抑郁障碍患者与家属家庭亲密度适应性和情绪状况的研究

目的探讨抑郁障碍患者与家属的家庭亲密度适应性和情绪状况,为抑郁障碍患者的健康教育及家庭干预提供科学有效的理论依据。方法选择2006年6～9月在北京大学第六医院就诊的抑郁障碍患者95例及共同陪伴的直系家属95例为调查对象。采用家庭亲密度和适应性量表中文版(FACES-CV)、Zung氏焦虑自评量表和Zung氏抑郁自评量表。结果1患者的家庭亲密度得分与国内常模一致(P>0.05),但适应性得分低于国内常模(P<0.01);焦虑、抑郁得分高于国内常模(P<0.01)。家属的家庭亲密度得分高于国内常模(P<0.01),适应性得分低于国内常模(P<0.01)。家属的焦虑得分与国内常模一致(P>0.05),但抑郁得分高于国内常模(P<0.05)。2家庭模式分型构成比:中间型47.9%,平衡性26.3%,极端型25.8%。患者的家庭"拱极模式"以"僵硬—松散型"居多,家属则以"自由—缠结型"居多。3家庭亲密度与患者的家属的文程化度有关,相关系数范围(r=0.21～0.26,P<0.05)、与家庭人数呈负相关(r=-0.21,P<0.01);与患者及家属的焦虑、抑郁情绪呈显著负相关,相关系数范围(r=-0.30～0.37,P<0.01);家庭适应性与患者的年龄(r=0.28,P<0.01)、文化程度(r=0.34,P<0.01)有关。与家属的年龄(r=0.26,P<0.05)文化程度(r=0.22,P<0.05)有关。与患者和家属的焦虑、抑郁情绪呈显著负相关,相关系数范围(r=-0.30～-0.42,P<0.01)。结论家庭亲密度适应性与患者和家属的文化程度、焦虑、抑郁情绪有关,家庭亲密度与患者的家庭人数有关,家庭适应性与患者和家属的年龄有关。     

Immunocytochemical localization of a granuliberin-like peptide in Rana pipiens brain

The histamine-releasing peptide “granuliberin”, originally isolated from the skin of Rana rugosa, was localized by immunofluorescence within nerve cell bodies and fibers in the brain of Rana pipiens. The granuliberin-positive neurons were characterized ultrastructurally by electron microscopic observation of ultrathin sections stained either with immunoperoxidase or with conventional stains. Granuliberin-positive nerve cell bodies were seen throughout the hypothalamus, from the suprachiasmatic area rostrally to the full length of the periinfundibular grey matter caudally. Similarly positive nerve fibers were localized in the hypothalamus radiating upwards to the optic vesicles in the midbrain, extending through the preoptic area into the subpallium in the forebrain, and throughout the white matter surrounding the floor and lateral walls of the fourth ventricle in the brainstem. The granuliberin-positive nerve cells showed the presence of variable numbers of small cytoplasmic neurosecretory granules. Possessing an electron dense elongated core, and measuring 250–350 nm in their largest diameter. The functional significance of a granuliberin-like peptide in neurons of the frog brain is not known.     

高师贫困生自我效能感与主观幸福感的特点及关系研究

目的分析高师贫困生自我效能感、主观幸福感的特点及关系，为心理健康教育提供依据。方法采用一般自我效能感量表、生活满意度量表、快乐感量表，对218名贫困生和216名非贫困生进行测查。结果①高师贫困生生活满意度、快乐感显著低于非贫困生（t=4．811，P〈0．001；t=2．504，P〈0．05），自我效能感差异不显著。②高师贫困生自我效能感存在性别差异（t=2．117，P〈0．05），男生的自我效能感显著高于女生；生活满意度年级差异显著（F=3．547，P〈0．05），大一学生的生活满意度显著高于大二和大三学生，大二和大三之间的差异不显著。③高师贫困生自我效能感与生活满意度、快乐感呈显著正相关（r=0．349，P〈0．01；r=0．436，P〈0．01）。自我效能感水平越高，幸福感越强。结论高师贫困生主观幸福感相对较低，自我效能感与主观幸福感显著相关，通过提升自我效能感水平可以增强主观幸福感。     

Immunofluorescent evidence for exocytosis and internalization of secretory granule membrane in isolated chromaffin cells

