应用语文探索和字词分析软件探讨两岸4例孤独症患儿母亲团体干预的研究

目的 分析孤独谱系障碍(ASD)患儿母亲参与半结构团体干预的心理历程变化过程,为团体干预改善ASD患儿母亲不良情绪状态提供研究基础。方法 研究采用量化取向语文探索与字词分析软件(LIWC)2007中文简体版,对上海市和台湾台中市4例ASD患儿母亲参与半结构支持性团体干预(12次,每次90 min)的前段(第1～4次)、中段(第5～8次)、后段(第9～12次)、结束后12个月共计4个时长段的团体干预咨询录音文稿进行字词分析。结果 4位参与团体干预的ASD患儿母亲从团体干预前段到后段负性情绪词汇不断减少;团体干预中段积极关注自我,工作、个人成就、家庭词汇增多;团体干预后段休闲等提高生活质量词汇上升;干预后母亲心理词汇、关爱词汇较干预前增加,差异有统计学意义(t=3.758,3.794,P均<0.05);干预后患儿孤独症儿童行为评定量表(ABC)评分较干预前降低,差异有统计学意义(t=-3.100,P<0.05)。结论 支持性团体干预能够帮助增加ASD患儿母子之间良性调试,减少患儿问题行为。同时,ASD患儿母亲会建构新的自我认同,降低不确定感,提升心理健康。     

多学科协作护理对心脏外科围术期患者心肺康复管理的应用效果

目的 探讨多学科协作护理对心脏外科围术期患者心肺康复管理的应用效果。方法 选取 2020 年 10 月至 2022 年 10 月期 间于本院进行心脏外科手术患者 84 例作为研究对象。按照随机数字表法将患者分为对照组和观察组,每组各 42 例。对照组采 用常规护理,观察组采用多学科协作护理。分析比较两组的不良情绪、康复时间、心肺功能。结果 护理 14d 后,观察组焦虑 评分、抑郁评分均显著低于对照组（P<0.05）。观察组的康复时间显著短于对照组（P<0.05）。护理 14d 后,观察组心肺功能指 标均显著高于对照组（P<0.05）。结论 在心脏外科围术期实施多学科协作护理,能改善患者心肺状态,缩短患者康复时间。     

The McGill Geriatric Lithium-Induced Diabetes Insipidus Clinical Study (McGLIDICS)

Objective:

Despite being a common and potentially serious condition, nephrogenic diabetes insipidus (NDI) remains poorly understood in older lithium users. Our main objective was to compare the prevalence of NDI symptoms and decreased urine osmolality ([UOsm] < 300 milli-Osmoles [mOsm/kg]) among geriatric and adult lithium users. We also assessed NDI symptoms, serum sodium (Na+), and urine specific gravity (USG) as possible surrogate measures of decreased UOsm, and ascertained whether potential etiologic factors independently correlated with decreased UOsm.

Method:

This was a cross-sectional study of 100 consecutive outpatients treated with lithium from 6 tertiary care clinics, of which 45 were geriatric (aged 65 years and older) and 55 adult (aged 18 to 64 years). Patients completed a symptom questionnaire and underwent laboratory tests, including UOsm, serum Na+, and USG.

Results:

Geriatric and adult lithium users had similar rates of decreased UOsm (12.5%, compared with 17.9%, P = 0.74), but geriatric patients reported less symptoms (P < 0.05). Although UOsm did not correlate with symptoms or current serum Na+, USG of less than 1.010 was suggestive of UOsm of less than 300 mOsm/kg. Age, lithium duration, and serum lithium level were independently associated with UOsm.

Conclusions:

The prevalence of decreased UOsm is similar in geriatric and adult lithium users, but older patients are less likely to report urinary and thirst symptoms. Although subjective symptoms do not correlate with UOsm, USG may be a cost-efficient clinical surrogate measure for UOsm. We suggest clinicians increase their vigilance for decreased UOsm, especially in lithium users with advanced age, longer duration of lithium exposure, and higher lithium levels. This may potentially prevent lithium intoxication, falls, hypernatremic events, and renal dysfunction.     

