Effects of demographic factors and mental status on wechsler memory scale performance in a geriatric clinic sample

A sample of 114 geriatric clinic patients over the age of 64 were referred by primary‐care physicians secondary to memory complaints. All patients were administered the Wechsler Memory Scale (WMS) and the Mini‐Mental State Exam (MMSE). Hierarchical multiple‐regression analyses using WMS total raw score as the dependent measure and age, education, and MMSE raw scores as predictors were conducted for the entire sample as well as for high‐scoring and low‐scoring MMSE groups within the sample. Age failed to predict a significant amount of WMS total score variance in any of the groups studied. General mental status (as measured by MMSE) was a significant predictor across all the groups. Education was a statistically significant predictor in the entire sample and in the low‐scoring MMSE group. Reasons for the observed patterns are discussed as they pertain to this special patient sample.     

强迫症患者认知功能与病期的关系

目的：探讨强迫症的认知功能障碍与病期的关系。方法：分别用韦氏记忆测验，数字划销测验和威斯康星卡片分类测验评估25例急性强迫症和36例慢性强迫症患者的记忆、注意和执行功能。结果：急性强迫症患者的记忆测验中记图和数字划销测验中第二阶段失误率显著性较慢性强迫症差，其余两组间记忆测验、划销测验和威斯康星卡片分类测验各量表分无显著性差异。结论：强迫症的认知功能与病期无明显相关。     

阿尔茨海默病与血管性痴呆患者认知功能的比较研究

目的 :评价阿尔茨海默病 (AD)和血管性痴呆 (VD)患者认知功能障碍的异同 ;方法 :用简易智力状态检查表 (MMSE)、韦氏记忆量表 (WMS)、日常生活能力量表 (ADL)对 34例AD患者和 4 9例VD患者的认知功能进行测查 ;结果 :(1)MMSE结果表明AD组在短程记忆得分低于VD组 (P <0 .0 1) ,在语言复述得分高于VD组 (P <0 .0 5 ) ;(2 )WMS结果表明AD组在经历 (P <0 .0 5 )、图形再认 (P <0 .0 5 )、理解记忆 (P <0 .0 5 ) ,定向 (P <0 .0 1)得分显著低于VD组 ;(3)ADL结果显示AD组与VD组无显著差异。结论 :AD组和VD组均有记忆障碍 ,AD组受损更为严重并以记忆注意受损为突出 ,VD组相对较轻并以语言复述受损为突出     

The psychometric structure of the Wechsler Memory Scale in comparison to the WAIS-R in a low-IQ clinical population

The psychometric structure of the Wechsler Memory Scale (WMS) and its relationship to the revised Wechsler Adult Intelligence Scale (WAIS-R) were studied in an outpatient population of 103 individuals with low Full Scale IQ scores (M = 71). We found that the age correction of the WMS scores gave memory quotients (WMQ) equivalent to WAIS-R FSIQ scores, but our findings also raised problems of interpretation. If the usual rule of thumb of a 12-point discrepancy between the MQ and the FSIQ were applied, the WMS might be relatively insensitive to memory impairment in this low-IQ clinical population, in which more numerous cases of impairment could be expected. Principal components analysis of the WMS raw scores and three WAIS-R scores included as reference variables yielded five orthogonal factors: Attention/Concentration; Visual Reproductions; New Verbal Learning; Well-learned Semantic Knowledge; and Intelligence. We argue that raw scores on the WMS should be reported to optimize possible diagnostic specificity and to align the WMS with experimental and clinical research in various types of memory functioning and impairment.     

