淮安市中老年农村居民图片记忆能力及相关因素

背景：人的记忆与认知功能显著相关，认知功能的下降往往首先表现为记忆能力的下降。农村人口的记忆能力如何？目的：分析淮安市50岁以上农村居民图片记忆的影响因素。单位：南京医科大学附属淮安第一医院老年科，复旦大学附属华山医院神经内科。对象：调查样本来源于2003—03／2004—02南枣医科大学附属淮安第一医院老年科住院好转将出院的农村患者（n=50）、患者家属（n=11）以及淮阴区丁集乡宗楼村的健康老人（n=55），年龄均〉50岁。方法：采用问卷调查的方法，对所有样本进行简易智能状态检查、听觉词语学习测验、图片学习测验及多种非记忆测验。按照文化程度的不同将调查对象分为文盲组、小学组、初中及以上文化组。比较图片记忆能力与性别、年龄、教育程度和简易智能状态检查的相关性，以及图片记忆各指标的内部相关性。主要观察指标：淮安市农村居民，图片记忆各指标与年龄、性别、教育程度、简易智能状态检查相关性。图片记忆各指标内部相关性。结果：按实际完成处理，纳入结果分析的样本量为103例。①图片记忆各指标与年龄、性别、教育程度、简易智能状态检查相关性：图片记忆各指标中除图片再认外与简易智能状态检查及教育程度均呈显著正相关（r=0．197-0.533,P〈0．05-0．01），其中即刻记忆与简易智能状态检查相关性最大（r=0．533）。图片延时记忆、图片再认及顺序记忆4（延时回忆中后4个图片回忆的数目）与年龄呈负相关（r=--0．194--0324，P〈0．05-0．01），其中顺序记忆4与年龄相关性最大（r=0．324），其余图片记忆指标与年龄不相关；图片记忆各指标与性别均无相关性。图片再认与教育程度1（教育年限0-11年）、2（文化程度为文盲、小学、初中及以上文化）及简易智能状态检查均不相关。②图片记忆各指标内部相关性：除图片再认与顺序记忆2（即刻记忆中后4个图片回忆的数目）不相关、顺序记忆1（即刻记忆中前4个图片回忆的数目）与顺序记忆2，4不相关及顺序记忆3与顺序记忆4不相关性外，其余图片记忆各指标间均有显著相关性（r=0．206-0．855，P〈0．05-0．01）。其中图片延时回忆与概念记忆2相关性最大（r=0．855）。结论：淮安市中老年农村居民图片记忆能力与性别无关，与年龄、教育程度、智能水平有关。     

淮安市中老年农村居民记忆能力及相关因素分析

目的：分析淮安市50岁以上不同文化程度农村居民记忆能力的差异及记忆能力与性别、年龄、教育程度和其他非记忆性指标的相关性。方法：调查样本来源于2003-03／2004-02南京医科大学附属淮安医院老年科住院的农村患者(n=44)或患者家属(n=7)以及淮阴区丁集乡宗楼村的健康老人(n=52)，所有受试对象无明显视觉．听觉障碍和语言交流困难．无严重躯体或精神疾病，2剧内无抑郁和／或焦虑情绪、年龄均&;gt;50岁。按照文化程度的不同将116例调查对象分为文盲组．小学组、初中及以上文化组。采用问卷调查的方法，对所有受试对象进行简易智能量表、听觉词语学习测验、图片学习测验及多种非记忆测验。比较不同文化程度调查对象之间的记忆能力差异及记忆能力与性别、年龄、教育程度和其他非记忆性指标的相关性。结果：按实际处理分析，共有103例受试对象(文盲组51例、小学组29例、初中及以上文化组22例)完成所有调查，数据纳入结果分析。①淮安市文化程度高的农村居民在图片即刻回忆、听觉词语即刻回忆2(第2次完整复述语句)、听觉词语即刻回忆3(第3次完整复述语句)及言语流畅性1(1min列举动物名称)方面记忆功能好于文化程度低的农村居民．差异有显著性意义(F=5．91，3．66，4．94，18．53；P&;lt;0．05～0．01）。②所有记忆指标与性别均无相关性(r=-0．144～0．164)：听觉语言忆记、图片再认及言语流畅性1与教育程度呈正相关(r=0．203～0.453，P&;lt;0．05～0．01，其中言语流畅性1与教育程度相关性最大(r=0．453)；除身体部位即刻回忆3(第3次1min内回忆5个身体部位)、身体部位延时回忆、言语流畅性2(1min列举蔬菜名称)外所有记忆指标与简易智能量表评分均呈正相关(r=0．209～0．538，P&;lt;0．05～0．01），其中以听觉词语线索回忆与简易智能量表评分相关性最大(r=0538)；各记忆指标除言语流畅性外均与年龄呈负相关(r=-0．222～-0.030，P&;lt;0．05～0．01)，其中图片再认与年龄相关性最大(r=-0.222)。③记忆性指标和各非记忆指标间有显著相关性(r=-0．206～0．607，P&;lt;0．05～001)，其中相似性与言语流畅性1相关性最大(r=0．607)。结论：淮安市文化程度高的中老年农村居民的记忆能力好于文化程度低的农村居民：记忆能力与性别无关．与受教育程度和智能水平呈正相关，但言语流畅性1与教育程度相关性最大，除此之外的各项记忆指标与年龄呈负相关，身体部位记忆中处龄及受教育程度无关，记忆和非记忆能力有相关性。     

