团体心理咨询干预银屑病患者病耻感的效果研究

目的 探讨基于ABC情绪理论和认知行为理论的团体心理咨询干预对寻常型银屑病患者病耻感、应对方式及生活质量的改善效果。方法 选取2019年5—9月大连市皮肤病医院住院治疗的40例寻常型银屑病患者,实施基于ABC情绪理论和认知行为理论的团体心理干预8次,应用银屑病患者病耻感体验问卷中文修订版、医学应对量表、皮肤病生活质量指数对患者病耻感、应对方式和生活质量进行评价。结果 共38例患者完成本研究,干预后除了拒绝维度,银屑病病耻感总分及其他各维度评分显著升高,差异有统计学意义(P 0.05)。应对方式中面对得分明显升高,屈服和回避得分明显降低,差异均有统计学意义(P 0.05)。生活质量各维度得分及总分均降低,且差异有统计学意义(P 0.05)。结论 基于ABC情绪理论和认知行为理论的团体心理干预可以改善寻常型银屑病患者的病耻感、应对方式和生活质量,为银屑病患者的心理支持和疾病应对护理提供参考。     

康复期精神分裂症患者病耻感与人格的相关分析

目的探讨康复期精神分裂症患者病耻感的现状及其与人格的关系。方法采用随机抽样的方法,对118名康复期内精神分裂症患者采用贬低-歧视感知量表、艾森克人格问卷(EPQ-88)以及一般情况调查表进行问卷调查。结果康复期精神分裂症患者的病耻感水平较高,女性的病耻感水平显著高于男性,外倾性与神经质可预测康复期精神分裂症患者的病耻感水平。结论康复期精神分裂症患者的病耻感水平与其人格的不同因子存在着明显的相关。     

正念减压疗法对永久性肠造口病人病耻感、焦虑抑郁及生活质量的影响

目的 探讨正念减压疗法对永久性肠造口病人病耻感、焦虑抑郁程度及生活质量的影响。方法 采用便利抽样,选择四川大学华西医院腹部肿瘤科2017年3—10月接受放化疗的永久性肠造口病人96例,按病区分为治疗组及对照组,各48例。对照组接受常规护理,治疗组在常规护理的同时接受8周正念减压疗法。在干预前、干预完成时及干预完成后3个月,使用社会影响量表(SIS)、医院焦虑抑郁量表(HADS)、造口病人生活质量量表(Stoma-QOL)进行评定。结果 8周正念减压干预后,治疗组病人SIS 总分得分为(53.20±6.47)分,HADS-A得分为(6.71±3.40)分,HADS-D得分为(6.51±3.05)分,Stoma-QOL得分为(49.16±6.97)分;干预完成后3个月,治疗组病人SIS 总分得分为(48.20±5.69)分,HADS-A得分为(6.13±3.45)分,HADS-D得分为(5.58±3.26)分,Stoma-QOL得分为(50.75±6.82)分;两组病人病耻感总分组间比较、时间比较、分组与时间的交互作用差异有统计学意义(均P＜0.001);两组病人的焦虑得分的组间比较、时间比较、分组与时间的交互作用差异有统计学意义(P＜0.001,P=0.009,P＜0.001);两组病人的抑郁得分的组间比较、时间比较、分组与时间的交互作用差异有统计学意义(P＜0.001,P=0.035,P=0.004);两组病人生活质量得分的组间比较、时间比较、分组与时间的交互作用差异有统计学意义(P＜0.001,P=0.006,P＜0.001)。结论 正念减压疗法能有效缓解永久性肠造口病人的病耻感及焦虑抑郁情绪,提高其生活质量。     

抑郁症残留症状患者家属心理健康和应对方式的调查研究

调查抑郁症残留症状患者家属的心理健康状况及其应对方式特征。选取2016年1月至2017年12月期间我所接受治疗后的抑郁症残留症状患者家属71例,使用SCL-90量表对家属的心理健康状况进行评估,使用SCSQ量表对家属的应对方式进行评估,将评估结果与全国常模进行对比。患者家属的SCL-90量表总分显著高于全国常模水平,差异有统计学意义（P＜0.05）,其中,抑郁、焦虑、躯体化以及精神病性等因子评分与全国常模数值差异较大,有统计学意义（P＜0.05或P＜0.01）;患者家属的积极应对评分显著低于全国常模水平（P＜0.01）,消极应对评分显著高于全国常模水平,差异有统计学意义（P＜0.05）。抑郁症残留症状患者家属的心理健康状况不理想,在某些因子上存在问题,应对方式上也呈现消极化趋向,应该给予科学的心理支持及应对方式指导,改善其心理健康状况。     

肛周脓肿患者生命质量现状及其影响因素分析

目的 对肛周脓肿患者的生命质量进行现状调查、分析探讨其生命质量的影响因素。方法 选取2021年1月—2022年3月就诊于本院的92例肛周脓肿患者为研究对象,采用一般资料问卷、病耻感量表、症状困扰量表、生命质量量表对入组肛周脓肿患者进行问卷调查。采用Pearson相关分析方法分别分析病耻感、症状困扰与生命质量间的相关性。结果 本研究共纳入92例肛周脓肿患者,Pearson相关分析：病耻感得分与生命质量得分间呈负相关（r=-0.415,P=0.002）;症状困扰得分与生命质量得分间呈负相关（r=-0.456,P=0.004）,相关关系均存在统计学意义。回归分析如下：固定职业、收入高、病耻感得分低、症状困扰得分低是肛周脓肿患者生命质量得分高的影响因素（P <0.05）。结论 临床护理人员应根据肛周脓肿患者的具体情况,了解患者存在的病耻感程度,给予足够的情感、信息支持,适当增加心理护理,积极与高危人群进行沟通,有利于降低患者病耻感水平,针对症状高发人群采取积极应对处理,对提高肛周脓肿患者生命质量水平有积极意义。     

