精神疾病患者家庭暴力危险因素的研究

目的探讨精神疾病患者家庭暴力行为相关因素,为家庭暴力的预测和干预研究积累资料和进行方法学的准备。方法对38例具有家庭暴力行为和40例无家庭暴力行为的两组精神疾病患者,应用人口学资料、既往史调查表、家庭暴力行为调查表、简明精神病评定量表(BPRS)、明尼苏达多相人格调查表(MMPI)、人格诊断问卷第4版(PDQ4 )、早年(18岁以前)不良家庭环境问卷、家庭环境量表-中文版(FES-CV)进行对照研究。结果(1)研究组的BPRS总分[(51.29±11.03)分]、敌意猜测[(4.00±1.77)分]、焦虑抑郁[(3.76±2.14)分];MMPI测试中的F[(64.86±11.28)分]、D[(64.04±8.81)分]、Hs[(66.91±8.79)分]、Hy[(64.25±11.15)分]、Pa[(66.30±11.22)分];PDQ4 的测定中的偏执型[(4.55±1.33)分]、依赖型[(4.37±1.73)分]、被动攻击型[(4.29±1.69)分]、抑郁型[(4.66±1.38)分]人格障碍;家庭环境量表的亲密度[(6.97±1.88)分]、情感表达[(5.66±1.51)分]、娱乐性[(5.61±1.82)分]、组织性[(6.40±1.59)分]方面与对照组有显著性差异(P<0.05)。(2)经Logistic回归分析结果显示攻击行为史[(2.63±0.52)分]、MMPI的D[(0.13±0.04)分]、Pa[(0.06±0.02)分]高分和BPRS的总分[(0.24±0.06)分]、敌对猜疑[(0.72±0.19)分]、焦虑抑郁[(0.55±0.17)分]因子高分及早年遭受父母虐待[(-4.14±1.42)分]、家庭结构不完整[(1.79±0.80)分]以及家庭环境量表中亲密度(0.48±0.16)低分、PDQ4 抑郁型(-1.47±0.47)高分可作为精神病患者家庭暴力行为的预测因子。结论心理社会因素、病理性人格和精神病理症状是精神病患者家庭暴力行为的始动因素,可作为家庭暴力行为的预测因子和指导干预的方向。     

精神疾病患者家庭暴力危险因素的研究

目的探讨精神疾病患者家庭暴力行为相关因素,为家庭暴力的预测和干预研究积累资料和进行方法学的准备.方法对38例具有家庭暴力行为和40例无家庭暴力行为的两组精神疾病患者,应用人口学资料、既往史调查表、家庭暴力行为调查表、简明精神病评定量表(BPRS)、明尼苏达多相人格调查表(MMPI)、人格诊断问卷第4版(PDQ4+)、早年(18岁以前)不良家庭环境问卷、家庭环境量表-中文版(FES-CV)进行对照研究.结果 (1)研究组的BPRS总分[(51.29±11.03)分]、敌意猜测[(4.00±1.77)分]、焦虑抑郁[(3.76±2.14)分];MMPI测试中的F[(64.86±11.28)分]、D[(64.04±8.81)分]、Hs[(66.91±8.79)分]、Hy[(64.25±11.15)分]、Pa[(66.30±11.22)分];PDQ4+的测定中的偏执型[(4.55±1.33)分]、依赖型[(4.37±1.73)分]、被动攻击型[(4.29±1.69)分]、抑郁型[(4.66±1.38)分]人格障碍;家庭环境量表的亲密度[(6.97±1.88)分]、情感表达[(5.66±1.51)分]、娱乐性[(5.61±1.82)分]、组织性[(6.40±1.59)分]方面与对照组有显著性差异(P＜0.05).(2)经Logistic回归分析结果显示攻击行为史[(2.63±0.52)分]、MMPI的D[(0.13±0.04)分]、Pa[(0.06±0.02)分]高分和BPRS的总分[(0.24±0.06)分]、敌对猜疑[(0.72±0.19)分]、焦虑抑郁[(0.55±0.17)分]因子高分及早年遭受父母虐待[(-4.14±1.42)分]、家庭结构不完整[(1.79±0.80)分]以及家庭环境量表中亲密度(0.48±0.16)低分、PDQ4+抑郁型(-1.47±0.47)高分可作为精神病患者家庭暴力行为的预测因子.结论心理社会因素、病理性人格和精神病理症状是精神病患者家庭暴力行为的始动因素,可作为家庭暴力行为的预测因子和指导干预的方向.     

住院精神疾病患者攻击行为临床分析

目的分析住院精神疾病患者攻击行为的相关因素.方法观察住院精神疾病患者895例,分别进行社会学资料统计和简明精神病评定量表(BPRS)评定,对住院期间发生攻击行为的145例进行相关因素的调查分析. 结果住院精神疾病患者攻击行为的发生与文化程度、婚姻状况、既往暴力行为、住院方式等有明显的相关性,且BPRS总分及思维障碍、激活性、敌对猜疑3个因子分较高.结论住院精神疾病患者发生攻击行为占16.2%;并提出相应措施,最大限度地减少此类事件的发生.     

