高等医学院校教师自尊特点与心理健康关系的调查分析

目的：探究不同自尊类型的高等医学院校教师心理健康水平的差异,阐明自尊特点与心理健康的关系。方法：采用分层随机抽样的方法,选取长春某高等医学院校教师665名,运用Rosenberg自尊量表（SES）、Marlowe-Crowne社会期望量表（MCSD）和心理健康问卷考察其自尊类型和心理健康水平。结果：自尊、社会期望量表得分与心理健康问卷总分均存在显著正相关关系（r=0.67,P<0.01;r=0.50,P<0.01）;不同自尊类型不论在心理健康问卷的
总分、各维度分还是各因子分上比较差异均有统计学意义（P<0.01）;高自尊者的心理健康问卷总分显著高于低自尊者（P<0.01）,防御性高自尊者的心理健康问卷总分显著高于安全性高自尊者（P<0.01）。结论：自尊与心理健康存在正相关关系,高自尊、尤其是防御性高自尊的医学院校教师心理健康水平更好。     

社交回避及苦恼量表在蒙古族大学生中应用的信效度

目的 检验社交回避与苦恼量表中文版在少数民族大学生中的信度和效度.方法 采用社交回避与苦恼量表、安全感量表、整体自尊量表和青少年生活满意度量表对399名蒙古族大学生进行测量.结果 ①社交回避与苦恼量表内部一致性信度0.872,回避分量表信度为0.726,苦恼分量表为0.742,总量表的重测信度为0.86,回避分量表为0.789,苦恼分量表为0.814;②结构方程模型拟合指数x2/df=4.864、NFI=0.92、TLI=0.90、GFI=0.90、IFI=0.87、GFI=0.92、A GFI=0.93、RMSEA=0.06,模型拟合较好;③社交回避分量表与社交苦恼显著正相关（r=0.634,P＜0.01）,与SES、SQ和AULC显著负相关（r=-0.202～-0.499,均P＜0.01）;社交苦恼分量表与安全感量表、整体自尊量表和青少年生活满意度量表显著负相关（r=-0.192～-0.556,均P＜0.01）.结论 社交回避与苦恼量表中文版在蒙古族大学生中的信效度较好.     

医学高职生的生活满意度与自尊、父母教养方式的关系

目的考察医学高职生的生活满意度与自尊、父母教养方法的关系。方法采用生活满意度量表（SWLS）、自尊量表（SES）和父母教养方式量表（EMBU）对630名医学高职生进行问卷调查。结果（1）医学高职生的生活满意度在性别、专业、年龄上的差异无统计学意义（P〉O．05）,独生子女的生活满意度显著高于非独生子女（f=2．614,P〈0．01）。（2）医学高职生的生活满意度与自尊、父母教养方式各因子之间存在显著相关（r=-0．09～0．35）;（3）中介效应检验表明,父母教养方式既直接影响生活满意度,也通过自尊作为中介变量间接影响生活满意度。结论父母教养方式、自尊是影响生活满意度的重要因素。     

应对方式对生活满意度和抑郁、焦虑症状关联的中介效应

目的：探讨应对方式在多维生活满意度和抑郁、焦虑症状之间的中介效应,阐明心理应对方式对生活满意度和青少年心理健康问题的重要作用。方法：采用多维学生生活满意度量表(MSLSS) 、特质应对方式问卷(TCSQ )、抑郁自评量表（SDS）、焦虑自评量表 (SAS)对全国8个城市17 622名青少年学生进行问卷调查。结果：一般生活满意度和积极应对方式与抑郁/焦虑均呈负相关（r=－0.471,－0.423,－0.550,－0.369,Ps < 0.01);消极应对方式与焦虑呈正相关（r=0.369,P<0.01）。积极/消极应对多维生活满意度与抑郁关联中介效应占总效应比例分别为35.4%～54.6%、9.6%～19.3%;积极/消极应对多维生活满意度和焦虑关联的中介效应占总效应比例分别为16.4%～33.1%、29.0%～42.3%。结论：应对方式在多维生活满意度和抑郁/焦虑之间有显著中介效应,提示在研究青少年抑郁和焦虑症状的发病机制和预防策略时应予关注。     

