伽玛刀术前心理干预对颅内肿瘤患者负性情绪的影响

目的 探讨心理干预对颅内肿瘤患者在接受伽玛刀治疗前情绪障碍的影响.方法 采用认知行为疗法、刺激暴露疗法等心理干预措施,对260例存有心理负性情绪的颅内肿瘤患者进行伽玛刀治疗前的心理干预.采用症状自评量表(SCL-90)、焦虑自评量表(SAS)、抑郁自评量表(SDS),对干预前后进行测评和对照比较.结果 干预前SCL-90、SAS、SDS总分分别为69.12±34.26、40.24±10.28和42.48±12.72,与正常人群比较(41.13±22.36,30.16±8.02,32.98±9.13)差异有显著性(P ＜0.01);干预后患者SCL-90、SAS、SDS总得分分别为49.36±31.22、32.16±7.08和36.166±7.98,与干预前比较差异显著(P ＜0.01).结论 对接受伽玛刀治疗的颅内肿瘤患者进行有针对性的术前心理干预,可以改善患者的焦虑、抑郁等负性情绪,对顺利进行伽玛刀治疗和康复预后具有积极的意义.     

早期复极综合征患者负性情绪障碍及心理行为干预疗效观察

目的探讨早期复极综合征患者负性情绪障碍及心理行为干预的疗效。方法心电图确诊的早期复极综合征(ERS)患者,共68例,随机分为研究组、对照组,每组各34例。两组均进行常规药物治疗,并对研究组进行心理行为干预。分别于入组时、治疗12周后进行焦虑自评量表(SAS)、抑郁自评量表(SDS)、症状自评量表(SCL-90)的测评。结果干预12周后,研究组SAS、SDS评分较对照组显著下降,分别为(43.56±6.54)分、(44.63±7.61)分,与对照组比较差异有显著性(P<0.01);且研究组SAS、SDS评分较干预前〔(63.21±9.86)分、(65.32±8.08)分〕评分显著下降,差异有显著性(P<0.01)。干预12周后两组SCL-90评分比较,研究组SCL-90总分、躯体化、强迫症状、人际关系、抑郁、焦虑、敌对及恐怖因子分,较对照组显著下降,差异有显著性(P<0.01或P<0.05)。结论ERS患者常有焦虑、抑郁等负性情绪,其心理状况较差,心理行为干预能有效的消除ERS患者的负性情绪,改善其心理状况,提高治疗效果。     

特殊护理干预对冠心病患者焦虑抑郁心理的影响研究

目的 探讨特殊护理干预对冠心痛患者焦虑抑郁心理的影响.方法 对226例冠心痛患者采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、症状自评量表(SCL)进行问卷调查,根据调查结果将108例焦虑抑郁情绪兼有者分为对照组与试验组,对照组仅采用药物治疗、常规护理干预,试验组采用药物治疗、常规护理干预联合特殊护理干预,比较两组干预前后焦虑抑郁情绪变化情况、平均住院时间及临床疗效.结果 226例冠心病患者中,伴焦虑情绪者127例(56.2％);伴抑郁情绪者116例(51.3％);焦虑、抑郁兼有者108例(47.8％).首次评估时两组SAS、SDS、SCL评分差异不明显;再次评估时试验组SAS(34.19±6.03)、SCL(1.48±0.53)明显低于对照组SAS(46.44±7.48)、SCL(2.26±0.44),P＜0.05;试验组SDS(34.57±4.86)、SCL(1.55±0.58)明显低于对照组SDS(47.28±7.76)、SCL(2.32±0.49),P＜0.05;试验组住院时间为(12.90±3.32)d、治愈率为64.8％,对照组住院时间为(19.41±6.89)d、治愈率为24.1％,两组比较差异有统计学意义(P＜0.05).结论 特殊护理干预能够显著改善冠心病患者的焦虑抑郁情绪,提高冠心病临床治疗效果.     

心理护理干预对老年腰椎间盘突出症患者负性情绪的影响

目的:探讨心理护理干预对老年腰椎间盘突出症患者负性情绪的影响.方法:对68 例老年腰椎间盘突出症患者进行调查,并将其随机分为干预组及对照组,干预组在进行常规检查和治疗的同时给予心理干预,采用焦虑自评量表(SAS) 、抑郁自评量表(SDS) 进行研究,将两组疗效及SAS 、SDS 评分进行比较.结果:经过心理护理干预后,干预组治疗有效率高于对照组,干预组焦虑自评量表(SAS) 、抑郁自评量表(SDS) 评分低于对照组(P<0.05).结论:老年腰椎间盘突出症患者有效的心理护理干预能提高腰椎间盘突出症治疗疗效,降低其负性情绪.     

