儿童期虐待、目睹家庭暴力对大学生自尊的影响

目的 了解儿童期虐待和目睹父母暴力对大学生自尊的影响.方法 采用儿童期虐待问卷(CTQ-SF)、目睹父母暴力行为调查问卷、自尊量表(SES)对412名大学生进行调查,并进行相关分析.结果 (1)有儿童期躯体虐待、情感虐待、情感忽视、躯体忽视或目睹父母暴力经历者自尊水平[依次为(28.04±4.31)分,(28.43±3.81)分,(28.55±3.70)分,(28.66±3.67)分,(28.15±3.87)分]比无儿童期躯体虐待、情感虐待、情感忽视、躯体忽视或目睹父母暴力经历者自尊水平低[依次为(29.02±3.41)分,(29.43±3.46)分,(30.77±3.18)分,(29.93±3.91)分,(29.30±3.51)分],差异有统计学意义(P＜0.05).(2)儿童期躯体虐待、情感虐待、情感忽视、躯体忽视和目睹父母暴力与大学生自尊负相关(r=-0.134,-0.216,-0.359,-0.250,-0.170),相关均达到显著性(P＜0.01).儿童情感忽视与儿童情感虐待相关性最高.结论 儿童期虐待和忽视以及目睹家庭暴力对个体自尊水平有负性影响,尤其是儿童情感忽视和虐待.     

儿童期虐待对青少年首发抑郁症患者非自杀性自伤行为的影响

目的 探讨儿童期虐待对青少年首发抑郁症患者的非自杀性自伤行为（non-suicidal self-injury,NSSI）的影响。方法 纳入2022年1～8月在云南省精神病医院住院治疗的136例12～18岁的抑郁症患者,使用一般人口学问卷、青少年非自杀性自伤行为问卷、儿童期创伤问卷进行调查。根据近1 a NSSI存在与否,分成NSSI组和无NSSI组,比较组间差异。儿童期虐待对NSSI的影响使用Logistic多因素回归。结果 与无NSSI组比较,NSSI组的情感虐待、情感忽视发生率更高,差异有统计学意义（P <0.05）;Logistic多因素回归分析示,在校正性别、受教育程度、父母是否离异、精神病家族史后,情感虐待与青少年抑郁症患者NSSI显著正相关（OR=3.015,95%CI:1.200～7.578）;情感忽视与NSSI显著正相关（OR=2.446,95%CI:1.089～5.496）。结论 情感虐待、情感忽视与NSSI密切相关。     

生命意义感在童年虐待经历与抑郁情绪的中介效应

目的:探究大学生群体中生命意义对儿童期心理虐待和抑郁情绪的中介效应。方法:采用儿童心理虐待量表(CTQ-SF)、人生意义问卷(MLQ)、病人健康问卷抑郁量表(PHQ-9),对1 878名在校大学生进行问卷调查。结果:(1)儿童期心理虐待中的情感虐待、躯体虐待维度和抑郁在性别上的差异有统计学意义,女生情感虐待得分高于男生(P=0.001),男生躯体虐待得分高于女生(P<0.001),女生抑郁得分高于男生(P=0.001)。(2)不同抑郁程度在儿童期心理虐待、人生意义的各个维度及其总分比较,差异有统计学意义(P<0.001)。(3)儿童期创伤与抑郁得分均呈正相关(r=0.157,P<0.01),与人生意义得分呈负相关(r=-0.48,P<0.05);人生意义得分与抑郁呈负相关(r=-0.342,P<0.01)。(4)人生意义感、儿童期心理虐待和抑郁情绪的中介效应显著,占总效应的10.24%。结论:儿童期心理虐待与其抑郁关系密切,人生意义感在大学生儿童期心理虐待和抑郁间起部分中介作用。     

温州市抑郁症患者自杀意念与儿童期受虐待情况的关系

目的：探讨抑郁症患者的自杀意念与儿童期受虐之间的关系。方法：采用儿童期虐待问卷（CTQ）和贝克自杀意念量表（BSI）对温州272名抑郁症患者进行测查。结果：在这次调查中,发生率最高的是躯体忽视,而得分最高的是情感忽视。各类型虐待之间存在正相关。除躯体虐待,各类型的虐待与自杀意念成正相关。结论：儿童期受虐待的抑郁患者有自杀意念的几率似乎要大。     

医学生儿童期创伤与成年早期执行功能、负性情绪

目的：探讨医学生儿童期创伤、执行功能和负性情绪的关系模型及执行功能的中介作用。方法采用儿童期创伤问卷、执行功能行为评定量表成人版和抑郁-焦虑-压力量表的抑郁焦虑分量表对492名医学生进行问卷调查。结果相关分析显示,性虐待与躯体虐待、情感忽视无显著相关,其余各变量之间均呈正相关（P＜0．05）。结构方程模型结果显示,儿童期创伤对成年早期负性情绪有直接效应,且可以通过执行功能间接作用于负性情绪。结论儿童期创伤对医学生执行功能和负性情绪有重要影响,执行功能在儿童期创伤与负性情绪间起部分中介作用。     

童年期创伤经历与自尊对新兵抑郁的影响

目的：了解童年期创伤经历对新兵抑郁的影响，探讨自尊在童年期创伤经历与抑郁关系中的作用。方法运用自尊量表（SES）、童年期创伤经历问卷（CTQ －SF）和抑郁自评量表（SDS）对1925名男性新兵进行问卷调查。结果控制年龄后，情感虐待、情感忽视和躯体忽视预测抑郁的回归系数为正；自尊在抑郁上的回归系数为负，在儿童期创伤经历各个因子和抑郁症状之间调节作用不显著，但其中介作用显著。结论童年期创伤经历显著影响新兵抑郁，并能通过自尊间接作用于抑郁，但自尊不能改变童年期创伤经历对抑郁的影响。     