综合康复锻炼对改善低位直肠癌患者术后前切除综合征的效果

目的:探讨综合康复功能锻炼对改善低位直肠癌术后患者前切除综合征(anterior resection syndrome,ARS)的护理效果.方法:选择低位直肠癌术后并发ARS的98例患者,按住院号的顺序随机分为对照组和综合组,其中对照组49例患者采取常规盆底相关肌肉力量锻炼方案;综合组49例患者采取盆底肌锻炼与神经康复锻炼,分别比较两组患者干预前及干预后1,3,6个月时两组患者的前切除综合征评分(low anterior resection syndrome score,LARSS)及生存质量情况.结果:两组在干预前和干预后1个月时LARSS评分,差异无统计学意义(P＞0.05),综合组在干预后3个月和6个月时LARSS评分明显低于对照组,差异有统计学意义(P＜0.05);两组在时间效应、组间效应及时间组间效应值,差异均具有统计学意义(P＜0.05);两组在干预前及1个月时生活质量各维度评分,差异无统计学意义(P＞0.05);在干预后3个月和6个月时除环境功能外综合组患者的生活质量其他维度评分均高于对照组,差异有统计学意义(P＜0.05);除环境功能组间效应外,两组患者在生活质量所有指标的时间效应、组间效应及时间-组间效应,差异有统计学意义(P＜0.05).结论:通过开展盆底肌力锻炼联合神经康复锻炼较单纯盆底肌力锻炼更能够快速改善低位直肠癌术后ARS症状,对改善患者生存质量更为显著,在临床值得进一步推广.     

高考学生感恩与自测健康的关系

目的:研究高考学生感恩与自测健康之间的关系。方法:采用感恩问卷(GQ-6)和自测健康评定量表(SRHMS V1.0)对207名高考学生进行调查,分析感恩与高考学生自测生理、心理、社会健康和健康总分的关系。结果:1除自测社会健康外,高考学生的自测生理、心理健康和健康量表总分均低于一般人群;2将高考学生感恩成绩分为高感恩组、中间组和低感恩组,且不同感恩组在自测生理健康(F=5.865,P0.01)、自测心理健康(F=7.105,P0.01)、自测社会健康(F=14.232,P0.01)和健康总分(F=13.027,P0.01)上差异均极其显著;3除在自测生理健康方面中间组与低感恩组无差异外,高感恩组在健康各维度上的得分高,中间组居中,低感恩组得分最低;4高考学生的感恩与自测生理健康(r=0.182,P0.01)、自测心理健康(r=0.270,P0.01)、自测社会健康(r=0.351,P0.01)和健康总分(r=0.333,P0.01)均为极其显著正相关;并且感恩能够显著预测自测生理健康(β=0.188,P0.05)、自测心理健康(β=0.274,P0.01)、自测社会健康(β=0.352,P0.01)和健康总分(β=0.338,P0.01)。结论:高考学生总体的自测健康状况不容乐观,应该积极关注高考学生的健康状况;感恩是影响高考学生自测健康的重要因素,应该进一步加强高考学生的感恩教育。     

Association between BDNF val66 met genotype and episodic memory.

The val66 met polymorphism of brain derived neurotrophic factor (BDNF) has been associated with variability in episodic memory [Egan et al., 2003]. In an attempt to replicate this finding, we genotyped 206 individuals (92 affected with schizophrenia or a related disorder and 114 unaffected relatives) from the Maudsley Family Study for the BDNF val66 met polymorphism. We analyzed the effect of this polymorphism on episodic memory using the Wechsler Memory Scale, revised version (WMS-R) by regression analysis between the WMS delayed score of logical memory and genotype (corrected for age, sex, and IQ). We found the met66 allele conferred a lower score on the WMS delayed measure (R2 = 0.014 P = 0.09), which was not significant. When cases and unaffected relatives were analyzed separately, met66 was associated with a lower score on the WMS delayed measure in the relatives only (R2 = 0.077 P = 0.01), which is consistent with previous findings.     