无性生活勃起功能障碍的临床特点

目的：收集无性生活勃起功能障碍（erectile dysfunction no sexual life,ED NS）患者临床资料,通过简单问卷研究其临床特点。方法：根据现有ED概念,将无性生活勃起功能障碍研究范围限定于6个月内无性生活且主诉勃起功能减退的患者,共收集患者61例,同时选择6个月内无性生活的正常健康男性57例作为对照。ED NS患者平均年龄（26.2±4.3）岁,正常对照组平均年龄（24.9±4.1）岁,2组年龄差异无统计学意义（P>0.05）。设定了1组调查问题,嘱患者根据6个月内的情况填写调查问卷,简要回答“是/否”,问题涉及性欲、平时勃起情况、夜间勃起情况、视听觉性刺激下勃起情况、异性相处条件下勃起及自信心情况、手淫时勃起情况等多个方面,共16个问题。根据各个问题组间频数分布情况,行四格表卡方检验,比较两组间差异。结果：ED-NS患者与正常对照组比较,共有13项问题差异具有统计学意义,涉及平时性欲（χ²=35.891,P<0.05）、勃起信心（χ²=75.608,P<0.05）、阴茎硬度（χ²=54.433,P<0.05）,夜间勃起（χ²=29.815,P<0.05）、异性相处时勃起硬度（χ²=21.211,P<0.05）、勃起信心（χ²=70.445,P<0.05）,视听觉性刺激下勃起硬度（χ²=34.422,P<0.05）等。ED-NS与正常对照组间在涉及手淫问题时,均有调查者否认手淫习惯。结论：通过此项研究,我们提出了1种新概念——无性生活ED,其定义为：6个月以上无性生活且阴茎勃起硬度下降、时间缩短,缺乏勃起信心而无法尝试性生活。可通过问卷法评价ED-NS患者的勃起功能,但尚待大规模、多中心的临床研究。     

Crohn病肠黏膜共刺激分子CD86与可诱导共刺激因子的表达及其病理意义

目的：研究共刺激分子CD86和可诱导共刺激因子（inducible co-stimulator, ICOS）在Crohn病（Crohn disease, CD）肠黏膜的表达及其病理意义。方法：采用免疫组织化学方法检测CD组（n=30）病变黏膜及相对正常黏膜共刺激分子CD86和ICOS的表达及CD4,CD8和CD20阳性表型的淋巴细胞分布,并与正常对照组（n=20）进行比较。结果：CD组病变黏膜固有层CD86⁺和ICOS⁺淋巴单核细胞数量显著高于CD组相对正常黏膜及正常对照组（q=9.23,P<0.01和q=5.46,P<0.01）。同时,CD86及ICOS在肠上皮中亦有强表达,CD组高于对照组（H=24.93,P<0.01和H=4.66,P<0.01）,而CD组内病变黏膜与相对正常黏膜的表达差异无统计学意义。另外,CD组病变黏膜的固有层、上皮内及小血管壁CD4⁺T细胞和CD8⁺T细胞数量均显著高于CD组相对正常黏膜及对照组（P<0.05 或P<0.01）。结论： CD病变组织中CD86⁺和ICOS⁺淋巴单核细胞数量显著增多及肠上皮阳性率显著提高,提示共刺激分子可能参与了CD细胞免疫的异常激活过程,CD肠上皮细胞可能作为非专职性抗原呈递细胞参与了该过程。     

大学生生命意义感与生活满意度的关系

目的 探讨大学生生命意义感与生活满意度之间的关系.方法 采用生活目的测试量表和生活满意度量表对473名大学生进行调查分析.结果 (1)高生命意义感的大学生在生活满意度[(4.53±1.04)分]、积极情感[(2.89±0.88)分]得分显著高于低生命意义感的大学生[(3.38±0.98)分,(2.04±1.07)分](F=27.806,P＜0.01; F=13.635,P＜0.01),而在消极情感[(1.09±1.12)分]得分显著低于低生命意义感的大学生[(2.45±1.41)分,F=21.513,P＜0.01);(2)逃避与生活满意度呈负相关(r=-0.336,P＜0.01),积极情感与生命的热诚和生活目标呈显著正相关(r=0.143 ～0.146,P＜0.05),生命意义感与消极情感呈显著负相关(r=-0.121 ～ -0.335,P＜0.05);(3)逃避对生活满意度和积极情感有显著地负向预测作用(β=-0.133 ～ -0.179,P＜0.05),生活目标和生命的热诚对生活满意度、积极情感有显著地正向预测作用(β=0.170 ～0.206,P＜0.05).结论 大学生生命意义感与生活满意度有密切的关系,高生命意义感有助于提升个体的生活满意度.     