心理干预对脑出血患者负性情绪及生存质量的改善作用

目的:探讨心理干预对脑出血后忧郁患者负性情绪及生活质量的影响. 方法:将2012年至2013年在我院住院治疗的脑出血后忧郁患者80例按住院号随机分为观察组和对照组,每组40例,对照组采用常规疗法,观察组在常规疗法基础上给予心理干预,两组患者在入院前和治疗1个月后采用焦虑自评量表( SAS)、抑郁自评量表( SDS)以及症状自评量表( SCL-90)进行评分,比较两组治疗前后SDS、SAS、SCL-90评分的变化. 结果:治疗后两组被试情绪SAS、SDS得分比较,观察组负性情绪和心理症状干预后优于干预前,不良情绪得到明显改善( P<0.05) ,对照组治疗前后抑郁和焦虑差异无显著性(P>0.05);观察组治疗前后除精神病性外其它八项都有统计学意义(P<0.05),而对照组在治疗前后差异均无统计学意义( P>0.05). 结论:对脑出血忧郁患者实施心理干预,可以提高病人生活质量、改善负性情绪,因此值得临床上结合实际情况进行推广应用     

心理剧治疗对癫痫患者负性情绪的影响

目的 探讨心理剧治疗对癫痫患者负性情绪的影响.方法 将60例癫痫患者随机分为研究组和对照组,在2组均使用抗癫痫药物治疗及一般健康教育的基础上,仅对研究组辅以心理剧治疗.采用抑郁自评量表(SDS)、焦虑自评量表(SAS)、症状自评量表(SCL-90)对2组进行效果评定.结果 研究组经心理剧治疗后SDS[(52.61±9.65)分、(41.13±9.23)分]、SAS[(51.32±9.12)分、(41.62±9.10)分]及SCL -90各因子分明显减少,差异具有显著性(P ＜0.01),而对照组各量表分治疗前、后比较无统计学差异.结论 心理剧治疗能改善癫痫患者的负性情绪,提高心理健康水平.     

心理干预疗法对恶性肿瘤患者负性情绪的影响

目的探讨心理干预疗法对恶性肿瘤患者焦虑、抑郁性情绪的影响。方法将80例确诊为恶性肿瘤的住院患者按时间段分为观察组和对照组,每组各40例。对照组实施一般(支持性)心理护理,观察组实施心理支持、社会支持、集体心理治疗和行为训练等综合心理干预措施。采用焦虑自评量表(SAS)和抑郁自评量表(SDS)测查负性情绪程度。结果干预后观察组SDS和SAS评分明显低于对照组(P<0.01),负性情绪发生率明显低于对照组(P<0.01)。结论对恶性肿瘤患者实施综合心理干预,有助于缓解患者的焦虑、抑郁情绪,保持平衡适应的心理状态,提高患者的生命质量。     

负性情绪对消化性溃疡的患者的影响及护理干预效果

目的:探讨负性情绪对消化性溃疡患者的影响及护理干预的效果.方法:选取我院2009 年6月至2010 年6月收治的90 例消化性溃疡患者为研究对象,采取医院焦虑自评量表(SAS) 及抑郁自评量表(SDS) 评定患者的心理状态,并随机分为观察组和对照组,对照组采用常规护理,观察组在对照组的基础上采用心理干预,比较两组患者护理干预前后负性情绪变化及疼痛缓解率.结果:该组患者均存在不同程度的焦虑、抑郁情绪,SAS 、SDS 评分均显著高于国内常模,P<0.05.观察组患者的负性情绪改善及疼痛缓解率均显著优于对照组,P<0.05.结论:护理人员要及时评估消化性溃疡患者的负性情绪,并采用恰当的心理干预,改善其不良心理,提高治疗效果.     

心理行为干预对青年乳腺癌患者负性情绪的影响

目的: 探讨心理行为干预对青年乳腺癌患者负性情绪的影响。方法: 将56例青年乳腺癌患者随机分为心理行为干预组和对照组各28例,2组均在确诊为乳腺癌后第一天和出院前一天采用焦虑自评量表(self-rating cavity scale,SAS)及抑郁自评量表(self-rating depression scale,SDS)进行问卷调查。结果: 2组患者心理行为干预前SAS及SDS评分差异均无统计学意义(P > 0.05),系统心理行为干预后,干预组患者焦虑、抑郁情绪明显改变,评分均低于对照组(P < 0.01)。结论: 对青年乳腺癌患者进行有效的心理行为干预能减轻其焦虑、抑郁等负性情绪,保持较平和的心态,积极接受治疗和护理,对疾病的恢复有积极作用。     

护理心理干预对高血压患者负性情绪的影响

目的 探讨心理护理干预对高血压患者负性情绪的影响.方法 采用症状自评量表(SCL-90)、焦虑自评量表(SAS)、抑郁自评量表(SDS)对100例高血压患者作为研究样本进行调查,并将其随机分为干预组及对照组,干预组为心理干预与常规慢性病管理相结合,对照组为单纯常规慢病管理,评估患者心理干预前后的焦虑、抑郁等负性情绪及其严重程度,监测干预前后2组患者的血压值,比较患者治疗依从率及血压控制率.结果 ①两组在干预前差异不显著,测SCL-90总分、SAS、SDS标准分均高于常模(P＞0.05);干预组前后测SCL-90、SAS、SDS标准分差异显著(P＜0.05),对照组差异不显著(P＞0.05).②干预组前后测治疗依从率和血压控制率差异显著(P＜0.05),对照组差异不显著(P＞0.05).结论 心理干预可以改善高血压患者的焦虑、抑郁等负性情绪,增加患者的药物治疗依从性,保持血压稳定,同时也有利于患者的身心健康,提高病人的生活质量.     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.