某部2011年度新兵心理健康状况的调查分析

目的 量化评估2011年度某部1 753名新兵心理健康状况及相关影响因素,为有效对新兵实施心理干预及心理素质训练提供科学依据.方法 应用症状自评量表（SCL-90）对1 753名新兵进行团体心理测试,并将结果与中国陆军新兵常模、中国新兵常模及中国军人常模比较.结果 ①1 753名新兵SCL-90的总分及各因子得分均显著低于2000年中国新兵常模及1999年中国军人男性常模（P＜0.01）;与2005年中国陆军新兵常模比较：抑郁因子、敌对因子得分差异无统计学意义（P＞0.05）,恐怖因子得分高于陆军新兵常模,差异有高度统计学意义（P＜0.01）,SCL-90总分及其他因子分低于陆军常模,差异有高度统计学意义（P＜0.01）.②可见非步兵组新兵的SCL-90的总分及各因子得分均显著高于步兵组新兵（P＜0.01）.结论 2011年新兵整体心理健康状况较好.     

整形美容受术者心理特征研究

[目的]探讨整形美容受术者心理健康状况与人格特征的关系,为采取针对性心理护理提供依据。[方法]采用症状自评量表（SCL-90）、艾森克人格问卷（EPQ）对142例整形美容受术者进行问卷调查,并将所得数据进行统计学处理。[结果]症状自评量表各因子分均高于常模（P〈0.01）。艾森克人格问卷中精神质（P）、神经质（N）、效度（L）量表分均高于常模,内外向（E）量表分低于常模,差异有统计学意义（P〈0.01）。整形美容受术者SCL-90各因子分与EPQ中N分呈正相关,强迫、人际关系、敌对、偏执和精神病性与P分呈正相关,强迫、抑郁、焦虑、恐惧与L分呈正相关,焦虑、恐惧与E分呈负相关。[结论]整形美容受术者存在较多心理症状,心理健康状况较差,具有内外向不稳定及较强的神经质和掩饰性人格特征,对受术者心理状况影响显著。在护理工作中应了解受术者的心理和人格特征,并给予针对性的心理干预。     

某部新兵心理健康状况调查

目的了解某部新兵的心理健康状况。方法对535名新兵采用症状自评量表进行测试,统计各因子分,并与军人常模进行比较,分析不同性别新兵的心理健康状况。结果新兵的强迫、人际关系分与军人常模比较差异有显著或极显著性(P<0.05或0.01),其中3.74%的新兵有不良心理反应,女兵躯体化、抑郁因子分明显高于男兵。结论该部新兵总的心理健康水平较好,女兵心理健康状况较男兵稍差。     

某部新兵心理健康状况调查

目的了解某部新兵的心理健康状况，为有效实施新兵心理健康教育和心理干预提供依据。方法采用症状自评量表对735名新兵进行测试，并与军人常模和地方常模进行对比分析。结果新兵症状自评量表各因子分均显著低于军队常模（P均〈0．01）；躯体化因子分显著高于地方常模（P〈0．05），人际关系敏感、抑郁、敌对、偏执因子分均显著低于地方常模（P〈0．01～0．05），其余各因子均无显著性差异；女兵恐怖因子分显著高于男兵（P〈0．05）。结论该部新兵总的心理健康水平较好，女兵的心理健康状况较男兵稍差。     

