医学生情绪智力与成就动机的关系研究

目的探讨医学生的情绪智力、成就动机及其二者关系。方法采用情绪智力量表中文版（EIS）、成就动机量表（AMS）对259名在校医学生进行调查。结果情绪智力在是否为学生干部（t=2．31,P=0．02）上差异有统计学意义,在是否为独生子女（t=0．27,P=0．79）和性别（t=0．65,P=0．52）上均无统计学意义;成就动机在是否为学生干部（t=3．40,P=0．001）上差异有统计学意义,在是否为独生子女（t=-1．49,P=0．14）和性别（t=0．87,P=0．39）上差异均无统计学意义。情绪智力与成就动机存在显著的正相关（r=0．320,P=0．000）。结论医学生的情绪智力越高其成就动机就越高。     

农村中小学教师职业压力、心理资本、睡眠质量关系研究

目的：了解农村中小学教师职业压力、心理资本、睡眠质量现状及三者的关系。方法运用问卷法对广西百色市德保县农村地区388名中小学教师进行调查,数据分析采用方差分析、相关性分析、结构方程模型等分析方法。结果性别在心理资本上的主效应显著（F＝5．28,P＜0．05）,职称在睡眠质量上的主效应显著（F＝3．53,P＜0．05）,性别、年龄在职业压力上的交互作用显著（F＝3．66,P＜0．05）,性别、年龄、职称在心理资本上的交互作用显著（F＝3．20,P＜0．05）;职业压力得分与睡眠质量得分显著正相关（r＝0．41,P＜0．01）,心理韧性得分分别与职业压力、睡眠质量得分显著负相关（r＝－0．35,P＜0．01;r＝－0．38, P＜0．01）;心理韧性的中介效应占总效应的31．98％。结论心理韧性在职业压力、睡眠质量之间起中介效应作用。     

青少年家庭环境与情绪智力的关系

目的：探讨家庭对青少年情绪智力的影响。方法使用《家庭环境量表》和《情绪智力量表》对随机抽取的230名青少年进行测试。结果被试的情绪智力处于中等之上;家庭环境的部分维度与情绪智力存在相关（ P＜0．05;P＜0．01）,情绪智力高、低组的被试在亲密度、情感表达、娱乐性、成功性及道德宗教观维度上有显著差异（ P＜0．05,P＜0．01）;逐步回归分析显示,亲密度、知识性、道德宗教观、独立性能够预测情绪智力总分或者部分维度（β值在0．13～0．23之间）,预测量为6％～10％。结论良好的家庭环境有利于情绪智力的培养。     

影响阿尔茨海默病患者家庭照料者生活质量的相关因素分析

目的：探讨阿尔茨海默病（AD）患者家庭照料者的生活质量及其影响因素。方法采用自制一般情况问卷、WHO生活质量测定简表（WHOQOL‐BREF）、Zarit照料负担量表（ZBI）、社会支持评定量表（SSRS）等对64名AD患者的家庭照料者进行调查。结果（1）AD患者照料者的生活质量总的主观感受得分显著低于健康状况总的主观感受得分（t＝－2．217,P＝0．030）。生理领域、心理领域得分与中国常模比较,差异无统计学意义（ t＝－0．252、－1．994,P＝0．801、0．050）;社会领域、环境领域得分与常模比较,差异有统计学意义（ t＝－3．830、3．658,P＜0．05）。（2）有配偶、亲子关系差、有躯体疾病及患者精神行为症状较重的照料者生活质量较低（P＜0．05）。（3）照料者的生活质量总分与照料负担总分呈负相关（r＝－0．433,P＜0．05）,与社会支持总分呈正相关（ r＝0．346,P＜0．05）。（4）婚姻状况、亲子关系、躯体疾病、社会支持是生活质量的主要影响因素（ r2＝0．409）。结论加强对有配偶、亲子关系较差、身体情况不良的AD照料者的社会支持和心理干预,有助于改善生活质量。     

