抑郁症患者心理防御方式65例分析

目的 探讨抑郁症患者的心理防御特征.方法 采用心理防御方式问卷对抑郁症患者和正常健康者各65例进行评定.结果 抑郁症患者不成熟防御机制因子及中间型防御机制因子得分均明显高于对照组;成熟型防御因子得分明显低于正常对照组.结论 抑郁症患者心理防御机制的成熟程度较正常人低,应该对患者防御方式进行干预,保持稳定的心态,更好地适应社会.     

青少年网络成瘾与父母养育方式及其心理防御机制的关系

目的：研究青少年网络成瘾者的父母养育方式及其心理防御机制.方法：采用网络成瘾测验问卷（IAT）,父母养育方式问卷（EMBU）,防御方式问卷（DSQ）对1 300名初中生筛查.结果：1、网络成瘾者的父母养育方式在父母的惩罚严厉、过分干涉、过度保护和拒绝否认四个因子得分显著高于对照组（P〈0.01或P〈0.05）;父亲的温暖理解得分显著低于对照组（P〈0.05）.2、网络成瘾者更多采用不成熟防御机制和中间型防御机制（P〈0.01）.不成熟防御机制中,投射、被动攻击、抱怨、幻想、退缩各因子得分显著高于对照组（P〈0.01）;中间型防御机制中,理想化、隔离、交往倾向、消耗倾向各因子得分显著高于对照组（P〈0.01）.结论：1、网络成瘾者的父母养育方式不良.2、网络成瘾者更多采用不成熟和中间型防御机制.     

Ⅱ型糖尿病患者主观幸福感及防御方式调查分析

目的对Ⅱ型糖尿病患者的主观幸福感及防御方式进行调查分析,为进一步了解糖尿病患者主观幸福感和心理防御机制提供有效的依据。方法采用主观幸福感问卷、防御方式问卷对两组样本的主观幸福感和心理防御方式进行评估。结果两组主观幸福感比较结果为在健康状况、正性情绪、负性情绪、总体幸福感具有统计学显著差异（P〈0.01）。两组防御方式比较结果为Ⅱ型糖尿病患者同正常对照相比在成熟防御机制因子、中间型防御机制和不成熟机制因子存在显著性差异（P〈0.01,P〈0.05）,Ⅱ型糖尿病患者更多的使用投射、被动攻击、潜意显现、抱怨、退缩、躯体化不成熟的防御机制,而正常对照组则更多的使用升华的成熟的防御机制,多数中间型防御机制的使用两组并无显著性差异,但Ⅱ型糖尿病患者使用反向形成、回避、假性利他、隔离、消耗倾向的防御机制显著高于对照组。结论健康对照组体验到更多的幸福感,糖尿病患者有更多的负性情绪;糖尿病患者更多地采用不成熟防御机制和中间型防御机制而较少使用成熟防御机制。糖尿病患者主观幸福感和心理防御机制情况值得关注,需结合心理干预共同起治疗和康复。     

抑郁症患者心理防御方式及其与人格特征相关性研究

目的探讨抑郁症患者特定的防御方式及其与人格特征的相关性。方法采用防御方式问卷(DSQ)、A型行为问卷(TABQ)、汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA),对72名抑郁症患者进行测试,并与72名正常人作对照研究。结果与正常对照组相比,抑郁症患者较多使用不成熟的心理防御机制:退缩、躯体化和中间型心理防御机制:理想化、假性利他,较少使用幻想和期望。HAMD量表分与退缩、躯体化、解除和交往倾向呈显著正相关;HAMA量表分与解除、交往倾向和期望呈显著正相关(P<0.05或P<0.01)。A型行为者在使用不成熟和中间型心理防御机制上显著多于非A型行为者(P<0.05或P<0.01);A型行为者TABQ总分与不成熟型心理防御方式、中间型心理防御方式和掩饰因子均呈显著正相关(P<0.001),与成熟型心理防御机制呈负相关。结论具有A型行为特征的抑郁症患者更多使用不成熟和中间型心理防御方式。     

综合医院躯体形式障碍患者三维人格特征及防御方式研究

目的 分析躯体形式障碍患者的三维人格特征、防御方式及其相互关系.方法 采用三维人格问卷(tridimensional personality questionnaire,TPQ)、防御方式问卷(defense styles questionnaire,DSQ)对60例门诊及住院躯体形式障碍患者及60名正常人进行人格评定及防御方式评定,并用独立样本的t检验对两组的(得分)结果进行比较,采用Pearson相关系数分析两者之间的相关性.结果 躯体形式障碍组在猎奇性得分高于正常对照组(P＜0.05);躯体形式障碍组在躲避伤害性维度上得分高于正常对照组(P＜0.01),躯体形式障碍组在奖赏依赖性维度上的得分低于正常对照组(P＜0.01);躯体形式障碍组在不成熟防御方式的得分高于正常对照组(P＜0.01),在成熟防御方式上的得分低于正常对照组(P＜0.01);三维人格特征中的躲避伤害性与成熟防御机制呈负相关(r=-0.612),奖赏依赖性与成熟防御机制呈正相关(r=0.350).结论 躯体形式障碍患者具有猎奇性、躲避伤害性以及依赖性等人格特征;躯体形式障碍患者较多使用不成熟防御方式,包括投射、抱怨、退缩、躯体化;人格特征与心理防御机制具有一定相关性.     