Cultured bovine adrenal medullary chromaffin cells were stimulated with the secretogogues Ba2+ or carbamyl choline plus Ca2+ in the presence of a monospecific rabbit IgG fraction directed against bovine dopamine beta-hydroxylase. The anti-dopamine beta-hydroxylase was labeled either with fluorescent protein A or with a fluorescent second antibody to rabbit IgG. Stimulation produced a patchy cell surface distribution of fluorescence. There was no noticeable internalization of the fluorescence for up to 2 h. In similar experiments using fluorescent monovalent fragments (Fab) of the same monospecificidopamine-beta-hydroxylase IgG, a more uniform distribution of the fluorescence was observed. A few min after a 5 min period of stimulation with Ba2+, the fluorescence appeared to be on or near the cell surface; however, after 20 min or more it was distributed throughout the cytoplasm except that the cell nuclei were not labeled. Thus, dopamine beta-hydroxylase which appeared on the cell surface as a consequence of exocytosis was internalized in the presence of monovalent antibody fragments, but not in the presence of the divalent (polyclonal) antibody, presumably because endocytosis of dopamine beta-hydroxylase was inhibited by crosslinking of the dopamine beta-hydroxylase molecules. The internalized anti-dopamine beta-hydroxylase Fab fragments were found to reappear on the cell surface during a second secretory response. It is concluded that the interior of the chromaffin granule membrane, for which dopamine beta-hydroxylase is a marker, becomes exposed on the surface of the cell during secretion and that the membrane is then retrieved back into the cell where it can be re-used in a further secretory cycle.     

总责任护士主导的医护一体化护理模式在创伤骨科的应用

目的探讨总责任护士主导的医护一体化临床护理模式在创伤骨科的应用效果。 方法选择2016年7月至2017年6月在南京大学医学院附属鼓楼医院创伤骨科行手术治疗的骨折患者200例，按照入院先后顺序分为对照组90例(实施创伤骨科常规护理)和观察组110例(实施医护一体化工作模式，包括成立医护合作小组、实施总责任护士主导的医护一体化查房、个体化诊疗方案的共同决策、疼痛管理、早期出院计划与延续护理)。比较2组患者的术后护理效果和医护合作满意度。对数据行t检验和χ²检验。 结果总责任护士主导的医护一体化模式下，观察组患者术后72 h内数字评分法(NRS)评分为(4.09±1.64)分，疼痛干预有效率为77.57%，对照组术后72 h内NRS评分为(5.15±1.69)分，疼痛干预有效率为57.95%，2组比较差异均有统计学意义(P值均小于0.05)；观察组下肢深静脉血栓、泌尿系统感染、便秘的发生例数分别为2、1、3，对照组下肢深静脉血栓、泌尿系统感染、便秘的发生例数分别为9、7、11，两组比较差异均有统计学意义(χ²＝4.486、4.296、6.812，P＝0.027、0.036、0.009)。观察组术后康复开始时间为(21.48±6.41)h，术后住院时间为(11.08±2.19)d；对照组术后康复开始时间为(36.48±10.75)h，术后住院时间为(13.95±2.93)d，2组比较差异均有统计学意义(t＝11.670、－7.616，P值均小于0.05)。2组医护合作满意度结果显示，观察组患者信息的交流得分为(3.78±0.85)分，共同参与治疗或护理决策得分为(3.86±0.87)分，医师和护士的关系得分为(4.00±0.84)分，总分为(3.87±0.67)分；对照组患者信息的交流得分为(3.32±1.00)分，共同参与治疗或护理决策得分为(3.23±0.93)分，医师和护士的关系得分为(3.45±0.96)分，总分为(3.33±0.84)分，2组比较差异均有统计学意义(P值均小于0.05)。 结论总责任护士主导的医护一体化护理模式的应用，以亚专科为核心，重新整合医护资源，共同参与制订患者的诊疗护理方案，共同聚焦患者安全与质量，加强了医护间的配合，提高了医疗护理服务质量，提升医护合作满意度。     

Comparison of synaptic plasma membrane and synaptic vesicle polypeptides by two-dimensional polyacrylamide gel electrophoresis.

Extracts of chick brain synaptic plasma membranes, synaptic vesicles, and mixtures of membranes and vesicles were examined by electrophoresis on two-dimensional polyacrylamide gels by a modification of the O'Farrell technique. Synaptic plasma membranes had twenty-one major polypeptides; synaptic vesicles had seventeen. Thirteen major polypeptides were common to both fractions. The similarities between the synaptic vesicle and synaptic plasma membrane patterns are unlikely to be due to contamination of one fraction by the other or to contamination of both fractions by microsomes, synaptoplasm or mitochondria. Our findings are consistent with mixing of membrane proteins occurring during exocytosis but it remains to be shown that these synaptic subfractions are not contaminated by a type of membrane for which markers are not yet available.     

Synaptic efficacy of inhibitory synapses in hypoglossal motoneurons after transection of the hypoglossal nerves

In cat hypoglossal motoneurons after axotomy the synaptic efficacy of inhibitory synapses made by the lingual nerve afferent fibers was studied. The amplitude of the short- and the long-lasting inhibitory postsynaptic potential produced in tongue protruder motoneurons 24 days after axotomy by stimulation of the lingual nerve was significantly reduced in size as compared with the control on the unoperated side. In most protruder motoneurons 40 days after axotomy a large excitatory postsynaptic potential and a spike was produced by stimulation of either the ipsilateral or the contralateral lingual nerve. We have demonstrated that the decline of synaptic efficacy of inhibitory synapses for the short-lasting inhibitory postsynaptic potential was more prominent than that for the long-lasting inhibitory potential in the motoneuron 24 days after axotomy. After the cut axons of protruder motoneurons were re-united to tongue muscles, we have demonstrated that the decline of synaptic efficacy of inhibitory synapses for the short-lasting inhibitory postsynaptic potential was less prominent than that in axotomized protruder motoneurons.     

