原发性失眠患者生活质量及影响因素

目的:探讨原发性失眠患者生活质量及影响因素。方法:对病例组85例和对照组57例进行生活质量综合评定问卷(GQOLI-74)评估比较,对可能影响生活质量的因素进行回归分析。结果:(1)GQOLI-74 总体评估中病例组的生活质量总分、躯体功能、心理功能、社会功能比对照组分别低33分、17分、10分、4分(均分分别为254.9±26.4/287.1±30.4,t=-5.15,P<0.01;60.3±8.9/77.7±7.2,t=-9.71,P<0.01;65.5±7.3/75.0±11.0.t=-4.98,P<0.01;64.9±8.7/68.8±9.4,t=-2.31,P<0.05);(2)已婚、年龄越大、睡眠脑电图参数中的总睡眠时间和慢波睡眠时间越长,原发性失眠患者生活质量评估越高;PSQI 评分越高及睡眠潜伏期越长、夜间觉醒次数越多,生活质量评估越低。结论:原发性失眠患者的生活质量在躯体、心理和社会维度有显著降低,部分人口学特征和失眠的主客观严重程度是影响生活质量评估的主要因素。     

社区随访干预对精神分裂症患者生活质量的影响

目的探讨社区随访干预对精神分裂症患者生活质量和社会功能康复的影响。方法将出院的精神分裂症患者152例随机分成干预组和对照组,对干预组患者及其家属、社区居民实施群体随访干预和个别指导,对照组针对患者个体给予一般健康指导,共干预1年。采用家庭关怀度指数问卷(APGAR)、社会功能缺陷量表(SDSS)和生活质量综合评定问卷(GQOL I-74)对干预效果进行评定。结果实施社区随访干预后,干预组患者的社会功能缺陷程度明显降低,与干预前及两组间比较,均有显著统计学意义(P<0.01)。患者得到较多的家庭、社会支持,家庭社会关怀度显著提高(P<0.05)。患者生活质量与家庭社会支持度的相关性分析,除物质生活维度,其余3个维度即躯体功能(r=0.37,P<0.01)、心理功能(r=0.35,P<0.01)、社会功能(r=0.27,P<0.05)均与家庭社会关怀度呈正相关。患者生活质量明显提高。结论社区随访干预可有效提高精神分裂症患者的生活质量和社会功能。     

青海高原武警官兵生活质量与人格特征和社会支持的关系

目的:了解青海高原武警官兵的生活质量与人格特征和社会支持的关系。方法:采用世界卫生组织生活质量测定量表简表(WHOQOL-BREF)、艾森克个性问卷(EPQ)、领悟社会支持量表(PSSS),对青海省西宁市某支队530名武警官兵进行问卷调查。结果:①青海高原武警官兵的生活质量各领域百分制得分如下,生理领域64.01±8.85;心理领域62.58±9.75;社会领域63.77±11.93;环境领域57.30±9.61;②艾森克个性问卷的E维度分和社会支持量表总均分与生活质量各领域的评分呈显著正相关,N维度分与生活质量得分呈显著负相关(P<0.01);③多元回归结果表明:在$=0.05的水平上,内外向人格维度、神经质人格维度和社会支持总均分均进入回归方程。结论:青海高原武警官兵的生活质量与人格和社会支持密切相关。     

帕金森患者家属生活质量的调查研究

目的了解帕金森患者家属的生活质量。方法采用生活质量综合评定问卷对102名帕金森患者家属及50名正常对照者进行测量。结果帕金森患者家属的总体生活质量(t=7.29,P<0.05)、心理健康维度(t=8.67,P<0.01)、躯体健康维度(t=6.57,P<0.01)、社会功能(t=4.59,P<0.05)及物质生活维度(t=2.52,P<0.05)均低于正常对照组,差异具有统计学意义,其中躯体健康和心理健康对生活质量的影响较大。结论帕金森患者家属的生活质量较差。     

阿立哌唑与舒必利治疗精神分裂症的疗效及生活质量对照研究

目的探讨阿立哌唑与舒必利治疗精神分裂症的疗效及对其生活质量的影响。方法将96例精神分裂症患者随机分为阿立哌唑组和舒必利组,治疗8周,采用阳性和阴性症状量表(PAN SS)评定疗效,生活质量综合评定问卷(GDOL I)评定生活质量,副反应量表(TESS)评定不良反应。结果两组PAN SS分值治疗前后差异均有显著性(P<0.01);但两组之间比较,差异无显著性(χ2=0.3226;P>0.05)。阿立哌唑组生活质量除生活条件维度外,在躯体健康、心理健康、社会功能维度均高于舒必利组,且有显著性差异(t=2.963,3.041,2.984;P<0.01)。结论阿立哌唑与舒必利抗精神分裂症的疗效相当,但阿立哌唑对精神分裂症患者的生活质量改善明显,副反应少。     

老年期痴呆患者一级亲属生活质量的调查分析

目的探讨老年期痴呆患者一级亲属的生活质量状况。方法采用生活质量综合评定问卷-74（GQOLI-74）对48例老年期痴呆患者亲属及与之相匹配的48例已婚健康受试者进行评定。结果老年期痴呆患者GQOLI-74维度评分和总体生活状态评分均明显低于正常对照组（t=1.97-1.98;P〈0.05或t=2.51-2.66;P〈0.01）具有统计学意义。其中以躯体健康和心理健康尤为显著。结论老年期痴呆患者一级亲属的生活质量较正常对照者差,并涉及到心身健康的多个方面。     