人格障碍与童年创伤经历的相关性研究

目的 研究人格障碍患者童年创伤经历的相关性和差异性.方法 采用系统抽样法抽取1511例就诊者.用人格障碍诊断问卷第四版(SDQ+4)对其中1402例进行筛查,结果阳性的986例被试用轴Ⅱ人格障碍临床访谈(SCID-Ⅱ)和童年期创伤性经历问卷进行研究.结果 儿童期创伤经历问卷(CTQ)总分与3群人格障碍呈正相关,以B群的相关性最强(r=0.312,P<0.01).CTQ5个因子在偏相关分析中,B群与情感虐待、躯体虐待、性虐待及情感忽视呈正相关,A群与情感虐待相关(r=0.139,P<0.01),C群则与各种童年创伤经历均无显著相关性;人格障碍及对照组之间在情感虐待、躯体虐待、性虐待及情感忽视上存在显著差异(P<0.01);情感虐待和情感忽视均进入A群和B群人格障碍的回归方程(标准偏回归系数分别为A群0.135和0.119,B群0.200和0.084),情感忽视进入C群人格障碍的回归方程(标准偏回归系数为0.103).结论 童年时期的创伤虐待是人格障碍易感的危险因素,对B群人格障碍的影响最为显著.不同群的人格障碍在童年创伤经历上各有特点.     

儿童期虐待和父母养育方式与抑郁症的关系研究

目的 探讨儿童期虐待和父母养育方式与抑郁症的关系.方法 采用儿童期虐待史自评量表(PRCA)、父母养育方式评价量表(EMBU)对符合入组标准的98例抑郁症患者进行评估,并与100例正常人群进行对照,采用汉密顿抑郁量表(24项,HAMD)评定抑郁症状严重程度.结果 抑郁症患者儿童期受虐待史率(36.7%)明显高于正常人(9.0%),差异具有显著性(P<0.01).抑郁症患者的父母惩罚严厉、拒绝否认[分别为(17.95±5.72)分,(13.89±5.40)分.(10.45±3.47)分,(13.99±4.85)分],高于对照组[分别为(15.98±4.86)分,(11.61±4.19分)分,(8.02±2.98)分,(11.14±3.76)分],而父母情感温暖理解因子,低于对照组,差异具有显著性(P<0.05).抑郁症状与情感虐待、性虐待、忽视因子及父母惩罚严厉、拒绝否认、母亲过分干涉因子呈显著正相关r=0.298～0.540,P<0.05或P<0.01),与父母情感温暖理解因子呈显著负相关(r=-0.350～-0.508,P<0.05或P<0.01).情感虐待、性虐待、忽视和虐待总分与父母养育方式多个因子分存在显著相关(r=-0.479～0.523,P<0.05或P<0.01).结论 抑郁症患者儿童期遭遇过较多的情感虐待、性虐待和忽视,父母养育方式影响儿童虐待的发生,儿童期被受虐待经历和父母不良养育方式与抑郁症的形成有关.     

儿童期虐待与精神分裂症患者人格特征的相关性

目的 探讨精神分裂症患者人格特征及其与儿童期虐待的相关性。方法 应用三维人格问卷(tridimensional personality questionnaire,TPQ)及儿童期虐待问卷(childhood trauma questionnaire short form,CTQ-SF)对210例精神分裂症患者(病例组)及190例正常人(对照组)进行测评。结果 病例组TPQ评分在伤害回避维度高于对照组,在奖赏依赖维度低于对照组(P<0.01);单因素分析发现,病例组寻求刺激维度与情感虐待、性虐待及CTQ-SF总分显著相关,伤害回避维度与躯体忽视显著相关,奖赏依赖维度与性虐待及CTQ-SF总分显著相关。多元逐步回归分析发现,情感虐待是寻求刺激维度的最佳预测因素,CTQ-SF总分是奖赏依赖维度的最佳预测因素。结论 精神分裂症患者在TPQ伤害回避维度及奖赏依赖维度具有独特的特征,儿童期虐待对其人格特征可能具有一定影响。     

儿童期精神虐待对大学生人格及抑郁情绪的影响

目的 探讨儿童期精神虐待对大学生人格及抑郁情绪的影响及其作用机制.方法 采用流调用抑郁量表、儿童虐待史问卷和艾森克人格问卷对河南省某高校的733名本科生进行问卷调查.结果 ①除儿童期母亲憎恶与成年期人格中内外倾相关不显著外,其余儿童期精神虐待与大学生人格均呈显著相关(P＜0.01);儿童期精神虐待4个维度与大学生抑郁呈显著正相关(r=0.257,r=0.304,r=0.237,r=0.256).②儿童期父亲憎恶在神经质上的标准回归系数(β=0.243,P＜0.01)为正,儿童期母亲忽视在大学生精神质上的标准回归系数(β=0.206,P＜0.01)为正,儿童期父亲忽视在大学生内外倾上的标准回归系数(β=-0.143,P＜0.01)为负,均达到显著性水平.儿童期父亲憎恶与母亲憎恶对大学生抑郁有正向的预测作用(分别β=0.078,β=0.103,P＜0.05),可以解释总变异的44%;③结构方程模型得出,儿童期父亲憎恶通过成年期神经质的部分中介作用对大学生抑郁产生间接影响,间接效应占总效应的59.8%.结论 儿童期精神虐待对大学生人格及抑郁情绪有直接预测作用;此外,儿童期精神虐待还通过成年期人格的部分中介作用对个体成年期抑郁情绪产生间接影响.     

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.