抑郁症患者应对方式与童年受虐经历的关系

目的：探讨抑郁症患者应对方式与童年受虐经历之间的关系。方法采用病例对照研究,对80例成年抑郁症患者及80例配比健康对照进行回顾性问卷调查。包括自设一般情况问卷了解其人口学资料、童年期创伤性经历问卷（CTQ‐SF）评估童年受虐情况和特质应对方式量表（TCSQ）评估应对方式,运用 t检验、非参数Mann‐Whitney U检验、Spearman相关分析和多元线性逐步回归分析抑郁症患者应对方式的特点及其与童年受虐经历的相关性。结果（1）抑郁症病例组的消极应对方式分值显著高于健康对照组（t＝9．13,P＜0．01）,而其积极应对方式分值显著低于健康对照组（t＝－12．01,P＜0．01）;有受虐经历的抑郁症病例组消极应对分显著高于有受虐经历的健康对照组（ Z＝－6．134,P＜0．01 ）,而其积极应对方式分显著低于健康对照组（Z＝－5．452,P＜0．01）;抑郁症组中有受虐经历的患者消极应对分显著高于无受虐经历患者（Z＝－2．159,P＜0．05）,积极应对分值两者之间无明显差异。（2）抑郁症患者童年受虐经历与其消极应对方式呈显著正相关,与其积极应对方式呈显著负相关（r＝0．562,P＜0．01;r＝－0．333,P＜0．05）。（3）抑郁症患者消极应对水平能够被童年受虐待总分和躯体因子共同解释占34．4％（P＜0．01）。结论童年受虐经历明显影响抑郁症患者的应对方式,且虐待程度越重,尤其有躯体虐待,其消极应对越明显。     

浙江省温岭市某医院护士情绪智力对其职业压力的影响

目的：探讨浙江省温岭市某医院护士情绪智力对其职业压力的影响。方法：对浙江省温岭市某医院236名护士进行问卷调查,了解其情绪智力和职业压力状况,采用Pearson相关分析、分层回归分析探讨情绪智力对职业压力的影响。结果：护士情绪智力和职业压力总分分别为3．53±0．51分和26．43±4．59分;Pearson相关分析结果显示,护士情绪智力各维度得分与职业压力各方面得分均呈显著负相关（均P〈0．05）;多重回归分析显示,情绪智力中的的管理情绪、自我激励及识别他人情绪均为护士职业压力的影响因素。结论：护士情绪智力是影响其职业压力的重要因素。     

儿童期虐待、人格、不安全感对医学生分离特质影响的路径分析

目的：构建医学生儿童期虐待、人格、不安全感与分离特质的关系模型。方法采用整群抽样法抽取某医学院262名医学生,使用解离特质量表（DTS）、儿童期虐待史自评量表（ PRCA）、不安全感心理自评量表（SRFIS）、简式大五人格问卷（NEO-FFI-R）等工具进行测评,用Amos7．0作路径分析。结果①儿童期虐待与不安全感、分离特质、神经质呈正相关（r＝0．248～0．361, P＜0．01）,与外向性、友善性、谨慎性呈负相关（r＝－0．168～－0．250, P＜0．01）;不安全感与分离特质、神经质呈正相关（r＝0．479～0．522, P＜0．01）,与外向性、友善性、谨慎性呈负相关（r＝－0．234～－0．324,P＜0．01）;分离特质与神经质呈正相关（r＝0．597, P＜0．01）,与外向性、开放性、友善性、谨慎性呈负相关（r＝－0．133～－0．453, P＜0．05）。②路径分析结果显示,儿童期虐待对不安全感有直接正向影响（B＝0．339, P＜0．01）,对大五人格有直接负向影响（B＝－0．226, P＜0．01）,对分离特质无直接影响（B＝－0．014,P＞0．05）;大五人格对不安全感、分离特质有直接负向影响（ B＝－0．609～－0．363, P＜0．01）;不安全感对分离特质有直接正向影响（ B＝0．448,P＜0．01）;大五人格和不安全感作为中介变量调节儿童期虐待对分离特质的影响。模型的拟合指数为χ^2／df＝1．151＜3．000, P＝0．080＞0．05,RMSEA＝0．024＜0．050,GFI＝0．935,AGFI＝0．909,NFI＝0．923,RFI＝0．902,IFI＝0．989,TLI＝0．986,CFI＝0．989,模型拟合良好。结论大五人格和不安全感作为中介变量调节着儿童期虐待对医学生分离特质的影响作用,儿童期虐待对分离特质无直接影响。     