淮安市中老年农村居民记忆能力及相关因素分析

目的:分析淮安市50岁以上不同文化程度农村居民记忆能力的差异记忆能力与性别、年龄、教育程度和其他非记忆性指标的相关性。方法:调查样本来源于2003-03/2004-02南京医科大学附属淮安院老年科住院的农村患者(n=44)或患者家属(n=7)以及淮阴区丁乡宗楼村的健康老人(n=52),所有受试对象无明显视觉、听觉障碍语言交流困难,无严重躯体或精神疾病,2周内无抑郁和/或焦虑情绪年龄均>50岁。按照文化程度的不同将116例调查对象分为文盲组小学组、初中及以上文化组。采用问卷调查的方法,对所有受试对象行简易智能量表、听觉词语学习测验、图片学习测验及多种非记忆验。比较不同文化程度调查对象之间的记忆能力差异及记忆能力与别、年龄、教育程度和其他非记忆性指标的相关性。结果:按实际处理分析,共有103例受试对象(文盲组52例、小学组29例初中及以上文化组22例)完成所有调查,数据纳入结果分析。①淮安市化程度高的农村居民在图片即刻回忆、听觉词语即刻回忆2(第2次完复述语句)、听觉词语即刻回忆3(第3次完整复述语句)及言语流畅1(1min列举动物名称)方面记忆功能好于文化程度低的农村居民,差有显著性意义(F=5.91,3.66,4.94,18.53;P<0.05～0.01)。②所有忆指标与性别均无相关性(r=-0.144～0.164);听觉语言记忆、图     

2型糖尿病患者尿白蛋白/肌酐比值与认知功能的相关性

目的探讨2型糖尿病患者尿微量白蛋白/肌酐比值与认知功能的相关性。方法 136例2型糖尿病患者,根据尿微量白蛋白/肌酐比值分为A(≤30mg/g),B(>30～300mg/g),C(>300mg/g)组,并依据是否合并糖尿病视网膜病变分为视网膜病变组和非视网膜病变组,以认知功能问卷调查方式进行认知功能评定,分析糖尿病患者认知功能同尿微量白蛋白/肌酐比值的相关性。结果 A,B,C组简易智能状态量表总分、听觉词语即刻记忆3个、身体部位延时记忆、指图总耗时、图片补缺、图片误认数、图片延时记忆、图片即刻记忆以及数字广度等比较差异有统计学意义(P<0.05);3组高血压病程、收缩压、C-反应蛋白及胰岛素抵抗指数等比较差异有统计学意义(P<0.05);尿微量白蛋白/肌酐比值及糖尿病视网膜病变与收缩压呈正相关(r=0.322,r=0.231),与胰岛素抵抗指数及伴冠心病呈正相关(r=0.309,r=0.302);微血管病变、是否伴冠心病与配偶健康程度3个自变量对该模型具有统计学意义(P<0.05)。结论糖尿病血管病变与患者尿微量白蛋白/肌酐比值有密切相关性;尿微量白蛋白/肌酐比值与胰岛素抵抗指数呈正相关;2型糖尿病早期有微量白蛋白尿时已发生认知功能变化,应尽早进行预防并治疗。     

