时进行心理干预,探讨临床心理干预对恶性血液病儿童生存质量的影响.     

饮食护理干预对肿瘤化疗期间血液系统的影响

目的饮食护理干预对肿瘤化疗期间血液系统的影响的分析。方法将112例肿瘤病人随机分为观察组和对照组,每组各56例,观察组在常规的基础上进行饮食干预,对照组进行常规干预,观察两组血红蛋白、血小板、白细胞及淋巴细胞计数以评价患者血液系统状况。结果两组肿瘤病人在化疗4周后,外周血红蛋白观察组正常为73．2％,对照组为53．6％,两组差异有统计学意义（P〈0．05）;血小板观察组正常为71．4％,对照组为55.3％,两组差异有统计学意义（P〈0．05）;白细胞观察组正常为75％,对照组为48．2％（P〈0．01）;淋巴细胞观察组正常为73．2％,对照组为46．4％（P〈0．01）。结论有效的饮食干预可改善化疗病人的血液系统状况。     

心理护理干预对血液内科患者遵医行为的影响

目的:通过临床观察和分析来探究心理护理干预对血液内科患者遵医行为的影响。方法:将128例患者临床资料作为研究对象,将所有患者随机分成观察组和对照组,每组各64例。对照组患者给予正常护理治疗;观察组患者除了正常的护理治疗之外加强心理护理干预。比较分析两组患者的遵医行为状况。结果:观察组患者经心理护理干预后,遵医情况和心理健康状况明显优于对照组,其差异有统计学意义(P<0.05)。结论:对血液内科患者进行心理护理干预可以有效提高其遵医行为的执行率,心理护理干预值得在血液内科住院患者的临床护理中应用推广。     

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.