认知性情绪调节策略在情绪智力与孤独感间的中介效应

目的：探讨认知性情绪调节策略在情绪智力与孤独感间的中介效应。方法采用认知情绪调节问卷中文版、情绪智力量表和孤独量表对542名大学生实施问卷调查,采用SPSS17．0软件进行相关分析;假设认知性情绪调节策略在情绪智力与孤独感间具有中介效应,建立路径模型,采用AMOS17．0软件进行路径分析。结果认知性情绪调节的积极策略[（28．64±5．90）分]总体上与情绪智力[题项平均分（2．38±0．27）分]显著正相关（r＝0．346,P＜0．05）,与孤独感[（42．29±7．88）分]显著负相关（r＝－0．301, P＜0．05）;路径分析显示：间接效果和直接效果的估计值均支持本研究假设（P＜0．05）。结论认知性情绪调节的积极策略在情绪智力与孤独感间具有部分中介效应。     

高胆红素血症新生儿经外周动静脉全自动换血术血生化及电解质水平的变化

目的：探讨经外周动静脉全自动换血术的高胆红素血症新生儿血生化及电解质水平的变化。方法对39例高胆红素血症新生儿进行共计40次的经外周动静脉全自动换血术进行分析。39例患儿按疾病严重程度分为胆红素脑病组和非胆红素脑病组。对换血前后的血常规、血气及电解质、生化进行回顾性分析。结果与换血前比较,换血后的血清总胆红素、间接胆红素水平显著下降（t＝－20．545,P＜0．05;t＝－20．594,P＜0．05）;血常规中的白细胞和血小板下降显著（t＝－7．307,P＜0．05;t＝－11．282,P＜0．05）,而血红蛋白前后变化差异无统计学意义（t ＝1．613,P＞0．05）;同时,钾离子和钠离子也显著下降（t＝－2．306,P＜0．05;t ＝－4．141,P＜0．05）;而血糖和碳酸氢根离子则显著上升（t＝2．951,P＜0．05;t＝2．320,P＜0．05）;其他生化指标在换血前后无显著变化（P＞0．05）。胆红素脑病组的乳酸水平较非胆红素脑病组显著升高（t＝11．241,P＜0．05）,动脉氧分压显著降低（t＝5．652,P＜0．05）。结论经外周动静脉全自动换血术安全有效,并无明显的不良反应。但在胆红素脑病患儿,换血术会对其循环状态造成影响。     

医学生的医患沟通技能教育现状调查

目的：了解综合性大学医学生医患沟通教育中,学生的学习态度及医患沟通技能的自我评价现状。方法利用国内外已发表的《医学生沟通技能态度量表》（CSAS）及《医学生医患沟通行为量表（自评）》对某综合性大学的127名医学生进行问卷调查。结果127名学生完成CSAS后其积极态度分量表平均得分为51．43分,消极态度分量表平均得分为32．94分。调查前、后比较,差异有统计学意义（ P＝0．000）,而男女、不同学制之间比较差异无统计学意义（ P＞0．05）。95．28％学生同意或完全同意“学习医患沟通技能与学习临床技能同样重要”。127名学生完成《医学生医患沟通行为量表（自评）》,总分150分,127名学生的平均自评得分为104．93分,男生得分高于女生（ P＝0．008）。五年制及八年制学生各项得分比较差异均无统计学意义（ P＞0．05）。结论医学生对医患沟通学习持积极态度,绝大多数学生认为“学习医患沟通技能与学习临床技能同样重要”,且对沟通技能自评不高,医患沟通技能教育亟待加强。     

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.