八段锦对轻度认知障碍患者记忆力影响的系统评价与Meta分析

目的系统评价八段锦对轻度认知障碍(mild cognitive impairment,MCI)患者记忆力的康复效果。方法计算机检索数据库中与八段锦对MCI患者记忆力影响有关的临床随机对照试验,纳入的文献使用Cochrane系统评价手册中的文献质量评价标准进行质量评价,记忆力相关指标运用RevMan 5.4软件进行Meta分析。结果最终纳入9篇研究,共计588例,Meta分析结果显示,八段锦干预后,MCI患者的AVLT延时回忆评分[MD=2.49,95%CI(2.11,2.86),P<0.001],延时再认评分[MD=1.65,95%CI(1.35,1.96),P<0.001],即刻回忆中第一遍回忆评分[MD=1.94,95%CI(1.14,2.73),P<0.001],即刻回忆中第二遍回忆评分[MD=2.00,95%CI(1.15,2.84),P<0.001],即刻回忆中第三遍回忆评分[MD=2.30,95%CI(1.44,3.15),P<0.001];WMS-RC理解记忆[MD=1.83,95%CI(1.35,2.30),P<0.001],图片回忆[MD=2.00,95%CI(1.28,2.72),P<0.001],联想记忆[MD=1.73,95%CI(1.13,2.33),P<0.001],背数[MD=1.60,95%CI(0.90,2.31),P<0.001],心智1-100[MD=1.95,95%CI(0.62,3.29),P=0.004],心智100-1[MD=1.71,95%CI(0.28,3.14),P=0.02],图片再认[MD=1.74,95%CI(0.46,3.01),P=0.008]。与对照组相比差异均具有统计学意义(P<0.05)。结论八段锦可有效改善MCI患者的记忆力。     

帕金森病患者脑白质疏松与认知功能损害的相关性及影响因素分析

目的探讨帕金森病(Parkinson's disease, PD)患者脑白质疏松(white matter hyperintensities, WMH)程度与认知功能损害的相关性及影响因素。方法 125例PD患者根据Fazekas量表评分分为轻度WMH组79例,中度WMH组26例,重度WMH组20例。比较3组临床资料、PD统一评分量表运动症状(UPDRS-PartⅢ)评分、24项汉密尔顿抑郁量表评分、14项汉密尔顿焦虑量表评分、Hoehn-Yahr(H-Y)分级、简易智能状态检查量表评分、蒙特利尔认知评估量表评分;Pearson相关分析WMH严重程度与简易智能状态检查量表评分、蒙特利尔认知评估量表评分的相关性;多因素logistic回归分析PD患者发生重度WMH的影响因素。结果轻、中、重度WMH组性别比例、吸烟比率、饮酒比率、24项汉密尔顿抑郁量表评分、14项汉密尔顿焦虑量表评分比较差异均无统计学意义(P0.05);轻、中、重度WMH组年龄、受教育时间、病程两两比较差异均有统计学意义(P0.05);重度WMH组高血压、糖尿病比率及UPDRS partⅢ评分、H-Y分级[85.0%、65.0%、(51.50±23.02)分、(3.08±0.80)级]高于中度WMH组[53.8%、46.2%、(42.58±15.33)分、(2.52±0.64)级]和轻度WMH组[39.2%、32.9%、(34.03±17.69)分、(2.16±0.88)级](P0.05),中度WMH组高于轻度WMH组(P0.05);重度WMH组简易智能状态检查量表评分、蒙特利尔认知评估量表评分[(21.70±3.91)、(21.25±4.49)分]低于中度WMH组[(24.65±2.88)分、(23.92±3.06)分]和轻度WMH组[(26.71±3.44)、(25.76±3.73)分](P0.05),中度WMH组低于轻度WMH组(P0.05)。PD患者WMH严重程度与简易智能状态检查量表评分、蒙特利尔认知评估量表评分均呈负相关(r=-0.497,P0.001;r=-0.428,P0.001)。年龄(OR=5.411,95%CI:1.237～23.678,P=0.025)、受教育时间(OR=0.134,95%CI:0.024～0.751,P=0.022)、病程(OR=7.780,95%CI:1.526～39.656,P=0.014)、高血压(OR=4.656,95%CI:1.134～19.122,P=0.033)、H-Y分级(OR=10.519,95%CI:1.604～68.967,P=0.014)是PD患者发生重度WMH的影响因素。结论 WMH可加重PD患者认知功能损害,高血压、年龄、病程、受教育时间、H-Y分级与重度WMH发生有关。     

