综合性干预模式对OSAHS患者焦虑抑郁情绪及睡眠质量的影响

目的探讨综合性干预模式对阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者焦虑抑郁情绪及睡眠质量的影响。方法60例OSAHS患者,分为观察组与对照组,各30例。两组均进行持续正压气道治疗。对照组：实施常规OSAHS健康教育。观察组：实施综合性干预模式。采用焦虑自评量表（SAS）和抑郁自评量表（SDS）观察OSAHS患者的焦虑抑郁情绪。采用Epworth嗜睡量表（ESS）及匹茨堡睡眠质量指数量表（PSQI）观察OSAHS患者的睡眠质量。结果干预4周后,观察组OSAHS患者的SAS、SDS评分的改善情况优于对照组,差异有统计学意义（P〈0．01—0．05）。干预4周后,观察组OSAHS患者ESS、PSQI评分的改善情况均优于对照组,差异有统计学意义（P〈0．01）。结论综合性干预模式不但能改善OSAHS患者的焦虑抑郁情绪,并还可明显改善患者的睡眠质量。     

医学专科学生睡眠质量与主观疲劳和记忆力的关系

目的：了解医学专科学生睡眠质量与疲劳、学习成绩和记忆能力的关系．方法：采用匹兹堡睡眠质量指数量表（PSQI）和疲劳评定量表（FAI）对福建省4所高校的1602名医学专科学生进行调查,采用再认法对106名学生进行记忆能力测定,采用随访研究方法随访794名学生,追踪记录其期末学习成绩,结果：睡眠质量较差者,疲劳严重度、疲劳结果和疲劳环境特异性等指标得分越高（F=66．684,13．915,18．399;P=0．000,0．000,0．000）,疲劳对休息睡眠的反应得分越低（F=7．373,P：0．000）,疲劳的发生率越高（Χ^2=86．381,P：0．000）．3组不同睡眠质量医学专科学生的具体图片保持量、抽象图片保持量、文字保持量和期末学习成绩间的差异均无统计学意义（F=0．502,0．387,2．002,0．781;P=0．607,0．680,0．140,0．458）．结论：睡眠质量差导致心理疲劳和躯体疲劳,但还未影响到短时记忆能力和学习成绩．     

医学生睡眠质量与焦虑抑郁情绪关系的探讨

目的 研究医学生睡眠质量与焦虑抑郁情绪的相关性,并对影响睡眠质量的有关因素进行探讨。方法 以匹慈堡睡眠质量指数（PSQI）、焦虑自评量表（SAS）、自评抑郁量表（SDS）为评价工具,采用分层整群抽样方法,调查某医学院1－4年级医学本科生睡眠障碍的发生率及分布特征。结果 医学生睡眠障碍的发生率为15．75％,男生（9．42％）女生（6．34％）间无显著性差异。19．18％的学生有抑郁情绪,男女生分别为10．10％和9．08％（P＜0．05）,15．75％的学生存在焦虑,并且10．27％的学生焦虑、抑郁情绪并存。PSQI总分与SAS、SDS得分均呈显著正相关。回归分析表明,影响PSQI总分的因素依次为睡眠效率、睡眠障碍、入睡时间、睡眠质量、日间功能、催眠质量、日间功能、催眠药物、睡眠时间。结论 焦虑、抑郁情绪是影响医学生睡眠质量的重要因素,提高医学生的心理素质,增强其适应环境的能力,对于保持良好的健康状态是十分必要的。     

基于合理信念替代疗法的心理护理干预对男性海军舰员心理健康的影响

目的 探讨基于合理信念替代疗法的心理护理干预对男性海军舰员心理健康的影响。方法 随机选取2021年1月至2022年1月期间进行心理咨询的200例男性海军舰员作为研究对象;采用随机数字表法将其分为对照组和干预组各100例,干预组给予合理信念替代疗法联合心理护理干预,对照组给予常规心理护理干预。比较2组不同心理干预时期的焦虑程度、抑郁程度,睡眠质量评分。结果 干预后1个月、3个月,干预组抑郁自评量表（SDS）评分、焦虑自评量表（SAS）评分和匹兹堡睡眠质量指数（PSQI）评分均低于对照组（P<0.05）。结论 基于合理信念替代疗法的心理护理干预可缓解海军舰员的不良心理情绪,改善其睡眠质量,值得推广。     

心理干预对脑卒中继发抑郁失眠患者的效果

[目的]探讨心理干预对脑卒中抑郁失眠患者的效果。[方法]对94例脑卒中抑郁失眠患者按入院时间的先后顺序分为观察组与对照组,观察组46例在常规药物治疗基础上实施心理干预,对照组48例在常规药物治疗基础上按常规护理,应用匹兹堡睡眠指数量表（PSQI）、汉密顿抑郁量表（HAMD）评定效果。[结果]干预后两组PSQI、HAMD评分较前明显改善（ P ＜0．05）,观察组睡眠及抑郁改善程度更优于对照组（ P ＜0．05）。[结论]心理干预对脑卒中继发抑郁失眠患者的睡眠,促进脑卒中继发抑郁失眠患者的心理及身体康复。     

