66例完成自杀者的心理剖析

目的用心理剖析的方法探讨完成自杀者的相关因素.方法对66例完成自杀者与66例正常对照者,分别采用一般问卷、汉密尔顿抑郁量表(HAMD)、工具社会支持量表(TSSS)、领悟社会支持量表(PSSS)、社会交流量表(SC)、自杀1年前和当时总体功能评定量表(O-GAF,P-GAF)、自杀企图量表(SAS)及自杀意念量表(SIS)进行调查.采用DSM-Ⅲ-R对精神问题进行了回顾性诊断.信息来源于2名知情亲友,在死后2～14月期间进行.结果自杀者中72.72%符合DSM-Ⅲ-R精神疾病诊断标准;男性明显高于女性(2.98:1);女性高峰年龄较男性前移10年(20～49,30～59);春、夏季常见(66.7%);抑郁和焦虑情绪,低收入和社会支持领悟差是高危因素(P＜0.05);躯体功能活动受限制是自杀的诱因(28.75%);服毒是被青睐的方法(69.7%),其次是自缢25.7%和其它(4.5%).信息人对精神疾病的认识差(9 /48).结论抑郁是自杀的最危险因素.普及精神病学的知识最重要.     

自杀未遂相关因素分析

目的 探讨自杀未遂者的相关因素。方法 对101例自杀未遂者，采用自制的自杀未遂调查表，自杀意图量表，汉密顿抑郁量表等进行测查，并做出精神病学诊断。以101名正常人为对照组进行领悟社会支持的研究。结果 自杀诱因主要为人际冲突（72．3％），自杀手段主要是过量服药（48．5％）和服有机磷农药（31．7％）。42．8％的自杀未遂者有既往自杀未遂史，重复自杀者冲动性较高（P＜0．01），冲动性高和低年龄者自杀意图较低（P＜0．01）。自杀未遂者领悟到的社会支持较少（P＜0．01），77．2％的自杀未遂者患精神障碍且以抑郁障碍最多。结论 对自杀未遂者要积极的进行心理干预和精神科治疗。     

150例自杀者原因和特征分析

目的分析150例自杀者的原因和特征，为采取相应干预措施提供依据，重塑他们的健康人格。方法调查分析我院急诊观察区自杀者150例的自杀原因及相关因素。结果150例自杀者中男66例（44．00％），女84例（56．00％），低学历和15～45岁者占多数；自杀原因家庭关系问题占54．66％，疾病占22％，学习和工作中的问题占6％，恋爱问题占4％；自杀方式主要是服药。结论分析自杀者不同的自杀原因和特征，有利于对自杀者进行危机干预，重塑健康人格。     

大学新生自杀意念及其影响因素的现况调查

目的：探讨有自杀意念的大学新生的自杀态度等影响因素及其与自杀意念的关系。方法：采用自杀态度问卷、自尊量表、简易应对方式问卷、社会支持量表、自评抑郁量表、焦虑自评量表对广西医科大学2009级500名新生进行调查。结果：自杀意念检出率为29.07%,大学新生对自杀的性质、对安乐死的态度持矛盾或中立的态度（〉2.5分-〈3.5分）,对自杀者的态度、对自杀者家属的态度持肯定和宽容的态度（≤2.5分）。有自杀意念的大学新生对自杀的性质、对安乐死的态度倾向于认可和宽容,而对自杀者家属的态度则倾向于否认和排斥,个体的自尊水平较高。有自杀意念的大学新生获得的总社会支持、主观社会支持、客观社会支持较少,对社会支持的利用度较低,表现出更多的抑郁焦虑情绪,较多采用消极的应付方式,Logistic回归分析表明抑郁、消极应付方式、社会支持总分3个指标对自杀意念的影响有统计学差异（P=0.001,0.014,-0.020）。结论：抑郁、消极应付方式、社会支持总分是影响大学新生自杀意念的重要因素。     