边防某部新兵入伍训练前后心理健康状况调查及心理干预效果评价

目的 探讨新兵训练前后的心理健康状况及心理干预效果.方法 对525名参加入伍训练的新兵于入伍训练前采用症状自评量表评定心理健康状况,针对评定结果在训练期间由军医对新兵开展心理卫生基础知识和心理健康教育讲座,对症状自评量表因子分高的新兵有针对性的心理干预;于训练结束后再次对入组新兵进行心理健康评定,并将两次测评结果与中国新兵常模进行对比分析.结果 新兵训练前心理问题检出率为19.04%,症状自评量表除抑郁因子分与中国新兵常模差异无显著性外,其他各因子分均显著高于中国新兵常模(P＜0.05或0.01);训练后新兵心理问题检出率为5.71%,较训练前显著下降(χ2=43.02,P＜0.01),其中症状自评量表躯体化、人际关系、敌对、恐怖、偏执、精神病性因子分差异有显著或极显著性(P＜0.05或0.01);但躯体化、焦虑、敌对和精神病性因子分仍显著高于中国新兵常模(P＜0.05或0.01),而抑郁因子分显著低于中国新兵常模(P＜0.01).结论 入伍新兵训练期间受多种因素影响,极易导致心理问题的发生;部队积极开展有针对性的心理健康教育和心理干预,对维护新兵的心理健康,增强部队的战斗力具有重要意义.     

个性、心理社会因素与肠易激惹综合征发病的关系

目的探讨个性、心理社会因素对肠易激惹综合征（IBS）的影响.方法采用艾森克个性问卷（EPQ）、症状自评量表（SCL-90）、生活事件量表（LES）测评46例IBS患者的个性、精神心理状态;另选32例健康人为对照组.结果 IBS患者的EPQ E分（内外向）低于对照组,N分（神经质）明显高于对照组（ P＜0.01）,SCL-90躯体化、强迫、焦虑、抑郁等因子分高于对照组（ P＜0.05）.IBS患者病前1年内经历负性生活事件的频度及刺激量以及生活事件总刺激量明显高于对照组（ P＜0.01）.结论个性心理特征、病前生活事件与IBS的发病相关.     

整形美容受术者心理特征研究

[目的]探讨整形美容受术者心理健康状况与人格特征的关系,为采取针对性心理护理提供依据。[方法]采用症状自评量表(SCL-90)、艾森克人格问卷(EPQ)对142例整形美容受术者进行问卷调查,并将所得数据进行统计学处理。[结果]症状自评量表各因子分均高于常模(P<0.01)。艾森克人格问卷中精神质(P)、神经质(N)、效度(L)量表分均高于常模,内外向(E)量表分低于常模,差异有统计学意义(P<0.01)。整形美容受术者SCL-90各因子分与EPQ中N分呈正相关,强迫、人际关系、敌对、偏执和精神病性与P分呈正相关,强迫、抑郁、焦虑、恐惧与L分呈正相关,焦虑、恐惧与E分呈负相关。[结论]整形美容受术者存在较多心理症状,心理健康状况较差,具有内外向不稳定及较强的神经质和掩饰性人格特征,对受术者心理状况影响显著。在护理工作中应了解受术者的心理和人格特征,并给予针对性的心理干预。     

脑卒中患者心理状况与人格特征的相关研究

目的探讨脑卒中患者心理状况与人格特征的关系。方法对103名脑卒中患者,利用症状自评量表和艾森克人格问卷测查心理状态和人格特征。结果脑卒中患者症状自评量表中的总分、躯体化、强迫、抑郁、焦虑、恐惧、精神病性因子分高于常模,人际关系低于正常人(P<0.05);艾森克人格问卷中神经质维度分高于中国常模,内外向和精神质维度分低于中国常模(P<0.05);艾森克人格问卷中神经质维度与症状自评量表各因子均呈正相关,内外向维度与敌对、偏执两因子呈正相关,精神质维度与偏执因子分呈正相关。结论脑卒中患者急性期的心理状态较差;情绪不稳定、内倾的人格特点可能为其人格基础。     