帕金森病患者的记忆障碍及相关因素研究

目的研究帕金森病患者记忆障碍的特点及影响因素。方法155 例帕金森病患者分为4 个年龄组,进行临床记忆量表测评及汉密尔顿抑郁、焦虑量表测评。结果帕金森病患者记忆商明显低于全国常模(P<0.01);帕金森病患者各年龄组联想学习、指向记忆、图像自由回忆及人像特点联系回忆得分均明显低于常模(P<0.01),而无意义图形再认仅在帕金森患者50 岁组得分高于常模(P<0.05);帕金森病患者的记忆商与文化程度及抑郁或焦虑情绪明显相关(P<0.01),而与年龄、性别、病程不相关(P>0.05)。结论帕金森病患者记忆商明显较低,尤其是联想学习、指向记忆、图像自由回忆及人像特点联系方面;帕金森病患者记忆商与文化程度及抑郁焦虑情绪明显相关。     

广西壮族自治区巴马县甲篆乡壮族老人认知功能的筛查结果分析

目的:调查广西壮族自治区巴马长寿地区65岁上老人的认知功能,探讨应用中文版简易智能状态检查对农村壮族老人进行认知功能筛查的可行性。方法:于2004-03-12/03-28在广西壮族自治区巴马县甲篆乡以村委会为单位进行整群抽取65岁以上老人320人。应用长寿地区老人心理健康调查表,包括人口学资料,国际通用的标准化工具中文版简易智能状态检查等。中文版简易智能状态检查分两阶段进行调查,第一阶段为对每个调查对象逐个进行检查。其阳性分值由教育程度决定,文盲组即文化程度<1年,中文版简易智能状态检查总分<17分;小学组即文化程度1～6年,总分<20分;中学组即文化程度>7年,总分<24分为阳性。第二阶段为对第一阶段中文版简易智能状态检查阳性的调查对象进行神经心理测试和精神检查,最后确定诊断进行痴呆分型。不改变量表内涵的前提下对量表的内容进行适当的修改。中文版简易智能状态检查的一致性测验组内相关系数(ICC)为0.89。采用描述性统计分析、卡方检验、t检验、多元逐步回归分析等统计方法。结果:发放问卷320份,剔除资料填写不全问卷2份,收回合格问卷318份,有效率99.4%。①中文版简易智能状态检查结果:文盲组(19.37±4.28)分,小学组(24.82±3.84)分,中学组(25.13±5.19)分;阳性检出率文盲组最高,中学组次之,小学组最低。②男性的中文版简易智能状态检查总分显著高于女性,差异有显著性意义犤(22.33±5.61),(19.12±3.53),P<0.01犦。③65～74岁、75～79岁、80～84岁3组间中文版简易智能状态检查总分接近,差异无显著性意义;超过85岁后,随着年龄的增长,中文版简易智能状态检查总分逐渐减少。④本调查最后被确诊为痴呆的被试仅2人,总分阳性者80人,据此得到中文版简易智能状态检查的敏感性为100%和特异性为75.3%。⑤影响认知功能的Logistic多元逐步回归分析得到回归方程:Y(年龄)=91.204 4.196×(是否经常锻炼身体)-1.827×(受教育程度)-3.357×(自我心理感觉) 1.527×(与邻居见面次数),提示该地区老人的年龄与是否经常锻炼及到邻居家拜访的间隔时间成正相关,与受教育程度、自我心理感觉成负相关。结论:广西壮族自治区巴马县甲篆乡老人总体认知功能良好,中文版简易智能状态检查的敏感性较高而特异性较低。适用于农村老人认知功能筛查。     