哮喘患者病耻感现状及其影响因素分析

目的 调查哮喘患者病耻感现状及其影响因素。方法 采用便利抽样法,选取2022年9月15日至2023年2月15日在徐州医科大学附属医院就诊的哮喘患者为研究对象。采用一般资料调查表、中文版慢性疾病病耻感量表、社会支持评定量表、一般自我效能量表对哮喘患者进行问卷调查,分析其病耻感的影响因素。结果 共纳入哮喘患者145例。患者的病耻感得分为（50.26±24.38）分。Pearson相关分析显示,社会支持总分、客观支持、主观支持、自我效能与病耻感总分均呈负相关（P <0.05）;不同性别、职业、人均月收入、运动情况、病史,是否规律服药、是否有诱因的病耻感总分差异具有统计学意义（P <0.05）;性别、人均月收入、社会支持为哮喘患者病耻感的独立影响因素（P <0.05）。结论 哮喘患者病耻感处于中等水平,应重点关注男性、低收入及低社会支持等高危因素人群,降低哮喘患者病耻感水平。     

康复期精神分裂症患者心理状况分析

目的 研究康复期精神分裂症患者的心理状况,分析影响因素,建立有效的心理干预措施.方法 采用症状自评量表(SCL-90)对90例康复期精神分裂症患者进行心理测试,并与国内常模进行对照.结果 康复期精神分裂症患者在躯体化、强迫、恐怖、抑郁、焦虑、和人际关系6个因子的得分与国内常模比较差异有显著性意义(P＜0.01或P＜0.05).结论 康复期精神分裂症患者存在心理问题较多,应积极采取有效的干预措施,加强心理治疗,改善其心理状况.     

军人职业倦怠与情境特质应对方式的相关性研究

目的 探讨官兵职业倦怠和情境特质应对方式状况及两者之间的关系,为减轻官兵职业倦怠提供参考依据.方法 使用军人职业倦怠量表和军人情境特质应对方式量表对南京军区某部508名陆军官兵进行调查,分别使用描述性统计分析、独立样本t检验、相关分析及多元线性回归分析等方法处理.结果 (1)已婚官兵成就感显著低于未婚官兵,躯体化程度显著高于未婚官兵(P＜0.05);(2)未婚官兵积极应对总分、个人发展积极应对、人际关系积极应对和健康及经济积极应对因子分显著高于已婚官兵(P＜0.05);高中及以下官兵情感消极显著低于大专及以上官兵,个人发展积极显著高于大专及以上官兵(P＜0.05);(3)职业倦怠总分及各因子分与消极应对和积极应对总分及各因子分均呈显著相关性(P＜0.01);(4)对影响官兵职业倦怠因素的逐步回归分析显示:消极应对、个人发展积极应对、个人发展消极应对、情感消极应对、人际关系积极应对和健康及经济积极应对进入职业倦怠的回归方程(P＜0.05或0.01).结论 官兵情境特质应对方式诸因子对职业倦怠具有明显预测作用.     

强制治疗精神病人家属感知病耻感的调查分析

目的：探讨强制精神病病人的家属病耻感及有关因素。方法：调查127例住院3—30年的强制精神病病人及其家庭监护人,其中精神分裂症69例,癫痫性精神障碍35例,情感性精神障碍11例,精神发育滞迟12例。采用Link的贬低一歧视感知量,对其家属作病耻感问卷（FSI）调查。结果：按住院时段总体家属病耻感评分,均分为2．53±0．26分,评分低于北京市某精神病医院精神分裂症患者家属的调查（2．60±0．40）分,与量表中点2．50比较,差异仍有统计学意义（t=2．52,p〈0．05）。多元分析显示,患者住院时间较长,家属的低学历以及家庭的低收入是感知病耻感的影响因素。结论：病耻感依然普遍存在于监管精神障碍患者的家庭,社会地位较高者尤为显著。     

心理健康教育多元家庭治疗对严重精神障碍患者病耻感影响效果研究

目的 了解心理健康教育多元家庭治疗对严重精神障碍患者病耻感的影响效果,从而分析其在严重精神障碍患者管理中的作用.方法 采用随机抽样的方法,在《国家严重精神障碍信息系统》中的衡水市11个县市区农村重性精神疾病患者中抽取确定100例居家治疗的严重精神障碍患者,随机分为研究组和对照组,每组50例,分别采用心理健康教育多元家庭治疗模式和常规社区管理模式对其及家属进行干预,干预前和干预12个月后分别用精神病患者病耻感评估量表和个人和社会功能量表(PSP)进行测评,评价患者病耻感和生活质量,以评价干预效果.结果干预前,2组患者病耻感、PSP评分比较差异无统计学意义(P>0.05),干预后,2组患者病耻感、PSP评分明显优于干预前(P<0.05),且研究组患者病耻感不论是社交、能力、治疗3个因子分还是总分均低于对照组,个人和社会功能量表得分高于对照组(P<0.05).结论 心理健康教育多元家庭治疗在一定程度上能减少家属对精神病患者的歧视,减轻患者病耻感,改善患者生活质量,促进康复. 提示心理健康教育多元家庭治疗对严重精神障碍患者管理的作用应引起重视.     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.