孕妇的主观睡眠质量及心身状况的对照研究

目的 了解孕妇在妊娠期的主观睡眠质量及心身状况。方法 采用匹兹堡睡眠质量指数量表（PSQI）、焦虑自评量表（SAS）、状态－特质焦虑量表（STAI）、抑郁自评量表（SDS）及症状自评量表（SCL－90）评定孕妇组与对照组的睡眠及心身状况。结果 与对照组相比,孕妇组PSQI主观睡眠质量、睡眠紊乱因子分高,睡眠时间、白天功能紊乱因子分低（P＜0．05）;SAS总分、STAI总分、状态焦虑因子分高,非状态焦虑因子分低（P＜0．05）;SDS躯体化障碍因子分高,精神情感症状因子分低（P＜0．05）;SCL－90躯体化因子分高,人际关系因子分低（P＜0．05）。结论 孕妇在妊娠期有明显的睡眠紊乱、焦虑及躯体化症状。     

八段锦对肿瘤相关负性情绪管理的应用

目的 探究八段锦运动对肿瘤患者的睡眠、焦虑以及抑郁等负性情绪的影响。方法 将符合纳入标准的恶性肿瘤患者36例,随机分成对照组和试验组,每组18例。对照组采用常规心理宣教,试验组在对照组基础上进行8周的八段锦干预。以问卷调查的形式,记录干预前后的睡眠质量指数（PSQI）、焦虑指数（SAS）与抑郁指数（SDS）、不良反应及并发症发生情况。结果 通过心理宣教和八段锦干预以后,试验组SAS、SDS评分低于干预前与对照组,差异均有统计学意义（P<0.05或0.01）;PSQI评分稍低于对照组,但差异无统计学意义（P>0.05）。两组未出现不良反应及并发症。结论八段锦对改善肿瘤患者的睡眠、焦虑、抑郁等负性情绪有一定的疗效,且安全性良好。     

SOR护理对高龄产妇产后抑郁发生率的影响研究

目的 探讨基于刺激–有机体–反应（stimulus-organism-response，SOR）理论的护理对高龄产妇产后抑郁发生率的影响。方法 选取2020年5月至2022年5月浙江大学医学院附属第二医院临平院区收治的高龄产妇102例，用Excel 2010软件生成随机数字，采用简单随机化法分为试验组和对照组，每组各51例。分娩前至产后42d，对照组实施常规护理干预，试验组实施SOR理论的护理干预。观察分析两组产后抑郁发生率、护理满意度、生活质量、护理质量、爱丁堡产后抑郁量表（Edinburgh postnatal depression scale，EPDS）及匹兹堡睡眠质量量表（Pittsburgh sleep quality index，PSQI）评分情况。结果 干预后，试验组产后抑郁发生率低于对照组[5.88%（3/51）vs. 27.45%（14/51）]，差异有统计学意义（2=5.371，P<0.05）；试验组护理总满意度度高于对照组[98.04%（50/51）vs. 76.47%（39/51）]，差异有统计学意义（2=6.287，P<0.05）；试验组生活质量（社会功能、躯体功能、心理功能、物质生活）评分均高于对照组，差异有统计学意义（P<0.05）；试验组护理质量（专业技能、医疗环境、医患关系、服务态度）均高于对照组，差异有统计学意义（P<0.05）；试验组EPDS评分及PSQI评分均低于对照组，差异有统计学意义（P<0.05）。结论 高龄产妇实施SOR护理可以显著减少产后抑郁的发生，提升护理质量与满意度，改善睡眠质量和生活质量，值得应用。     

松静诱导康复训练结合风险质控对脑卒中患者负性情绪及睡眠质量的影响

目的:探讨松静诱导训练结合风险质控对脑卒中恢复期患者负性情绪及睡眠质量的影响。方法:选取2018年1月至2020年6月浙江省金华市人民医院神经内科收治的90例脑卒中患者,按照入院时间分为两组,每组各45例。对照组使用常规干预,试验组在对照组干预基础上使用松静诱导训练干预措施。统计两组治疗前后的匹兹堡睡眠质量指数量表(PSQI)、医院焦虑抑郁量表(HADS)、脑卒中专用生活质量量表(SS-QOL)评分变化情况及干预效果情况。结果:两组治疗前的PSQI、HADS及SS-QOL评分比较,差异均无统计学意义(P>0.05);干预后,试验组的匹兹堡睡眠质量指数(PSQI)7个维度评分及总分均低于对照组,差异有统计学意义(P<0.05)。在焦虑抑郁(HADS)评分方面,干预后,试验组的得分显著低于对照组,差异有统计学意义(P<0.05);试验组的干预效果优于对照组,差异有统计学意义(P<0.05)。结论:对脑卒中患者进行松静诱导训练结合风险质控干预,可显著降低患者的焦虑与抑郁水平,提升睡眠质量,改善患者的生活质量。     

心理行为干预模式对冠心病住院期失眠患者的效果分析

目的探讨适合冠心病住院期失眠患者的心理行为干预模式并评价其临床效果,为开展有效的护理干预提供依据。方法采取主观抽样的方法,抽取研究对象110例,干预组56人,对照组54人。对照组给予常规护理,干预组在常规护理基础上实施心理行为干预模式。两组被试干预前后分别应Zung焦虑自评量表（SAS）、抑郁自评量表（SDS）及匹兹堡睡眠质量指数量表（PSQI）进行情绪及睡眠质量的测评。结果干预组与对照组睡眠质量、焦虑及抑郁情绪在时间和分组因素上均存在交互作用,差异有统计学意义（P〈0.05）。简单效应分析对照组干预前后睡眠质量得分差异具有统计学意（P〈0.05）。而干预后干预组被试焦虑、抑郁情绪及睡眠质量得分较对照组明显改善（P〈0.01）。结论心理行为干预模式有助于改善冠心病住院期失眠患者的负性情绪及睡眠质量,具有较好的可行性和有效性。     

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.