Evaluation of antiviral therapies for coronavirus disease 2019 pneumonia in Shanghai,China

The aim of our study was to evaluate the therapeutic effect of antiviral drugs on coronavirus disease 2019 (COVID-19) pneumonia. Patients confirmed with COVID-19 pneumonia were enrolled and divided into seven groups according to the treatment option. Information including age, sex, and duration from illness onset to admission, clinical manifestations, and laboratory data at admission, and length of hospital stay were evaluated. The chest computed tomography (CT) imaging obtained at admission and after a 5-day treatment cycle were assessed. The clinical symptoms and laboratory tests at discharge were also assessed. At admission, no significant differences were found among the groups, including the duration from illness onset to admission, clinical symptoms, and main laboratory results. No significant differences were found among the groups in terms of the proportion of patients with pneumonia resolution (P = .151) after treatment or the length of hospital stay (P = .116). At discharge, 7 of 184 (4%) patients had a mild cough while their other symptoms had disappeared, and the proportion of patients with abnormal liver function and with increased leukocytes, neutrophils or erythrocyte sedimentation rate among the 184 patients were close to those at admission. According to the results, the inclusion of antiviral drugs in therapeutic regimens based on symptomatic treatment had no significant additional impact on the improvement in COVID-19 patients. In addition, the results of chest CT imaging, clinical manifestations, and laboratory tests at discharge were not completely consistent.     

Relationship of medical students' admission interview scores to their dean's letter ratings.

The authors examined the relationship between the admission interview scores for 62 students in the 1986 entering class at Dartmouth Medical School and the students' dean's letter ratings given four years later; they found the relationship to be significant (V = .372, p = .014) and the interview scores to be better independent predictors of the ratings than were total Medical College Admission Test scores or science grade-point averages. Among the 17 students receiving "strong" admission interview scores, 53% received dean's letter ratings in the top one-third and 47% received ratings in the lower two-thirds. Of those 34 who received "medium" interview scores, 68% received ratings in the lower two-thirds; all 11 students who received "weak" interview scores received ratings in the lower two-thirds. The authors suggest (1) that admission interview scores help schools to identify more clearly those applicants most likely to become strong, competitive performers in residency and (2) that the significant relationship between interview scores and dean's letter ratings indicates a need to discover what qualities the interview actually measures and to consider the methods by which interviewers are trained, rather than to forsake the interview.     

A randomized trial of the effect of a walking regimen on the functional status of 100 adult allogeneic donor hematopoietic cell transplant patients.

To investigate the impact of exercise on adult allogeneic hematopoietic cell transplant recipients, we randomized 100 patients to either a structured walking regimen or to a control group with no formal exercise program. Starting on the day of admission for transplant, patients in the exercise arm were asked to walk on a treadmill twice a day for 15 minutes while in the hospital. After discharge, they were asked to walk once a day for 30 minutes. The effect of the exercise program was primarily measured by the change in the Karnofsky score (KPS) from transplant admission to day 100 posttransplant, which was scored by the attending physician who was blinded to the assigned exercise regimen. The decline in KPS was smaller in the exercise group than in the control group: 10 points versus 20 points. This difference was not statistically significant in the total study population (P=.21) but was statistically significant among the subset of older and less fit patients receiving nonmyeloablative pretransplant conditioning (P=.04). Sixty-four percent of patients on the exercise arm who had a baseline KPS<90 had a score>or=90 by day 100 compared to 18% of the control arm (P=.03). Thirty-two percent of patients with a baseline score>or=90 had a score>or=90 by day 100 in both groups (P=.99). Analyses of patients' self reported scores at the time of discharge for physical and emotional well-being showed that the exercise arm had better scores for physical well-being (P<.01). Among the subset of nonmyeloablative patients, scores for physical and emotional well-being were both higher in the exercise arm (P=.02). Length of hospitalization and survival were not different between the 2 study arms. We conclude that assignment of a structured walking regimen to patients can lead to better physical performance during the recovery period and by patient assessment, a better perceived physical and emotional state. In addition, exercise has a greater impact among patients who are less fit coming into transplant. Structured exercise may have a positive impact on physical and emotional recovery following transplant therapy and may accelerate patients' return to health and function.     

The effect of a summer MCAT performance improvement program on minority medical student acceptance

The effect of a commercial Medical College Admission Test (MCAT) review course on MCAT retake scores and acceptance into medical school for a group of minority students is reported. The review course enhanced MCAT performance in all of the subgroups. The increase in total MCAT score was more pronounced in students with an initial MCAT score below 36 or a high undergraduate total or science grade point average. Results suggest a relationship between MCAT performance and medical school admission.     