西部边疆某部新兵集训前后心理健康与适应状况调查

目的 探讨西部边疆某部新兵集训前后心理健康与适应状况,为制定心理干预措施提供依据.方法 对西部边疆某部1 302名新兵采用中国军人心理健康量表和军人适应不良量表进行测评分析.结果 中国军人心理健康量表评分,新兵集训中除强迫、躯体化因子外,总分及其他因子分均显著低于集训前(P＜0.05或0.01).集训后除掩饰因子外,总分及其他因子分均显著低于集训前(P＜0.01);除强迫、神经衰弱因子外,总分及其他因子分与集训中差异均有显著性(P＜0.05或0.01).集训前总分及各因子分,集训中除焦虑因子,集训后除强迫、精神病性、人际关系因子外总分及其他因子分均显著高于军人常模(P＜0.05或0.01).军人适应不良量表评分,新兵集训中人际关系、环境适应因子分显著低于集训前(P＜0.01);集训后环境适应因子分显著高于集训中(P＜0.01);集训各阶段军人适应不良量表总分及各因子分均显著高于战士常模(P＜0.05或0.01).新兵集训前军人适应不良量表总分及各因子分与中国军人心理健康量表总分及除掩饰因子外的其他因子分均呈显著正相关(P＜0.05或0.01),情绪适应因子分与掩饰因子分呈显著负相关(P＜0.05).少数民族新兵焦虑、躯体化、人际关系因子分均高于汉族,强迫、恐怖因子分均低于汉族(P＜0.05);低文化程度者抑郁、恐怖、躯体化、敏感等因子分均高于高文化程度者(P＜0.05).结论 新兵集训前后心理健康状况有不同程度的变化,进行针对性的心理健康教育及适应性训练,将有助于提高新兵的健康水平与社会适应能力,使其顺利度过集训期.     

集训期新兵独生子女心理健康状况调查

目的了解集训期新兵独生子女心理健康状况,为制定新兵集训期管理教育模式和心理问题干预措施提供依据。方法对71名独生子女和51名非独生子女集训期新兵采用症状自评量表、艾森克人格问卷、抑郁自评量表、焦虑自评量表进行评定分析。结果集训期新兵独生子女症状自评量表强迫、敌对因子分和艾森克人格问卷的情绪稳定性维度分均显著高于新兵非独生子女（P〈0．05或0．01）;抑郁自评量表、焦虑自评量表评分比较均无显著性差异（P均〉0．05）。结论集训期新兵独生子女较非独生子女存在较多的心理问题,这可能与其特殊的家庭生长环境有关。部队管理人员应针对集训期新兵独生子女的心理特点培养其良好的心理素质,加强心理卫生知识的宣教,强化心理训练,使他们能在最短的时间内适应部队生活。     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

手转胎头术失败的原因与分娩结局临床分析

目的 探讨手转胎头术失败的原因与分娩结局.方法 选择2008年1月至2010年12月于我院住院分娩的持续性枕横位、枕后位产妇198例,根据行手转胎头术后结果分为成功组126例、失败组72例.比较两组分娩结局,对比分析失败原因.结果 失败组胎儿体质量≥3500 g的发生率[76.4％(55/72)]明显高于成功组[31.7％(40/126)],差异有统计学意义(x2=30.177,P=0.001)、失败组宫缩乏力发生率[58.3％(42/72)]高于成功组[38.1％ (48/126)],差异有统计学意义(x2=7.569,P=0.006)、失败组骨盆临界或轻度狭窄发生率[38.9％ (28/72)]高于成功组[23.8％(30/126)],差异有统计学意义(x2 =5.030,P=0.002)、失败组手转胎头时机不当(宫口开大＜6 cm、胎头位于坐骨棘上及宫口开大8～10 cm、胎头位于坐骨棘下≥2 cm)发生率[61.1％(44/72)]高于成功组[38.9％(49/126)],差异有统计学意义(x2=9.084,P=0.003).失败组母儿并发症(产后出血、产褥病率、胎儿窘迫、新生儿窒息)发生率高于成功组(x2 =9.586,P=0.002、x2=9.334,P=0.002、x2=5.910,P=0.015、x2=5.240,P=0.022)、失败组剖宫产发生率[72.2％(52/72)]明显高于成功组[34.1 ％(43/126),x2=26.641,P=0.001)].结论 手转胎头术能使难产变顺产,降低剖宫产率,减少母儿并发症,但须积极预防、处理导致手转胎头术失败的原因,对矫正失败后继续矫正及试产应慎重.