医院职工个性特征、职业应激、应对方式与心理压力的相关性

目的:分析医院职工个性特征、职业应激、应对方式与心理压力的相关性。方法:采用分层随机抽样法选择我院在职职工为研究对象,共发放130份问卷,实际纳入分析120份,采用中文版知觉心理压力量表(CPSS)评价心理压力,采用艾森克人格问卷(EPQ)评价个性特征[精神质(EPQ-P)、内外向(EPQ-E)、神经质(EPQ-N)],采用职业应激量表(OSI)评价职业应激,采用简易应对方式问卷(SCSQ)评价应对方式,并采用Spearman相关性分析CPSS心理压力评分与个性特征、职业应激、应对方式的相关性。结果:120例调查者CPSS评分显著高于全国常模,差异有统计学意义(t=8.738,P0.05);其中CPSS评分≥26分者65例(54.17%),将其纳为压力组。余下CPSS评分26分者55例(45.83%),将其纳为非压力组;压力组EPQ-P评分、职业应激评分、每日紧张感评分及积极应对评分显著高于非压力组,EPQ-E评分及消极应对评分显著低于非压力组,差异有统计学意义(t=-8.830,-10.306,-10.756,9.280,8.960,-6.729;P0.05);Spearman相关性分析显示,CPSS心理压力评分与EPQ-P(r=0.488)、职业应激(r=0.571)、每日紧张感(r=0.633)及消极应对(r=0.495)呈正相关关系(P0.001),与EPQ-E(r=-0.595)及积极应对(r=-0.633)呈负相关关系(P0.001)。结论:高水平心理压力可导致医院职工情绪不稳定,社交主动性降低,并出现职业应激反应,采用消极应对方式面对工作。     

认知行为治疗对抑郁症患者的疗效及生活质量的影响

目的探讨药物合并认知行为治疗对抑郁症患者的疗效及生活质量的影响。方法将72例抑郁症患者随机分为药物合并认知行为治疗组与药物治疗组,治疗观察8周。于治疗前及治疗2、4、8周末采用汉密尔顿抑郁量表(HAM D-24)、临床疗效总评量表(CG I)与副反应量表(TESS)分别评定疗效与不良反应。于治疗前及治疗8周末采用生活质量综合评定问卷(GQOL-74)评定患者生活质量。结果①治疗8周末两组HAM D评分有显著性差异(t=5.12,P<0.01);②两组G I评分治疗6、8周末组间比较有显著性差异(t=2.22,2.65;P<0.05),E I评分治疗8周末组间比较有显著性差异(t=1.95,P<0.05);③研究组治疗8周末除物质生活维度外,其他3个维度评分与对照组比较均有显著性差异(t=2.24,3.34,2.46;P<0.05)。结论药物合并认知行为治疗可提高抑郁症的治疗效果和生活质量。     

米氮平和氯米帕明对抑郁症患者生活质量的影响

目的比较米氮平和氯米帕明治疗对抑郁症患者生活质量的影响。方法将符合CCMD-3诊断标准的抑郁症患者48例随机分组,分别使用米氮平(23例)、氯米帕明(25例)治疗,随访6个月。以汉密顿抑郁量表(HAMD)评定疗效,以精神药物不良反应量表(TESS)评定不良反应,以生活质量综合评定问卷(GQO-LI)评定生活质量。结果6个月后,米氮平组HAMD评分(9.4±3.4)低于氯米帕明组(14.2±3.5,t=3.42,P<0.05);GQOLI评分(196.2±10.1)高于氯米帕明组(170.7±19.9,t=7.62,P<0.01);不良反应较氯米帕明组少。治疗前后相比,米氮平组患者的GQOLI总分升高(165.2±21.9,196.2±10.1,P<0.01)。氯米帕明组患者GQOLI总分变化(166.4±19.6,170.7±19.9)不显著(P>0.05)。结论米氮平治疗抑郁症疗效好,不良反应少,对患者生活质量的改善作用优于氯米帕明,有利于患者重返社会。     

火车司机人格特质对婚姻质量的影响

目的探讨火车司机人格特质对婚姻质量的影响,为婚姻咨询和心理健康教育提供参考依据。方法采用Olson婚姻质量问卷(ENRICH)中婚姻满意度、夫妻交流、解决冲突的方式、性生活4因子和艾森克人格问卷(EPQ)测试火车司机335名。结果外向-内向与婚姻质量各因子呈显著正相关(P<0.01);掩饰性与婚姻满意度、夫妻交流、性生活呈显著正相关(P<0.01),与解决冲突的方式呈显著正相关(P<0.05);神经质和精神质与婚姻质量各因子呈显著负相关(P<0.01);外向和低神经质者婚姻满意度、夫妻交流、解决冲突的方式、性生活高于内向和高神经质者(t=4.20,4.95,5.64,4.26,4.77,4.71;P<0.001;t=2.83,P<0.01;t=2.31,P<0.05);低神经质者对婚姻满意度正性评价显著高于高神经质者(t=4.35,P<0.001;t=3.69,3.56,3.33,2.82;P<0.01)。结论火车司机人格特质影响婚姻质量,以神经质为最重要的影响因素。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

The case for allele‐specific recognition by the TCR

There is a sharp difference in how one views TCR structure–function–behaviour dependent on whether its recognition of major histocompatibility complex‐encoded restriction elements (R) is germline selected or somatically generated. The generally accepted or Standard model is built on the assumption that recognition of R is by the V regions of the αβ TCR, which is not driven by allele specificity, whereas the competing model posits that recognition of R is allele‐specific. The establishing of allele‐specific recognition of R by the TCR would rule out the Standard model and clear the road to a consideration of a competing construct, the Tritope model. Here, the case for allele‐specific recognition (germline selected) is detailed making it obvious that the Standard model is untenable.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.