认知行为疗法在合并焦虑的慢性难愈合创面患者中的临床研究

目的探讨认知行为疗法对合并焦虑的慢性难愈合创面患者创面治疗效果的影响。 方法选取2018年2月至9月于临沂市中心医院烧伤整形科住院治疗的符合入选标准的40例合并焦虑的慢性难愈合创面患者,将所有患者随机编号,编号为奇数的设为干预组,编号为偶数的设为对照组,每组各20例。2组患者均接受常规慢性难愈合创面的治疗和护理,干预组患者在此基础上给予认知行为疗法干预,包括会谈治疗、音乐治疗及腹式呼吸放松治疗,共4周,对照组未予任何心理干预治疗。分别于入院时、治疗2周、治疗4周采用焦虑自评量表(SAS)、汉密尔顿焦虑量表(HAMA)对2组患者进行焦虑程度评分;应用毫米网格纸法测量患者入院时、治疗2周、治疗4周创面面积并计算创面愈合率。数据比较采用t检验。 结果入院时,干预组患者SAS评分(67.1±2.4) 分,对照组(65.9±2.2) 分,2组比较差异无统计学意义(t＝0.49, P＝0.65);认知行为疗法干预治疗2、4周后,干预组患者SAS评分分别为(55.6±1.9)、(49.3±2.6) 分,低于同期对照组(59.8±2.1)、(53.5±2.7) 分,差异均有统计学意义(t＝2.17、2.54,P＝0.04、0.02);入院时,干预组患者HAMA评分(23.8±3.3) 分,对照组(24.1±3.6) 分,2组比较差异无统计学意义(t＝0.96, P＝0.34);干预2、4周后,干预组患者HAMA评分分别为(17.2±2.7)、(11.9±2.1) 分,低于同期对照组(20.8±3.4)、(15.3±3.0) 分,差异均有统计学意义(t＝2.23、2.86,P＝0.03、0.01)。治疗2、4周后,干预组患者创面愈合率分别为(26.2±2.4)%、(80.5±4.2)%,均高于同期对照组(22.3±2.1)%、(59.2±3.9)%,2组比较差异均有统计学意义(t＝2.54、2.86,P＝0.02、0.01)。 结论认知行为疗法干预有助于缓解慢性难愈合创面患者的焦虑情绪,提高慢性难愈合创面的愈合速度。     

心理支持干预对稽留流产患者焦虑和抑郁的改善作用

目的:探讨心理支持干预对稽留流产患者精神焦虑和抑郁的改善作用。方法:选取2014年2月—2016年2月因稽留流产于我院治疗的患者共150例,随机分干预组和对照组,每组75例,干预组采用心理支持干预,对照组采用常规的护理,在干预前后采用焦虑自评量表(SAS)、抑郁自评量表(SDS)患者进行疗效评价。结果:两组患者入院时的SAS和SDS评分比较差异无统计学意义,出院时两组患者的SAS和SDS评分均较入院时有所下降(P0.05),干预组患者显著低于对照组,差异具有统计学意义(t=8.161,P0.001),两组患者入院前的焦虑和抑郁人数比例差异均无统计学意义(χ~2=0.110,P=0.740;χ~2=1.000,P=0.317),而出院时出院时干预组患者的无或轻度焦虑和抑郁人数比例显著高于对照组,差异具有统计学意义(χ~2=7.535,7.985;P0.01)。结论:心理支持干预有助于缓解稽留流产患者的焦虑和抑郁情绪,值得临床推广。     

Visuoconstructional drawing ability in the differential diagnosis of neurologic compromise versus depression.