医护人员慢性疲劳综合征的情绪记忆改变

目的研究医护人员慢性疲劳综合征(chronic fatigue syndrome,CFS)的情绪记忆改变,初步探讨不同情绪效价对CFS的记忆特点及可能的神经机制。方法使用不同效价的情绪图片学习-再认任务分别对36名CFS患者及年龄、性别、受教育程度相匹配的36名对照进行情绪记忆测试。结果学习阶段,CFS组的情绪图片评分成绩[分别为正性(11.08±3.16)分,中性(11.31±2.70)分,负性(11.61±2.63)分]与对照组相比[分别为正性(11.28±3.15)分,中性(11.03±2.90)分,负性(12.33±2.13)分],差异无统计学意义(均P0.05)。在再认阶段,CFS组总情绪图片再认正确得分较对照组明显下降[分别为CFS组(39.39±4.33)分和对照组(41.94±3.54)分],差异有统计学意义(P0.05)。CFS组对不同效价情绪图片再认存在分离现象,相对于正常对照组,CFS组在正性情绪图片再认[分别为CFS组(12.47±2.27)分,对照组(13.58±2.05)分]和中性情绪图片再认[分别为CFS组(12.94±2.16)分,对照组(13.97±2.08)分]正确得分明显下降,差异有统计学意义(均P0.05);而两组负性情绪效价图片的再认正确得分[分别为CFS组(13.97±1.77)分,对照组(14.39±1.68)分]的差异无统计学意义(P0.05)。结论 CFS存在情绪记忆的损害,主要表现为正性、中性情绪记忆受损,而负性情绪记忆相对保留。     

脑静息态功能磁共振局部一致性分析在轻度认知障碍患者中的初步研究

目的利用局部一致性(regional homogeneity,ReHo)分析方法来探讨轻度认知障碍(mild cognitive impairment,MCI)患者局部自发脑活动特点,并进一步探讨相应脑区ReHo值改变与认知功能及临床生理指标的相关性。材料与方法39例被试入组,其中临床诊断的MCI患者17例,年龄、性别及受教育年限相匹配的健康志愿者22例,所有受试者均行静息态功能磁共振成像(resting-state fMRI,rs-fMRI)扫描,采用rs-fMRI的ReHo分析方法,比较静息状态下MCI患者与健康志愿者ReHo值存在差异的脑区,对存在显著差异脑区的ReHo值与认知评估量表及临床生理指标进行相关分析。结果与正常对照比较,MCI组右侧岛叶、左侧小脑半球、旁扣带回、颞下回、左右梭状回ReHo值升高;而左侧颞上回、右侧背外侧额上回ReHo值降低。所有被试蒙特利尔认知评估量表(montreal cognitive assessment scale,MoCA)评分与右侧脑岛区(r=-0.487,P=0.002)ReHo值呈负相关,与左侧颞上回(r=0.610,P<0.001)及右侧背外侧额上回(r=0.475,P=0.002)呈正相关。所有被试简易智能状态检查量表(mini mental status examination,MMSE)评分与左侧小脑上回(r=-0.407,P=0.010)呈负相关,与左侧颞上回(r=0.466,P=0.003)呈正相关。MCI组右侧岛叶ReHo值与血浆果糖胺浓度呈负相关(r=-0.630,P=0.007),左侧小脑半球ReHo值与血清肌酐浓度呈负相关(r=-0.579,P=0.015)。结论轻度认知障碍患者rs-fMRI的ReHo值有明显改变,并与认知功能改变及临床生理指标存在一定的相关性。     

Zinc protoporphyrin levels, blood lead levels and neurocognitive deficits in Andean children with chronic lead exposure

