社会认知交互训练在精神分裂症住院患者康复中的应用

目的：探讨社会认知交互训练（SCIT）在精神分裂症住院患者康复期的应用价值。方法：118例精神分裂症患者随机分为SCIT组（58例）和对照组（60例）,SCIT组接受为期9周,每周2次的SCIT干预和抗精神病药物治疗,对照组仅接受抗精神病药物治疗。比较2组在干预后的社会认知能力,包括阳性和阴性症状量表（PANSS）总分、阳性症状、阴性症状、责备偏向总分（TBB）、暗示任务及住院精神患者社会功能评定量表（SSPI）。结果：干预后SCIT组与对照组比较,PANSS得分均有显著改善,社会功能亦有改善。而与自身干预前比较,SCIT组精神症状（t=7.163,P＜0.01）、阳性症状（t=19.154,P＜0.01）、阴性症状（t=4.601,P＜0.01）及社会功能（t=-8.990,P＜0.01）均有显著改善。结论：SCIT有利于精神分裂症住院患者的康复。     

作业治疗对住院慢性精神分裂症患者的康复疗效分析

目的：探讨作业治疗对住院慢性精神分裂症患者的康复作用。方法：将住我院的40例精神分裂症患者随机分为两组,20人为治疗组,参加作业治疗10周,对照组20人。采用阳性与阴性症状量表（PANSS）及住院精神病患者日常生活能力评定量表（ADLPI）评定疗效。结果：作业治疗前阳性和阴性症状量表、日常生活活动能力测定量表总分及各因子分两组间无明显差异（P〉0.05）。予作业治疗10周后,治疗组在阴性症状,一般精神病理症状方面有显著进步（P〈0.01）;住院精神病患者日常生活能力评定量表（ADLPI）对照,治疗组于作业治疗后亦有显著差异（P〈0.01）。结论：作业治疗对减轻长期住院慢性精神分裂症患者的衰退病情、恢复或改善心理与躯体的功能、帮助学习和掌握如何适应生活及工作的技巧是有一定疗效的。作业治疗可以改善慢性精神分裂症患者的社会功能缺损状况。     

精神分裂症社区康复患者症状严重程度与社会功能关系的随访研究

目的 了解社区精神康复对精神分裂症患者症状严重程度及社会功能的影响,以及社区精神康复下精神分裂症患者症状严重程度与社会功能的关系。方法 选取56例社区精神分裂症患者,通过个案管理及小组训练等方式进行社区精神康复,并在基线、随访3个月及6个月时采用阴性与阳性症状（PANSS）量表、个体与社会功能（PSP）量表及世界卫生组织残疾评定（WHO-DAS）量表对其症状严重程度及社会功能进行评定,分析不同时间点各量表评分的差异及相关关系。结果 PANSS总分及各分量表得分在基线、随访3个月及6个月时的评定差异有统计学意义 （P<0.00）,评分呈逐渐下降趋势;随访3个月时PSP总分高于基线时的评定、 DAS总分低于基线时的评定,6个月时PSP总分高于3个月时的评定,差异具有统计学意义 （P<0.05）;不同时间点PANSS总分、阴性量表得分及一般病理总分与PSP量表评分呈负相关,与DAS量表评分呈正相关,3个月、6个月时阳性量表得分与PSP量表评分呈负相关,与DAS量表评分呈正相关 （P<0.01）,PANSS总分回归方程具有统计学意义 （P<0.01）。结论 社区精神康复能促进精神分裂症患者社会功能的恢复,且在社区精神康复下社区精神分裂症患者症状严重程度与社会功能密切相关,其症状越严重、治疗效果越差,社会功能恢复越慢。     

利伯曼精神康复技术在精神分裂症患者中的应用

目的探讨利伯曼精神康复技术在精神分裂症患者中的应用效果。方法将100例住院精神分裂症患者按随机数字表分为对照组和观察组各50例,对照组按照精神分裂症护理常规实施护理,观察组在对照组常规护理基础上实施利伯曼精神康复技术训练,观察比较两组患者日常生活技能和社会功能水平。结果训练前两组患者生活技能训练(SST)评价表和社会功能缺陷筛选量表(SDSS)总分差异无统计学意义(P>0.05);训练12周后,观察组SST总分高于对照组,SDSS总分低于对照组,组间比较差异有统计学意义(P<0.001)。结论利伯曼精神康复技术训练可提高精神分裂症患者的日常生活技能和社会功能。     

社会技能训练对康复期精神分裂症患者社会适应能力的影响

目的探讨社会技能训练对分裂症康复期患者社会适应能力的影响。方法选择我院收治的160例住院精神分裂症康复期患者,随机分为观察组与对照组,在药物维持治疗的基础上,观察组进行社会技能训练,对照组给予一般康复活动,以精神病阳性阴性症状量表（PANSS）,住院精神病患者社会功能评定量表（SSPI）评定社会适应能力的变化。结果经过半年的社会技能训练后观察组的PANSS总分与SSPI量表总分均显著低于训练前,对照组经过半年的治疗也显著降低,但观察组PANSS总分与SSPI量表总分均优于对照组,两组的差异均有统计学意义（P〈0.05）。结论社会技能训练对康复期精神分裂症患者有较好的效果,能减轻阴性症状,改善社会适应能力。     