Neuropsychologists are often called upon to assist in making differential diagnoses between neurologic compromise and depression. However, the literature has been inconsistent about the impact of depression on neurocognitive functioning. This makes interpretation of neuropsychological test data among depressed individuals difficult. In a retrospective cross-sectional study of 200 patients, the relationship between depression (Beck Depression Inventory or Geriatric Depression Scale) and visuoconstructional drawing ability/praxis (Rey-Osterrieth Copy [RO]) was evaluated. Age and education both correlated significantly with RO performance (p <.001 and.005, respectively). There were no significant relationships found between copy performance and depression, even when controlling for the significant effects of age and education. A prospective longitudinal study of 20 psychiatric inpatients with depression tested on admission and again at discharge matched with 20 nondepressed normal controls yielded similar results in that the two groups did not differ in their initial RO performance. Moreover, an improvement in depression as measured by a decrease in Beck Depression Inventory scores did not coincide with any improvement in RO scores. By comparison, a matched positive control group of 20 neurologically compromised patients was significantly worse than both the normal control and the depressed groups on the RO (p <.05). These data suggest that poor performance on the RO should not be interpreted simply as a consequence of depression. Age and education, though, should be considered when interpreting the RO.     

The movement of hostility during recovery from depression

Sixteen depressed in-patients from a hospital in Athens were assessed using the Hamilton Rating Scale and the Hostility and Direction of Hostility Questionnaire. Comparison of admission, discharge and mid-treatment scores showed that: (1) There was a larger drop in depression score in the first half of treatment. (2) Hostility scores, except for extrapunitiveness, decreased significantly over time, larger changes occurring in the first half of treatment. (3) Comparisons with British scores showed that during illness there were no significant differences between British and Greeks, though the latter tended to be more extrapunitive. At recovery, the Greeks were significantly more extrapunitive. The movement of hostility in depressive illness, the validity of the HDHQ and need for national norms are discussed.     

乙肝肝硬化失代偿期腹水患者血钠水平与其并发症及临床预后的关系

目的:探求乙肝肝硬化失代偿期腹水患者血钠水平与其并发症及临床预后的关系.方法:回顾性分析2015年5月至2016年10月年收治的乙型肝炎肝硬化失代偿期伴腹水患者98例病例资料,据血钠水平分为低钠血症组与正常组,通过分层分析,对比不同组别患者入院时肝肾功能、血清白蛋白含量、Child-pugh评分、肝纤维化程度及并发症情况,治疗2周后,对比两组患者腹水疗效及出院后预后.结果:98例患者中血钠水平＜130 mmol/L者41例(41.8％).低钠血症组入院时转氨酶、血肌酐、总胆红素、凝血酶原时间、Child-pugh评分均明显高于正常组,血清白蛋白含量则低于血钠水平正常组,差异均具有统计学意义(P＜0.05).低钠血症组与正常组入院时伴肝性脑病、肝肾综合征、消化道出血、自发性腹膜炎比例差异均具有统计学意义(分别为24.4％ vs.7.0％,19.5％vs.5.3％,26.8％ vs.10.5％及24.4％vs.8.8％;P＜0.05).入院14d,两组腹水治疗效果中显效比例分别为73.2％,89.5％(x2=4.421,P=0.036);出院后12个月随访期间内,两组病死率分别为36.6％,15.8％(x2=5.577,P=0.018).结论:血钠水平与肝硬化失代偿期病情密切相关,低钠血症患者病情较重,疗效与预后较差.     

CAPS评分对急性加重期慢性阻塞性肺疾病并无创通气患者远期预后评估

目的：探讨慢性阻塞性肺疾病和支气管哮喘生理评分(the COPD and asthma physiology score, CAPS)对慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)并无创通气患者远期预后的评估效果。方法：以2014年6月至2015年10月在我院接受无创通气的AECOPD患者为观察对象,并根据其CAPS评分将其分为CAPS≥35组和CAPS<35组。比较不同CAPS评分患者出院时炎症细胞因子水平、肺功能和出院后1个月生活质量的差异。结果：CAPS≥35的患者出院时的CRP和IL-6等炎症细胞因子指标明显高于CAPS<35组患者,差异具有统计学意义(P<0.05);出院时CAPS<35的患者肺功能指标明显优于CAPS≥35组,差异具有统计学意义(P<0.05);治疗前,CAPS≥35组和CAPS<35组患者的生活质量各维度得分无明显差别,出院1个月时的调查结果显示：两组患者的生活质量均较治疗前增高,且CAPS<35组患者生活质量提高更明显(P<0.05)。结论：CAPS评分对AECOPD并无创通气患者的远期预后有较好的评估价值：CAPS评分高的患者病死率较高,预后较差。     