住院精神疾病患者攻击行为临床分析

目的:分析住院精神疾病患者攻击行为的相关因素。方法:观察住院精神疾病患者895例,分别进行社会学资料统计和简明精神病评定量表(BPRS)评定,对住院期间发生攻击行为的145例进行相关因素的调查分析。结果:住院精神疾病患者攻击行为的发生与文化程度、婚姻状况、既往暴力行为、住院方式等有明显的相关性,且BPRS总分及思维障碍、激活性、敌对猜疑3个因子分较高。结论:住院精神疾病患者发生攻击行为占16.2%;并提出相应措施,最大限度地减少此类事件的发生。     

农村精神病人攻击行为相关因素的对照研究

目的：研究农村精神病人攻击行为的相关因素。方法：98例有攻击行为者列为研究组，103例无攻击行为者列为对照组，重点根据两组既往史、家族史、个人史、BPRS量表评分及病人妄想类别来探讨其导致攻击行为的相关因素。结果：既往史中的暴力行为及酒精滥用，家族史中教育方式、家族成员之间关系及阳性家族史、个人史中曾受父母虐待，BPRS量表中思维障碍及敌对猜疑均显示差异有显著性(P＜0．05)，妄想类别两组间差别也有显著性差异(P＜0．05)。结论：精神病人攻击行为是多因素的，病理性妄想、家庭环境等是重要因素之一。     

精神疾病暴力人群与家庭环境的相关研究

目的：探讨家庭环境及其相关因素对精神疾病患者暴力行为的影响，探寻不良家庭环境的危险因素，旨在提出干预措施。方法：应用人口学资料、人格障碍诊断问卷（PDQ-4）、简明精神病评定量表（BPRS）、早年不良家庭环境问卷、家庭环境量表中文版（FES—CV）对38例具有家庭暴力行为和40例无家庭暴力行为的两组精神疾病患者进行对照研究。结果：精神分裂症及抑郁症这两种疾病类型为主要的暴力人群，其中家庭结构不完整、家庭亲密度及情感表达为暴力发生的主要危险因素，父母虐待、不良教养方式、娱乐性、组织性为一般危险因素。结论：家庭结构完整性、家庭成员间支持度及情感表达对精神病人暴力发生构成危险因素，对干预措施作出指导性建议。     

对住院精神病患者攻击行为的分析与护理对策

目的:对住院精神病患者攻击行为进行分析,提出相应的护理对策。方法:对本院2005年12月-2007年12月1 163例住院精神病患者,根据病史收集患者的社会人口学资料,采用简明精神病评定量表(BPRS)来评定相关因素。结果:有攻击行为的患者BPRS总分和思维障碍、激活性、敌对猜疑3个因子分明显高于无攻击行为患者(均P<0.01),而其他焦虑抑郁、缺乏活力2个因子分比较差异无显著性(均P>0.05)。结论:针对精神病患者的攻击行为采取相应的护理对策,可减少精神病患者攻击行为的发生。     

住院精神病患者攻击行为的相关性分析

目的 了解精神病患者住院期间的攻击行为的相关因素,为医护人员寻求防范措施. 方法 观察对象为男性住院的精神病患者,采用简明精神病评定量表(BPRS)对住院期间发生攻击行为患者的精神病性症状进行相关性分析.并比较几种常见精神病的攻击行为的发生率.结果 有明显攻击行为的患者的思维障碍、激活性、敌对猜疑因子分明显高于无明显攻击行为者.结论 有明显攻击行为的患者的思维障碍、激活性、敌对猜疑因子分明显高于无明显攻击行为者.脑外伤所致精神障碍的攻击发生率最高,其次分别为癫痫所致精神障碍、酒精所致精神障碍及阿尔茨海默病.     

住院精神病患者52例攻击行为调查分析

目的探讨精神病患者攻击行为的相关问题。方法采用回顾性研究的方法对52例有攻击行为的精神病患者进行分析。结果发生攻击行为者,男性明显高于女性,精神分裂症明显高于其他疾病,既往攻击行为史、幻听、被害妄想、激惹性、敌对猜疑为攻击行为的主要危险因子。结论精神病患者攻击行为发生率较高,提示某些危险因子对精神病患者发生攻击行为具有预测价值。     

住院女性精神分裂症患者攻击行为预测及对策

目的 探讨女性精神分裂症患者攻击行为的相关因素。方法 应用简明精神测量表（BPRS）及住院患者观察量表（NOSIE）对43例（观察组）无攻击行为精神分裂症患者和113例（对照组）无攻击行为精神分裂症患者进行临床对照研究。结果 观察组51．16％患者有精神病家族史，58．14％患者既往有攻击行为，而对照组分别为30．97％、30．97％，观察组显著高于对照组（P〈0．05、P〈0．01）观察组BPRS中敌对猜疑，激惹性、思维障碍，行为紊乱因子及NOSIS中激惹精神症状因子分显著高于对照组（P〈0．05 P〈0．01）。结论 精神病家族史阳性，既往有攻击行为，易激惹，思维障碍敌对猜疑，行为紊乱等可能是女性精神分裂症患者攻击行为的危险因素。早期预测干预，可减少其攻击行为的发生。     

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.