骨髓增生异常综合症病态造血的综合研究

病态造血是MDS的发病关键,亦是临床诊断本症的重要标准之一,本文对本症的病态造血进行了多学科,多方法和多途径的综合研究。对病态粒细胞、红细胞和巨核细胞系统的各阶段细胞进行详细观察,提出了本症病态巨核细胞形态学分类及其相     

心尖肥厚型心肌病9例报告及误诊分析

本文对9例心尖肥厚型心肌病进行了分析,结果表明,本病起病隐匿,症状和体征缺乏特异性,容易漏诊和误诊。其确诊的主要依据为心电图示左室高电压及心前导联出现巨大倒置T波,二维超声心动图左室长轴切面及心尖四腔切面显示左室腔里“黑桃样”并有心尖部心肌明显肥厚。     

急性髓细胞白血病骨髓有核细胞的TGF－β mRNA，TNF－αmRNA表达

急性髓细胞白血病骨髓有核细胞的ＴＧＦ－β　ｍＲＮＡ，ＴＮＦ－αｍＲＮＡ表达吴克复，宋玉华，马小彤，郑国光，孔祥银，李牧，邱录贵，孟庆祥近年来研究表明：β－转化生长因子（ＴＧＦ－β）是造血前体细胞的重要生理性负调节因子￣［１］。它不仅以旁分泌（Ｐａｒａ...     

粒细胞生成的体外研究与临床

体外骨髓培养集落形成试验已为研究造血调节因子提供了新知识。用这些功能试验系统所作的研究工作有助于识别定向前体细胞和研究集落刺激因子(CSF-GM)的生化性质,即粒单核细胞的前体细胞(CFU-GM)在体调外增殖和分化的体液刺激物质以及抑制物质的节作用。虽然目前对这些体外粒细胞生成参数的可能生理学意义尚未能确立,但用集落形成试验巳获得了在各种恶性血液病时所发生的生     

脑卒中偏瘫后遗症期老年患者抑郁的治疗研究

目的 评价道家认知疗法对脑卒中偏瘫后遗症期老年患者抑郁及生活质量的影响.方法 77例脑卒中偏瘫后遗症期伴发抑郁的老年患者,按随机数字表法分为常规治疗组(38例)和综合治疗组(39例),常规治疗组采用抗抑郁剂联合一般支持性心理治疗,综合治疗组在此基础上进行道家认知治疗,两组均治疗8周,随访6个月.于治疗前,治疗后2、4、8周末及随访期末,采用汉密尔顿抑郁分级量表(HAMD)、脑卒中专用生活质量量表(SS-QOL)分别对患者的抑郁症状及生活质量进行评定,并进行统计学分析.结果 常规治疗组治疗后HAMD评分逐渐下降,治疗后8周[(22.35±4.69)分]与治疗前[(29.62±5.95)分]比较差异有统计学意义(t=6.425,P＜0.01);随访期末HAMD评分[(24.48±4.12)分]又升高,与治疗后8周比较差异有统计学意义(t=2.014,P＜0.05),但较治疗前HAMD评分仍显著降低(t=4.836,P＜0.01).常规治疗组SS-QOL评分在治疗后逐渐升高,治疗后8周[(105.39±25.84)分]与治疗前[(86.63±23.84)分]比较差异有统计学意义(t=4.933,P＜0.01);随访期末SS-QOL评分[(96.09±21.37)分]较治疗后8周又有所下降(t=2.543,P＜0.05),但较治疗前仍显著升高(t=2.790,P＜0.05).综合治疗组治疗后HAMD评分持续下降,治疗后8周[(20.08±4.60)分]及随访期末[(15.21±3.42)分]与治疗前[(30.14±4.92)分]比较差异均有统计学意义(t=8.341、15.443,P＜0.01),并且随访期末HAMD评分显著低于治疗后8周(t=4.724,P＜0.01).综合治疗组治疗后SS-QOL评分呈逐渐升高趋势,治疗后8周[(117.56±26.22)分]及随访期末[(126.57±21.82)分]较治疗前[(86.54±23.90)分]显著升高(t=6.716、8.916,P＜0.01);随访期末SS-QOL评分也较治疗后8周显著升高(t=2.378,P＜0.05).综合治疗组治疗后8周及随访期末HAMD评分显著低于常规治疗组同时间点评分(t=2.118,P＜0.05;t=8.405,P＜0.01),SS-QOL评分显著高于常规治疗组同时间点评分(t=3.123,P＜0.05;t=6.580,P＜0.01).结论 抗抑郁剂联合一般支持性心理治疗或在此基础上进行的道家认知治疗均可不同程度地改善脑卒中偏瘫后遗症期老年患者的抑郁症状,提高其生活质量.道家认知疗法起效虽慢,但远期疗效好.