Early rehabilitation outcome in patients with middle cerebral artery stroke

Although important data on the prognosis and rehabilitation outcome in stroke patients have been reported, data on functional recovery according to stroke subtypes are limited. This retrospective study aimed to evaluate functional outcome in patients with middle cerebral artery (MCA) stroke-the most common subtype of ischemic stroke. The records of stroke patients that underwent the rehabilitation program at our brain injury rehabilitation service between January 2007 and December 2008 were reviewed, and those with MCA stroke were included in the study. Patient demographic and clinical data, and Barthel Index (BI) and Functional Independence Measure (FIM) scores at admission and discharge were collected. The study included 80 MCA stroke patients with a mean age of 63.54 years. FIM and BI scores improved significantly post rehabilitation (P < 0.05). Age was negatively correlated with both BI and FIM scores at admission and discharge. Length of stay was not correlated with improvement in BI or FIM scores during hospitalization. The patients that had ≤1 month of inpatient rehabilitation had similar outcomes as those that had >1 month of inpatient rehabilitation (P > 0.05). Length of time after stroke onset was not correlated with BI or FIM scores at admission. Regardless of initial functional status, prediction of discharge functional status was misleading. Physiatrists should keep in mind that functional improvement does not always increase with duration of inpatient therapy.     

Relationship between age and IQ among fragile X males: a multicenter study

Longitudinal decline in IQ among fragile X males was reported recently. However, there are problems in retesting IQ that may affect scores. Two such factors are intertest time interval and score obtained on the first test. To determine the generality of IQ score changes, we examined 101 fragile X males from 6 centers. To ensure high test-retest reliability, only results from Stanford-Binet and Wechsler tests were used. Thus there were retest scores from 60 subjects. Test-retest reliability between first and last scores was very good (r = 0.85) and comparable to those seen in nonfragile X mentally retarded individuals. Also computed were z-scores of differences in IQ scores. The z-score differences were distributed about a mean at 1 SD below the expected zero value. Eighteen subjects showed statistically significant decreases in IQ, 6 showed statistically significant increases, while 5 showed the same scores. Z-score differences were not correlated with type of residence or elapsed intertest interval, but were negatively correlated with first score obtained, indicating a regression-to-the-mean effect. Using a multiple regression analysis, we found first score obtained, age tested, and age retested significant predictors of score differences, accounting for 19% of the total variance. These results suggest that factors previously identified as affecting retest scores have a smaller effect than originally thought. It is suspected that decline in IQ is associated with dynamic neurological processes and needs to be investigated further.     

支持性心理治疗对首发抑郁症患者生活质量的影响

目的 观察支持性心理治疗对抑郁症患者生活质量的影响.方法 将符合CCMD-3抑郁症诊断标准的67例患者随机分为观察组(支持性心理治疗联合抗抑郁药治疗)33例,对照组(单用抗抑郁药治疗)34例,采用汉密顿抑郁量表(HAMD)、汉密顿焦虑量表(HAMA)和生活质量量表(WHO-QOL-100)评定两组治疗前后的治疗效果和生活质量情况.结果 67例进入结果分析.HAMD、HAMA量表结果显示观察组的显效时间是在4周末,明显优于对照组(t=3.14,P＜0.01).两组患者的生活质量均有改善,观察组的生活质量总评、心理领域、独立性领域及社会关系领域显著好于对照组(t=4.38,2.86,5.10,2.53,P＜0.05～0.001),差异有显著性意义.结论 支持性心理治疗不仅能促进患者的治疗,而且可改善患者的生活质量.