大学生应对方式与失眠的关系：反刍思维的中介效应

目的 探讨大学生反刍思维在应对方式与失眠之间的中介效应。方法 采用失眠严重程度指数（ISI）、反刍思维量表（RRS）、特质应对方式问卷（TCSQ）对四川省某所高校767名大学生进行调查。结果 大学生失眠检出率为36.6%;积极应对与RRS总分及各维度得分呈显著负相关（r=-0.127~-0.116,P<0.01）,与ISI总分呈显著负相关（r=-0.159,P<0.001）;消极应对与RRS总分及各维度得分呈显著正相关（r=0.298~0.334,P<0.001）,与ISI总分呈显著正相关（r=0.264,P<0.001）;RRS总分及各维度得分与ISI总分呈显著正相关（r=0.251~0.281,P<0.001）;反刍思维在积极应对、消极应对与失眠之间均存在部分中介效应。 结论 应对方式既可以直接影响大学生的失眠状况,也可以通过反刍思维的中介效应间接影响其失眠状况。     

昼夜节律与睡眠质量的链式中介模型:焦虑特质和睡眠信念态度的作用

目的：探究在大学生群体中昼夜节律类型与睡眠质量之间的关系,并明确焦虑特质和睡眠信念态度在其中所起的中介作用。方法：对某医学院大学生进行线上调查,使用清晨型与夜晚型量表-5项（MEQ-5）特质焦虑量表（STAI-T）、简易睡眠信念和态度量表（DBAS- 16）、匹兹堡睡眠量表指数（PSQI）分别评估大学生的昼夜节律类型、焦虑特质水平、睡眠信念态度以及睡眠质量。采用Pearson相关分析和中介效应分析昼夜节律类型、焦虑特质水平、睡眠信念态度以及睡眠质量之间的关系。结果：共回收问卷238份,有效问卷233份,有效率97.90%。Pearson相关分析指出昼夜节律类型、焦虑特质水平、睡眠信念态度以及睡眠质量四个变量得分两两之间呈显著相关（P<0.01）。以昼夜节律类型为自变量,睡眠质量为因变量,焦虑特质水平、睡眠信念态度为中介变量进行中介效应分析。焦虑特质水平的中介效应量（MEQ → STAI-T → PSQI）占总效应的 30.48%（r=-0.128,95% CI：-0.211至-0.066）,睡眠信念态度得分的中介效应量（MEQ → DBAS → PSQI）占总效应的12.62%（r=-0.053,95% CI：-0.106 至-0.014）;2个中介变量的链式中介效应量（MEQ → STAI → DBAS → PSQI）占总效应的11.19%（r = -0.047,95% CI：-0.085 至-0.022）。结论：大学生的昼夜节律类型能够负向预测其睡眠质量,并且焦虑特质水平与睡眠信念态度在其中起链式中介作用。     

行IVF-ET患者的睡眠质量与认知情绪调节的相关性研究

目的调查行体外受精-胚胎移植(IVF-ET)患者的睡眠质量与认知情绪调节的现状,探讨二者之间的关系。方法选取168例进入周期的IVF-ET患者,采用中文版认知情绪调节量表(CERQ-C)和匹茨堡睡眠质量指数量表(PSQI)调查其认知情绪调节及睡眠质量情况,Pearson相关性分析探讨两者之间的相关性。结果 168例患者的低睡眠质量检出率为41.7%,明显高于正常人(21.7%~33.9%);年龄、不孕年限、居住地、职业及是否重复周期与低睡眠质量相关(P<0.05);认知情绪调节中自我责难、接受、沉思、灾难化四个因子得分高于常模(P<0.01),而重新关注计划、积极重新评价、理性分析、责难他人四个因子得分低于常模(P<0.01);PSQI总分显著高于常模(P<0.01),除催眠药物这一因子外,各因子得分均高于常模(P<0.01);消极认知情绪调节方式得分与PSQI总分呈正相关(r=0.459,P<0.01),而积极认知情绪调节方式得分与PSQI总分呈负相关(r=-0.378,P<0.01);不孕年限、居住地、消极与积极认知情绪调节方式对睡眠质量具有预测作用。结论行IVF-ET患者的睡眠质量亟待提高,临床应及早对其进行心理干预,引导患者多使用积极的认知情绪调节方式去应对问题,切实改善睡眠质量。     