支持性心理干预联合康复训练对慢性精神分裂症远期治疗效果的影响

目的探讨支持性心理干预联合康复训练在慢性精神分裂症患者中的应用效果。方法采用随机数字表法将122例慢性精神分裂症患者分为两组,对照组61例予以抗精神病药物常规治疗,治疗组61例在对照组基础上给予支持性心理干预联合康复训练,比较两组患者治疗12周后的治疗效果、阴性症状量表评分、精神症状评分、生活质量评分及社会功能评分。结果经12周的治疗后,对照组治疗总有效率为55.74%(34/61),治疗组为73.77%(45/61),差异有统计学意义(P<0.05);治疗组阴性症状量表(简称SANS)、精神病评定表(简称BPRS)、生活质量量表(简称QOL)以及社会功能评定表(DAS)评分均显著优于对照组(P<0.05)。结论支持性心理干预联合康复训练能提高慢性精神分裂症治疗的临床疗效,改善患者病情,提高其生活自理能力,改善患者阴性症状、生活质量,促进社会功能康复。     

住院流浪精神分裂症患者与普通精神分裂症患者相关资料比较

目的:了解住院流浪精神分裂症患者的疗效、社会功能及日常生活能力的特点.方法:以在我院住院1年以上流浪精神分裂症患者64例为观察组;在我院住院1年以上非流浪的精神分裂症患者中随机选取65例作为对照组.并采用阳性与阴性症状量表(PANSS)、住院精神病患者社会功能缺陷评定表(SDSI)、日常生活能力量表(ADL)进行统计分析.结果:PANSS阳性症状量表分无差异,但PANSS的总分,阴性症状量表分,一般精神病理分均高于对照组(P<0.01),观察组SDSI分及ADL分高于对照组(P<0.01),差异有显著性.结论:住院的流浪精神分裂症患者其阳性精神症状与非流浪的住院精神分裂症患者一样,控制得较好,但前者的阴性精神症状和一般精神病态表现更严重;社会功能和日常生活能力更差.     

精神分裂症患者的共情缺陷及其影响因素

目的：探讨精神分裂症患者共情缺陷的特点,分析共情能力、临床症状以及社会功能的关联性。方法：以30例首发精神分裂症住院患者(精神分裂症患者组)和30名健康对照者(健康对照组)作为研究对象,采用《人际反应指针量表》（IRI-C）、《阳性和阴性症状评定量表》（PANSS）和《住院精神
病人社会功能评定量表》（SSPI）分别评定患者的共情能力、精神症状和社会功能,比较2组共情能力测量总分和4个分量表得分,患者组共情能力量表总分分别与临床症状评分和社会功能评分进行相关性分析。结果：精神分裂症患者组共情测量总分显著低于健康对照组(P<0.05);精神分裂症患者组中阴性症状较重的患者共情能力更差,存在更严重的共情缺陷,共情能力与阴性症状评分存在负相关关系（r=－0.572,P<0.01）。精神分裂症患者组
共情能力与社会功能无相关关系（r=0.166,P<0.05）。结论：首发精神分裂症患者存在共情缺陷,患者的阴性症状严重程度对共情能力具有影响,阴性症状越严重共情能力越差。     

快步行走在精神分裂症治疗中效果分析

目的:验证快步行走在精神分裂症治疗中的效果。方法:将100例未服用过抗精神病药的精神分裂症患者,随机分为快步行走联合抗精神病药物治疗组(A组50例)和抗精神病药物治疗组(B组50例),于治疗前和治疗第8周末用阳性和阴性症状量表(PANSS)评定疗效。结果:治疗8周末,两组患者的阳性、阴性症状量表分数及量表总分数与治疗前比较,差异有统计学意义(P<0.05);治疗8周末,A组患者的阳性、阴性症状量表分数及量表总分数与B组比较,差异有统计学意义(P<0.05)。结论:快步行走能明显改善精神分裂症患者的临床症状,促进病人康复。     

团体认知行为联合作业疗法对精神分裂症患者症状及社会功能的影响

摘要：目的 探讨团体认知行为联合作业疗法对精神分裂症患者症状及社会功能的影响。方法 选择2020年1月-2020年12月于本院住院治疗的125例精神分裂症患者作为研究对象,随机数字表法分为观察组（n=62）和对照组（n=63）。两组均接受常规药物治疗,此基础上对照组采用作业疗法,观察组采用团体认知行为联合作业疗法。观察精神症状、社会功能、认知功能改善以及复发情况,评价服药依从性、生活质量和满意度。结果 治疗后两组患者阳性与阴性症状量表（PANSS）各维度及总分、社会功能缺陷筛选量表（SDSS）得分、精神分裂症病人生活质量量表（SQLS）各维度得分均较治疗前显著降低,且治疗后观察组低于对照组（P＜0.05）;治疗后两组患者精神分裂症认知功能成套测验（MCCB）各维度得分、服药依从性均较治疗前显著升高,且治疗后观察组高于对照组（P＜0.05）;观察组治疗总有效率和总满意度显著高于对照组（P＜0.05）。结论 团体认知行为联合作业疗法可有效减轻精神分裂症患者症状,提高社会和认知功能,利于患者康复。     

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.