汉族与少数民族抑郁症患者抑郁和自杀风险因素的分析

目的 探讨汉族与少数民族抑郁症患者中,应激性生活事件和认知情绪调节与抑郁情绪和自杀意念及行为之间的关系.方法 应用生活事件量表、认知情绪凋查问卷、汉密顿抑郁量表对126名抑郁症患者进行测评,其中少数民族55人,汉族71人,利用SPSS17.0对各量表的结果进行双变量相关和逐步回归分析.结果 全部样本中抑郁与负性认知情绪调节方式和生活事件、自杀意念呈正相关(自责r=0.599,接受r=0.527,沉思r=0.484,灾难化r=0.618,LES总分r=0.649,自杀r=0.482,P均<0.01),与正性认知情绪调节呈负相关(积极重新关注r=-0.476,重新关注计划r=-0.254,积极重新评价r=-0.221,理性分析r=-0.492,P均<0.01).自杀意念与工作学习问题、生活事件总分、负性认知情绪调节和抑郁、呈正相关(工作学习问题r=0.182,LES总分r=0.482,自责r=0.438,接受r=0.338,沉思r=0.378,灾难化r=0.457,抑郁r=0.724,P均<0.01),与积极重新关注和理性分析呈负相关(r=-0.319,r=-0.326,均P<0.01).汉族和少数民族患者中上述指标的相关性分析结果相似.少数民族抑郁症患者中应激性生活事件和灾难化、责难他人对抑郁的贡献显著,汉族抑郁症患者中生活事件和灾难化对抑郁的贡献显著,两组中抑郁程度对自杀的贡献最大.结论 应激性生活事件和负性认知情绪调节对抑郁症状有着重要影响,而抑郁的严重程度是影响自杀的重要因素,各民族间没有质的差别.

Abstract：

Objective To explore the difference of risk factors to depression between different nationalities, the relationship of stressing life events, cognitive emotion regulation, and depression and suicide ideation were studied by correlate and regression analysis. Methods 126 patients with depression diagnosed by CCMD-III,55 minority nationality and 71 Han nationality patients,completed life events questionnaires,cognitive emotion regulation questionaire(CERQ) and HAMD. All the parameters be analyzed by SPSS 17.0, and correlation analysis and stepwise regression analysis be employed to analyze the relationship between the parameters. Results Negative cognitive emotion, stressing life events and suicide ideation related positively to depression, while positive cognitive emotion related to depression negatively(r self-blame=0.599,r acceptance=0.527,r rumination=0.484,r catastrophizing=0.618,r LES=0.649,r suicide ideation=0.482,P<0.01;r positive refocusing=-0.476,r planning=-0.0254,r positive reapprasial=-0.363,r putting into perspective=-0.492,p<0.01);stressing life events and negative cognitive emotion and depression related positively to suicide i-deation(r LES=0.482.r self-blame=0.438,r acceptance=0.338,r rumination=0.378,r catastrophizing=0.457,r depression=0.724,p<0.01) , and positive cognitive emotion related negatively to it(r positive refocusing=-0.319,r putting into perspective=-0.326,p<0.01). The outcome of correlate analysis was similar in different nationalities. Stressing life events and catastrophizing and other-blame contributed more to depression than other factors in minority nationality group, and only the former two factors contributed to depression in Han nationality group. In both two groups, depression contributed more to suicide ideation than others. Conclusions Stressing rife events and negative cognitive emotion regulation have a significant effect on the development of depression, and the severity of depression is a critical factor to suicide ideation. There is no significant difference about above outcome between different nationalities.     

CT血管成像和CT灌注点征的联合应用在选择中等量脑出血超早期手术方式中的价值

目的探讨联合应用CT血管成像(CTA)、CT灌注(CTP)点征在基底节中等量脑出血超早期抽吸术或开颅手术的手术方式选择中的应用价值。方法选择中等量基底节脑出血(出血量30～60ml)且家属同意超早期手术治疗221例,根据入院后患者是否同意行颅脑CTA及CTP检查,分为研究组(同意检查者)105例,对照组(不同意检查者)116例,研究组CTA或CTP点征阳性者,入开颅手术亚组32例,CTA和CTP点征阴性者入抽吸亚组73例。对照组根据患者家属知情同意后选择的手术方式,分为开颅亚组39例,抽吸亚组77例。对比研究组与对照组患者治疗效果的差异,评估联合应用CTA、CTP点征在基底节中等量脑出血超早期手术方式选择中的应用价值。结果研究组有效率、术后血肿增大率、病死率、颅内感染率分别为77.1%、3.8%、3.8%、2.9%,对照组分别为52.6%、18.1%、15.6%、12.1%,2组比较差异有统计学意义。(P0.05)。结论联合应用CTA、CTP点征选择基底节中等量脑出血手术方式,可明显改善患者预后。     