OBJECTIVES: To investigate the relationship between blood lead (PbB), zinc protoporphyrin (ZPP) levels and performance on a test of auditory memory in Andean children and adolescents with chronic lead (Pb) exposure. DESIGN AND METHODS: PbB and ZPP levels were measured in blood samples from 166 participants (aged 6-16 yrs.) exposed to Pb in a local ceramic glazing cottage industry in Ecuadorian villages. PbB levels and ZPP/heme ratios were analyzed in relation to performance on the Digit Span subtest of the Wechsler IV intelligence scale, a test of auditory memory. RESULTS: Mean PbB level for the study group was 18.0 microg/dL (S.D.: 15.1; range: 3.0-86.0), and the mean ZPP/heme ratio was 105.7 mumol/mol (S.D.: 100.9; range: 36.0-592.0). There was no significant difference in PbB and ZPP levels between the 84 females and the 82 males. The mean Digit Span scale score (DS SS) for the study group was 6.81 (S.D.: 2.95; range: 1.0-17.0), which is below the average score of 10 for the test, with the females performing significantly better than males (t=2.435; p=0.01). Regression analyses revealed statistically significant inverse associations between DS SS and PbB level (r=0.251, p=0.001), and between DS SS and ZPP/heme ratio (r=0.246, p=0.001). CONCLUSION: Elevated PbB levels, representing acute exposure, and ZPP levels, reflecting chronic Pb exposure in this cohort of Andean inhabitants were associated with poor performance on a test of auditory memory, suggesting that the children and adolescents in the study area have neurocognitive deficits that may affect learning.     

The effects of live, taped, and no music on people experiencing posttraumatic amnesia

This study compared the effects of live, taped, and no music, on agitation and orientation levels of people experiencing posttraumatic amnesia (PTA). Participants (N = 22) were exposed to all 3 conditions, twice over 6 consecutive days. Songs used in the live and taped music conditions were identical and were selected based on participants' own preferred music. Pre and posttesting was conducted for each condition using the Agitated Behavior Scale (Corrigan, 1989) and the Westmead PTA Scale (Shores, Marosszeky, Sandanam, Batchelor, 1986). Participants' memory for the music used was also tested and compared with their memory for pictorial material presented in the Westmead PTA Scale. Results indicate that music significantly reduced agitation (p <.0001) and enhanced orientation (p <.001) however, the difference between live and taped music was not significant (p =.7). The mean number of pictures in the Westmead PTA scale recalled was 0.84 and the mean number of music selections recalled was 1.22 but this difference was not significant (p =.7). However, the trend suggests that music selections are more easily encoded in memory and then retrieved on request, than that of pictures. Analysis of responses in a follow-up assessment questionnaire showed that 77% of participants recalled the music program while in PTA, indicating that it reached the memory threshold. Sixty-four percent recalled the live music and 55% recalled the taped music condition however this difference was not significant (p =.7). Results suggest that music therapy programs have an important role to play in the management of people in PTA.     

脑外伤患者部分认知功能的临床观察

27例轻、中、重型脑外伤恢复期患者用韦氏成人智力量表中的有关知识、领悟及图片排列、符号数字转换和移珠、指向记忆、联想学习、图像回忆、人物特征联想回忆、符号划消、词语流畅和阅读流畅性等内容进行了测试。结果表明：脑外伤患者大脑皮层功能很长时间内都遗留着不同程度的记忆力、注意力、信息处理速度及语言流畅等各个方面的功能障碍，与正常人比较差异有显著意义，P＜0．05或0．01。另外脑外伤患者还存在心理方面的障碍，这对今后的研究治疗提供了一个值得探讨的领域。     