大学生公正世界信念、乐观与生活满意度的关系

目的 探讨大学生公正世界信念及乐观对生活满意度的共同影响.方法 采用方便取样的方式抽取370名大学生,用大学生公正世界信念量表(Just World Scale for College Students,JWS)、生活满意度量表(satisfaction with life scale,SWLS)和生活定向量表(The Life Orientation Test-revised,LOT-R)进行测查;采用相关分析、回归分析等方法对数据进行统计分析.结果 ①大学生公正世界信念、乐观及生活满意度的得分均在中点以上[分别为(3.22±0.46)分,(3.50±0.57)分,(3.70±1.21)分].②大学生公正世界信念与乐观、生活满意度之间均存在显著正相关(r=0.44,0.36,P＜0.01),乐观与生活满意度之间也存在显著正相关(r=0.38,P＜0.01).③大学生公正世界信念、乐观对生活满意度均有显著的直接影响(标准化回归系数分别为β=0.24,0.29,P＜0.01),并且两者之间存在交互作用(标准化回归系数为β=0.09,P＜0.05),在乐观学生中,公正世界信念水平低的个体生活满意度水平远远低于公正世界信念高的个体;而在悲观学生中,不同公正世界信念水平的学生生活满意度水平差异很小.结论 大学生的公正世界信念、乐观对生活满意度均有重要的直接预测作用,且二者之间存在交互作用.     

2406名农村初中生心理健康影响因素的分析

目的 探讨农村初中生心理健康状况的影响因素.方法 采用一般资料调查表、青少年生活事件量表、家庭关怀度量表、领悟社会支持量表、简易应对方式量表.艾森克个性问卷儿童版、自尊量表和中国中学生心理健康量表对湖南省5个县(市)5个乡(镇)中学2406名初中生进行调查.结果 不同性别(P=0.509)、月收入(P=0.267)、母亲文化(P=0.266)、父亲职业(P=0.473)、母亲职业(P=0.105)的农村初中生心理状况均分没有统计学意义,不同年龄(P=0.000)、年级(P=0.000)、父母外出情况(P=0.000)、父母离异(P=0.001)以及父亲文化(P=0.023)的农村初中生心理状况得分的差别具有统计学意义(P＜0.05);留守与否(r=0.095)、生活事件总得分(r=0.522)、家庭关怀度(r=-0.146)、社会支持(r=-0.186)、积极应对(r=-0.020)、消极应对(r=0.369)、精神质(r=0.322)、内外向(r=-0.132)、情绪稳定(r=0.555)、掩饰性(r=-0.293)自尊(r=-0.329)与心理状况均显著相关;除年龄、年级、父母离异与否、父母亲文化以及父母亲职业未进入方程,其余各变量均进入方程,可以解释心理状况变异的51.2%(F=227.809,P=0.000).结论 要促进农村初中生心理健康发展,可以在生活中给与其更多关照,减少生活中负性生活事件的发生,通过一系列健康教育引导其采用积极的应对方式面对生活中的困难和挫折,促进其个性健康发展.     

医学院校大一新生压力知觉与生活满意度的关系及应对方式的中介效应分析

目的 探讨医学院校大一新生压力知觉与生活满意度的关系以及应对方式的中介作用。方法 采用方便抽样法于2021年8月下旬使用压力知觉量表（CPSS），简易应对方式量表（SCSQ），青少年生活满意度量表（CASLSS）对广西中医药大学1 080名大一新生进行问卷调查，问卷回收有效率达98.7%。结果 医学院校大一新生的压力知觉与其生活满意度呈显著负相关（r=0.673,P <0.01）；压力知觉对生活满意度的直接效应为-0.053 (95%CI:-0.059～-0.047)，应对方式的中介效应为-0.024 (95%CI:-0.028～-0.019)，占总效应的30.89%。结论 医学新生压力知觉越高，生活满意度越低，但可通过调节个体的应对方式减弱压力对生活满意度的负面影响。     

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.     

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.     

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.