3,4-二氯苯丙烯酰另丁胺抗抑郁机制研究

用荧光测定法研究3,4一二氯苯丙烯酰另丁胺(简称7903)对动物脑内NA及5—HT能系统的影响,结果表明,7903急性给药可以明显增加小鼠全脑及大鼠大脑皮层的NA及5—HT的含量,大鼠下丘脑5—HT的含量也有增加的趋势;慢性给药则降低大鼠大脑皮层的NA含量及5—HIAA/5—H T:慢性给予7903还可使小鼠脑内NA及5—HT的更新率均明显下降。对大鼠大脑皮层β受体及5—HT_2受体的特异性结合无明显影响。     

The genetics of cornea plana congenita.

Cornea plana congenita is believed to occur in a mild autosomal dominant (CNA1) and a more severe autosomal recessive (CNA2) form. We recently assigned a CNA2 locus to a region on chromosome 12 by linkage analysis. In this study we compared these traits clinically and genetically. Using the horizontal corneal refraction value in diopters (D) as a parameter, a control population (n = 473) had a mean value of 43 center dot 4 (SD 1 center dot 5 D) for men and 43 center dot 7 (SD 1 center dot 6 D) for women, whereas in 51 subjects affected with CNA2 the mean value was 29 center dot 9 (SD 5 center dot 2 D) and in five subjects affected with CNA1 the mean value was 37 center dot 8 (SD 1 center dot 6 D). By linkage analysis in two CNA1 families the CNA2 locus could be conclusively excluded. These data suggest that at least two forms of hereditary cornea plana exist which are both clinically and genetically distinct.     

Pharmacokinetic study of IV infusions of adriamycin

Summary The plasma pharmacokinetics of adriamycin has been studied in 21 cancer patients (31–85 years old) without liver tumours after short (3.00 min) and prolonged (45 min-16h) i.v. infusions.The area under the plasma concentration-time curve and the maximum plasma concentration compensated for dose variation showed a more than 3-fold individual variation. The pharmacokinetics of adriamycin was linear. There was no pharmacokinetic rational for variation of the dose with the age of the patients.There was good agreement between the measured plasma concentration-time curves for prolonged infusions and curves predicted from pharmacokinetic data from short term infusions.     

河豚毒素对钠通道的影响及其可能的镇痛机制

河豚毒素为强效钠通道阻滞剂 ,它可通过阻断钠通道而影响细胞膜动作电位的产生。其中河豚毒素耐受性钠通道在损伤组织中的高表达为寻找新一代有效镇痛药提供了新靶标。本文综述了河豚毒素对钠通道的影响并探讨了其可能的镇痛机制     

大面积脑梗死80例临床分析

脑梗死占脑血管疾病的70%~80%,其病情危重,病死率、致残率高。现就我院2001年1月~2007年3月收治的80例大面积脑梗死患者的临床资料分析如下。1临床资料1.1一般资料80例患者中,男39例,女41例,年龄29~81岁,中位年龄55.5岁。既往有风湿性心脏病史者27例,高血压、冠心病史者各22例,     

乳腺原位癌15例诊治体会

目的：探讨乳腺原位癌的早期发现、早期诊断的方法及治疗。方法：对我院1999年1月-2003年12月间治疗的15例乳腺原位癌的临床资料进行回顾性分析。结果：术前乳腺钼钯摄片14例，其中10例阳性；乳导管造影2例，全部阳性；术前X线摄片阳性率85．71％。术后15例全部由病理检验确诊，其中乳腺导管内癌13例、小叶原位癌2例。15例中13例行根治术，2例行象限切除术，术后14例行化疗。结论：乳腺原位癌的诊断需要在普查、临床和乳腺辅助检查(钼靶、乳导管造影、彩超、溢液涂片)的基础上，最后经活检或术后病理检验确诊。     

卓越中医师基本素养培养的探讨

近年来,我国的中医药事业发展迅猛,但仍存在人才队伍建设较为滞后问题,开展卓越中医师的培养就显的尤为重要。对于卓越中医师的培养,基本素养决定其成长轨迹和未来的职业成就。因此,卓越中医师基本素养的培养分别从人文素养和职业素养2个方面进行探讨,以期卓越中医师担当传承、发展中医的重任,是中医药事业的根基。