首次发作脑梗死患者认知障碍发生率434例分析

背景:出现认知功能障碍是脑卒中生存者功能恢复较差的强预测因子.缺血性脑卒中后认知功能障碍的发生率及可信区间分析对预防脑卒中后发生认知功能障碍及区别老年期认知功能障碍有实用意义.目的:探讨新发缺血性脑卒中患者认知功能障碍的发生率.设计:3个月随访的单因素病例分析.单位:解放军第三军医大学大坪医院野战外科研究所.对象:选择1999-05-08/2000-12-31解放军第三军医大学大坪医院神经内科的急性脑梗死患者434例,男218例,女216例,年龄55～85(70.3±9.5)岁,均为新发脑卒中48 h内入院,并自愿参加此项目.方法:入院时收集患者的人文资料和临床资料.发病后7～10 d和出院后3个月应用简易智能量表(由20题组成,共30项.分为5个方面:定向力、记忆力、计算力及回忆、语言.每项回答正确得1分,回答错误或答不知道评0分,量表总分范围为0～30分)对患者进行认知功能障碍测试.认知功能障碍的诊断标准为脑卒中后3个月简易智能量表分值低于划界值(文盲17分,≤6年受教育水平20分,≥7年受教育水平24分).主要观察指标:①出院后3个月认知功能障碍的发生率.②脑梗死后认知功能障碍患者简易智能量表评分的单因素分析.结果:434例患者均进入结果分析.①出院后3个月434例脑梗死患者中161例被诊断为脑卒中后认知功能障碍,发生率为37.1%(161/434),认知功能正常273例,为62.9%(273/434).②脑梗死后认知功能障碍组的平均年龄明显高于认知功能正常组[(73.0±7.0)岁,(64.5±6.6)岁,t=2.626,P＜0.01].≤6年文化程度者比例显著高于认知功能正常组[45.3%,22.7%,OR=2.823,95%可信区间为1.855～4.297].简易智能量表评分明显低于认知功能正常组[(16.3±8.7)分,(23.4±4.2)分,t=3.352,P＜0.001].结论:老年脑梗死患者认知功能障碍的发生率较高.脑梗死后发生认知功能障碍者年龄明显偏高,接受教育水平明显偏低,提示脑梗死后认知功能障碍与患者的年龄、受教育水平等变量因素有明显的协同效应.     

Memory for stress-associated acute pain.

Negative emotions (eg, tension, anxiety, fear, anger) influence acute pain recall. Given reliance on patient-provided pain reports across the care continuum, an understanding of factors that modulate pain memory processing become important to patients, clinicians, and health care organizations. The purpose of this study was to investigate the influence of negative emotions on the prediction of 6-month pain recall by using an experimental stress manipulation (speech task) + pain (forehead cold pressor) versus nonstress control + pain crossover design (n = 68). Results showed that (1) negative emotions were greater in the stress session than the nonstress session, and experienced pain levels did not differ by condition or sex; (2) the level negative emotions at the time of the pain stimuli mediated the ability of experienced pain to predict pain recall; and (3) women recalled more stress session pain than men, and nonstress pain was accurately recalled. Integrating these findings with those of others, we present a model of acute pain memory recall in which negative emotions influence pain memory processing wherein the level of experienced pain predicts short-term recall and affective state at the time of the experience becomes a powerful predictor for the long-term recall of experienced pain level. PERSPECTIVE: After 6 months the level of recalled experimental pain delivered within a stressful context becomes exaggerated. Negative emotions at the time of the painful stimuli and at recall influenced the prediction of the level of recalled pain. Emotional arousal may influence how memory for pain is encoded, processed, and retrieved.     

A Study on the Theory of Mind Deficits and Delusions in Schizophrenic Patients

Purpose: This study was conducted to find differences between patients with schizophrenia and healthy control group in ToM and to examine relationships among intelligence, ToM, and delusion in patients with schizophrenia. Methods: Data was collected from 50 patients of schizophrenia and 32 healthy subjects. Participants were given the psychological test form with structured questionnaire. The SPSS 22.0 program was used for t-test, ANCOVA, and, Pearson's Correlation. Measurements used for this study were Korean-Wechsler intelligence scale, three types of Theory of Mind test (Hinting task, False belief task, and Emotional attribution test), and Peters delusion inventory. Results: Performances of the ToM and intelligence in patients were lower than healthy controls. After controlling the impact of IQ, education level, and age, there was a difference between patients and healthy controls on the performance of the Hinting task (F(1,83) = 10.03, p =.002). Correlation analysis showed that the score of false belief task was correlated with delusion (r = ?.360, p <.01) and intelligence (r =.449, p <.01). The emotional attribution task was correlated with intelligence (r = 0.309, p <.05). Conclusions: Through the finding of this study, theory of mind is highly recommended as a new target factor considering to develop nursing interventions for schizophrenia.     