Effects of MDMA and Intranasal Oxytocin on Social and Emotional Processing

MDMA (±3,4-methylenedioxymethamphetamine, ‘ecstasy'') is used recreationally, reportedly because it increases feelings of empathy, sociability, and interpersonal closeness. One line of evidence suggests that MDMA produces these effects by releasing oxytocin, a peptide involved in social bonding. In the current study, we investigated the acute effects of MDMA and oxytocin on social and emotional processing in healthy human volunteers. MDMA users (N=65) participated in a 4-session, within-between-subjects study in which they received oral MDMA (0.75, 1.5 mg/kg), intranasal oxytocin (20 or 40 IU), or placebo under double-blind conditions. The primary outcomes included measures of emotion recognition and sociability (desire to be with others). Cardiovascular and subjective effects were also assessed. As expected, MDMA dose-dependently increased heart rate and blood pressure and feelings of euphoria (eg, ‘High'' and ‘Like Drug''). On measures of social function, MDMA impaired recognition of angry and fearful facial expressions, and the larger dose (1.5 mg/kg) increased desire to be with others, compared with placebo. Oxytocin produced small but significant increases in feelings of sociability and enhanced recognition of sad facial expressions. Additionally, responses to oxytocin were related to responses to MDMA with subjects on two subjective measures of sociability. Thus, MDMA increased euphoria and feelings of sociability, perhaps by reducing sensitivity to subtle signs of negative emotions in others. The present findings provide only limited support for the idea that oxytocin produces the prosocial effects of MDMA.     

The influence of affective state on respiratory muscle activity

Measures of neural respiratory drive through the use of electromyography of the parasternal intercostal muscles (EMGpara) are accurate markers of respiratory load and are reflective of pulmonary function. A previous observation of a significant reduction in EMGpara from a first to second measurement occasion was attributed to participants’ acclimatization to the laboratory environment and a reduction in anxiety. This study therefore aimed to investigate whether manipulation of participants’ affective state would influence EMGpara and related variables. Healthy adult participants underwent measurement of EMGpara and respiratory flow and volume during exposure to four conditions: no stimulus, music, and tense and calm videos. Respiratory rate (RR), raw neural respiratory drive index (rawNRDI, the product of EMGpara in microvolts and RR) and minute ventilation (VE) differed significantly across conditions: RR and VE were significantly higher in the tense condition than all other conditions (all P<0·05); rawNRDI was higher in the tense compared to the calm video condition (P = 0·03). There was also a significant relationship between EMGpara and subjective tension ratings (measured via visual analogue scale) in the tense condition (Spearman's rho = 0·508, P = 0·016), with multivariate modelling indicating significant interactions between rawNRDI and subjective ratings of both tension and calmness. This suggests that anxiety could contribute to elevated respiratory muscle activity and ventilation. Greater consideration should be given to the influence of anxiety when undertaking measurement of respiratory muscle activity to ensure data accurately represent underlying respiratory load.     

Depressive mood modulates the anterior lateral CA1 and DG/CA3 during a pattern separation task in cognitively intact individuals: A functional MRI study

Although patients with major depressive disorder typically have a reduced hippocampal volume, particularly in the cornu ammonis 1 (CA1), animal studies suggest that depressive mood is related to the dentate gyrus (DG). In this study, our objective was to clarify which hippocampal subregions are functionally associated with depressive mood in humans. We conducted a functional MRI (fMRI) study on 27 cognitively intact volunteers. Subjects performed a modified version of a delayed matching‐to‐sample task in an MRI scanner to investigate pattern separation‐related activity during each phase of encoding, delay, and retrieval. In each trial, subjects learned a pair of sample cues. Functional MR images were acquired at a high spatial resolution, focusing on the hippocampus. Subjects also completed the Beck Depression Inventory (BDI), a questionnaire about depressive mood. Depending on the similarity between sample cues, activity in the DG/CA3 and medial CA1 in the anterior hippocampus changed only during encoding. Furthermore, the DG/CA3 region was more active during successful encoding trials compared to false trials. Activity in the DG/CA3 and lateral CA1 was negatively correlated with BDI scores. These results suggest that the DG/CA3 is the core region for pattern separation during the encoding phase and interacts with the medial CA1, depending on the similarity of the stimuli, to achieve effective encoding. Impaired activity in the DG/CA3, as well as in the lateral CA1, was found to be associated with depressive symptoms, even at a subclinical level. © 2013 Wiley Periodicals, Inc.