肺癌患者与正常人心理防御机制的对比研究

目的研究肺癌患者心理防御机制的特点,观察与正常人之间的差别．方法对118例肺癌患者及与之1：1配对的118例健康人采用Bond编制的“防御机制问卷（DSQ）”对不成熟防御机制、成熟防御机制、中间型防御机制和掩饰因子分别进行评测．结果病例组和对照组两组有较好的均衡性,肺癌患者的不成熟防御机制中的被动攻击、潜意显现、退缩的得分明显高于对照组（P〈0．05）;中间型防御机制中的消耗倾向高于对照组,两组间的成熟型防御机制无统计差异．结论肺癌患者的心理防御特点不同于健康人,多采用不成熟及中间型心理防御机制．     

精神分裂症患者的成人亲附类型与其防御机制的研究

目的探索精神分裂症患者的成人亲附类型与防御机制，为进一步理解其临床症状提供相关的研究基础。方法符合中国精神障碍分类标准第三版（CCMD-Ⅲ）中关于精神分裂症的诊断标准，选取30名确诊为精神分裂症的患者，建立配对正常对照组30人。采用成人亲附量表（AAS）及防御方式问卷（DSQ）为主要测量工具。结果研究组与对照组在成人亲附安全和不安全类型的分布上差异有显著性意义；研究组和对照组在不成熟防御机制和成熟防御机制得分上差异有显著性意义；研究组与对照组在投射、同一化等防御机制得分上差异有统计学意义。结论精神分裂症患者的成人亲附类型以不安全型为主，主要使用不成熟的防御机制；可能精神分裂症患者所运用的防御机制以投射、同一化等为主。     

军人失眠症患者防御机制与心理应激及人格特征的相关研究

目的:研究军人失眠症患者的心理防御机制特点与人格特征和心理应激的关系.方法:采用防御方式问卷(DSQ)、生活事件量表(LES)和艾森克个性问卷(EPQ)对某三级甲等部队医院心理科收治的48例失眠症官兵(研究组)和随机抽取某部50名官兵(对照组)进行调查.结果:①军人失眠症患者更多采用不成熟和中间型防御机制(P<0.05或0.01),最常用采用的6种心理防御因子是:抱怨、回避、退缩、躯体化、幻想、消耗倾向;②军人失眠症患者人格特征多为内向、神经质个性,防御机制与人格特征存在着显著的相关性(P<0.05或0.01).③研究组所遭遇生活事件总数、负性生活事件及正性生活事件均显著高于对照组(P<0.05或0.01),以负性生活事件为主;防御机制同所经历的负性生活事件有显著相关性(P<0.01).结论:军人失眠症患者呈现不同程度的人格缺陷,在应对应激事件时更多采用不成熟和中间型防御机制.     

男女大学生心理防御方式比较

目的：研究不同性别大学生群体心理防御方式的特点及差异。方法：采用防御方式问卷（DSQ）对324名本科大学生进行调查。其中男性138名，女性186名。结果：男女大学生的心理防御方式有一定的差别，女性不成熟因子高于男性，男女大学生成熟防御机制与中间型防御机制未见明显不同。结论：女性大学生表现出整体不成熟度较高的倾向；女性多采取压抑的方式而男性则采取幽默的成熟防御机制；男女之间虽然中间型防御机制无明显不同，但女性喜欢理想化与否认，而男性多采用无能之全能的防御方式；男性的掩饰度高于女性。     

亚甲基二氧苯丙胺依赖患者防御方式及其与行为类型的相关性

目的 探讨亚甲基二氧苯丙胺依赖患者特定的防御方式及其与行为类型的相关性.方法 采用防御方式问卷(DSQ)、A型行为问卷(TABQ),对72名亚甲基二氧苯丙胺依赖患者进行测试,并与72名正常人作对照研究.结果 与正常对照组相比,亚甲基二氧苯丙胺依赖患者较多使用不成熟的心理防御机制:退缩[(4.26±2.07)分Vs(5.56±2.31)分]、躯体化[(4.23±l.77)分Vs(5.22±2.15)分]和中间型心理防御机制:理想化、假性利他,较少使用幻想和期望.其中A型行为者在使用不成熟和中间型心理防御机制上显著多于非A型行为者;A型行为者TABQ总分与不成熟型心理防御方式、中间型心理防御方式和掩饰因子均呈显著正相关,与成熟型心理防御机制呈负相关.结论 具有A型行为特征的亚甲基二氧苯丙胺依赖患者更多使用不成熟和中间型心理防御方式.     

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.     

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.     

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.