大庆有偿解除劳务合同职工与在职职工心理健康状况调查

目的 调查大庆石油管理局350名有偿解除劳务合同职工与在职职工心理健康问题。方法 采用SCL-90量表对200名有偿解除劳务合同职工,150名在职职工进行调查。结果 共发放问卷350份,收回有偿解除劳务合同职工组有效问卷196份,在职职工组148份。两组性别、年龄、婚姻、职业、文化程度均无显著差异。躯体化、抑郁、焦虑、恐怖、精神病性总分及阳性项目分,有偿解除劳务合同职工组均高于在职职工组(P<0.05～0.001),且两组男女间亦有显著差异(女148.96±42.60,n=68;男132.78±34.52,n=128,u=2.697,P<0.01)。结论 有偿解除劳务合同作为重大生活事件影响着职工的心理健康,应引起自身及有关部门的重视。     

Implicit Memory and Posttraumatic Stress Symptoms

Recent theories of Posttraumatic Stress Disorder (PTSD) suggest that memory dysregulation plays a crucial role in symptom maintenance. However, it is not clear which specific memory systems are involved in PTSD. In this study we used a visual implicit memory paradigm to examine memory bias in individuals with PTSD symptoms. Three hundred nineteen participants provided self-report measures of PTSD, anxiety and depression symptoms. Next they completed a visual clarity-rating task (Amir et al. Cognition and Emotion 17(4):567–583, 2003) to assess implicit memory for three picture types (trauma-relevant, neutral, and negative). Results revealed that participants with PTSD symptoms had greater implicit memory for negative and trauma-relevant pictures compared to neutral pictures. Traumatized individuals without PTSD symptoms showed greater implicit memory for negative pictures relative to trauma and neutral pictures. This pattern of results suggests that implicit memory bias for trauma-relevant and negative visual information may be an important factor in the maintenance of PTSD symptoms.     

腔隙性脑梗死患者智能障碍的前瞻性研究

目的对腔隙性脑梗死患者进行前瞻研究,以期发现其智能损害的规律性。方法广东医学院附属湛江中心医院神经内科住院的各类腔隙性脑梗死患者186例,51例伴有轻度运动性失语,入院1周内明显改善;肢体瘫痪症状较轻,肌力IV级左右,并在1周内明显好转。采用韦氏成人智力量表对患者进行测定,根据其影像学特征及患者的性别、年龄、职业和受教育程度进行多元相关分析研究。结果186例中130例智能低于正常,占70.0%,严重智能障碍51例(VIQ<69分)占27.4%,受教育程度高低与智能损害呈显著负相关(r=-0.6307,P=0.001)。左侧基底节、放射冠区及左侧颞叶脑梗死较右侧更易造成智能障碍(r=-0.217,P=0.003)。Binswanger综合征是造成智能障碍的重要原因(r=-0.2677,P<0.001)。结论腔隙性脑梗死损害部位不同,其智能损害程度差异较大。左侧半球病变更易造成智能障碍,尤其左侧基底节及颞叶;多发病灶者其智能损害较单发病灶者重,单发的皮质下腔梗死也可造成明显智能障碍。性别、年龄、职业与腔隙性脑梗死后引发的智能障碍无相关性,但受教育程度的高低与智能障碍的程度呈负相关。     

Recent trends in surgery of peripheral nerves

The Frenchay Activities Index (FAI), a brief scale developed to measure lifestyle in stroke patients, was given to 119 community-dwelling people, aged 70 years or older, in order to obtain a baseline estimate of social, domestic, and leisure activity among older people. Factor analysis identified three main factors, similar in composition to those previously reported. A general linear models regression analysis of selected variables indicated that both fluid intelligence and memory test performance were significantly associated with level of activity. There was no significant association with age or crystallized intelligence in this sample. An apparently strong bias towards higher levels of activity among female respondents was diluted when marital status was included in the equation. This study suggests that the FAI is appropriate for measuring levels of activity in community-dwelling older people and that such activity is related to current cognitive abilities.