Abstract：

Objective To evaluate the effects of Taoist cognitive psychotherapy on depression of aged patients with cerebral stroke hemiplegia convalescence. Methods Seventy-seven hemiplegia convalescence patients with depression were divided into general treatment group (38 patients, received general back-up psychology therapy) and combined treatment group (39 patients, received general back-up psychology therapy and Taoist cognitive psychotherapy) by random digits table. All patients were treated for 8 weeks and followed up for 6 months. Two groups were evaluated with HAMD and SS-QOL before treatment and at the end of the 2 weeks,4 weeks, 8 weeks and 6 months after treatment. The results were analyzed with statistics. Results In general treatment group, the HAMD scores were gradually decreased, and the HAMD scores of patients after 8 weeks' treatment were significantly lower than those before treatment[(22.35 ± 4.69)scores vs. (29.62 ± 5.95 ) scores,t = 6.425 ,P ＜ 0.01]. At the end of 6 months after treatment, the scores increased [(24.48 ± 4.12 ) scores vs. (22.35 ± 4.69 ) scores, t = 2.014, P ＜ 0.05], but they were lower than those before treatment(t = 4.836, P ＜ 0.01 ). At the end of 6 months after treatment, the SS-QOL scores were lower than those after 8 weeks' treatment (t =2.543,P ＜0.05),but they were higher than those before treatment (t = 2.790,P ＜ 0.05 ). In combined treatment group, the HAMD scores decreased continuously,and the scores after 8 weeks' treatment [(20.08 ± 4.60) scores] and 6 months' treatment [( 15.21 ± 3.42)scores] were significantly lower than those before treatment [( 30.14 ± 4.92 ) scores] (t = 8.341,15.443, P ＜0.01). Meanwhile,the HAMD scores after 6 months'treatment were significantly Iower than those after 8 weeks' treatment (t =4.724,P ＜ 0.01 ). The SS-QOL scores after 8 weeks' treatment [( 117.56 ± 26.22)scores] and 6 months' treatment [(126.57 ±21.82) scores] were significantly higher than those before treatment[(86.54 ± 23.90) scores] (t = 6.716,8.916,P ＜ 0.01 ) ,and there was significantly difference(t=2.378,P ＜ 0.05). The HAMD scores of combined treatment group after 8 weeks' and 6 months' treatment were significantly lower than those of general treatment group at the same time(t = 2.118, P ＜ 0.05 ;t = 8.405,P＜ 0.01 ) ,and SS-QOL scores were significantly higher than those of general treatment group at the same time (t = 3.123,P ＜ 0.05 ;t = 6.580,P ＜ 0.01 ). Conclusions General back-up psychology therapy combined with Taoist cognitive psychotherapy can improve depression and life quality of cerebral stroke hemiplegia convalescence in aged patients. The effects of Taoist cognitive psychotherapy is slower, but it is more beneficial in the long time.     

脑梗死患者院内获得性压力性损伤的影响因素及预防措施分析

目的探讨脑梗死患者院内获得性压力性损伤的影响因素及预防措施。方法回顾性分析2016年7月至2019年12月我院就诊的242例脑梗死患者临床资料,分析脑梗死患者院内获得性压力性损伤相关影响因素。结果 242例脑梗死患者中出现院内获得性压力性损伤21例(8.68%);住院时间≥10d、发热、瘫痪、贫血、大小便失禁、空腹血糖6.1mmol/L是脑梗死患者出现院内获得性压力性损伤的独立危险因素(P0.05且OR≥1);营养支持、使用预防性敷料是脑梗死患者出现院内获得性压力性损伤的保护因素(P0.05且OR≥1)。结论脑梗死患者发生院内获得性压力性损伤是多种因素共同作用结果,临床需针对各种危险因素加强预防措施,尽可能的减少压力性损伤发生。     

合肥市管教所犯罪青少年心理健康水平的现况研究

目的了解合肥市管教所犯罪青少年心理健康水平,为进一步开展心理健康的预防和干预提供参考依据。方法2008年6月份采用分层整群抽样的方法抽取合肥市某管教所8个大队共408名犯罪青少年,选用症状自评量表（SCL-90））进行心理健康状况的调查。结果在10个因子中,有3.2%的个体出现躯体化症状,有6.9%的个体出现强迫症状,7.4%出现人际关系敏感症状,4.9%的个体出现抑郁症状,4.9%的个体出现焦虑症状,9.8%的个体分别出现敌对症状,2.2%出现恐怖症状,7.1%出现偏偏执症状,5.9%个体出现精神病性躯体化症状,有8.3%的个体出现其他症状。总筛查阳性率为21.3%,其中男性为21.1%,女性为26.7%,差异无显著性,不同年龄组之间各因子筛查阳性率及总筛查阳性率差异也无显著性。结论目前犯罪青少年存在较高的心理健康问题,个别因子检出率尤为特出,对该群体加强心理健康知识的宣传及干预是当务之急。