海岛环境作业人群睡眠状况及影响因素研究

目的 探究海岛环境下作业人群睡眠状况及影响因素,为开展针对性干预提供科学依据。方法 应用一般资料调查表、匹兹堡睡眠质量指数量表(PSQI)、情绪自评量表(DASS-21)、简易应对方式量表(SCSQ)、心理弹性量表(CD-RISC),对897名长期位于边远海岛环境作业的人群开展心理调查并进行统计学分析,对睡眠相关指标开展相关性分析和Logistic回归分析。结果 海岛作业人群PSQI得分为8.0(4.0),PSQI＞7分者512人,占57.08%。睡眠质量与情绪状态、消极应对方式呈显著正相关(均P<0.001),与积极应对方式、心理弹性呈显著负相关(均P<0.001)。Logistic分析显示,情绪状态(P<0.001)、积极应对方式(P=0.017)或消极应对方式(P=0.005)是海岛作业人群睡眠状况的独立影响因素。结论 长期处于海岛特殊环境作业人群睡眠质量差,情绪状态、应对方式是睡眠质量的独立影响因素。     

应对方式在围绝经期女性睡眠状况和生存质量之间的中介效应

目的 探讨应对方式在围绝经期女性睡眠状况与生存质量之间的中介效应。方法 采用便利抽样方法,选取2017年10月—2018年9月辽宁省丹东市40～60岁围绝经期女性600例,采用简易应对方式问卷（SCSQ）、匹兹堡睡眠质量指数量表（PSQI）、绝经生存质量量表（MENQOL）对绝经过渡期女性进行调查。结果 积极应对方式平均（1.615±0.577）分,消极应对方式平均（1.380±0.678）分,睡眠质量平均（6.820±3.575）分,绝经生存质量平均（57.470±38.790）分。睡眠质量得分与积极应对方式得分呈负相关（r?=-0.432,P?=0.000）,与消极应对方式得分呈正相关（r?=0.393,P?=0.000）;绝经生存质量得分与积极应对方式得分呈负相关（r?=-0.516,P?=0.000）,与消极应对方式得分呈正相关（r?=0.446,P?=0.000）;睡眠质量得分与绝经生存质量得分呈正相关（r?= 0.593,P?=0.000）;睡眠状况不仅可以直接影响围绝经期女性绝经期生存质量,还可以通过应对方式这一中介作用间接影响其绝经期生存质量,且中介效应占总效应的31.06%（0.250/0.805）。结论 应对方式在围绝经期女性睡眠状况与生存质量间起部分中介效应。     

综合性心理干预对精神分裂症病人家属应对方式、情绪及生活质量的影响

目的探讨心理干预对精神分裂症病人家属应对方式、情绪及生活质量的影响。方法对精神分裂症病人家属进行为期12周的心理干预,在干预前后应用应对方式问卷、焦虑自评量表(SAS)、抑郁自评量表(SDS)、生活质量量表(SF-36)进行心理测评。结果干预后病人家属消极应对、SAS、SDS得分减少,积极应对和部分SF-36得分增加,与干预前和对照组相比差异有显著性(t=2.02～4.15,P<0.05)。病人家属的精神健康和角色情绪得分与积极应对得分呈正相关(r=1.12、0.21,P<0.05),与消极应对、SAS、SDS得分呈负相关(r=-0.13～-0.37,P<0.05);病人家属的活力得分与积极应对得分呈正相关(r=0.13,P<0.05),与SDS得分呈负相关(r=-0.13,P<0.05)。结论心理干预可有效改善精神分裂症病人家属的应对方式、情绪和生活质量。     