大连市部分地区农村人群的自杀态度分析

目的研究中国农村人群的自杀态度。方法采取序贯抽样的方法,采集了2000年度、2001年度大连市金州和庄河两地区66个自杀死亡病例的132个信息人和66个正常对照本人及其132个信息人。用自杀态度问卷了解病例组信息人和对照组本人及其信息人对自杀的态度,然后运用SPSS11.5进行数据整理与分析。结果自杀组信息人对自杀总的理解程度以及对不同性别自杀者的理解程度[评分平均秩次分别为总理解程度121.57,对男性自杀者理解程度121.41,对女性自杀者理解程度121.53],均低于对照组信息人[对应的评分平均秩次分别为143.43,143.59,143.47,差异具有显著性。Z值、P值分别为(-2.628,0.009),(-2.681,0.007),(-2.624,0.009)]。信息人对女性自杀者的理解和宽容程度高于对男性自杀者(Z=-2.565,P=0.010),男性信息人更倾向于理解和接受女性自杀(Z=-2.060,P=0.039)。结论该地区农村人群总体上对自杀持不接受态度,但是对女性自杀比对男性自杀更加认可和宽容。此发现可能有助于解释中国女性较高的自杀率。     

自杀未遂相关因素分析

目的探讨自杀未遂者的相关因素.方法对101例自杀未遂者,采用自制的自杀未遂调查表,自杀意图量表,汉密顿抑郁量表等进行测查,并做出精神病学诊断.以101名正常人为对照组进行领悟社会支持的研究.结果自杀诱因主要为人际冲突(72.3%),自杀手段主要是过量服药(48.5%)和服有机磷农药(31.7%).42.8%的自杀未遂者有既往自杀未遂史,重复自杀者冲动性较高(P<0.01),冲动性高和低年龄者自杀意图较低(P<0.01).自杀未遂者领悟到的社会支持较少(P<0.01),77.2%的自杀未遂者患精神障碍且以抑郁障碍最多.结论对自杀未遂者要积极的进行心理干预和精神科治疗.     

精神病患者自杀的原因分析及干预

随着社会的进步和医学科学的发展，自杀越来越受到人们的关注。自杀是指自愿并主动结束自己生命的行为。按其原因大致可分为三类，即：精神疾病所致自杀、躯体疾病所致自杀、非疾病因素所致自杀。其中精神疾病所致自杀高居首位，占全部自杀者近半数。西方国家的研究大都表明，在自杀者中精神疾病患者达90％以上。而自杀也是精神科患者最主要的死因之一。大量证据表明，适当的预防措施可以有效的降低自杀率。因此，精神病患者的自杀预防工作是整个自杀预防工作的重中之重。     

大连市部分地区农村人群的自杀态度分析

目的 研究中国农村人群的自杀态度.方法 采取序贯抽样的方法,采集了2000年度、2001年度大连市金州和庄河两地区66个自杀死亡病例的132个信息人和66个正常对照本人及其132个信息人.用自杀态度问卷了解病例组信息人和对照组本人及其信息人对自杀的态度,然后运用SPSS11.5进行数据整理与分析.结果 自杀组信息人对自杀总的理解程度以及对不同性别自杀者的理解程度[评分平均秩次分别为总理解程度121.57,对男性自杀者理解程度121.41,对女性自杀者理解程度121.53],均低于对照组信息人[对应的评分平均秩次分别为143.43,143.59,143.47,差异具有显著性.Z值、P值分别为(-2.628,0.009),(-2.681,0.007),(-2.624,0.009)].信息人对女性自杀者的理解和宽容程度高于对男性自杀者(Z ＝-2.565,P ＝0.010),男性信息人更倾向于理解和接受女性自杀(Z ＝-2.060,P ＝0.039).结论 该地区农村人群总体上对自杀持不接受态度,但是对女性自杀比对男性自杀更加认可和宽容.此发现可能有助于解释中国女性较高的自杀率.     

抑郁症与自杀行为

抑郁症是自杀行为中最危险的症状。全世界每年至少有50万人死于自杀。在自杀者中,10％～40％患有精神疾病,其余大多是在精神困扰下发生。与精神障碍相关的自杀死亡者中50％～70％患有抑郁性疾病,而自杀死亡率可达12％     

295例服毒自杀患者的临床资料分析

自杀是导致社会劳动力急性丧失或致残的原因之一’‘1，也是临床急救中常见的重危急症。在自杀方式中，服毒自杀方法发生相对缓慢．如果发现及时，抢救成活率高，可减少家庭痛苦和社会劳动力的丧失，并为社会安定做出贡献。我们收集和分析了在我院急救中心抢救的295例服毒自杀者的有关资料，现将结果报告如下。1临床资料1．1资料来源295例均为我院1992年1月至1997年12月因自杀而服毒的患者。12资料分析121性别与年龄自杀者男性70人，占2373％；女性255人，占7627％。年龄最小14岁，最大79岁，平均年龄304土122岁。各年龄组男女自杀发生情况…     

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.     

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.     

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.