Detection of radiolabelled bone marrow cells bearing surface ace immunoglobulins by combined autoradiography and immunoperoxidase

A method is described for the simultaneous detection of radiolabelled bone marrow cells bearing surface immunoglobulins by combined autoradiography and immunoperoxidase. Bone marrow cells from normal CBA mice prelabelled in vivo with ¹²⁵IUDR or exposed in vitro to [³H]thymidine were incubated with rabbit anti-mouse immunoglobulins under capping conditions, washed, cytocentrifuged and treated with methanol and hydrogen peroxide to destroy endogenous peroxidase. Cells were then covered with peroxidase-conjugated goat anti-rabbit immunoglobulins, washed, treated with diaminobenzidine a and hydrogen peroxide and finally covered with autoradiographic stripping film and exposed for different times. Peroxidase-positive cells were typically capped and those radiolabelled had autoradiographic silver grains overlying the nucleus.     

The pharmacology of fever

The ability to minimise, if not prevent, large variations in deep body temperature that would otherwise result from some environmental conditions is a homeostatic function of unquestioned benefit that is demonstrated only by the more highly evolved animals. Nevertheless, body temperature is raised above normal values in many pathological conditions. This increase in temperature or fever is an active and co-ordinated response, which indicates the involvement of the CNS. Central injection and lesion studies have shown that the brain, in particular the PO/AH, is the site of action of fever-inducing agents, termed pyrogens. Electrophysiological data show that pyrogens modify the activity of central thermosensitive neurones as if to increase heat gain and decrease heat loss. The common response of fever to pyrogens of diverse origins is attributable to fever being mediated by an endogenous pyrogen released by phagocytic cells in the host. The mechanism by which central neuronal function is disturbed by pyrogens present in the periphery is not known. Tracer studies have yet to demonstrate the passage of a pyrogen across the blood-brain barrier. The possible involvement of several putative neuro- transmitters and modulators in fever has been reviewed here, but most compounds have not been studied sufficiently to allow firm conclusions to be drawn. Much of the data is limited to the effects of the putative mediators on normal thermoregulation but, even when the effect is hyperthermia, such observations do not necessarily indicate a role for the endogenous material in fever. Dose-response curves for agonists and the effects of antagonists are often undetermined. This shortfall in data is due to some extent to the nature of fever; a central response in vivo over several hours. Although fever may enhance other host reactions to combat infection and inflammation, neither this benefit nor the undesirability of antipyretic therapy has been demonstrated unequivocally in either homeothermic laboratory animals or humans. Consequently, antipyretic drugs continue to be used clinically to alleviate the fever, malaise and/or pain commonly associated with disease. The drugs in common usage are the nonsteroidal antipyretic analgesics, many of which also have an anti-flammatory effect. The primary mode of action of these drugs as antipyretics appears at present to be the inhibition of cyclo-oxygenase and a consequent reduction of prostanoid material in pyrogen-sensitive areas of the brain. PGEs in the PO/AH have received most study to date, but other mediators in other parts of the CNS, where the density of pyrogen receptors may be sparse, cannot be discounted and await further investigation.     

Changes in the biochemical and biophysical parameters of cholinergic synaptic vesicles on transmitter release and during a subsequent period of rest

Synaptic vesicles were isolated on sucrose density gradients from perfused blocks of Torpedo electric organ under varying experimental conditions. Newly synthesized acetylcholine was labelled with [³H]acetate in order to distinguish synaptic vesicles which had been recycled during stimulation-induced transmitter release and, in consequence, had become smaller and denser from the larger, lighter vesicles characteristic of unstimulated tissue. After 1800 pulses at 0.1 Hz, the density of these smaller vesicles increased from a pre-stimulation value of 1.056 g.ml^?1 to 1.067 g.ml^?1, whereas their water space (measured as the space occupied by the permeant solute glycerol), decreased by 34% from 65% to 43% of vesicle volume. During a subsequent 12 h rest period, these changes were partially reversed; water space returned to 52% of control and this change was highly correlated with a decrease in vesicle density and an increase in vesicular acetylcholine. The diameter of vesicles in whole tissue sections showed corresponding changes. An additional 12 h rest period did not lead to further significant recovery, suggesting that the preparation had a limited suitability for following long term processes depending on normal energy metabolism.The results can be explained on the assumption that when vesicles reform after releasing transmitter their core has a lower osmotic pressure than that of fully loaded vesicles. Reloading is accompanied by osmotically induced rehydration.