社会支持在犯罪青少年及情绪障碍青少年依恋模式和应对方式间的中介作用

目的 探讨社会支持的中介作用对犯罪青少年和情绪障碍青少年的依恋模式以及应对方式的影响.方法 采用应对方式问卷、亲密关系问卷和社会支持评定量表,抽取177例犯罪青少年、80例情绪障碍青少年和163例正常青少年进行问卷调查.结果 ①三组在依恋回避、依恋焦虑、客观支持、主观支持、对支持利用度、解决问题、合理化、自责和退避等维度差异显著（F=7.902,8.047,59.009,19.248,5.304,7.596,10.652,6.699,11.009; P＜0.05）.②情绪障碍组依恋回避与对支持利用度、求助呈显著负相关（r=-0.470,-0.350; P＜0.01）;犯罪组依恋回避与主观支持、支持利用度呈显著负相关（r=-0.232,-0.235;P＜0.01）,主观支持与解决问题呈显著正相关（r=0.272,P＜0.01）,支持利用度与解决问题、求助呈显著正相关（r=0.258,0.424;P＜0.01）,依恋焦虑与客观支持呈显著负相关、与自责呈显著正相关（r=-0.253,0.300;P＜0.01）.③情绪障碍组和犯罪组对支持利用度在依恋回避和求助之间都起到完全中介作用;犯罪组主观支持和对支持利用度在依恋回避和解决问题之间均起部分中介作用.结论 犯罪青少年和情绪障碍青少年都具有不安全型依恋特征,在社会支持方面均有欠缺,且都容易采取消极退避的应对方式.两类问题青少年的依恋模式均通过社会支持的中介作用对应对方式产生影响,但影响路径略有差异.     

医护人员应对方式对风险认知和心理健康的中介效应

目的:探讨医护人员风险认知、应对方式、心理健康之间的关系。方法:采用风险认知量表、特质应对方式问卷、突发公共卫生事件心理问卷对某市公立医院255名医护人员进行问卷调查，其中有效问卷248份，并对数据进行分析。结果:(1)风险认知水平与消极应对呈正相关(r_s=0.192,P<0.01),与心理健康得分呈正相关(r_s=0.374,P<0.01);心理健康得分与消极应对方式呈正相关(r_s=0.346,P<0.01),与积极应对方式呈负相关(r_s=-0.180,P<0.01);(2)中介效应分析表明，风险认知对心理健康的预测作用显著(β=0.501,t=5.773,P<0.01),且当放入中介变量后，风险认知对心理健康的直接预测作用依然显著(P<0.01)。在95%的置信区间内，消极应对方式在风险认知和心理健康的中介效应占比为12.4%,具有统计学意义(P<0.01)。结论:医护人员风险认知能直接影响心理健康，也能通过消极应对方式间接影响心理健康。     

彝族2型糖尿病患者睡眠质量与焦虑抑郁情绪的相关性研究

目的 了解彝族2型糖尿病患者睡眠质量,焦虑抑郁情绪以及之间的关系.方法 对168例确诊的2型糖尿病患者同时进行匹兹堡睡眠质量指数（PSQI）,焦虑自评量表（SAS）和抑郁自评量表（SDS）评定.结果 PSQI（7.97±3.08）分,SAS（39.23±7.61）分,SDS（42.97±7.09）分,SAS与SDS存在显著的正相关（P〈0.01）.PSQI总分与焦虑和抑郁情绪均呈显著正相关.结论 糖尿病患者除饮食运动及药物治疗外,改善睡眠,控制负性情绪可增强治疗效果及提高患者生活质量.     

青少年罪犯焦虑、抑郁情绪及其与应对方式的相关性研究

目的调查重庆市青少年罪犯焦虑、抑郁状况与应对方式的关系,为制定符合青少年罪犯心理的综合干预措施提供科学依据。方法采用一般情况问卷、焦虑自评量表(SAS)、抑郁自评量表(SDS)和特质应对方式问卷(TCSQ)对重庆市未成年犯管教所909名青少年罪犯进行横断面问卷调查研究。结果青少年罪犯焦虑、抑郁症状检出率分别为40.4%、51.2%,明显高于常模(P<0.01),共患焦虑、抑郁占31.3%。家庭经济状况好、学历高是抑郁发生的保护因素,童年期受虐是抑郁发生的危险因素;家庭经济状况好是焦虑发生的保护因素,而童年期受虐、非独生子女是焦虑发生的危险因素。其积极应对方式与焦虑、抑郁水平之间呈显著负相关(r=-0.172,r=-0.208,P<0.01),而消极应对方式与焦虑、抑郁水平之间呈显著正相关(r=0.419,r=0.390,P<0.01)。结论青少年罪犯存在明显的焦虑、抑郁情绪,与其消极应对方式密切相关。帮助他们采用积极的应对方式可以有助于降低焦虑、抑郁情绪的发生。     

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.